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Xu Z, Zou A, Li L, Wu Y, Cai W, Ma J, Yu J. Effect of virtual reality-based visual training for myopia control in children: a randomized controlled trial. BMC Ophthalmol 2024; 24:358. [PMID: 39278928 PMCID: PMC11404007 DOI: 10.1186/s12886-024-03580-w] [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: 01/29/2024] [Accepted: 07/17/2024] [Indexed: 09/18/2024] Open
Abstract
BACKGROUND To assess the efficacy and safety of virtual reality-based visual training (VRVT) in myopia control among children. METHODS The randomized, parallel-group, single-blind clinical trial conducted at the Department of Ophthalmology of Shanghai Tenth People's Hospital enrolled 65 low-myopic children (aged 8 to 13 years) with cycloplegic spherical equivalent (SE) between - 0.50 and - 3.00 diopters (D), astigmatism less than - 1.00 D, anisometropia less than 1.50D, and best corrected visual acuity (BCVA) more than 0.0 logarithm (LogMAR) of the minimum angle of resolution. The participants were enrolled in December 2020, and the follow-up of this study concluded on August 2021. Children were assigned randomly to the intervention group (VRVT plus single-vision spectacle [SVS]) and the control group (only SVS without receiving VRVT). The intervention group was administered for 20 min per day with VRVT under parental supervision at home. The primary outcome was changes in axial length (AL) at 3 months. Macular choroidal thickness (mCT) was regarded as a key secondary outcome. RESULTS Among 65 participants (mean age: 10.8 years, 52.3% male), 60 children (92.3%) who completed the 3-month intervention and 6-month follow-up were included in the analysis (30 in the intervention group and 30 in the control group). The changes of AL were 0.063 ± 0.060 mm (95% confidence interval [CI], 0.074 to 0.119 mm) in the intervention group and 0.129 ± 0.060 mm (95% CI, 0.107 to 0.152 mm) and in the control group at 3 months (t = - 2.135, P = 0.037), and the mean difference between the two groups was 0.066 mm. The change of mCT were 22.633 ± 36.171 μm (95% CI, 9.127 to 36.140 μm) in the intervention group and - 3.000 ± 31.056 μm (95% CI, - 14.597 to 8.597 μm) in the control group at 3 months (t = 2.945, P = 0.005). VR vertigo was the most common adverse event which was occurred in two children (2/30, 6.67%) in the intervention group. CONCLUSIONS VRVT is a promising method for myopia control in children with good user acceptability. Among children aged 8 to 13 years with low-myopia, nightly use of VRVT resulted in slowing myopia progression. TRIAL REGISTRATION This protocol was registered with ClinicalTrials.gov (NCT06250920), retrospectively registered on 01 February 2024.
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Affiliation(s)
- Zihang Xu
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tenth People's Hospital of Tongji University, School of Medicine, Tongji University, Shanghai, 200072, China
- The Third the People's Hospital of Bengbu, Central Hospital of Bengbu, Anhui, 233099, China
| | - Aiqi Zou
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tenth People's Hospital of Tongji University, School of Medicine, Tongji University, Shanghai, 200072, China
| | - Li Li
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tenth People's Hospital of Tongji University, School of Medicine, Tongji University, Shanghai, 200072, China
| | - Yan Wu
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tenth People's Hospital of Tongji University, School of Medicine, Tongji University, Shanghai, 200072, China
| | - Wenting Cai
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tenth People's Hospital of Tongji University, School of Medicine, Tongji University, Shanghai, 200072, China
| | - Jingyang Ma
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tenth People's Hospital of Tongji University, School of Medicine, Tongji University, Shanghai, 200072, China
| | - Jing Yu
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tenth People's Hospital of Tongji University, School of Medicine, Tongji University, Shanghai, 200072, China.
- The Third the People's Hospital of Bengbu, Central Hospital of Bengbu, Anhui, 233099, China.
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Yuan J, Li L, Fan Y, Xu X, Huang X, Shi J, Zhang C, Shi L, Wang Y. Effects of artificial light with different spectral compositions on refractive development and matrix metalloproteinase 2 and tissue inhibitor of metalloproteinases 2 expression in the sclerae of juvenile guinea pigs. Eur J Histochem 2024; 68:3982. [PMID: 38934084 PMCID: PMC11228571 DOI: 10.4081/ejh.2024.3982] [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: 01/31/2024] [Accepted: 05/17/2024] [Indexed: 06/28/2024] Open
Abstract
Artificial light can affect eyeball development and increase myopia rate. Matrix metalloproteinase 2 (MMP-2) degrades the extracellular matrix, and induces its remodeling, while tissue inhibitor of matrix MMP-2 (TIMP-2) inhibits active MMP-2. The present study aimed to look into how refractive development and the expression of MMP-2 and TIMP-2 in the guinea pigs' remodeled sclerae are affected by artificial light with varying spectral compositions. Three weeks old guinea pigs were randomly assigned to groups exposed to five different types of light: natural light, LED light with a low color temperature, three full spectrum artificial lights, i.e. E light (continuous spectrum in the range of ~390-780 nm), G light (a blue peak at 450 nm and a small valley 480 nm) and F light (continuous spectrum and wavelength of 400 nm below filtered). A-scan ultrasonography was used to measure the axial lengths of their eyes, every two weeks throughout the experiment. Following twelve weeks of exposure to light, the sclerae were observed by optical and transmission electron microscopy. Immunohistochemistry, Western blot and RT-qPCR were used to detect the MMP-2 and TIMP-2 protein and mRNA expression levels in the sclerae. After four, six, eight, ten, and twelve weeks of illumination, the guinea pigs in the LED and G light groups had axial lengths that were considerably longer than the animals in the natural light group while the guinea pigs in the E and F light groups had considerably shorter axial lengths than those in the LED group. Following twelve weeks of exposure to light, the expression of the scleral MMP-2 protein and mRNA were, from low to high, N group, E group, F group, G group, LED group; however, the expression of the scleral TIMP-2 protein and mRNA were, from high to low, N group, E group, F group, G group, LED group. The comparison between groups was statistically significant (p<0.01). Continuous, peaks-free or valleys-free artificial light with full-spectrum preserves remodeling of scleral extracellular matrix in guinea pigs by downregulating MMP-2 and upregulating TIMP-2, controlling eye axis elongation, and inhibiting the onset and progression of myopia.
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Affiliation(s)
- Jianbao Yuan
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing; Department of Ophthalmology, Clinical College of Yizheng People's Hospital, Jiangsu Health Vocational College, Yangzhou, Jiangsu; The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu.
| | - Linfang Li
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing; The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu.
| | - Yi Fan
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu; The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu.
| | - Xinyu Xu
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu; The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu.
| | - Xiaoqiong Huang
- The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu.
| | - Jiayu Shi
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu; The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu.
| | - Chuanwei Zhang
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu.
| | - Lixin Shi
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu.
| | - Yuliang Wang
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu; The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu.
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Yuan J, Wang Y, Xu X, Yang M, Fan Y, Shi X, Sun L, Shan M, Ma L. Effects of Different Light Environments with Varying Spectral Composition on the Axial Lengths and Scleral Specificity Protein 1 and Collagen Type I Expression in Juvenile Guinea Pigs. Folia Biol (Praha) 2024; 70:219-228. [PMID: 39692576 DOI: 10.14712/fb2024070040219] [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] [Indexed: 12/19/2024]
Abstract
The study aimed to investigate changes in the eye axial length in juvenile guinea pigs and the expression of scleral specificity protein 1 (Sp1) and collagen type I (Col-I) under different light environments with varying spectral composition. The animals were randomly divided into five groups: natural light (N), LED light with a low colour temperature (L), E light (E), Fulia light (F), and Gulia light (G). Axial lengths were measured every two weeks, and the expression of Sp1 and Col-I in the sclera was assessed by immunohistochemistry, Western blot and RT-qPCR. After 4, 6, 8, 10, and 12 weeks of light exposure, the L and G groups showed considerably longer axial lengths than the N group, with the L group exhibiting significantly longer axial lengths compared with the E and F groups. The protein and mRNA expression levels of Sp1 and Col-I, ranked from highest to lowest, were as follows: N, E, F, G, and L. The expression of Sp1 and Col-I was positively correlated, but both were negatively correlated with the length of the eye axis. The E group demonstrated higher Sp1 and Col-I expression than the other artificial light groups. Artificial light with a continuous, full spectrum lacking peaks and valleys can inhibit the elongation of the eye axis in juvenile guinea pigs and has a protective effect against myopia. There may be a certain relationship between Sp1 and Col-I, and the transforming growth factor-β1-Sp1-Col-I signalling pathway may play a crucial role in myopic scleral extracellular matrix remodelling.
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Affiliation(s)
- Jianbao Yuan
- Department of Ophthalmology, Clinical College of Yizheng People's Hospital, Jiangsu Health Vocational College, Yangzhou, Jiangsu, China.
| | - Yuliang Wang
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Xinyu Xu
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Mei Yang
- Department of Ophthalmology, Clinical College of Yizheng People's Hospital, Jiangsu Health Vocational College, Yangzhou, Jiangsu, China
| | - Yipeng Fan
- Department of Ophthalmology, Clinical College of Yizheng People's Hospital, Jiangsu Health Vocational College, Yangzhou, Jiangsu, China
| | - Xiaopan Shi
- Department of Ophthalmology, Clinical College of Yizheng People's Hospital, Jiangsu Health Vocational College, Yangzhou, Jiangsu, China
| | - Lulu Sun
- Department of Ophthalmology, Clinical College of Yizheng People's Hospital, Jiangsu Health Vocational College, Yangzhou, Jiangsu, China
| | - Mingyu Shan
- Department of Ophthalmology, Clinical College of Yizheng People's Hospital, Jiangsu Health Vocational College, Yangzhou, Jiangsu, China
| | - Lei Ma
- Department of Ophthalmology, Clinical College of Yizheng People's Hospital, Jiangsu Health Vocational College, Yangzhou, Jiangsu, China
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Duan H, Yan W. Visual fatigue a comprehensive review of mechanisms of occurrence, animal model design and nutritional intervention strategies. Crit Rev Food Sci Nutr 2023; 65:1631-1655. [PMID: 38153314 DOI: 10.1080/10408398.2023.2298789] [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] [Indexed: 12/29/2023]
Abstract
When the eyes work intensively, it is easy to have eye discomfort such as blurred vision, soreness, dryness, and tearing, that is, visual fatigue. Visual fatigue not only affects work and study efficiency, but long-term visual fatigue can also easily affect physical and mental health. In recent years, with the popularization of electronic products, although it has brought convenience to the office and study, it has also caused more frequent visual fatigue among people who use electronic devices. Moreover, studies have reported that the number of people with visual fatigue is showing a trend of increasing year by year. The range of people involved is also extensive, especially students, people who have been engaged in computer work and fine instruments (such as microscopes) for a long time, and older adults with aging eye function. More and more studies have proposed that supplementation with the proper nutrients can effectively relieve visual fatigue and promote eye health. This review discusses the physiological mechanisms of visual fatigue and the design ideas of animal experiments from the perspective of modern nutritional science. Functional food ingredients with the ability to alleviate visual fatigue are discussed in detail.
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Affiliation(s)
- Hao Duan
- College of Biochemical Engineering, Beijing Key Laboratory of Bioactive Substances and Functional Food, Beijing Union University, Beijing, China
| | - Wenjie Yan
- College of Biochemical Engineering, Beijing Key Laboratory of Bioactive Substances and Functional Food, Beijing Union University, Beijing, China
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Deng B, Li W, Chen Z, Zeng J, Zhao F. Temporal bright light at low frequency retards lens-induced myopia in guinea pigs. PeerJ 2023; 11:e16425. [PMID: 38025747 PMCID: PMC10655705 DOI: 10.7717/peerj.16425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose Bright light conditions are supposed to curb eye growth in animals with experimental myopia. Here we investigated the effects of temporal bright light at very low frequencies exposures on lens-induced myopia (LIM) progression. Methods Myopia was induced by application of -6.00 D lenses over the right eye of guinea pigs. They were randomly divided into four groups based on exposure to different lighting conditions: constant low illumination (CLI; 300 lux), constant high illumination (CHI; 8,000 lux), very low frequency light (vLFL; 300/8,000 lux, 10 min/c), and low frequency light (LFL; 300/8,000 lux, 20 s/c). Refraction and ocular dimensions were measured per week. Changes in ocular dimensions and refractions were analyzed by paired t-tests, and differences among the groups were analyzed by one-way ANOVA. Results Significant myopic shifts in refractive error were induced in lens-treated eyes compared with contralateral eyes in all groups after 3 weeks (all P < 0.05). Both CHI and LFL conditions exhibited a significantly less refractive shift of LIM eyes than CLI and vLFL conditions (P < 0.05). However, only LFL conditions showed significantly less overall myopic shift and axial elongation than CLI and vLFL conditions (both P < 0.05). The decrease in refractive error of both eyes correlated significantly with axial elongation in all groups (P < 0.001), except contralateral eyes in the CHI group (P = 0.231). LFL condition significantly slacked lens thickening in the contralateral eyes. Conclusions Temporal bright light at low temporal frequency (0.05 Hz) appears to effectively inhibit LIM progression. Further research is needed to determine the safety and the potential mechanism of temporal bright light in myopic progression.
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Affiliation(s)
- Baodi Deng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Wentao Li
- Huizhou Third People’s Hospital, Guangzhou Medical University, Huizhou, China
| | - Ziping Chen
- Guangdong Light Visual Health Research Institute, Guangzhou, China
| | - Junwen Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Feng Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
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