1
|
Lal B, Alonso-Caneiro D, Read SA, Carkeet A. Repeatability of retinal and choroidal optical coherence tomography angiography indices in healthy children and young adults. Ophthalmic Physiol Opt 2024; 44:1114-1127. [PMID: 38923564 DOI: 10.1111/opo.13357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024]
Abstract
PURPOSE To evaluate the repeatability of retinal and choroidal optical coherence tomography angiography (OCT-A) indices among healthy children and compare it to healthy young adults. METHODS This prospective study captured 3 mm × 3 mm and 6 mm × 6 mm macular OCT-A scans including superficial and deep retinal layers, choriocapillaris and deep choroid over two visits, 1 week apart at approximately the same time of day, for 22 healthy adults (18-30 years) and 21 children (6-15 years). Magnification and projection-artefact corrected indices extracted using a custom image analysis program and individual biometry were compared between visits using Bland-Altman analysis and intraclass correlation (ICC). Retinal indices included foveal avascular zone metrics, perfusion and vessel density and choroidal indices included choriocapillaris flow deficit metrics and deep choroid perfusion density, in the foveal, parafoveal and perifoveal regions. Repeatability between adults and children was compared with F-test. RESULTS Bland-Altman analysis showed that the mean differences between repeated OCT-A indices were not significantly different from zero for either of the zones, layers and scan sizes in the two age groups (p > 0.05) except for foveal vessel density and foveal avascular zone perimeter (p = 0.04 for both) of 6-mm-deep retinal layer scans. The ICC ranged between 0.67 and 0.99. Significantly higher variability between visits (p < 0.05) in the indices was noted among adults than children, especially for choroidal indices of larger scan size. CONCLUSION The retinal and choroidal OCT-A indices in the foveal, parafoveal and perifoveal zones were repeatable in healthy children except for the foveal vessel density and foveal avascular zone perimeter of the 6-mm-deep retinal layer, which exhibited statistically borderline differences between visits. The adult group showed more variability between visits compared to children, especially in the larger scan size for choroidal OCT-A indices.
Collapse
Affiliation(s)
- Barsha Lal
- Centre for Vision and Eye Research, Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Australia
| | - David Alonso-Caneiro
- Centre for Vision and Eye Research, Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Australia
| | - Scott A Read
- Centre for Vision and Eye Research, Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Australia
| | - Andrew Carkeet
- Centre for Vision and Eye Research, Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Australia
| |
Collapse
|
2
|
Qiu T, Fang Q, Tian X, Feng Z, Cao Y, Li Y, Tu Y, Bai J, Liu Y. Postnatal nighttime light exposure and infant temperament at age 12 months: mediating role of genus Akkermansia. Eur Child Adolesc Psychiatry 2024; 33:2413-2425. [PMID: 38691180 DOI: 10.1007/s00787-024-02445-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/19/2024] [Indexed: 05/03/2024]
Abstract
The gut microbiome has been reported to be associated with nighttime light (NTL) exposure and temperament. However, the specific role of infant gut microbiome plays in NTL exposure and temperament is unclear. This study investigated the potential mediating role of infants' gut microbiome in correlations between NTL exposure and temperament. Demographic information, stool samples, and temperament scores were collected from 40 infants. Temperament was evaluated using the Infants Behavior Questionnaire-Revised (IBQ-R). The gut microbiota was analyzed using 16S rRNA sequencing. Cumulative and lagged effects of NTL exposure were calculated based on residential address (NTLpoint) and a concentric 1 km radius buffer zone around the address (NTL1000m), respectively. Mediation models were utilized for assessing the mediating effects of the gut microbiome. The gut microbiome of infants with higher fear scores was characterized by a higher abundance of Akkermansia and Clostridium_sensu_stricto_1 and a lower abundance of Bacteroides. Mediation models indicated Akkermansia played a full mediating role in associations between NTLpoint, NTL1000m and fear in specific time periods. Genus Akkermansia explained 24.46% and 33.50% of associations between fear and cumulative exposure to NTLpoint and NTL1000m, respectively. This study provides evidence for the mediating role of Akkermansia between NTL exposure and fear. However, further experimental is required to elucidate the mechanisms through which the gut microbiome mediates between NTL exposure and temperament in infants.
Collapse
Affiliation(s)
- Tianlai Qiu
- Center for Women's and Children's Health Research, Wuhan University School of Nursing; Research Center for Lifespan Health, Wuhan University, 169 Donghu Road, Wuhan, 430071, China
| | - Qingbo Fang
- Center for Women's and Children's Health Research, Wuhan University School of Nursing; Research Center for Lifespan Health, Wuhan University, 169 Donghu Road, Wuhan, 430071, China
| | - Xuqi Tian
- Center for Women's and Children's Health Research, Wuhan University School of Nursing; Research Center for Lifespan Health, Wuhan University, 169 Donghu Road, Wuhan, 430071, China
| | - Zijun Feng
- Center for Women's and Children's Health Research, Wuhan University School of Nursing; Research Center for Lifespan Health, Wuhan University, 169 Donghu Road, Wuhan, 430071, China
| | - Yanan Cao
- Center for Women's and Children's Health Research, Wuhan University School of Nursing; Research Center for Lifespan Health, Wuhan University, 169 Donghu Road, Wuhan, 430071, China
| | - Yanting Li
- Center for Women's and Children's Health Research, Wuhan University School of Nursing; Research Center for Lifespan Health, Wuhan University, 169 Donghu Road, Wuhan, 430071, China
| | - Yiming Tu
- Center for Women's and Children's Health Research, Wuhan University School of Nursing; Research Center for Lifespan Health, Wuhan University, 169 Donghu Road, Wuhan, 430071, China
| | - Jinbing Bai
- Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA, 30322, USA
| | - Yanqun Liu
- Center for Women's and Children's Health Research, Wuhan University School of Nursing; Research Center for Lifespan Health, Wuhan University, 169 Donghu Road, Wuhan, 430071, China.
| |
Collapse
|
3
|
Gopalakrishnan A, Sivaraman V, Hussaindeen JR, Swaminathan M, Gentle A, Armitage JA, Backhouse S. Ocular Biometry Percentile Curves and Their Relation to Myopia Development in Indian Children. J Clin Med 2024; 13:2867. [PMID: 38792406 PMCID: PMC11122416 DOI: 10.3390/jcm13102867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/29/2024] [Accepted: 05/04/2024] [Indexed: 05/26/2024] Open
Abstract
Background: The aim of the present study was to provide ocular biometry percentile values for Indian children between the ages of 6 and 12 and to validate the usefulness of centiles in predicting myopia development. Methods: The study was part of a longitudinal study-the Sankara Nethralaya Tamil Nadu Essilor Myopia Study (STEM), where objective refraction and ocular biometry were measured for children studying in grades 1, 4, and 6 at baseline (2019-2020). These data were used to generate ocular biometry percentile curves (both for axial length (AL) and AL/corneal curvature (AL/CR) ratios). The usefulness of percentile values in predicting myopia development was estimated from follow-up data (2022). Results: The total number of children in the three grades at baseline was 4514 (age range 6 to 12). Boys represented 54% (n = 2442) of the overall sample. The prevalence of myopia at baseline was 11.7% (95% CI from 10.8 to 12.7%) in these three grades. Both the AL and AL/CR ratio centiles showed a linear trend with an increase in AL and AL/CR with increasing grades (p < 0.001) for all percentiles (2, 5, 10, 25, 50, 75, 90, 95, 98, and 99) when stratified by sex. In the follow-up data (n = 377), the 75th and 50th percentiles of the AL/CR ratio had an area under the curve (AUC) of 0.79 and 0.72 to predict myopia onset for grade 4 and 6 children at baseline. Combining baseline AL with the centile shift in follow-up as a predictor increased the AUC to 0.83. Conclusions: The present study has provided centile values specific for Indian children between the ages of 6 and 12 to monitor and intervene where children are at a higher risk of myopia development.
Collapse
Affiliation(s)
- Aparna Gopalakrishnan
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai 600006, India; (V.S.); (J.R.H.); (M.S.)
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, VIC 3216, Australia; (A.G.); (J.A.A.); (S.B.)
- R&D, EssilorLuxottica, Singapore 339338, Singapore
| | - Viswanathan Sivaraman
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai 600006, India; (V.S.); (J.R.H.); (M.S.)
| | - Jameel Rizwana Hussaindeen
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai 600006, India; (V.S.); (J.R.H.); (M.S.)
| | - Meenakshi Swaminathan
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai 600006, India; (V.S.); (J.R.H.); (M.S.)
| | - Alex Gentle
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, VIC 3216, Australia; (A.G.); (J.A.A.); (S.B.)
| | - James A. Armitage
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, VIC 3216, Australia; (A.G.); (J.A.A.); (S.B.)
| | - Simon Backhouse
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, VIC 3216, Australia; (A.G.); (J.A.A.); (S.B.)
| |
Collapse
|
4
|
Moore M, Lingham G, Flitcroft DI, Loughman J. Myopia progression patterns among paediatric patients in a clinical setting. Ophthalmic Physiol Opt 2024; 44:258-269. [PMID: 38062894 DOI: 10.1111/opo.13259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/10/2023] [Accepted: 11/21/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE This retrospective analysis of electronic medical record (EMR) data investigated the natural history of myopic progression in children from optometric practices in Ireland. METHODS The analysis was of myopic patients aged 7-17 with multiple visits and not prescribed myopia control treatment. Sex- and age-specific population centiles for annual myopic progression were derived by fitting a weighted cubic spline to empirical quantiles. These were compared to progression rates derived from control group data obtained from 17 randomised clinical trials (RCTs) for myopia. Linear mixed models (LMMs) were used to allow comparison of myopia progression rates against outputs from a predictive online calculator. Survival analysis was performed to determine the intervals at which a significant level of myopic progression was predicted to occur. RESULTS Myopia progression was highest in children aged 7 years (median: -0.67 D/year) and progressively slowed with increasing age (median: -0.18 D/year at age 17). Female sex (p < 0.001), a more myopic SER at baseline (p < 0.001) and younger age (p < 0.001) were all found to be predictive of faster myopic progression. Every RCT exhibited a mean progression higher than the median centile observed in the EMR data, while clinic-based studies more closely matched the median progression rates. The LMM predicted faster myopia progression for patients with higher baseline myopia levels, in keeping with previous studies, which was in contrast to an online calculator that predicted slower myopia progression for patients with higher baseline myopia. Survival analysis indicated that at a recall period of 12 months, myopia will have progressed in between 10% and 70% of children, depending upon age. CONCLUSIONS This study produced progression centiles of untreated myopic children, helping to define the natural history of untreated myopia. This will enable clinicians to better predict both refractive outcomes without treatment and monitor treatment efficacy, particularly in the absence of axial length data.
Collapse
Affiliation(s)
- Michael Moore
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland
| | - Gareth Lingham
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia
| | - Daniel I Flitcroft
- Centre for Eye Research Ireland, School of Physics, 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, Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland
| |
Collapse
|
5
|
Lal B, Cantrell A, Ostrin LA. Repeatability and agreement of the MYAH and Lenstar. Optom Vis Sci 2024; 101:157-163. [PMID: 38546757 PMCID: PMC10987055 DOI: 10.1097/opx.0000000000002113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
SIGNIFICANCE Validation of new biometry instruments against the gold standard and establishing repeatability are important before being utilized for clinical and research applications. PURPOSE This study aimed to investigate intersession repeatability of the MYAH optical biometer and corneal topographer and examine agreement with the Lenstar LS900 optical biometer in healthy young adults. METHODS Forty participants (mean age, 25.2 ± 3.1 years) presented for two visits, 2 to 4 days apart. At each visit, measurements for right eyes were collected with the MYAH and Lenstar LS 900 and included axial length, corneal power, white-to-white distance, and pupil diameter. Bland-Altman analysis was used to assess the intrasession agreement between the MYAH and Lenstar for each parameter and intersession repeatability for the two devices. For each device, coefficient of variation and intraclass correlation coefficient were calculated, and paired t tests between visits were performed to assess intersession repeatability. RESULTS Good agreement (mean difference [95% limits of agreement]) between the MYAH and Lenstar was found for axial length (-0.01 [-0.07 to 0.04] mm), corneal power (-0.02 D [-0.15 to 0.19 d]), white-to-white distance (-0.13 [-0.43 to 0.17] mm), and pupil diameter (-0.27 [-0.79 to 1.33] mm). The limits of agreement, coefficient of variations, and intraclass correlation coefficients for MYAH-measured parameters were -0.04 to 0.04, 0.06%, and >0.99 for axial length; -0.24 to 0.19, 0.18%, and >0.99 for corneal power; -1.05 to 1.15, 0.57%, and 0.96 for white-to-white distance; and -0.17 to 0.21, 7.0%, and 0.76 for pupil diameter, with no significant difference between visits (p>0.05 for all), indicating good intersession repeatability. Similar intersession repeatability was also noted for Lenstar. CONCLUSIONS Findings show good intersession repeatability of the MYAH and good agreement with the Lenstar for axial length, corneal power, and white-to-white distance in young adults. Pupil diameter was more variable, likely due to the dynamic nature of the pupil. This study provides validation and supports the use of the MYAH for ocular biometry.
Collapse
Affiliation(s)
| | - Amy Cantrell
- University of Houston College of Optometry, Houston, Texas
| | - Lisa A Ostrin
- University of Houston College of Optometry, Houston, Texas
| |
Collapse
|
6
|
Bullimore MA, Brennan NA. Juvenile-onset myopia-who to treat and how to evaluate success. Eye (Lond) 2024; 38:450-454. [PMID: 37709925 PMCID: PMC10858167 DOI: 10.1038/s41433-023-02722-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 07/26/2023] [Accepted: 08/25/2023] [Indexed: 09/16/2023] Open
Abstract
The risk of eye diseases such as myopic macular degeneration increases with the level of myopia, but there is no safe level of myopia and the burden of lower degrees of myopia remains considerable. Effective treatments are available that slow progression and thus limit the final degree of myopia. In this review, the rationale for slowing progression is summarized, and a case made for treating all myopic children. Measurement of refractive error and axial length is reviewed, stressing the precision of optical biometry, but also the need for cycloplegic autorefraction. The factors influencing progression are considered and the available tools for interpretation of progression rate are discussed. Finally, the need to set attainable treatment goals is emphasized.
Collapse
|
7
|
Bao WW, Zhao Y, Dadvand P, Jiang N, Chen G, Yang B, Huang W, Xiao X, Liang J, Chen Y, Huang S, Pu X, Huang S, Lin H, Guo Y, Dong G, Chen Y. Urban greenspace and visual acuity in schoolchildren: a large prospective cohort study in China. ENVIRONMENT INTERNATIONAL 2024; 184:108423. [PMID: 38241831 DOI: 10.1016/j.envint.2024.108423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/28/2023] [Accepted: 01/03/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND Greenspace is known to have a positive impact on human health and well-being, but its potential effects on visual acuity have not been extensively studied. OBJECTIVES Our aim was to examine the relationship between long-term greenspace exposure and visual acuity in children, while also exploring the potential mechanisms in this association. METHODS We conducted this prospective cohort study based on the Children's growth environment, lifestyle, physical, and mental health development project (COHERENCE), which screened 286,801 schoolchildren in Guangzhou, China, starting in the 2016/17 academic year and followed them up for three academic years (2017/18-2019/20). Visual acuity was measured using a standardized logarithmic chart, and visual impairment was defined as visual acuity worse than 0.0 logarithm of the minimum angle of resolution (LogMAR) units in the better eye. We used the Normalized Difference Vegetation Index (NDVI), the Soil-Adjusted Vegetation Index (SAVI), and the Enhanced Vegetation Index (EVI) to assess the greenspace surrounding child's geocoded home and school at each visit. RESULTS Our analysis indicated that higher greenspace exposure was associated with greater visual acuity z-score at baseline and with slower decline in visual acuity z-score during the 3-year follow-up. An interquartile range increase in home-school-based NDVI 300m was associated with a 7% decrease [hazard ratios (HRs): 0.93, 95% confidence interval (CI): 0.92, 0.94] in the risk of visual impairment. We also found that air pollution, physical activity, outdoor time, and recreational screen time partially mediated the greenspace-visual acuity association. CONCLUSION Our findings suggest that increasing greenspace exposure could benefit children's visual acuity development and reduce the risk of visual impairment by reducing air pollution and recreational screen time while increasing physical activity and outdoor time. All results could have potential policy implications, given the individual and societal burdens associated with visual impairment.
Collapse
Affiliation(s)
- Wen-Wen Bao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yu Zhao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain, CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Nan Jiang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Boyi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Wenzhong Huang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Xiang Xiao
- Department of Geography, Hong Kong Baptist University, Hong Kong SAR; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, China
| | - Jinghong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yican Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Shan Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xueya Pu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Shaoyi Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Haotian Lin
- Zhongshan Ophthalmic Centre, Sun Yat-sen University, 7# Jinsui Road, Guangzhou, 510623, China
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Guanghui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
| |
Collapse
|
8
|
Dang J, Cai S, Zhong P, Liu Y, Shi D, Chen Z, Chen M, Dong Y, Ma J, Song Y, Lau PWC, Stafford RS. Associations of school physical activity environment with comorbid obesity and myopia in children and adolescents: Findings from a Chinese national follow-up study. Scand J Med Sci Sports 2024; 34:e14562. [PMID: 38268065 DOI: 10.1111/sms.14562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/18/2023] [Accepted: 01/02/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Overweight and obesity (OWOB) and myopia have become two of the most important issues affecting the health of children and adolescents worldwide. Despite the recognition that the school physical activity (PA) environment is a critical factor for preventing and controlling overweight, obesity (OWOB), and myopia in children and adolescents, research on OWOB and myopia as a comorbidity remains unexplored, with evidence for effective strategies still being inconclusive. Hence, this study aimed to assess the prevalence and progression of comorbid OWOB/myopia and each condition alone, and to explore the association with school PA environment. METHODS A total of 9814 children and adolescents aged 6-18 years were included from the Chinese National Survey on Students' Constitution and Health follow-up survey conducted from November 2019 to November 2020 in China. Anthropometric measurements, unaided distance vision acuity and non-cycloplegic refraction data were collected to assess OWOB and myopia, while eight indicators from questionnaires for children and adolescents aged 9-18 years were investigated to assess school PA environment. We calculated the one-year incidence and progression rates of comorbid OWOB/myopia, OWOB alone, and myopia alone. Mixed effect logistic regression was evaluated the association between school PA environment and incidence and progression of comorbid OWOB/myopia, OWOB, and myopia. RESULTS The prevalence of comorbid OWOB/myopia increased from 11.1% in 2019 to 17.9% in 2020, and the incidence of comorbid OWOB/myopia was 10.9%. Children and adolescents experiencing an unfavorable school PA environment had a higher risk of the incidence of comorbid OWOB/myopia compared to a favorable school environment (OR = 1.85, 95% CI: 1.42-2.42). Similar findings were seen in the incidence of obesity (OR = 1.86, 95% CI: 1.26-2.75). Children and adolescents in an unfavorable school PA environment had a higher risk of myopia progression (OR = 1.29, 95% CI: 1.01-1.65). CONCLUSIONS Obesity and myopia and their comorbidity have been serious among children and adolescents in China. A favorable school PA environment might mitigate the risk of comorbid OWOB/myopia, OWOB, and myopia progression.
Collapse
Affiliation(s)
- Jiajia Dang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Shan Cai
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Panliang Zhong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yunfei Liu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Di Shi
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Ziyue Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Manman Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Patrick W C Lau
- Department of Sport, Physical Education & Health, Hong Kong Baptist University, Hong Kong, SAR, China
- Laboratory of Exercise Science and Health, BNU-HKBU United International College, Zhuhai, China
| | - Randall S Stafford
- Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
| |
Collapse
|
9
|
Sanz Diez P, Ohlendorf A, Barraza-Bernal MJ, Kratzer T, Wahl S. Evaluating the impact of COVID-19 pandemic-related home confinement on the refractive error of school-aged children in Germany: a cross-sectional study based on data from 414 eye care professional centres. BMJ Open 2023; 13:e071833. [PMID: 37989374 PMCID: PMC10668271 DOI: 10.1136/bmjopen-2023-071833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/22/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE This study aimed at evaluating refractive changes in German school-aged children before and after the COVID-19 pandemic. DESIGN Cross-sectional study. SETTING 414 eye care professional centres from Germany. PARTICIPANTS Refractive data from 59 926 German children aged 6-15 years were examined over a 7-year period (2015-2021). PRIMARY AND SECONDARY OUTCOME MEASURES Spherical equivalent refraction was assessed as a function of year, age and gender. The refractive values concerning 2020 and 2021 were compared with those assigned to prior years (2015-2019). RESULTS The refractive data associated with 2020 and 2021 showed a myopic refractive shift of approximately -0.20D compared with the 2015-2019 range. The refractive change was statistically considerable in the 6 to 11-year range (p<0.05), while from 12 to 15 years was negligible (p≥0.10). Percentage of myopes was also impacted in 2021 (p=0.002), but not in 2020 (p=0.25). From 6 to 11 years, the percentage of myopes in 2021 increased significantly by 6.02% compared with the 2015-2019 range (p≤0.04). The highest percentage increase occurred at 8 and 10 years of age, showing a rise of 7.42% (p=0.002) and 6.62% (p=0.005), respectively. From 12 to 15 years, there was no significant increase in the percentage of myopes in 2021 (p≥0.09). Percentage of myopes in 2020 was not influenced at any age (p≥0.06). CONCLUSION Disruption of normal lifestyle due to pandemic-related home confinement appears to lead to a myopic refractive shift in children aged 6-11 years in Germany. The greater effect observed at younger ages seems to emphasise the importance of refractive development in this age group.
Collapse
Affiliation(s)
- Pablo Sanz Diez
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Germany
- Technology and Innovation, Carl Zeiss Vision International GmbH, Aalen, Germany
| | - Arne Ohlendorf
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Germany
- Technology and Innovation, Carl Zeiss Vision International GmbH, Aalen, Germany
| | | | - Timo Kratzer
- Technology and Innovation, Carl Zeiss Vision GmbH, Aalen, Germany
| | - Siegfried Wahl
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Germany
- Technology and Innovation, Carl Zeiss Vision International GmbH, Aalen, Germany
| |
Collapse
|
10
|
Oke I, Nihalani BR, VanderVeen DK. Axial length and corneal curvature of normal eyes in the first decade of life. Eur J Ophthalmol 2023; 33:2217-2221. [PMID: 37093758 DOI: 10.1177/11206721231167643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
BACKGROUND/AIMS To establish normative curves for axial length and corneal curvature in the first decade of life. METHODS This is a cross-sectional study from a single institution in the United States. Children from 0- to 10-years of age with no underlying ocular pathology were prospectively enrolled to obtain ultrasound biometry and hand-held keratometry while under anaesthesia for an unrelated procedure. Older cooperative children had optical biometry obtained in-office. Logarithmic quantile regression models were used to determine the change in axial length and average keratometry as a function of age. RESULTS Single-eye measurements from 100 children were included. 75% of children were White and 49% female. Median axial length ranged from 20.6 mm (IQR, 20.2 to 21.1 mm) at age one year to 23.1 mm (IQR, 22.5 to 23.8 mm) at age ten years. Median average keratometry ranged from 44.1 D (IQR, 42.6 to 45.4 D) at age one year to 43.5 (IQR, 42.2 to 44.0 D) at age ten years. As age increased, there was a significant increase in axial length (0.74 mm per doubling of age; 95% CI, 0.62 to 0.82 mm), and a non-significant trend towards lower average keratometry (-0.21 D per doubling of age; 95% CI, -0.62 to 0.08 D). CONCLUSIONS We provide a set of normative charts for axial length and corneal curvature which may facilitate the identification of eyes outside the normal range and assist in the management of ocular conditions such as glaucoma or cataract.
Collapse
Affiliation(s)
- Isdin Oke
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Bharti R Nihalani
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Deborah K VanderVeen
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
11
|
Wang B, Watt K, Chen Z, Kang P. Predicting the child who will become myopic - can we prevent onset? Clin Exp Optom 2023; 106:815-824. [PMID: 37194117 DOI: 10.1080/08164622.2023.2202306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 04/06/2023] [Indexed: 05/18/2023] Open
Abstract
Myopia has become a global epidemic with significant public health impacts. Identifying the child at risk of developing myopia, i.e. the pre-myopic child and implementing strategies to prevent the onset of myopia, could significantly reduce the burden of myopia on an individual and society. This paper is a review of publications that have identified ocular characteristics of children at risk of future myopia development including a lower than age normal amount of hyperopia and accelerated axial length elongation. Risk factors associated with increased risk of myopia development such as education exposure and reduced outdoor time, and strategies that could be implemented to prevent myopia onset in children are also explored. The strong causal role of education and outdoor time on myopia development suggests that lifestyle modifications could be implemented as preventative measures to at-risk children and may significantly impact the myopia epidemic by preventing or delaying myopia onset and its associated ocular health consequences.
Collapse
Affiliation(s)
- Bingjie Wang
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Kathleen Watt
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Zhi Chen
- Department of Ophthalmology, Fudan University Eye and ENT Hospital, Shanghai, China
| | - Pauline Kang
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| |
Collapse
|
12
|
Barraza-Bernal MJ, Ohlendorf A, Sanz Diez P, Feng X, Yang LH, Lu MX, Wahl S, Kratzer T. Prediction of refractive error and its progression: a machine learning-based algorithm. BMJ Open Ophthalmol 2023; 8:e001298. [PMID: 37793703 PMCID: PMC10551949 DOI: 10.1136/bmjophth-2023-001298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 09/07/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVE Myopia is the refractive error that shows the highest prevalence for younger ages in Southeast Asia and its projection over the next decades indicates that this situation will worsen. Nowadays, several management solutions are being applied to help fight its onset and development, nonetheless, the applications of these techniques depend on a clear and reliable assessment of risk to develop myopia. METHODS AND ANALYSIS In this study, population-based data of Chinese children were used to develop a machine learning-based algorithm that enables the risk assessment of myopia's onset and development. Cross-sectional data of 12 780 kids together with longitudinal data of 226 kids containing age, gender, biometry and refractive parameters were used for the development of the models. RESULTS A combination of support vector regression and Gaussian process regression resulted in the best performing algorithm. The Pearson correlation coefficient between prediction and measured data was 0.77, whereas the bias was -0.05 D and the limits of agreement was 0.85 D (95% CI: -0.91 to 0.80D). DISCUSSION The developed algorithm uses accessible inputs to provide an estimate of refractive development and may serve as guide for the eye care professional to help determine the individual best strategy for management of myopia.
Collapse
Affiliation(s)
| | - Arne Ohlendorf
- Technology and Innovation, Carl Zeiss Vision International GmbH, Aalen, Germany
| | | | - Xiancai Feng
- Myopia Prevention and Management, Carl Zeiss Shanghai Co Ltd, Shanghai, China
| | - Li-Hua Yang
- Wuhan Center for Adolescent Poor Vision Prevention and Control, Wuhan, China
| | - Mei-Xia Lu
- Wuhan Commission of Experts for the Prevention and Control of Adolescent Poor Vision, Wuhan, China
| | | | - Timo Kratzer
- Technology and Innovation, Carl Zeiss Vision GmbH, Aalen, Germany
| |
Collapse
|
13
|
Naduvilath T, He X, Xu X, Sankaridurg P. Normative data for axial elongation in Asian children. Ophthalmic Physiol Opt 2023; 43:1160-1168. [PMID: 37132642 DOI: 10.1111/opo.13159] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 04/03/2023] [Accepted: 04/19/2023] [Indexed: 05/04/2023]
Abstract
AIM To determine the influence of refractive error (RE), age, gender and parental myopia on axial elongation in Chinese children and to develop normative data for this population. METHODS This is a retrospective analysis of eight longitudinal studies conducted in China between 2007 and 2017. Data of 4701 participants aged 6-16 years with spherical equivalent from +6 to -6D contributed to one, two or three annualised progression data resulting in a dataset of 11,262 eyes of 26.6%, 14.8% and 58.6% myopes, emmetropes and hyperopes, respectively. Longitudinal data included axial length and cycloplegic spherical equivalent RE. Axial elongation was log-transformed to develop an exponential model with generalised estimating equations including main effects and interactions. Model-based estimates and their confidence intervals (CIs) are reported. RESULTS Annual axial elongation decreased significantly with increasing age, with the rate of decrease specific to the RE group. Axial elongation in myopes was higher than in emmetropes and hyperopes but these differences reduced with age (0.58, 0.45 and 0.27 mm/year at 6 years and 0.13, 0.06 and 0.05 mm/year at 15 years for myopes, emmetropes and hyperopes, respectively). The rate of elongation in incident myopes was similar to that in myopes at baseline (0.33 vs. 0.34 mm/year at 10.5 years; p = 0.32), while it was significantly lower in non-myopes (0.20 mm/year at 10.5 years, p < 0.001). Axial elongation was greater in females than in males and in those with both parents myopic compared with one or no myopic parent, with larger differences in non-myopes than in myopes (p < 0.01). CONCLUSIONS Axial elongation varied with age, RE, gender and parental myopia. Estimated normative data with CIs could serve as a virtual control group.
Collapse
Affiliation(s)
- Thomas Naduvilath
- Brien Holden Vision Institute (BHVI), Sydney, New South Wales, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Xiangui He
- Shanghai Eye Disease Prevention and Treatment Centre, Shanghai Eye Hospital, Shanghai Vision Health Centre & Shanghai Children Myopia Institute, Shanghai, China
| | - Xun Xu
- Shanghai Eye Disease Prevention and Treatment Centre, Shanghai Eye Hospital, Shanghai Vision Health Centre & Shanghai Children Myopia Institute, Shanghai, China
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute (BHVI), Sydney, New South Wales, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
14
|
Gisbert S, Wahl S, Schaeffel F. L-opsin expression in chickens is similarly reduced with diffusers and negative lenses. Vision Res 2023; 210:108272. [PMID: 37269575 DOI: 10.1016/j.visres.2023.108272] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 06/05/2023]
Abstract
Previous studies have shown that the expression of L- and M-opsins was reduced in chicken retina when eyes were covered with diffusers. The purpose of the current study was to find out whether this is a result of altered spatial processing during development of deprivation myopia or merely a consequence of light attenuation by the diffusers. Therefore, retinal luminances were matched by neutral density filters in fellow eyes that served as controls for diffuser-treated eyes. Furthermore, the effects of negative lenses on opsins expression were studied. Chickens wore diffusers or -7D lenses for a period of 7 days and refractive state and ocular biometry were measured at the beginning and at the end of the experiment. Retinal tissue was extracted from both eyes to quantify L-, M- and S-opsins expression by qRT-PCR. It was found that L-opsin expression was significantly lower in eyes wearing diffusers, compared to fellow eyes covered with neutral density filters. Interestingly, L-opsin was also reduced in eyes wearing negative lenses. In summary, this study shows that L-opsin expression is reduced due to the loss of high spatial frequencies and general contrast reduction in the retinal image, rather than by a decline in retinal luminance. Moreover, the fact that L-opsin was similarly reduced in eyes treated with negative lenses and diffusers suggests the existence of a common pathway for emmetropization, but it could also be just a consequence of reduced high spatial frequencies and lower contrast.
Collapse
Affiliation(s)
- Sandra Gisbert
- Carl Zeiss Vision International GmbH, Technology, and Innovation, Turnstrasse 27, 73430 Aalen, Germany; Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Strasse 7, 72076 Tuebingen, Germany.
| | - Siegfried Wahl
- Carl Zeiss Vision International GmbH, Technology, and Innovation, Turnstrasse 27, 73430 Aalen, Germany; Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Strasse 7, 72076 Tuebingen, Germany
| | - Frank Schaeffel
- Carl Zeiss Vision International GmbH, Technology, and Innovation, Turnstrasse 27, 73430 Aalen, Germany; Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Strasse 7, 72076 Tuebingen, Germany; Institute of Molecular and Clinical Ophthalmology Basel, Mittlere Strasse 91, CH-4031 Basel, Switzerland
| |
Collapse
|
15
|
Nilagiri VK, Lee SSY, Lingham G, Charng J, Yazar S, Hewitt AW, Griffiths LR, Sanfilippo PG, Tsai TH, Mackey DA. Distribution of Axial Length in Australians of Different Age Groups, Ethnicities, and Refractive Errors. Transl Vis Sci Technol 2023; 12:14. [PMID: 37594450 PMCID: PMC10445212 DOI: 10.1167/tvst.12.8.14] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/06/2023] [Indexed: 08/19/2023] Open
Abstract
Purpose Treatments are available to slow myopic axial elongation. Understanding normal axial length (AL) distributions will assist clinicians in choosing appropriate treatment for myopia. We report the distribution of AL in Australians of different age groups and refractive errors. Methods Retrospectively collected spherical equivalent refraction (SER) and AL data of 5938 individuals aged 5 to 89 years from 8 Australian studies were included. Based on the SER, participants were classified as emmetropes, myopes, and hyperopes. Two regression model parameterizations (piece-wise and restricted cubic splines [RCS]) were applied to the cross-sectional data to analyze the association between age and AL. These results were compared with longitudinal data from the Raine Study where the AL was measured at age 20 (baseline) and 28 years. Results A piece-wise regression model (with 1 knot) showed that myopes had a greater increase in AL before 18 years by 0.119 mm/year (P < 0.001) and after 18 years by 0.011 mm/year (P < 0.001) compared to emmetropes and hyperopes, with the RCS model (with 3 knots) showing similar results. The longitudinal data from the Raine Study revealed that, when compared to emmetropes, only myopes showed a significant change in the AL in young adulthood (by 0.016 mm/year, P < 0.001). Conclusions The AL of myopic eyes increases more rapidly in childhood and slightly in early adulthood. Further studies of longitudinal changes in AL, particularly in childhood, are required to guide myopia interventions. Translational Relevance The axial length of myopic eyes increases rapidly in childhood, and there is a minimal increase in the axial length in non-myopic eyes after 18 years of age.
Collapse
Affiliation(s)
- Vinay Kumar Nilagiri
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Samantha Sze-Yee Lee
- 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, School of Physics, Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland
| | - Jason Charng
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
- Department of Optometry, School of Allied Health, University of Western Australia, Perth, Western Australia, Australia
| | - Seyhan Yazar
- Garvan-Weizmann Centre for Cellular Genomics, Garvan Institute of Medical Research, Sydney, Australia
| | - Alex W. Hewitt
- School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Tasmania, Australia
- Centre for Eye Research Australia, University of Melbourne, Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Lyn R. Griffiths
- Genomics Research Centre, Centre for Genomics and Personalised Health, School of Biomedical Sciences, Queensland University of Technology, Queensland, Australia
| | - Paul G. Sanfilippo
- Centre for Eye Research Australia, University of Melbourne, Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Tzu-Hsun Tsai
- Department of Ophthalmology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
| | - David A. Mackey
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
- School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Tasmania, Australia
| |
Collapse
|
16
|
Mahmoud O, Andrews C, Soeken T, Nallasamy S, Nallasamy N. Optical Biometry Changes Throughout Childhood and Adolescence in Patients Wearing Ortho-K Lenses. Clin Ophthalmol 2023; 17:1919-1927. [PMID: 37425028 PMCID: PMC10329451 DOI: 10.2147/opth.s413810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/08/2023] [Indexed: 07/11/2023] Open
Abstract
Background Orthokeratology has been shown to suppress progressive myopia in some children. We examine the changes in optical biometry parameters in orthokeratology (Ortho-K) patients, in a retrospective longitudinal study at a tertiary eye care center in Ann Arbor, MI, USA. Methods Optical biometry measurements obtained with the Lenstar LS 900 (Haag-Streit USA Inc, EyeSuite software version i9.1.0.0) were aggregated from 170 patients who had undergone Ortho-K for myopia correction between 5 and 20 years of age. Pre-intervention biometry measurements were compared with follow-up measurements done 6-18 months after initiation of Ortho-K. Linear mixed models were used to quantify associations in biometry changes with age of intervention allowing for correlation between measurements on two eyes of the same patient. Results A total of 91 patients were included in the study. Axial length increased through the age of 15.7 ± 0.84 years for Ortho-K patients at our center. The growth curve in our Ortho-K population was comparable to previously published normal growth curves in Wuhan and Germany populations. Corneal thickness and keratometry decreased at a stable rate regardless of age of intervention (-7.9 µm, 95% CI [-10.2, -5.7], p < 0.001). Conclusion In our population, Ortho-K did not appear to affect the overall trajectory of axial length progression when compared to normal growth curves, despite showing a previously described reduction in corneal thickness. As Ortho-K has been shown to have varying effects that differ from individual to individual, it continues to be important to reassess its effects on new populations to better understand its ideal uses.
Collapse
Affiliation(s)
- Ossama Mahmoud
- Kellogg Eye Center Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
- School of Medicine, Wayne State University, Detroit, MI, USA
| | - Chris Andrews
- Kellogg Eye Center Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Timothy Soeken
- Kellogg Eye Center Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Sudha Nallasamy
- The Vision Center, Children’s Hospital Los Angeles, Los Angeles, CA, USA
- USC Roski Eye Institute, Keck School of Medicine of the University of Southern California, LA, California, USA
| | - Nambi Nallasamy
- Kellogg Eye Center Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
17
|
Huang Z, Zhao W, Mao YZ, Hu S, Du CX. Factors influencing axial elongation in myopic children using overnight orthokeratology. Sci Rep 2023; 13:7715. [PMID: 37173387 PMCID: PMC10182044 DOI: 10.1038/s41598-023-34580-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
Several factors influence axial length in children with myopia treated using overnight orthokeratology. To identify these factors, this retrospective study collected axial length and corneal aberration data on 78 eyes before and 1-year after orthokeratology. Patients were divided according to axial elongation (cut-off, 0.25 mm/year). Baseline characteristics included age, sex, spherical equivalent refraction, pupil diameter, axial length, and orthokeratology lens type. Corneal shape effects were compared through tangential difference maps. Group differences in higher-order aberrations of a 4 mm zone were compared at baseline and 1-year following therapy. Binary logistic regression analysis was conducted to identify the variables determined for axial elongation. Significant differences between both groups included the initial age of wearing orthokeratology lenses, type of orthokeratology lens, size of central flattening area, corneal total surface C12 (1-year), corneal total surface C8 (1-year), corneal total surface spherical aberration (SA) (1-year root mean square [RMS] values), change in total corneal surface C12, and change in front and total corneal surface SA (RMS values). The age when wearing an orthokeratology lens was the most important factor influencing axial length in children with orthokeratology-treated myopia, followed by lens type and change in the C12 of the total corneal surface.
Collapse
Affiliation(s)
- Zhu Huang
- Department of Ophthalmology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Wei Zhao
- College of Medicine, Zhejiang University, Hangzhou, 310030, China
| | - Ying-Zheng Mao
- College of Medicine, Zhejiang University, Hangzhou, 310030, China
| | - Shan Hu
- Department of Ophthalmology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Chi-Xin Du
- Department of Ophthalmology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, China.
| |
Collapse
|
18
|
Vera-Diaz FA, Jnawali A, Panorgias A, Bex PJ, Kerber KL. Baseline metrics that may predict future myopia in young children. Ophthalmic Physiol Opt 2023; 43:466-481. [PMID: 36892148 PMCID: PMC10416753 DOI: 10.1111/opo.13113] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 03/10/2023]
Abstract
PURPOSE We used baseline data from the PICNIC longitudinal study to investigate structural, functional, behavioural and heritable metrics that may predict future myopia in young children. METHODS Cycloplegic refractive error (M) and optical biometry were obtained in 97 young children with functional emmetropia. Children were classified as high risk (HR) or low risk (LR) for myopia based on parental myopia and M. Other metrics included axial length (AXL), axial length/corneal radius (AXL/CR) and refractive centile curves. RESULTS Based on the PICNIC criteria, 46 children (26 female) were classified as HR (M = +0.62 ± 0.44 D, AXL = 22.80 ± 0.64 mm) and 51 (27 female) as LR (M = +1.26 ± 0.44 D, AXL = 22.77 ± 0.77 mm). Based on centiles, 49 children were HR, with moderate agreement compared with the PICNIC classification (k = 0.65, p < 0.01). ANCOVA with age as a covariate showed a significant effect for AXL (p < 0.01), with longer AXL and deeper anterior chamber depth (ACD) (p = 0.01) in those at HR (differences AXL = 0.16 mm, ACD = 0.13 mm). Linear regression models showed that central corneal thickness (CCT), ACD, posterior vitreous depth (PVD) (=AXL - CCT - ACD-lens thickness (LT)), corneal radius (CR) and age significantly predicted M (R = 0.64, p < 0.01). Each 1.00 D decrease in hyperopia was associated with a 0.97 mm elongation in PVD and 0.43 mm increase in CR. The ratio AXL/CR significantly predicted M (R = -0.45, p < 0.01), as did AXL (R = -0.25, p = 0.01), although to a lesser extent. CONCLUSIONS Although M and AXL were highly correlated, the classification of pre-myopic children into HR or LR was significantly different when using each parameter, with AXL/CR being the most predictive metric. At the end of the longitudinal study, we will be able to assess the predictability of each metric.
Collapse
Affiliation(s)
| | | | | | - Peter J. Bex
- College of Science, Northeastern University, Boston, Massachusetts, USA
| | | |
Collapse
|
19
|
Pedersen HR, Svarverud E, Hagen LA, Gilson SJ, Baraas RC. Comparing ocular biometry and autorefraction measurements from the Myopia Master with the IOLMaster 700 and the Huvitz HRK-8000A autorefractor. Ophthalmic Physiol Opt 2023; 43:410-417. [PMID: 36734669 DOI: 10.1111/opo.13101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/23/2022] [Accepted: 01/13/2023] [Indexed: 02/04/2023]
Abstract
PURPOSE To compare axial length (AL) and corneal radius (CR) measured with the Oculus Myopia Master and the Zeiss IOLMaster 700, and cycloplegic refractive error measured with the Myopia Master and the Huvitz Auto Ref/Keratometer (HRK-8000A). METHODS The study included both eyes of 74 participants (16 male), with a mean (SD) age of 22.8 (3.7) years. The parameters indicated were measured under cycloplegia with these instruments: Myopia Master (AL, CR and refractive error), IOLMaster 700 (AL and CR) and HRK-8000A (refractive error and CR). Bland-Altman plots with mixed effects 95% limits of agreement (LoA) and corresponding 95% confidence intervals were used to assess the agreement in ocular biometry between the Myopia Master and the IOLMaster 700, and for refractive error between the Myopia Master and the HRK-8000A. RESULTS The analysis included 139 eyes, of which 52 were myopic (spherical equivalent refractive error, SER ≤ -0.50 D), 32 emmetropic and 55 hyperopic (SER ≥ 0.50 D). The 95% LoA for AL between the Myopia Master and IOLMaster 700 was -0.097 to 0.089 mm. There was no mean difference in AL [mean (SD) = -0.004 (0.047) mm, p = 0.34]. There was a significant difference in mean CR, with that measured with the Myopia Master being flatter than that found with the IOLMaster 700 [0.035 (0.028) mm, p < 0.001]. The 95% LoA for CR was -0.02 to 0.09 mm. Compared with HRK-8000A, the Myopia Master measured a significantly more negative SER [-0.19 (0.33) D, p < 0.001], with 95% LoA of -0.86 to 0.46 D. CONCLUSION The LoA for measurements of SER, CR and AL when comparing the Myopia Master with the HRK-8000A and the IOLMaster 700 were wider than deemed acceptable for making direct comparisons. This indicates that the instruments cannot be used interchangeably in clinical practice or research.
Collapse
Affiliation(s)
- Hilde R Pedersen
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Ellen Svarverud
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Lene A Hagen
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Stuart J Gilson
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| |
Collapse
|
20
|
He X, Sankaridurg P, Naduvilath T, Wang J, Xiong S, Weng R, Du L, Chen J, Zou H, Xu X. Normative data and percentile curves for axial length and axial length/corneal curvature in Chinese children and adolescents aged 4-18 years. Br J Ophthalmol 2023; 107:167-175. [PMID: 34531198 PMCID: PMC9887397 DOI: 10.1136/bjophthalmol-2021-319431] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 09/01/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE To develop age-specific and gender-specific reference percentile charts for axial length (AL) and AL/corneal radius of curvature (AL/CR) and, to use percentiles to determine probability of myopia and estimate refractive error (RE). METHODS Analysis of AL, cycloplegic RE and CR of 14 127 Chinese participants aged 4-18 years from 3 studies. AL and AL/CR percentiles estimated using Lambda-Mu-Sigma method and compared for agreement using intraclass correlation (ICC). Logistic regression was used to model risk of myopia based on age, gender, AL and AL/CR percentiles. Accuracy of AL progression and RE estimated using percentiles was validated using an independent sample of 5742 eyes of children aged 7-10 years. RESULTS Age-specific and gender-specific AL and AL/CR (3rd, 5th, 10th, 25th, 50th, 75th, 90th and 95th) percentiles are presented. Concordance between AL and AL/CR percentiles improved with age (0.13 at 4 years to >0.75 from 13 years) and a year-to-year change was observed for all except <10th percentile from 15 years. Increasing age, AL and AL/CR was associated with a more myopic RE (r2=0.45,0.70 and 0.83, respectively). The sensitivity and specificity of the model to estimate probability of myopia was 86.0% and 84.5%, respectively. Estimation of 1-year change in AL using percentiles correlated highly with actual AL (ICC=0.98). Concordance of estimated to actual RE was high (ICC=0.80) and within ±0.50D and ±1.0D of actual RE for 47.4% and 78.9% of eyes, respectively. CONCLUSION Age-specific and gender-specific AL and AL/CR percentiles provide reference data, aid in identifying and monitoring individuals at risk of myopia and have utility in screening for myopia. AL/CR percentiles were more accurate in estimating probability of myopia in younger children.
Collapse
Affiliation(s)
- Xiangui He
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Center of Eye Shanghai Key Laboratory of Ocular Fundus Disease, Shanghai, China,National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute, Sydney, New South Wales, Australia,School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Thomas Naduvilath
- Brien Holden Vision Institute, Sydney, New South Wales, Australia,School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Jingjing Wang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Center of Eye Shanghai Key Laboratory of Ocular Fundus Disease, Shanghai, China,National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Shuyu Xiong
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Center of Eye Shanghai Key Laboratory of Ocular Fundus Disease, Shanghai, China,National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Rebecca Weng
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
| | - Linlin Du
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Center of Eye Shanghai Key Laboratory of Ocular Fundus Disease, Shanghai, China,National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Jun Chen
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Center of Eye Shanghai Key Laboratory of Ocular Fundus Disease, Shanghai, China,National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Haidong Zou
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Center of Eye Shanghai Key Laboratory of Ocular Fundus Disease, Shanghai, China,National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Xun Xu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Center of Eye Shanghai Key Laboratory of Ocular Fundus Disease, Shanghai, China,National Clinical Research Center for Eye Diseases, Shanghai, China
| |
Collapse
|
21
|
Tuncer Orhan F, Gursoy HH. A Proposed Method for Estimating Refractive Error in Primary School Children. Cureus 2023; 15:e34554. [PMID: 36879692 PMCID: PMC9985458 DOI: 10.7759/cureus.34554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Background This study aimed to evaluate consecutive measurements of biometric parameters, age, and refraction in a cohort of Turkish primary school-age children and to assess the correlation between biometric changes and refraction. Methodology The study population was seven and 12-year-old children (n = 197). The retrieved data consisted of three consecutive measurements with a one-year interval for each subject. Data from one eye (right) were used. Age, gender, body mass index, spherical equivalent (SE), axial length (AL), anterior chamber depth (ACD), central corneal thickness (CCT), keratometry (K), and lens thickness (LT) were analyzed. The onset and final data were retrieved from the database in 2013 and 2016, respectively. Statistically, logistic and Cox regression models of all parameters were analyzed, and the significance level was set at 5%. Results The median of the onset and final SE values were -0.00 D (0.00-0.00) and 0.50 D (0.19-1.00), respectively. The onset AL (hazard ratio (HR) = 5.82, 95% confidence interval (CI) = 3.45-9.76, β = 1.76, p < 0.001), Kmean (HR = 2.28, 95% CI = 1.67-3.11, β = 0.82, p < 0.001), and age (HR = 0.77, 95% CI = 0.59-0.99, β = -0.26, p = 0.046) were correlated with myopia progression. To calculate the estimated SE, the onset data were included in the logistic regression model. The onset SE (β = 0.916, p < 0.001), AL (β = -0.451, p < 0.001), ACD (β = 0.430, p = 0.005), and K (β = -0.172, p < 0.001) were correlated with the mean final SE. An equation was generated using the regression model analysis. Conclusions The onset parameters of SE, AL, ACD, and K were confirmed to correlate with the final SE values in the proposed model. To confirm the use of the refractive calculator, a cross-validation analysis is needed to estimate three-year subsequent refractive error among seven and 12-year-old children.
Collapse
|
22
|
Zhou X, Fan F, Liu X, Yang J, Yang T, Luo Y. The impact of pre-operative axial length on myopic shift 3 years after congenital and developmental cataract surgery and intraocular lens implantation. Front Med (Lausanne) 2023; 9:1093276. [PMID: 36714118 PMCID: PMC9874092 DOI: 10.3389/fmed.2022.1093276] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/28/2022] [Indexed: 01/12/2023] Open
Abstract
Purpose To investigate the impact of the pre-operative axial length (AL) on myopic shift (MS) 3 years after primary intraocular lens (IOL) implantation in congenital/developmental cataract patients. Methods A retrospective study of patients who underwent congenital/developmental cataract surgery and primary IOL implantation at age 2-3 years at EENT Hospital was conducted. All patients were followed up regularly for at least 3 years after surgery. Refractive outcomes, including spherical equivalent (SE) and MS, were collected at each follow-up. Results Forty eyes from 40 patients were included. The mean age at surgery was 2.56 ± 0.57 years old, and the mean follow-up time was 3.05 ± 0.22 years. Patients were divided into two groups: Group 1 included 20 patients with longer pre-operative ALs (≥22 mm), and Group 2 included 20 patients with average pre-operative ALs (<22 mm). By the last follow-up, the MS was 2.13 (0.38, 2.63) D in Group 1 and 3.88 (2.85, 5.72) D in Group 2. The post-operative MS in Group 2 was statistically greater than that in Group 1 at 3 years after surgery (P < 0.001). Conclusion In congenital/developmental cataract patients who underwent cataract extraction and primary IOL implantation at age 2-3 years, eyes with longer pre-operative ALs had a slower MS than those with average pre-operative ALs 3 years after surgery. This finding could have implications for the target refraction decision in congenital/developmental cataract surgery.
Collapse
|
23
|
Huang L, Chen X, Lin J, Fan X, Chen T, Yu Y, Chen J, Hu J. Association between sleep duration and myopia among Chinese children during the COVID-19 pandemic: A cross-sectional study. Front Public Health 2023; 10:1015138. [PMID: 36699911 PMCID: PMC9868807 DOI: 10.3389/fpubh.2022.1015138] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
Background The studies on the association between sleep duration and myopia are limited, and the evidence is inconsistent. This study aimed to evaluate the association between sleep duration and myopia, cycloplegic spherical equivalent (SE) and axial length (AL) among Chinese children during the Corona Virus Disease 2019 (COVID-19) pandemic. Methods The study was a cross-sectional study on Chinese children aged 6-18 years. The comprehensive ophthalmic examinations for children included cycloplegic SE, AL, and standardized questionnaires. The questionnaire included sleep duration, parental myopia, outdoor time, and continuous near work duration without breaks. Myopia was defined as SE ≤-0.50 diopters (D). Results A total of 1,140 children were included in the analyses, with 84.7% of myopic children and 74.4% of children's daily sleep duration being more than 8 h/d. In univariate regression analysis, compared with sleep duration < 8 h/d, children with sleep duration of 8-9 and >9 h/d were less myopia (p < 0.01 for all), and had less myopic SE (p < 0.01 for all), and shorter AL (p < 0.01 for all). After adjusting for age, gender, parental myopia, outdoor time, and continuous near work duration without breaks, sleep duration was not associated with myopia, cycloplegic SE, and AL (p > 0.05 for all). Conclusions This study showed sleep duration was related to myopia, cycloplegic SE, and AL among Chinese children during the COVID-19 pandemic-related lifestyles, but no independent association.
Collapse
Affiliation(s)
- Luoming Huang
- Department of Ophthalmology and Optometry, The School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, China,The Research Center for Juvenile Myopia Prevention and Control of Fujian Province, Fuzhou, China
| | - Xuelan Chen
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China,The Research Center for Juvenile Myopia Prevention and Control of Fujian Province, Fuzhou, China,Engineering Research Center of Assistive Technology for Visual Impairment, Fujian Province University, Quanzhou, China
| | - Jiajia Lin
- Eye Institute and Affiliated Xiamen Eye Center of Xiamen University, Xiamen, China
| | | | - Ting Chen
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China,The Research Center for Juvenile Myopia Prevention and Control of Fujian Province, Fuzhou, China,Engineering Research Center of Assistive Technology for Visual Impairment, Fujian Province University, Quanzhou, China
| | - Yang Yu
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China,The Research Center for Juvenile Myopia Prevention and Control of Fujian Province, Fuzhou, China,Engineering Research Center of Assistive Technology for Visual Impairment, Fujian Province University, Quanzhou, China
| | - Jiaxin Chen
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China,The Research Center for Juvenile Myopia Prevention and Control of Fujian Province, Fuzhou, China,Engineering Research Center of Assistive Technology for Visual Impairment, Fujian Province University, Quanzhou, China
| | - Jianmin Hu
- Department of Ophthalmology and Optometry, The School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, China,Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China,The Research Center for Juvenile Myopia Prevention and Control of Fujian Province, Fuzhou, China,Engineering Research Center of Assistive Technology for Visual Impairment, Fujian Province University, Quanzhou, China,*Correspondence: Jianmin Hu ✉
| |
Collapse
|
24
|
Lanca C, Repka MX, Grzybowski A. Topical Review: Studies on Management of Myopia Progression from 2019 to 2021. Optom Vis Sci 2023; 100:23-30. [PMID: 36705712 DOI: 10.1097/opx.0000000000001947] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
SIGNIFICANCE Myopia is a common eye condition that increases the risk of sight-threatening complications. Each additional diopter increases the chance of complications. The purpose of this review was to make an overview of myopia control treatment options for children with myopia progression.In this nonsystematic review, we searched PubMed and Cochrane databases for English-language studies published from 2019 to September 2021. Emphasis was given to selection of randomized controlled trials. Nineteen randomized controlled trials and two retrospective studies were included. Topical atropine and orthokeratology remain the most used treatments, whereas lenses with novel designs are emerging treatments. Overall myopia progression in the treatment groups for low-dose atropine and orthokeratology was lower than in the control groups, and their efficacy was reported in several randomized controlled trials and confirmed by various systematic reviews and meta-analysis. The findings of myopia progression and axial elongation for the MiSight, defocus incorporated multiple segment spectacle lens, highly aspherical lenslets, and diffusion optics technology spectacle lens were comparable. Public health interventions to optimize environmental influences may also be important strategies to control myopia. Optimal choice of management of myopia depends on treatment availability, acceptability to child and parents, and specific patient features such as age, baseline myopia, and lifestyle. Eye care providers need to understand the advantages and disadvantages of each therapy to best counsel parents of children with myopia.
Collapse
Affiliation(s)
| | - Michael X Repka
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | |
Collapse
|
25
|
Huang Z, Chen XF, He T, Tang Y, Du CX. Synergistic effects of defocus-incorporated multiple segments and atropine in slowing the progression of myopia. Sci Rep 2022; 12:22311. [PMID: 36566245 PMCID: PMC9789944 DOI: 10.1038/s41598-022-25599-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 12/01/2022] [Indexed: 12/25/2022] Open
Abstract
Myopia is a leading cause of visual impairment in young people worldwide. It sometimes increases the risk of blindness and reduces life quality. Previous reports have revealed the treatment effects of defocus-incorporated multiple segments (DIMS) and topical atropine (ATP) on myopia control. However, no study has evaluated these two interventions together. In this retrospective study, we aimed to determine whether the combination of DIMS lenses and 0.01% ATP can slow the progression of myopia compared with DIMS lenses or single vision (SV) lenses alone. We included 107 children with myopia who were treated with DIMS and 0.01% ATP combination (DIMS + ATP group), DIMS monotherapy (DIMS group), or a control group (SV group). We compared treatment effects among three groups in axial length and myopia progression. After a 1-year follow-up, the DIMS + ATP group showed a smaller change in axial length and myopia progression than the DIMS and SV groups (P < 0.05). Hence, combination treatment with DIMS and 0.01% ATP might be a better choice for children with myopia.
Collapse
Affiliation(s)
- Zhu Huang
- grid.13402.340000 0004 1759 700XDepartment of Ophthalmology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003 China ,grid.13402.340000 0004 1759 700XDepartment of Ophthalmology, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, 322000 China
| | - Xu-Fei Chen
- grid.13402.340000 0004 1759 700XDepartment of Ophthalmology, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, 322000 China
| | - Ting He
- grid.13402.340000 0004 1759 700XDepartment of Ophthalmology, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, 322000 China
| | - Yun Tang
- grid.13402.340000 0004 1759 700XDepartment of Ophthalmology, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, 322000 China
| | - Chi-Xin Du
- grid.13402.340000 0004 1759 700XDepartment of Ophthalmology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003 China ,grid.13402.340000 0004 1759 700XDepartment of Ophthalmology, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, 322000 China
| |
Collapse
|
26
|
Axial Length Shortening and Choroid Thickening in Myopic Adults Treated with Repeated Low-Level Red Light. J Clin Med 2022; 11:jcm11247498. [PMID: 36556114 PMCID: PMC9780890 DOI: 10.3390/jcm11247498] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/06/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022] Open
Abstract
This study aimed to explore the effect of repeated low-level red light (RLRL) on axial length (AL), choroid blood flow, and anterior segment components in myopic adults. Ninety-eight myopic adults were randomly divided into the RLRL group (n = 52) and the control group (n = 46). Subjects in the RLRL group completed a 4-week treatment composed of a 3-min RLRL treatment session twice daily, with an interval of at least 4 h. Visits were scheduled before and on 7, 14, 21, and 28 days after the treatment. AL, subfoveal choroidal thickness (SChT), choroidal vascularity index (CVI), and anterior segment parameters were measured at each visit. A linear mixed-effects model showed that the AL of the subjects in RLRL decreased from 24.63 ± 1.04 mm to 24.57 ± 1.04 mm, and the SChT thickened by 18.34 μm. CVI had a slight but significant increase in the 0-6 zone. However, all the anterior segment parameters did not change after RLRL treatment. Our study showed that the choroid's thickening is insufficient to explain the axial length shortening. The unchanged anterior segment and improved choroid blood flow suggest that the AL shortening in this study is mainly related to changes in the posterior segment.
Collapse
|
27
|
Gopalakrishnan A, Hussaindeen JR, Chaudhary R, Ramakrishnan B, Arunachalam S, Balakrishnan AC, Sri J S D, Sahoo M, S R, M V, S V, Narayanan A. Results of the School Children Ocular Biometry and Refractive Error Study in South India. Turk J Ophthalmol 2022; 52:412-420. [PMID: 36578223 PMCID: PMC9811226 DOI: 10.4274/tjo.galenos.2021.90008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objectives Axial length (AL) is an important contributor to refraction, and growth curves are gaining importance in the prediction of myopia. This study aimed to profile the distribution of ocular biometry parameters and to identify correlates of spherical equivalent refraction (SE) among school children in South India. Materials and Methods The School Children Ocular Biometry and Refractive Error study was conducted as part of a school screening program in southern India. The enrolled children underwent tests that included vison check, refraction, binocular vision assessment, and biometry measurements. Results The study included 1382 children whose mean (standard deviation [SD]) age was 10.18 (2.88) years (range: 5-16 years). The sample was divided into 4 groups (grades 1-2, grades 3-5, grades 6-9, and grade 10) based on significant differences in right AL (p<0.001). The mean (SD) AL (range: 20.33-27.27 mm) among the four groups was 22.50 (0.64) mm, 22.88 (0.69) mm, 23.30 (0.82) mm, and 23.58 (0.87) mm, respectively. The mean SE (range: +1.86 to -6.56 D) was 0.08 (0.65 D) in class 1 and decreased with increasing grade to -0.39 (1.20 D) in grade 10. There was a significant difference in all biometry parameters between boys and girls (p<0.001). Age, AL, and mean corneal curvature were the main predictors of SE. Conclusion This study provides a profile of ocular biometry parameters among school children in South India for comparison against profiles from other regions across the country. The study data will form a reference for future studies assessing myopia in this ethnicity.
Collapse
Affiliation(s)
- Aparna Gopalakrishnan
- *Srimathi Sundari Subramanian Department of Visual Psychophysics, Unit of Medical Research Foundation, Myopia Clinic, Chennai, India
| | - Jameel Rizwana Hussaindeen
- *Srimathi Sundari Subramanian Department of Visual Psychophysics, Unit of Medical Research Foundation, Myopia Clinic, Chennai, India,* Address for Correspondence: Srimathi Sundari Subramanian Department of Visual Psychophysics, Unit of Medical Research Foundation, Myopia Clinic, Chennai, India E-mail:
| | - Romans Chaudhary
- The Sankara Nethralaya Academy, Unit of Medical Research Foundation, Chennai, India
| | - Bhavatharini Ramakrishnan
- *Srimathi Sundari Subramanian Department of Visual Psychophysics, Unit of Medical Research Foundation, Myopia Clinic, Chennai, India
| | - Sushil Arunachalam
- *Srimathi Sundari Subramanian Department of Visual Psychophysics, Unit of Medical Research Foundation, Myopia Clinic, Chennai, India
| | | | - Deepika Sri J S
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
| | - Manaswini Sahoo
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
| | - Robin S
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
| | - Varsaharinya M
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
| | - Vishnupriya S
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
| | - Anuradha Narayanan
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
| |
Collapse
|
28
|
Xiao J, Liu M, Huang Q, Sun Z, Ning L, Duan J, Zhu S, Huang J, Lin H, Yang H. Analysis and modeling of myopia-related factors based on questionnaire survey. Comput Biol Med 2022; 150:106162. [PMID: 36252365 DOI: 10.1016/j.compbiomed.2022.106162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/12/2022] [Accepted: 10/01/2022] [Indexed: 11/03/2022]
Abstract
With the rapid development of science and technology, the trend of low age myopia is becoming increasingly significant. The latest national survey done by the Chinese government found that more than 80% of Chinese teenagers suffer from myopia. Adolescent myopia is closely related to living environment, heredity, and living habits. Quantifying the relationship between myopia and living environment, heredity, and living habits is conductive to the prevention and intervention of adolescent myopia. In this study, we investigated the relationships between four main factors (environment, habits, parental vision, and demographic) and myopia status by analyzing the questionnaire data. Data were collected from Chengdu, China in 2021, including 2808 myopia samples and 5693 non-myopia samples, with a total of 22 features. Then, these 22 features were inputted into three machine learning algorithms to discriminate the two classes of samples. Results show that the computational model could produce an AUC of 0.768. To pick out the most important features which play important roles in classification, we used incremental feature selection strategy to screen the 22 features. As a result, we found that the 4 most influential features with XGBoost could achieve a competitive AUC of 0.764. To further investigate the risk and protective factors affecting adolescent myopia, we used OR values derived from MLE-LR to analyze the relationship between 22 features and adolescent myopia. Results showed that the age variable was the most significant risk factor for myopia, followed by the myopia status of parents. The most protective factor for eyesight is the measure taken by the children, followed by the distance between books and eyes when reading. These discoveries can guide the prevention and control of myopia in children and adolescents.
Collapse
Affiliation(s)
- Jianqiang Xiao
- Eye School, Chengdu University of Traditional Chinese Medicine, Ineye Hospital of Chengdu University of TCM, China
| | - Mujiexin Liu
- Eye School, Chengdu University of Traditional Chinese Medicine, Ineye Hospital of Chengdu University of TCM, China
| | - Qinlai Huang
- School of Life Science and Technology, Center for Informational Biology, University of Electronic Science and Technology of China, Chengdu, 610054, China
| | - Zijie Sun
- School of Life Science and Technology, Center for Informational Biology, University of Electronic Science and Technology of China, Chengdu, 610054, China
| | - Lin Ning
- School of Healthcare Technology, Chengdu Neusoft University, Chengdu, 611844, China
| | - Junguo Duan
- Eye School, Chengdu University of Traditional Chinese Medicine, Ineye Hospital of Chengdu University of TCM, China
| | - Siquan Zhu
- Eye School, Chengdu University of Traditional Chinese Medicine, Ineye Hospital of Chengdu University of TCM, China
| | - Jian Huang
- School of Life Science and Technology, Center for Informational Biology, University of Electronic Science and Technology of China, Chengdu, 610054, China
| | - Hao Lin
- School of Life Science and Technology, Center for Informational Biology, University of Electronic Science and Technology of China, Chengdu, 610054, China.
| | - Hui Yang
- School of Life Science and Technology, Center for Informational Biology, University of Electronic Science and Technology of China, Chengdu, 610054, China; School of Computer Science, Chengdu University of Information Technology, Chengdu, 611844, China.
| |
Collapse
|
29
|
Zhou W, Li Q, Chen H, Liao Y, Wang W, Pei Y, Li S, Zhang W, Wang Q, Wang X. Trends of myopia development among primary and junior school students in the post-COVID-19 epidemic period. Front Public Health 2022; 10:970751. [PMID: 36267993 PMCID: PMC9577103 DOI: 10.3389/fpubh.2022.970751] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/16/2022] [Indexed: 01/25/2023] Open
Abstract
Purpose To investigate the trends of myopia among primary and junior school students in the post-COVID-19 epidemic period. Method A prospective of cross-sectional study using spot photoscreenings in 123,538 children among primary and junior school students from 2019 to 2021 was conducted to evaluate the development of myopia in Xuzhou, China in the post-COVID-19 epidemic period. Equivalent refraction and the prevalence of myopia were recorded. Results The spherical equivalent refraction of myopia decreased across all grades except grade 1 (0.23 ± 0.56 D in 2019, 0.24 ± 0.63 D in 2020) from 2019 to 2020. However, refraction exhibited a hyperopic shift in 2021 compared to 2020 for grades 1-5 (no significant decreased for grade 4). The prevalence of myopia in all grades increased in 2020 compared to 2019, and the most dramatic changes were observed from grades 2-5 and grades 7-8 (P < 0.05). The changes in myopia prevalence in grades 1-4 were mild, and the reduction in myopia for Grade 5 is significant from 2020 to 2021. Nevertheless, students in grades 6 and 9 exhibited the greatest growth in myopia prevalence (P < 0.01). All grades had higher myopia prevalence in 2021 compared with 2019, except grade 1 (P = 0.25). The prevalence of myopia in girls was higher compared with boys, and the urban myopia prevalence was higher than in rural areas over the 3 years except in 2019 (P = 0.18). Conclusions The prevalence of myopia increased during the COVID-19 epidemic. However, the spherical equivalent refraction of lower grade children drifted to hyperopia and the trends of myopia development remained stable in the post-COVID-19 epidemic period. We should be more concerned about the prevalence of myopia in graduating for the primary or junior grades in the future.
Collapse
Affiliation(s)
- Wen Zhou
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China
| | - Qin Li
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China
| | - Hongyan Chen
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China
| | - Ya Liao
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China
| | - Wei Wang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Yifei Pei
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, China
| | - Suyan Li
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China
| | - Wenxuan Zhang
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China
| | - Qian Wang
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China
| | - Xiaojuan Wang
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China,*Correspondence: Xiaojuan Wang
| |
Collapse
|
30
|
Pawar N, Maheshwari D, Meenakshi R. COVID-19 myopia, myopia of pandemic: Are we heading towards unpredictable high myopic era? Indian J Ophthalmol 2022; 70:3158-3160. [PMID: 35919004 DOI: 10.4103/ijo.ijo_2959_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Neelam Pawar
- Department of Pediatric Ophthalmology and Strabismus, Aravind Eye Hospital, Tirunelveli, Tamil Nadu, India
| | - Devendra Maheshwari
- Department of Pediatric Ophthalmology and Strabismus, Aravind Eye Hospital, Tirunelveli, Tamil Nadu, India
| | - R Meenakshi
- Department of Pediatric Ophthalmology and Strabismus, Aravind Eye Hospital, Tirunelveli, Tamil Nadu, India
| |
Collapse
|
31
|
Chen X, Xiong Y, Liu F, Wang J, Yang B, Liu L. Factors determining the myopia control effect of an orthokeratology lens: A two‐year multi‐level model. Ophthalmic Physiol Opt 2022; 42:786-796. [PMID: 35499112 DOI: 10.1111/opo.12990] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 03/28/2022] [Indexed: 02/05/2023]
Affiliation(s)
- Xiaohang Chen
- Department of Optometry and Visual Science, West China School of Medicine Sichuan University Chengdu China
- Laboratory of Optometry and Vision Sciences, West China Hospital Sichuan University Chengdu China
- Department of Ophthalmology, West China Hospital Sichuan University Chengdu China
| | - Yan Xiong
- Department of Pediatrics Affiliated Hospital of North Sichuan Medical University Nanchong China
| | - Fengyang Liu
- Department of Optometry Guizhou Provincial People's Hospital Guiyang China
| | - Jianglan Wang
- Department of Optometry and Visual Science, West China School of Medicine Sichuan University Chengdu China
- Laboratory of Optometry and Vision Sciences, West China Hospital Sichuan University Chengdu China
- Department of Ophthalmology, West China Hospital Sichuan University Chengdu China
| | - Bi Yang
- Department of Optometry and Visual Science, West China School of Medicine Sichuan University Chengdu China
- Laboratory of Optometry and Vision Sciences, West China Hospital Sichuan University Chengdu China
- Department of Ophthalmology, West China Hospital Sichuan University Chengdu China
| | - Longqian Liu
- Department of Optometry and Visual Science, West China School of Medicine Sichuan University Chengdu China
- Laboratory of Optometry and Vision Sciences, West China Hospital Sichuan University Chengdu China
- Department of Ophthalmology, West China Hospital Sichuan University Chengdu China
| |
Collapse
|
32
|
Myopia prediction: a systematic review. Eye (Lond) 2022; 36:921-929. [PMID: 34645966 PMCID: PMC9046389 DOI: 10.1038/s41433-021-01805-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 08/21/2021] [Accepted: 10/01/2021] [Indexed: 11/08/2022] Open
Abstract
Myopia is a leading cause of visual impairment and has raised significant international concern in recent decades with rapidly increasing prevalence and incidence worldwide. Accurate prediction of future myopia risk could help identify high-risk children for early targeted intervention to delay myopia onset or slow myopia progression. Researchers have built and assessed various myopia prediction models based on different datasets, including baseline refraction or biometric data, lifestyle data, genetic data, and data integration. Here, we summarize all related work published in the past 30 years and provide a comprehensive review of myopia prediction methods, datasets, and performance, which could serve as a useful reference and valuable guideline for future research.
Collapse
|
33
|
Sanz Diez P, Yang LH, Lu MX, Kiess W, Wahl S. LMS parameters, percentile, and Z-score growth curves for axial length in Chinese schoolchildren in Wuhan. Sci Rep 2022; 12:4850. [PMID: 35318391 PMCID: PMC8941183 DOI: 10.1038/s41598-022-08907-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/10/2022] [Indexed: 11/09/2022] Open
Abstract
Understanding the ocular structural changes are fundamental to defining strategies for myopia prevention and management. This study aimed to establish age-gender specific normative LMS parameters for axial length to generate percentile and Z-score growth curves in a population of Chinese schoolchildren. A total of 14,760 individuals aged 6 to 15 years from Wuhan, central China, contributed to this study. The LMS method was used for the calculation of LMS parameters and the generation of percentile and Z-score growth curves for axial length. Growth curves derived from the LMS parameters were compared with those originally calculated. Axial elongation was age- and percentile-dependent. The highest elongation rate occurred at the 98th percentile in the range 6 to 9 years, being up to 1.46 mm in boys and 1.42 mm in girls. The largest differences between original and newly generated growth curves were detected at the 98th percentile at age 15; 0.78 mm (females) and 0.63 mm (males). Multinomial logistic regression and receiver operating characteristic analyses revealed Z-scores as a good predictor for estimating high myopia development. The axial length growth curves presented in this study provide a technically solid instrument that depicts the best description of physiological eye growth for Chinese schoolchildren aged 6 to 15 years.
Collapse
Affiliation(s)
- Pablo Sanz Diez
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Strasse 7, 72076, Tuebingen, Germany. .,Carl Zeiss Vision International GmbH, Technology and Innovation, Turnstrasse 27, 73430, Aalen, Germany.
| | - Li-Hua Yang
- Wuhan Center for Adolescent Poor Vision Prevention and Control, Wuhan, China
| | - Mei-Xia Lu
- Wuhan Commission of Experts for the Prevention and Control of Adolescent Poor Vision, Wuhan, China.,Department of Epidemiology and Statistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wieland Kiess
- Leipzig Research Center for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany.,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Leipzig, Germany.,Center for Pediatric Research, Leipzig University, Leipzig, Germany
| | - Siegfried Wahl
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Strasse 7, 72076, Tuebingen, Germany.,Carl Zeiss Vision International GmbH, Technology and Innovation, Turnstrasse 27, 73430, Aalen, Germany
| |
Collapse
|
34
|
Mu J, Zhong H, Liu M, Jiang M, Shuai X, Chen Y, Long W, Zhang S. Trends in Myopia Development Among Primary and Secondary School Students During the COVID-19 Pandemic: A Large-Scale Cross-Sectional Study. Front Public Health 2022; 10:859285. [PMID: 35392469 PMCID: PMC8980682 DOI: 10.3389/fpubh.2022.859285] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 02/21/2022] [Indexed: 12/28/2022] Open
Abstract
ObjectivesTo evaluate myopia development among primary and secondary school students during the coronavirus 2019 (COVID-19) pandemic.MethodsA cross-sectional study was conducted to evaluate the development of myopia among students in Shenzhen, China during the COVID-19 outbreak.ResultsThe study included 1,472,957 and 1,573,824 students in 2019 and 2020, respectively. The prevalence of myopia was 46.9 and 50.5% in 2019 and 2020, respectively. The prevalence of myopia among students in the former Shenzhen Special Economic Zone (SEZ) was higher than that in areas outside the former Shenzhen SEZ (2019: 47.0 vs. 43.7%; 2020: 50.5 vs. 47.3%). The prevalence of myopia among girls was higher than that among boys (2019: 50.4 vs. 44.0%; 2020: 54.0 vs. 47.6%). The 50th percentile (P50) of spherical equivalent refraction (SER) in the right eye among girls was lower than that in boys. The prevalence of myopia continued to increase as the grade increased, with the greatest annual increase observed in Grades 2–5 (3.4–3.9%). The P50 of SER in the right eye of students decreased as the grade increased.ConclusionsThe prevalence of myopia among students increased during the COVID-19 pandemic, especially in primary school Grades 2–5.
Collapse
Affiliation(s)
- Jingfeng Mu
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Shenzhen Eye Hospital affiliated to Jinan University, Shenzhen, China
- School of Optometry, Shenzhen University, Shenzhen, China
| | - Haoxi Zhong
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Shenzhen Eye Hospital affiliated to Jinan University, Shenzhen, China
- School of Optometry, Shenzhen University, Shenzhen, China
| | - Meizhou Liu
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Shenzhen Eye Hospital affiliated to Jinan University, Shenzhen, China
- School of Optometry, Shenzhen University, Shenzhen, China
| | - Mingjie Jiang
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Shenzhen Eye Hospital affiliated to Jinan University, Shenzhen, China
- School of Optometry, Shenzhen University, Shenzhen, China
| | - Xinyi Shuai
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Shenzhen Eye Hospital affiliated to Jinan University, Shenzhen, China
- School of Optometry, Shenzhen University, Shenzhen, China
| | - Yanjie Chen
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Shenzhen Eye Hospital affiliated to Jinan University, Shenzhen, China
- School of Optometry, Shenzhen University, Shenzhen, China
| | - Wen Long
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Shenzhen Eye Hospital affiliated to Jinan University, Shenzhen, China
- School of Optometry, Shenzhen University, Shenzhen, China
| | - Shaochong Zhang
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Shenzhen Eye Hospital affiliated to Jinan University, Shenzhen, China
- School of Optometry, Shenzhen University, Shenzhen, China
- *Correspondence: Shaochong Zhang
| |
Collapse
|
35
|
Liang JH, Chen YC, Zhao Y, Kakaer A, Jiang N, Huang S, Zhang SX, Chen YJ. Prevalence of Visual Impairment Among Students Before and During the COVID-19 Pandemic, Findings From 1,057,061 Individuals in Guangzhou, Southern China. Front Pediatr 2022; 9:813856. [PMID: 35223714 PMCID: PMC8875203 DOI: 10.3389/fped.2021.813856] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 12/27/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Visual impairment (VI) is a growing public health concern among students as a result of the COVID-19 pandemic. OBJECTIVE This study investigated the change in VI before and during the pandemic among students. METHODS Data on 547,864 and 497,371 students were obtained from the Guangzhou Survey on Students' Constitution and Health (GSSCH) collected in October 2019 and October 2020, respectively. VI was defined as the unaided distance visual acuity lower than 20/25 Snellen equivalent (LogMAR 0.10) in the worse eye. Change in VI based on age and sociodemographic variables were evaluated by chi-square test for trend as appropriate. Comparisons of different categorical variables were tested by contingency tables-based chi-square test. We have further analysis of the students who went through both of the 2019 and 2020 examinations for evaluating the VI incidence during the COVID-19 pandemic. RESULTS More than 1,045,235 students were involved in our study, among whom 271,790 (54.65%) out of 497,371 students in Guangzhou suffered from VI during the COVID-19 compared with 293,001(53.48%) visually impaired students (total tested participants = 547,864) before the COVID-19 pandemic. During the pandemic, the overall prevalence of VI actually showed an increased age tendency and reached the highest level in the 17 [80.04%, 95%Confidence interval (CI):79.53 to 80.54%] and the 18 (79.64, 95%CI: 79.06 to 80.23%) age groups. Rapid growth was detected among students aged between 9 and 16 years old (raised by 46.21) while older students were more likely to get moderate and severe VI than younger ones. Students involved in more screen-based activities [(64.83%, 2019); (66.59%, 2020)] appeared to have a higher prevalence of VI than those involved in less [(49.17%, 2019); (49.26%, 2020)]. CONCLUSION A rising trend of VI among students was detected before and during the COVID-19 pandemic. Moreover, the pandemic appeared to be associated with a rapid VI shift in younger and boy populations. Potential danger may arise when public health emergencies occur in the school, and more effort should be made to improve students' vision.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Ya-jun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
36
|
Linderman RE, Heffernan E, Ferrante S, Bachman Groth J, Carroll J. The Impact of Axial Eye Growth on Foveal Avascular Zone Measurements in Children. Optom Vis Sci 2022; 99:127-136. [PMID: 34897231 PMCID: PMC8816819 DOI: 10.1097/opx.0000000000001854] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SIGNIFICANCE Foveal avascular zone (FAZ) area is a frequently used biomarker in diseases impacting the retinal vasculature in pediatric populations. Variation in axial length between individuals results in differences in lateral image scale, which affect the accuracy of FAZ area measurements. Accordingly, changes in axial length over time within individual children would affect estimates of FAZ area change. PURPOSE This study aimed to quantify how changes in axial length over time affect estimates of FAZ area change using optical coherence tomography angiography (OCT-A) images. METHODS Twenty pediatric participants (<18 years old) and 40 adult participants were imaged on Optovue's Avanti system (Fremont, CA) and had axial length measurements acquired at two time points. The FAZ was segmented twice using the OCT-A image at each time point. Foveal avascular zone area was estimated at both time points using the assumed/fixed axial length of the OCT-A device (unscaled) and using the participant's axial length (scaled). Changes in FAZ area over time were compared between the pediatric and adult groups using both unscaled and scaled data. RESULTS The average ± standard deviation follow-up time was 3.35 ± 1.66 years for the pediatric group and 2.90 ± 1.65 years for the adult group. Using unscaled data, FAZ area seemed to decrease between visits in the pediatric group (P = .004), whereas the FAZ area increased between visits in the adult group (P = .003). When correctly scaled data were used, the FAZ area still increased between visits for the adult group (P < .001), although the FAZ area no longer showed a significant change between visits for the pediatric group (P = .37). When comparing the normalized FAZ area change across visits between unscaled and scaled data, a significant difference was found between the adult and pediatric groups (P < .001). CONCLUSIONS Scaled data should be used when measuring FAZ area in pediatric populations, especially in longitudinal studies.
Collapse
Affiliation(s)
- Rachel E. Linderman
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Elizabeth Heffernan
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Samantha Ferrante
- School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Jane Bachman Groth
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Joseph Carroll
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
- School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, Wisconsin
| |
Collapse
|
37
|
Yang Y, Cheung SW, Cho P, Vincent SJ. Comparison between estimated and measured myopia progression in Hong Kong children without myopia control intervention. Ophthalmic Physiol Opt 2021; 41:1363-1370. [PMID: 34596263 PMCID: PMC9291478 DOI: 10.1111/opo.12895] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 12/15/2022]
Abstract
Purpose To compare myopia progression estimated by the Brien Holden Vision Institute (BHVI) Myopia Calculator with cycloplegic measures in Hong Kong children wearing single‐vision distance spectacles over a 1‐ and 2‐year period. Methods Baseline age, spherical equivalent refraction (SER) and ethnicity of control participants from previous longitudinal myopia studies were input into the BHVI Myopia Calculator to generate an estimate of the SER at 1 and 2 years. Differences between the measured and estimated SER (116 and 100 participants with 1‐ and 2‐year subjective refraction data, respectively, and 111 and 95 participants with 1‐ and 2‐year objective refraction, respectively) were analysed, and the measured SER compared with the 95% confidence interval (CI) of the estimated SER. Results In children aged 7–13 years, 36% progressed within the 95% CI of the Myopia Calculator's estimate, whereas 33% became less myopic than predicted (range 0.31 to 1.92 D less at 2 years) and 31% became more myopic than predicted (range 0.25 to 2.33 D more myopic at 2 years). The average difference between the estimated and measured subjective or objective SER at 1 and 2 years of follow‐up was not clinically significant (<0.25 D). Conclusions On average, the BHVI Myopia Calculator estimated SER was in close agreement with measured cycloplegic SER after 1 and 2 years of follow‐up (mean differences < 0.25 D). However, the measured myopia progression only fell within the 95% CI of the estimated SER for 32%–38% of children, suggesting that the BHVI ‘without management’ progression data should be interpreted with caution. The inclusion of additional data, modified to include axial elongation, from longitudinal studies of longer duration with larger sample sizes and a range of racial backgrounds may improve the Calculator's ability to predict future myopia progression for individual children.
Collapse
Affiliation(s)
- Yajing Yang
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region, China
| | - Sin Wan Cheung
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region, China
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region, China
| | - Stephen J Vincent
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia.,Contact Lens and Visual Optics Laboratory, Queensland University of Technology, Brisbane, Queensland, Australia
| |
Collapse
|
38
|
Chen YX, Liao CM, Tan Z, He MG. Who needs myopia control? Int J Ophthalmol 2021; 14:1297-1301. [PMID: 34540602 DOI: 10.18240/ijo.2021.09.01] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/14/2021] [Indexed: 12/16/2022] Open
Abstract
Myopia has become a major visual disorder among school-aged children in East Asia due to its rising prevalence over the past few decades and will continue to be a leading health issue with an annual incidence as high as 20%-30%. Although various interventions have been proposed for myopia control, consensus in treatment strategies has yet to be fully developed. Atropine and orthokeratology stand out for their effectiveness in myopia progression control, but children with rapid progression of myopia require treatment with higher concentrations of atropine that are associated with increased rates of side effects, or with orthokeratology that carries risk of significant complication. Therefore, improved risk assessment for myopia onset and progression in children is critical in clinical decision-making. Besides traditional prediction models based on genetic effects and environmental exposures within populations, individualized prediction using machine learning and data based on age-specific refraction is promising. Although emerging treatments for myopia are promising and some have been incorporated into clinical practice, identifying populations who require and benefit from intervention remains the most important initial step for clinical practice.
Collapse
Affiliation(s)
- Yan-Xian Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China.,Department of Ophthalmology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen 518000, Guangdong Province, China
| | - Chi-Mei Liao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China
| | - Zachary Tan
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne 3010, Australia
| | - Ming-Guang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, China.,Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne 3010, Australia
| |
Collapse
|
39
|
Wang J, Liu J, Ma W, Zhang Q, Li R, He X, Liu L. Prevalence of myopia in 3-14-year-old Chinese children: a school-based cross-sectional study in Chengdu. BMC Ophthalmol 2021; 21:318. [PMID: 34470605 PMCID: PMC8411514 DOI: 10.1186/s12886-021-02071-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 08/14/2021] [Indexed: 02/08/2023] Open
Abstract
Background The prevalence of myopia among children in Chengdu is unknown. The aim of this study was to determine the prevalence of myopia in 3- to 14-year-old Chinese children in Chengdu. Methods This study was a school-based cross-sectional study in children aged 3–14 years. Visual acuity (VA), spherical equivalent error (SER) with noncycloplegic autorefraction, axial length (AL) and corneal radius (CR) were measured. Results A total of 19,455 children were recruited for this study. The prevalence of myopia was 38.1 %; the prevalence of low myopia was 26.6 %, that of moderate myopia was 9.8 %, and that of high myopia was 1.7 %. The prevalence of myopia and SER increased with age from 6 years old. The prevalence of myopia was higher, and the SER indicated more severe myopia in the girls than in the boys (40.1 % vs. 36.2 %, χ2 = 30.67, df = 1, P < 0.001; -0.93 D ± 1.75 D vs. -0.84 D ± 1.74 D, t = 3.613, df=19,453, P < 0.001). The girls had a higher prevalence of myopia and myopic SER than did the boys aged 9 years and older (P < 0.05). Among the myopic children, the rates of uncorrected, undercorrected and fully corrected myopia were 54.8 %, 31.1 and 14.1 %, respectively. AL and AL/CR increased with age from 6 years old, but CR remained stable after 4 years old. The AL was longer, and the CR was flatter in the boys than in the girls aged 3 to 14 years old (P < 0.05). Conclusions The prevalence of myopia, AL and AL/CR increased, and the SER became more myopic with age from 6 years old. The girls had a higher prevalence of myopia and myopic SER than did the boys, but the boys had a longer AL, flatter CR and higher AL/CR ratio than did the girls. The rate of uncorrected myopia was very high in the myopic children. More actions need to be taken to decrease the prevalence of myopia, especially uncorrected myopia in children.
Collapse
Affiliation(s)
- Jianglan Wang
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, 37 Guoxue Xiang, Sichuan Province, Chengdu, China
| | - Jinnan Liu
- EyeSee Medical Science & Technology Chengdu Co, Ltd. 49 Dongfu street, Jinjiang District, Chengdu, Sichuan Province, China
| | - Wei Ma
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, 37 Guoxue Xiang, Sichuan Province, Chengdu, China
| | - Qi Zhang
- EyeSee Medical Science & Technology Chengdu Co, Ltd. 49 Dongfu street, Jinjiang District, Chengdu, Sichuan Province, China
| | - Rong Li
- EyeSee Medical Science & Technology Chengdu Co, Ltd. 49 Dongfu street, Jinjiang District, Chengdu, Sichuan Province, China
| | - Xiao He
- West China Clinical Skills Training Center, West China School of Medicine/West China Hospital, Sichuan University, 37 Guoxue Xiang, Sichuan Province, 610041, Chengdu, China
| | - Longqian Liu
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, 37 Guoxue Xiang, Sichuan Province, Chengdu, China.
| |
Collapse
|
40
|
Risk factors for rapid axial length elongation with low concentration atropine for myopia control. Sci Rep 2021; 11:11729. [PMID: 34083576 PMCID: PMC8175344 DOI: 10.1038/s41598-021-88719-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/08/2021] [Indexed: 11/20/2022] Open
Abstract
Three hundred and twenty-eight myopic children, randomized to use either 0.01% (N = 166) or 0.02% (N = 162) atropine were enrolled in this study. Gender, age, body mass index(BMI), parental myopia status, atropine concentration used, pupil diameter, amplitude of accommodation, spherical equivalent refractive error (SER), anterior chamber depth (ACD) and axial length (AL) were collected at baseline and 1 year after using atropine. Rapid AL elongation was defined as > 0.36 mm growth per year. Univariate analyses showed that children with rapid AL elongation tend to be younger, have a smaller BMI, use of 0.01% atropine, narrow ACD, lower SER, shorter AL, smaller change in pupil diameter between 1 year and baseline (all P < 0.05). Multivariate logistic regression analyses confirmed that rapid AL elongation was associated with children that were younger at baseline (P < 0.0001), use of 0.01% atropine (P = 0.04), a shorter baseline AL (P = 0.03) and a smaller change in pupil diameter between 1 year and baseline (P = 0.04). Younger children with shorter AL at baseline, less change in their pupil diameter with atropine treatment and using the lower of the two atropine concentrations may undergo rapid AL elongation over a 12 months myopia control treatment period.
Collapse
|
41
|
Ghoushchi VP, Mompeán J, Prieto PM, Artal P. Binocular dynamics of accommodation, convergence, and pupil size in myopes. BIOMEDICAL OPTICS EXPRESS 2021; 12:3282-3295. [PMID: 34221660 PMCID: PMC8221970 DOI: 10.1364/boe.420334] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/27/2021] [Accepted: 05/05/2021] [Indexed: 05/11/2023]
Abstract
The purpose of this work is to study the dynamics of the accommodative response as a function of the subject's refractive error, as a first step in determining whether an anomalous accommodative function could affect emmetropization or trigger myopia progression. A secondary goal was to establish potential relationships between the speed of accommodation and other parameters in the accommodation process. Parameters related to the speed and amplitude of accommodation, convergence, miosis, and change in high-order aberrations were measured during the accommodative process for 2.8 D demand in 18 young healthy subjects (mean age 25.0 ± 4.7 years) with a range of refractive errors between 0 and -7.5 D (spherical equivalent). Measurements were performed in real time (25 Hz) with an open-view binocular Hartmann-Shack (HS) sensor using a GPU-based processing unit. Correlation coefficients were calculated between refractive error and each computed variable. Additionally, the speed of accommodation was correlated with all the other parameters in the study. Correlation coefficients with refractive error had non-zero values for several parameters of the accommodative response but p-values were higher than 0.05 except in two cases: with pupil miosis speed (R = -0.49, p = 0.041) and with lag of accommodation (R = -0.57, p = 0.014). Additionally, correlation values with p-value < 0.05 were found between accommodation speed and convergence duration (R = 0.57, p = 0.014), convergence speed (R = 0.48, p = 0.044), and pupil miosis amplitude (R = 0.47, p = 0.049). We did not find strong evidence of a link between myopia and altered dynamics of the accommodation process. Only miosis speed was found to be correlated to refractive error with p < 0.05, being slower for myopes. On the other hand, increased lag of accommodation tends to be associated to larger refractive errors. Additionally, our data suggests that the faster the accommodation, the faster and longer the convergence and the larger the pupil miosis.
Collapse
|
42
|
Jong M, Jonas JB, Wolffsohn JS, Berntsen DA, Cho P, Clarkson-Townsend D, Flitcroft DI, Gifford KL, Haarman AEG, Pardue MT, Richdale K, Sankaridurg P, Tedja MS, Wildsoet CF, Bailey-Wilson JE, Guggenheim JA, Hammond CJ, Kaprio J, MacGregor S, Mackey DA, Musolf AM, Klaver CCW, Verhoeven VJM, Vitart V, Smith EL. IMI 2021 Yearly Digest. Invest Ophthalmol Vis Sci 2021; 62:7. [PMID: 33909031 PMCID: PMC8088231 DOI: 10.1167/iovs.62.5.7] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 01/24/2021] [Indexed: 12/17/2022] Open
Abstract
Purpose The International Myopia Institute (IMI) Yearly Digest highlights new research considered to be of importance since the publication of the first series of IMI white papers. Methods A literature search was conducted for articles on myopia between 2019 and mid-2020 to inform definitions and classifications, experimental models, genetics, interventions, clinical trials, and clinical management. Conference abstracts from key meetings in the same period were also considered. Results One thousand articles on myopia have been published between 2019 and mid-2020. Key advances include the use of the definition of premyopia in studies currently under way to test interventions in myopia, new definitions in the field of pathologic myopia, the role of new pharmacologic treatments in experimental models such as intraocular pressure-lowering latanoprost, a large meta-analysis of refractive error identifying 336 new genetic loci, new clinical interventions such as the defocus incorporated multisegment spectacles and combination therapy with low-dose atropine and orthokeratology (OK), normative standards in refractive error, the ethical dilemma of a placebo control group when myopia control treatments are established, reporting the physical metric of myopia reduction versus a percentage reduction, comparison of the risk of pediatric OK wear with risk of vision impairment in myopia, the justification of preventing myopic and axial length increase versus quality of life, and future vision loss. Conclusions Large amounts of research in myopia have been published since the IMI 2019 white papers were released. The yearly digest serves to highlight the latest research and advances in myopia.
Collapse
Affiliation(s)
- Monica Jong
- Discipline of Optometry and Vision Science, University of Canberra, Canberra, Australian Capital Territory, Australia
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Jost B. Jonas
- Department of Ophthalmology Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - James S. Wolffsohn
- Optometry and Vision Science Research Group, Aston University, Birmingham, United Kingdom
| | - David A. Berntsen
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, Texas, United States
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Danielle Clarkson-Townsend
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, Georgia, United States
- Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, United States
| | - Daniel I. Flitcroft
- Department of Ophthalmology, Children's University Hospital, Dublin, Ireland
| | - Kate L. Gifford
- Myopia Profile Pty Ltd, Brisbane, Queensland, Australia
- Queensland University of Technology (QUT) School of Optometry and Vision Science, Kelvin Grove, Queensland, Australia
| | - Annechien E. G. Haarman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Machelle T. Pardue
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, Georgia, United States
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, United States
| | - Kathryn Richdale
- College of Optometry, University of Houston, Houston, Texas, United States
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Milly S. Tedja
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Joan E. Bailey-Wilson
- Computational and Statistical Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Baltimore, Maryland, United States
| | - Jeremy A. Guggenheim
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom
| | - Christopher J. Hammond
- Section of Academic Ophthalmology, School of Life Course Sciences, King's College London, London, United Kingdom
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Stuart MacGregor
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - David A. Mackey
- Centre for Eye Research Australia, Ophthalmology, Department of Surgery, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- Department of Ophthalmology, Menzies Institute of Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Anthony M. Musolf
- Computational and Statistical Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Baltimore, Maryland, United States
| | - Caroline C. W. Klaver
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Virginie J. M. Verhoeven
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Veronique Vitart
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Earl L. Smith
- College of Optometry, University of Houston, Houston, Texas, United States
| |
Collapse
|
43
|
Truckenbrod C, Meigen C, Brandt M, Vogel M, Sanz Diez P, Wahl S, Jurkutat A, Kiess W. Longitudinal analysis of axial length growth in a German cohort of healthy children and adolescents. Ophthalmic Physiol Opt 2021; 41:532-540. [PMID: 33792977 DOI: 10.1111/opo.12817] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/05/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE To generate continuous growth curves for axial length (AL) in German children. We hypothesise that percentile curves of AL can be used as a predictive measure of myopia. METHODS In this longitudinal and cross-sectional LIFE Child Study, children's non-cycloplegic refraction data was collected using the Zeiss i.Profiler plus while AL was measured using the Haag-Streit Lenstar. Reference growth curves were estimated as a continuous non-parametric function of age. RESULTS Data from 4511 visits of 1965 participants (1021 boys and 944 girls) between 3 and 18 years of age were analysed. For all ages and percentiles, the estimated AL was higher in boys than girls. AL differences between boys and girls were most pronounced in the 98th percentile at 3 years of age, being 0.93 mm longer eyes in boys. This difference decreased to 0.21 mm at 18 years of age. While the lower percentiles of AL reach their final value around age 13, the 50th percentile was still increasing by 0.05 mm per year until the end of the observation period. While, in general, children with longer eyes are more likely to develop myopia, this relationship is weaker between the ages of 5 and 8. CONCLUSION The LIFE Child Study data provides European AL data. In both Germany and China, AL has comparable growth rates when the baseline ALs are compared as percentiles. Thus, percentile curves of AL can be used as a predictive measure for the likelihood of developing as well as the progression of myopia.
Collapse
Affiliation(s)
- Carolin Truckenbrod
- Leipzig Research Center for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
| | - Christof Meigen
- Leipzig Research Center for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
| | - Manuela Brandt
- Leipzig Research Center for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
| | - Mandy Vogel
- Leipzig Research Center for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
| | - Pablo Sanz Diez
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Germany.,Carl Zeiss Vision International GmbH, Aalen, Germany
| | - Siegfried Wahl
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Germany.,Carl Zeiss Vision International GmbH, Aalen, Germany
| | - Anne Jurkutat
- Leipzig Research Center for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany
| | - Wieland Kiess
- Leipzig Research Center for Civilization Diseases (LIFE), Leipzig University, Leipzig, Germany.,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Leipzig, Germany.,Center for Pediatric Research, Leipzig University, Leipzig, Germany
| |
Collapse
|
44
|
Wang J, Li Y, Musch DC, Wei N, Qi X, Ding G, Li X, Li J, Song L, Zhang Y, Ning Y, Zeng X, Hua N, Li S, Qian X. Progression of Myopia in School-Aged Children After COVID-19 Home Confinement. JAMA Ophthalmol 2021; 139:293-300. [PMID: 33443542 PMCID: PMC7809617 DOI: 10.1001/jamaophthalmol.2020.6239] [Citation(s) in RCA: 231] [Impact Index Per Article: 77.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Question Is home confinement due to coronavirus disease 2019 associated with the burden of myopia? Findings In this cross-sectional study that included 194 904 photoscreening tests conducted in 123 535 children, a substantial myopic shift (−0.3 diopters) was noted after home confinement due to coronavirus disease 2019 for children aged 6 to 8 years. The prevalence of myopia increased 1.4 to 3 times in 2020 compared with the previous 5 years. Meaning Home confinement due to coronavirus disease 2019 appeared to be associated with a substantial myopic shift in children; younger (aged 6-8 years) children’s refractive status may be more sensitive to environmental changes than older children, given that they are in an important period for the development of myopia. Importance Time spent in outdoor activities has decreased owing to home confinement for the coronavirus disease 2019 (COVID-19) pandemic. Concerns have been raised about whether home confinement may have worsened the burden of myopia owing to substantially decreased time spent outdoors and increased screen time at home. Objective To investigate the refractive changes and prevalence of myopia in school-aged children during the COVID-19 home confinement. Design, Setting, and Participants A prospective cross-sectional study using school-based photoscreenings in 123 535 children aged 6 to 13 years from 10 elementary schools in Feicheng, China, was conducted. The study was performed during 6 consecutive years (2015-2020). Data were analyzed in July 2020. Exposures Noncycloplegic photorefraction was examined using a photoscreener device. Main Outcomes and Measures The spherical equivalent refraction was recorded for each child and the prevalence of myopia for each age group during each year was calculated. The mean spherical equivalent refraction and prevalence of myopia were compared between 2020 (after home confinement) and the previous 5 years for each age group. Results Of the 123 535 children included in the study, 64 335 (52.1%) were boys. A total of 194 904 test results (389 808 eyes) were included in the analysis. A substantial myopic shift (approximately −0.3 diopters [D]) was found in the 2020 school-based photoscreenings compared with previous years (2015-2019) for younger children aged 6 (−0.32 D), 7 (−0.28 D), and 8 (−0.29 D) years. The prevalence of myopia in the 2020 photoscreenings was higher than the highest prevalence of myopia within 2015-2019 for children aged 6 (21.5% vs 5.7%), 7 (26.2% vs 16.2%), and 8 (37.2% vs 27.7%) years. The differences in spherical equivalent refraction and the prevalence of myopia between 2020 and previous years were minimal in children aged 9 to 13 years. Conclusions and Relevance Home confinement during the COVID-19 pandemic appeared to be associated with a significant myopic shift for children aged 6 to 8 years according to 2020 school-based photoscreenings. However, numerous limitations warrant caution in the interpretation of these associations, including use of noncycloplegic refractions and lack of orthokeratology history or ocular biometry data. Younger children’s refractive status may be more sensitive to environmental changes than older ages, given the younger children are in a critical period for the development of myopia.
Collapse
Affiliation(s)
- Jiaxing Wang
- Department of Ophthalmology, Emory University, Atlanta, Georgia
| | - Ying Li
- Department of Ophthalmology, Emory University, Atlanta, Georgia
| | - David C Musch
- Department of Ophthalmology and Visual Sciences, Department of Epidemiology, University of Michigan, Ann Arbor
| | - Nan Wei
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xiaoli Qi
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Gang Ding
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xue Li
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Jing Li
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Linlin Song
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Ying Zhang
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yuxian Ning
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xiaoyu Zeng
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Ning Hua
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Shuo Li
- Department of Respiratory and Critical Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Xuehan Qian
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| |
Collapse
|
45
|
Lee BJ, Lee K, Chung SA, Lim HT. Ocular biometric features of pediatric patients with fibroblast growth factor receptor-related syndromic craniosynostosis. Sci Rep 2021; 11:6172. [PMID: 33731768 PMCID: PMC7969619 DOI: 10.1038/s41598-021-85620-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 03/03/2021] [Indexed: 11/09/2022] Open
Abstract
Ametropia is reported as a common ophthalmic manifestation in craniosynostosis. We retrospectively compared childhood refractive error and ocular biometric features of fibroblast growth factor receptor (FGFR)-related syndromic craniosynostosis patients with those of non-syndromic craniosynostosis and control subjects. Thirty-six eyes (18 patients) with FGFR-related syndromic craniosynostosis, 76 eyes (38 patients) with non-syndromic craniosynostosis, and 114 eyes (57 patients) of intermittent exotropes were included in the analysis. Mean age at examination was 7.82 ± 2.51 (range, 4–16) years and mean spherical equivalent was -0.09 ± 1.46 Diopter. Mean age and refractive error were not different between groups, but syndromic craniosynostosis patients had significantly longer axial length, lower corneal power, and lower lens power than other groups (p < 0.01, p < 0.01, and p < 0.01, respectively). Axial length was positively correlated and keratometry and lens power were negatively correlated with age in non-syndromic craniosynostosis and controls, while these correlations between age and ocular biometric parameters were not present in the FGFR-related syndromic craniosynostosis. In conclusion, ocular biometric parameters in FGFR-related syndromic craniosynostosis differed from those of non-syndromic craniosynostosis and age-matched controls, and did not show the relations with age, suggesting this cohort may have abnormal refractive growth.
Collapse
Affiliation(s)
- Byung Joo Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
| | - Kihwang Lee
- Department of Ophthalmology, Ajou University School of Medicine, 164 World Cup‑ro, Yeongtong‑gu, Suwon, 16499, South Korea
| | - Seung Ah Chung
- Department of Ophthalmology, Ajou University School of Medicine, 164 World Cup‑ro, Yeongtong‑gu, Suwon, 16499, South Korea.
| | - Hyun Taek Lim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
| |
Collapse
|
46
|
Jiang Y, Zhang Z, Wu Z, Sun S, Fu Y, Ke B. Change and Recovery of Choroid Thickness after Short-term Application of 1% Atropine Gel and Its Influencing Factors in 6-7-year-old Children. Curr Eye Res 2021; 46:1171-1177. [PMID: 33390025 DOI: 10.1080/02713683.2020.1863431] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate the change and recovery of choroid thickness after short-term application of 1% atropine gel and its influencing factors in 6-7-year-old children. MATERIALS AND METHODS 71 right eyes of 71 children were enrolled and divided into myopia and control group. 1% atropine gel was administered twice a day for one week and then stopped. Spherical equivalent (SE), accommodative amplitude (AA), keratometry (K), axial length (AL), and choroidal thickness (CT) were obtained at baseline and 1st, 4th, and 8th weeks. CT was measured at subfovea and 1 mm, 2 mm, and 3 mm temporal, superior, nasal, and inferior from the fovea using spectral-domain optical coherence tomography. RESULTS In both groups, all CTs increased following the change in SE, AA, and AL after administration of 1% atropine for one week. They gradually recovered to baseline levels seven weeks after withdrawal. The change (Δ) in CT at 3 mm superior from the fovea was significantly higher in the myopia group than in the control group. In both groups, ΔCT at subfovea had no significant correlation with SE, AA, and AL, both at baseline and one week. However, ΔCT at subfovea was negatively correlated with ΔAL in the control group. CONCLUSIONS One-week application of 1% atropine gel may increase CT in 6-7-year-old Chinese children. Meanwhile, the recovery process after withdrawal lasts seven weeks. During the recovery process, the changes in structural parameters (AL, CT) and functional parameters (AA, SE) in both groups occurred synchronously. The SE, AA, and AL at baseline may not predict the extent of atropine's effect on CT.
Collapse
Affiliation(s)
- Yunjia Jiang
- Department of Ophthalmology, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.,Department of Ophthalmology, The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi, Jiangsu Province, China.,Department of Ophthalmology, The Affiliated Wuxi Clinical College of Nantong University, Wuxi, Jiangsu Province, China
| | - Zhengwei Zhang
- Department of Ophthalmology, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.,Department of Ophthalmology, The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi, Jiangsu Province, China.,Department of Ophthalmology, The Affiliated Wuxi Clinical College of Nantong University, Wuxi, Jiangsu Province, China
| | - Zhifeng Wu
- Department of Ophthalmology, The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi, Jiangsu Province, China.,Department of Ophthalmology, The Affiliated Wuxi Clinical College of Nantong University, Wuxi, Jiangsu Province, China
| | - Song Sun
- Department of Ophthalmology, The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi, Jiangsu Province, China.,Department of Ophthalmology, The Affiliated Wuxi Clinical College of Nantong University, Wuxi, Jiangsu Province, China
| | - Yuting Fu
- Department of Ophthalmology, The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi, Jiangsu Province, China.,Department of Ophthalmology, The Affiliated Wuxi Clinical College of Nantong University, Wuxi, Jiangsu Province, China
| | - Bilian Ke
- Department of Ophthalmology, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.,Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,National Clinical Research Center for Eye Diseases, Shanghai, China.,Shanghai Key Laboratory of Fundus Disease, Shanghai, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| |
Collapse
|
47
|
Brennan NA, Toubouti YM, Cheng X, Bullimore MA. Efficacy in myopia control. Prog Retin Eye Res 2020; 83:100923. [PMID: 33253901 DOI: 10.1016/j.preteyeres.2020.100923] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 11/17/2020] [Accepted: 11/23/2020] [Indexed: 12/14/2022]
Abstract
There is rapidly expanding interest in interventions to slow myopia progression in children and teenagers, with the intent of reducing risk of myopia-associated complications later in life. Despite many publications dedicated to the topic, little attention has been devoted to understanding 'efficacy' in myopia control and its application. Treatment effect has been expressed in multiple ways, making comparison between therapies and prognosis for an individual patient difficult. Available efficacy data are generally limited to two to three years making long-term treatment effect uncertain. From an evidence-based perspective, efficacy projection should be conservative and not extend beyond that which has been empirically established. Using this principle, review of the literature, data from our own clinical studies, assessment of demonstrated myopia control treatments and allowance for the limitations and context of available data, we arrive at the following important interpretations: (i) axial elongation is the preferred endpoint for assessing myopic progression; (ii) there is insufficient evidence to suggest that faster progressors, or younger myopes, derive greater benefit from treatment; (iii) the initial rate of reduction of axial elongation by myopia control treatments is not sustained; (iv) consequently, using percentage reduction in progression as an index to describe treatment effect can be very misleading and (v) cumulative absolute reduction in axial elongation (CARE) emerges as a preferred efficacy metric; (vi) maximum CARE that has been measured for existing myopia control treatments is 0.44 mm (which equates to about 1 D); (vii) there is no apparent superior method of treatment, although commonly prescribed therapies such as 0.01% atropine and progressive addition spectacles lenses have not consistently provided clinically important effects; (viii) while different treatments have shown divergent efficacy in the first year, they have shown only small differences after this; (ix) rebound should be assumed until proven otherwise; (x) an illusion of inflated efficacy is created by measurement error in refraction, sample bias in only treating 'measured' fast progressors and regression to the mean; (xi) decision to treat should be based on age of onset (or refraction at a given age), not past progression; (xii) the decreased risk of complications later in life provided by even modest reductions in progression suggest treatment is advised for all young myopes and, because of limitations of available interventions, should be aggressive.
Collapse
Affiliation(s)
- Noel A Brennan
- Johnson & Johnson Vision, 7500 Centurion Pkwy, Jacksonville, FL, 32256, USA.
| | - Youssef M Toubouti
- Johnson & Johnson Vision, 7500 Centurion Pkwy, Jacksonville, FL, 32256, USA
| | - Xu Cheng
- Johnson & Johnson Vision, 7500 Centurion Pkwy, Jacksonville, FL, 32256, USA
| | | |
Collapse
|
48
|
Tang T, Yu Z, Xu Q, Peng Z, Fan Y, Wang K, Ren Q, Qu J, Zhao M. A machine learning-based algorithm used to estimate the physiological elongation of ocular axial length in myopic children. EYE AND VISION 2020; 7:50. [PMID: 33102610 PMCID: PMC7579939 DOI: 10.1186/s40662-020-00214-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 09/14/2020] [Indexed: 12/12/2022]
Abstract
Background Axial myopia is the most common type of myopia. However, due to the high incidence of myopia in Chinese children, few studies estimating the physiological elongation of the ocular axial length (AL), which does not cause myopia progression and differs from the non-physiological elongation of AL, have been conducted. The purpose of our study was to construct a machine learning (ML)-based model for estimating the physiological elongation of AL in a sample of Chinese school-aged myopic children. Methods In total, 1011 myopic children aged 6 to 18 years participated in this study. Cross-sectional datasets were used to optimize the ML algorithms. The input variables included age, sex, central corneal thickness (CCT), spherical equivalent refractive error (SER), mean K reading (K-mean), and white-to-white corneal diameter (WTW). The output variable was AL. A 5-fold cross-validation scheme was used to randomly divide all data into 5 groups, including 4 groups used as training data and one group used as validation data. Six types of ML algorithms were implemented in our models. The best-performing algorithm was applied to predict AL, and estimates of the physiological elongation of AL were obtained as the partial derivatives of ALpredicted-age curves based on an unchanged SER value with increasing age. Results Among the six algorithms, the robust linear regression model was the best model for predicting AL, with a R2 value of 0.87 and relatively minimal averaged errors between the predicted AL and true AL. Based on the partial derivatives of the ALpredicted-age curves, the estimated physiological AL elongation varied from 0.010 to 0.116 mm/year in male subjects and 0.003 to 0.110 mm/year in female subjects and was influenced by age, SER and K-mean. According to the model, the physiological elongation of AL linearly decreased with increasing age and was negatively correlated with the SER and the K-mean. Conclusions The physiological elongation of the AL is rarely recorded in clinical data in China. In cases of unavailable clinical data, an ML algorithm could provide practitioners a reasonable model that can be used to estimate the physiological elongation of AL, which is especially useful when monitoring myopia progression in orthokeratology lens wearers.
Collapse
Affiliation(s)
- Tao Tang
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044 China.,College of Optometry, Peking University Health Science Center, Beijing, China.,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China.,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Zekuan Yu
- Academy for Engineering & Technology, Fudan University, Shanghai, China.,Department of Biomedical Engineering, College of Engineering, Peking University, Beijing, 100871 China
| | - Qiong Xu
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044 China.,College of Optometry, Peking University Health Science Center, Beijing, China.,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China.,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Zisu Peng
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044 China.,College of Optometry, Peking University Health Science Center, Beijing, China.,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China.,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Yuzhuo Fan
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044 China.,College of Optometry, Peking University Health Science Center, Beijing, China.,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China.,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Kai Wang
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044 China.,College of Optometry, Peking University Health Science Center, Beijing, China.,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China.,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Qiushi Ren
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing, 100871 China
| | - Jia Qu
- College of Optometry, Peking University Health Science Center, Beijing, China.,School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Mingwei Zhao
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044 China.,College of Optometry, Peking University Health Science Center, Beijing, China.,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China.,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| |
Collapse
|
49
|
Axial growth and refractive change in white European children and young adults: predictive factors for myopia. Sci Rep 2020; 10:15189. [PMID: 32938970 PMCID: PMC7494927 DOI: 10.1038/s41598-020-72240-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 08/21/2020] [Indexed: 12/18/2022] Open
Abstract
This report describes development of spherical equivalent refraction (SER) and axial length (AL) in two population-based cohorts of white, European children. Predictive factors for myopic growth were explored. Participants were aged 6-7- (n = 390) and 12-13-years (n = 657) at baseline. SER and AL were assessed at baseline and 3, 6 and 9 years prospectively. Between 6 and 16 years: latent growth mixture modelling identified four SER classes (Persistent Emmetropes-PEMM, Persistent Moderate Hyperopes-PMHYP, Persistent High Hyperopes-PHHYP and Emerging Myopes-EMYO) as optimal to characterise refractive progression and two classes to characterise AL. Between 12 and 22-years: five SER classes (PHHYP, PMHYP, PEMM, Low Progressing Myopes-LPMYO and High Progressing Myopes-HPMYO) and four AL classes were identified. EMYO had significantly longer baseline AL (≥ 23.19 mm) (OR 2.5, CI 1.05-5.97) and at least one myopic parent (OR 6.28, CI 1.01-38.93). More myopic SER at 6-7 years (≤ + 0.19D) signalled risk for earlier myopia onset by 10-years in comparison to baseline SER of those who became myopic by 13 or 16 years (p ≤ 0.02). SER and AL progressed more slowly in myopes aged 12-22-years (- 0.16D, 0.15 mm) compared to 6-16-years (- 0.41D, 0.30 mm). These growth trajectories and risk criteria allow prediction of abnormal myopigenic growth and constitute an important resource for developing and testing anti-myopia interventions.
Collapse
|
50
|
Lin Y, Ding Y, Jiang D, Li C, Huang X, Liu L, Xiao H, Vasudevan B, Chen Y. Genome-Wide Association of Genetic Variants With Refraction, Axial Length, and Corneal Curvature: A Longitudinal Study of Chinese Schoolchildren. Front Genet 2020; 11:276. [PMID: 32269590 PMCID: PMC7109285 DOI: 10.3389/fgene.2020.00276] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 03/09/2020] [Indexed: 01/22/2023] Open
Abstract
Background Myopia is a common eye disorder that is approaching epidemic proportions worldwide. A genome-wide association study identified AREG (rs12511037), GABRR1 (rs13215566), and PDE10A (rs12206610) as being associated with refractive error in Asian populations. The present study investigated the associations between these three genetic variants and the occurrence and development of myopia, spherical equivalent refraction (SER), axial length (AL), and corneal curvature (CC) in a cohort of southeastern Chinese schoolchildren. Methods We examined and followed 550 children in grade 1 enrolled in the Wenzhou Epidemiology of Refractive Error (WERE) project. During the 4-year follow-up, non-cycloplegic refraction was evaluated twice each year, and the AL and CC were measured once every year. Age, sex, and the amounts of time spent on near work and outdoors were documented with a questionnaire. Sanger DNA sequencing was used to genotype single nucleotide polymorphisms (SNPs). SNPtest software was used to identify potential genetic variants associated with myopia, SER, AL, and CC. Ten thousand permutations were used to correct for multiple testing. Results In total, 469 children, including 249 (53.1%) boys and 220 (46.9%) girls, were included in analyses. The mean age of all the children was 6.33 ± 0.48 years. After adjusting for age, sex, time spent on near work and time spent outdoors, neither the genotypes nor the allele frequencies of the three SNPs were significantly associated with myopic shift, incident myopia or the change in SER. After adjusting for age, sex, near-work time and outdoor time with 10,000 permutations, the genotype AREG (rs12511037) was associated with an increase in AL (P′-values for the dominant, recessive, additive and general models were 0.0032, 0.0275, 0.0045, and 0.0099, respectively); the genotype PDE10A (rs12206610) was associated with a change in CC in the additive (P′ = 0.0096), dominant (P′ = 0.0096), and heterozygous models (P′ = 0.0096). Conclusion These findings preliminarily indicate that AREG SNP rs12511037 and PDE10A SNP rs12206610 are etiologically relevant for ocular traits, providing a basis for further exploration of the development of myopia and its molecular mechanism. However, elucidating the role of AREG and PDE10A in the pathogenesis of myopia requires further animal model and human genetic epidemiology studies. This trial is registered as ChiCTR1900020584 at www.Chictr.org.cn.
Collapse
Affiliation(s)
- Yaoyao Lin
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, China
| | - Yu Ding
- The Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Dandan Jiang
- The Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Chunchun Li
- The Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xiaoqiong Huang
- The Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Linjie Liu
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, China
| | - Haishao Xiao
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, China
| | | | - Yanyan Chen
- The Eye Hospital, Wenzhou Medical University, Wenzhou, China
| |
Collapse
|