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Kobia-Acquah E, Flitcroft DI, Lingham G, Kerin E, Loughman J. Short-term effects of cyclopentolate and tropicamide eye drops on macular choroidal thickness in myopic children. Ophthalmic Physiol Opt 2024; 44:280-291. [PMID: 38037443 DOI: 10.1111/opo.13256] [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: 08/11/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND To investigate the short-term effects of cyclopentolate and tropicamide eyedrops on choroidal thickness (ChT) in myopic children using placebo or low-dose atropine eyedrops. METHODS The analysis included 242 myopic individuals (7-19 years) enrolled in two randomised placebo-controlled clinical trials of low-dose atropine eyedrops. Cycloplegia was induced using either one drop of 1% cyclopentolate (n = 161), two drops of 1% cyclopentolate (n = 32) or two drops of 1% tropicamide (n = 49). ChT measurements were taken using swept-source optical coherence tomography before and 30 min after administering the cycloplegic eye drops. A subset of 51 participants underwent test-retest measurements prior to cycloplegia. RESULTS Mean changes in subfoveal ChT after two drops of tropicamide and one and two drops of cyclopentolate were -2.5 μm (p = 0.10), -4.3 μm (p < 0.001) and -9.6 μm (p < 0.001), respectively. Subfoveal ChT changes after one and two drops of cyclopentolate were significantly greater than the test-retest changes (test-retest mean change: -3.1 μm; p < 0.05), while the tropicamide group was not significantly different (p = 0.64). Choroidal thinning post-cyclopentolate was not significantly different between atropine and placebo treatment groups (p > 0.05 for all macular locations). The coefficient of repeatability (CoR) in the tropicamide group (range: 8.2-14.4 μm) was similar to test-retest (range: 7.5-12.2 μm), whereas greater CoR values were observed in the cyclopentolate groups (one drop: range: 10.8-15.3 μm; two drops: range: 12.2-24.6 μm). CONCLUSIONS Cyclopentolate eye drops caused dose-dependent choroidal thinning and increased variation in pre- to post-cycloplegia measurements compared with test-retest variability, whereas tropicamide did not. These findings have practical implications for ChT measurements when cyclopentolate is used, particularly for successive measurements.
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Affiliation(s)
- Emmanuel Kobia-Acquah
- Centre for Eye Research Ireland, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - Daniel Ian Flitcroft
- Centre for Eye Research Ireland, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
- Department of Ophthalmology, Children's Health Ireland at Temple Street Hospital, Dublin, Ireland
| | - Gareth Lingham
- Centre for Eye Research Ireland, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - Eoin Kerin
- Centre for Eye Research Ireland, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - James Loughman
- Centre for Eye Research Ireland, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
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Abstract
Purpose: The present study was performed to compare the optical quality of the eyes of myopic children before and after treatment with atropine eye drops of different concentrations. Methods: In the study population of 71 patients (131 eyes), 34 patients (63 eyes) were given 0.01% atropine eye drops and 37 patients (68 eyes) were given 0.05% atropine eye drops. The modulation transfer function (MTF) cutoff frequency, Strehl ratio, objective scattering index (OSI), and predicted visual acuities (PVAs 100%, 20%, and 9%) under different lighting conditions were measured before and after two weeks of atropine treatment. Results: After using 0.05% atropine eye drops for two weeks, the Strehl ratio decreased from 0.27 ± 0.07 to 0.23 ± 0.07 (P = 0.0026), PVA 20% decreased from 1.15 ± 0.32 to 1.03 ± 0.36 (P = 0.0344), and PVA 9% decreased from 0.74 ± 0.23 to 0.64 ± 0.23 (P = 0.0073). The OSI was significantly higher after using 0.05% than 0.01% atropine eye drops (P = 0.0396), while both the Strehl ratio and PVA 20% were lower after using 0.05% than 0.01% atropine eye drops (P = 0.0087 and P = 0.0492, respectively). Conclusion: The children’s optical quality did not change significantly after using 0.01% atropine eye drops, whereas it decreased after using 0.05% atropine eye drops.
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Affiliation(s)
- Weiran Li
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Yiting Cao
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Jibo Zhou
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine; Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
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Sun CC, Liao GY, Liao LL, Chang LC. A Cooperative Management App for Parents with Myopic Children Wearing Orthokeratology Lenses: Mixed Methods Pilot Study. Int J Environ Res Public Health 2021; 18:10316. [PMID: 34639618 DOI: 10.3390/ijerph181910316] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/17/2021] [Accepted: 09/25/2021] [Indexed: 11/17/2022]
Abstract
Orthokeratology (OK) lens wear is an effective modality to inhibit axial elongation in myopic children. Willingness for commitment from both parents and children contributes to the success of OK treatment. We aimed to develop and assess the usability of a mobile application on OK lens wear by quantitatively and qualitatively evaluating parents with myopic children and eye care professionals (ECPs). Moreover, the preliminary outcome was also evaluated in this study. The app was developed and tested using a co-design approach involving key stakeholders. Two prototype tests were conducted during the feasibility and utility assessment. The app features include self-reported compliance documentation, analytics, and personalized and generalized messages for compliance behaviors of OK lenses. After the trial period, the full usage of app functions ranged from 40% to 60% among the enrolled parents. After app implementation, the compliance with follow-up visits substantially improved. Qualitative data show that the high-satisfaction app functions reported by parents were the app’s reminder and axial length recording, although it was recommended that the number of compliance questions should be reduced to minimize the survey completion time. Additionally, who should complete the recording of the axial length data as well as the management and reminder for the follow-up visit remained controversial. This is the first app developed to improve parents of myopic children’s compliance with OK lens wear and to assist ECPs and parents in collaboratively monitoring and managing the use and care of OK lenses among myopic children. This study highlights the importance of interdisciplinary collaboration in the design, development, and validation of such an app.
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Chen R, Chen Y, Lipson M, Kang P, Lian H, Zhao Y, McAlinden C, Huang J. The Effect of Treatment Zone Decentration on Myopic Progression during Or-thokeratology. Curr Eye Res 2020; 45:645-651. [PMID: 31560222 DOI: 10.1080/02713683.2019.1673438] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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: 01/12/2023]
Abstract
Purpose: To evaluate the relationship between magnitude of orthokeratology (OrthoK) treatment zone decentration and 2-year axial length (AL) elongation in myopic children.Methods: One-hundred and one Chinese children who wore OrthoK contact lenses for 2 years. The magnitude and direction of the OrthoK treatment zone center from the entrance pupil center were recorded after 3 and 24 months of lens wear along with AL measurement. Stepwise multiple linear regression analysis was performed to assess which factors significantly affected an increase in AL.Results: After 3 and 24 months of OrthoK treatment, the mean (± standard deviation [SD]) magnitude of the OrthoK treatment zone decentration was 0.64 ± 0.38 mm and 0.68 ± 0.32 mm, respectively. There were no significant differences between the two time points (P > .05). After 2 years of OrthoK contact lenses wear, the mean (± SD) AL growth was 0.36 ± 0.34 mm. The axial elongation was slightly correlated with baseline age of subjects (r = -0.073, P < .001), baseline spherical equivalent refractive error (r = -0.088, P < .001) and magnitude decentration of treatment zone (r = -0.190, P = .027).Conclusions: The decentration of OrthoK treatment zone stabilizes after 3 months of lens wear and slightly decreases AL growth.
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Affiliation(s)
- Ruru Chen
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China
| | - Yan Chen
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China
| | - Michael Lipson
- Department of Ophthalmology and Visual Science, University of Michigan, Northville, Michigan, USA
| | - Pauline Kang
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Hengli Lian
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China
| | - Yune Zhao
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China
| | - Colm McAlinden
- Department of Ophthalmology, Princess of Wales Hospital, Bridgend, UK
| | - Jinhai Huang
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China
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Yu X, Zhang B, Bao J, Zhang J, Wu G, Xu J, Zheng J, Drobe B, Chen H. Design, methodology, and baseline data of the Personalized Addition Lenses Clinical Trial (PACT). Medicine (Baltimore) 2017; 96:e6069. [PMID: 28296722 PMCID: PMC5369877 DOI: 10.1097/md.0000000000006069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The aim of this study was to describe the design, methods, and baseline characteristics of children enrolled in the Personalized Addition lenses Clinical Trial (PACT). PACT aims to test the myopia control efficacy of progressive addition lenses (PALs) with personalized addition values compared with standard (+2.00 D) addition PALs and single vision lenses (SVLs). METHODS PACT is a randomized, controlled, double-masked clinical trial. Two hundred eleven myopic Chinese children (7-12 years) were enrolled and randomized into 1 of the 3 following groups: personalized addition PALs; +2.00 addition PALs; and SVLs. Personalized addition values were determined based on the highest addition that satisfied Sheard criterion. Axial length and other biometric data were also recorded. RESULTS At baseline, no differences were found between the right and left eyes for any of the main parameters. The enrolled children were 9.7 ± 1.1 years' old with cycloplegic autorefraction (right eye [OD]: -2.36 ± 0.64 D), near phoria (1.0 ± 5.0 prism diopter esophoria), lag of accommodation (1.40 ± 0.50 D) and axial length (OD: 24.58 ± 0.74 mm). The personalized addition values ranged from +0.75 to +3.00 (average ± SD: 2.19 ± 0.73 D). CONCLUSION PACT is a clinical trial evaluating whether myopia progression in children can be slowed by wearing personalized addition PALs compared with fixed addition PALs and SVLs as measured by cycloplegic autorefraction and axial length. Baseline data were comparable with those of previous myopia control studies in children. Subjects will be followed up every 6 months for 2 years.
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Affiliation(s)
- Xinping Yu
- The Eye Hospital of Wenzhou Medical University
- WMU-Essilor international Research Centre
| | - Binjun Zhang
- The Eye Hospital of Wenzhou Medical University
- WMU-Essilor international Research Centre
| | - Jinhua Bao
- The Eye Hospital of Wenzhou Medical University
- WMU-Essilor international Research Centre
| | - Junxiao Zhang
- The Eye Hospital of Wenzhou Medical University
- WMU-Essilor international Research Centre
| | - Ge Wu
- The Eye Hospital of Wenzhou Medical University
- WMU-Essilor international Research Centre
| | - Jinling Xu
- The Eye Hospital of Wenzhou Medical University
- WMU-Essilor international Research Centre
| | - Jingwei Zheng
- The Eye Hospital of Wenzhou Medical University
- WMU-Essilor international Research Centre
| | - Björn Drobe
- WMU-Essilor international Research Centre
- R&D Asia, Essilor International, Wenzhou, Zhejiang, China
| | - Hao Chen
- The Eye Hospital of Wenzhou Medical University
- WMU-Essilor international Research Centre
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