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Baksh J, Lee D, Mori K, Zhang Y, Torii H, Jeong H, Hou J, Negishi K, Tsubota K, Kurihara T. Myopia Is an Ischemic Eye Condition: A Review from the Perspective of Choroidal Blood Flow. J Clin Med 2024; 13:2777. [PMID: 38792319 PMCID: PMC11122110 DOI: 10.3390/jcm13102777] [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: 04/09/2024] [Revised: 05/02/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
Myopia is a common refractive error that affects a large proportion of the population. Recent studies have revealed that alterations in choroidal thickness (ChT) and choroidal blood flow (ChBF) play important roles in the progression of myopia. Reduced ChBF could affect scleral cellular matrix remodeling, which leads to axial elongation and further myopia progression. As ChT and ChBF could be used as potential biomarkers for the progression of myopia, several recent myopia treatments have targeted alterations in ChT and ChBF. Our review provides a comprehensive overview of the recent literature review on the relationship between ChBF and myopia. We also highlight the importance of ChT and ChBF in the progression of myopia and the potential of ChT as an important biomarker for myopia progression. This summary has significant implications for the development of novel strategies for preventing and treating myopia.
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Affiliation(s)
- Jiaul Baksh
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Deokho Lee
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Kiwako Mori
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yan Zhang
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Heonuk Jeong
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Jing Hou
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Kazuo Tsubota
- Tsubota Laboratory, Inc., 34 Shinanomachi, Shinjuku-ku, Tokyo 160-0016, Japan
| | - Toshihide Kurihara
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
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Lorrai R, Cavaterra D, Giammaria S, Sbardella D, Tundo GR, Boccaccini A. Eye Diseases: When the Solution Comes from Plant Alkaloids. PLANTA MEDICA 2024; 90:426-439. [PMID: 38452806 DOI: 10.1055/a-2283-2350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Plants are an incredible source of metabolites showing a wide range of biological activities. Among these, there are the alkaloids, which have been exploited for medical purposes since ancient times. Nowadays, many plant-derived alkaloids are the main components of drugs used as therapy for different human diseases. This review deals with providing an overview of the alkaloids used to treat eye diseases, describing the historical outline, the plants from which they are extracted, and the clinical and molecular data supporting their therapeutic activity. Among the different alkaloids that have found application in medicine so far, atropine and pilocarpine are the most characterized ones. Conversely, caffeine and berberine have been proposed for the treatment of different eye disorders, but further studies are still necessary to fully understand their clinical value. Lastly, the alkaloid used for managing hypertension, reserpine, has been recently identified as a potential drug for ameliorating retinal disorders. Other important aspects discussed in this review are different solutions for alkaloid production. Given that the industrial production of many of the plant-derived alkaloids still relies on extraction from plants, and the chemical synthesis can be highly expensive and poorly efficient, alternative methods need to be found. Biotechnologies offer a multitude of possibilities to overcome these issues, spanning from genetic engineering to synthetic biology for microorganisms and bioreactors for plant cell cultures. However, further efforts are needed to completely satisfy the pharmaceutical demand.
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Affiliation(s)
- Riccardo Lorrai
- Dipartimento di Biologia e Biotecnologie "Charles Darwin", Sapienza Università di Roma, Rome, Italy
| | - Dario Cavaterra
- Dipartimento di Scienze e Tecnologie Chimiche, Università di Tor Vergata, Rome, Italy
| | | | | | - Grazia Raffaella Tundo
- Dipartimento di Scienze Cliniche e Medicina Traslazionale, Università di Roma Tor Vergata, Rome, Italy
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Yan C, Zhao F, Gao S, Liu X, Yu T, Mu Y, Zhang L, Xu J. Observation of the effect of posterior scleral reinforcement combined with orthokeratology and 0.01% atropine in the treatment of congenital myopia: a case report. BMC Ophthalmol 2023; 23:486. [PMID: 38012561 PMCID: PMC10683125 DOI: 10.1186/s12886-023-03211-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/08/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Myopia has recently emerged as a significant threat to global public health. The high and pathological myopia in children and adolescents could result in irreversible damage to eye tissues and severe impairment of visual function without timely control. Posterior scleral reinforcement (PSR) can effectively control the progression of high myopia by limiting posterior scleral expansion, improving retrobulbar vascular perfusion, thereby stabilizing the axial length and refraction of the eye. Moreover, orthokeratology and low concentrations of atropine are also effective in slowing myopia progression. CASE PRESENTATION A female child was diagnosed with binocular congenital myopia and amblyopia at the age of 3 and the patient's vision had never been rectified with spectacles at the first consultation. The patient's ophthalmological findings suggested, high refractive error with low best corrected visual acuity, longer axial length beyond the standard level of her age, and fundus examination suggesting posterior scleral staphyloma with weakened hemodynamics of the posterior ciliary artery. Thereby, PSR was performed to improve fundus health and the combination of orthokeratology and 0.01% atropine were performed to control the development of myopia. Following up to 8 years of clinical treatment and observations, the progression of myopia could be well controlled and fundus health was stable. CONCLUSION In this report, 8-year of clinical observation indicated that PSR could improve choroidal thickness and hemodynamic parameters of the retrobulbar vessels, postoperative orthokeratology combined with 0.01% atropine treatment strategy may be a good choice for myopia control effectively.
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Affiliation(s)
- Chunxiao Yan
- The Third People's Hospital of Dalian, Dalian Municipal Eye Hospital, Dalian Municipal Cancer Hospital, Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, Liaoning, China
- Dalian Medical University, Dalian, Liaoning, China
| | - Fangkun Zhao
- The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Shang Gao
- The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xiaoyu Liu
- The Third People's Hospital of Dalian, Dalian Municipal Eye Hospital, Dalian Municipal Cancer Hospital, Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, Liaoning, China
| | - Taorui Yu
- The Third People's Hospital of Dalian, Dalian Municipal Eye Hospital, Dalian Municipal Cancer Hospital, Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, Liaoning, China
- Dalian Medical University, Dalian, Liaoning, China
| | - Yanan Mu
- The Third People's Hospital of Dalian, Dalian Municipal Eye Hospital, Dalian Municipal Cancer Hospital, Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, Liaoning, China
| | - Lijun Zhang
- The Third People's Hospital of Dalian, Dalian Municipal Eye Hospital, Dalian Municipal Cancer Hospital, Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, Liaoning, China.
- Dalian Medical University, Dalian, Liaoning, China.
| | - Jun Xu
- The Third People's Hospital of Dalian, Dalian Municipal Eye Hospital, Dalian Municipal Cancer Hospital, Liaoning Provincial Key Laboratory of Cornea and Ocular Surface Diseases, Liaoning Provincial Optometry Technology Engineering Research Center, Dalian, Liaoning, China.
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Wei P, Han G, He M, Wang Y. Retinal Neurotransmitter Alteration in Response to Dopamine D2 Receptor Antagonist from Myopic Guinea Pigs. ACS Chem Neurosci 2023; 14:3357-3367. [PMID: 37647579 DOI: 10.1021/acschemneuro.3c00099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
This study aimed to investigate the changes in retinal neurotransmitters and the role of the dopamine D2 receptor (D2R) pathway in regulating the myopic refractive state. Tricolor guinea pigs were randomly divided into two groups: the normal control group (NC) and the form-deprivation myopia group (FDM). Animals in the FDM group had their right eye covered with a balloon for 4 weeks. These two groups were further divided into two subgroups based on intravitreal injection with D2R antagonist sulpiride once a week for 3 weeks (NC, NC-Sul, FDM, and FDM-Sul groups). Ultrahigh-performance liquid chromatography-tandem mass spectrometry was used to quantitatively detect the changes in 17 retinal neurotransmitters. Compared to the NC group, the concentrations of dopamine (DA) and γ-aminobutyric acid (GABA) decreased, while those of glutamate (Glu), 3-methoxytyramine (3-MT), and glycine increased, accompanied by an increase in myopic refraction and axial length (AL) in the FDM group. In the FDM-Sul group, glycine and DA levels were upregulated, whereas 3-MT and Glu levels were downregulated, accompanied by a decrease in myopic refraction and AL. The ratio of Glu to GABA (RGG) represents the balance between excitatory and inhibitory neurotransmitters. Notably, RGG changes occurred with corresponding AL changes, which increased in the FDM group and decreased in the FDM-Sul group. Decreased retinal DA concentration, with an increase in Glu, may be involved in the myopia progression. D2R antagonists might effectively slow myopia progression by increasing retinal DA, regulating Glu concentration to match GABA, and maintaining the balance between excitatory and inhibitory neurotransmitters.
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Affiliation(s)
- Pinghui Wei
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin 300020, PR China
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, PR China
- Nankai University Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, Tianjin 300020, China
| | - Guoge Han
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin 300020, PR China
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, PR China
- Nankai University Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, Tianjin 300020, China
| | - Meiqin He
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300192, PR China
| | - Yan Wang
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin 300020, PR China
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, PR China
- Nankai University Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, Tianjin 300020, China
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Wang Z, Wang P, Jiang B, Meng Y, Qie S, Yan Z. The efficacy and safety of 0.01% atropine alone or combined with orthokeratology for children with myopia: A meta-analysis. PLoS One 2023; 18:e0282286. [PMID: 37494360 PMCID: PMC10370708 DOI: 10.1371/journal.pone.0282286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/13/2023] [Indexed: 07/28/2023] Open
Abstract
OBJECTIVE To evaluate the efficacy and safety of 0.01% atropine alone and in combination with orthokeratology for myopia control using a meta-analysis. METHODS PubMed, Cochrane Library, and EMBASE were searched. We included eligible randomized controlled trials (RCTs), non-RCTs, and retrospective cohort studies, published up to August 1, 2022. We calculated the weighted mean difference (WMD) and 95% confidence interval (CI) for all outcomes and plotted them in forest plots. RESULTS Fourteen studies were included; 4 and 11 in the 0.01% atropine monotherapy and atropine-orthokeratology (AOK) groups, respectively. Compared with orthokeratology (OK) alone, 0.01% atropine alone had similar effects on slowing the axial elongation (WMD: -0.00 mm; 95% CI: -0.05-0.04, p<0.31), while AOK significantly lowered axial growth. Moreover, the baseline myopic degree and duration of treatment were influential for the change in axial elongation (WMD: -0.12 mm; 95% CI: -0.17--0.07, p = 0.00001 and WMD: -0.11 mm; 95% CI: -0.15--0.108, p<0.00001, respectively). Additionally, the AOK may reduce the change rate of the spherical equivalent refraction and the accommodation amplitude (WMD: -0.13 D; 95% CI: 0.07-0.19, p<0.001 and WMD: -1.08 mm; 95% CI: -1.73--0.43, p<0.0001, respectively), and cause a slight increase in the diameter of the pupil (WMD: 0.56 mm; 95% CI: 0.43-0.70, p = 0.007). No significant differences in the uncorrected distant visual acuity, best corrected visual acuity, intraocular pressure, tear film break-up time, lipid layer thickness, and corneal endothelial cell density were found between the OK and AOK groups. CONCLUSION In slowing the axial elongation, 0.01% atropine alone and OK alone have similar effects, while AOK is more effective than OK alone in slowing down the axial elongation. Furthermore, the baseline degree of myopia and treatment duration may affect changes in axial elongation.
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Affiliation(s)
- Zengying Wang
- The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Pengfei Wang
- The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Bohua Jiang
- The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Yifei Meng
- The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Sufang Qie
- The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Zhipeng Yan
- The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
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Wu J, Gong H, Li H, Liang J, Zhang X, Yang H, Liu X, Zhang G, Cheng G, Bai G, Zhang H. Changes in choroidal thickness in myopic children with 0.01% atropine: Evidence from a 12-month follow-up. Photodiagnosis Photodyn Ther 2023; 42:103528. [PMID: 36966864 DOI: 10.1016/j.pdpdt.2023.103528] [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: 02/09/2023] [Revised: 03/08/2023] [Accepted: 03/21/2023] [Indexed: 04/08/2023]
Abstract
PURPOSE To investigate the changes of low-dose atropine (0.01%) on the choroidal thickness (ChT) of young children with low myopia. METHODS A total of 25 eyes of 25 low myopic children were included. All subjects were prescribed 0.01% atropine eye drops to be applied once per night before bedtime in involving eyes. The ChT and ocular biometry parameters were measured before and after 1 month, 3 months, 6 months and 12 months. The children were followed up for 12 months. RESULTS At 3 months, the ChT under the fovea significantly increased (309.96±70.82 μm) in comparison with the baseline (297.92±66.31 μm, P<0.0001) and was continuous thickening till 12 months after treatments with 0.01% atropine. Similarly, the changes of ChT under the fovea significantly increased from baseline to 3 months in comparison with the baseline to 1 month after treatments (P<0.0001). There was a significant relationship between changes in subfoveal ChT and central cornea thickness (CCT, beta=-1.76, 95% confidence intervals: -3.49 to -0.04, P = 0.045). CONCLUSIONS Using low dose atropine eye drops significantly increased subfoveal ChT after 3 months in eyes of myopic children. In addition, the changes in subfoveal ChT may be associated with the changes of CCT.
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Affiliation(s)
- Jianhua Wu
- Department of Ophthalmology, Inner Mongolia Chaoju Eye Hospital, 010050 Hohhot, China
| | - Hui Gong
- Department of Ophthalmology, Inner Mongolia Chaoju Eye Hospital, 010050 Hohhot, China
| | - Huixia Li
- Department of Ophthalmology, Inner Mongolia Chaoju Eye Hospital, 010050 Hohhot, China
| | - Junfeng Liang
- Department of Ophthalmology, Siziwang Banner People's Hospital, 011800 Ulanqab, China
| | - Xiaoguang Zhang
- Department of Ophthalmology, Inner Mongolia Chaoju Eye Hospital, 010050 Hohhot, China
| | - Hailong Yang
- Department of Ophthalmology, Inner Mongolia Chaoju Eye Hospital, 010050 Hohhot, China
| | - Xiaolin Liu
- Department of Ophthalmology, Inner Mongolia Chaoju Eye Hospital, 010050 Hohhot, China
| | - Guisen Zhang
- Department of Ophthalmology, Inner Mongolia Chaoju Eye Hospital, 010050 Hohhot, China
| | - Gongyuan Cheng
- Department of Ophthalmology, Inner Mongolia Chaoju Eye Hospital, 010050 Hohhot, China
| | - Gang Bai
- Department of Ophthalmology, Inner Mongolia Chaoju Eye Hospital, 010050 Hohhot, China.
| | - Han Zhang
- Department of Ophthalmology, Inner Mongolia Chaoju Eye Hospital, 010050 Hohhot, China.
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Xiong R, Zhu Z, Jiang Y, Wang W, Zhang J, Chen Y, Bulloch G, Yuan Y, Zhang S, Xuan M, Zeng J, He M. Longitudinal Changes and Predictive Value of Choroidal Thickness for Myopia Control after Repeated Low-Level Red-Light Therapy. Ophthalmology 2023; 130:286-296. [PMID: 36240954 DOI: 10.1016/j.ophtha.2022.10.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/30/2022] [Accepted: 10/03/2022] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To evaluate longitudinal changes in macular choroidal thickness (mCT) in myopic children treated for 1 year with repeated low-level red-light (RLRL) therapy and their predictive value for treatment efficacy on myopia control. DESIGN A secondary analysis of data from a multicenter, randomized controlled trial (RCT; NCT04073238). PARTICIPANTS Myopic children aged 8-13 years who participated in the RCT at 2 of 5 sites where mCT measurements were available. METHODS Repeated low-level red-light therapy was delivered using a home-use desktop light device that emitted red-light at 650 nm. Choroidal thickness was measured by SS-OCT at baseline and 1-, 3-, 6-, and 12-month follow-ups. Visual acuity, axial length (AL), cycloplegic spherical equivalent refraction (SER), and treatment compliance were measured. MAIN OUTCOME MEASURES Changes in mCT at 1, 3, 6, and 12 months relative to baseline, and their associations with myopia control. RESULTS A total of 120 children were included in the analysis (RLRL group: n = 60; single-vision spectacle [SVS] group: n = 60). Baseline characteristics were well balanced between the 2 groups. In the RLRL group, changes in mCT from baseline remained positive over 1 year, with a maximal increase of 14.755 μm at 1 month and gradually decreasing from 5.286 μm at 3 months to 1.543 μm at 6 months, finally reaching 9.089 μm at 12 months. In the SVS group, mCT thinning was observed, with changes from baseline of -1.111, -8.212, -10.190, and -10.407 μm at 1, 3, 6, and 12 months, respectively. Satisfactory myopia control was defined as annual progression rates of less than 0, 0.05, or 0.10 mm for AL and less than 0, 0.25, or 0.50 diopters for SER. Models that included mCT changes at 3 months alone had acceptable predictive discrimination of satisfactory myopia control over 12 months, with areas under the curve of 0.710-0.786. The predictive performance of the models did not significantly improve after adding age, gender, and baseline AL or SER. CONCLUSIONS This analysis from a multicenter RCT found RLRL induced sustained choroidal thickening over the full course of treatment. Macular choroidal thickness changes at 3 months alone can predict 12-month myopia control efficacy with reasonable accuracy. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Ruilin Xiong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Zhuoting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Yu Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Jian Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Yanping Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Gabriella Bulloch
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Yixiong Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Shiran Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Meng Xuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Junwen Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China; Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia.
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Hvid-Hansen A, Jacobsen N, Hjortdal J, Møller F, Ozenne B, Kessel L. Low-Dose Atropine Induces Changes in Ocular Biometrics in Myopic Children: Exploring Temporal Changes by Linear Mixed Models and Contribution to Treatment Effect by Mediation Analyses. J Clin Med 2023; 12:jcm12041605. [PMID: 36836139 PMCID: PMC9966043 DOI: 10.3390/jcm12041605] [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: 01/20/2023] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023] Open
Abstract
This study aimed to investigate changes in non-cycloplegic ocular biometrics during the initial six months of treatment with a 0.1% atropine loading dose and 0.01% atropine compared with a placebo and analyze their contribution to the treatment effect on cycloplegic spherical equivalent (SE) progression. The study was based on a randomized, double-masked, placebo-controlled, multicenter trial evaluating a 0.1% atropine six-month loading dose and 0.01% atropine in reducing myopic progression in Danish children. The treatment phase was 24 months, and the washout phase was 12 months. Parameters measured included changes in axial length (AL), anterior chamber depth (ACD), lens thickness (LT), vitreous chamber depth (VCD), and choroidal thickness (ChT), while cycloplegic SE and lens power were calculated. Longitudinal changes and contributions to treatment effects were analyzed using constrained linear mixed models and mediation analyses, respectively. After six months, AL was 0.13 mm shorter (95% confidence interval [CI], -0.18 to -0.07 [adjusted p < 0.001]) and 0.06 mm shorter (95% CI, -0.11 to -0.01 [adjusted p = 0.060]) with a 0.1% atropine loading dose and 0.01% atropine, respectively, compared to the placebo group. Similar concentration-dependent changes were found with ACD, LT, VCD, ChT, and cycloplegic SE. Although the treatment effects trended toward concentration-dependent responses, only the treatment effect mediated by AL at three months differed significantly between 0.01% atropine and a 0.1% atropine loading dose (adjusted p = 0.023). Several ocular biometrics, including AL, ACD, and LT, changed dose-dependently during low-dose atropine treatment. Moreover, the treatment effect of atropine on SE progression was mediated by a subset of ocular biometrics, mainly AL, with trends toward concentration dependency and distributional shifts over time.
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Affiliation(s)
- Anders Hvid-Hansen
- Department of Ophthalmology, Copenhagen University Hospital—Rigshospitalet-Glostrup, DK-2600 Glostrup, Denmark
- Correspondence:
| | - Nina Jacobsen
- Department of Ophthalmology, Copenhagen University Hospital—Rigshospitalet-Glostrup, DK-2600 Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, DK-2200 København N, Denmark
| | - Jesper Hjortdal
- Department of Ophthalmology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Flemming Møller
- Department of Ophthalmology, University Hospital of Southern Denmark—Vejle Hospital, DK-7100 Vejle, Denmark
| | - Brice Ozenne
- Department of Public Health, Section of Biostatistics, University of Copenhagen, DK-1014 København K, Denmark
- Neurobiology Research Unit, Copenhagen University Hospital—Rigshospitalet, DK-2200 København N, Denmark
| | - Line Kessel
- Department of Ophthalmology, Copenhagen University Hospital—Rigshospitalet-Glostrup, DK-2600 Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, DK-2200 København N, Denmark
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Shi Y. Effect of Atropine Eye Drops Combined with VR-Based Binocular Visual Function Balance Training for Prevention and Control of Juvenile Myopia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:4159996. [PMID: 36147642 PMCID: PMC9489366 DOI: 10.1155/2022/4159996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/26/2022] [Accepted: 08/08/2022] [Indexed: 11/20/2022]
Abstract
Purpose This study mainly analyzes the efficacy of 0.01% atropine eye drops (low-dose atropine (LDA)) combined with virtual reality (VR)-based binocular visual function (BVF) balance training in the prevention and control of juvenile myopia. Methods One hundred and thirty-six juvenile myopia patients admitted between November 2018 to November 2021 were selected, including 76 cases (research group) receiving LDA + VR-based BVF balance training and 60 cases (control group) treated by LDA intervention alone. Visual acuity (VA; naked vision), ocular parameters (pupil diameter (PD), axial length (AXL), and diopter), intraocular pressure (IOP), accommodation facility, clinical efficacy, and incidence of adverse reactions were observed, compared, and analyzed in both groups. Results After analysis, it was found that the research group showed significantly higher naked vision and PD while statistically lower D after intervention than the corresponding preinterventional parameters than the control group. While AXL showed no statistical difference between the groups and within groups. The IOP also differed insignificantly between groups, but the post-treatment accommodation facility was better in the research group compared with the baseline (before treatment) and control group. In terms of curative effects, an obviously higher total effective rate was determined in the research group. In addition, the two groups showed no significant difference in the incidence of adverse reactions. Conclusions LDA + VR-based BVF balance training deserves clinical popularization, as it can prevent and control myopia among teenagers, with better adjusting effects on eye function and certain safety.
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Affiliation(s)
- Yuping Shi
- Chengdu Aier Eye Hospital, Chengdu 610041, Sichuan, China
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10
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Zheng NN, Tan KW. The synergistic efficacy and safety of combined low-concentration atropine and orthokeratology for slowing the progression of myopia: A meta-analysis. Ophthalmic Physiol Opt 2022; 42:1214-1226. [PMID: 35919929 DOI: 10.1111/opo.13029] [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: 10/19/2021] [Revised: 06/24/2022] [Accepted: 06/24/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE To explore the efficacy and safety of combined low-concentration atropine and orthokeratology (OK) for slowing the progression of myopia. METHODS We performed a systematic search of English and Chinese databases to collect potentially eligible randomised controlled trials (RCTs), nonrandomised controlled trials (non-RCTs) and retrospective cohort studies (REs) published between the establishment of the database and 1 January 2022. The weighted mean difference (WMD) and 95% confidence interval (CI) were calculated for each outcome. RESULTS Fifteen studies were ultimately included in the meta-analysis, which indicated that compared with OK lenses alone, the combination of low-concentration atropine with OK lenses significantly slowed axial growth (WMD = -0.12 mm; 95% CI: -0.13 to -0.11, p < 0.001) and reduced the rate of change of the spherical equivalent refraction (WMD = 0.15 D; 95% CI: 0.06 to 0.24, p < 0.001). Additionally, the combined treatment may cause a slight increase in pupil diameter (WMD = 0.62 mm; 95% CI: 0.42 to 0.81, p < 0.001). No significant difference in the amplitude of accommodation, intraocular pressure, tear film break-up time or corneal endothelial cell density was found between the OK and combination therapy groups. CONCLUSIONS The combination therapy of low-concentration atropine and OK lenses had a greater effect in slowing myopia progression during a 6-to-12-month treatment interval and was still effective over a 24-month period. Increased pupil diameter was the major side effect of the combination therapy, with no negative impact on the amplitude of accommodation, intraocular pressure, tear film break-up time or corneal endothelial cell density.
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Affiliation(s)
| | - Kai-Wen Tan
- SuZhou Medical College of Soochow University, Suzhou, China
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11
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Prieto-Garrido FL, Villa-Collar C, Hernandez-Verdejo JL, Alvarez-Peregrina C, Ruiz-Pomeda A. Changes in the Choroidal Thickness of Children Wearing MiSight to Control Myopia. J Clin Med 2022; 11:jcm11133833. [PMID: 35807117 PMCID: PMC9267297 DOI: 10.3390/jcm11133833] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 01/27/2023] Open
Abstract
Background: Due to the importance of choroidal thickness in the development of myopia, this study examined the effect of MiSight contact lenses (CLs) on the choroidal thickness of myopic children and the differences between responders and non-responders to the treatment with these CLs. Methods: A total of 41 myopic children were fitted with MiSight CLs and 33 with single-vision spectacles. They were followed up for two years. Subfoveal choroidal thickness and choroidal thickness 1 and 3 mm temporal and nasal to the fovea were measured by OCT at baseline and one and two years after the treatment. Differences in all the choroidal thickness parameters were assessed in each group over time. Patients from the MiSight group were classified based on a specific range of changes in axial length at the end of the second year of treatment as “responders” (AL change < 0.22 mm/per year) and “non-responders”, and the choroidal thickness of both groups was analyzed. Results: The subfoveal choroidal thickness of the MiSight and single-vision spectacle groups did not show any changes over time. Wearing MiSight CLs induced relative choroidal thickening in the responder group in the first year of treatment. Conclusion: Choroidal thickness might work as a predictor of the effectiveness of MiSight in myopia treatment.
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Affiliation(s)
- Francisco Luis Prieto-Garrido
- Hospital Universitario del Henares, Fundación para la Investigación e Innovación Biomédica, FIIB HUIS HHEN, 28822 Madrid, Spain;
- Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain;
| | - Cesar Villa-Collar
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain;
| | | | | | - Alicia Ruiz-Pomeda
- Ophthalmology Department, Hospital Universitario de Móstoles, 28935 Madrid, Spain;
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12
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Yam JC, Jiang Y, Lee J, Li S, Zhang Y, Sun W, Yuan N, Wang YM, Yip BHK, Kam KW, Chan HN, Zhang XJ, Young AL, Tham CC, Cheung CY, Chu WK, Pang CP, Chen LJ. The Association of Choroidal Thickening by Atropine With Treatment Effects for Myopia: Two-Year Clinical Trial of the Low-concentration Atropine for Myopia Progression (LAMP) Study. Am J Ophthalmol 2022; 237:130-138. [PMID: 34942105 DOI: 10.1016/j.ajo.2021.12.014] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate longitudinal changes in subfoveal choroidal thickness (SFChT) among children receiving atropine 0.05%, 0.025%, or 0.01% over 2 years and their associations with treatment outcomes in myopia control. DESIGN Double-blinded randomized controlled trial. METHODS SFChT was measured at 4-month intervals using spectral domain optical coherence tomography. Cycloplegic spherical equivalent (SE), axial length (AL), best-corrected visual acuity, parental SE, outdoor time, near work diopter hours, and treatment compliance were also measured. RESULTS 314 children were included with qualified choroidal data. The 2-year changes in SFChT from baseline were 21.15 ± 32.99 µm, 3.34 ± 25.30 µm, and -0.30 ± 27.15 µm for the atropine 0.05%, 0.025%, and 0.01% groups, respectively (P < .001). A concentration-dependent response was observed, with thicker choroids at higher atropine concentrations (β = 0.89, P < .001). Mean SFChT thickness significantly increased at 4 months in the atropine 0.025% (P = .001) and 0.05% groups (P < .001) and then remained stable until the end of the second year (P > .05 for all groups). Over 2 years, an increase in SFChT was associated with slower SE progression (β = 0.074, P < .001) and reduced AL elongation (β = -0.045, P < .001). In the mediation analysis, 18.45% of the effect on SE progression from atropine 0.05% was mediated via its choroidal thickening. CONCLUSIONS Low concentration atropine induced a choroidal thickening effect along a concentration-dependent response throughout the treatment period. The choroidal thickening was associated with a slower SE progression and AL elongation among all the treatment groups. Choroidal response can be used for assessment of long-term treatment outcomes and as a guide for concentration titrations of atropine.
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Affiliation(s)
- Jason C Yam
- From the Department of Ophthalmology and Visual Sciences (J.C.Y., Y.J., J.L., S.L., Y.Z., N.Y., Y.M.W., K.W.K., H.-N.C., X.J.Z., A.L.Y., C.C.T., C.Y.C., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong, Hong Kong;; Hong Kong Eye Hospital, (J.C.Y., C.C.T.), Hong Kong; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, (J.C.Y., K.W.K., A.L.Y.,C.C.T., L.J.C.), Hong Kong; Hong Kong Hub of Paediatric Excellence (J.C.Y., C.C.T., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong; Department of Ophthalmology, Hong Kong Children's Hospital (J.C.Y.), Hong Kong.
| | - Yuning Jiang
- From the Department of Ophthalmology and Visual Sciences (J.C.Y., Y.J., J.L., S.L., Y.Z., N.Y., Y.M.W., K.W.K., H.-N.C., X.J.Z., A.L.Y., C.C.T., C.Y.C., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong, Hong Kong
| | - Jackie Lee
- From the Department of Ophthalmology and Visual Sciences (J.C.Y., Y.J., J.L., S.L., Y.Z., N.Y., Y.M.W., K.W.K., H.-N.C., X.J.Z., A.L.Y., C.C.T., C.Y.C., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong, Hong Kong
| | - Sherie Li
- From the Department of Ophthalmology and Visual Sciences (J.C.Y., Y.J., J.L., S.L., Y.Z., N.Y., Y.M.W., K.W.K., H.-N.C., X.J.Z., A.L.Y., C.C.T., C.Y.C., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong, Hong Kong
| | - Yuzhou Zhang
- From the Department of Ophthalmology and Visual Sciences (J.C.Y., Y.J., J.L., S.L., Y.Z., N.Y., Y.M.W., K.W.K., H.-N.C., X.J.Z., A.L.Y., C.C.T., C.Y.C., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong, Hong Kong
| | - Wen Sun
- Jockey Club School of Public Health and Primary Care (W.S., B.H.K.Y.), The Chinese University of Hong Kong, Hong Kong, China
| | - Nan Yuan
- From the Department of Ophthalmology and Visual Sciences (J.C.Y., Y.J., J.L., S.L., Y.Z., N.Y., Y.M.W., K.W.K., H.-N.C., X.J.Z., A.L.Y., C.C.T., C.Y.C., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong, Hong Kong
| | - Yu Meng Wang
- From the Department of Ophthalmology and Visual Sciences (J.C.Y., Y.J., J.L., S.L., Y.Z., N.Y., Y.M.W., K.W.K., H.-N.C., X.J.Z., A.L.Y., C.C.T., C.Y.C., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong, Hong Kong
| | - Benjamin Hon Kei Yip
- Jockey Club School of Public Health and Primary Care (W.S., B.H.K.Y.), The Chinese University of Hong Kong, Hong Kong, China
| | - Ka Wai Kam
- From the Department of Ophthalmology and Visual Sciences (J.C.Y., Y.J., J.L., S.L., Y.Z., N.Y., Y.M.W., K.W.K., H.-N.C., X.J.Z., A.L.Y., C.C.T., C.Y.C., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong, Hong Kong;; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, (J.C.Y., K.W.K., A.L.Y.,C.C.T., L.J.C.), Hong Kong
| | - Hei-Nga Chan
- From the Department of Ophthalmology and Visual Sciences (J.C.Y., Y.J., J.L., S.L., Y.Z., N.Y., Y.M.W., K.W.K., H.-N.C., X.J.Z., A.L.Y., C.C.T., C.Y.C., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong, Hong Kong
| | - Xiu Juan Zhang
- From the Department of Ophthalmology and Visual Sciences (J.C.Y., Y.J., J.L., S.L., Y.Z., N.Y., Y.M.W., K.W.K., H.-N.C., X.J.Z., A.L.Y., C.C.T., C.Y.C., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong, Hong Kong
| | - Alvin L Young
- From the Department of Ophthalmology and Visual Sciences (J.C.Y., Y.J., J.L., S.L., Y.Z., N.Y., Y.M.W., K.W.K., H.-N.C., X.J.Z., A.L.Y., C.C.T., C.Y.C., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong, Hong Kong;; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, (J.C.Y., K.W.K., A.L.Y.,C.C.T., L.J.C.), Hong Kong
| | - Clement C Tham
- From the Department of Ophthalmology and Visual Sciences (J.C.Y., Y.J., J.L., S.L., Y.Z., N.Y., Y.M.W., K.W.K., H.-N.C., X.J.Z., A.L.Y., C.C.T., C.Y.C., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong, Hong Kong;; Hong Kong Eye Hospital, (J.C.Y., C.C.T.), Hong Kong; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, (J.C.Y., K.W.K., A.L.Y.,C.C.T., L.J.C.), Hong Kong; Hong Kong Hub of Paediatric Excellence (J.C.Y., C.C.T., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong
| | - Carol Y Cheung
- From the Department of Ophthalmology and Visual Sciences (J.C.Y., Y.J., J.L., S.L., Y.Z., N.Y., Y.M.W., K.W.K., H.-N.C., X.J.Z., A.L.Y., C.C.T., C.Y.C., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong, Hong Kong
| | - Wai Kit Chu
- From the Department of Ophthalmology and Visual Sciences (J.C.Y., Y.J., J.L., S.L., Y.Z., N.Y., Y.M.W., K.W.K., H.-N.C., X.J.Z., A.L.Y., C.C.T., C.Y.C., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong, Hong Kong;; Hong Kong Hub of Paediatric Excellence (J.C.Y., C.C.T., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong
| | - Chi Pui Pang
- From the Department of Ophthalmology and Visual Sciences (J.C.Y., Y.J., J.L., S.L., Y.Z., N.Y., Y.M.W., K.W.K., H.-N.C., X.J.Z., A.L.Y., C.C.T., C.Y.C., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong, Hong Kong;; Hong Kong Hub of Paediatric Excellence (J.C.Y., C.C.T., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong
| | - Li Jia Chen
- From the Department of Ophthalmology and Visual Sciences (J.C.Y., Y.J., J.L., S.L., Y.Z., N.Y., Y.M.W., K.W.K., H.-N.C., X.J.Z., A.L.Y., C.C.T., C.Y.C., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong, Hong Kong;; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, (J.C.Y., K.W.K., A.L.Y.,C.C.T., L.J.C.), Hong Kong; Hong Kong Hub of Paediatric Excellence (J.C.Y., C.C.T., W.K.C., C.P.P., L.J.C.), The Chinese University of Hong Kong
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13
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Yeung SC, Park JY, Park D, You Y, Yan P. The effect of systemic and topical ophthalmic medications on choroidal thickness: a review. Br J Clin Pharmacol 2022; 88:2673-2685. [DOI: 10.1111/bcp.15237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/02/2022] [Accepted: 01/10/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Shanna C. Yeung
- Faculty of Medicine The University of British Columbia Vancouver Canada
| | | | - Daniel Park
- Faculty of Medicine University of Toronto Toronto Canada
| | - Yuyi You
- Department of Clinical Medicine Macquarie University Sydney Australia
- Save Sight Institute The University of Sydney Sydney Australia
| | - Peng Yan
- Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, University Health Network University of Toronto Toronto Canada
- Kensington Vision and Research Center Toronto Canada
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14
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Kaymak H, Neller K, Graff B, Körgesaar K, Langenbucher A, Seitz B, Schwahn H. [Optometric eye screening in schools : First epidemiological data for children and adolescents in grades 5-7]. Ophthalmologe 2022; 119:33-40. [PMID: 34114061 PMCID: PMC8191721 DOI: 10.1007/s00347-021-01427-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/09/2021] [Accepted: 05/10/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Annually recurring optometric screening helps to identify children with increased axial growth and also to create awareness for wearing properly corrected glasses and for spending enough time outdoors, both of which are crucial for healthy eyes. The obtained biometric data help to expand the epidemiological information on myopia in schoolchildren, which is fundamental for the selection of the correct treatment. MATERIAL AND METHODS Contact-free biometry of the eye was used to assess central corneal thickness, anterior chamber depth, lens thickness and axial length. Central choroidal thickness was manually assessed using optical coherence tomography (OCT). In addition, the mesopic and photopic pupil sizes were measured. RESULTS Biometric data were obtained from 257 (mean age 11.2 ± 1.1 years, 31.9% female, n = 82, 68.1% male, n = 175) out of a total of 274 examined children. Mean corneal radius (mean ± SD, female/male) was 7.74 ± 0.23 mm/7.89 ± 0.22 mm, central corneal thickness was 556.80 ± 31.31 µm/565.68 ± 33.12 µm, anterior chamber depth was 3.62 ± 0.28 mm/3.71 ± 0.25 mm, lens thickness was 3.48 ± 0.18 mm/3.46 ± 0.17 mm and axial length was 23.03 ± 0.88 mm/23.51 ± 0.88 mm. Choroidal thickness was assessed in 240 children and was 335.12 ± 60.5 µm. Mesopic and photopic pupil sizes were 6.38 ± 0.70 mm and 3.11 ± 0.63 mm, respectively. CONCLUSION The axial lengths found are consistent with the normal values for European children. A difference between male and female eyes could be observed. The repetition of these examinations in the future will enable the generation of growth charts.
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Affiliation(s)
- Hakan Kaymak
- Institut für Experimentelle Ophthalmologie, Universitätsklinikum des Saarlandes UKS, Homburg/Saar, Deutschland.
- Internationale Innovative Ophthalmochirurgie, Breyer Kaymak Klabe Augenchirurgie, Düsseldorf, Deutschland.
| | - Kai Neller
- Institut für Experimentelle Ophthalmologie, Universitätsklinikum des Saarlandes UKS, Homburg/Saar, Deutschland
- Internationale Innovative Ophthalmochirurgie, Breyer Kaymak Klabe Augenchirurgie, Düsseldorf, Deutschland
| | - Birte Graff
- Institut für Experimentelle Ophthalmologie, Universitätsklinikum des Saarlandes UKS, Homburg/Saar, Deutschland
- Internationale Innovative Ophthalmochirurgie, Breyer Kaymak Klabe Augenchirurgie, Düsseldorf, Deutschland
| | | | - Achim Langenbucher
- Institut für Experimentelle Ophthalmologie, Universitätsklinikum des Saarlandes UKS, Homburg/Saar, Deutschland
| | - Berthold Seitz
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes UKS, Homburg/Saar, Deutschland
| | - Hartmut Schwahn
- Internationale Innovative Ophthalmochirurgie, Breyer Kaymak Klabe Augenchirurgie, Düsseldorf, Deutschland
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15
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Yuan Y, Zhu C, Liu M, Zhou Y, Yang X, Zheng B, Li Z, Mao X, Ke B. Efficacy of combined orthokeratology and 0.01% atropine for myopia control: the study protocol for a randomized, controlled, double-blind, and multicenter trial. Trials 2021; 22:863. [PMID: 34852833 PMCID: PMC8633914 DOI: 10.1186/s13063-021-05825-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 11/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of myopia is increasing worldwide and is presently recognized as a major public health issue. Researchers and clinicians have been devoted in exploring appropriate clinical interventions to slow its progression in children. Mounting publications have proven that both orthokeratology (OK lens) and 0.01% atropine eyedrop can retard eye growth and myopia progression. However, it remains unclear whether the combination of OK lens and 0.01% atropine has the potential to magnify the effectiveness of myopia control. The present study aims to compare the myopia control efficiency of the combination of OK lens and 0.01% atropine with the monotherapy of OK lens in children. METHODS The present study is a randomized, controlled, double-blind and multicenter clinical trial. A total of 96 children within 8-12 years old were recruited. These participants are treated with the combination of OK lens and 0.01% atropine eyedrop or the combination of OK lens and placebo eyedrop. Each group includes 48 participants. The inclusion criteria are as follows: myopia between - 1.00 and - 4.00 D in either eye and astigmatism of no more than 1.50 D. The follow-up time points will be 1, 6, 12, 18, and 24 months from randomization. The primary outcome is determined by the difference in axial length of the two groups, between the baseline and 24 months from randomization. DISCUSSION The present randomized, controlled clinical trial would indicate the additive effects of the combination of OK lens and 0.01% atropine, and the extent of these effects, in retarding myopia progression and axial elongation in children. TRIAL REGISTRATION Chinese Clinical Trial Registry (ChiCTR), ChiCTR1800018419 . Registered on 17 September 2018. http://www.chictr.org.cn/showproj.aspx?proj=29216.
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Affiliation(s)
- Ying Yuan
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China.,National Clinical Research Center for Eye Diseases, Shanghai, China.,Shanghai Key Laboratory of Fundus Disease, Shanghai, China
| | - Chengcheng Zhu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China.,Shanghai Key Laboratory of Fundus Disease, Shanghai, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Mingming Liu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China.,Shanghai Key Laboratory of Fundus Disease, Shanghai, China.,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Yali Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China.,Shanghai Key Laboratory of Fundus Disease, Shanghai, China.,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Xiao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center Sun Yat-Sen University, Guangzhou, China
| | - Bingru Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center Sun Yat-Sen University, Guangzhou, China
| | - Zhouyue Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center Sun Yat-Sen University, Guangzhou, China
| | - Xinjie Mao
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027, Zhejiang, China.
| | - Bilian Ke
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China. .,National Clinical Research Center for Eye Diseases, Shanghai, China. .,Shanghai Key Laboratory of Fundus Disease, Shanghai, China.
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16
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Ye L, Shi Y, Yin Y, Li S, He J, Zhu J, Xu X. Effects of Atropine Treatment on Choroidal Thickness in Myopic Children. Invest Ophthalmol Vis Sci 2021; 61:15. [PMID: 33320168 PMCID: PMC7745623 DOI: 10.1167/iovs.61.14.15] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose To examine the changes in choroidal thickness (ChT) after 6 months of 1% or 0.01% atropine treatment and the independent factors associated with eye elongation. Methods A total of 207 myopic children aged 6 to 12 years were recruited and randomly assigned to groups A and B in a ratio of 1:1. Participants in group A received 1% atropine once a day for 1 week, and then once a week for 23 weeks. Participants in group B received 0.01% atropine once a day for 6 months. ChT and internal axial length (IAL) were measured at baseline, 1 week, 3 months, and 6 months. Results In group A, the ChT significantly increased after a 1-week loading dose of 1% atropine (26 ± 14 µm; P < 0.001) and the magnitude of increase stabilized throughout the following weekly treatment. The internal axial length did not significantly change at the 6-month visit (−0.01 ± 0.11 mm; P = 0.74). In contrast, a decreased ChT (−5 ± 17 µm; P < 0.001) and pronounced eye elongation (0.19 ± 0.12 mm; P < 0.001) were observed in group B after 6 months. Multivariable regression analysis showed that less increase in ChT at the 1-week visit (P = 0.03), younger age (P < 0.001), and presence of peripapillary atrophy (P = 0.001) were significantly associated with greater internal axial length increase over 6 months in group A. Conclusions One percent atropine could increase the ChT, whereas 0.01% atropine caused a decrease in ChT after 6 months of treatment. For participants receiving 1% atropine, the short-term increase in ChT was negatively associated with long-term eye elongation. Younger age and the presence of peripapillary atrophy were found to be risk factors for greater eye elongation.
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Affiliation(s)
- Luyao Ye
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Ya Shi
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Yao Yin
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Shanshan Li
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Jiangnan He
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Jianfeng Zhu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Xun Xu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
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