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Zhang S, Liu J, Gao J, Yan Y, Hao P, Li X. Assessment of dynamic corneal response parameters in Chinese patients of different ages with myopia and orthokeratology lenses using the Corvis ST. Cont Lens Anterior Eye 2024; 47:102123. [PMID: 38246852 DOI: 10.1016/j.clae.2024.102123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 01/03/2024] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
OBJECTIVE To investigate the effects of orthokeratology lenses (OK lenses) on corneal biomechanics in subjects of different ages. METHODS Fifty subjects with mild to moderate myopia were categorized into three groups (Group I-III) based on their age. Corvis ST was used to collect dynamic corneal response parameters (DCRs) at different follow-up time points. Repeated measures analysis of variance combined with simple effect analysis was used to analyze the changes in DCRs in different groups during the follow-up period. Multiple linear regression analysis was used to analyze the correlations between axial length growth (ALG) at 6 months (ALG-6M) or 12 months (ALG-12M) and sex, baseline spherical equivalent refraction (SER), and DCRs. RESULTS The DCRs changed in all three groups after wearing OK lenses. Most DCRs showed significant differences between baseline and 6 months after wearing OK lenses, while the differences between DCRs at 6 months and 12 months were not statistically significant. No significant differences in DCRs were observed among the three groups at the same follow-up time point. Additionally, at 6 months post-OK lens wear, ALG-6M was significantly correlated with velocity of the corneal apex at the first applanation (A1V-6M) (P = 0.002), Corvis biomechanical index (CBI-6M) (P = 0.004), the maximum amount of corneal movement (DAM-6M) (P = 0.010), deformation amplitude ratio of 2 mm (DAR2-6M) (P = 0.010), and stress-strain index (SSI-6M) (P = 0.038) in Group I. Furthermore, ALG-12M showed significant correlations with SSI-6M (P = 0.031), peak distance at the DAM (PD)-6M (P = 0.037), baseline Ambrósio Relational Thickness to the horizontal profile (P = 0.013) in Group I. CONCLUSIONS The majority of DCRs displayed significant changes within the initial 6 months of OK lens wear. Minimal variation in DCRs was observed across different age groups at the same follow-up time point. Certain DCR parameters exhibited correlations with ALG, suggesting their potential in predicting ALG in myopic children undergoing OK lenses correction.
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Affiliation(s)
- Shuxian Zhang
- Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Vision Science,Tianjin 300020, China; Optometry Center of Tianjin Eye Hospital, Tianjin 300020, China; Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, China
| | - Jinghua Liu
- Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Vision Science,Tianjin 300020, China; Nankai University Affiliated Eye Hospital, Tianjin 300020, China
| | - Juan Gao
- Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Vision Science,Tianjin 300020, China
| | - Yarong Yan
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, China
| | - Peng Hao
- Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Vision Science,Tianjin 300020, China
| | - Xuan Li
- Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Vision Science,Tianjin 300020, China; School of Medicine, Nankai University, Tianjin 300110, China; Nankai University Affiliated Eye Hospital, Tianjin 300020, China; Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, China.
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Tang W, Li J, Fu X, Lin Q, Zhang L, Luo X, Zhao W, Liao J, Xu X, Wang X, Zhang H, Li J. Machine learning-based nomogram to predict poor response to overnight orthokeratology in Chinese myopic children: A multicentre, retrospective study. Acta Ophthalmol 2024. [PMID: 38516719 DOI: 10.1111/aos.16678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 02/02/2024] [Accepted: 03/13/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE To develop and validate an effective nomogram for predicting poor response to orthokeratology. METHODS Myopic children (aged 8-15 years) treated with orthokeratology between February 2018 and January 2022 were screened in four hospitals of different tiers (i.e. municipal and provincial) in China. Potential predictors included 32 baseline clinical variables. Nomogram for the outcome (1-year axial elongation ≥0.20 mm: poor response; <0.20 mm: good response) was computed from a logistic regression model with the least absolute shrinkage and selection operator. The data from the First Affiliated Hospital of Chengdu Medical College were randomly assigned (7:3) to the training and validation cohorts. An external cohort from three independent multicentre was used for the model test. Model performance was assessed by discrimination (the area under curve, AUC), calibration (calibration plots) and utility (decision curve analysis). RESULTS Between January 2022 and March 2023, 1183 eligible subjects were screened from the First Affiliated Hospital of Chengdu Medical College, then randomly divided into training (n = 831) and validation (n = 352) cohorts. A total of 405 eligible subjects were screened in the external cohort. Predictors included in the nomogram were baseline age, spherical equivalent, axial length, pupil diameter, surface asymmetry index and parental myopia (p < 0.05). This nomogram demonstrated excellent calibration, clinical net benefit and discrimination, with the AUC of 0.871 (95% CI 0.847-0.894), 0.863 (0.826-0.901) and 0.817 (0.777-0.857) in the training, validation and external cohorts, respectively. An online calculator was generated for free access (http://39.96.75.172:8182/#/nomogram). CONCLUSION The nomogram provides accurate individual prediction of poor response to overnight orthokeratology in Chinese myopic children.
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Affiliation(s)
- Wenting Tang
- Department of Ophthalmology, The First Affiliated Hospital of Chengdu Medical College, Chengdu Medical College, Chengdu, China
| | - Jiaqian Li
- Department of Ophthalmology, The First People's Hospital of Ziyang, Ziyang, China
| | - Xuelin Fu
- Department of Ophthalmology, Chengdu First People's Hospital, Chengdu, China
| | - Quan Lin
- Department of Ophthalmology, Nanning Aier Eye Hospital, Nanning, China
| | - Li Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Chengdu Medical College, Chengdu Medical College, Chengdu, China
| | - Xiangning Luo
- Department of Ophthalmology, The First Affiliated Hospital of Chengdu Medical College, Chengdu Medical College, Chengdu, China
| | - Wenjing Zhao
- Department of Ophthalmology, The First Affiliated Hospital of Chengdu Medical College, Chengdu Medical College, Chengdu, China
| | - Jia Liao
- Department of Ophthalmology, The First Affiliated Hospital of Chengdu Medical College, Chengdu Medical College, Chengdu, China
| | - Xinyue Xu
- Department of Ophthalmology, The First Affiliated Hospital of Chengdu Medical College, Chengdu Medical College, Chengdu, China
| | - Xiaoqin Wang
- Department of Ophthalmology, Chengdu First People's Hospital, Chengdu, China
| | - Huidan Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Chengdu Medical College, Chengdu Medical College, Chengdu, China
| | - Jing Li
- Department of Ophthalmology, The First Affiliated Hospital of Chengdu Medical College, Chengdu Medical College, Chengdu, China
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Xiang K, Chen J, Zhao W, Zhu Z, Ding L, Bulloch G, Du L, Xu X, Zhu M, He X. Changes of corneal biomechanics in children using orthokeratology and their roles in predicting axial length progression-A prospective 2-year study. Acta Ophthalmol 2023; 101:755-765. [PMID: 36959685 DOI: 10.1111/aos.15662] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/19/2023] [Accepted: 03/08/2023] [Indexed: 03/25/2023]
Abstract
PURPOSE To determine how orthokeratology (ortho-k) affects corneal biomechanical properties in myopia control and whether corneal biomechanical parameters can predict clinical efficacy of ortho-k. METHODS A total of 125 children 7-15 years of age using ortho-k lenses were followed in this clinical practice and data of their right eyes were analysed. Corneal biomechanical parameters and most ocular biometry were measured at baseline, 1 week, and at 1, 3, 6, 12, 18 and 24 months. Axial length (AL) was collected every 6 months after baseline measurements. RESULTS During the 2-year follow up, nine corneal biomechanical parameters, including deformation amplitude maximum (DA), varied between baseline and 1 week (p < 0.05) and stabilized during the rest of wearing period (p > 0.05). The mean AL increased from 25.02 ± 0.84 mm to 25.38 ± 0.81 mm and baseline DA strongly correlated with AL progression (Pearson r = 0.37). In the multiple regression models, baseline age, AL and DA were the independent factors for AL progression (R2 : 0.7849, 0.2180 in low and moderate myopes). The area under the receiver operating characteristic curves using the three variables for predicting excessive AL progression (>0.35 mm during 2 years) in low and moderate myopes was 0.902 and 0.698. CONCLUSIONS Corneal biomechanics firstly fluctuated before becoming stable with long-term ortho-k use. Corneal biomechanics was associated with AL progression in children wearing ortho-k lenses. DA combined with age and AL at baseline could predict AL progression in low myopes using ortho-k.
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Affiliation(s)
- Kaidi Xiang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Chen
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Wenchen Zhao
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhuoting Zhu
- Ophthalmology, Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Li Ding
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Gabriella Bulloch
- Ophthalmology, Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Linlin Du
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Xun Xu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mengjun Zhu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Xiangui He
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University, Shanghai, China
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Bullimore MA, Liu M. Efficacy of the Euclid orthokeratology lens in slowing axial elongation. Cont Lens Anterior Eye 2023; 46:101875. [PMID: 37365049 DOI: 10.1016/j.clae.2023.101875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023]
Abstract
PURPOSE The Euclid Emerald lens designs for orthokeratology have been available in global markets for over 20 years and is used extensively by clinicians for slowing myopia progression in children. This paper comprehensively reviews data from published studies of the efficacy of this lens. METHODS A comprehensive systematic search was performed in March 2023 using Medline with the following search terms: orthokeratology AND myopi* AND (axial or elong*) NOT (review or meta). RESULTS The original search identified 189 articles, of which 140 reported axial elongation. Of those, 49 reported data on the Euclid Emerald design. Unique axial elongation data could be extracted from 37 papers-14 of which included an untreated control group. Among these, the mean 12-month efficacy-the difference in axial elongation between orthokeratology wearers and controls-was 0.18 mm (range: 0.05-0.29 mm), and the mean 24-month efficacy was 0.28 mm (range: 0.17-0.38 mm). The orthokeratology wearers in 23 studies without an untreated comparison group showed similar axial elongation to those in the 14 studies with a control group. For example, the mean 12-month axial elongation for the studies with controls was 0.20 ± 0.06 mm compared with 0.20 ± 0.07 mm for the studies without controls. CONCLUSIONS This extensive body of literature on a single device for myopia control is unique and demonstrates the efficacy of this design in slowing axial elongation in myopic children.
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Affiliation(s)
- Mark A Bullimore
- University of Houston, College of Optometry, 4901 Calhoun Rd., Houston, TX 77204, United States.
| | - Maria Liu
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, CA 94720, United States.
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