Advanced myopia, prevalence and incidence analysis

Temporal Protrusion of the Optic Disc Implicated in Central Visual Field Abnormalities in High Myopia: Two Case Reports

Introduction

Severe central visual field defects are frequently observed in highly myopic eyes. This report details 2 cases of central visual field defects in individuals with high myopia, characterized by an unusual temporal protrusion of the optic disc, a feature not previously documented.

Case Presentation

Two patients, a 54-year-old man and a 65-year-old woman, were diagnosed with high myopia in their left eyes, displaying an outward protrusion of the optic disc toward the macula. Swept-source optical coherence tomography revealed a focal lamina cribrosa defect at the temporal edge of the protruding optic disc, corresponding to the papillomacular bundle area of retinal nerve fibers, which exhibited thinning around the focal lamina cribrosa defect. Visual field examination indicated a central visual field defect in the affected eyes, which pattern corresponded to the papillomacular bundle responsible area.

Conclusion

The emergence of a temporal protrusion in the optic disc may lead to a focal lamina cribrosa defect, resulting in a central visual field defect in highly myopic eyes. This distinctive optic disc feature may constitute a critical risk factor for a central visual field defect. Hence, optic disc protrusion in high myopia warrants attention, necessitating careful ophthalmic examinations for central visual field defects.

Screen time and myopia: A serial multiple mediator SEM analysis

Background

COVID-19 has influenced education systems worldwide, and significantly increased screen time for college students, posing a potential risk of myopia. In China, ninety percent of college students suffer from myopia. Excessive screen time changes college students' lifestyles, imposes potential health risks, and affects opportunities for employment. It is important to identify the potential correlation between screen time use and myopia among college students.

Methods

This paper conducted a nationwide experiment using Chinese college students and set a multiple-mediator SEM model to analyze the potential correlation between screen time and myopia. The two mediators were sedentary behavior and physical activity, respectively.

Results

We obtained three valuable conclusions as follows: First, there was no significant direct relationship between screen time and myopia among Chinese college students during the COVID-19 pandemic. Second, sedentary behavior and physical activity significantly predicted the increase/decrease of myopia among Chinese college students, respectively. Third, a serial multiple mediator that encompassed sedentary behavior and physical activity sequentially fully mediated the relationship between screen time and myopia.

Conclusions

Although there was no directly significant relationship between screen time and myopia, screen time can indirectly influence the risk of suffering myopia by influencing sedentary behavior and physical activity. Our study demonstrates the need to prevent the potential influence of overuse of electronic devices on myopia in college students, especially during the COVID-19 pandemic.

Extended Depth of Focus Versus Monofocal IOLs in Patients With High Myopia: Objective and Subjective Visual Outcomes

PURPOSE

To compare the objective and subjective outcomes between the extended depth of focus (EDOF) Mini Well intraocular lens (IOL) and the aspheric monofocal Mini-4-Ready IOL (both SIFI S.p.A.) in patients with high myopia.

METHODS

In this prospective comparative study, 40 patients with high myopia (axial length ≥ 26 mm) were enrolled: 20 patients were bilaterally implanted with the EDOF Mini Well IOL (EDOF group) and 20 patients were bilaterally implanted with the Mini-4-Ready IOL (monofocal group). Three-month follow-up data included corrected and uncorrected distance visual acuity at 4 m and 80, 67, and 40 cm, defocus curves, subjective and objective contrast sensitivity, objective optical quality (calculated with Optical Quality Analysis System; Visiometrics SL), halometry, and reading performance. Subjective visual quality was evaluated with National Eye Institute Refractive Error Quality of Life Instrument 42 scores.

RESULTS

All visual acuities were significantly better in the EDOF group (P ⩽ .04) except monocular and binocular uncorrected and corrected distance visual acuities for distance (P ≥ .50). Defocus curves for myopic and hyperopic values were better in the EDOF group (P ⩽ .05), apart from +0.50 to -0.50 D (P ≥ .16). Contrast sensitivity curves was worse in the EDOF group in the mesopic-with-glare condition (P ⩽ .04). No differences were found in halometric values (P ≥ .15) and OQAS outcomes (P ≥ .47). National Eye Institute Refractive Error Quality of Life Instrument 42 subscale scores were better for expectation, near vision, activity limitations, and dependence on correction in the EDOF group (P ⩽ .04).

CONCLUSIONS

Intermediate and near visual acuities were better in the EDOF group than in the monofocal group, with a comparable visual quality index between groups. [J Refract Surg. 2022;38(3):158-166.].

Optical Quality of Highly Myopic Eyes under Different Lighting Conditions and Other Relevant Parameters

Purpose: To evaluate the optical quality of highly myopic eyes under light and dark conditions and correlate it with other relevant parameters. Materials and Methods: A cross-sectional, observational study was performed on 180 eyes of 90 highly myopic patients (29 males and 61 females; mean age: 27.833 ± 0.364 years [range: 18-45 years]). The modulation transfer function (MTF) cutoff frequency, Strehl ratio, objective scattering index (OSI), and predicted visual acuity (PVA; 100%, 20%, and 9%) under different lighting conditions were measured to evaluate the optical quality, which was correlated with probable relevant factors, including, axis length, spherical equivalent (SE), uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (BDVA), astigmatism, and corneal curvature. The relationship between these visual parameters and optical quality was analyzed using a generalized linear model. Results: The OSIs were 1.241 ± 0.068 and 1.515 ± 0.076; the MTF cutoff frequencies were 37.725 ± 0.559 and 30.238 ± 0.550 cpd; the Strehl ratios were 0.219 ± 0.004 and 0.175 ± 0.003; and the PVAs at 100%, 20%, and 9% were 1.257 ± 0.019 and 1.001 ± 0.018, 0.949 ± 0.017 and 0.719 ± 0.015, and 0.579 ± 0.011 and 0.439 ± 0.010, under bright and dark conditions respectively. The optical quality parameters were correlated with age, SE, BDVA, corneal astigmatism, and curvature to different degrees under different lighting conditions. Conclusions: The optical quality declined in highly myopic eyes under both bright and dark lighting conditions. SE, BDVA, corneal astigmatism, and curvature were correlated with optical quality to different degrees under different lighting conditions.

Clinical efficacy of femtosecond laser for myopia: A systematic review protocol of randomized controlled trial

BACKGROUND

Femtosecond laser (FL) is an effective method to treat patients with myopia, but its relative efficacy and safety is still unclear. Thus, this study will be conducted to assess the efficacy and safety of FL for myopia systematically.

METHODS

This study will systematically retrieve the following electronic databases up to the present: Cochrane Library, PubMed, EMBASE, Web of Science, PsycINFO, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, Wanfang, VIP, and China National Knowledge Infrastructure. All electronic databases will be searched without any limitations of language and publication status. RevMan 5.3 software will be utilized for statistical analysis.

RESULTS

We will summarize the targeted results evaluating the efficacy and safety of FL for patients with myopia.

CONCLUSIONS

This study will provide a comprehensive evidence summary on FL for patients with myopia.PROSPERO registration number: PROSPERO CRD42019148659.