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Li M, Shi Y, Chen Q, Hu G, Xie J, Ye L, Fan Y, Zhu J, He J, Xu X. Peripapillary atrophy area predicts the decrease of macular choroidal thickness in young adults during myopia progression. BMJ Open Ophthalmol 2024; 9:e001555. [PMID: 38589233 PMCID: PMC11015195 DOI: 10.1136/bmjophth-2023-001555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/23/2024] [Indexed: 04/10/2024] Open
Abstract
OBJECTIVE This study aimed to investigate the influence of peripapillary atrophy (PPA) area and axial elongation on the longitudinal changes in macular choroidal thickness (ChT) in young individuals with myopia. METHODS AND ANALYSIS In this longitudinal investigation, 431 eyes-342 categorised as non-high myopia (non-HM) and 89 as HM-were examined for 2 years. Participants were examined with swept-source optical coherence tomography. The macular ChT, PPA area and axial length (AL) were measured at baseline and follow-up visits. Multiple regression analysis was performed to identify factors associated with ChT changes. The areas under the receiver operating characteristic curves were analysed to ascertain the predictive capacity of the PPA area and axial elongation for the reduction in macular ChT. RESULTS Initial measurements revealed that the average macular ChT was 240.35±56.15 µm in the non-HM group and 198.43±50.27 µm in the HM group (p<0.001). It was observed that the HM group experienced a significantly greater reduction in average macular ChT (-7.35±11.70 µm) than the non-HM group (-1.85±16.95 µm, p=0.004). Multivariate regression analysis showed that a greater reduction of ChT was associated with baseline PPA area (β=-26.646, p<0.001) and the change in AL (β=-35.230, p<0.001). The combination of the baseline PPA area with the change in AL was found to be effective in predicting the decrease in macular ChT, with an area under the curve of 0.741 (95% CI 0.694 to 0.787). CONCLUSION Over 2 years, eyes with HM exhibit a more significant decrease in ChT than those without HM. Combining the baseline PPA area with the change in AL could be used to predict the decrease of macular ChT.
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Affiliation(s)
- Menghan Li
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
| | - Ya Shi
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiuying Chen
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guangyi Hu
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
| | - Jiamin Xie
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
| | - Luyao Ye
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Fan
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
| | - Jianfeng Zhu
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
| | - Jiangnan He
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
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Gupta SK, Dhakal R, Verkicharla PK. Biometry-Based Technique for Determining the Anterior Scleral Thickness: Validation Using Optical Coherence Tomography Landmarks. Transl Vis Sci Technol 2024; 13:25. [PMID: 38285460 PMCID: PMC10829803 DOI: 10.1167/tvst.13.1.25] [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: 08/01/2023] [Accepted: 12/22/2023] [Indexed: 01/30/2024] Open
Abstract
Purpose Considering the potential role of anterior scleral thickness (AST) in myopia and the ubiquitous use of optical biometers, we applied and validated a biometry-based technique for estimating AST using optical coherence tomography (OCT) landmarks. Methods The AST was determined across four meridians in 62 participants (aged 20-37 years) with a swept-source OCT and a noncontact optical biometer at a mean ± SD distance of 3.13 ± 0.88 mm from the limbus. The biometer's graticule was focused and aligned with the anterior scleral reflex, which led to the generation of four prominent A-scan peaks: P1 (anterior bulbar conjunctiva), P2 (anterior episclera), P3 (anterior margin of anterior sclera), and P4 (posterior margin of anterior sclera), which were analyzed and compared with the corresponding OCT landmarks to determine tissue thickness. Results The AST measurements between biometer and OCT correlated for all meridians (r ≥ 0.70, overall r = 0.82; coefficient of variation [CV], 9%-12%; P < 0.01). The mean difference ± SD between two instruments for overall AST measures was 3 ± 2.8 µm (range, -18 to +16 µm; lower limits of agreement, -89 to +83 µm; P = 0.23) across all meridians. The mean ± SE AST with both instruments was found to be thickest at the inferior (562 ± 7 µm and 578 ± 7 µm) and thinnest at the superior (451 ± 7 µm and 433 ± 6 µm) meridian. The biometer demonstrated good intrasession (CV, 8.4%-9.6%) and intersession (CV, 7.9%-13.3%) repeatability for AST measurements across all meridians. Conclusions The noncontact optical biometer, which is typically used to determine axial length, is capable of accurately estimating AST based on OCT landmarks. Translational Relevance The high-resolution optical biometers can demonstrate wider application in the field of myopia research and practice to determine AST.
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Affiliation(s)
- Satish Kumar Gupta
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
| | - Rohit Dhakal
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
- The INFOR Myopia Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Pavan Kumar Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
- The INFOR Myopia Centre, L V Prasad Eye Institute, Hyderabad, India
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Zhao W, Wang J, Chen J, Xie H, Yang J, Liu K, He X, Xu X. The rate of orthokeratology lens use and associated factors in 33,280 children and adolescents with myopia: a cross-sectional study from Shanghai. Eye (Lond) 2023; 37:3263-3270. [PMID: 37046055 PMCID: PMC10564736 DOI: 10.1038/s41433-023-02503-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 01/21/2023] [Accepted: 03/08/2023] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVES To investigate the rate of orthokeratology lens (ortho-k lens) use and its associated factors in children and adolescents with myopia. METHODS Cross-sectional study. Children from 104 primary and middle schools in Shanghai were enrolled by cluster sampling. Ophthalmic examinations were conducted and information was obtained using questionnaires for associated factors analysis. RESULTS A total of 72,920 children and adolescents were included, among which 32,259 were the potential population for ortho-k lens use. A total of 1021 participants used ortho-k lenses, equating to a use rate of 1.4% in the total population and 3.1% in the potential population. Age (OR 0.91, 95% CI: 0.88-0.95, p < 0.001), BMI (≥95th percentile: OR 0.48, 95% CI: 0.35-0.66, p < 0.001), age at initiation of refractive correction (≤12 years: OR 1.75, 95% CI: 1.31-2.33, p < 0.001), and parental myopia (either: OR 2.09, 95% CI: 1.58-2.75, p < 0.001; both: OR 3.94, 95% CI: 3.04-5.11, p < 0.001) were independently associated with ortho-k lens use. Of the ortho-k lenses users, 12.4% had a logMAR CVA of ≥0.3. A correction target (SE) of ≤-3.0 D (OR 2.05, 95% CI: 1.38-3.05, p < 0.001) and a sleeping duration of ≤6 h (OR 4.19, 95% CI: 2.03-8.64, p < 0.001) were factors independently associated with CVA ≥ 0.3. CONCLUSIONS A certain proportion of children and adolescents in Shanghai chose to wear ortho-k lenses, related to the situation of parents and children themselves. Health education and follow-ups should be strengthened to ensure orthokeratology application quality.
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Affiliation(s)
- Wenchen Zhao
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China
| | - Jingjing Wang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
| | - Jun Chen
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
| | - Hui Xie
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
| | - Jinliuxing Yang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
| | - Kun Liu
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China
| | - Xiangui He
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China.
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China.
| | - Xun Xu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China.
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China.
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Augusteyn RC, Mohamed A. Biometry of the human cornea and globe: An evaluation by age, gender and population. Exp Eye Res 2022; 216:108932. [PMID: 35041822 DOI: 10.1016/j.exer.2022.108932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 12/18/2021] [Accepted: 01/05/2022] [Indexed: 11/04/2022]
Abstract
The purpose of this study was to examine the effects of age, gender and population origin on human globe and corneal dimensions and to explore the relationships between the dimensions. Human post-mortem eyes were obtained in Hyderabad (n = 223; range, 0-85 years) and Miami (n = 486; range, 6-103 years). The eyes were freed of extraneous tissues and globe antero-posterior length (GAPL), mean globe diameter (MGD) (average of horizontal and vertical), and corneal horizontal (HCD) and vertical (VCD) diameters were measured using digital calipers. The relationships of age, gender and population origin with globe and corneal dimensions and the relationships between the dimensions were assessed by bivalent and multiple regression analyses. Globe and cornea dimensions increase asymptotically with age until around the late teens but do not change thereafter. Bivariate and multivariate regression analysis of the >20-year-old eyes showed that population was significantly correlated with GAPL, MGD. HCD and VCD. Male globes and corneas were larger than those from females, but the difference did not appear to be statistically significant. All Hyderabad dimensions were significantly larger than those from the Miami. Neither GAPL nor MGD were correlated with the corneal dimensions. GAPL was significantly correlated with MGD as was HCD with VCD.
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Affiliation(s)
- Robert C Augusteyn
- Brien Holden Vision Institute Limited, Sydney, NSW, Australia; School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW, Australia; Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Ashik Mohamed
- Brien Holden Vision Institute Limited, Sydney, NSW, Australia; School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW, Australia; Ophthalmic Biophysics, L V Prasad Eye Institute, Hyderabad, India
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Tey KY, Hoang QV, Loh IQ, Dan YS, Wong QY, Yu DJG, Yandri VR, Ang M, Cheung GCM, Lee SY, Wong TY, Chong RS, Wong CW. Multimodal Imaging-Based Phenotyping of a Singaporean Hospital-Based Cohort of High Myopia Patients. Front Med (Lausanne) 2022; 8:670229. [PMID: 35059405 PMCID: PMC8764286 DOI: 10.3389/fmed.2021.670229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 11/22/2021] [Indexed: 11/08/2022] Open
Abstract
Purpose: To assess the effect of axial length (AL) on the prevalence of pathologic myopia (PM) and associated myopic features in a Singaporean hospital-based cohort of patient with high myopia (HM). Methods: In total, 923 HM eyes from 495 individuals were recruited from the Myopic and Pathologic Eyes in Singapore (MyoPES) cohort and underwent ocular biometry, fundus photography, fundus autofluorescence, and swept-source optical coherence tomography (SS-OCT). Images were analyzed for the presence of myopic macular degeneration (MMD), myopic choroidal neovascularization (mCNV), myopic traction maculopathy (MTM), peripapillary atrophy (PPA), myopic tilted disc, posterior staphyloma (PS), dome-shaped macula (DSM), vitremacular adhesions (VMA), and the epiretinal membrane (ERM). Eyes were stratified into quartiles based on ALs to determine cut-off values to perform comparisons between shorter-length and longer-length groups. A χ2-test was done to determine the difference in the prevalence of pathologies between groups. Results: Overall, mean AL was 29.2 ± 2.2 mm (range 25.0-36.7 mm). Myopic macular degeneration, PPA, myopic tilted disc, and ERM have AL threshold of ≥27.5 mm, whereas MTM has an AL threshold of ≥29.0 mm. We found that there was a significantly higher prevalence of MMD (88.2 vs. 49.4%; p < 0.001), PPA (98.1 vs. 80.1%; p < 0.001), myopic tilted disc (72.7 vs. 50.2%; p < 0.001), and ERM (81.4 vs. 17.3%; p = 0.003) in eyes with AL ≥ 27.5 mm vs. eyes without AL <27.5 mm. Prevalence of MTM (34.7 vs. 32.1%; p < 0.001), mCNV (17.4 vs. 12.1%; p = 0.03), PS (43.4 vs. 34.7%; p = 0.012), DSM (21.3 vs. 13.2%; p = 0.002), and VMA (5.9 vs. 2.6%; p = 0.014) in eyes with AL ≥ 29.0 mm compared with AL < 29.0 mm. Conclusion: Our study describes the overall prevalence of PM and related pathologies among patients with HM in our hospital-based cohort. Longer eyes even among HM eyes had a significantly higher prevalence of PM-associated pathologies studied. This supports the premise that eyes with longer AL, even among HM eyes may be at greater risk of vision-threatening changes and therefore merit regular follow-up.
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Affiliation(s)
- Kai Yuan Tey
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore, Singapore
| | - Quan V. Hoang
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore, Singapore,Department of Ophthalmology, Columbia University College of Physicians and Surgeons, New York, NY, United States,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore,*Correspondence: Quan V. Hoang
| | - Isabella Q. Loh
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore, Singapore
| | - Yee Shan Dan
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore, Singapore
| | - Qiu Ying Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore, Singapore
| | - Daryle Jason G. Yu
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore, Singapore
| | - Vivi R. Yandri
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore, Singapore
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore, Singapore
| | - Gemmy C. M. Cheung
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore, Singapore
| | - Shu Yen Lee
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore, Singapore
| | | | - Rachel S. Chong
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore, Singapore
| | - Chee Wai Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore, Singapore
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Du R, Xie S, Igarashi-Yokoi T, Watanabe T, Uramoto K, Takahashi H, Nakao N, Yoshida T, Fang Y, Ohno-Matsui K. Continued Increase of Axial Length and Its Risk Factors in Adults With High Myopia. JAMA Ophthalmol 2021; 139:1096-1103. [PMID: 34436537 DOI: 10.1001/jamaophthalmol.2021.3303] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Importance Pathologic myopia due to an excessive increase of axial length is associated with severe visual impairments. Systematic analyses to determine the rate of and the risk factors associated with the axial elongation in adults with high myopia based on long-term follow-up of a large population are needed. Objective To determine the risk factors associated with axial elongation in adults with high myopia. Design, Setting, and Participants This cohort study used the medical records of 43 201 patient visits in a single-hospital database that were collected from January 3, 2011, to December 28, 2018. A total of 15 745 medical records with the patients' sex, best-corrected visual acuity (BCVA), axial length, type of myopic maculopathy, and the presence or absence of choroidal neovascularization (CNV) were reviewed. Data were analyzed from April 3, 2019, to August 5, 2020. Main Outcomes and Measures Changes in the axial length at each examination were calculated. The significance of the associations between the annual increase of the axial length and age, sex, baseline axial length, types of myopic maculopathy, and a history of CNV was determined. Generalized linear mixed models were used to evaluate the strength of the risk factors associated with an increase of the axial length in high myopia. Results Among 1877 patients with 9161 visits included in the analysis, the mean (SD) age was 62.10 (12.92) years, and 1357 (72.30%) were women. The mean (SD) axial length was 29.66 (2.20) mm with a mean (SD) growth rate of 0.05 (0.24) mm/y. Among the 9161 visits, 7096 eyes (77.46%) had myopic maculopathy and 2477 eyes (27.04%) had CNV. The odds ratio for inducing a severe elongation of the axial length was 1.46 (95% CI, 1.38-1.55) for female sex, 0.44 (95% CI, 0.35-0.56) to 0.63 (95% CI, 13 0.50-0.78) for older than 40 years, 1.33 (95% CI, 1.15-1.54) for BCVA of less than 20/400, 1.67 (95% CI, 1.54-1.81) to 2.67 (95% CI, 2.46-2.88) for baseline axial length of 28.15 mm or greater, 1.06 (95% CI, 0.96-1.17) to 1.39 (95% CI, 1.24-1.55) for the presence of maculopathy, and 1.37 (95% CI, 1.29-1.47) for prior CNV. Conclusions and Relevance This cohort study found continuing axial elongation in adults with high myopia. The risk factors for elongation do not appear to be modifiable, so prevention of myopia may be the best approach to reduce the incidence of pathologic myopia and its complications in the future.
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Affiliation(s)
- Ran Du
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shiqi Xie
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tae Igarashi-Yokoi
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Watanabe
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kengo Uramoto
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroyuki Takahashi
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Noriko Nakao
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Yoshida
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuxin Fang
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.,Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
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Kim HK, Kim SS. Factors associated with axial length elongation in high myopia in adults. Int J Ophthalmol 2021; 14:1231-1236. [PMID: 34414089 DOI: 10.18240/ijo.2021.08.15] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/16/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate the association of axial length (AL) and ocular factors on AL elongation. METHODS A retrospective chart review of patients who underwent two or more AL examinations for more than two years. Totally 4 groups were divided according to initial AL (<24 mm, 24-26 mm, 26-28 mm, ≥28 mm). Initial fundus photograph was used to find risk factors associated AL elongation. RESULTS The mean age of the patients was 47.21±7.79y. AL remained almost unchanged in the groups with AL<24 mm and 24≤AL<26 mm. On the contrary, AL increased by 0.011 mm/y in the group with 26≤AL<28 mm and 0.035 mm/y in the group with AL≥28 mm (P<0.001). In high myopia, AL elongation increased in eye with longer AL (r=0.003, P=0.024), female gender (r=0.014, P=0.019), eye with larger peripapillary chorioretinal atrophic area (r=0.002, P=0.019), and smaller vascular arcade angle (r=-0.004, P=0.006). The risk of elongation 0.03 mm/y in high myopia was increased in female gender (P=0.040), and gradually increased in eye with large peripapillary chorioretinal atrophy area (P<0.01). CONCLUSION AL elongate significantly in the eye with longer AL, female gender, and the eye with larger atrophic area and smaller arcade angle on fundus photography.
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Affiliation(s)
- Hong Kyu Kim
- Department of Ophthalmology, Dankook University Hospital, Dankook University College of Medicine, Cheonan 31116, Republic of Korea.,Yonsei University Graduate School of Medicine, Seoul 03722, Republic of Korea
| | - Sung Soo Kim
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
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Gaurisankar ZS, Rijn GA, Haasnoot GW, Verhoeven VJM, Klaver CCW, Luyten GPM, Beenakker JM. Long-term longitudinal changes in axial length in the Caucasian myopic and hyperopic population with a phakic intraocular lens. Acta Ophthalmol 2021; 99:e562-e568. [PMID: 33124166 PMCID: PMC8359445 DOI: 10.1111/aos.14647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 08/28/2020] [Indexed: 12/13/2022]
Abstract
Purpose To determine the long‐term longitudinal axial length changes in myopic and hyperopic adults with an iris‐fixated phakic intraocular lens (pIOL). Methods The medical records of patients aged ≥18 years with myopia or hyperopia who were treated with pIOL implantation between 1996 and 2011 for refractive correction with a minimum follow‐up of 5 years after pIOL implantation were analyzed. The main outcome measure was change in ocular axial length over time. Results 149 eyes of 149 myopic patients and 27 hyperopic eyes of 27 patients were included in this study. Mean patient age was 37.1 ± 10.4 years (35% male) in the myopic group and 39.4 ± 9.4 years (4% male) in the hyperopic group. The eyes of the myopic patients showed a significant mean increase in axial length of 0.45 ± 0.61 mm after a mean follow‐up time of 144 ± 38 months (p < 0.001). In 26 eyes (17%), the axial length had increased by ≥1 mm. The mean annual axial length increase was 0.04 ± 0.06 mm. Axial elongation was associated with a higher degree of myopia (p < 0.001) and younger age (p = 0.02). The eyes of the hyperopic patients showed no change in axial length over time. Conclusions Myopic eyes corrected with an iris‐fixated pIOL show continuous increase in axial length at an adult age. Although this study is limited to subjects with a pIOL, this is the first time myopization in Caucasian adults has been reported in a large long‐term longitudinal study.
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Affiliation(s)
| | - Gwyneth A. Rijn
- Department of Ophthalmology Leiden University Medical Center Leiden The Netherlands
| | - Geert W. Haasnoot
- Department of Immunohematology and Blood Transfusion Leiden University Medical Center Leiden The Netherlands
| | - Virginie J. M. Verhoeven
- Department of Ophthalmology Erasmus University Medical Center Rotterdam The Netherlands
- Department of Clinical Genetics Erasmus University Medical Center Rotterdam The Netherlands
- Department of Epidemiology Erasmus University Medical Center Rotterdam The Netherlands
| | - Caroline C. W. Klaver
- Department of Ophthalmology Erasmus University Medical Center Rotterdam The Netherlands
- Department of Epidemiology Erasmus University Medical Center Rotterdam The Netherlands
- Department of Ophthalmology Radboud University Medical Center Nijmegen The Netherlands
| | | | - Jan‐Willem M. Beenakker
- Department of Ophthalmology Leiden University Medical Center Leiden The Netherlands
- Department of Radiology C.J. Gorter Center for High‐Field MRILeiden University Medical Center Leiden The Netherlands
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Delgado-Tirado S, López-Miguel A, Báez-Peralta Y, González-Buendía L, Fernández I, Alió JL, Maldonado MJ, Coco-Martín RM. Monochromatic higher order aberrations in highly myopic eyes with Staphyloma. BMC Ophthalmol 2021; 21:223. [PMID: 34006229 PMCID: PMC8130529 DOI: 10.1186/s12886-021-01965-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 04/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prevalence of high myopia is continuously increasing, thus, patients affected with staphyloma are abundant worldwide. Assessment of the quality of vision in these patients is mandatory for a proper clinical counselling, specially when undergoing surgical procedures that require intraocular lenses implantation. Thus, the purpose of the study was to assess monochromatic higher order aberrations (HOAs) in highly myopic eyes with staphyloma with or without a dome-shaped macula. METHODS Participants underwent spectral-domain optical coherence tomography, ocular axial biometry, dual Scheimpflug photography and integrated Placido disk topography, and Hartmann-Shack wavefront analysis. Five groups were evaluated: a low-moderate myopia control group (< 6.00 diopters, n = 31) and four high myopia (≥6.00 diopters) groups: eyes without staphyloma (n = 18), eyes with inferior staphyloma (n = 14), eyes with posterior staphyloma without dome-shaped macula (n = 15) and eyes with posterior staphyloma with dome-shaped macula (n = 17). Subsequently, two new groups (including all participants) were created to assess differences between myopia with and without staphyloma. One-way analysis of covariance was performed using age and lens densitometry as covariates. RESULTS Statistically significant (p ≤ 0.05) differences in anterior corneal fourth-order HOAs were observed between the low-moderate myopia and no-dome-shaped macula (Mean: 0.16 μm) and dome-shaped macula posterior staphyloma groups (Mean: 0.12 μm) in younger patients (≤45 years old). The same groups also showed (p ≤ 0.05) significant differences for anterior corneal primary spherical aberration (Mean: 0.19 and 0.13 μm, respectively). In addition, anterior corneal tetrafoil was significantly higher (p = 0.04) in dome-shaped macula compared to no-dome-shaped macula (Mean: 0.18 vs 0.06 μm, respectively). When all participants were grouped together, significantly lower mean anterior corneal primary spherical aberration (0.15 μm vs. 0.27 μm, p = 0.004) and higher internal primary spherical aberration (0.04 μm vs. -0.06 μm, p = 0.04) was observed in staphyloma compared to no-staphyloma myopic patients. CONCLUSIONS Eyes with high myopia and staphyloma have less positive anterior corneal primary spherical aberration and less negative internal primary spherical aberration, suggesting that the anterior corneal surface tends to mimic in a specular fashion the posterior pole profile. This corneal behaviour appears to change in patients older than 45 years.
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Affiliation(s)
| | - Alberto López-Miguel
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain.,Networks for Cooperative Research in Health (Oftared), Instituto de Salud Carlos III, Madrid, Spain
| | - Yazmin Báez-Peralta
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Lucía González-Buendía
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Itziar Fernández
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Jorge L Alió
- Networks for Cooperative Research in Health (Oftared), Instituto de Salud Carlos III, Madrid, Spain.,Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain
| | - Miguel J Maldonado
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain. .,Networks for Cooperative Research in Health (Oftared), Instituto de Salud Carlos III, Madrid, Spain.
| | - Rosa M Coco-Martín
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain.,Networks for Cooperative Research in Health (Oftared), Instituto de Salud Carlos III, Madrid, Spain
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Igarashi-Yokoi T, Shinohara K, Fang Y, Ogata S, Yoshida T, Imanaka T, Yoshida H, Shibagaki K, Inoue H, Toshimori M, Togashi Y, Ohno-Matsui K. Prognostic Factors for Axial Length Elongation and Posterior Staphyloma in Adults With High Myopia: A Japanese Observational Study. Am J Ophthalmol 2021; 225:76-85. [PMID: 33309693 DOI: 10.1016/j.ajo.2020.11.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/26/2020] [Accepted: 11/30/2020] [Indexed: 01/18/2023]
Abstract
PURPOSE To identify prognostic factors for axial length (AL) elongation and incidence of posterior staphyloma (PS) in adult Japanese patients with high myopia. DESIGN Retrospective, observational cohort study. METHODS Six-year follow-up data for 345 patients (620 eyes with AL ≥ 26.5 mm and spherical equivalent [SE] ≤- 8.00 diopters) admitted to the Tokyo Medical and Dental University Hospital from 2007 to 2017 were analyzed retrospectively. Main outcome measures were change in AL from baseline, factors associated with AL, categorization of eyes with high myopia, factors associated with incidence of PS, and impact of PS on myopic maculopathy and visual function. RESULTS The mean annual increase in AL was 0.03 mm. Presence of optic nerve disc conus (P = .025), steeper corneal curvature, lower SE, and decreased choroidal thickness (CT) (all P < .001) were associated with increased AL in univariate and multivariate analyses. Younger age (P = .003) and no use of intraocular pressure-lowering medications (P = .046) were associated with increased AL. Eyes with high myopia were categorized using factor analysis as associated with glaucoma, severe pathologic myopia, and mild-to-moderate pathologic myopia. Older age, increased AL, glaucoma, and choroidal thinning (all P ≤ .001) were identified as significant risk factors for the incidence of PS in univariate and/or multivariate analyses. Incidence of PS was a precursor for myopic maculopathy and visual field defects. CONCLUSIONS Optic nerve disc conus, steeper corneal curvature, lower SE, decreased CT, and no use of intraocular pressure-lowering medications were prognostic factors for increased AL. Older age, increased AL, glaucoma, and decreased CT were prognostic factors for PS.
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11
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Zhang Z, Qi Y, Wei W, Jin ZB, Wang W, Duan A, Liu W. Investigation of Macular Choroidal Thickness and Blood Flow Change by Optical Coherence Tomography Angiography After Posterior Scleral Reinforcement. Front Med (Lausanne) 2021; 8:658259. [PMID: 34017847 PMCID: PMC8130341 DOI: 10.3389/fmed.2021.658259] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/18/2021] [Indexed: 12/15/2022] Open
Abstract
Purpose: This work aimed to study the effect of posterior scleral reinforcement (PSR) on choroidal thickness (CT) and blood flow. Methods: This study included 25 eyes of 24 patients with high myopia ( ≤ -6.0 dioptres or axial length ≥ 26.0 mm) who underwent PSR surgery. All patients completed the 1-month follow-up visit. Myopic macular degeneration (MMD) was graded according to the International Meta-Analysis for Pathologic Myopia (META-PM) classification based on color fundus photographs. Swept-source optical coherence tomography angiography (SSOCTA) was performed to investigate CT, choroidal perfusion area (CPA), and choriocapillaris perfusion area (CCPA) change following PSR surgery. Results: The distribution of MMD categories was 9 (36.0%) in category 1, 10 (40.0%) in category 2, and 6 (24.0%) in category 3 or 4. MMD severity was strongly correlated with CT (all P < 0.01) and CPA (all P < 0.04). Postoperative CT at each sector increased significantly at 1 week's follow-up, compared to preoperative measures (all P < 0.05). Postoperative CPA at subfoveal, superior, inferior, and nasal sectors also increased significantly 1 week after PSR surgery (all P < 0.05). Moreover, the increased CT, CPA, and CCPA remain after PSR surgery at 1 month's follow-up, but the difference was not statistically significant. Conclusions: We demonstrated that the CT and choroidal blood flow increased significantly in patients with high myopia who underwent PSR surgery in a short period of time. In addition, the CT and CPA were independently associated with MMD. However, whether the transient improvement of the choroidal circulation could prevent long-term progression of high myopia warrants further study in the future.
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Affiliation(s)
- Zheng Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China.,Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yue Qi
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China.,Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wenbin Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China.,Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zi-Bing Jin
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China.,Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wen Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China.,Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Anli Duan
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China.,Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wu Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China.,Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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12
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Bak E, Lee KM, Kim M, Oh S, Kim SH. Angular Location of Retinal Nerve Fiber Layer Defect: Association With Myopia and Open-Angle Glaucoma. Invest Ophthalmol Vis Sci 2021; 61:13. [PMID: 32902578 PMCID: PMC7488617 DOI: 10.1167/iovs.61.11.13] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To compare retinal nerve fiber layer (RNFL) defects' angle measurements determined from the center of the optic disc and Bruch's membrane opening (BMO), as a function of myopia and open-angle glaucoma (OAG) subtypes. Methods In total, 118 patients with OAG were grouped by axial length (AL; high myopia, AL >26 mm; mild to moderate myopia, 24 ≤ AL ≤26 mm; nonmyopia, AL <24 mm) and OAG subtype (normal-tension glaucoma [NTG], high-tension glaucoma [HTG]). The disc and BMO centers were determined by a merged image of red-free fundus photography and spectral-domain optical coherence tomography. The angular location of the RNFL defect close to the fovea (angle α) was measured from the disc center and BMO center, respectively (angle αdisc and angle αBMO). The difference between angle αdisc and αBMO (Δα), as well as the RNFL defect width (angle γ), was evaluated. Results Angle αdisc was smaller in myopic eyes and correlated significantly with AL (P = 0.001), whereas it did not differ among OAG subgroups. Angle αBMO and angle γ were not different in the myopic and OAG subgroups. The Δ α was larger for eyes with higher degree of myopia and had significant correlation with AL (P < 0.001) and was larger in NTG eyes than in HTG eyes (P = 0.023). Conclusions The angular location of the RNFL defect measured from the disc center, but not from the BMO center, was closer to the fovea for glaucomatous eyes with higher values of AL. The present study may facilitate understanding of the characteristic locational pattern of the RNFL defect in myopic glaucomatous eyes.
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Affiliation(s)
- Eunoo Bak
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.,Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
| | - Kyoung Min Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.,Department of Ophthalmology, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Martha Kim
- Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Sohee Oh
- Department of Biostatistics, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Seok Hwan Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.,Department of Ophthalmology, Seoul National University Boramae Medical Center, Seoul, Korea
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13
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Use of a Machine Learning Method in Predicting Refraction after Cataract Surgery. J Clin Med 2021; 10:jcm10051103. [PMID: 33800825 PMCID: PMC7961666 DOI: 10.3390/jcm10051103] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/26/2021] [Accepted: 03/01/2021] [Indexed: 11/17/2022] Open
Abstract
The present study aims to describe the use of machine learning (ML) in predicting the occurrence of postoperative refraction after cataract surgery and compares the accuracy of this method to conventional intraocular lens (IOL) power calculation formulas. In total, 3331 eyes from 2010 patients were assessed. The objects were divided into training data and test data. The constants for the IOL power calculation formulas and model training for ML were optimized using training data. Then, the occurrence of postoperative refraction was predicted using conventional formulas, or ML models were calculated using the test data. We evaluated the SRK/T formula, Haigis formula, Holladay 1 formula, Hoffer Q formula, and Barrett Universal II formula (BU-II); similar to ML methods, we assessed support vector regression (SVR), random forest regression (RFR), gradient boosting regression (GBR), and neural network (NN). Among the conventional formulas, BU-II had the lowest mean and median absolute error of prediction. Therefore, we compared the accuracy of our method with that of BU-II. The absolute errors of some ML methods were lower than those of BU-II. However, no statistically significant difference was observed. Thus, the accuracy of our method was not inferior to that of BU-II.
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14
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Wu A, Ling K, Chuang L, Chen K, Chen Y, Yeung L, Wang N, Liu L, Chen T, Hwang Y, Wu W, Lai C. Treatment of macular hole retinal detachment with macular plug in highly myopic eyes: three-year results. Acta Ophthalmol 2020; 98:e839-e847. [PMID: 32243725 DOI: 10.1111/aos.14418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 03/03/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE To investigate the long-term surgical outcomes of macular hole retinal detachment (MHRD) following vitrectomy with macular plug in highly myopic eyes. METHODS Thirty-five cases of highly myopic eyes with MHRD in 35 patients who underwent an initially successful vitrectomy with macular plug and were followed up for at least 3 years were reviewed. The anatomical outcomes were evaluated by fundus examination, fundus photographs and optical coherence tomography (OCT). Myopic features after the surgery were differentiated according to recommendations of the Meta-analysis of Pathologic Myopia (META-PM) Study Group. The best-corrected visual acuities (BCVAs) before and after surgery were analysed as the functional outcome. Main outcome measures time-course changes in BCVA and complications. RESULTS The mean patient age was 61.0 ± 11.4 years. The follow-up was 45.2 ± 8.6 months (ranged from 36 to 71 months). The mean axial length was 29.3 ± 1.2 mm. All eyes demonstrated attached retina, but 2 eyes (5.7%) developed reopened macular holes until the last follow-up. Complications of postoperative rhegmatogenous retinal detachment were detected in 2 eyes (5.7%) within 1 year and retina reattached after the secondary vitrectomy. Three cases (8.6%) of prolonged subretinal fluid lasting more than 1 year were detected but finally absorbed completely. Comparing 1-3 years postoperatively, myopic features showed significant progression of myopic maculopathy category (p = 0.035). Functionally, significantly improved BCVA could be maintained postoperatively between 6 months and 3 years. However, vision of 14 eyes (40.0%) worsened within 1-3 years postoperatively, and visual deterioration was associated with progression of myopic maculopathy (p = 0.004) and pre-existing disease of glaucoma (p = 0.006). CONCLUSIONS A vitrectomy combined with macular plug provided favourable outcomes in the long term, over the ≥3-year follow-up period.
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Affiliation(s)
- An‐Lun Wu
- Department of Ophthalmology Chang Gung Memorial Hospital Taoyuan Taiwan
- Department of Ophthalmology Mackay Memorial Hospital Hsinchu Taiwan
| | - Kiet‐Phang Ling
- Department of Ophthalmology Chang Gung Memorial Hospital Taoyuan Taiwan
- Department of Ophthalmology Sultanah Aminah Hospital Johor Malaysia
| | - Lan‐Hsin Chuang
- Department of Ophthalmology Chang Gung Memorial Hospital Keelung Taiwan
- College of Medicine Chang Gung University Taoyuan Taiwan
| | - Kuan‐Jen Chen
- Department of Ophthalmology Chang Gung Memorial Hospital Taoyuan Taiwan
- College of Medicine Chang Gung University Taoyuan Taiwan
| | - Yen‐Po Chen
- Department of Ophthalmology Chang Gung Memorial Hospital Taoyuan Taiwan
- College of Medicine Chang Gung University Taoyuan Taiwan
| | - Ling Yeung
- Department of Ophthalmology Chang Gung Memorial Hospital Keelung Taiwan
- College of Medicine Chang Gung University Taoyuan Taiwan
| | - Nan‐Kai Wang
- Department of Ophthalmology Chang Gung Memorial Hospital Taoyuan Taiwan
- College of Medicine Chang Gung University Taoyuan Taiwan
- Edward S. Harkness Eye Institute Department of Ophthalmology Columbia University New York NY USA
| | - Laura Liu
- Department of Ophthalmology Chang Gung Memorial Hospital Taoyuan Taiwan
- College of Medicine Chang Gung University Taoyuan Taiwan
| | - Tun‐Lu Chen
- Department of Ophthalmology Chang Gung Memorial Hospital Taoyuan Taiwan
- College of Medicine Chang Gung University Taoyuan Taiwan
| | - Yih‐Shiou Hwang
- Department of Ophthalmology Chang Gung Memorial Hospital Taoyuan Taiwan
- College of Medicine Chang Gung University Taoyuan Taiwan
| | - Wei‐Chi Wu
- Department of Ophthalmology Chang Gung Memorial Hospital Taoyuan Taiwan
- College of Medicine Chang Gung University Taoyuan Taiwan
| | - Chi‐Chun Lai
- Department of Ophthalmology Chang Gung Memorial Hospital Taoyuan Taiwan
- College of Medicine Chang Gung University Taoyuan Taiwan
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15
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Lee JTL, Guo X, Li Z, Jong M, Sankaridurg P, He M. Progression and Longitudinal Biometric Changes in Highly Myopic Eyes. Invest Ophthalmol Vis Sci 2020; 61:34. [PMID: 32334434 PMCID: PMC7401968 DOI: 10.1167/iovs.61.4.34] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose To examine 2-year progression rate and associated biometric changes in highly myopic eyes. Methods This is a longitudinal, observational cohort study that included 657 participants aged 7 to 70 years with bilateral high myopia (≤-6.00 diopters [D]) and followed for 2 years. All participants underwent ocular biometry and cycloplegic refraction examinations. Main outcome measures were changes in spherical equivalent refraction (SE) and ocular biometry in the right eyes. Results Mean age of participants was 21.6 ± 12.2 years. At baseline, mean SE was -9.82 ± 3.28 D and ocular biometric measurements were 27.40 ± 1.56 mm for axial length, 3.16 ± 0.27 mm for anterior chamber depth, 3.60 ± 0.35 mm for lens thickness, and 20.09 ± 1.50 mm for vitreous chamber depth. After 2 years of follow-up, there was a trend toward more myopia and greater axial elongation in all age groups. Younger participants (≤20 years) had significantly (P < 0.001) greater rates of myopic shift and axial elongation compared with older participants (>20 years). However, highly myopic adults aged 40 to 70 years continued to demonstrate refractive progression, particularly if they had extremely high myopia (≤-10.00 D). In the multiple regression analysis, each additional diopter of myopia at baseline was associated with a 11% higher risk of a >1.00-D/y myopic shift (odds ratio, 1.11; 95% confidence interval, 1.04-1.18; P = 0.002). Conclusions Longitudinal data from this large Chinese cohort suggest that highly myopic eyes continue to progress in SE throughout life, with the greatest rates of progression observed in younger participants. Axial elongation rates appeared to stabilize after 20 years of age and were predominantly due to an increase in the vitreous chamber depth. Other risk factors for a myopic shift included a higher degree of myopic refraction at baseline.
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16
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Wong YL, Sabanayagam C, Wong CW, Cheung YB, Man REK, Yeo ACH, Cheung G, Chia A, Kuo A, Ang M, Ohno-Matsui K, Wong TY, Wang JJ, Cheng CY, Hoang QV, Lamoureux E, Saw SM. Six-Year Changes in Myopic Macular Degeneration in Adults of the Singapore Epidemiology of Eye Diseases Study. Invest Ophthalmol Vis Sci 2020; 61:14. [PMID: 32298432 PMCID: PMC7401489 DOI: 10.1167/iovs.61.4.14] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose To examine the 6-year incidence, progression, associated risk factors, and impact of myopic macular degeneration (MMD) in a myopic population in Singapore. Methods We examined myopic (spherical equivalent ≤-0.5 diopters) adults (N = 2157 persons and 3661 eyes) who were phakic at baseline and participated in both baseline and 6-year follow-up visits of the Singapore Epidemiology of Eye Diseases study. Eye examinations, including visual acuity, subjective refraction and axial length (AL) measurements, were performed. MMD was graded from fundus photographs following the META-PM classification. Vision-related quality of life was assessed with Rasch-transformed scores from reading, mobility, and emotional domains of the Impact of Vision Impairment questionnaire. Results The 6-year eye-specific incidence of MMD among myopic eyes was 1.2% (95% CI, 0.9%-1.6%). Older age, worse spherical equivalent, and longer AL at baseline were associated with MMD incidence (all P < 0.001). The 6-year eye-specific progression of MMD in 288 eyes with baseline MMD was 17.0% (95% CI, 12.6%-21.4%). More severe MMD at baseline, worse spherical equivalent, and longer AL (all P < 0.05) were associated with MMD progression. Patients with Meta-PM categories 3 and 4 had worse best-corrected visual acuity and poorer vision-related quality of life outcomes than those without MMD (all P < 0.05). Conclusions Over a 6-year period, one in 80 myopic eyes developed MMD and one in six with existing MMD had MMD progression. Myopia severity and AL were strong predictors of MMD development and progression. Eyes with severe MMD were at higher risk of MMD progression than those with less severe MMD, and were associated with poorer visual acuity and vision-related quality of life.
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17
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Lee EJ, Han JC, Park DY, Kee C. Long-term morphologic fundus and optic nerve head pattern of progressive myopia in congenital glaucoma distinguished by age at first surgery. Sci Rep 2020; 10:10041. [PMID: 32572115 PMCID: PMC7308308 DOI: 10.1038/s41598-020-67051-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 04/09/2020] [Indexed: 11/09/2022] Open
Abstract
The purpose of this study was to investigate the preservation of round optic nerve head (ONH) shape in myopic eyes of surgically treated congenital glaucoma patients, with regard to factors associated with intraocular pressure (IOP) elevation-induced peripapillary scleral (PPS) deformation. Using optical coherence tomography (OCT) on the ONH and macula, we identified myopic eyes with round ONH and internally oblique border tissue and those with non-round ONH. We investigated differences in clinical factors between the two groups. We included 51 eyes of 34 patients. Age at first surgery (2.8 vs. 15.2 months, P < 0.001) was significantly different between the two groups. Axial length was also significantly longer (P = 0.004) in the non-round group, but multiple logistic regression analysis revealed age as the only significant factor (P < 0.05) in ONH roundness. Interestingly, the round ONH group also had non-curved fundus morphology and a thick choroid, while the non-round ONH group showed diverse degrees of disc tilt and posterior pole curvature, and a thin choroid. In conclusion, in eyes with congenital glaucoma, age at first surgery, particularly when older than 6 months, was associated with round ONH and emmetropia-like fundus despite high myopia. The findings may indicate two different changes in the posterior sclera and the neural canal in response to the increased IOP.
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Affiliation(s)
- Eun Jung Lee
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Chul Han
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Do Young Park
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Changwon Kee
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Asano S, Asaoka R, Yamashita T, Aoki S, Matsuura M, Fujino Y, Murata H, Nakakura S, Nakao Y, Kiuchi Y. Visualizing the dynamic change of Ocular Response Analyzer waveform using Variational Autoencoder in association with the peripapillary retinal arteries angle. Sci Rep 2020; 10:6592. [PMID: 32313133 PMCID: PMC7170838 DOI: 10.1038/s41598-020-63601-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 03/31/2020] [Indexed: 12/20/2022] Open
Abstract
The aim of the current study is to identify possible new Ocular Response Analyzer (ORA) waveform parameters related to changes of retinal structure/deformation, as measured by the peripapillary retinal arteries angle (PRAA), using a generative deep learning method of variational autoencoder (VAE). Fifty-four eyes of 52 subjects were enrolled. The PRAA was calculated from fundus photographs and was used to train a VAE model. By analyzing the ORA waveform reconstructed (noise filtered) using VAE, a novel ORA waveform parameter (Monot1-2), was introduced, representing the change in monotonicity between the first and second applanation peak of the waveform. The variables mostly related to the PRAA were identified from a set of 41 variables including age, axial length (AL), keratometry, ORA corneal hysteresis, ORA corneal resistant factor, 35 well established ORA waveform parameters, and Monot1-2, using a model selection method based on the second-order bias-corrected Akaike information criterion. The optimal model for PRAA was the AL and six ORA waveform parameters, including Monot1-2. This optimal model was significantly better than the model without Monot1-2 (p = 0.0031, ANOVA). The current study suggested the value of a generative deep learning approach in discovering new useful parameters that may have clinical relevance.
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Affiliation(s)
- Shotaro Asano
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan.
- Seirei General Hospital, Shizuoka, 430-8558, Japan.
- Seirei Christopher University, Shizuoka, 433-8558, Japan.
| | - Takehiro Yamashita
- Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, 890-0075, Japan
| | - Shuichiro Aoki
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Masato Matsuura
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
- Department of Ophthalmology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, 252-0374, Japan
| | - Yuri Fujino
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
- Seirei General Hospital, Shizuoka, 430-8558, Japan
- Department of Ophthalmology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, 252-0374, Japan
| | - Hiroshi Murata
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Shunsuke Nakakura
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Hyogo, 671-1227, Japan
| | - Yoshitaka Nakao
- Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima, 739-8511, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima, 739-8511, Japan
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Allon G, Machluf Y, Mezer E, Chaiter Y. Screening for Myopia-Related Retinal Changes Among Teenagers. Ophthalmic Surg Lasers Imaging Retina 2020; 50:e311-e319. [PMID: 31755983 DOI: 10.3928/23258160-20191031-19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 06/10/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVE To evaluate the relationship between spherical equivalent (SE) refractive error and myopia-related peripheral retinal changes (MPRCs) and to find the optimal cutoff for screening myopic teenagers. PATIENTS AND METHODS The study included 2,286 myopic subjects who had a dilated fundus examination between 1998 and 2011 and SE of -4.0 diopters (D) or higher in both eyes. RESULTS Ninety-five subjects (4.16%) had MPRCs. Two subjects (0.09%) had moderate-to-severe MPRCs. A significant correlation (P < .0001) between SE and MPRC was found. The highest sum of sensitivity (72.63%) and specificity (73.44%) was achieved when a SE of -6.25 D in the more myopic eye was utilized as the cutoff. CONCLUSIONS SE and MPRCs are highly associated. The optimal cutoff to detect MPRC in teenagers is -6.25 D. However, using a SE of -4.0 D as the cutoff may be the practical choice for screening due to the noninvasiveness nature and low cost of the examination. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:e311-e319.].
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Wong CW, Yanagi Y, Tsai ASH, Shihabuddeen WA, Cheung N, Lee SY, Jonas JB, Cheung CMG. Correlation of axial length and myopic macular degeneration to levels of molecular factors in the aqueous. Sci Rep 2019; 9:15708. [PMID: 31673022 PMCID: PMC6823508 DOI: 10.1038/s41598-019-52156-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 07/22/2019] [Indexed: 02/06/2023] Open
Abstract
To elucidate the molecular processes associated with the development of myopic macular degeneration (MMD), we measured the intraocular concentrations of molecular factors in emmetropic and myopic eyes. This is a retrospective clinic-based case-control study that included eyes undergoing routine cataract surgery whereby aqueous humour samples were obtained. We measured the concentrations of pigment epithelium derived factor(PEDF), matrix metalloproteinase 2(MMP-2), tissue inhibitor of metalloproteinase(TIMP-2), vascular endothelial growth factor isoform A(VEGF-A), interleukin 8(IL-8), interleukin 6(IL-6), C-reactive protein(CRP), angiopoietin 2(Ang2), and amphiregulin. 38 eyes (axial length (AL): 22.4–32.4 mm), including 12 highly myopic (HM) eyes (AL ≥ 26.5 mm) without MMD and 12 HM eyes with MMD but without neovascularization were included. Eyes with MMD were found to have significantly lower VEGF-A levels (p = 0.007) and higher MMP-2 levels (p = 0.02) than control eyes after adjusting for age and gender. MMP-2 levels correlated positively (r = 0.58, p = 0.002), while VEGF-A levels correlated negatively with longer axial length (r = −0.75, p < 0.001). Both the concentrations of VEGF-A (P = 0.25) and MMP-2 (P = 0.69) were not significantly associated with MMD after adjusting for AL. These findings suggest that the predominant mechanism underlying the development of non-neovascular MMD may be axial elongation, driven in part by MMP-2 related mechanisms.
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Affiliation(s)
- Chee Wai Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Yasuo Yanagi
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Andrew Shih Hsiang Tsai
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Mannheim, Germany
| | | | - Ning Cheung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Shu Yen Lee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Mannheim, Germany
| | - Chui Ming Gemmy Cheung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore. .,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.
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Hashimoto S, Yasuda M, Fujiwara K, Ueda E, Hata J, Hirakawa Y, Ninomiya T, Sonoda KH. Association between Axial Length and Myopic Maculopathy. ACTA ACUST UNITED AC 2019; 3:867-873. [DOI: 10.1016/j.oret.2019.04.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/19/2019] [Accepted: 04/19/2019] [Indexed: 12/14/2022]
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Asano S, Asaoka R, Yamashita T, Aoki S, Matsuura M, Fujino Y, Murata H, Nakakura S, Nakao Y, Kiuchi Y. Correlation Between the Myopic Retinal Deformation and Corneal Biomechanical Characteristics Measured With the Corvis ST Tonometry. Transl Vis Sci Technol 2019; 8:26. [PMID: 31440423 PMCID: PMC6701875 DOI: 10.1167/tvst.8.4.26] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 06/03/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose We previously reported that the retinal deformation due to myopia was represented by the peripapillary retinal arteries angle (PRAA). In this study, we investigated the relationship between the PRAA and biomechanical properties measured with Corvis ST (CST) tonometry. Methods Thirty-four normative eyes of 34 subjects who underwent CST measurement were enrolled. The PRAA was calculated from a fundus photograph. Variables related to the PRAA were identified from age, axial length, spherical equivalent refractive error, and 10 CST parameters using model selection with the second-order bias-corrected Akaike information criterion index. Results The PRAA was best described with axial length (coefficient = −5.66, P < 0.0001), maximum deflection amplitude (mm; coefficient = 130.5, P = 0.0004), and deflection amplitude ratio (DA ratio) 2 mm (coefficient = −25.8, P = 0.0032), where mm was the amount of the maximum corneal apex movement and DA ratio 2 mm was the ratio between the deformation amplitudes at the apex and 2 mm away from the apex. The optimal model was significantly better than the model only with axial length (P = 0.0014, analysis of variance). Conclusions The PRAA was significantly better described with the CST parameters compared to the axial length model only; eyes with small PRAA (larger myopic retinal deformation) showed narrow and shallow maximum corneal deflection. Translational Relevance The Corvis ST parameters, which represents corneal biomechanical characteristics, were associated with myopic retinal deformation.
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Affiliation(s)
- Shotaro Asano
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takehiro Yamashita
- Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Shuichiro Aoki
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Ophthalmology, Sapporo City General Hospital, Hokkaido, Japan
| | - Masato Matsuura
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Ophthalmology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Yuri Fujino
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Ophthalmology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Hiroshi Murata
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shunsuke Nakakura
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Hyogo, Japan
| | - Yoshitaka Nakao
- Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima, Japan
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Lee MW, Lee SE, Lim HB, Kim JY. Longitudinal changes in axial length in high myopia: a 4-year prospective study. Br J Ophthalmol 2019; 104:600-603. [PMID: 31409648 DOI: 10.1136/bjophthalmol-2019-314619] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/25/2019] [Accepted: 07/30/2019] [Indexed: 12/19/2022]
Abstract
AIM To determine the longitudinal changes in the axial length (AL) in patients with high myopia without any other ophthalmic disease METHODS: Participants were divided into two groups: a high myopia group (60 eyes) without myopic degeneration, such as chorioretinal atrophy or posterior staphyloma, and a control group (60 eyes). Both groups were further divided into subgroups according to the AL: subgroup 1 (≥27.5 mm), subgroup 2 (26.0-27.5 mm), subgroup 3 (24.5-26.0 mm) and subgroup 4 (<24.5 mm). The ALs were measured five times at 1-year interval using an IOL master, and the AL was fitted with linear mixed models. RESULTS In the high myopia group, the AL showed a relatively constant increase at each visit, and they were significantly different with previous measurements at most visits, whereas the control group showed no significant change of AL. Subgroups 1,2 and 3 showed significant changes in AL over time (0.064, 0.032 and 0.012 mm/y, respectively). In univariate analyses, age, best-corrected visual acuity, baseline AL and anterior chamber depth were significantly correlated with changes in the AL in the high myopia group. In multivariate analysis, only baseline AL remained significant (p<0.001). CONCLUSIONS Myopic eyes, including moderately myopic eyes, showed a consistent increase in AL over 4 years, and eyes with a longer baseline AL showed a greater increase in AL than eyes with a shorter AL.
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Affiliation(s)
- Min Woo Lee
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea, Republic of.,Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea, Republic of
| | - Seong-Eun Lee
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea, Republic of
| | - Hyung-Bin Lim
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea, Republic of
| | - Jung-Yeul Kim
- Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea, Republic of
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Asano S, Asaoka R, Yamashita T, Aoki S, Matsuura M, Fujino Y, Murata H, Nakakura S, Nakao Y, Kiuchi Y. Relationship Between the Shift of the Retinal Artery Associated With Myopia and Ocular Response Analyzer Waveform Parameters. Transl Vis Sci Technol 2019; 8:15. [PMID: 31016069 PMCID: PMC6467091 DOI: 10.1167/tvst.8.2.15] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/21/2019] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We have recently reported that the retinal stretch due to myopia is closely related to the peripapillary retinal arteries angle (PRAA) (Yamashita et al., Invest Ophthalmol Vis Sci 2013;54:5481-5488). The purpose of the current study was to investigate the relationship between retinal artery position and Ocular Response Analyzer (ORA) waveform parameters. METHODS In 43 eyes of 41 healthy subjects, ORA measurements were carried out and the PRAA was calculated from fundus photographs. Then, the variables related to PRAA were identified from 40 variables of age, axial length (AL), keratometry, ORA corneal hysteresis (CH), ORA corneal resistant factor (CRF), and 35 ORA waveform parameters, using the Lasso regression and model selection with the second-order bias-corrected Akaike information criterion index. RESULTS The optimal model for PRAA included AL, CRF, and three ORA waveform parameters (aindex, w2, and slew1). This optimal model was significantly better than the model with AL-only, the model only with AL and CH, and the model only with AL and CRF (P < 0.0001, P < 0.0001, P < 0.0001, respectively; analysis of variance). CONCLUSIONS The PRAA was significantly better represented by using AL and ORA parameters including waveform parameters, compared with AL alone, with AL and CH alone, and with AL and CRF alone. TRANSLATIONAL RELEVANCE ORA waveform, which represents corneal biomechanical properties, was associated with myopic retinal stretch.
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Affiliation(s)
- Shotaro Asano
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takehiro Yamashita
- Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Shuichiro Aoki
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masato Matsuura
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Ophthalmology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Yuri Fujino
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Ophthalmology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Hiroshi Murata
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shunsuke Nakakura
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Hyogo, Japan
| | - Yoshitaka Nakao
- Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Science, Hiroshima University, Hiroshima, Japan
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Long-Term Natural Course of Pathologic Myopia in Chinese Patients. J Ophthalmol 2019; 2019:1210398. [PMID: 31016036 PMCID: PMC6444239 DOI: 10.1155/2019/1210398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 03/03/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the natural progression in Chinese patients with pathological myopia (PM) and its associated factors. Methods The medical records of 28 patients with PM (worse than −6 diopter), including 31 eyes of 21 children and 12 eyes of 7 adults, were studied. All of the patients underwent a complete ophthalmologic examination at least twice over 3-year period, including the measurement of refractive error (shown as spherical equivalent, SE), axial length (AL), intraocular pressure, visual acuity (uncorrected visual acuity, UCVA, and best-corrected visual acuity, BCVA), and dilated fundus examination. Results The median AL of adults increased significantly from 29.8 mm to 31.43 mm over 5.4 years follow-up (P=0.0037), accompanied with the median SE progressing significantly from −16.4 D to −18.94 D (P=0.0005). Similarly, the median AL of children increased significantly from 26.13 mm to 27.81 mm over 3.9 years (P=0.0001). However, the improvements of UCVA and BCVA in children were significant (P=0.0304, 0.0001), and they had a negative correlation with age (P=0.0010, 0.0005). Also, UCVA and BCVA in children with bilateral PM were significantly better than those with unilateral PM (P=0.0385, 0.0210). Conclusions Fundus degenerations in children with pathological myopia may lead its way since the age of 10 years. Besides, children with bilateral pathological myopia can have parallel development in visual acuity.
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Cho P, Tan Q. Myopia and orthokeratology for myopia control. Clin Exp Optom 2018; 102:364-377. [PMID: 30380591 DOI: 10.1111/cxo.12839] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 08/17/2018] [Accepted: 08/20/2018] [Indexed: 12/18/2022] Open
Abstract
The prevalence of myopia in children is increasing worldwide and is viewed as a major public health concern. This increase has driven interest in research into myopia prevention and control in children. Although there is still uncertainty in the risk factors underlying differences in myopia prevalence between ethnic groups, rates in children of East Asian descent are typically higher regardless of where they live. Mounting evidence also suggests that myopia prevalence in children increases with age. Earlier commencement and more rigorous education systems in these countries, resulting in more time spent on near-work activities and less time on outdoor activities, may be responsible for the earlier age of myopia onset. However, to date, the mechanisms regulating myopia onset and progression are still poorly understood. Findings from several studies have shown orthokeratology to be effective in slowing axial elongation and it is a well-accepted treatment, particularly in East Asian regions. While our understanding of this treatment has increased in the last decade, more work is required to answer questions, including: How long should the treatment be continued? Is there a rebound effect? Should the amount of myopia control be increased? To whom and when should the treatment be offered? Practitioners are now faced with the need to carefully guide and advise parents on whether and when to undertake a long somewhat complex intervention, which is costly, both in time and money. In the near future, a greater demand for effective prophylaxis against childhood myopia is envisaged. Other than orthokeratology, atropine therapy has been shown to be effective in slowing myopia progression. While its mechanism of control is also not fully understood, it is likely that it acts via a different mechanism from orthokeratology. Thus, a combined treatment of orthokeratology and atropine may have great potential to maximise the effectiveness of myopia control interventions.
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Affiliation(s)
- Pauline Cho
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
| | - Qi Tan
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
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Real-world data on ranibizumab for myopic choroidal neovascularization due to pathologic myopia: results from a post-marketing surveillance in Japan. Eye (Lond) 2018; 32:1871-1878. [PMID: 30158574 PMCID: PMC6292850 DOI: 10.1038/s41433-018-0192-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 06/20/2018] [Accepted: 07/22/2018] [Indexed: 01/07/2023] Open
Abstract
Objectives The aim of this study was to obtain real-world clinical data on the safety and efficacy of ranibizumab treatment for myopic choroidal neovascularization (CNV) due to pathologic myopia. Methods This was a prospective, observational, post-marketing surveillance study in ranibizumab-naive Japanese patients with myopic CNV. Patients who initiated ranibizumab treatment were registered and prospectively observed over 12 months. Safety endpoints were the incidence of ocular and non-ocular adverse drug reactions (ADRs) and serious adverse events (SAEs). The efficacy endpoint included the average change in best-corrected visual acuity (BCVA) in logarithm of the minimal angle of resolution (logMAR) units (logMAR BCVA) from baseline to the last observation. Results Three hundred and eighteen patients were included in the safety analysis population. Of these 79.9% were female and the mean age was 65.5 years. The incidences of SAEs and ADRs were 0.6 and 0.3%, respectively. A total of 268 patients (84.0%) completed the 12-month study period. The mean (±SD) and median number of ranibizumab injections were 2.0 ± 1.5 and 1.0 during the 12-month study period, respectively. The number of ranibizumab injections received was one in 52.2% of patients and less than or equal to three in 89.2%. The mean change in logMAR BCVA from baseline to month 12 was −0.193, and the mean logMAR BCVA improved from 0.517 to 0.319 between baseline and month 12. Conclusions This study showed that ranibizumab is generally well tolerated, and that a minimum number of injections were necessary to produce a therapeutic effect in Japanese myopic CNV patients in a real-world setting.
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A novel classification of high myopia into anterior and posterior pathologic subtypes. Graefes Arch Clin Exp Ophthalmol 2018; 256:1847-1856. [DOI: 10.1007/s00417-018-4071-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 06/17/2018] [Accepted: 07/12/2018] [Indexed: 01/26/2023] Open
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Lee JJ, Lee IH, Ahn MW, Pak KY, Park SW, Byon IS, Lee JE. Change in Axial Length in Highly Myopic Adults Using Partial Coherence Interferometry. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.3.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jae Jung Lee
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - In Ho Lee
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Min Won Ahn
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Kang Yeun Pak
- Department of Ophthalmology, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Sung Who Park
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Ik Soo Byon
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ji Eun Lee
- Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
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