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Walther G, Meyer D, Richards J, Rickert M, Kollbaum P. On-eye centration of soft contact lenses. Ophthalmic Physiol Opt 2024; 44:737-745. [PMID: 38217323 DOI: 10.1111/opo.13278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 01/15/2024]
Abstract
PURPOSE To evaluate the relative positions of modern soft contact lenses (SCLs) relative to the limbus/cornea and the pupil. METHODS Sixty images of the anterior eyes of 101 subjects were acquired over 10 s while participants fixated the centre of the camera lens located 33 cm in front of the eye in a well-lit (300 lux) clinic. Custom validated image analysis software was used to locate the boundaries of the contact lenses, pupils and corneas (limbus). Horizontal and vertical relative positions of the contact lens, pupil and limbus were calculated from the fitted boundaries. RESULTS The mean (standard deviation) pupil and corneal diameters for all subjects were 3.84 mm, (0.83) and 11.97 mm (0.48), respectively. The mean [95% confidence interval] pupil centre was located 0.28 mm [0.26, 0.30] nasally and 0.07 mm [0.05, 0.10] superiorly to the corneal centre. Consistent with clinical observations, the contact lenses centred accurately relative to the corneal centre both nasally 0.04 mm [0.01, 0.07] and inferiorly -0.01 mm [-0.06, 0.03]. However, regardless of the eye, the contact lens was significantly (p < 0.001) decentred relative to the pupil centre both temporally -0.23 mm [-0.26, -0.20] and inferiorly -0.08 mm [-0.12, -0.04]. Decentration magnitudes were significantly correlated between the right and left eyes. CONCLUSIONS Spherical SCLs centred well on the cornea but temporally and inferiorly from the primary line of sight (pupil centre), due to the differences in the location of the pupil and corneal centres. Contrary to some previous reports, there was no evidence that lens optics or material affected lens centration significantly.
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Affiliation(s)
| | - Dawn Meyer
- Indiana University, Bloomington, Indiana, USA
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Loughman J, Kobia-Acquah E, Lingham G, Butler J, Loskutova E, Mackey DA, Lee SSY, Flitcroft DI. Myopia outcome study of atropine in children: Two-year result of daily 0.01% atropine in a European population. Acta Ophthalmol 2024; 102:e245-e256. [PMID: 37694816 DOI: 10.1111/aos.15761] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/29/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023]
Abstract
PURPOSE The Myopia Outcome Study of Atropine in Children (MOSAIC) is an investigator-led, double-masked, randomized controlled trial investigating the efficacy and safety of 0.01% atropine eye drops for managing myopia progression in a predominantly White, European population. METHODS Children aged 6-16 years with myopia were randomly allocated 2:1 to nightly 0.01% atropine or placebo eye drops in both eyes for 2 years. The primary outcome was cycloplegic spherical equivalent (SE) progression at 24 months. Secondary outcomes included axial length (AL) change, safety and acceptability. Linear mixed models with random intercepts were used for statistical analyses. RESULTS Of 250 participants enrolled, 204 (81.6%) completed the 24-month visit (136 (81.4%) treatment, 68 (81.9%) placebo). Baseline characteristics, drop-out and adverse event rates were similar between treatment and control groups. At 24 months, SE change was not significantly different between 0.01% atropine and placebo groups (effect = 0.10 D, p = 0.07), but AL growth was lower in the 0.01% atropine group, compared to the placebo group (-0.07 mm, p = 0.007). Significant treatment effects on SE (0.14 D, p = 0.049) and AL (-0.11 mm, p = 0.002) were observed in children of White, but not non-White (SE = 0.05 D, p = 0.89; AL = 0.008 mm, p = 0.93), ethnicity at 24 months. A larger treatment effect was observed in subjects least affected by COVID-19 restrictions (SE difference = 0.37 D, p = 0.005; AL difference = -0.17 mm, p = 0.001). CONCLUSIONS Atropine 0.01% was safe, well-tolerated and effective in slowing axial elongation in this European population. Treatment efficacy varied by ethnicity and eye colour, and potentially by degree of COVID-19 public health restriction exposure during trial participation.
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Affiliation(s)
- James Loughman
- Centre for Eye Research Ireland, School of Physics, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - Emmanuel Kobia-Acquah
- Centre for Eye Research Ireland, School of Physics, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - Gareth Lingham
- Centre for Eye Research Ireland, School of Physics, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Western Australia, Australia
| | - John Butler
- Centre for Eye Research Ireland, School of Physics, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
- School of Mathematical Sciences, Technological University Dublin, Dublin, Ireland
| | - Ekaterina Loskutova
- Centre for Eye Research Ireland, School of Physics, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - David A Mackey
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Western Australia, Australia
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
| | - Samantha S Y Lee
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Western Australia, Australia
| | - Daniel I Flitcroft
- Centre for Eye Research Ireland, School of Physics, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
- Department of Ophthalmology, Children's Health Ireland at Temple Street Hospital, Dublin, Ireland
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Sarkar S, Khuu S, Kang P. A systematic review and meta-analysis of the efficacy of different optical interventions on the control of myopia in children. Acta Ophthalmol 2024; 102:e229-e244. [PMID: 37578349 DOI: 10.1111/aos.15746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 07/03/2023] [Accepted: 07/27/2023] [Indexed: 08/15/2023]
Abstract
To compare the treatment efficacy of childhood myopia control optical interventions [spectacles, soft contact lenses (SCLs) and orthokeratology (OK) lenses], explore the consistency of treatment efficacies during the treatment period and evaluate the impact of baseline spherical equivalent refraction (SER), axial length (AL) and age on the treatment effect. A literature search of EMBASE, PubMed and Google Scholar databases identified 220 articles published between January 2000 and April 2022, which reported the treatment efficacy by differences in the SER and AL change between intervention and control groups. Thirty-five articles were included in the analysis. Treatment effect sizes (ESs) were calculated, where more positive and negative directions indicated greater treatment efficacy for SER and AL respectively. For SER, the ESs with peripheral add design spectacles (0.66) and SCLs (0.53) were large but not significantly different between treatment types (p = 0.69). For AL, ESs with peripheral add design spectacles (-0.37), SCLs (-0.55) and OK lenses (-0.93) were large, but OK lenses had a significantly greater effect than peripheral add design spectacles (p ≤ 0.001). ESs were large during the first 12 months of treatment for all interventions [peripheral add design SCLs and OK (F ≥ 5.39, p ≤ 0.01), peripheral add design spectacles (F = 0.47, p = 0.63)] but reduced towards the end of 24-36 months of treatment. Baseline SER had an impact on the treatment effect with peripheral add design spectacles only. Optical interventions are efficacious in controlling childhood myopia progression. However, treatment effects were largest only during the first 12 months of treatment and reduced over time.
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Affiliation(s)
- Samrat Sarkar
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Sieu Khuu
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Pauline Kang
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Naik A, Karthikeyan SK, Ramesh JJ, Bhaskar S, Ganapathi CA, Biswas S. An Insight into Knowledge, Perspective, and Practices of Indian Optometrists towards Childhood Myopia. Vision (Basel) 2024; 8:22. [PMID: 38651443 PMCID: PMC11036249 DOI: 10.3390/vision8020022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
The current understanding of clinical approaches and barriers in managing childhood myopia among Indian optometrists is limited. This research underscores the necessity and relevance of evidence-based practice guidelines by exploring their knowledge, attitude, and practice towards childhood myopia. A self-administered internet-based 26-item survey was circulated online among practicing optometrists in India. The questions assessed the demographics, knowledge, self-reported clinical practice behavior, barriers, source of information guiding their management, and extent of adult caregiver engagement for childhood myopia. Of 393 responses, a significant proportion of respondents (32.6-92.4%) were unaware of the ocular complications associated with high myopia, with less than half (46.5%) routinely performing ocular biometry in clinical practice. Despite the growing awareness of emerging myopia management options, the uptake remains generally poor, with single-vision distance full-correction spectacles (70.3%) being the most common mode of vision correction. Barriers to adopting optimal myopia care are medicolegal concerns, absence of clinical practice guidelines, and inadequate consultation time. Own clinical experience and original research articles were the primary sources of information supporting clinical practice. Most (>70%) respondents considered involving the adult caregiver in their child's clinical decision-making process. While practitioners' awareness and activity of newer myopia management strategies are improving, there is plenty of scope for its enhancement. The importance of evidence-based practice guidelines and continuing education on myopia control might help practitioners enhance their clinical decision-making skills.
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Affiliation(s)
- Archana Naik
- Department of Optometry, Netra Jyothi Institute of Allied Health Sciences, Udupi 576101, Karnataka, India; (A.N.); (S.K.K.); (S.B.)
- Aloka Vision Programme, Carl Zeiss India Pvt. Ltd., Bangalore 560099, Karnataka, India
| | - Siddharth K. Karthikeyan
- Department of Optometry, Netra Jyothi Institute of Allied Health Sciences, Udupi 576101, Karnataka, India; (A.N.); (S.K.K.); (S.B.)
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India;
| | - Jivitha Jyothi Ramesh
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India;
| | - Shwetha Bhaskar
- Department of Optometry, Netra Jyothi Institute of Allied Health Sciences, Udupi 576101, Karnataka, India; (A.N.); (S.K.K.); (S.B.)
- Aloka Vision Programme, Carl Zeiss India Pvt. Ltd., Bangalore 560099, Karnataka, India
| | - Chinnappa A. Ganapathi
- Department of Paediatric Ophthalmology, Prasad Netralaya, Udupi 576101, Karnataka, India;
| | - Sayantan Biswas
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
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Tran HDM, Ha TTX, Tran YH, Coroneo M, Tran TD, Truong TU, Sankaridurg P. Impact of Various Concentrations of Low-Dose Atropine on Pupillary Diameter and Accommodative Amplitude in Children with Myopia. J Ocul Pharmacol Ther 2024. [PMID: 38621178 DOI: 10.1089/jop.2023.0173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024] Open
Abstract
Purpose: To assess over 2 weeks, the effect of 3 different low concentrations of atropine on pupillary diameter and accommodative amplitude in children with myopia. Methods: Fifty-eight children with myopia [spherical equivalent (SE) of -0.50 diopters (D) or worse, astigmatism of less than or equal to 2.00 D] were randomly allocated to 3 groups receiving 0.01%, 0.02%, or 0.03% atropine eye drops, once nightly for 2 weeks. The primary outcome was the change from baseline in pupillary diameter and accommodative amplitude with each of the concentrations. Results: Fifty-seven participants (114 eyes), aged between 6 and 12 years, completed the 2-week trial (mean age 9.3 ± 1.7 years and mean SE -3.53 ± 1.79 D). After 2 weeks of use, all the 3 concentrations were found to have a statistically significant effect on both the pupillary diameter and accommodative amplitude. Accommodative amplitude reduced by an average of 5.23 D, 9.28 D, and 9.32 D, and photopic pupil size increased by an average of 0.95 ± 1.05 mm, 1.65 ± 0.93 mm, and 2.16 ± 0.88 mm with 0.01%, 0.02%, and 0.03%, respectively. Of the eyes, a total of 5.3% and 5.9% of the eyes on 0.02% and 0.03% atropine had a mean residual accommodative amplitude of <5 D. The percentage of eyes having a pupillary dilation >3 mm were 4.8%, 10.5%, and 23.5% for 0.01%, 0.02%, and 0.03% atropine, respectively. Conclusions: Low-dose atropine had an effect on pupillary diameter and accommodative amplitude. With the highest concentration assessed, that is, 0.03% nearly 1 of 4 eyes had pupillary dilation of >3 mm. Clinical Trial Registration number: NCT03699423.
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Affiliation(s)
- Huy D M Tran
- Department of Ophthalmology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Myopia Control Clinic, Hai Yen Eye Care, Ho Chi Minh City, Vietnam
- Myopia Program, Brien Holden Vision Institute, Sydney, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Thao T X Ha
- Myopia Control Clinic, Hai Yen Eye Care, Ho Chi Minh City, Vietnam
| | - Yen H Tran
- Myopia Control Clinic, Hai Yen Eye Care, Ho Chi Minh City, Vietnam
- Department of Ophthalmology, An-Sinh Hospital, Ho Chi Minh City, Vietnam
| | - Minas Coroneo
- Department of Ophthalmology, University of New South Wales, Sydney, Australia
| | - Tuan D Tran
- Department of Paediatrics, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Trang U Truong
- Myopia Control Clinic, Hai Yen Eye Care, Ho Chi Minh City, Vietnam
| | - Padmaja Sankaridurg
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Amorim-de-Sousa A, Macedo-de-Araújo RJ, Fernandes P, González-Méijome JM, Queirós A. Enhancement of the Inner Foveal Response of Young Adults with Extended-Depth-of-Focus Contact Lens for Myopia Management. Vision (Basel) 2024; 8:19. [PMID: 38651440 PMCID: PMC11036275 DOI: 10.3390/vision8020019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Myopia management contact lenses have been shown to successfully decrease the rate of eye elongation in children by changing the peripheral refractive profile of the retina. Despite the efforts of the scientific community, the retinal response mechanism to defocus is still unknown. The purpose of this study was to evaluate the local electrophysiological response of the retina with a myopia control contact lens (CL) compared to a single-vision CL of the same material. METHODS The retinal electrical activity and peripheral refraction of 16 eyes (16 subjects, 27.5 ± 5.7 years, 13 females and 3 males) with myopia between -0.75 D and -6.00 D (astigmatism < 1.00 D) were assessed with two CLs (Filcon 5B): a single-vision (SV) CL and an extended-depth-of-focus (EDOF) CL used for myopia management. The peripheral refraction was assessed with an open-field WAM-5500 auto-refractometer/keratometer in four meridians separated by 45° at 2.50 m distance. The global-flash multifocal electroretinogram (gf-mfERG) was recorded with the Reti-port/scan21 (Roland Consult) using a stimulus of 61 hexagons. The implicit time (in milliseconds) and response density (RD, in nV/deg2) of the direct (DC) and induced (IC) components were used for comparison between lenses in physiological pupil conditions. RESULTS Although the EDOF decreased both the HCVA and the LCVA (one and two lines, respectively; p < 0.003), it still allowed a good VA. The EDOF lens induced a myopic shift in most retinal areas, with a higher and statistically significant effect on the nasal retina. No differences in the implicit times of the DC and IC components were observed between SV and EDOF. Compared with the SV, the EDOF lens showed a higher RD in the IC component in the foveal region (p = 0.032). In the remaining retinal areas, the EDOF evoked lower, non-statistically significant RD in both the DC and IC components. CONCLUSIONS The EDOF myopia control CL enhanced the response of the inner layers of the fovea. This might suggest that, besides other mechanisms potentially involved, the central foveal retinal activity might be involved in the mechanism of myopia control with these lenses.
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Affiliation(s)
- Ana Amorim-de-Sousa
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
| | - Rute J. Macedo-de-Araújo
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
- Physics Center of Minho and Porto Universities (CF-UM-UP), 4710-057 Braga, Portugal
| | - Paulo Fernandes
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
- Physics Center of Minho and Porto Universities (CF-UM-UP), 4710-057 Braga, Portugal
| | - José M. González-Méijome
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
- Physics Center of Minho and Porto Universities (CF-UM-UP), 4710-057 Braga, Portugal
| | - António Queirós
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
- Physics Center of Minho and Porto Universities (CF-UM-UP), 4710-057 Braga, Portugal
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Luo Y, Yin Z, Zhang J, Wang W, Huang Y, Li X, Chen H, Lu F, Bao J. Differential Impact of 0.01% and 0.05% Atropine Eyedrops on Ocular Surface in Young Adults. Transl Vis Sci Technol 2024; 13:22. [PMID: 38625083 PMCID: PMC11033597 DOI: 10.1167/tvst.13.4.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/11/2024] [Indexed: 04/17/2024] Open
Abstract
Purpose To evaluate the effect of low-concentration (0.01% and 0.05%) atropine eyedrops on ocular surface characteristics in young adults. Methods Twenty-six myopic students aged 18 to 30 years were randomly assigned to receive either 0.01% or 0.05% atropine once nightly for 14 days, followed by cessation, with a ≥14-day interval between each administration. Assessments were conducted one, two, seven, and 14 days after using atropine with corresponding timepoints after atropine cessation. Tear meniscus height and first and average noninvasive keratograph tear film breakup time (NIKBUT-first, NIKBUT-average) were measured using Keratograph 5M, whereas the objective scatter index (OSI) was measured by OQAS II devices; the ocular surface disease index (OSDI) score was also obtained. Results The mean OSI peaked after two days of administration of 0.05% atropine (β = 0.51, P = 0.001), accompanied by significant decreases in NIKBUT-first (β = -7.73, P < 0.001) and NIKBUT-average (β = -8.10, P < 0.001); the OSDI peaked after 14 days (β = 15.41, P < 0.001). The above parameters returned to baseline one week after atropine discontinuation (all P > 0.05). NIKBUT-first and NIKBUT-average reached their lowest points after 14 days of 0.01% atropine administration (NIKBUT-first: β = -4.46, P = 0.005; NIKBUT-average: β = -4.42, P = 0.001), but those significant changes were diminished once atropine treatment stopped. Conclusions Young adult myopes experienced a significant but temporary impact on the ocular surface with 0.05% atropine administration, whereas 0.01% atropine had a minimal effect. Translational Relevance The investigation of the ocular surface effects of different concentrations of atropine may inform evidence-based clinical decisions regarding myopia control in young adults.
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Affiliation(s)
- Yifan Luo
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Ziang Yin
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jiali Zhang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Weijia Wang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yingying Huang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xue Li
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Hao Chen
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Fan Lu
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jinhua Bao
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
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Corpus G, Molina-Martin A, Piñero DP. Efficacy of Soft Contact Lenses for Myopia Control: A Systematic Review. Semin Ophthalmol 2024; 39:185-192. [PMID: 37853677 DOI: 10.1080/08820538.2023.2271063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/25/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE To summarize and analyze critically the scientific evidence focused on the effectiveness of the use of hydrophilic contact lenses (HCLs) in myopia control, as well as their impact on visual quality and the involvement on the accommodative and binocular function. METHODS This systematic review was developed selecting all original studies which evaluated HCLs for myopia control with follow-up of at least 1 year. Eligible randomized controlled trials (RCTs) were retrieved from PubMed MEDLINE and Scopus. Methodological quality of the studies was assessed using the Critical Appraisal Skills Programme (CASP) for RCTs. RESULTS The search provided a total of 276 articles, selecting 13 according to the inclusion and exclusion criteria. The majority of studies evaluating the effectiveness of HCL showed a good efficacy in myopia progression, providing a good quality of vision. The quality of these studies was found to be suitable according to the CASP tool. The accommodative and binocular function with these lenses was evaluated in few studies, reporting a trend to an increase in the accommodative response and exophoria in near vision, while maintaining good level of stereopsis. Aberrometry and pupillometry were only studied in one trial, in which the authors did not find changes in these variables after the use of a myopia control HCL. CONCLUSIONS There is a strong evidence about the effectiveness of different HCLs designs for slowing down myopia progression in children, providing all of them good levels of visual quality. However, there is still poor evidence about changes in accommodation and binocular function, as well as in pupil size and aberrometry with myopia control HCLs, being necessary more studies focused on this issue.
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Affiliation(s)
- Gema Corpus
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, San Vicente del Raspeig, Spain
| | - Ainhoa Molina-Martin
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, San Vicente del Raspeig, Spain
| | - David P Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, San Vicente del Raspeig, Spain
- Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
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Lee SH, Tseng BY, Wang JH, Chiu CJ. Efficacy and Safety of Low-Dose Atropine on Myopia Prevention in Premyopic Children: Systematic Review and Meta-Analysis. J Clin Med 2024; 13:1506. [PMID: 38592670 PMCID: PMC10932201 DOI: 10.3390/jcm13051506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/20/2024] [Accepted: 03/04/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Early-onset myopia increases the risk of irreversible high myopia. Methods: This study systematically evaluated the efficacy and safety of low-dose atropine for myopia control in children with premyopia through meta-analysis using random-effects models. Effect sizes were calculated using risk ratios (RRs) with 95% confidence intervals (CIs). Comprehensive searches of PubMed, EMBASE, Cochrane CENTRAL, and ClinicalTrials.gov were conducted until 20 December 2023, without language restrictions. Results: Four studies involving 644 children with premyopia aged 4-12 years were identified, with atropine concentrations ranging from 0.01% to 0.05%. The analysis focused on myopia incidence and atropine-related adverse events. Lower myopia incidence (RR, 0.62; 95% CI, 0.40-0.97 D/y; p = 0.03) and reduction in rapid myopia shift (≥0.5 D/1y) (RR, 0.50; 95% CI, 0.26-0.96 D/y; p < 0.01) were observed in the 12-24-month period. Spherical equivalent and axial length exhibited attenuated progression in the atropine group. No major adverse events were detected in either group, whereas the incidence of photophobia and allergic conjunctivitis did not vary in the 12-24-month period. Conclusions: Our meta-analysis supports atropine's efficacy and safety for delaying myopia incidence and controlling progression in children with premyopia. However, further investigation is warranted due to limited studies.
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Affiliation(s)
- Ssu-Hsien Lee
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (S.-H.L.); (B.-Y.T.)
| | - Bor-Yuan Tseng
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (S.-H.L.); (B.-Y.T.)
| | - Jen-Hung Wang
- Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien 970, Taiwan;
| | - Cheng-Jen Chiu
- Department of Ophthalmology and Visual Science, Tzu Chi University, Hualien 970, Taiwan
- Department of Ophthalmology, Hualien Tzu Chi Hospital, the Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan
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Wu J, Li X, Huang Y, Luo Y, Zhang S, Cui Z, Hou F, Bao J, Chen H. Effect of myopia-control lenses on central and peripheral visual performance in myopic children. Ophthalmic Physiol Opt 2024; 44:249-257. [PMID: 38071500 DOI: 10.1111/opo.13257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 11/04/2023] [Accepted: 11/12/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE To evaluate the short-term effects of three myopia-control lenses, which impose peripheral myopic defocus while providing clear central vision, on central and peripheral visual performance in myopic children. METHODS Twenty-one myopic children were enrolled in the study. Central visual performance was assessed using the quick contrast sensitivity function. Peripheral visual performance was evaluated by measuring peripheral contrast threshold and global motion perception, while subjects maintained fixation through the central portion of the lens. Single-vision spectacle lenses (SVL), spectacle lenses with highly aspherical lenslets (HAL) and defocus-incorporated soft contact (DISC) lenses were evaluated in random order, followed by orthokeratology (OK) lenses. All tests were performed monocularly on the right eye. RESULTS The area under the log contrast sensitivity function (AULCSF) with DISC lenses was lower than that with SVL (1.14 vs. 1.40, p < 0.001) and HAL (1.14 vs. 1.33, p = 0.001). HAL increased the temporal visual field contrast threshold compared with OK lenses (p = 0.04), and OK lenses decreased the superior visual field contrast threshold compared with that of SVL (p = 0.04) and HAL (p = 0.005). HAL also increased the peripheral coherence threshold for identifying the contraction movement compared with OK lenses (p = 0.01). CONCLUSIONS The short-term use of these optical interventions for myopia control exhibited measurable differences in central and peripheral visual performance. Relevant attention could be paid to these differences, especially when children switch to different treatments. DISC lenses exhibited worse central contrast sensitivity than SVL and HAL. Imposing peripheral defocus signals did not affect children's peripheral visual performance compared with SVL. However, considering the poorer peripheral visual performance provided by HAL, OK lenses are recommended for children if there are specific demands for global scene recognition and motion perception.
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Affiliation(s)
- Junqian Wu
- National Engineering Research Centre of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xue Li
- National Engineering Research Centre of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yingying Huang
- National Engineering Research Centre of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yifan Luo
- National Engineering Research Centre of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Siqi Zhang
- National Engineering Research Centre of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Zaifeng Cui
- National Engineering Research Centre of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Fang Hou
- National Engineering Research Centre of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jinhua Bao
- National Engineering Research Centre of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Hao Chen
- National Engineering Research Centre of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
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11
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Ostrin LA, Schill AW. Red light instruments for myopia exceed safety limits. Ophthalmic Physiol Opt 2024; 44:241-248. [PMID: 38180093 PMCID: PMC10922340 DOI: 10.1111/opo.13272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 12/23/2023] [Accepted: 12/25/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE Low-level red light (LLRL) therapy has recently emerged as a myopia treatment in children, with several studies reporting significant reduction in axial elongation and myopia progression. The goal of this study was to characterise the output and determine the thermal and photochemical maximum permissible exposure (MPE) of LLRL devices for myopia control. METHODS Two LLRL devices, a Sky-n1201a and a Future Vision, were examined. Optical power measurements were made using an integrating sphere radiometer through a 7-mm diameter aperture, in accordance with ANSI Z136.1-2014, sections 3.2.3-3.2.4. Retinal spot sizes of the devices were obtained using a model eye and high-resolution beam profiler. Corneal irradiance, retinal irradiance and MPE were calculated for an eye positioned at the oculars of each device. RESULTS Both devices were confirmed to be Class 1 laser products. Findings showed that the Sky-n1201a delivers laser light as a point source with a 654-nm wavelength, 0.2 mW power (Ø 7 mm aperture, 10-cm distance), 1.17 mW/cm2 corneal irradiance and 7.2 W/cm2 retinal irradiance (Ø 2 mm pupil). The MPE for photochemical damage is 0.55-7.0 s for 2-7 mm pupils and for thermal damage is 0.41-10 s for 4.25-7 mm pupils. Future Vision delivers the laser as an extended source subtending 0.75 × 0.325°. It has a 652-nm wavelength, 0.06 mW power (Ø 7 mm aperture, 10 cm distance), 0.624 mW/cm2 corneal irradiance and 0.08 W/cm2 retinal irradiance (Ø 2 mm pupil). MPE for photochemical damage is 50-625 s for 2-7 mm pupils. DISCUSSION For both of the LLRL devices evaluated here, 3 min of continuous viewing approached or surpassed the MPE, putting the retina at risk of photochemical and thermal damage. Clinicians should be cautious with the use of LLRL therapy for myopia in children until safety standards can be confirmed.
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Affiliation(s)
- Lisa A Ostrin
- University of Houston College of Optometry, Houston, Texas., USA
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12
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Lee SSY, Nilagiri VK, Lingham G, Blaszkowska M, Sanfilippo PG, Franchina M, Clark A, Mackey DA. Myopia progression following 0.01% atropine cessation in Australian children: Findings from the Western Australia - Atropine for the Treatment of Myopia (WA-ATOM) study. Clin Exp Ophthalmol 2024. [PMID: 38400607 DOI: 10.1111/ceo.14368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/11/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND A rebound in myopia progression following cessation of atropine eyedrops has been reported, yet there is limited data on the effects of stopping 0.01% atropine compared to placebo control. This study tested the hypothesis that there is minimal rebound myopia progression after cessation of 0.01% atropine eyedrops, compared to a placebo. METHODS Children with myopia (n = 153) were randomised to receive 0.01% atropine eyedrops or a placebo (2:1 ratio) daily at bedtime during the 2-year treatment phase of the study. In the third year (wash-out phase), all participants ceased eyedrop instillation. Participants underwent an eye examination every 6 months, including measurements of spherical equivalent (SphE) after cycloplegia and axial length (AL). Changes in the SphE and AL during the wash-out phase and throughout the 3 years of the study (treatment + wash-out phase) were compared between the treatment and control groups. RESULTS During the 1-year wash-out phase, SphE and AL progressed by -0.41D (95% CI = -0.33 to -0.22) and +0.20 mm (95% CI = -0.46 to -0.36) in the treatment group compared to -0.28D (95% CI = 0.11 to 0.16) and +0.13 mm (95% CI = 0.18 to 0.21) in the control group. Progression in the treatment group was significantly faster than in the control group (p = 0.016 for SphE and <0.001 for AL). Over the 3-year study period, the cumulative myopia progression was similar between the atropine and the control groups. CONCLUSIONS These findings showed evidence of rapid myopia progression following cessation of 0.01% atropine. Further investigations are warranted to ascertain the long-term effects of atropine eyedrops.
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Affiliation(s)
- Samantha Sze-Yee Lee
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Vinay Kumar Nilagiri
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Gareth Lingham
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
- Centre for Eye Research Ireland, Environmental, Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - Magdalena Blaszkowska
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Paul G Sanfilippo
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Maria Franchina
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
- Perth Children's Hospital, Perth, Western Australia, Australia
| | - Antony Clark
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
- Perth Children's Hospital, Perth, Western Australia, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
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13
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Lupon M, Nolla C, Cardona G. New Designs of Spectacle Lenses for the Control of Myopia Progression: A Scoping Review. J Clin Med 2024; 13:1157. [PMID: 38398469 PMCID: PMC10888677 DOI: 10.3390/jcm13041157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/09/2024] [Accepted: 02/17/2024] [Indexed: 02/25/2024] Open
Abstract
Myopia control with new designs of spectacle lenses is a flourishing area of research. The present work reviews the effectiveness of new designs (DIMSs, defocus-incorporated multiple segments; CARE, cylindrical annular refractive element; HALs/SALs, highly/slightly aspherical lenslets; DOT, diffusion optics technology) aiming at slowing myopia progression. A search through the PubMed database was conducted for articles published between 1 January 2003 and 28 February 2023. Publications were included if they documented baseline central refraction (SER) and/or axial length (AL) data, and the change in these parameters, in myopic children wearing new designs of spectacle lenses (treatment group) compared to myopic children using single-vision lenses, SVLs (control group). The selection process revealed nine suitable articles. Comparing the mean and standard error values of the treatment and control groups, the highest differences in the change in the SER and AL were -0.80 (1.23) D [95% CI: -1.053 to -0.547; p < 0.001] and 0.35 (0.05) mm [95% CI: 0.252 to 0.448; p < 0.001], respectively; the effect of treatment provided by a HAL design, compared to SVLs, led to a deceleration of 54.8% in the SER and 50.7% in the AL. However, the heterogeneity of the results prevents reaching strong conclusions about the effectiveness of these new designs.
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Affiliation(s)
- Marta Lupon
- Vision, Optometry and Health (VOS), Department of Optics and Optometry, Universitat Politècnica de Catalunya, Violinista Vellsolà 37, 08022 Terrassa, Spain;
| | - Carme Nolla
- Terrassa School of Optics and Optometry (FOOT), Universitat Politècnica de Catalunya, Violinista Vellsolà 37, 08022 Terrassa, Spain;
| | - Genis Cardona
- Applied Optics and Image Processing Group (GOAPI), Department of Optics and Optometry, Universitat Politècnica de Catalunya, Violinista Vellsolà 37, 08022 Terrassa, Spain
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Hansen NC, Hvid-Hansen A, Møller F, Bek T, Larsen DA, Jacobsen N, Kessel L. Two-Year Results of 0.01% Atropine Eye Drops and 0.1% Loading Dose for Myopia Progression Reduction in Danish Children: A Placebo-Controlled, Randomized Clinical Trial. J Pers Med 2024; 14:175. [PMID: 38392608 PMCID: PMC10890135 DOI: 10.3390/jpm14020175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 01/27/2024] [Accepted: 01/31/2024] [Indexed: 02/24/2024] Open
Abstract
We investigated the two-year safety and efficacy of 0.1% loading dose and 0.01% low-dose atropine eye drops in Danish children for reduction in myopia progression in an investigator-initiated, placebo-controlled, double-masked, randomized clinical trial. Ninety-seven six- to twelve-year old myopic participants were randomized to 0.1% loading dose for six months and then 0.01% for eighteen months (loading dose group, N = 33), 0.01% for two years (0.01% group, N = 32) or placebo for two years (placebo, N = 32). Axial length (AL) and spherical equivalent refraction (SER) were primary outcomes. Secondary outcomes included adverse events and reactions, choroidal thickness, and other ocular biometrical measures. Outcomes were measured from baseline and at six-month intervals. Individual eyes nested by participant ID were analyzed with linear-mixed model analysis. Data were analyzed with intention-to-treat. Mean AL was 0.08 mm less (95% confidence interval (CI): -0.01; 0.17, p-value = 0.08) in the 0.1% loading dose and 0.10 mm less (95% CI: 0.01; 0.19, p-value = 0.02) in the 0.01% group after two years of treatment compared to placebo. Mean SER progression was 0.12 D (95% CI: -0.10; 0.33) less in the loading dose and 0.26 D (95% CI: 0.04; 0.48) less in the 0.01% groups after two years of treatment compared to placebo (p-value = 0.30 and 0.02, respectively). In total, 17 adverse events were reported in the second-year follow-up, and all were rated as mild. Adjusting for iris color did not affect treatment effect estimates. Intra-ocular pressure increased over two years comparably between all groups but remained within normal limits. Two-year treatment with 0.01% low-dose atropine eye drops is a safe and moderately efficacious intervention in Danish children for reducing myopia progression.
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Affiliation(s)
- Niklas Cyril Hansen
- Department of Ophthalmology, Copenhagen University Hospital-Rigshospitalet-Glostrup, DK-2600 Glostrup, Denmark
| | - Anders Hvid-Hansen
- Department of Ophthalmology, Copenhagen University Hospital-Rigshospitalet-Glostrup, DK-2600 Glostrup, Denmark
| | - Flemming Møller
- Department of Ophthalmology, University Hospital of Southern Denmark-Vejle Hospital, DK-7100 Vejle, Denmark
| | - Toke Bek
- Department of Ophthalmology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Dorte Ancher Larsen
- Department of Ophthalmology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Nina Jacobsen
- Department of Ophthalmology, Copenhagen University Hospital-Rigshospitalet-Glostrup, DK-2600 Glostrup, Denmark
| | - Line Kessel
- Department of Ophthalmology, Copenhagen University Hospital-Rigshospitalet-Glostrup, DK-2600 Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, DK-2200 København N, Denmark
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15
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Erdinest N, Atar-Vardi M, London N, Landau D, Smadja D, Pras E, Lavy I, Morad Y. Treatment of Rapid Progression of Myopia: Topical Atropine 0.05% and MF60 Contact Lenses. Vision (Basel) 2024; 8:3. [PMID: 38391084 PMCID: PMC10885127 DOI: 10.3390/vision8010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 01/11/2024] [Accepted: 01/14/2024] [Indexed: 02/24/2024] Open
Abstract
This retrospective study evaluates the effectiveness of combining 0.05% atropine with MF60 contact lenses in managing rapid myopia progression in children over one year. The study involved three groups: the treatment group (TG) with 15 children (53% male, average age 12.9 ± 1.04), the MF group (MF) with 12 children (50% male, average age 12.8 ± 0.8) using only MF60 lenses, and the control group (CG) with 14 children (43% male, average age 12.1 ± 0.76). Baseline myopia and axial length (AL) were similar across groups, with the TG, MF, and CG showing -4.02 ± 0.70 D, -4.18 ± 0.89 D, -3.86 ± 0.99 D, and 24.72 ± 0.73 mm, 24.98 ± 0.70 mm, 24.59 ± 1.02 mm, respectively. Prior to the study, all groups exhibited significant myopia and AL progression, with no previous myopia control management. The treatment involved daily 0.05% atropine instillation, the use of MF60 lenses and increased outdoor activity. Biannual cycloplegic refraction and slit lamp evaluations confirmed no adverse reactions. After one year, the TG showed a significant reduction in myopia and AL progression (-0.43 ± 0.46 D, p < 0.01; 0.22 ± 0.23 mm, p < 0.01), whereas the CG showed minimal change (-1.30 ± 0.43 D, p = 0.36; 0.65 ± 0.35 mm, p = 0.533). The MF group also exhibited a notable decrease (-0.74 ± 0.45 D, p < 0.01; 0.36 ± 0.23 mm). Increased outdoor activity during the treatment year did not significantly impact myopia control, suggesting its limited additional effect in this cohort. The study concludes that the combination of 0.05% atropine and peripheral defocus soft contact lenses effectively controls myopia progression in children.
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Affiliation(s)
- Nir Erdinest
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
- The Myopia Center, Petach Tikva 4900519, Israel
| | - Maya Atar-Vardi
- Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin 7033001, Israel
| | - Naomi London
- Private Practice, 5 Even Israel, Jerusalem 9422805, Israel
| | - David Landau
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
| | - David Smadja
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
| | - Eran Pras
- Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin 7033001, Israel
| | - Itay Lavy
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
| | - Yair Morad
- The Myopia Center, Petach Tikva 4900519, Israel
- Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin 7033001, Israel
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16
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Queirós A, Rolland le Moal P, Angioi-Duprez K, Berrod JP, Conart JB, Chaume A, Pauné J. Efficacy of the DRL orthokeratology lens in slowing axial elongation in French children. Front Med (Lausanne) 2024; 10:1323851. [PMID: 38239610 PMCID: PMC10794606 DOI: 10.3389/fmed.2023.1323851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/11/2023] [Indexed: 01/22/2024] Open
Abstract
Background This study aims to assess and compare the impact of Orthokeratology Double Reservoir Lens (DRL) versus Single Vision Lenses (SVL) on axial elongation and anterior chamber biometric parameters in myopic children over a 6- and 12-month treatment period in France. Methods A retrospective study involving 48 patients aged 7 to 17 years, who underwent either orthokeratology treatment or single-vision spectacle correction, was conducted. Changes in refractive error, axial length, and anterior chamber depth were examined. Results Twenty-five patients comprised the Orthokeratology (OK) group, while twenty-three were in the control group (single-vision spectacle group). Significant increases in mean axial length were observed over time in both the control (0.12 ± 0.13 mm and 0.20 ± 0.17 mm after 6 and 12 months, respectively; F (2,28.9) = 27.68, p < 0.001) and OK groups (0.02 ± 0.07 mm and 0.06 ± 0.13 mm after 6 and 12 months, respectively; F (2,29.1) = 5.30, p = 0.023). No statistically significant differences in axial length were found between male and female children (p > 0.620). Age-specific analysis revealed no significant axial elongation after 12 months in the 14-17 years group in the OK group. Anterior biometric data analysis at 6 and 12 months showed statistical significance only for the DRL group. Conclusion Orthokeratology resulted in an 86 and 70% reduction in axial elongation after 6 and 12 months of lens wear, respectively, compared to the single-vision spectacles group. Myopia progression was more pronounced in younger children, underscoring the importance of initiating myopia control strategies at early ages.
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Affiliation(s)
- António Queirós
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science University of Minho, Braga, Portugal
- Physics Center of Minho and Porto Universities, Braga, Portugal
| | | | - Karine Angioi-Duprez
- Department of Ophthalmology, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France
| | - Jean-Paul Berrod
- Department of Ophthalmology, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France
| | - Jean-Baptiste Conart
- Department of Ophthalmology, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France
| | | | - Jaume Pauné
- Teknon Medical Center, Barcelona, Spain
- Faculty of Optics and Optometry Polytechnic, University of Catalonia, Terrassa, Spain
- Optometry School Optometry, University of Montreal, Montreal, QC, Canada
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17
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Marcellán Vidosa MC, Remón L, Ávila FJ. Peripheral refraction under different levels of illuminance. Ophthalmic Physiol Opt 2024; 44:191-198. [PMID: 37950504 DOI: 10.1111/opo.13244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/21/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Abstract
Peripheral refraction is believed to be involved in the development of myopia. The aim of this study was to compare the relative peripheral refraction (RPR) at four different levels of illuminance, ranging from photopic conditions to complete darkness, using an open-field autorefraction method. The RPR was calculated for each eccentricity by subtracting central from peripheral autorefraction measurements. The study included 114 myopic eyes from 114 subjects (mean age of 21.81 ± 1.91 years) and the mean difference in RPR between scotopic and photopic conditions (0 and 300 lux, respectively) was +0.32 D at 30° temporal and +0.37 D at 30° in the nasal visual field (NVF). Statistically significant differences were observed between 0 and 300 lux at 30° in the temporal visual field and at 30° and 20° in the NVF. Our results revealed a significant increase in relative peripheral hyperopia with increasing visual field eccentricity along the horizontal visual field in myopic eyes of young adults. Furthermore, this relative peripheral hyperopia increased as illumination decreased. These findings suggest that an increase in peripheral illuminance may protect against myopic eye growth.
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Affiliation(s)
| | - Laura Remón
- Department of Applied Physics, Universidad de Zaragoza, Zaragoza, Spain
| | - Francisco J Ávila
- Department of Applied Physics, Universidad de Zaragoza, Zaragoza, Spain
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18
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Wong YL, Li X, Huang Y, Yuan Y, Ye Y, Lim EW, Yang A, Spiegel D, Drobe B, Bao J, Chen H. Eye growth pattern of myopic children wearing spectacle lenses with aspherical lenslets compared with non-myopic children. Ophthalmic Physiol Opt 2024; 44:206-213. [PMID: 37712499 DOI: 10.1111/opo.13232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023]
Abstract
INTRODUCTION To evaluate eye growth of children wearing spectacle lenses with highly aspherical lenslets (HAL), slightly aspherical lenslets (SAL) and single-vision lenses (SVL) compared to eye growth patterns in non-myopes in Wenzhou, China. METHODS The randomised trial had 170 myopic children (aged 8-13 years) randomly assigned to the HAL, SAL or SVL group. Normal eye growth was examined using 700 non-myopic schoolchildren (aged 7-9 years) in the Wenzhou Medical University-Essilor Progression and Onset of Myopia (WEPrOM) cohort study using logistic function models. Slow, normal and fast eye growth was defined as range of values <25th, 25th-75th and >75th percentiles, respectively. RESULTS The predicted upper limits of slow eye growth (25th percentile) among non-myopes aged 7-10 years and 11-13 years were 0.20-0.13 and 0.08-0.01 mm (after 2-year period; 0.37-0.33 and 0.29-0.14 mm), respectively, while the upper limits of normal eye growth (75th percentile) were 0.32-0.31 and 0.28-0.10 mm (after 2-year period; 0.58-0.55 and 0.50-0.24 mm), respectively. The 2-year trial had 157 children, 96 of whom wore their lenses full time (everyday ≥12 h/day). The mean 2-year axial length change for HAL, SAL and SVL was 0.34, 0.51 and 0.69 mm (0.28, 0.46 and 0.69 mm in full-time wear), respectively. Slow eye growth was found in 35%, 17% and 2% (44%, 29% and 3% in full-time wear); normal eye growth in 35%, 26% and 12% (44%, 32% and 9% in full-time wear) and fast eye growth in 30%, 57% and 86% (12%, 39% and 88% in full-time wear), respectively (p < 0.001). CONCLUSIONS The eye growth pattern in approximately 90% wearing HAL full time (compared with about 10% wearing SVL full time) was similar or slower than that of non-myopic children both after 1- and 2-year periods.
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Affiliation(s)
- Yee Ling Wong
- R&D Singapore, Essilor International, Singapore, Singapore
- Wenzhou Medical University-Essilor International Research Centre (WEIRC), Wenzhou Medical University, Wenzhou, China
| | - Xue Li
- Wenzhou Medical University-Essilor International Research Centre (WEIRC), Wenzhou Medical University, Wenzhou, China
- National Engineering Research Centre of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yingying Huang
- Wenzhou Medical University-Essilor International Research Centre (WEIRC), Wenzhou Medical University, Wenzhou, China
- National Engineering Research Centre of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yimin Yuan
- Wenzhou Medical University-Essilor International Research Centre (WEIRC), Wenzhou Medical University, Wenzhou, China
- National Engineering Research Centre of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yingying Ye
- Wenzhou Medical University-Essilor International Research Centre (WEIRC), Wenzhou Medical University, Wenzhou, China
- National Engineering Research Centre of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Ee Woon Lim
- R&D Singapore, Essilor International, Singapore, Singapore
- Wenzhou Medical University-Essilor International Research Centre (WEIRC), Wenzhou Medical University, Wenzhou, China
| | - Adeline Yang
- R&D Singapore, Essilor International, Singapore, Singapore
- Wenzhou Medical University-Essilor International Research Centre (WEIRC), Wenzhou Medical University, Wenzhou, China
| | - Daniel Spiegel
- R&D Singapore, Essilor International, Singapore, Singapore
- Wenzhou Medical University-Essilor International Research Centre (WEIRC), Wenzhou Medical University, Wenzhou, China
| | - Björn Drobe
- R&D Singapore, Essilor International, Singapore, Singapore
- Wenzhou Medical University-Essilor International Research Centre (WEIRC), Wenzhou Medical University, Wenzhou, China
| | - Jinhua Bao
- Wenzhou Medical University-Essilor International Research Centre (WEIRC), Wenzhou Medical University, Wenzhou, China
- National Engineering Research Centre of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Hao Chen
- National Engineering Research Centre of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
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Chamberlain P, Hammond DS, Arumugam B, Bradley A. Six-year cumulative treatment effect and treatment efficacy of a dual focus myopia control contact lens. Ophthalmic Physiol Opt 2024; 44:199-205. [PMID: 37897105 DOI: 10.1111/opo.13240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/29/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023]
Abstract
PURPOSE Accumulated axial growth observed during a 6-year clinical trial of a dual focus myopia control contact lens was used to explore different approaches to assess treatment efficacy. METHODS Axial length measurements from 170 eyes in a 6-year clinical trial of a dual focus myopia control lens (MiSight 1 day, CooperVision) were analysed. Treatment groups comprised one having undergone 6 years of treatment and the other (the initial control group) having 3 years of treatment after 3 years of wearing a single vision control lens. Efficacy was assessed by comparing accumulated ocular growth during treatment to that expected of untreated myopic and emmetropic eyes. The impact of treatment on delaying axial growth was quantified by comparing the increased time required to reach criterion growths for treated eyes and survivor analysis approaches. RESULTS When compared to the predicted accumulated growth of untreated eyes, 6 years of treatment reduced growth by 0.52 mm, while 3 years of treatment initiated 3 years later reduced growth by 0.19 mm. Accumulated differences between the growth of treated and untreated myopic eyes ranged between 67% and 52% of the untreated myopic growth, and between 112% and 86% of the predicted difference in growth between untreated myopic and age-matched emmetropic eyes. Treated eyes took almost 4 years longer to reach their final accumulated growth than untreated eyes. Treatment increased the time to reach criterion growths by 2.3-2.7 times. CONCLUSION Estimated growth of age-matched emmetropic and untreated myopic eyes provided evidence of an accumulated slowing in axial elongation of 0.52 mm over 6 years, and the treated growth remained close to that expected of emmetropic eyes. Six years of dual focus myopia control delayed the time to reach the final growth level by almost 4 years.
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Chiu YC, Tsai PC, Lee SH, Wang JH, Chiu CJ. Systematic Review of Myopia Progression after Cessation of Optical Interventions for Myopia Control. J Clin Med 2023; 13:53. [PMID: 38202060 PMCID: PMC10779574 DOI: 10.3390/jcm13010053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Despite high discontinuation rates for myopia optical interventions, limited attention has been given to the potential rebound effects post-discontinuation. This systematic review aims to assess the extent of the rebound effects following the cessation of common clinical optical myopia-control interventions in children. A comprehensive search of PubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov was conducted from inception to October 2023. The rebound effects, defined as changes in the axial length or spherical equivalent during and after treatment cessation, were categorized into four levels. These studies encompassed 703 participants and spanned from 2019 to 2023, with durations of treatment and cessation ranging from 6 months to 3.5 years and from 2 weeks to 5 years, respectively. This review, encompassing 14 studies, revealed a predominant strong rebound effect in orthokeratology (8 studies), a weak rebound effect in multifocal soft contact lenses (4 studies), and a variable rebound effect in peripheral-plus spectacle lenses (2 studies). Notably, with the increasing cessation duration, the rebound effects diminished, potentially linked to the reversal of choroidal thickening and the disappearance of peripheral myopic defocus. In conclusion, a temporal trend of rebound effects exists in all three myopia optical interventions, possibly contributing to their myopia control mechanisms.
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Affiliation(s)
- Yu-Chieh Chiu
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (Y.-C.C.); (P.-C.T.); (S.-H.L.)
| | - Ping-Chiao Tsai
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (Y.-C.C.); (P.-C.T.); (S.-H.L.)
| | - Ssu-Hsien Lee
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (Y.-C.C.); (P.-C.T.); (S.-H.L.)
| | - Jen-Hung Wang
- Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien 970, Taiwan;
| | - Cheng-Jen Chiu
- Department of Ophthalmology and Visual Science, Tzu Chi University, Hualien 970, Taiwan
- Department of Ophthalmology, Hualien Tzu Chi Hospital, the Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan
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Wang M, Ji N, Yu SA, Liang LL, Ma JX, Fu AC. Comparison of 0.02% atropine eye drops, peripheral myopia defocus design spectacle lenses, and orthokeratology for myopia control. Clin Exp Optom 2023:1-7. [PMID: 38043135 DOI: 10.1080/08164622.2023.2288180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 09/22/2023] [Indexed: 12/05/2023] Open
Abstract
CLINICAL RELEVANCE There are many methods to control the progression of myopia. However, it is currently unknown which method could better control myopia progression: 0.02% atropine eye drops, peripheral myopic defocus design spectacle lenses (PMDSL), or orthokeratology (OK). BACKGROUND To compare the efficacy of 0.02% atropine, PMDSL, and OK to control axial length (AL) elongation in children with myopia. METHODS This study was analysed based on a previous cohort study (0.02% atropine group) and retrospective data (PMDSL and OK group). Overall, 387 children aged 6-14 years with myopia - 1.00D to - 6.00D in the three groups were divided into four subgroups according to age and spherical equivalent refraction (SER). The primary outcome was changed in AL over 1-year. RESULTS The mean axial elongation was 0.30 ± 0.21 mm, 0.23 ± 0.16 mm, and 0.17 ± 0.19 mm in the 0.02% atropine, PMDSL, and OK groups, respectively. Multivariate linear regression analyses showed significant differences in axial elongation among the three groups, especially in children aged 6-10, but not in children aged 10.1-14; the corresponding axial elongation was 0.35 ± 0.21 mm, 0.23 ± 0.17 mm, and 0.21 ± 0.20 mm (P < 0.05 between any two groups, except between PMDSL and OK groups at P > 0.05) and 0.22 ± 0.20 mm, 0.21 ± 0.13 mm, and 0.13 ± 0.18 mm (P < 0.05 between any two groups, except between 0.02% atropine and PMDSL groups at P > 0.05) in children with SER from - 1.00D to - 3.00D and from - 3.01D to - 6.00D, respectively. CONCLUSIONS Within the limits of this study design and using only the current brand of PMDSL, OK appeared to be the best method, followed by PMDSL and then 0.02% atropine, for controlling AL elongation over one year. However, different effects were found in the various age and SER subgroups.
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Affiliation(s)
- Ming Wang
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Na Ji
- Department of Optometry, The Affiliated Eye Hospital of Suzhou Vocational Health College, Suzhou, China
| | - Shi-Ao Yu
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ling-Ling Liang
- Department of Ophthalmology, Shi Jiazhuang Aier Eye Hospital, Shi Jiazhuang, China
| | - Jing-Xue Ma
- Department of Ophthalmology, Shi Jiazhuang Aier Eye Hospital, Shi Jiazhuang, China
| | - Ai-Cun Fu
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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22
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Guo B, Cheung SW, Kojima R, Cho P. Variation of Orthokeratology Lens Treatment Zone (VOLTZ) Study: A 2-year randomised clinical trial. Ophthalmic Physiol Opt 2023; 43:1449-1461. [PMID: 37545099 DOI: 10.1111/opo.13208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 08/08/2023]
Abstract
PURPOSE To compare axial elongation (AE) and treatment zone (TZ) characteristics in children wearing 6 mm or 5 mm back optic zone diameter (BOZD) orthokeratology (ortho-k) lenses over 2 years. METHODS Forty-five (6 to <11 years of age) myopic (-4.00 to -0.75 D) children of Chinese ethnicity were randomly assigned to use the two different lens designs (23 and 22 wore the 6 and 5 mm lenses, respectively). Data collection was performed at baseline and every 6-months after commencing lens wear. RESULTS After 24 months, subjects wearing lenses with a 5 mm BOZD achieved smaller TZ diameter (horizontal: 2.69 ± 0.28 vs. 3.84 ± 0.39 mm; vertical: 2.65 ± 0.22 vs. 3.42 ± 0.34 mm, p < 0.001) and less AE (0.15 ± 0.21 vs. 0.35 ± 0.23, p = 0.005) compared to those using the 6 mm design, with no difference in choroidal thickness (ChT) changes (p = 0.93). A significant increase in ChT, using pooled data analysis, was noted at the 6-month (11.8 ± 19.77 μm, p < 0.001) and 12-month (12.0 ± 23.7 μm, p = 0.004) visits, compared to baseline, indicating a transient change in ChT. Significant associations were noted, using linear mixed models, between AE and the TZ diameters (p < 0.003) after adjusting for baseline data. A very weak association was found between ChT changes and AE, with the effect size close to zero. CONCLUSIONS Smaller BOZD ortho-k lenses resulted in a smaller TZ diameter, which was associated with less AE after 2 years of treatment. The changes in ChT played a very weak role, suggesting that other factors may contribute more to the reduced AE in subjects wearing lenses having a smaller BOZD.
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Affiliation(s)
- Biyue Guo
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Sin Wan Cheung
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Randy Kojima
- College of Optometry, Pacific University, Forest Grove, Oregon, USA
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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23
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Erdinest N, London N, Morad Y, Naroo SA. Myopia management -A survey of optometrists and ophthalmologists in Israel. Eur J Ophthalmol 2023:11206721231211465. [PMID: 37899737 DOI: 10.1177/11206721231211465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
PURPOSE Myopia management is practiced by ophthalmologists and optometrists. This study evaluated the approach and standard of myopia management among eye-care practitioners (ECPs) in Israel. The findings may ultimately affect the quality of care. METHODS A questionnaire was sent to 954 optometrists and 365 ophthalmologists, including demographic questions; whether they owned any devices to monitor myopia progression; the lowest progression they considered significant; various questions pertaining to myopia management and treatment methods. RESULTS Responses from 135 optometrists and 126 ophthalmologists were collected, the majority practicing more than five years; 94% of optometrists, and 64% of ophthalmologists. Around 53% of optometrists and 27% of the ophthalmologists proclaimed to practice myopia management. ECPs primary parameters influencing risk assessment for progression were age, genetic background and history of progression. Time outdoors, during daylight hours, is advised by ophthalmologists (97%) and optometrists (78%). Limiting screentime is encouraged by 87% of ophthalmologists and 69% of optometrists. Myopia progression of 0.50D-0.75D after six months is regarded to require intervention by 93% of ophthalmologists and 83% of optometrists. Optometrists selected multiple myopia management treatments, primarily optical (ophthalmic myopia management lenses 40%, multifocal ophthalmic lenses 24%, peripheral blur contact lenses 38%, orthokeratology 11%), while 95% of ophthalmologists chose atropine and only 3-11% selected any additional treatments to consider. CONCLUSION This study highlighted ECPs' agreement on the principles, importance of, and timeline of intervention with myopia management. The disconnect between the two professions lies in management methods. Genuine dialogue and co-management should be encouraged for maximum implementation, benefit and effectiveness of available patient treatments.
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Affiliation(s)
- Nir Erdinest
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Yair Morad
- Department of Ophthalmology, Shamir Medical Center, Tzrifin, Israel
| | - Shehzad A Naroo
- College of Health and Life Sciences, Aston University, Birmingham, UK
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24
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Wnękowicz-Augustyn E, Teper S, Wylęgała E. Preventing the Progression of Myopia in Children-A Review of the Past Decade. Medicina (Kaunas) 2023; 59:1859. [PMID: 37893579 PMCID: PMC10608552 DOI: 10.3390/medicina59101859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/05/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023]
Abstract
The growing incidence of myopia worldwide justifies the search for efficient methods of myopia prevention. Numerous pharmacological, optical, and lifestyle measures have already been utilized, but there remains a need to explore more practical and predictable methods for myopia control. This paper presents a review of the most recent studies on the prevention of myopia progression using defocus-incorporated multiple-segment spectacle lenses (DIMSsl), repeated low-level red-light (RLRL) therapy, and a combination of low-dose atropine (0.01%) with orthokeratology lenses.
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Affiliation(s)
- Emilia Wnękowicz-Augustyn
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Okręgowy Szpital Kolejowy, Panewnicka 65, 40-760 Katowice, Poland; (S.T.); (E.W.)
- Municipal Hospital Group, Truchana 7, 41-500 Chorzów, Poland
- Eye and Optics Center Augmed, Łabędzka 20d, 44-100 Gliwice, Poland
| | - Sławomir Teper
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Okręgowy Szpital Kolejowy, Panewnicka 65, 40-760 Katowice, Poland; (S.T.); (E.W.)
| | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Okręgowy Szpital Kolejowy, Panewnicka 65, 40-760 Katowice, Poland; (S.T.); (E.W.)
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25
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Radhakrishnan H, Lam CSY, Charman WN. Multiple segment spectacle lenses for myopia control. Part 1: Optics. Ophthalmic Physiol Opt 2023; 43:1125-1136. [PMID: 37378657 DOI: 10.1111/opo.13191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 05/27/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE To understand and compare the optics of two multiple segment (MS) spectacle lenses (Hoya MiyoSmart and Essilor Stellest) designed to inhibit myopia progression in children. METHODS The optics of the two designs are presented, together with geometrical optics-based calculations to understand the impact of the lenses on the optics of the eye. Lenses were evaluated with three techniques: surface images, Twyman-Green interferometry and focimetry. The carrier lens powers and the spatial distribution, powers and forms of the lenslets were measured. RESULTS MS lenses as manufactured were found to match most of the design specifications provided by their manufacturers, although some apparent small discrepancies were found. The focimeter-measured power of the lenslets was approximately +3.50 D for the MiyoSmart and +4.00 D for the highly aspheric lenslets of the Stellest design. For both lens designs, image contrast would be expected to become modestly reduced in the focal planes of the distance-correcting carrier lenses. Images become much more degraded in the combined carrier-lenslet focal plane, due to the generation of multiple laterally displaced images formed by adjacent lenslets within the effective pupil. The exact effects observed depended on the effective pupil size and its location with respect to the lenslets, as well as the power and arrangement of the lenslets. CONCLUSION Wearing either of these lenses will produce broadly similar effects on retinal imagery.
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Affiliation(s)
- Hema Radhakrishnan
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Carly Siu Yin Lam
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- Centre for Eye and Vision Research (CEVR), Hong Kong SAR, China
| | - W Neil Charman
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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26
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Radhakrishnan H, Lam CSY, Charman WN. Multiple segment spectacle lenses for myopia control. Part 2: Impact on myopia progression. Ophthalmic Physiol Opt 2023; 43:1137-1144. [PMID: 37378880 DOI: 10.1111/opo.13194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 05/27/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE Initial studies have suggested that multiple segment (MS) spectacle lenses can reduce the progression rate of childhood myopia and axial eye growth. This paper aimed to compare the effectiveness of two different available designs of MS lens and to explore the nature of their control effect. METHOD Published data from the only two clinical trials in which changes in mean spherical equivalent refraction (SER) and axial length (AL) for matched groups of myopic children wearing either MS or single-vision (SV) spectacle corrections, recorded over a period of at least 2 years, were further analysed and compared. Both trials involved Chinese children of similar ages and visual characteristics, but the trials were located in different cities. The two MS lenses examined were MiyoSmart or DIMS (Hoya) and Stellest (Essilor). RESULTS Absolute changes in SER and AL differed over time during the two trials. However, if the results were expressed in terms of efficacy over successive 6-month periods, then the two MS lenses produced broadly similar results (initial efficacy for the control of myopia progression of about 60%-80%, declining over 2 years to about 35%-55%). Control appears to be absolute rather than proportional. DISCUSSION Myopia control may be due to either the additional myopic defocus induced by the MS lenses (i.e., asymmetry of the through-focus image changes about the distance focus) or to the general reduction in image contrast that the lenslets create in the peripheral field. CONCLUSION Multiple segment spectacle lenses offer a valuable new approach to the control of myopia progression in children. Further work is required to clarify their mechanism of action and to optimise their design parameters.
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Affiliation(s)
- Hema Radhakrishnan
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Carly Siu Yin Lam
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- Centre for Eye and Vision Research (CEVR), Hong Kong SAR, China
| | - W Neil Charman
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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27
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Turnbull PRK, Goodman LK, Phillips JR. Dual-focus contact lenses for myopia control modify central retinal electrophysiology in humans. Ophthalmic Physiol Opt 2023; 43:1100-1109. [PMID: 37184059 DOI: 10.1111/opo.13163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/30/2023] [Accepted: 05/02/2023] [Indexed: 05/16/2023]
Abstract
INTRODUCTION Dual-focus contact lenses create two focal planes, one providing a clear retinal image while the other imposes myopic defocus on the retina to slow myopia progression. This study used global-flash multifocal electroretinogram (gmfERG) response amplitudes to compare central versus peripheral retinal responses under dual-focus conditions and to assess the optimal degree of myopic defocus compared with a single-vision control lens. METHODS Twenty participants each underwent three gmfERG trials, wearing a spectacle correction over dual-focus contact lenses with plano central power and peripheral secondary focal powers of either +2.00D, +4.00D or a plano single-vision lens. We compared amplitudes and latencies of the gmfERG direct and induced components (DC and IC) within participants, between the three different contact lens powers and at different retinal eccentricities (gmfERG ring). RESULTS We observed significant differences in the gmfERG responses between the single-vision and dual-focus contact lenses. Overall, DC amplitudes peaked between zero and +2.00D secondary power, while IC amplitudes were maximal between +2.00D and +4.00D. Compared with the single-vision control, the greatest increase in DC and IC amplitudes while wearing dual-focus lenses occurred within the central 10° of the retina. There was no interaction effect between gmfERG ring (eccentricity) and secondary power, and no difference in the latency of the gmfERG responses between different powers. CONCLUSION We found that dual-focus contact lenses with a +2.00D secondary power are close to that expected to induce the greatest increase in gmfERG responses relative to a single-vision lens. Dual-focus lenses produced the highest DC and IC response amplitudes relative to a single-vision lens in the central 10° of the retina. This suggests that dual-focus contact lenses slow myopia progression by modifying central rather than peripheral retinal activity.
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Affiliation(s)
- Philip R K Turnbull
- Myopia Laboratory, School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Lucy K Goodman
- Myopia Laboratory, School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - John R Phillips
- Myopia Laboratory, School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
- Department of Optometry, Asia University, Taichung, Taiwan
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Yu LH, Zhuo R, Song GX, Lin M, Jin WQ. High myopia control is comparable between multifocal rigid gas-permeable lenses and spectacles. Front Med (Lausanne) 2023; 10:1207328. [PMID: 37636562 PMCID: PMC10449577 DOI: 10.3389/fmed.2023.1207328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/31/2023] [Indexed: 08/29/2023] Open
Abstract
Purpose Ocular pathology may be reduced by slowing myopia progression. The purpose of this study was to evaluate the potential of a novel custom-designed rigid gas permeable (RGP) contact lens to control high myopia by comparing the efficacy of multifocal RGP lenses and single-vision spectacles for high myopia control. Methods The medical records of children fitted with spectacles or multifocal rigid gas-permeable lenses between January 2018 and May 2020 were retrospectively reviewed. Children (5-17 years) with non-cycloplegic spherical equivalent refraction of ≤ -6.00 D or spherical equivalent refraction > - 6.00 D with baseline axial length ≥ 26.5 mm, and astigmatism of ≥ -2.00 D were included. Axial length and refraction were measured at baseline, before fitting the participants with multifocal rigid gas-permeable lenses or spectacles, and at 1- and 2-year follow-up visits. Changes in axial length were compared between the groups. Results Among the 77 children with 1-year follow-up data, the mean axial elongation was 0.20 ± 0.17 mm and 0.21 ± 0.14 mm in the multifocal rigid gas-permeable and control groups, respectively, without significant differences between groups (F = 0.004, p = 0.835). Among the 41 patients who completed 2 years of follow-up, the mean axial elongation values in the multifocal rigid gas-permeable and control groups were 0.21 ± 0.15 mm and 0.24 ± 0.13 mm, respectively, at the 1-year follow-up, and 0.37 ± 0.27 mm and 0.43 ± 0.23 mm, respectively, at the 2-year follow-up, without significant between-group differences at either time point (p = 0.224). Conclusion Axial length increased at a similar rate in both the control (spectacles) and multifocal rigid gas-permeable lens groups, suggesting that multifocal rigid gas-permeable lenses have no significant impact on controlling high myopia progression compared with spectacles.
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Affiliation(s)
- Li-hua Yu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ran Zhuo
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Guan-xing Song
- School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Meng Lin
- School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wan-qing Jin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- The First People’s Hospital of Aksu District in Xinjiang, Aksu, China
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29
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Chen ZR, Chen SC, Wan TY, Chuang LH, Chen HC, Yeh LK, Kuo YK, Wu PC, Chen YW, Lai IC, Hwang YS, Liu CF. Treatment of Myopia with Atropine 0.125% Once Every Night Compared with Atropine 0.125% Every Other Night: A Pilot Study. J Clin Med 2023; 12:5220. [PMID: 37629261 PMCID: PMC10456055 DOI: 10.3390/jcm12165220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/04/2023] [Accepted: 07/20/2023] [Indexed: 08/27/2023] Open
Abstract
(1) Purpose: To investigate the efficacy of myopia treatment in children using atropine 0.125% once every two nights (QON) compared with atropine 0.125% once every night (HS). (2) Methods: This retrospective cohort study reviewed the medical records of two groups of children with myopia. Group 1 comprised children treated with atropine 0.125% QON, while group 2 included children treated with atropine 0.125% HS. The first 6 months of data of outcome measurements were subtracted as washout periods in those children undergoing both atropine QON and HS treatment. The independent t-test and Pearson's chi-square test were used to compare the baseline clinical characteristics between the two groups. A generalized estimating equations (GEE) model was used to determine the factors that influence treatment effects. (3) Results: The average baseline ages of group 1 (38 eyes from 19 patients) and group 2 (130 eyes from 65 patients) were 10.6 and 10.2 years, respectively. There were no significant differences in axial length (AL) or cycloplegic spherical equivalent (SEq) at baseline or changes of them after 16.9 months of follow-up. GEE showed that the frequency of atropine 0.125% use has no association with annual AL (QON vs. HS: 0.16 ± 0.10 vs. 0.18 ± 0.12) and SEq (QON vs. HS: -0.29 ± 0.44 vs. -0.34 ± 0.36) changes in all children with myopia. It also showed that older baseline age (B = -0.020, p < 0.001) was associated with lesser AL elongation. (4) Conclusion: The treatment effects of atropine 0.125% HS and QON were similar in this pilot study. The use of atropine 0.125% QON may be an alternative strategy for children who cannot tolerate the side effects of atropine 0.125% HS. This observation should be confirmed with further large-scale studies.
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Affiliation(s)
- Zi-Rong Chen
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
| | - Shin-Chieh Chen
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei 100, Taiwan;
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 100, Taiwan
| | - Tsung-Yao Wan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
| | - Lan-Hsin Chuang
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 204, Taiwan
| | - Hung-Chi Chen
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
- Center for Tissue Engineering, Chang Memorial Hospital, Linkou, Taoyuan 333, Taiwan
| | - Lung-Kun Yeh
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
| | - Yu-Kai Kuo
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 204, Taiwan
| | - Pei-Chang Wu
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
| | - Yun-Wen Chen
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
| | - Ing-Chou Lai
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi City 613, Taiwan
| | - Yih-Shiou Hwang
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi City 613, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Xiamen Branch, Xiamen 361000, China
| | - Chun-Fu Liu
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (Z.-R.C.); (T.-Y.W.); (L.-H.C.); (H.-C.C.); (L.-K.Y.); (Y.-K.K.); (P.-C.W.); (Y.-W.C.); (I.-C.L.); (Y.-S.H.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 204, Taiwan
- Program in Molecular Medicine, National Yang Ming University, Taipei 112, Taiwan
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Abstract
OBJECTIVE To describe the labeling, packaging practices, and characteristics of compounded 0.01% ophthalmic atropine. METHODS A convenience sample of parents of children who had previously been prescribed low-concentration atropine for myopia management were randomized to obtain 0.01% atropine ophthalmic solution from one of nine compounding pharmacies. The products were analyzed for various important quality attributes. The main outcomes were labeling practices, concentration of atropine and degradant product tropic acid, pH, osmolarity, viscosity, and excipients in 0.01% atropine samples obtained from nine US compounding pharmacies. RESULTS Twenty-four samples from nine pharmacies were analyzed. The median bottle size was 10 mL (range 3.5-15 mL), and eight of nine pharmacies used clear plastic bottles. Storage recommendations varied and were evenly split between refrigeration (33%), room temperature (33%), and cool, dark, dry location (33%). Beyond use dates ranged from 7 to 175 days (median, 91 days). Median pH of samples was 7.1 (range, 5.5-7.8). Median measured concentration relative to the prescribed concentration was 93.3% (70.4%-104.1%). One quarter of samples were under the 90% minimum target concentration of 0.01%. CONCLUSIONS An inconsistent and wide variety of formulation and labeling practices exist for compounding 0.01% atropine prescribed to slow pediatric myopia progression.
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Affiliation(s)
- Kathryn Richdale
- University of Houston College of Optometry (K.R., K.S., E.T., M.B.), Houston, TX; and Southern California College of Optometry at Marshall B. Ketchum University (E.T.), Fullerton, CA
| | - Kelsea V. Skidmore
- University of Houston College of Optometry (K.R., K.S., E.T., M.B.), Houston, TX; and Southern California College of Optometry at Marshall B. Ketchum University (E.T.), Fullerton, CA
| | - Erin S. Tomiyama
- University of Houston College of Optometry (K.R., K.S., E.T., M.B.), Houston, TX; and Southern California College of Optometry at Marshall B. Ketchum University (E.T.), Fullerton, CA
| | - Mark A. Bullimore
- University of Houston College of Optometry (K.R., K.S., E.T., M.B.), Houston, TX; and Southern California College of Optometry at Marshall B. Ketchum University (E.T.), Fullerton, CA
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Amorim-de-Sousa A, Pauné J, Silva-Leite S, Fernandes P, Gozález-Méijome JM, Queirós A. Changes in Choroidal Thickness and Retinal Activity with a Myopia Control Contact Lens. J Clin Med 2023; 12:jcm12113618. [PMID: 37297813 DOI: 10.3390/jcm12113618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
PURPOSE The axial elongation in myopia is associated with some structural and functional retinal changes. The purpose of this study was to investigate the effect of a contact lens (CL) intended for myopia control on the choroidal thickness (ChT) and the retinal electrical response. METHODS Ten myopic eyes (10 subjects, 18-35 years of age) with spherical equivalents from -0.75 to -6.00 diopters (D) were enrolled. The ChT at different eccentricities (3 mm temporal, 1.5 mm temporal, sub-foveal ChT, 1.5 mm nasal, and 3 mm nasal), the photopic 3.0 b-wave of ffERG and the PERG were recorded and compared with two material-matched contact lenses following 30 min of wear: a single-vision CL (SV) and a radial power gradient CL with +1.50 D addition (PG). RESULTS Compared with the SV, the PG increased the ChT at all eccentricities, with statistically significant differences at 3.0 mm temporal (10.30 ± 11.51 µm, p = 0.020), in sub-foveal ChT (17.00 ± 20.01 µm, p = 0.025), and at 1.5 mm nasal (10.70 ± 14.50 µm, p = 0.044). The PG decreased significantly the SV amplitude of the ffERG photopic b-wave (11.80 (30.55) µV, p = 0.047), N35-P50 (0.90 (0.96) µV, p = 0.017), and P50-N95 (0.46 (2.50) µV, p = 0.047). The amplitude of the a-wave was negatively correlated with the ChT at 3.0T (r = -0.606, p = 0.038) and 1.5T (r = -0.748, p = 0.013), and the amplitude of the b-wave showed a negative correlation with the ChT at 1.5T (r = -0.693, p = 0.026). CONCLUSIONS The PG increased the ChT in a similar magnitude observed in previous studies. These CLs attenuated the amplitude of the retinal response, possibly due to the combined effect of the induced peripheral defocus high-order aberrations impacting the central retinal image. The decrease in the response of bipolar and ganglion cells suggests a potential retrograde feedback signaling effect from the inner to outer retinal layers observed in previous studies.
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Affiliation(s)
- Ana Amorim-de-Sousa
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
| | - Jaume Pauné
- Teknon Medical Center, 08022 Barcelona, Spain
- Faculty of Optics and Optometry Polytechnic, University of Catalonia, 08222 Terrassa, Spain
| | - Sara Silva-Leite
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
| | - Paulo Fernandes
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
- Physics Center of Minho and Porto Universities, CF-UM-UP, 4710-057 Braga, Portugal
| | - José Manuel Gozález-Méijome
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
- Physics Center of Minho and Porto Universities, CF-UM-UP, 4710-057 Braga, Portugal
| | - António Queirós
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
- Physics Center of Minho and Porto Universities, CF-UM-UP, 4710-057 Braga, Portugal
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Zhang HY, Lam CSY, Tang WC, Lee PH, Tse DY, To CH. Changes in relative peripheral refraction in children who switched from single-vision lenses to Defocus Incorporated Multiple Segments lenses. Ophthalmic Physiol Opt 2023; 43:319-326. [PMID: 36583393 DOI: 10.1111/opo.13086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE To investigate changes in relative peripheral refraction (RPR) associated with myopia progression in children who wore single-vision (SV) lenses for 2 years and switched to Defocus Incorporated Multiple Segments (DIMS) lenses in the third year versus children who wore DIMS lenses for 3 years. METHODS In the first 2 years, children were allocated randomly to wear either DIMS or SV lenses. In the third year, children in the DIMS group continued to wear these lenses, while those in the SV group were switched to DIMS lenses (Control-to-DIMS group). Central and peripheral refraction and axial length were monitored every 6 months. RESULTS Over 3 years, the DIMS group (n = 65) showed good myopia control and maintained a relatively constant and symmetrical RPR profile without significant changes. In the first 2 years, children who wore SV lenses (n = 55) showed asymmetrical RPR changes, with significant increases in hyperopic RPR at 20° nasal (N) (mean difference: 0.88 ± 1.06 D, p < 0.0001) and 30N (mean difference: 1.07 ± 1.09 D, p < 0.0001). The Control-to-DIMS group showed significant myopia retardation after wearing DIMS lenses in the third year. When compared with the RPR changes in the first 2 years, significant reductions in hyperopic RPR were observed at 20N (mean difference: -1.14 ± 1.93 D, p < 0.0001) and 30N (mean difference: -1.07 ± 1.17 D, p < 0.0001) in the third year. However, no significant difference between the RPR changes found in the nasal retina and temporal retina (p > 0.05) was noted in the third year. CONCLUSION Symmetrical changes in RPR were found in children switching from SV to DIMS lenses, and a symmetrical pattern of RPR was noted in children who wore DIMS for 3 years. Myopia control using myopic defocus in the mid-periphery influenced the RPR changes and retarded myopia progression by altering the eye's growth pattern.
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Affiliation(s)
- Han Yu Zhang
- School of Medicine, Nankai University, Tianjin, China
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
- Centre for Eye and Vision Research (CEVR), Shatin, Hong Kong SAR
| | - Carly Siu Yin Lam
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
- Centre for Eye and Vision Research (CEVR), Shatin, Hong Kong SAR
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Wing Chun Tang
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Paul H Lee
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Dennis Y Tse
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
- Centre for Eye and Vision Research (CEVR), Shatin, Hong Kong SAR
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Chi Ho To
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
- Centre for Eye and Vision Research (CEVR), Shatin, Hong Kong SAR
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
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Wolffsohn JS, Whayeb Y, Logan NS, Weng R. IMI-Global Trends in Myopia Management Attitudes and Strategies in Clinical Practice-2022 Update. Invest Ophthalmol Vis Sci 2023; 64:6. [PMID: 37126357 PMCID: PMC10155870 DOI: 10.1167/iovs.64.6.6] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/07/2023] [Indexed: 05/02/2023] Open
Abstract
Purpose Surveys in 2015 and 2019 identified a high level of eye care practitioner concern/activity about myopia, but the majority still prescribed single vision interventions to young myopes. This research aimed to provide updated information. Methods A self-administered, internet-based questionnaire was distributed in 13 languages, through professional bodies to eye care practitioners globally. The questions examined awareness of increasing myopia prevalence, perceived efficacy and adoption of available strategies, and reasons for not adopting specific strategies. Results Of the 3195 respondents, practitioners' concern about the increasing frequency of pediatric myopia in their practices differed between continents (P < 0.001), being significantly higher in Asia (9.0 ± 1.5 of 10) than other continents (range 7.7-8.2; P ≤ 0.001). Overall, combination therapy was perceived by practitioners to be the most effective method of myopia control, followed by orthokeratology and pharmaceutical approaches. The least effective perceived methods were single vision distance undercorrection, spectacles and contact lenses, as well as bifocal spectacles. Practitioners rated their activity in myopia control between (6.6 ± 2.9 in South America to 7.9 ± 1.2/2.2 in Australasia and Asia). Single-vision spectacles are still the most prescribed option for progressing young myopia (32.2%), but this has decreased since 2019, and myopia control spectacles (15.2%), myopia control contact lenses (8.7%) and combination therapy (4.0%) are growing in popularity. Conclusions More practitioners across the globe are practicing myopia control, but there are still significant differences between and within continents. Practitioners reported that embracing myopia control enhanced patient loyalty, increasing practice revenue and improving job satisfaction.
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Affiliation(s)
- James S. Wolffsohn
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom
| | - Yasmin Whayeb
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom
| | - Nicola S. Logan
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom
| | - Rebecca Weng
- Brien Holden Vision Institute, Sydney, NSW, Australia
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Choi KY, Cheung JKW, Wong GTK, Li PH, Chan SSH, Lam TC, Chan HHL. Myopia Control Efficacy and Long-Term Safety of a Novel Orthokeratology Lens (MESOK Study)-A Randomized Controlled Clinical Trial Combining Clinical and Tear Proteomics Data. J Clin Med 2023; 12:jcm12093210. [PMID: 37176650 PMCID: PMC10179394 DOI: 10.3390/jcm12093210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/31/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
Myopia control efficacy and long-term safety of the Breath-O-Correct orthokeratology (OK) lens was evaluated in a 2-year randomized, single vision (SV) spectacle lens-controlled, single-blind clinical trial combining clinical and tear proteomics data. A total of 71 children (43 OK, 9.8 ± 1.3 years; 28 SV, 9.5 ± 1.4 years) completed the 2-year study. Axial length (AL), cycloplegic refraction, clinical safety parameters (best-corrected visual acuity, central cornea thickness, corneal endothelial health, ocular surface disease index), and quantitative tear proteomics were evaluated by masked examiners. Mean 2-year-normalized AL elongations in the OK and SV groups differed significantly (p = 0.03) and were 0.37 ± 0.37 mm and 0.60 ± 0.41 mm, respectively. OK-mediated myopia control efficacy was 37.1%. No significant difference was found in clinical safety parameters of both groups (p > 0.10), except for a thinner central corneal thickness in the OK group (p = 0.01). Proteomics revealed modest OK lens-mediated effects on immune response proteins, including an increased abundance of haptoglobin at 6 and 12 months and a decreased abundance of two proteins (neutrophil defensin 3 and histone 4) at 6 months. The changes were further validated using a high-resolution multiple-reaction monitoring (MRMHR) mass spectrometry. In summary, the Breath-O-Correct OK lens significantly reduced AL elongation in schoolchildren without adverse clinical effects or subclinical inflammatory responses.
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Affiliation(s)
- Kai Yip Choi
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Jimmy K W Cheung
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong SAR, China
| | - Gigi T K Wong
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Peter H Li
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong SAR, China
| | - Sonia S H Chan
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Thomas C Lam
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong SAR, China
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Henry H L Chan
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong SAR, China
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Hong Kong SAR, China
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Gao Y, Lim EW, Drobe B. Impact of myopia control spectacle lenses with highly aspherical lenslets on peripheral visual acuity and central visual acuity with peripheral gaze. Ophthalmic Physiol Opt 2023; 43:566-571. [PMID: 36916874 DOI: 10.1111/opo.13127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 03/03/2023] [Accepted: 03/04/2023] [Indexed: 03/16/2023]
Abstract
PURPOSE Myopia control spectacle lenses with peripheral lenslets are gaining popularity because they are non-invasive and easy to manage, and ongoing clinical trials have shown promising results. This study aimed to evaluate peripheral and central visual acuity (VA) with peripheral gaze in conditions where the eyes are turned to look obliquely through the lenslets. METHODS High-contrast (100%) VA was measured at 300 cm and 10 lx. For each test, two lens designs were evaluated in counterbalanced order: a spectacle lens with highly aspherical lenslets (HALs) and a standard single-vision lens (SVL). The target screen was placed at a visual angle of 21.6° to the nasal side of the right eye. Sixteen adults (27-52 years of age; spherical equivalent refraction (SER), -8.75 D to +0.50 D) wearing their habitual visual correction performed all tests monocularly. RESULTS Mean (SD) central VAs with peripheral gaze through the SVL and the HAL lens were 0.08 (0.13) and 0.17 (0.12) logMAR, respectively. The HAL lens reduced central VA with peripheral gaze by 0.10 (0.08) logMAR (p = 0.03). No significant correlation was observed between the impact of the HAL lens and other factors, such as age or SER. Peripheral VA was not significantly different through the two lenses (1.09 (0.06) logMAR and 1.09 (0.09) logMAR for the SVL and the HAL lens, respectively; p = 0.86). CONCLUSIONS Under high-contrast and low-luminance conditions, the HAL lens reduced central VA with peripheral gaze by approximately one line compared with the SVL. The impact on central VA did not vary with gaze direction, age or SER. The HAL lens did not affect peripheral VA in this condition.
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Affiliation(s)
- Yi Gao
- Essilor R&D Center Singapore, Singapore, Singapore
| | - Ee Woon Lim
- Essilor R&D Center Singapore, Singapore, Singapore
| | - Björn Drobe
- Essilor R&D Center Singapore, Singapore, Singapore
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Bullimore MA, Brennan NA, Flitcroft DI. The future of clinical trials of myopia control. Ophthalmic Physiol Opt 2023; 43:525-533. [PMID: 36897281 DOI: 10.1111/opo.13120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/11/2023]
Abstract
In the field of myopia control, effective optical or pharmaceutical therapies are now available to patients in many markets. This creates challenges for the conduct of placebo-controlled, randomised clinical trials, including ethics, recruitment, retention, selective loss of faster progressors and non-protocol treatments: Ethics: It is valid to question whether withholding treatment in control subjects is ethical. Recruitment: Availability of treatments is making recruitment into clinical trials more difficult. Retention: If masking is not possible, parents may immediately withdraw their child if randomised to no treatment. Selective loss: Withdrawal of fast progressors in the control group leading to a control group biased towards low progression. Non-protocol treatment: Parents may access other myopia treatments in addition to those within the trial. We propose that future trials may adopt one of the following designs: Non-inferiority trials using an approved drug or device as the control. The choice will depend on whether a regulatory agency has approved the drug or device. Short conventional efficacy trials where data are subsequently entered into a model created from previous clinical trials, which allows robust prediction of long-term treatment efficacy from the initial efficacy. Virtual control group trials based on data relating to axial elongation, myopia progression or both, accounting for subject's age and race. Short-term control data from a cohort, for example, 1 year or less, and applying an appropriate, proportional annual reduction in axial elongation to that population and extrapolating to subsequent years. Time-to-treatment-failure trials using survival analysis; once a treated or control subject progresses or elongates by a given amount, they exit the study and can be offered treatment. In summary, the future development of new treatments in myopia control will be hampered if significant changes are not made to the design of clinical trials in this area.
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Affiliation(s)
- Mark A Bullimore
- College of Optometry, University of Houston, Houston, Texas, USA
| | | | - Daniel Ian Flitcroft
- Centre for Eye Research Ireland, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland.,Department of Ophthalmology, Children's University Hospital, Dublin, Ireland
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van der Sande E, Polling JR, Tideman JWL, Meester-Smoor MA, Thiadens AAHJ, Tan E, De Zeeuw CI, Hamelink R, Willuhn I, Verhoeven VJM, Winkelman BHJ, Klaver CCW. Myopia control in Mendelian forms of myopia. Ophthalmic Physiol Opt 2023; 43:494-504. [PMID: 36882953 DOI: 10.1111/opo.13115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 03/09/2023]
Abstract
PURPOSE To study the effectiveness of high-dose atropine for reducing eye growth in Mendelian myopia in children and mice. METHODS We studied the effect of high-dose atropine in children with progressive myopia with and without a monogenetic cause. Children were matched for age and axial length (AL) in their first year of treatment. We considered annual AL progression rate as the outcome and compared rates with percentile charts of an untreated general population. We treated C57BL/6J mice featuring the myopic phenotype of Donnai-Barrow syndrome by selective inactivation of Lrp2 knock out (KO) and control mice (CTRL) daily with 1% atropine in the left eye and saline in the right eye, from postnatal days 30-56. Ocular biometry was measured using spectral-domain optical coherence tomography. Retinal dopamine (DA) and 3,4-dihydroxyphenylacetic acid (DOPAC) were measured using high-performance liquid chromatography. RESULTS Children with a Mendelian form of myopia had average baseline spherical equivalent (SE) -7.6 ± 2.5D and AL 25.8 ± 0.3 mm; children with non-Mendelian myopia had average SE -7.3 ± 2.9 D and AL 25.6 ± 0.9 mm. During atropine treatment, the annual AL progression rate was 0.37 ± 0.08 and 0.39 ± 0.05 mm in the Mendelian myopes and non-Mendelian myopes, respectively. Compared with progression rates of untreated general population (0.47 mm/year), atropine reduced AL progression with 27% in Mendelian myopes and 23% in non-Mendelian myopes. Atropine significantly reduced AL growth in both KO and CTRL mice (male, KO: -40 ± 15; CTRL: -42 ± 10; female, KO: -53 ± 15; CTRL: -62 ± 3 μm). The DA and DOPAC levels 2 and 24 h after atropine treatment were slightly, albeit non-significantly, elevated. CONCLUSIONS High-dose atropine had the same effect on AL in high myopic children with and without a known monogenetic cause. In mice featuring a severe form of Mendelian myopia, atropine reduced AL progression. This suggests that atropine can reduce myopia progression even in the presence of a strong monogenic driver.
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Affiliation(s)
- Emilie van der Sande
- Department Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
| | - Jan Roelof Polling
- Department Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Departments Orthoptics and Optometry, Hogeschool Utrecht, Utrecht, The Netherlands
| | - J Willem L Tideman
- Department Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department Ophthalmology, Martini Hospital, Groningen, The Netherlands
| | - Magda A Meester-Smoor
- Department Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Emily Tan
- Department Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Chris I De Zeeuw
- Netherlands Institute for Neuroscience, Amsterdam, The Netherlands.,Department Neuroscience, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Ralph Hamelink
- Netherlands Institute for Neuroscience, Amsterdam, The Netherlands.,Department Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Ingo Willuhn
- Netherlands Institute for Neuroscience, Amsterdam, The Netherlands.,Department Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Virginie J M Verhoeven
- Department Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Beerend H J Winkelman
- Department Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Netherlands Institute for Neuroscience, Amsterdam, The Netherlands.,Department Neuroscience, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Caroline C W Klaver
- Department Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department Ophthalmology, Radboud Medical Center, Nijmegen, The Netherlands.,Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
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Chaurasiya RK, Sutar S, Gupta A, Pandey R, Agarwal P. Knowledge, attitude, and practice of childhood myopia among Indian optometrists: A questionnaire-based study. Indian J Ophthalmol 2023; 71:951-956. [PMID: 36872716 DOI: 10.4103/ijo.ijo_2660_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Abstract
Purpose To investigate the knowledge of myopia and its natural history including complications and clinical approaches for management adopted by optometrists across India. Methods An online survey was distributed to Indian optometrists. A pre-validated questionnaire was adopted from previous literature. Respondents provided information about their demographics (gender, age, practice location, and modality), myopia knowledge, self-reported practice behaviors relating to childhood myopia, the information and evidence base used to guide their practice, and perceived extent of adult caregiver engagement in making management decisions for myopic children. Results A total of 302 responses were collected from different regions of the country. Most respondents demonstrated knowledge of the association between high myopia and retinal breaks, retinal detachment and primary open-angle glaucoma. Optometrists used a range of techniques to diagnose childhood myopia, with a preference for non-cycloplegic refractive measures. The most common approaches to management were single-vision distance despite most optometrists identifying orthokeratology and low-dose (0.01%) topical atropine as two potentially more effective therapeutic interventions for controlling childhood myopia progression. Almost 90% of respondents considered increasing the time spent outdoors to be beneficial for reducing the rate of myopia progression. The main sources of information used to guide clinical practice were continuing education conferences, seminars, research articles, and workshops. Conclusion : Indian optometrists appear to be aware of emerging evidence and practices, but are not routinely adopting measures. Clinical guidelines, regulatory approval, and sufficient consultation time may be of value for assisting practitioners in making clinical decisions based on the current available research evidence.
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Affiliation(s)
| | - Samir Sutar
- Department of Optometry and Vision Sciences, C L Gupta Eye Institute, Uttar Pradesh, India
| | - Akansha Gupta
- Department of Optometry and Vision Sciences, C L Gupta Eye Institute, Uttar Pradesh, India
| | - Ramji Pandey
- Department of Optometry and Vision Sciences, C L Gupta Eye Institute, Uttar Pradesh, India
| | - Pradeep Agarwal
- Department of Paediatric Ophthalmology and Strabismus, C L Gupta Eye Institute, Uttar Pradesh, India
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Hvid-Hansen A, Jacobsen N, Møller F, Bek T, Ozenne B, Kessel L. Myopia Control with Low-Dose Atropine in European Children: Six-Month Results from a Randomized, Double-Masked, Placebo-Controlled, Multicenter Study. J Pers Med 2023; 13:jpm13020325. [PMID: 36836559 PMCID: PMC9960354 DOI: 10.3390/jpm13020325] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 02/16/2023] Open
Abstract
The effect and safety of low-dose atropine in myopia control have not been studied in randomized, placebo-controlled trials outside Asia. We investigated the efficacy and safety of 0.1% atropine loading dose and 0.01% atropine compared with a placebo in a European population. Investigator-initiated, randomized, double-masked, placebo-controlled, equal-allocation, multicenter study comparing 0.1% atropine loading dose (six months) followed by 0.01% atropine (18 months), 0.01% atropine (24 months), and placebo (24 months). Participants were monitored for a 12-months washout period. Outcome measures were axial length (AL), cycloplegic spherical equivalent (SE), photopic and mesopic pupil size, accommodation amplitude, visual acuity, intraocular pressure (IOP), and adverse reactions and events. We randomized 97 participants (mean [standard deviation] age, 9.4 [1.7] years; 55 girls (57%) and 42 boys (43%)). After six months, AL was 0.13 mm shorter (95% confidence interval [CI], -0.18 to -0.07 [adjusted p < 0.001]) with 0.1% atropine loading dose and 0.06 mm shorter (95% CI, -0.11 to -0.01 [adjusted p = 0.06]) with 0.01% atropine than in the placebo group. We observed similar dose-dependent changes in SE, pupil size, accommodation amplitude, and adverse reactions. No significant differences in visual acuity or IOP were found between groups, and no serious adverse reactions were reported. We found a dose-dependent effect of low-dose atropine in European children without adverse reactions requiring photochromatic or progressive spectacles. Our results are comparable to those observed in East Asia, indicating that results on myopia control with low-dose atropine are generalizable across populations with different racial backgrounds.
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Affiliation(s)
- Anders Hvid-Hansen
- Department of Ophthalmology, Copenhagen University Hospital—Rigshospitalet-Glostrup, DK-2600 Glostrup, Denmark
- Correspondence:
| | - Nina Jacobsen
- Department of Ophthalmology, Copenhagen University Hospital—Rigshospitalet-Glostrup, DK-2600 Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, DK-2200 København N, Denmark
| | - Flemming Møller
- Department of Ophthalmology, University Hospital of Southern Denmark—Vejle Hospital, DK-7100 Vejle, Denmark
| | - Toke Bek
- Department of Ophthalmology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Brice Ozenne
- Department of Public Health, Section of Biostatistics, University of Copenhagen, DK-1014 København K, Denmark
- Neurobiology Research Unit, Copenhagen University Hospital—Rigshospitalet, DK-2200 København N, Denmark
| | - Line Kessel
- Department of Ophthalmology, Copenhagen University Hospital—Rigshospitalet-Glostrup, DK-2600 Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, DK-2200 København N, Denmark
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Liu X, Wang P, Xie Z, Sun M, Chen M, Wang J, Huang J, Chen S, Chen Z, Wang Y, Li Y, Qu J, Mao X. One-year myopia control efficacy of cylindrical annular refractive element spectacle lenses. Acta Ophthalmol 2023. [PMID: 36779428 DOI: 10.1111/aos.15649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 01/03/2023] [Accepted: 01/31/2023] [Indexed: 02/14/2023]
Abstract
PURPOSE To evaluate the 1-year myopia control efficacy of a spectacle lens with annular cylindrical microstructures. METHODS A total of 118 consecutive eligible children aged 8-12 years with -1.00 D to -4.00 D of spherical component myopia and <1.50 D astigmatism were enrolled between August 2020 and November 2020 at the Eye Hospital of Wenzhou Medical University. Participants were randomly assigned to wear cylindrical annular refractive element (CARE) (n = 61) or single-vision (n = 57) spectacle lenses. Cycloplegic autorefraction (spherical equivalent refraction [SER]) and axial length (AL) were measured at baseline and 6-month intervals. Adaptation and compliance questionnaires were administered during all visits. RESULTS Among 118 randomized participants, 96 (81.4%) were included in the analyses (mean [SE] age, 10.4 [0.6] years; 49 [51.0%] were female; mean [SE] spherical equivalent refractive error, -2.67 [0.66] D; mean [SE] axial length, 24.75 [0.77] mm). Adjusted 1-year myopia progression was -0.56 D for CARE and -0.71 D for single-vision spectacle lenses. The difference in progression was 0.14 D (95% CI, -0.04 to 0.32) for CARE vs single vision. Adjusted 1-year eye growth was 0.27 mm for CARE and 0.35 mm for single vision. The difference in eye growth was 0.09 mm (95% CI, -0.15 to -0.02) for CARE vs single vision. All groups adapted to their lenses with no reported adverse events, complaints, or discomfort. CONCLUSIONS Among children with myopia, treatment with cylindrical annular refractive element spectacle lenses significantly reduced the rate of axial elongation over 1 year compared with single-vision spectacle lenses.
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Affiliation(s)
- Xinting Liu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Pengqi Wang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhu Xie
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Muhan Sun
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Minfeng Chen
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jiefang Wang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jing Huang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Siyun Chen
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhaohe Chen
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yanli Wang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yiyu Li
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jia Qu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xinjie Mao
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
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Silva-Leite S, Amorim-de-Sousa A, Queirós A, González-Méijome JM, Fernandes P. Peripheral Refraction and Visual Function of Novel Perifocal Ophthalmic Lens for the Control of Myopia Progression. J Clin Med 2023; 12. [PMID: 36835968 DOI: 10.3390/jcm12041435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023] Open
Abstract
This study aimed to evaluate the peripheral defocus induced with a novel perifocal ophthalmic lens for myopia progression control and the potential impact on visual function. This experimental, non-dispensing crossover study evaluated 17 myopic young adults. The peripheral refraction was measured using an open-field autorefractor, at 2.50 m from the target point, in two eccentric points, 25° temporal, 25° nasal, and central vision. Visual contrast sensitivity (VCS) was measured at 3.00 m with a Vistech system VCTS 6500 in low light conditions. Light disturbance (LD) was assessed with a light distortion analyzer 2.00 m away from the device. Peripheral refraction, VCS, and LD were assessed with a monofocal lens and perifocal lens (with an add power of +2.50 D on the temporal side of the lens, and +2.00 D on the nasal side). The results showed that the perifocal lenses induced an average myopic defocus of -0.42 ± 0.38 D (p-value < 0.001) in the nasal retina, at 25° The changes induced by the lower add power in the nasal part of the lens did not induce statistically significant changes in the refraction of the temporal retina. The VCS and LD showed no significant differences between the monofocal and perifocal lenses.
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Gantes-Nuñez J, Jaskulski M, López-Gil N, Kollbaum PS. Optical characterisation of two novel myopia control spectacle lenses. Ophthalmic Physiol Opt 2023; 43:388-401. [PMID: 36738176 DOI: 10.1111/opo.13098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 02/05/2023]
Abstract
PURPOSE To quantify the amount of myopic defocus, contrast modulation and other optical characteristics of two novel spectacle lenses (MiYOSMART by Hoya and Stellest by Essilor) with the inclusion of lenslets in their designs were investigated computationally and experimentally. This paper examined the hypothesis that despite the non-coaxial nature of the optics, image degradation will exist due to the fragmented nature of the base optic when imaging through the lens regions populated by lenslets. METHODS Optical power was evaluated by computing wavefront vergence and curvature from wavefront slope measured with the Optocraft aberrometer within 1.0 and 6.0 mm apertures across MiYOSMART hexagons and Stellest rings. Point-spread functions (PSFs) were computed using physical (wave) optics and geometrical ray optics principles, and compared with experimental measurements using a 4f optical system. Simulated retinal images and modulation transfer functions (MTFs) were computed from PSF-derived optical transfer functions (OTFs). RESULTS Mean lenslet power in MiYOSMART was +3.95 ± 0.10 D through the hexagons and +6.00 ± 0.15 D in Stellest in rings 1-5 and decreased by 0.42 D/ring reaching 3.50 D in the final one. Stellest lenslets included up to -0.015 microns of primary spherical aberration. PSFs and retinal images revealed simultaneous contributions of the base optic and lenslets. MTFs showed a decrease in contrast at low (1-10 c/deg) spatial frequencies (SFs) comparable to 0.25 D of defocus, and retention of diminished levels of contrast at higher SFs. CONCLUSIONS Varying sagittal power and consistent curvature power across the lenslets is an identifying signature of the novel non-coaxial lens design included in both spectacle lenses. Lenslet array structure itself plays a significant role in determining image characteristics. For both lenses, the blur created by the fragmented base optic contributes to the image quality. The reduced MTFs over a wide range of spatial frequencies result in lowered image contrast.
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Affiliation(s)
| | - Matt Jaskulski
- Indiana University School of Optometry, Bloomington, Indiana, USA
| | | | - Pete S Kollbaum
- Indiana University School of Optometry, Bloomington, Indiana, USA
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Jakobsen TM, Søndergaard AP, Møller F. Peripheral refraction, relative peripheral refraction, and axial growth: 18-month data from the randomised study-Clinical study Of Near-sightedness; TReatment with Orthokeratology Lenses (CONTROL study). Acta Ophthalmol 2023; 101:e69-e80. [PMID: 35941831 PMCID: PMC10087546 DOI: 10.1111/aos.15217] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 06/03/2022] [Accepted: 07/19/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE To investigate changes in peripheral and relative peripheral refraction (RPR) during orthokeratology lens (OKL) use in children, and predictors for myopia progression in a randomized controlled trial. METHODS Refraction and axial length (AL) were measured at baseline, 6, 12, and 18 months for children aged 6-12 years, with myopia of 0.5 to 4.75 dioptres (D) spherical component randomized to either OKL or single-vision spectacles (SVS) at baseline. Cycloplegic spherical equivalent refractive error (SEQ) was measured on-axis and eccentric at 10°, 20°, and 30° during nasal and temporal gaze in the horizontal plane with Shin-Nippon Nvision-K 5001. RPR was computed as SEQ(eccentricity) minus SEQ(on axis) . AL was measured with Lenstar LS900. RESULTS Twenty-one and 28 subjects from the OKL and SVS groups, respectively were available for analysis. OKL wear induced significant myopic RPR at all eccentricities (p ≤ 0.004) whereas peripheral refraction only changed in two out of six eccentric measuring points. Baseline peripheral refraction SEQ at all eccentricities, baseline on-axis SEQ, and baseline RPR at 30° nasal eccentricity were positively correlated to treatment efficacy defined as change in AL. CONCLUSION We found no correlations between change in RPR and treatment efficacy defined as change in AL. Interestingly, our results suggest that the central emmetropisation that occurs during OKL-use accounts for most of the optical changes and to a lesser extent the mid-peripheral plus-zone of the lens.
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Affiliation(s)
- Trine M Jakobsen
- Department of Ophthalmology, University Hospital of Southern Denmark, Vejle Hospital, Vejle, Denmark
| | - Anders P Søndergaard
- Department of Ophthalmology, University Hospital of Southern Denmark, Vejle Hospital, Vejle, Denmark
| | - Flemming Møller
- Department of Ophthalmology, University Hospital of Southern Denmark, Vejle Hospital, Vejle, Denmark
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Yu M, Jiang L, Chen M. Effect of atropine 0.01% on myopia control in children aged 6-13 years during the 2022 lockdown in Shanghai. Front Public Health 2023; 11:1074272. [PMID: 36778567 PMCID: PMC9909278 DOI: 10.3389/fpubh.2023.1074272] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/10/2023] [Indexed: 01/27/2023] Open
Abstract
Purpose To compare the myopic progression in children treated with 0. 01% atropine and those who discontinued atropine during the 2022-home quarantine in Shanghai. Methods In this retrospective study, children aged 6-13 years with follow-up visits before (between January 2022 and February 2022) and after the lockdown (between July 2022 and August 2022) were included. Cycloplegic refraction and axial length (AL) were measured at both visits. The atropine group had continuous medication during the lockdown while the control group discontinued. The 0.01% atropine eyedrops were administered daily before bedtime. The types of spectacle lens were recorded: single vision (SV) spectacles or defocus incorporated multiple segments lenses (DIMS). Results In total, 41 children (81 eyes) in the atropine group and 32 children (64 eyes) in the control group were enrolled. No significant difference was found in the demographic characteristics, spherical diopter, spherical equivalent (SE), AL, and follow-up time between the two groups before the lockdown in 2022 (all p > 0.1). After the home confinement, a greater myopia progression was observed in the control group (-0.46 ± 0.42 D) compared to atropine group (-0.26 ± 0.37 D; p = 0.0023). Axial elongation was also longer in the control group than that in children sustained with atropine (0.21 ± 0.17 vs. 0.13 ± 0.15 mm, p = 0.0035). Moreover, there was no significant change of spherical diopter and SE during lockdown in the atropine + DIMS combined subgroup (0.03 ± 0.033 D for spherical diopter, p = 0.7261 and 0.08 ± 0.27 D for SE, p = 0.2042, respectively). However, significant myopic shift was observed in the atropine + SV subgroup during the quarantine time (-0.31 ± 0.39 D for SE and 0.15 ± 0.16 mm for AL, both p < 0.001). Conclusion Children treated with 0.01% atropine had slower myopia progression during the lockdown period in Shanghai compared with children discontinued. Moreover, the effect of atropine on myopic prevention can be strengthened with DIMS lenses.
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Affiliation(s)
- Manrong Yu
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China,Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, Shanghai, China,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China,Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
| | - Lingli Jiang
- Department of Ophthalmology, The Affiliated Wenling Hospital of Wenzhou Medical University, Wenling, China
| | - Minjie Chen
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China,Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, Shanghai, China,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China,Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China,*Correspondence: Minjie Chen ✉
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Moore M, Flitcroft DI, Loughman J. Prescribing patterns of myopia control contact lenses among optometrists in Ireland. Ophthalmic Physiol Opt 2023; 43:377-387. [PMID: 36651759 DOI: 10.1111/opo.13096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/19/2023]
Abstract
PURPOSE This retrospective analysis of electronic medical record (EMR) data investigated the prescribing patterns of soft myopia control contact lens (MCCL) treatments since their introduction in Ireland in 2017. METHODS Anonymised EMR data were sourced from 33 optometry practices in Ireland from 2017 to 2021 to determine the number of practices prescribing MCCLs to myopic children 5-18 years old. In MCCL-prescribing practices, the proportion of contact lens wearing children fitted with MCCLs and the proportion of progressive (≤-0.25 D/year) myopic children fitted with MCCLs were determined. Logistic regression was used to determine which factors influenced the likelihood of being prescribed a MCCL. RESULTS Overall, just 10 practices were found to prescribe MCCLs of any type. The Coopervision MiSight contact lens was used in 85% of all MCCL fittings with most other fits being off-label multifocals. The use of MCCLs rose from 3% of contact lens fits in 2017 to 27% in 2021. Children fitted with MCCLs were on average younger (12.2 ± 2.3 years vs. 15.4 ± 2.1 years) but more myopic (-3.46 ± 1.84 D vs. -3.03 ± 1.69 D) than those fitted with standard contact lenses. The most predictive factors for being fitted with MCCLs were year of examination (OR: 2.54, 95% CI: 2.13, 3.03), younger age (OR: 1.52, 95% CI: 1.39, 1.64) and greater myopia (OR: 1.25, 95% CI: 1.11, 1.39). CONCLUSION Clinician engagement in myopia management has increased in Ireland since the formal introduction of MCCLs, but more than two-thirds of practices included are yet to offer this form of myopia management. The proportion of children with progressive myopia that has been prescribed MCCLs has increased, but the majority of children are still managed for vision correction only. There is significant scope for improving the uptake of evidence-based myopia control treatments and for optimising the age and degree of myopia at which such interventions are initiated.
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Affiliation(s)
- Michael Moore
- Centre for Eye Research Ireland, School of Physics and Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland
| | - Daniel Ian Flitcroft
- Centre for Eye Research Ireland, School of Physics and Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland.,Children's University Hospital, Dublin, Ireland
| | - James Loughman
- Centre for Eye Research Ireland, School of Physics and Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland
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Lin W, Li N, Lu K, Li Z, Zhuo X, Wei R. The relationship between baseline axial length and axial elongation in myopic children undergoing orthokeratology. Ophthalmic Physiol Opt 2023; 43:122-131. [PMID: 36377631 PMCID: PMC10100030 DOI: 10.1111/opo.13070] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/07/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate the correlation between the baseline axial length (AL) and axial elongation in myopes undergoing orthokeratology (ortho-k). METHODS This was a retrospective study. During the 1-year follow-up, 1176 children (aged 8-14 years) were included and divided into an ortho-k group (n = 588) and a single-vision spectacle group (n = 588). The ortho-k group participants (8-11 years of age) who completed the 3-year follow-up (n = 150) were further divided into three subgroups stratified by their baseline AL: subgroup 1 (AL < 24.5 mm), subgroup 2 (24.5 ≤ AL < 26 mm) and subgroup 3 (AL ≥ 26 mm). AL was measured at baseline and during the annual visit. RESULTS The ortho-k group exhibited slower 1-year axial elongation (39% reduction) than the spectacle group. The 1-year axial elongation was negatively correlated with initial age in both groups. A negative association between 1-year axial elongation and baseline AL was observed in the ortho-k group but not in the spectacle group. However, this relationship only existed in ortho-k participants 8-11 years of age. For the younger ortho-k participants who completed the 3-year follow-up, the annual axial elongation was significantly higher in subgroup 1 for the first and second years but not in the third year compared with subgroups 2 and 3. CONCLUSION Axial elongation was negatively correlated with baseline AL in the ortho-k group. Children aged 8-11 years with longer baseline AL (≥24.5 mm) demonstrated slower annual axial elongation during the first 2 years of ortho-k treatment, which may provide insight into establishing individual guidelines for controlling myopia using ortho-k in children with different baseline characteristics.
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Affiliation(s)
- Weiping Lin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Na Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Kunpeng Lu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Zhaochun Li
- Euclid China (Euclid Trading (Shanghai) Ltd.), Shanghai, China
| | - Xiaohua Zhuo
- Euclid China (Euclid Trading (Shanghai) Ltd.), Shanghai, China
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
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Erdinest N, London N, Lavy I, Landau D, Ben Ephraim Noyman D, Levinger N, Morad Y. Low-Concentration Atropine Monotherapy vs. Combined with MiSight 1 Day Contact Lenses for Myopia Management. Vision (Basel) 2022; 6. [PMID: 36548935 DOI: 10.3390/vision6040073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
Objectives: To assess the decrease in myopia progression and rebound effect using topical low-dose atropine compared to a combined treatment with contact lenses for myopic control. Methods: This retrospective review study included 85 children aged 10.34 ± 2.27 (range 6 to 15.5) who were followed over three years. All had a minimum myopia increase of 1.00 D the year prior to treatment. The children were divided into two treatment groups and a control group. One treatment group included 29 children with an average prescription of 4.81 ± 2.12 D (sphere equivalent (SE) range of 1.25−10.87 D), treated with 0.01% atropine for two years (A0.01%). The second group included 26 children with an average prescription of 4.14 ± 1.35 D (SE range of 1.625−6.00 D), treated with MiSight 1 day dual focus contact lenses (DFCL) and 0.01% atropine (A0.01% + DFCL) for two years. The control group included 30 children wearing single-vision spectacles (SV), averaging −5.06 ± 1.77 D (SE) range 2.37−8.87 D). Results: There was an increase in the SE myopia progression in the SV group of 1.19 ± 0.43 D, 1.25 ± 0.52 D, and 1.13 ± 0.36 D in the first, second, and third years, respectively. Myopia progression in the A0.01% group was 0.44 ± 0.21 D (p < 0.01) and 0.51 ± 0.39 D (p < 0.01) in the first and second years, respectively. In the A0.01% + DFCL group, myopia progression was 0.35 ± 0.26 D and 0.44 ± 0.40 D in the first and second years, respectively (p < 0.01). Half a year after the cessation of the atropine treatment, myopia progression (rebound effect) was measured at −0.241 ± 0.35 D and −0.178 ± 0.34 D in the A0.01% and A0.01% + DFCL groups, respectively. Conclusions: Monotherapy low-dose atropine, combined with peripheral blur contact lenses, was clinically effective in decreasing myopia progression. A low rebound effect was found after the therapy cessation. In this retrospective study, combination therapy did not present an advantage over monotherapy.
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Yang J, Wu S, Zhang C, Yu W, Dai R, Chen Y. Global trends and frontiers of research on pathologic myopia since the millennium: A bibliometric analysis. Front Public Health 2022; 10:1047787. [PMID: 36561853 PMCID: PMC9763585 DOI: 10.3389/fpubh.2022.1047787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 11/10/2022] [Indexed: 12/12/2022] Open
Abstract
Background and purpose Pathologic myopia (PM) is an international public health issue. This study aimed to analyze PM research trends by reporting on publication trends since 2000 and identifying influential journals, countries, authors, and keywords involved in PM. Methods A bibliometric analysis was performed to evaluate global production and development trends in PM since 2000 and the keywords associated with PM. Results A total of 1,435 publications were retrieved. PM has become a fascinating topic (with relative research interest ranging from 0.0018% in 2000 to 0.0044% in 2021) and a global public health issue. The top three countries with the highest number of publications were China, the USA, and Japan. The journals, authors, and institutions that published the most relevant literature came from these three countries. China exhibited the most rapid increase in the number of publications (from 0 in 2000 to 69 in 2021). Retina published the most papers on PM. Kyoko Ohno-Matsui and Tokyo Medical and Dental University contributed the most publications among authors and institutions, respectively. Based on keyword analysis, previous research emphasized myopic choroidal neovascularization and treatment, while recent hotspots include PM changes based on multimodal imaging, treatment, and pathogenesis. Keyword analysis also revealed that deep learning was the latest hotspot and has been used for the detection of PM. Conclusion Our results can help researchers understand the current status and future trends of PM. China, the USA, and Japan have the greatest influence, based on the number of publications, top journals, authors, and institutions. Current research on PM highlights the pathogenesis and application of novel technologies, including multimodal imaging and artificial intelligence.
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Affiliation(s)
- Jingyuan Yang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Shan Wu
- Department of Anaesthesiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Chenxi Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Weihong Yu
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Rongping Dai
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China
| | - Youxin Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China,Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China,*Correspondence: Youxin Chen
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Gao Y, Spiegel DP, Muzahid IAI, Lim EW, Drobe B. Spectacles with highly aspherical lenslets for myopia control do not change visual sensitivity in automated static perimetry. Front Neurosci 2022; 16:996908. [PMID: 36507344 PMCID: PMC9733526 DOI: 10.3389/fnins.2022.996908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022] Open
Abstract
Purpose Spectacle lenses with arrays of lenslets have gained popularity in myopia control due to their high efficacy, low impact on visual performance, and non-invasiveness. One of the questions regarding their impact on visual performance that still remain is that: do the lenslets impact visual field sensitivity? The current study aims to investigate the impact of wearing spectacle lenses with highly aspherical lenslets (HAL) on the visual field sensitivity. Methods An automated static perimetry test (Goldman perimeter target III) was employed to measure the detection sensitivity in the visual field. Targets were white light dots of various luminance levels and size 0.43°, randomly appearing at 76 locations within 30° eccentricity. Twenty-one adult subjects (age 23-61, spherical equivalent refractive error (SER) -8.75 D to +0.88 D) participated in the study. Sensitivities through two lenses, HAL and a single vision lens (SVL) as the control condition, were measured in random order. Results The mean sensitivity differences between HAL and SVL across the 76 tested locations ranged between -1.14 decibels (dB) and 1.28 dB. Only one location at 30° in the temporal visual field reached statistical significance (p < 0.00065) whereby the sensitivity increased by 1.1 dB with HAL. No significant correlation was found between the difference in sensitivity and age or SER. Such a difference is unlikely to be clinically relevant. Conclusion Compared to the SVL, the HAL did not change detection sensitivity to static targets in the whole visual field within 30° eccentricity.
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Martínez-Plaza E, Molina-Martín A, Arias-Puente A, Piñero DP. Clinical Validation of a New Optical Biometer for Myopia Control in a Healthy Pediatric Population. Children (Basel) 2022; 9. [PMID: 36360441 DOI: 10.3390/children9111713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 11/10/2022]
Abstract
To assess the clinical validation of the Myah device in a pediatric population by evaluating the repeatability of biometric evaluations and analyzing its agreement with the Myopia Master system. A total of 51 children (51 eyes) were enrolled. Repeated measurements of flat (K1) and steep (K2) corneal radius, white-to-white (WTW) distance and axial length (AL) were performed with the Myah device. The same parameters were obtained from a subgroup (30 eyes) with the Myopia Master for the agreement analysis. The repeatability was assessed using the intrasubject standard deviation (Sw) and the intraclass correlation coefficient (ICC). The agreement was analyzed using the Bland−Altman method and the paired Student t-test. The Sw was 0.018 D, 0.021 D, 0.071 mm and 0.017 mm for K1, K2, WTW and AL, respectively (ICC ≥ 0.971). The mean difference and limits of agreement when comparing instruments were −0.013 (−0.102/0.077) for K1 (p = 0.16), −0.058 (−0.127/0.012) for K2 (p < 0.001), 0.151 (−0.370/0.673) for WTW (p < 0.001) and 0.030 (−0.091/0.151) for AL (p = 0.009). In conclusion, the Myah device provides consistent measurements of corneal radius, WTW distance and AL in a healthy pediatric population, validating their usefulness in clinical practice. These measurements could be used interchangeably with those provided by the Myopia Master device, although with some caution.
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