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Mu J, Zhong H, Jiang M, Wang J, Zhang S. Development of a nomogram for predicting myopia risk among school-age children: a case-control study. Ann Med 2024; 56:2331056. [PMID: 38507901 PMCID: PMC10956924 DOI: 10.1080/07853890.2024.2331056] [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: 10/15/2023] [Accepted: 02/23/2024] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVES To analyze the factors influencing myopia and construct a nomogram to forecast the risk of myopia among school-age children, providing a reference for identifying high-risk groups to aid prevention and control. METHODS This case-control study enrolled 3512 students from three primary schools in Shenzhen using random cluster sampling for a questionnaire survey, myopia screening and ocular biometric parameter measurement. Logistic regression was used to analyze the influencing factors of myopia, and a nomogram was constructed to forecast myopia risk. Bootstrap resampling was used to verify the practicability of the nomogram. RESULTS Older age (odds ratio[OR] = 1.164; 95% confidence interval [CI]: 1.111-1.219), female sex (OR = 2.405; 95% CI: 2.003-2.887), maternal myopia (OR = 1.331; 95% CI: 1.114-1.589), incorrect posture during reading and writing (OR = 1.283; 95% CI: 1.078-1.528) and axial length (OR = 7.708; 95% CI: 6.044-8.288) are risk factors for myopia, whereas an increase in corneal radius (OR = 0.036; 95% CI: 0.025-0.052) is a protective factor against myopia. The area under the receiver operating characteristic (ROC) curve of the nomogram was 0.857, and the net benefit was high when the risk threshold of the decision curve analyses (DCA) ranged from 0.20 to 1.00. The measured values were consistent with the prediction. CONCLUSION The nomogram was accurate in predicting the risk of myopia among schoolchildren. This study provides a reference for screening high-risk students and for individualized myopia prevention and control.
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Affiliation(s)
- Jingfeng Mu
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Haoxi Zhong
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Mingjie Jiang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Jiantao Wang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Shaochong Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
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Wang K, Han G, Hao R. Advances in the study of the influence of photoreceptors on the development of myopia. Exp Eye Res 2024; 245:109976. [PMID: 38897270 DOI: 10.1016/j.exer.2024.109976] [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: 12/05/2023] [Revised: 06/12/2024] [Accepted: 06/16/2024] [Indexed: 06/21/2024]
Abstract
This review examines the pivotal role of photoreceptor cells in ocular refraction development, focusing on dopamine (DA) as a key neurotransmitter. Contrary to the earlier view favoring cone cells, recent studies have highlighted the substantial contributions of both rod and cone cells to the visual signaling pathways that influence ocular refractive development. Notably, rod cells appeared to play a central role. Photoreceptor cells interact intricately with circadian rhythms, color vision pathways, and other neurotransmitters, all of which are crucial for the complex mechanisms driving the development of myopia. This review emphasizes that ocular refractive development results from a coordinated interplay between diverse cell types, signaling pathways, and neurotransmitters. This perspective has significant implications for unraveling the complex mechanisms underlying myopia and aiding in the development of more effective prevention and treatment strategies.
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Affiliation(s)
- Kailei Wang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, PR China; Tianjin Key Lab of Ophthalmology and Vision Science, Tianjin Eye Hospital, Tianjin, 300020, PR China
| | - Guoge Han
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, PR China; Tianjin Key Lab of Ophthalmology and Vision Science, Tianjin Eye Hospital, Tianjin, 300020, PR China; Nankai University Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, Tianjin, 300020, PR China.
| | - Rui Hao
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, PR China; Tianjin Key Lab of Ophthalmology and Vision Science, Tianjin Eye Hospital, Tianjin, 300020, PR China; Nankai University Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, Tianjin, 300020, PR China.
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Dai Y, Wang L, Hong J, Sun X. Eight Years and Beyond Longitudinal Changes of Peripapillary Structures on OCT in Adult Myopia. Am J Ophthalmol 2024; 264:178-186. [PMID: 38521154 DOI: 10.1016/j.ajo.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 03/02/2024] [Accepted: 03/11/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE To investigate the long-term changes of peripapillary structures detected by enhanced depth imaging of optical coherence tomography (OCT) in adult myopia. DESIGN Observational case series. METHODS Myopic participants who had undergone a full baseline ophthalmologic examination and had been followed up for a minimum of 8 years were included. Using enhanced depth imaging of OCT, scans around the optic disc in the Spectralis software Follow-up mode, which enabled capturing of the same positions, were performed in 65 eyes. The peripapillary parameters including the size of border tissue, Bruch membrane opening (BMO), peripapillary choroidal thickness, and the angle between peripapillary Bruch membrane (BM) and anterior sclera were manually delineated and measured. RESULTS The axial length showed a significant elongation after a mean follow-up of 9.46 ± 0.92 years. The rates of changes were 0.015 ± 0.011 mm/y in the medium myopia group and 0.057 ± 0.039 mm/y in the high myopia group. At the last visit, the average border tissue length and BMO diameter were increased. The angle between peripapillary BM did not show significant change, while the angle between the peripapillary sclera showed a significant rise. On multivariate analysis, the border tissue elongation, BMO enlargement, and increased sclera angle were all associated with a change in axial length. The development of a BM defect and inward protrusion of sclera in the temporal peripapillary region was observed on 8 eyes (34.8%) in the high myopia group, along with an extreme thinning or disappearing of the peripapillary choroid. CONCLUSION Marked longitudinal changes in peripapillary structures including border tissue, BM, choroid, and sclera could be observed in adult myopic eyes, which may impact the biomechanical environment around the optic nerve head.
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Affiliation(s)
- Yi Dai
- From the Department of Ophthalmology & Visual Science (Y.D., L.W., X.S.), Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University) (Y.D., L.W., X.S.), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China.
| | - Li Wang
- From the Department of Ophthalmology & Visual Science (Y.D., L.W., X.S.), Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University) (Y.D., L.W., X.S.), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China
| | - Jie Hong
- Development Planning and Double First-class Office (J.H.), Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xinghuai Sun
- From the Department of Ophthalmology & Visual Science (Y.D., L.W., X.S.), Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University) (Y.D., L.W., X.S.), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, China; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science (X.S.), Institutes of Brain Science, Fudan University, Shanghai, China.
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Liu MX, Zhu KY, Li DL, Dong XX, Liang G, Grzybowski A, Pan CW. Corneal Biomechanical Characteristics in Myopes and Emmetropes Measured by Corvis ST: A Meta-Analysis. Am J Ophthalmol 2024; 264:154-161. [PMID: 38556185 DOI: 10.1016/j.ajo.2024.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 02/17/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE To comprehensively identify the corneal biomechanical differences measured by Corvis ST between different degrees of myopia and emmetropia. DESIGN Systematic review and meta-analysis. METHODS Electronic databases, including PubMed, Embase, and Web of Science, were systematically searched for studies comparing the corneal biomechanics among various degrees of myopes and emmetropes using Corvis ST. The weighted mean differences and 95% confidence intervals were calculated. Meta-analysis was performed in high and nonhigh myopes and in myopes and emmetropes, respectively. RESULTS Eleven studies were included in this study. The meta-analysis among myopes and emmetropes included 1947 myopes and 621 emmetropes, and 443 high myopes and 449 nonhigh myopes were included in the meta-analysis among high and nonhigh myopia. Myopes showed the cornea with significantly longer time at the first applanation (A1t) and lower length at the second applanation (A2L) than emmetropes. High myopes showed significantly greater A1t, velocity at the second applanation (A2v), deformation amplitude at the highest concavity (HC-DA), and peak distance at the highest concavity (HC-PD) and decreased time at the second applanation (A2t) and radius of the highest concavity (HC-R). CONCLUSIONS Corneal biomechanics is different in myopia, especially in high myopia. Compared with nonhigh myopes, the corneas of high myopes deformed slower during the first applanation, faster during the second applanation, and showed greater deformation amplitude, indicating greater elasticity and viscidity.
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Affiliation(s)
- Min-Xin Liu
- School of Public Health (M.X.L., D.L.L., X.X.D., C.W.P.), Suzhou Medical College of Soochow University, Suzhou, China
| | - Ke-Yao Zhu
- Pasteurien College of Soochow University (K.Y.Z.), Suzhou, China
| | - Dan-Lin Li
- School of Public Health (M.X.L., D.L.L., X.X.D., C.W.P.), Suzhou Medical College of Soochow University, Suzhou, China
| | - Xing-Xuan Dong
- School of Public Health (M.X.L., D.L.L., X.X.D., C.W.P.), Suzhou Medical College of Soochow University, Suzhou, China
| | - Gang Liang
- Department of Ophthalmology (G.L.), The Affiliated Hospital of Yunnan University, Kunming, China
| | - Andrzej Grzybowski
- Institute for Research in Ophthalmology (A.G.), Foundation for Ophthalmology Development, Poznan, Poland
| | - Chen-Wei Pan
- School of Public Health (M.X.L., D.L.L., X.X.D., C.W.P.), Suzhou Medical College of Soochow University, Suzhou, China.
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Moin KA, Manion GN, Pandiri S, Hoopes PC, Moshirfar M. Three-Month Comprehensive Outcomes of Topography-Guided LASIK Versus Keratorefractive Lenticule Extraction (KLEx): A Prospective Contralateral Study. Ophthalmol Ther 2024; 13:2265-2284. [PMID: 38951314 PMCID: PMC11246376 DOI: 10.1007/s40123-024-00987-y] [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: 05/13/2024] [Accepted: 06/17/2024] [Indexed: 07/03/2024] Open
Abstract
INTRODUCTION The aim of this study was to compare outcomes of topography-guided laser-assisted in situ keratomileusis (TG-LASIK) and small incision lenticule extraction (SMILE®) for correcting myopia and myopic astigmatism. METHODS In this prospective, randomized contralateral study, 34 patients (68 eyes) received TG-LASIK in one eye, and SMILE in their fellow eye. Efficacy, safety, predictability, higher-order aberrations, corneal tomography, biomechanics, and patient-reported outcomes (PROs) were assessed preoperatively and up to 3 months postoperatively. RESULTS Both platforms showed comparable efficacy at 3 months (TG-LASIK 1.08 ± 0.19; SMILE 0.98 ± 0.17, p = 0.055). However, TG-LASIK demonstrated quicker visual recovery, with 63% and 89% achieving uncorrected distance visual acuity (UDVA) of 20/16 or better at 1 day and 1 week, respectively, compared to SMILE (34% and 63%; p < 0.05). Safety index at 3 months did not significantly differ between TG-LASIK and SMILE (p = 0.223). TG-LASIK and SMILE had 44% and 56% of eyes within 0.13 D of spherical equivalent (SEQ) target, respectively. SMILE induced more total higher-order aberrations (HOAs), vertical coma, and oblique trefoil than TG-LASIK at 3 months (p < 0.05). Both platforms showed similar increases in epithelial remodeling, but SMILE induced thicker epithelium than TG-LASIK at the 7.0-mm nasal zonal area. No significant differences were found in corneal hysteresis (CH) or corneal resistance factor (CRF) at 3 months (p > 0.05). Reported symptoms of glare, halos, rings, starbursts, or dry eye did not significantly differ between groups at 3 months (p > 0.05). Overall, 59% of patients preferred their TG-LASIK treated eye at 1 month, but 65% of patients had no specific eye preference at 3 months. CONCLUSION TG-LASIK and SMILE demonstrate excellent and comparable efficacy, safety, and predictability at 3 months, but TG-LASIK offers faster postoperative visual recovery at 1 day and 1 week. TG-LASIK induces fewer HOAs than SMILE, but both procedures affect corneal biomechanics similarly. TRIAL REGISTRATION ClincialTrials.gov identifier, NCT05611294.
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Affiliation(s)
- Kayvon A Moin
- Hoopes Vision Research Center, Hoopes Vision, 11820 S State St #200, Draper, UT, 84020, USA
| | | | - Srujay Pandiri
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Phillip C Hoopes
- Hoopes Vision Research Center, Hoopes Vision, 11820 S State St #200, Draper, UT, 84020, USA
| | - Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, 11820 S State St #200, Draper, UT, 84020, USA.
- John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA.
- Utah Lions Eye Bank, Murray, UT, USA.
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Yuexin W, Yu Z, Yifei Y, Yan L, Yueguo C. The impact of accommodation function on the difference between noncycloplegic and cycloplegic refraction in adult myopes. Acta Ophthalmol 2024; 102:e727-e735. [PMID: 38235947 DOI: 10.1111/aos.16632] [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: 06/22/2023] [Revised: 12/21/2023] [Accepted: 01/04/2024] [Indexed: 01/19/2024]
Abstract
PURPOSE To investigate the impact of accommodation function on the difference between cycloplegic and noncycloplegic subjective and automatic refraction in adult myopes. METHODS Myopic patients between 18 and 50 years old evaluated at Peking University Third Hospital who underwent cycloplegic and noncycloplegic automatic and subjective refraction were enrolled. Accommodation function, including negative and positive relative accommodation (PRA/NRA) and accommodation response (binocular cross cylinder, BCC) was examined. RESULTS Of the 3268 individuals enrolled, the mean age was 27.3 ± 6.9 years, and 34.8% of participants were male. The noncycloplegic spherical equivalent (SE) was 0.23 ± 0.29 D and 0.64 ± 0.61 D more myopic than cycloplegic subjective and automatic refraction. Adjusting for associated factors, participants with at least 0.50 D of more myopia SE refraction by noncycloplegic subjective refraction were more likely to be older (odds ratio [OR], 1.029; 95% confidence interval [CI], 1.013-1.045) and with insufficient (OR, 1.514; 95% CI, 1.093-2.096) and excessive (OR, 2.196; 95% CI, 1.538-3.137) NRA value. The automatic refraction SE difference of at least 1.00 D more myopia was more likely to be found in individuals with older age (OR, 1.036; 95% CI, 1.022-1.050) and accommodative lead (OR, 1.255; 95% CI, 1.004-1.568). CONCLUSION A quarter of adult myopes had at least 0.50 and 1.00 D of subjective and automatic SE difference with cycloplegia. The accommodation function significantly affects the difference between cycloplegic and noncycloplegic refraction. Investigating the differences in refraction measurement guarantees the proper use of cycloplegia in adults for myopia correction.
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Affiliation(s)
- Wang Yuexin
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
| | - Zhang Yu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
| | - Yuan Yifei
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
| | - Liu Yan
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
| | - Chen Yueguo
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
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Li F, Ye X, Li M, Nie Q, Wang H, Zhang G, Dong L, Wang C, Wu L, Liu H, Wang L, Peng C, Zhang J. Enhanced ophthalmic bioavailability and stability of atropine sulfate via sustained release particles using polystyrene sulfonate resin. Int J Pharm 2024; 660:124294. [PMID: 38823467 DOI: 10.1016/j.ijpharm.2024.124294] [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: 02/02/2024] [Revised: 05/17/2024] [Accepted: 05/29/2024] [Indexed: 06/03/2024]
Abstract
Atropine sulfate (ATS) eye drops at low concentrations constitute a limited selection for myopia treatment, with challenges such as low ophthalmic bioavailability and inadequate stability. This study proposes a novel strategy by synthesizing ophthalmic sodium polystyrene sulfonate resin (SPSR) characterized by a spherical shape and uniform size for cationic exchange with ATS. The formulation of ATS@SPSR suspension eye drops incorporates xanthan gum and hydroxypropyl methylcellulose (HPMC) as suspending agents. In vitro studies demonstrated that ATS@SPSR suspension eye drops exhibited sustained release characteristics, and tropic acid, its degradation product, remained undetected for 30 days at 40 °C. The ATS levels in the tear fluids and aqueous humor of New Zealand rabbits indicated a significant increase in mean residence time (MRT) and area under the drug concentration-time curve (AUC0-12h) for ATS@SPSR suspension eye drops compared to conventional ATS eye drops. Moreover, safety assessment confirmed the non-irritating nature of ATS@SPSR suspension eye drops in rabbit eyes. In conclusion, the cation-responsive sustained-release ATS@SPSR suspension eye drops enhanced the bioavailability and stability of ATS, offering a promising avenue for myopia treatment.
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Affiliation(s)
- Falan Li
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; Yangtze Delta Drug Advanced Research Institute, Nantong 226133, China; Jiangsu Yunshi Pharmaceutical Technology Co. Ltd., Nantong 226133, China
| | - Xinyue Ye
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; Yangtze Delta Drug Advanced Research Institute, Nantong 226133, China; Jiangsu Yunshi Pharmaceutical Technology Co. Ltd., Nantong 226133, China
| | - Mingwei Li
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; Yangtze Delta Drug Advanced Research Institute, Nantong 226133, China; Jiangsu Yunshi Pharmaceutical Technology Co. Ltd., Nantong 226133, China
| | - Qin Nie
- Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201210, China
| | - Huihui Wang
- Yangtze Delta Drug Advanced Research Institute, Nantong 226133, China; Jiangsu Yunshi Pharmaceutical Technology Co. Ltd., Nantong 226133, China
| | - Guoqing Zhang
- Jiangsu Yunshi Pharmaceutical Technology Co. Ltd., Nantong 226133, China
| | - Liyun Dong
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; Yangtze Delta Drug Advanced Research Institute, Nantong 226133, China; Jiangsu Yunshi Pharmaceutical Technology Co. Ltd., Nantong 226133, China
| | - Caifen Wang
- Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201210, China
| | - Li Wu
- Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201210, China
| | - Hongfei Liu
- Jiangsu University, Zhenjiang 212000, China; Jiangsu Yunshi Pharmaceutical Technology Co. Ltd., Nantong 226133, China.
| | - Lifeng Wang
- Yangtze Delta Drug Advanced Research Institute, Nantong 226133, China.
| | - Can Peng
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China.
| | - Jiwen Zhang
- College of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201210, China; Yangtze Delta Drug Advanced Research Institute, Nantong 226133, China; Jiangsu Yunshi Pharmaceutical Technology Co. Ltd., Nantong 226133, China.
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Yuan M, Zhu Y, Ren Y, Chen L, Dai X, Wang Y, Huang Y, Wang H. Global burden and attributable risk factors of breast cancer in young women: historical trends from 1990 to 2019 and forecasts to 2030 by sociodemographic index regions and countries. J Glob Health 2024; 14:04142. [PMID: 39026460 DOI: 10.7189/jogh.14.04142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
Background Breast cancer in young women (BCY) is much less common but has significant health sequelae and societal costs. We aimed to evaluate the global and regional burden of breast cancer in women aged 15-39 years from 1990 to 2019. Methods We collected detailed data on breast cancer from the Global Burden of Disease Study 2019 (GBD 2019) Data Resources. The age-standardised incidence rate (ASIR), age-standardised mortality rate (ASMR), age-standardised disability-adjusted life years rate (ASDR), and estimated annual percentage change (EAPC) were used to assess the disease burden of BCY. The Bayesian Age-Period-Cohort model was used to forecast disease burden from 2020 to 2030. Results From 1990 to 2019, significant increases in ASIR were found for BCY (EAPC = 0.59, 95% confidence interval (CI) = 0.5 to 0.68), whereas decreases in ASMR (EAPC = -0.41, 95% CI = -0.53 to -0.3) and ASDR (EAPC = -0.35, 95% CI = -0.46 to -0.24). Across countries with varying sociodemographic indexes (SDI), all regions showed an upward trend in BCY morbidity, except for countries with a high SDI. While mortality and DALYs rates have decreased in countries with high, high-middle, and middle SDI, they have increased in countries with low-middle and low SDI. Countries with lower SDIs are projected to bear the greatest burden of BCY over the next decade, including both low and low-middle categories. Alcohol use was the main risk factor attributed to BCY deaths in most countries, while exposure to second hand smoke was the predominant risk factor for BCY deaths in middle and low-middle SDI countries. Conclusions The burden of breast cancer in young women is on the rise worldwide, and there are significant regional differences. Countries with a low-middle or low SDI face even more challenges, as they experienced a more significant and increasing BCY burden than countries with higher SDIs.
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Affiliation(s)
- Mengqi Yuan
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Yi Zhu
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Yitao Ren
- School of Health Services Management, Southern Medical University, Guangzhou, PR China
| | - Lijin Chen
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Xiaochen Dai
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Yuying Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Yixiang Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Hongmei Wang
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
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Kayabaşı M, Köksaldı S, Durmaz Engin C. Evaluating the quality and reliability of YouTube videos on myopia: a video content analysis. Int Ophthalmol 2024; 44:329. [PMID: 39026115 DOI: 10.1007/s10792-024-03250-2] [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: 04/14/2024] [Accepted: 07/14/2024] [Indexed: 07/20/2024]
Abstract
PURPOSE To evaluate the quality and reliability of YouTube videos as an educational resource about myopia. METHODS The videos were identified by searching YouTube with the keywords 'myopia' and 'nearsightedness', using the website's default search settings. The number of views, likes, dislikes, view ratio, source of the upload, country of origin, video type, and described treatment techniques were assessed. Each video was evaluated using the DISCERN, Journal of the American Medical Association (JAMA), Ensuring Quality Information for Patients (EQIP), Health On the Net Code of Conduct Certification (HONcode), and the Global Quality Score (GQS) scales. RESULTS A total of 112 videos were included. The classification of videos by source indicated that the top three contributors were health channels (30 videos [26.8%]), physicians (24 videos [21.4%]), and academic centers (19 videos [16.9%]). Most of these videos originated from the United States (74 videos [66.1%]) and focused on the pathophysiology (n = 89, 79.4%) and the treatment (n = 77, 68.7%) of myopia. Statistical comparisons among the groups of video sources showed no significant difference in the mean DISCERN score (p = 0.102). However, significant differences were noted in the JAMA (p = 0.011), GQS (p = 0.009), HONcode (p = 0.011), and EQIP (p = 0.002) scores. CONCLUSIONS This study underscored the variability in the quality and reliability of YouTube videos related to myopia, with most content ranging from 'weak to moderate' quality based on the DISCERN and GQS scales, yet appearing to be 'excellent' according to the HONcode and EQIP scales. Videos uploaded by physicians generally exhibited higher standards, highlighting the importance of expert involvement in online health information dissemination. Given the potential risks of accessing incorrect medical data that can affect the decision-making processes of patients, caution should be exercised when using online content as a source of information.
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Affiliation(s)
- Mustafa Kayabaşı
- Department of Ophthalmology, Mus State Hospital, Yeni Mahalle, Eski Tekel Depoları Yanı, Bitlis Yolu Üzeri, Muş-Bitlis Şosesi, Merkez, Mus, Turkey.
| | - Seher Köksaldı
- Department of Ophthalmology, Mus State Hospital, Yeni Mahalle, Eski Tekel Depoları Yanı, Bitlis Yolu Üzeri, Muş-Bitlis Şosesi, Merkez, Mus, Turkey
| | - Ceren Durmaz Engin
- Department of Ophthalmology, Buca Seyfi Demirsoy Education and Research Hospital, Izmir, Turkey
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Tuo Y, Zhang G, Yi H. Vision for the future: pioneering strategies in China's battle against myopia. Eye (Lond) 2024:10.1038/s41433-024-03250-7. [PMID: 39026097 DOI: 10.1038/s41433-024-03250-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 06/20/2024] [Accepted: 07/11/2024] [Indexed: 07/20/2024] Open
Affiliation(s)
- Yurong Tuo
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guochao Zhang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hang Yi
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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11
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Tomiyama ES, Kobia-Acquah E, Ansari SM, Logan AK, Gialousakis J, Ng S, Wagner H. Scoping review: Reporting characteristics for the safety of contact lenses in the pediatric population. Optom Vis Sci 2024:00006324-990000000-00210. [PMID: 38950144 DOI: 10.1097/opx.0000000000002156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2024] Open
Abstract
SIGNIFICANCE Contact lenses are an increasingly popular option for correcting pediatric refractive error due to increased awareness of interventions to slow myopia progression. With limited information on the safety profiles of contact lenses in children, it is important to characterize the current understanding and promote this device's safe and effective use. PURPOSE This scoping review evaluates characteristics of the current literature that have examined the safety of contact lenses in pediatric patients. It provides future directions for systematic reviews and identifies any gaps in the current literature or areas for future research. METHODS Literature searches in MEDLINE via PubMed, EMBASE, The Cochrane Library, trial registries, and U.S. Food and Drug Administration clinical trial documentation were performed. Included studies (i.e., experimental and quasi-experimental studies; observational studies including prospective and retrospective cohort, case-control, and analytical cross-sectional studies, and case series of 30 or more participants) reported safety and/or complications of the use of any contact lens for correcting refractive error in children (0 to 18 years). Two independent reviewers first screened the titles and abstracts, and then full-text reports for eligibility. Conflicts in eligibility were resolved by discussions with a third reviewer. Two independent reviewers extracted data, including details about the participants, context, study methods, and key findings relevant to the review question. RESULTS This scoping review included 73 studies from 10 countries using different contact lens modalities, primarily orthokeratology and soft contact lenses, in children (6 to 18 years). The most common adverse event reported by the studies was corneal staining (60% orthokeratology, 45% soft contact lens). CONCLUSIONS The need for uniform reporting standards for adverse events poses challenges for comprehensive data synthesis. However, this scoping review identified a sufficient number of studies for a future systematic review to quantify the risks associated with orthokeratology and soft contact lens use in children.
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Affiliation(s)
| | | | - Shora M Ansari
- Southern California College of Optometry, Marshall B. Ketchum University, Fullerton, California
| | | | - John Gialousakis
- Midwestern University Chicago College of Optometry, Downers Grove, IL
| | - Sueko Ng
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Heidi Wagner
- Southern California College of Optometry, Marshall B. Ketchum University, Fullerton, California
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12
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Zhang L, Yi K, Sun Q, Chen Z, Xiang Y, Ren W, Wu P, He S, Yang Y, Feng L, Hu K, Wan W. Palladium nanocrystals regulates scleral extracellular matrix remodeling in myopic progression by modulating the hypoxia signaling pathway Nrf-2/Ho-1. J Control Release 2024; 373:S0168-3659(24)00462-0. [PMID: 39019088 DOI: 10.1016/j.jconrel.2024.07.031] [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: 04/26/2024] [Revised: 06/15/2024] [Accepted: 07/12/2024] [Indexed: 07/19/2024]
Abstract
Myopia represents a widespread global public health concern influenced by a combination of environmental and genetic factors. The prevailing theory explaining myopia development revolves around scleral extracellular matrix (ECM) remodeling, characterized by diminished Type I collagen (Col-1) synthesis and increased degradation, resulting in scleral thinning and eye axis elongation. Existing studies underscore the pivotal role of scleral hypoxia in myopic scleral remodeling. This study investigates the peroxidase-like activity and catalytic performance of octahedral Palladium (Pd) nanocrystals, recognized as nanozymes with antioxidative properties. We explore their potential in reducing oxidative stress and alleviating hypoxia in human scleral fibroblasts (HSF) and examine the associated molecular mechanisms. Our results demonstrate the significant peroxidase-like activity of Pd nanocrystals. Furthermore, we observe a substantial reduction in oxidative stress in HSF under hypoxia, mitigating cellular damage. These effects are linked to alterations in Nrf-2/Ho-1 expression, a pathway associated with hypoxic stress. Importantly, our findings indicate that Pd nanocrystals contribute to attenuated scleral matrix remodeling in myopic guinea pigs, effectively slowing myopia progression. This supports the hypothesis that Pd nanocrystals regulate myopia development by controlling oxidative stress associated with hypoxia. Based on these results, we propose that Pd nanocrystals represent a novel and potential treatment avenue for myopia through the modulation of scleral matrix remodeling. This study introduces innovative ideas and directions for the treatment and prevention of myopia.
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Affiliation(s)
- Li Zhang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Prevention and Treatment on major blinding diseases, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing 400016, People's Republic of China
| | - Kun Yi
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Prevention and Treatment on major blinding diseases, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing 400016, People's Republic of China; The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Prevention and Treatment on major blinding diseases, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing 400016, People's Republic of China
| | - Qiuyun Sun
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Prevention and Treatment on major blinding diseases, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing 400016, People's Republic of China
| | - Zhijun Chen
- Bishan Hospital of Chongqing, Bishan Hospital of Chongqing Medical University, 404100, People's Republic of China
| | - Yongguo Xiang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Prevention and Treatment on major blinding diseases, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing 400016, People's Republic of China
| | - Wenyang Ren
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Prevention and Treatment on major blinding diseases, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing 400016, People's Republic of China
| | - Peijuan Wu
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Prevention and Treatment on major blinding diseases, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing 400016, People's Republic of China
| | - Shan He
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Prevention and Treatment on major blinding diseases, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing 400016, People's Republic of China
| | - Yanlin Yang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Prevention and Treatment on major blinding diseases, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing 400016, People's Republic of China
| | - Lili Feng
- Key Laboratory of Superlight Materials and Surface Technology, Ministry of Education, College of Materials Science and Chemical Engineering, Harbin Engineering University, Harbin 150001, People's Republic of China.
| | - Ke Hu
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Prevention and Treatment on major blinding diseases, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing 400016, People's Republic of China.
| | - Wenjuan Wan
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Prevention and Treatment on major blinding diseases, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing 400016, People's Republic of China.
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13
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Santodomingo-Rubido J, Cheung SW, Villa-Collar C. The safety of orthokeratology contact lens wear in slowing the axial elongation of the eye in children. Cont Lens Anterior Eye 2024:102258. [PMID: 39003152 DOI: 10.1016/j.clae.2024.102258] [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: 01/27/2024] [Revised: 06/27/2024] [Accepted: 06/27/2024] [Indexed: 07/15/2024]
Abstract
PURPOSE To evaluate the safety of orthokeratology contact lens wear in slowing the axial elongation of the eye in myopic children. METHODS Safety data from three prospective studies, which evaluated the use of orthokeratology for slowing myopia progression in children in comparison to a parallel control group of single-vision spectacle lens wearers over a 2-year period, were pooled together for analysis. The primary and secondary safety endpoints are the comparisons of adverse events and slit-lamp findings grades ≥ 2 between orthokeratology and control groups, respectively. RESULTS Collectively, data from 125 orthokeratology and 118 control subjects were analyzed in this study. Of these, 101 (81 %) and 88 (75 %) orthokeratology and control subjects completed the 2-year follow-up period, respectively. Nineteen orthokeratology subjects experienced 28 adverse events, of which 6 were significant, whereas just one adverse event was found in the control group; this difference was statistically significant (p < 0.001). Most adverse events found in the orthokeratology group were corneal in nature, primarily corneal abrasion/staining, accounting for around 40 % of all adverse events. Of the 28 adverse events, only 18 (3 significant) are likely to be contact lens-related, leading to incidence rates of total and device-related adverse events per 100 patient years of lens wear (95 % confidence intervals) of 13.1 (9.2-18.2) and 8.4 (5.4-10.7), respectively. No significant differences were found between groups in the total number of silt-lamps findings with grades ≥ 2 (p > 0.05). CONCLUSION Around 13% of eyes wearing overnight orthokeratology contact lenses are likely to experience an adverse event over one year of lens wear, with this figure being lower when considering device-related adverse events alone. No serious adverse events were found, with most being non-significant. These results inform eye care practitioners on the safety of orthokeratology lenses when prescribed for slowing myopia progression to myopic children.
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Affiliation(s)
| | - Sin-Wan Cheung
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - César Villa-Collar
- Faculty of Biomedical and Health Sciences, Universidad Europea, Madrid, Spain
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14
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Hao J, Lin Z, Xi X, Yang Z, Artal P, Lan W. The induced defocus by Defocus Incorporated Soft Contact lenses is dependent on visual distance and ambient illuminance. Ophthalmic Physiol Opt 2024. [PMID: 38980146 DOI: 10.1111/opo.13364] [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: 02/27/2024] [Revised: 06/26/2024] [Accepted: 06/26/2024] [Indexed: 07/10/2024]
Abstract
PURPOSE Defocus Incorporated Soft Contact (DISC) lenses, a commonly used type of multifocal lens in clinical practice, may slow down myopia progression by inducing myopic retinal defocus. The purpose of this study was to explore whether the induced defocus across the retina could be affected by visual environments encountered in the real world, such as differences in viewing distance and ambient illuminance. METHODS In this cross-over trial, 30 myopic adults wore both DISC lenses and single vision contact (SVC) lenses in random order. An open-view Hartmann-Shack scanning wavefront sensor was used to measure defocus at different retinal locations along the horizontal meridian under four experimental conditions: far target (3 m) and near targets (0.33 m) under scotopic (<1 lux) or photopic (~300 lux) conditions. RESULTS The results showed that DISC lenses induced more myopic retinal defocus than SVC lenses in all conditions (all p < 0.05), except for the scotopic near target. In addition, for DISC lenses, the defocus was greater in the photopic than the scotopic conditions for both the far and near targets (both p < 0.05). CONCLUSION In conclusion, the retinal defocus induced by these multifocal lenses was dependent on both visual distance and ambient illuminance, indicating that the visual conditions might affect the anti-myopia efficacy of these devices.
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Affiliation(s)
- Jiangdong Hao
- Aier Academy of Ophthalmology, Central South University, Changsha, China
- Hunan Province Optometry Engineering and Technology Research Centre, Changsha, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China
| | - Zhenghua Lin
- Hunan Province Optometry Engineering and Technology Research Centre, Changsha, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China
- Laboratorio de Óptica, Universidad de Murcia, Murcia, Spain
| | - Xiaoyun Xi
- Hunan Province Optometry Engineering and Technology Research Centre, Changsha, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China
| | - Zhikuan Yang
- Aier Academy of Ophthalmology, Central South University, Changsha, China
- Hunan Province Optometry Engineering and Technology Research Centre, Changsha, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China
| | - Pablo Artal
- Aier Academy of Ophthalmology, Central South University, Changsha, China
- Laboratorio de Óptica, Universidad de Murcia, Murcia, Spain
| | - Weizhong Lan
- Aier Academy of Ophthalmology, Central South University, Changsha, China
- Hunan Province Optometry Engineering and Technology Research Centre, Changsha, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China
- Guangzhou Aier Eye Hospital, Jinan University, Guangzhou, China
- Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Xianning, China
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15
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Yang HWW, Liang CKL, Chou SC, Wang HH, Chiang HK. Development and evaluation of a deep neural network model for orthokeratology lens fitting. Ophthalmic Physiol Opt 2024. [PMID: 38980216 DOI: 10.1111/opo.13360] [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: 01/14/2024] [Revised: 06/19/2024] [Accepted: 06/20/2024] [Indexed: 07/10/2024]
Abstract
PURPOSE To optimise the precision and efficacy of orthokeratology, this investigation evaluated a deep neural network (DNN) model for lens fitting. The objective was to refine the standardisation of fitting procedures and curtail subjective evaluations, thereby augmenting patient safety in the context of increasing global myopia. METHODS A retrospective study of successful orthokeratology treatment was conducted on 266 patients, with 449 eyes being analysed. A DNN model with an 80%-20% training-validation split predicted lens parameters (curvature, power and diameter) using corneal topography and refractive indices. The model featured two hidden layers for precision. RESULTS The DNN model achieved mean absolute errors of 0.21 D for alignment curvature (AC), 0.19 D for target power (TP) and 0.02 mm for lens diameter (LD), with R2 values of 0.97, 0.95 and 0.91, respectively. Accuracy decreased for myopia of less than 1.00 D, astigmatism exceeding 2.00 D and corneal curvatures >45.00 D. Approximately, 2% of cases with unique physiological characteristics showed notable prediction variances. CONCLUSION While exhibiting high accuracy, the DNN model's limitations in specifying myopia, cylinder power and corneal curvature cases highlight the need for algorithmic refinement and clinical validation in orthokeratology practice.
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Affiliation(s)
- Hsiu-Wan Wendy Yang
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | | | - Shih-Chi Chou
- Ophthalmology Clinics, EyePlus Group, Taipei, Taiwan
| | - Hsin-Hui Wang
- Ophthalmology Clinics, EyePlus Group, Taipei, Taiwan
| | - Huihua Kenny Chiang
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
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16
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Jiravarnsirikul A, Belghith A, Rezapour J, Micheletti E, Nishida T, Moghimi S, Suh MH, Jonas JB, Walker E, Christopher M, Fazio MA, Weinreb RN, Zangwill LM. Rates of Choriocapillaris Microvascular Dropout and Macular Structural Changes in Glaucomatous Optic Neuropathy With and Without Myopia. Am J Ophthalmol 2024:S0002-9394(24)00295-2. [PMID: 38986858 DOI: 10.1016/j.ajo.2024.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/18/2024] [Accepted: 06/24/2024] [Indexed: 07/12/2024]
Abstract
PURPOSE To evaluate the association between rates of juxtapapillary choriocapillaris microvasculature dropout (MvD) change and rates of ganglion cell inner plexiform layer (GCIPL) loss in primary open-angle glaucoma (POAG) and glaucoma suspect eyes with and without myopia. DESIGN Cohort study from clinical trial data METHODS: 238 eyes from 155 POAG and glaucoma suspect patients were stratified into no-myopia (axial length (AL) ≤ 24 mm; n = 78 eyes), mild myopia (24 mm< AL ≤ 26 mm; n = 114 eyes), and high myopia (AL > 26 mm; n = 46 eyes). Eyes with a minimum of 3 visits and 1.5 years of follow-up with both optical coherence tomography angiography (OCT-A) and OCT macula scans were included. Presence, area, and angular circumference of juxtapapillary MvD were evaluated on en face choroidal images and horizontal B-scans obtained from OCT-A imaging. RESULTS Over the mean follow-up of 4.4 years, the mean MvD area rates of change (95% CI) were largest in high and mild myopia group (0.04 (0.03, 0.05) mm2/year in both groups), followed by the no-myopia group (0.03 (0.02, 0.04) mm2/year). The mean MvD angular circumference rates of change (95% CI) were highest in mild myopia group (8.7o (6.9o, 10.5o)/year) followed by the high myopia and no-myopia groups (8.1o (5.3o, 10.9o)/year, and 7.4o (5.3o, 9.6o)/year, respectively). While the mean global GCIPL thinning rates between eyes with MvD at baseline compared to eyes without were similar in all myopia groups, the rates of MvD area change were significantly faster in all myopia groups with baseline MvD (all p≤0.004). Significant faster rates of MvD angular circumference change were found in the mild myopia group with baseline MvD (p<0.001) only. In multivariable models, the rates of GCIPL thinning over time were significantly associated with rates of MvD angular circumference change and MvD area change (R2=0.33, p<0.001 and R2=0.32, p=0.006, respectively). CONCLUSIONS Rates of GCIPL thinning were associated with rates of MvD area and angular circumference change over time in myopic POAG eyes. Utilizing OCT-A to detect MvD may provide an additional tool for monitoring macular structural changes in glaucomatous eyes with myopia.
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Affiliation(s)
- Anuwat Jiravarnsirikul
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, UC San Diego, La Jolla, CA, United States; Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Akram Belghith
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, UC San Diego, La Jolla, CA, United States
| | - Jasmin Rezapour
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, UC San Diego, La Jolla, CA, United States; Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | | | - Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, UC San Diego, La Jolla, CA, United States
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, UC San Diego, La Jolla, CA, United States
| | - Min Hee Suh
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, UC San Diego, La Jolla, CA, United States; Department of Ophthalmology, Inje University Heaundae Paik Hospital, Busan, Korea (the Republic of)
| | - Jost B Jonas
- Singapore Eye Research Institute, Singapore; Institute of Molecular and Clinical Ophthalmology Basel, Switzerland
| | - Evan Walker
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, UC San Diego, La Jolla, CA, United States
| | - Mark Christopher
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, UC San Diego, La Jolla, CA, United States
| | - Massimo A Fazio
- Department of Ophthalmology and Vision Science, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, UC San Diego, La Jolla, CA, United States
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, UC San Diego, La Jolla, CA, United States.
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Semenova Y, Urazhanova M, Lim L, Kaiyrzhanova N. Refractive Errors, Amplitude of Accommodation, and Myopia Progression in Kazakhstani Medical Students: 5-Year Follow-Up. J Clin Med 2024; 13:3985. [PMID: 38999549 PMCID: PMC11242746 DOI: 10.3390/jcm13133985] [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: 05/26/2024] [Revised: 07/04/2024] [Accepted: 07/06/2024] [Indexed: 07/14/2024] Open
Abstract
Background/Objectives: this longitudinal study aimed to investigate the refractive errors, the amplitude of accommodation, and myopia progression in Kazakhstani medical students as they progressed from the first to the fifth course of their studies. Methods: A total of 696 students from Semey Medical University underwent non-cycloplegic and cycloplegic autorefraction in the first course, and 655 were available for examination in the fifth year of study. The amplitude of accommodation was measured before the instillation of cycloplegics using the push-up and push-down methods. A self-administered questionnaire was applied to evaluate the risk factors associated with myopia progression. Results: In the first course, the median spherical equivalent was -0.75 Diopters before cycloplegia and -0.25 Diopters after cycloplegia. In the fifth course, it constituted -1.125 Diopters before cycloplegia and -0.5 Diopters after cycloplegia. The proportion of students with myopia following cycloplegic refraction increased from 44.7% in the first course to 47.5% in the fifth course. The proportion of emmetropic students declined from 31.5% to 30.3%, and hyperopia decreased from 23.8% to 16.8%. The dioptric power of accommodative excess increased from 0.375 in the first year to 0.50 in the fifth year. The hours spent on near-work activities, such as reading books, writing, working at a computer, and using a mobile device, were significantly associated with a myopia progression of ≥0.5 Diopters. Conclusions: the findings of this study suggest implications for public health policy and educational practice.
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Affiliation(s)
- Yuliya Semenova
- Department of Surgery, Nazarbayev University School of Medicine, Astana 010000, Kazakhstan
| | - Malika Urazhanova
- Department of Neurology, Ophthalmology, and Otorhinolaryngology, Semey Medical University, Semey 071400, Kazakhstan;
| | - Lisa Lim
- Nazarbayev University Graduate School of Public Policy, Astana 010000, Kazakhstan;
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Chen X, Zuo S, Zhang C, Sun B, Zhang M, Jiang D, Chen Y. Interventional Study on the Effectiveness of Eye Exercises Based on Composite Feedback Model in School-Age Children. Risk Manag Healthc Policy 2024; 17:1787-1801. [PMID: 39007108 PMCID: PMC11244621 DOI: 10.2147/rmhp.s467570] [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: 03/06/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024] Open
Abstract
Objective This study aims to explore the effects of eye exercises on the accommodative ability of Chinese school-aged children. Methods This study used a convenience cluster sampling and selected 149 students from grades 2-5 in a Wenzhou primary school to participate in the intervention in June 2022. This study involved a one-month intervention teaching eye exercises using a composite feedback model. Assessments were made at 3 and 9 months post-intervention. Data collection occurred thrice, including a baseline and two follow-ups, measuring monocular and binocular accommodative facility, monocular and binocular accommodative amplitude, CISS scale, spherical equivalent refraction, and uncorrected visual acuity. Analysis used chi-square tests and generalized estimating equations to evaluate the exercises' effectiveness, with a significance threshold of P < 0.05. Results 134 students completed the follow-up, including 61 females (45.52%). After teaching intervention, students showed significant improvements in the accuracy of manipulation, rhythm, acupoint location, strength effectiveness and rhythm of acupressure eye exercises (all P < 0.05), with increases of 10.37%, 13.03%, 16.96%, and 25.17%, respectively. Follow-up assessments revealed both monocular and binocular accommodative amplitude at T3 were significantly higher than at T1 and T2. Moreover, the binocular accommodative amplitude in the high-quality eye exercise group remained significantly higher than that in the low-quality group even(B=1.39,1.46, P < 0.01). Eye exercises could improve monocular and binocular accommodative amplitude in the short term(P < 0.05). High-quality eye exercises could alleviate visual fatigue (B=-2.00--3.49, both P < 0.05). However, eye exercises did not demonstrate any advantages in affecting spherical equivalent refraction or uncorrected visual acuity (P > 0.05). Conclusion Eye exercises can alleviate myopia-related symptoms in Chinese children aged 7 to 11 years. However, this study did not find that eye exercises effectively reduce the degree of myopia in children. Trial Registration The original trial (Registration site: https://www.chictr.org.cn/ Registration number: ChiCTR2300070903) was retrospectively registered on 26/04/2023.
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Affiliation(s)
- Xiaojun Chen
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
| | - Shushu Zuo
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
| | - Chunhua Zhang
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
| | - Bing Sun
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
| | - Mengyue Zhang
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
| | - Dandan Jiang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
| | - Yanyan Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
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Shin YI, Kim YK, Jeoung JW, Park KH. Intraocular pressure reduction and progression of highly myopic glaucoma: a 12-year follow-up cohort study. Br J Ophthalmol 2024:bjo-2022-323069. [PMID: 38164537 DOI: 10.1136/bjo-2022-323069] [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: 12/12/2022] [Accepted: 11/05/2023] [Indexed: 01/03/2024]
Abstract
AIMS To investigate any association between intraocular pressure (IOP) reduction amount and open-angle glaucoma (OAG) progression in highly myopic eyes and to determine the associated risk factors. METHODS One hundred and thirty-one (131) eyes of 131 patients with highly myopic OAG, all of whom had received topical medications and been followed for 5 years or longer, were enrolled. Based on the IOP reduction percentage, patients were categorised into tertile groups, and subsequently, the upper-tertile and lower-tertile groups were compared for the cumulative probability of glaucoma progression. Kaplan-Meier survival analysis and log-rank testing were applied in the comparison, and multivariate analysis with Cox's proportional hazard model, additionally, was performed to identify progression risk factors. RESULTS Throughout the average 11.6±4.4 year follow-up on the 131 eyes (mean age, 41.2 years at initial visit; baseline IOP, 16.4 mm Hg), 72 eyes (55.0%) showed glaucoma progression. The upper-tertile group (IOP reduction percentage>23.7%) showed a high cumulative probability of non-progression relative to the lower-tertile group (IOP reduction percentage<11.0%; p=0.034), according to the Kaplan-Meier analysis. Presence of disc haemorrhage (DH; HR=2.189; p=0.032) was determined by the multivariate Cox's proportional hazard model to be significantly associated with glaucoma progression. For progressors, the average rate of retinal nerve fibre layer thickness thinning was -0.88±0.74 µm/year, while the MD change was -0.42±0.36 dB/year. CONCLUSIONS Glaucoma progression is associated with amount of IOP reduction by topical medications in highly myopic eyes, and DH occurrence is a glaucoma progression risk factor.
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Affiliation(s)
- Young In Shin
- Department of Ophthalmology, Seoul National University Hospital, Jongno-gu, South Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
| | - Young Kook Kim
- Department of Ophthalmology, Seoul National University Hospital, Jongno-gu, South Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University Hospital, Jongno-gu, South Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University Hospital, Jongno-gu, South Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea
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Su B, Cho P, Vincent SJ, Zheng J, Chen J, Ye C, Wang T, Zhang J, Zhang K, Lu F, Jiang J. A novel Lenslet-ARray-Integrated spectacle lenses for myopia control: a one-year randomized, double-masked, controlled trial. Ophthalmology 2024:S0161-6420(24)00413-5. [PMID: 38972357 DOI: 10.1016/j.ophtha.2024.07.002] [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: 04/12/2024] [Revised: 06/27/2024] [Accepted: 07/01/2024] [Indexed: 07/09/2024] Open
Abstract
PURPOSE To investigate the myopia control efficacy of novel Lenslet-ARray-Integrated (LARI) spectacle lenses with positive (PLARI) and negative (NLARI) power lenslets worn for one year in myopic children. DESIGN Randomized, double-masked, controlled clinical trial. PARTICIPANTS A total of 240 children, aged 6 to 12 years, with spherical equivalent refraction (SER) between -4.00 and -1.00 diopter (D), astigmatism of 1.50 D or less, and anisometropia of 1.00 D or less. METHODS Participants were assigned randomly in a 1:1:1 ratio to PLARI, NLARI, and a control (single-vision (SV)) groups. Cycloplegic autorefraction and axial length were measured at baseline and 6-month intervals after lens wear. MAIN OUTCOME MEASURES Changes in SER, axial elongation (AE), and differences between groups. RESULTS After 1-year, SER changes and AE in the PLARI and NLARI groups were significantly less than those in the SV group (SER: -0.30 ± 0.48 D, -0.21 ± 0.35 D, -0.66 ± 0.40 D; AE: 0.19 ± 0.20 mm, 0.17 ± 0.14 mm, 0.34 ± 0.18 mm, respectively) (all P < 0.001). There were no significant differences in SER changes and AE between PLARI and NLARI groups (P = 0.54 and P = 1.00, respectively). Younger age was associated with more rapid SER increase and larger AE in the SV (r = 0.40, P < 0.001 and r = -0.59, P < 0.001, respectively) and PLARI (r= 0.46, P < 0.001 and r = -0.52, P < 0.001, respectively) groups, but not in the NLARI group (r = -0.002, P = 0.98 and r = -0.08, P = 0.48, respectively). CONCLUSIONS Compared with the SV group, both PLARI and NARI groups showed significantly slower myopia progression in terms of SER and axial elongation. Faster myopia progression, in terms of both SER and AE, was associated with younger age in the SV and PLARI groups, but not in the NLARI group.
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Affiliation(s)
- Binbin Su
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Pauline Cho
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China; Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Stephen J Vincent
- Discipline of Optometry and Vision Science, Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jingwei Zheng
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Jiaojie Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Cong Ye
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Tengfei Wang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Jingwei Zhang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Kou Zhang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Fan Lu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
| | - Jun Jiang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
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Little JA, Congdon NG, Resnikoff S, Braithwaite T, Leasher J, Naidoo K, Fricke T, Tapply I, Fernandes AG, Cicinelli MV, Arrigo A, Leveziel N, Taylor HR, Sedighi T, Flaxman S, Parodi MB, Bikbov MM, Bron A, Cheng CY, Del Monte MA, Ehrlich JR, Ellwein LB, Friedman D, Furtado JM, Gazzard G, George R, Hartnett ME, Jonas JB, Kahloun R, Kempen JH, Khairallah M, Khanna RC, Kim JE, Lansingh VC, Nangia V, Nowak M, Pesudovs K, Peto T, Ramulu P, Topouzis F, Tsilimbaris M, Wang YX, Wang N, Bourne RRA, Little JA, Congdon NG, Resnikoff S, Braithwaite T, Leasher JL, Naidoo KS, Tahhan N, Fricke T, Fernandes AG, Cicinelli MV, Arrigo A, Leveziel N, Briant PS, Vos T, Flaxman S, Abate YH, Dolatabadi ZA, Abdelmasseh M, Abdollahi M, Abebe AM, Abiodun O, Aboagye RG, Abrha WA, Ali HA, Abu-Gharbieh E, Aburuz S, Adal TGG, Adamu LH, Adderley NJ, Addo IY, Adekiya TA, Adhikari K, Adnani QES, Afzal S, Aghamiri S, Agodi A, Agyemang-Duah W, Ahinkorah BO, Ahmad A, Ahmadzadeh H, Ahmed A, Ahmed H, Alahdab F, Albashtawy M, AlBataineh MT, Alemu T, Alfaar AS, Alhalaiqa FAN, Alhassan RK, Ali A, Ali SSS, Almidani L, Alzoubi KH, Androudi S, Anguita R, Anil A, Anyasodor AE, Arabloo J, Aravkin AY, Areda D, Asgedom AA, Ashemo MY, Ashraf T, Athari SS, Atinafu BTT, Wahbi Atout MM, Atreya A, Ayatollahi H, Azzam AY, Bagherieh S, Bai R, Baig AA, Bailey F, Baltatu OC, Barati S, Barchitta M, Bardhan M, Bärnighausen TW, Barrow A, Parodi MB, Bayileyegn NS, Berhie AY, Bhadra A, Bhagavathula ASS, Bhardwaj P, Bhaskar S, Bhat AN, Bhatti GK, Bikbov M, Birck MG, Bustanji Y, Butt ZA, dos Santos FLC, Carneiro VLA, Cenderadewi M, Chanie GS, Cherbuin N, Chu DT, Coberly K, Cruz-Martins N, Dadras O, Dai X, Dandona L, Dandona R, Dascalu AM, Dastiridou A, Dejenie TA, Demeke D, Dereje D, Dervenis N, Devanbu VGC, Diaz D, Diress M, Do TC, Do THP, Dziedzic AM, Edinur HA, Ehrlich JR, Ekholuenetale M, Elhabashy HR, Elhadi M, Emamian MH, Emamverdi M, Etemadimanesh A, Fagbamigbe AF, Farrokhpour H, Fatehizadeh A, Feizkhah A, Desideri LF, Fetensa G, Fischer F, Forouhari A, Furtado JM, Gadanya MA, Gaidhane AM, Gandhi AP, Gebi TG, Gebrehiwot M, Gebremeskel GG, Gela YY, Yazdi BG, Falavarjani KG, Ghassemi F, Ghozy S, Golchin A, Golechha M, Goleij P, Guan SY, Gupta S, Gupta VK, Haddadi R, Haile TG, Hammond BR, Harorani M, Hasaballah AI, Hasan I, Hasani H, Hassanian-Moghaddam H, Heidari G, Heyi DZ, Holla R, Hosseinzadeh M, Hu C, Huynh HH, Hwang BF, Iavicoli I, Ilic IM, Immurana M, Islam SMS, Jacob L, Jafarzadeh A, Jakovljevic M, Janodia MD, Jayapal SK, Jayaram S, Jonas JB, Joseph N, Joshua CE, Kamath S, Kandel H, Karaye IM, Kasraei H, Kaup S, Kaur H, Kaur N, Kayode GA, Kempen JH, Khader YS, Khajuria H, Khalilov R, Khan A, Khatatbeh MM, Khatib MN, Kibret BG, Kim YJ, Kisa A, Kisa S, Kosen S, Koyanagi A, Krishan K, Bicer BK, Kumar N, Kutikuppala LVS, Lahariya C, Laksono T, Lal DK, Lansingh VC, Lee M, Lee SW, Lee WC, Lim SS, Liu X, Maharaj SB, Mahmoudi A, Malhotra K, Malik AA, Malik I, Mallhi TH, Mansouri V, Marzo RR, Maugeri A, Meles GG, Mersha AM, Mestrovic T, Miller TR, Mirzaei M, Misganaw A, Misra S, Mithra P, Mohammadi S, Mohammadian-Hafshejani A, Mohammadzadeh M, Mojiri-forushani H, Mokdad AH, Momeni-Moghaddam H, Montazeri F, Moradi M, Mousavi P, Murray CJL, Naik GR, Naik G, Natto ZS, Naveed M, Nayak BP, Negash H, Nejadghaderi SA, Nguyen DH, Nguyen DH, Nguyen HQ, Nguyen PT, Nguyen VT, Niazi RK, Noman EA, Oancea B, Okonji OC, Olagunju AT, Olufadewa II, Onwujekwe OE, Opejin AO, Ordak M, Osuagwu UL, Otstavnov N, Owolabi MO, Padubidri JR, Panda-Jonas S, Pandey A, Pardhan S, Parsaei A, Patel J, Pawar S, Perianayagam A, Perumalsamy N, Pesudovs K, Petcu IR, Pham HT, Pourazizi M, Prates EJS, Qattea I, Raghav PR, Rahman MHU, Rahman M, Ramasamy SK, Ramasubramani P, Rashidi MM, Redwan EMM, Rezaei N, Rodriguez JAB, Saadatian Z, Sabour S, Saddik B, Saeed U, Safi S, Saghazadeh A, Sharif-Askari FS, Sharif-Askari NS, Sahebkar A, Sahraian MA, Sakshaug JW, Saleh MA, Samadzadeh S, Samodra YL, Samy AM, Saylan M, Selvaraj S, Sethi Y, Seylani A, Shahwan MJ, Shaikh MA, Shamim MA, Shashamo BB, Shiferaw WS, Shigematsu M, Shittu A, Shobeiri P, Shorofi SA, Sibhat MM, Siddig EE, Silva JC, Singh JA, Singh P, Sotoudeh H, Sousa RARC, Sreeramareddy CT, Tabish M, Taheri M, Tan Y, Taye BT, Temsah MH, Ticoalu JHV, Tillawi T, Tiruneh MG, Tsatsakis A, Tsegay GM, Tsilimbaris MK, Ty SS, Ubah CS, Umair M, Tahbaz SV, Valizadeh R, Viskadourou M, Wassie GT, Wickramasinghe ND, Wondimagegn GS, Yahya G, Yang L, Yao Y, Yiğit A, Yismaw Y, Yonemoto N, You Y, Zastrozhin MS, Zenebe GA, Zhang ZJ, Zhao H, Zielińska M, Zoladl M, Steinmetz JD, Bourne R. Global estimates on the number of people blind or visually impaired by Uncorrected Refractive Error: a meta-analysis from 2000 to 2020. Eye (Lond) 2024:10.1038/s41433-024-03106-0. [PMID: 38965322 DOI: 10.1038/s41433-024-03106-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 04/08/2024] [Accepted: 04/19/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Uncorrected refractive error (URE) is a readily treatable cause of visual impairment (VI). This study provides updated estimates of global and regional vision loss due to URE, presenting temporal change for VISION 2020 METHODS: Data from population-based eye disease surveys from 1980-2018 were collected. Hierarchical models estimated prevalence (95% uncertainty intervals [UI]) of blindness (presenting visual acuity (VA) < 3/60) and moderate-to-severe vision impairment (MSVI; 3/60 ≤ presenting VA < 6/18) caused by URE, stratified by age, sex, region, and year. Near VI prevalence from uncorrected presbyopia was defined as presenting near VA < N6/N8 at 40 cm when best-corrected distance (VA ≥ 6/12). RESULTS In 2020, 3.7 million people (95%UI 3.10-4.29) were blind and 157 million (140-176) had MSVI due to URE, a 21.8% increase in blindness and 72.0% increase in MSVI since 2000. Age-standardised prevalence of URE blindness and MSVI decreased by 30.5% (30.7-30.3) and 2.4% (2.6-2.2) respectively during this time. In 2020, South Asia GBD super-region had the highest 50+ years age-standardised URE blindness (0.33% (0.26-0.40%)) and MSVI (10.3% (8.82-12.10%)) rates. The age-standardized ratio of women to men for URE blindness was 1.05:1.00 in 2020 and 1.03:1.00 in 2000. An estimated 419 million (295-562) people 50+ had near VI from uncorrected presbyopia, a +75.3% (74.6-76.0) increase from 2000 CONCLUSIONS: The number of cases of VI from URE substantively grew, even as age-standardised prevalence fell, since 2000, with a continued disproportionate burden by region and sex. Global population ageing will increase this burden, highlighting urgent need for novel approaches to refractive service delivery.
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Jonas JB, Bikbov MM, Kazakbaeva GM, Wang YX, Xu J, Nangia V, Nangia PV, Panda-Jonas S. Positive and Negative Associations of Myopia with Ocular Diseases in Population-Based Studies. Ophthalmology 2024:S0161-6420(24)00414-7. [PMID: 38971323 DOI: 10.1016/j.ophtha.2024.07.003] [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: 04/14/2024] [Revised: 06/18/2024] [Accepted: 07/01/2024] [Indexed: 07/08/2024] Open
Abstract
OBJECTIVE Prevalence of myopia and vision impairment due to myopic macular degeneration and myopia-related optic neuropathies have markedly increased worldwide. We evaluated whether myopia is associated with the prevalence of other ocular disorders in a positive or negative sense. DESIGN Population-based studies conducted in Russia, China and India. PARTICIPANTS The Russian Ural Eye and Medical Study (UEMS) and the Beijing Eye Study (BES) included 5899 individuals and 4439 individuals (all aged 40+ years), respectively, and the Central India Eye and Medical Study (CIEMS) consisted of 4711 individuals, aged 30+ years. The studies were conducted in rural and urban regions in Bashkortostan/Russia, Nagpur/India, and Beijing/China. METHODS The participants underwent a series of ophthalmological and general medical examinations. MAIN OUTCOME MEASURES Axial length as surrogate for myopia, and prevalence of diabetic retinopathy (DR), age-related macular degeneration (AMD), angle-closure glaucoma (ACG), and open-angle glaucoma (OAG). RESULTS In the UEMS, DR prevalence (OR:0.73;95%CI:0.56,0.96), AMD prevalence (OR:0.85;95%CI:0.74,0.98) and ACG prevalence (OR:0.72;95%CI:0.55,0.95) decreased, and OAG prevalence (OR:1.65;95%CI:1.45,1.88) increased with longer axial length in multivariable analyses. In the CIEMS, lower AMD prevalence (OR:0.81;95%CI:0.69,0.95) and lower ACG prevalence (OR:0.55;95%CI:0.36,0.83), and higher OAG prevalence (OR:1.45;95%CI:1.15,1.83) were associated with longer axial length. DR prevalence (0.33%;95%CI:0.16,0.50) was too low for statistical analysis in the CIEMS. In the BES, prevalence (OR:0.64;95%CI:0.50,0.81) and 10-year incidence of DR (OR:0.48;95%CI:0.33,0.71) and prevalence (OR:0.83;95%CI:0.77,0.89) and 5-year incidence of AMD (OR:0.996;95%CI:0.993,0.999) decreased, and prevalence (OR:1.35;95% CI:1.17,1.56) and 10-year incidence of OAG (OR:1.40;95%CI:1.22,1.61) increased with longer axial length. In all three studies, the association between higher OAG prevalence and longer axial length was nonlinear with a slight increase for the moderate myopia range, and a steep increase in the highly myopic range. CONCLUSIONS AND RELEVANCE Myopia is associated with a lower prevalence of DR, AMD and ACG and lower incidence of DR and AMD, while high myopia more than moderate myopia is associated with a higher prevalence and incidence of OAG. Future studies may assess whether in myopia, in particular in moderate myopia, the myopia-related advantages, i.e., lower prevalence of DR, AMD and ACG, may outweigh the increased risks for OAG and other myopia-related disorders.
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Affiliation(s)
- Jost B Jonas
- Institut Français de Myopie, Hôpital Fondation Adolphe de Rothschild, Paris, France; Singapore Eye Research Institute, Singapore; Privatpraxis Prof Jonas und Dr Panda-Jonas, Heidelberg, Germany.
| | | | | | - Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | - Jie Xu
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
| | | | | | - Songhomitra Panda-Jonas
- Privatpraxis Prof Jonas und Dr Panda-Jonas, Heidelberg, Germany; Department of Ophthalmology, Medical Faculty Heidelberg, Heidelberg University Heidelberg, Germany
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Hoerig C, Hoang QV, Mamou J. In-vivo high-frequency quantitative ultrasound-derived parameters of the anterior sclera correlated with level of myopia and presence of staphyloma. Clin Exp Ophthalmol 2024. [PMID: 38964827 DOI: 10.1111/ceo.14415] [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: 03/29/2024] [Revised: 06/11/2024] [Accepted: 06/21/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND A high-frequency point-of-care (POC) ultrasound instrument was used to evaluate the microstructural and biomechanical properties of the anterior sclera in vivo using parameters computed from quantitative ultrasound (QUS) methods. METHODS In this cross-sectional study, both eyes of 85 enrolled patients were scanned with the POC instrument and ultrasound data were processed to obtain QUS parameters. Pearson correlation and multi-linear regression were used to identify relationships between QUS parameters and refractive error (RE) or axial length. After categorising eyes based on RE, binary support vector machine (SVM) classifiers were trained using the QUS or ophthalmic parameters (anterior chamber depth, central corneal thickness, corneal power, and intraocular pressure) to classify each eye. Classifier performance was evaluated by computing the area under the receiver-operating characteristic curve (AUC). RESULTS Individual QUS parameters correlated with RE and axial length (p < 0.05). Multi-linear regression revealed significant correlation between the set of QUS parameters and both RE (R = 0.49, p < 0.001) and axial length (R = 0.46, p = 0.001). Classifiers trained with QUS parameters achieved higher AUC (𝑝 = 0.06) for identifying myopic eyes (AUC = 0.71) compared to classifiers trained with ophthalmic parameters (AUC = 0.63). QUS-based classifiers attained the highest AUC when identifying highly myopic eyes (AUC = 0.77). CONCLUSIONS QUS parameters correlate with progressing myopia and may be indicative of myopia-induced microstructural and biomechanical changes in the anterior sclera. These methods may provide critical clinical information complementary to standard ophthalmic measurements for predicting myopia progression and risk assessment for posterior staphyloma formation.
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Affiliation(s)
- Cameron Hoerig
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Quan V Hoang
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS, Singapore
- Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Ophthalmology, Columbia University Irving Medical Center, New York, New York, USA
| | - Jonathan Mamou
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
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Lee SC, Hsu MY, Huang SC, Chen C. Soft peripheral contact lens for eye elongation control (SPACE): 1-year results of a double-blinded randomized controlled trial. Cont Lens Anterior Eye 2024:102256. [PMID: 38965001 DOI: 10.1016/j.clae.2024.102256] [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: 04/28/2023] [Revised: 06/05/2024] [Accepted: 06/24/2024] [Indexed: 07/06/2024]
Abstract
PURPOSE To examine the safety and efficacy of soft multifocal contact lenses on slowing the rate of myopia progression. METHODS A prospective, randomized, double-masked clinical trial was conducted including 115 children (55 boys and 60 girls) aged 8 to 15 years. Children were assigned to wear one of two daily disposable soft contact lens designs; a multifocal design (Pegavision) or a dual-focus design (MiSight, Coopervision) in both eyes for at least 8 h per day for one year. All contact lenses were replaced on a daily basis. Measurements were obtained using a logMAR vision meter, including objective refraction, handheld retinoscopy, high (96 %) and low (12 %) contrast sensitivity, and distance and near visual acuity. Axial length was measured every 6 months. RESULTS After one year, the spherical equivalent refractive error and axial length of the experimental group (Pegavision) increased by -0.50 ± 0.48 D and 0.24 ± 0.16 mm, respectively, in the right eye and -0.47 ± 0.37 D and 0.23 ± 0.16 mm, respectively, in the left eye. The spherical equivalent refractive error and axial length of the control group (MiSight) increased by -0.48 ± 0.47 D and 0.22 ± 0.13 mm, respectively, in the right eye and by -0.50 ± 0.44 D and 0.23 ± 0.14 mm, respectively, in the left eye, with no significant differences observed between the two lens types. CONCLUSIONS The one-year results from this clinical trial show that the multifocal soft contact lenses used in the experimental group have a similar myopia control efficacy with respect to spherical equivalent refraction and axial length elongation as a commercially available dual focus soft contact lens design.
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Affiliation(s)
- Shan-Chih Lee
- Department of Medical Imaging And Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan
| | - Min-Yen Hsu
- Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Shih-Chien Huang
- Department of Nutrition, Chung Shan Medical University, Taichung, Taiwan
| | - Connie Chen
- Department of Optometry, Chung Shan Medical University, Taichung, Taiwan; Institute of Optometry, Chung Shan Medical University, Taichung, Taiwan.
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Jiménez-García M, Segura-Calvo FJ, Puzo M, Castro-Alonso FJ. Biometric description of 34 589 eyes undergoing cataract surgery: sex differences. J Cataract Refract Surg 2024; 50:668-675. [PMID: 38446495 DOI: 10.1097/j.jcrs.0000000000001435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/22/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE To describe gender differences in the biometric parameters of a large sample of patients with cataract. Cataract surgery has evolved from a vision restoration to a refractive procedure, and population-based studies are vital to optimize normative databases and postsurgical outcomes. SETTING Miguel Servet University Hospital, Zaragoza, Spain. DESIGN Retrospective single-center observational study. METHODS The study included 34 589 eyes (20 004 patients with cataract). Biometric data were obtained from IOL Master 700 and Pentacam HR. Linear mixed models were used to account for intereye correlation. HofferQST formula was used to calculate the hypothetical distribution of intraocular lens (IOL) power (arbitrary lens; A = 119.2). RESULTS Most biometric variables showed significant differences between sexes ( P < .0001), such as 0.53 mm shorter eyes found in females, of which 0.16 mm are explained by shorter aqueous depth. Steeper anterior keratometries (∼0.75 diopter [D]) were found in women, to end up in no difference on anterior astigmatism magnitude, but different orientation ( P < .0001). The distribution of IOL power differed between sexes ( P < .001), with the interquartile range shifting 1 D toward more powerful lenses in women and odds ratio (power >26 D) = 2.26, P < .0001 (Fisher). CONCLUSIONS Large sample size studies provide smaller margin of error, higher power, and controlled risk of reporting false (negative or positive) findings. Highly significant differences between sexes in ocular biometry were found; this supports the idea that including sex as a parameter in IOL calculation should be explored and may improve results. In addition, the distribution of IOL powers was provided, which may be useful for manufacturers and hospital stock planning.
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Affiliation(s)
- Marta Jiménez-García
- From the GIMSO, Institute for Health Research Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain (Jiménez-García, Segura-Calvo, Puzo, Castro-Alonso); UFR, Department of Ophthalmology, University Hospital Miguel Servet, Zaragoza, Spain (Jiménez-García, Segura-Calvo, Puzo, Castro-Alonso); ARCCA, Department of Ophthalmology, Hospital Nuestra Señora de Gracia, Zaragoza, Spain (Jiménez-García, Segura-Calvo, Puzo, Castro-Alonso); Surgery Department, Ophthalmology Area, University of Zaragoza, Zaragoza, Spain (Segura-Calvo); Department of Ophthalmology, Alcañiz Hospital, Alcañiz (Teruel), Spain (Puzo, Castro-Alonso)
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Parolini B, Rosales Padrón JF, Lopes E, Matello V, Crincoli E. EVALUATION OF MACULAR ATROPHY IN PATIENTS TREATED WITH MACULAR BUCKLE FOR MYOPIC TRACTION MACULOPATHY: Mid- and Long-Term Follow-Up. Retina 2024; 44:1180-1187. [PMID: 38452307 DOI: 10.1097/iae.0000000000004094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/01/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE To evaluate the incidence, rate, and pattern of progression of myopic maculopathy in eyes operated with macular buckle (MB) for myopic traction maculopathy versus a control group without surgery to find out whether the progression varies due to the MB's indentation and to evaluate possible MB-related pigmentary changes or atrophy. METHODS Eyes operated with MB with two good quality fundus images: one preoperative or early postoperative image and a second image at least 12 months apart; the control group comprised the contralateral eyes. Demographics, axial length, follow-up, stage of myopic traction maculopathy, and myopic maculopathy were reported. Progression results of groups and subgroups (mid- and long-term follow-up) were reported and compared. RESULTS Overall, 116 eyes of 66 patients were included. Progression was found in 29 eyes (41.4%) and 23 eyes (50%) in the MB group and control group, respectively. The progression rate was 73 per 1,000 eye-years and 88.9 per 1,000 eye-years in the MB group and the control group, respectively. Axial length was found to predict progression (odds ratio [OR], 2.59; P = 0.02). CONCLUSION Progression of myopic maculopathy was similar in both groups and was mildly greater in the control group. No MB-related pigmentary changes or atrophy was detected.
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Affiliation(s)
| | - Jaime Francisco Rosales Padrón
- Department of Ophthalmology, Eyecare Clinic, Brescia, Italy
- Department of Retina, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico
| | - Edgar Lopes
- Department of Ophthalmology, Eyecare Clinic, Brescia, Italy
- Department of Ophthalmology, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal; and
| | | | - Emanuele Crincoli
- Department of Ophthalmology, Eyecare Clinic, Brescia, Italy
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Créteil, France
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Chow AHY, Mungalsingh MA, Thai D, Selimos Z, Yan SK, Xu H, Jones DA. Suitability of multifunction devices Myah and Myopia Master for monitoring myopia progression in children and adults. Ophthalmic Physiol Opt 2024; 44:1017-1030. [PMID: 38760986 DOI: 10.1111/opo.13332] [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: 12/22/2023] [Revised: 04/22/2024] [Accepted: 04/28/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE To assess the feasibility of using multifunction instruments to measure axial length for monitoring myopia progression in children and adults. METHODS Axial length was measured in 60 children (aged 6-18 years) and 60 adults (aged 19-50 years) with multifunction instruments (Myah and Myopia Master) and stand-alone biometers (Lenstar LS900 and IOLMaster 700). Repeatability (measurements by the same examiner) and reproducibility (measurements by different examiners) were computed as the within-subject standard deviation (Sw) and 95% limits of agreement (LoA). Inter-instrument agreement was computed as intraclass correlation coefficients. The threshold for detecting myopic progression was taken as 0.1 mm. Measures were repeated only in children following the administration of 1% tropicamide to determine the impact of cycloplegia on axial length. RESULTS Overall, the IOLMaster 700 had the best repeatability in children (0.014 mm) and adults (0.009 mm). Repeatability Sw values for all devices ranged from 0.005 to 0.021 mm (children) and 0.003 to 0.016 mm (adults). In children, reproducibility fell within 0.1 mm 95% of the time for the Myah, Myopia Master and IOLMaster 700. Agreement among all devices was classified as excellent (ICC 0.999; 95% CI 0.998-0.999), but the 95% LoA among the Myah, Myopia Master and Lenstar LS900 was ≥0.1 mm. Cycloplegia had no statistically significant effect on axial length (all p > 0.13). CONCLUSIONS The Myah and Myopia Master multifunction instruments demonstrated good repeatability and reproducibility, and their accuracy was comparable to stand-alone biometers. Axial length measurements using different instruments can be considered interchangeable but should be compared with some caution. Accurate axial length measurements can be obtained without cycloplegia. The multifunction instruments Myah and Myopia Master are as well suited for monitoring myopia progression in children as the stand-alone biometers IOLMaster 700 and Lenstar LS900.
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Affiliation(s)
- Amy H Y Chow
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
- Centre for Eye and Vision Research, Hong Kong, SAR China
| | - Melanie A Mungalsingh
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Danny Thai
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Zoe Selimos
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Sarah Kathryn Yan
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Hellen Xu
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Deborah A Jones
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
- Centre for Eye and Vision Research, Hong Kong, SAR China
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Boily L, Michaud L, Garon ML, Marcotte R. Effects of Optical Zone Variation of High-Addition Multifocal Contact Lenses on the Global Flash Multifocal Electroretinography. Eye Contact Lens 2024; 50:315-320. [PMID: 38758160 DOI: 10.1097/icl.0000000000001099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVES To evaluate the retinal response to myopic defocus after the wear of soft multifocal contact lenses with high addition through electroretinography. METHODS Twenty-seven participants meeting inclusion criteria were enrolled. Tropicamide 1% drops (2) were instilled. Participants were then fitted with three different contact lenses: a single-vision spherical lens (SE +3.00 D), L1, serving as a control, and two soft multifocal lens designs (SE +3.00 D/add +10 D), one with a central distance zone of 4.0 mm (L2) and one with a central distance zone of 7.0 mm (L3). A global flash multifocal electroretinography was performed. Direct component (DC) amplitude, DC peak time, induced component (IC) amplitude, and IC peak time were recorded. Waveforms were grouped into five concentric areas, covering from 0° to 24° of retinal eccentricity. Differences of L2/L3 versus L1 were analyzed with t tests. Finally, correlations were calculated between the percentage of defocus in the pupil area versus the electroretinography results. RESULTS Results show that the DC amplitude, caused mainly by photoreceptors and bipolar cells, is not influenced by the design of the lenses. The IC amplitude, however, is significantly decreased when the lens with a smaller optical zone (L2) is worn. This significant difference only concerns the ring 5, which corresponds to a retinal eccentricity of 15.7° to 24.0°. CONCLUSION Soft multifocal lens designs influence the peripheral retinal reaction to defocus. A larger treatment zone seems to significantly impact the retinal response to defocus between 15.7° and 24.0° of eccentricity from the macula.
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Affiliation(s)
- Laurence Boily
- Optometry School, University of Montreal, Montreal, QC, Canada
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Feo A, De Simone L, Cimino L, Angi M, Romano MR. Differential diagnosis of myopic choroidal neovascularization (mCNV): insights from multimodal imaging and treatment implications. Graefes Arch Clin Exp Ophthalmol 2024; 262:2005-2026. [PMID: 38060000 DOI: 10.1007/s00417-023-06320-w] [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: 09/20/2023] [Revised: 10/31/2023] [Accepted: 11/23/2023] [Indexed: 12/08/2023] Open
Abstract
PURPOSE The aim of this article is to conduct a comprehensive systematic review about the current understandings and differential diagnosis of myopic choroidal neovascularization (mCNV) and other several similar diseases, describing their multimodal imaging analysis, prognostic implications, and current types of management. METHODS This systematic review was performed based on a search on the PubMed database of relevant papers regarding mCNV and other entities discussed in the paper, according to our current knowledge. RESULTS Through the integration of a multimodal imaging approach, especially optical coherence tomography (OCT), along with accurate demographic and clinical assessment, it becomes possible to effectively differentiate mCNV from similar yet heterogeneous entities. These conditions include macular hemorrhage due to new lacquer crack (LC) formation, inflammatory diseases such as punctate inner choroidopathy (PIC)/multifocal choroidits (MFC) and epiphenomenon multiple evanescent white dot syndrome (Epi-MEWDS), neovascular age-related macular degeneration (nAMD), idiopathic CNV (ICNV), dome-shaped macula (DSM) with subretinal fluid, retinal pigment epithelium (RPE) humps, angioid streaks (AS), choroidal rupture (CR), and choroidal osteoma (CO). Each one of these entities will be described and discussed in this article. CONCLUSION Myopic choroidal neovascularization is a common retinal condition, especially among young individuals. Accurate diagnosis and differentiation from similar conditions are crucial for effective treatment. Multimodal imaging, particularly OCT, plays a crucial role in precise assessment. Future research should focus on defining biomarkers and distinguishing features to facilitate prompt treatment.
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Affiliation(s)
- Alessandro Feo
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele-Milan, Italy.
| | - Luca De Simone
- Ocular Immunology Unit, Azienda USL-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
| | - Luca Cimino
- Ocular Immunology Unit, Azienda USL-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
| | - Martina Angi
- Ocular Oncology Service, Department of Surgery, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Mario R Romano
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele-Milan, Italy
- Department of Ophthalmology, Eye Unit Humanitas Gavazzeni-Castelli, Via Mazzini 11, Bergamo, Italy
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Sui J, Li H, Bai Y, He Q, Sun Z, Wei R. Morphological characteristics of the foveal avascular zone in pathological myopia and its relationship with macular structure and microcirculation. Graefes Arch Clin Exp Ophthalmol 2024; 262:2121-2133. [PMID: 38367069 DOI: 10.1007/s00417-024-06403-2] [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: 11/14/2023] [Revised: 01/09/2024] [Accepted: 02/02/2024] [Indexed: 02/19/2024] Open
Abstract
PURPOSE To explore the characteristics of macular structure, microcirculation, and foveal avascular zone (FAZ) morphology in pathological myopia and to research the associations between these factors and pathological myopia. METHODS This is a cross-sectional study. The study included 103 eyes with non-high myopia and 206 eyes with high myopia (139 with simple high myopia and 67 with pathological myopia). Macular structural and microcirculation parameters were determined using optical coherence tomography angiography (OCTA). The FAZ morphological parameters were measured manually using Image J software. Correlations between pathological myopia and various factors were analyzed. RESULTS Patients with pathological myopia had a thinner retinal thickness (RT) and choroidal thickness (CT) and a lower retinal superficial vascular density (SVD), retinal deep vascular complex density (DVD), choriocapillaris perfusion area (CCPA), and choroidal vascularity index (CVI) (all P < 0.05). Patients with pathological myopia had a larger FAZ area, perimeter, major axis, minor axis, acircularity index (AI), and lower circularity index (CI) (all P < 0.01). The axial length (AL), the major axis of the superficial FAZ, CI, and AI were significantly correlated with myopia severity (all P < 0.05). CONCLUSIONS Patients with pathological myopia exhibited worse macular microcirculation and thinner macular retina and choroid. The FAZ in pathological myopia was larger and more irregular. The AL, CI, and AI were significantly associated with myopia severity. Thus, CI and AI might serve as new indicators for monitoring the progression of myopia. Further investigations should be performed. TRIAL REGISTRATION Clinical Trials.gov Identifier: ChiCTR2100046590.
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Affiliation(s)
- Jinyuan Sui
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Haoru Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Yang Bai
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Qing He
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Ziwen Sun
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China.
- Tianjin Binhai High-Tech Industrial Development Zone, No. 251 Fukang Road, Huayuan Industrial Zone (Nankai District), Tianjin, China.
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Zhao Q, Zhao X, Luo Y, Yang Z. Ultra-Wide-Field Optical Coherence Tomography and Gaussian Curvature to Assess Macular and Paravascular Retinoschisis in High Myopia. Am J Ophthalmol 2024; 263:70-80. [PMID: 38401851 DOI: 10.1016/j.ajo.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 01/29/2024] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
PURPOSE To evaluate the severity and related factors of macular retinoschisis (MRS) and paravascular retinoschisis (PVRS) in high myopia (HM) using ultra-wide-field optical coherence tomography (UWF-OCT) and a novel Gaussian curvature (K). DESIGN A cross-sectional study. METHODS Patients diagnosed with HM in Peking Union Medical College Hospital were recruited between January 2022 and November 2022. The presence and severity of retinoschisis, along with the three highest K values, were assessed using UWF-OCT and en face images. Logistic regressions were employed to identify factors associated with MRS, PVRS, and the severity of retinoschisis in the 24 × 20 mm scan region. RESULTS A total of 108 HM eyes from 55 patients were recruited. The highest Gaussian curvature (K1) was predominantly found in the vascular arcade (43, 40%). Multivariable logistic regression found that age and PVRS were significant risk factors for MRS occurrence (P < .05), while MRS and higher K1 were significantly associated with the presence of PVRS in HM patients (P < .05). The axial length (AL) and spherical equivalent were associated with the severity of MRS, while AL and K1 values were associated with the severity of retinoschisis in the 24 × 20 mm scan region (P < .05). CONCLUSIONS An association existed between large Gaussian curvature and the presence of MRS and PVRS, as well as the severity of retinoschisis in a wide field of view. UWF-OCT, which enables visualization of the central and peripheral retinal areas, holds promise as an imaging technique for the early detection of extrafoveal retinoschisis.
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Affiliation(s)
- Qing Zhao
- From the Department of Ophthalmology (Q.Z., X.Z., Y.L., Z.Y.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; Key Laboratory of Ocular Fundus Diseases (Q.Z., X.Z., Y.L., Z.Y.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xinyu Zhao
- From the Department of Ophthalmology (Q.Z., X.Z., Y.L., Z.Y.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; Key Laboratory of Ocular Fundus Diseases (Q.Z., X.Z., Y.L., Z.Y.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yan Luo
- From the Department of Ophthalmology (Q.Z., X.Z., Y.L., Z.Y.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; Key Laboratory of Ocular Fundus Diseases (Q.Z., X.Z., Y.L., Z.Y.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhikun Yang
- From the Department of Ophthalmology (Q.Z., X.Z., Y.L., Z.Y.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; Key Laboratory of Ocular Fundus Diseases (Q.Z., X.Z., Y.L., Z.Y.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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Zhao D, Yuan Z, Yang XY, Zhou CY. Comparison of Objective Visual Quality Following SMILE and SmartPulse Technology-Assisted TransPRK at a 1,050-Hz Ablation Frequency for Moderate-to-High Myopia. J Refract Surg 2024; 40:e490-e498. [PMID: 39007811 DOI: 10.3928/1081597x-20240514-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
PURPOSE To compare the objective visual quality of moderate-to-high myopia corrected by small incision lenticule extraction (SMILE) and transepithelial photorefractive keratectomy (TransPRK) at a 1,050-Hz ablation frequency, assisted by Smart-Pulse technology (SCHWIND eye-tech-solutions). METHODS This study involved 123 patients (123 eyes) with moderate-to-high myopia between July 2020 and January 2021. They were categorized into the SMILE group (67 patients, 67 eyes) and the TransPRK group (56 patients, 56 eyes). Follow-ups were conducted at 6 months postoperatively to record the logarithm of the minimum angle of resolution visual acuity, and the Strehl ratio and higher order aberrations were measured using the Sirius anterior segment analysis device (SCHWIND eye-tech-solutions) under a 6-mm pupil diameter at various postoperative intervals. RESULTS At 1 week and 1 month postoperatively, the uncorrected distance visual acuity (UDVA) in the SMILE group was superior to that in the TransPRK group (P < .05 for both). At 1 week and 1 month postoperatively, the Strehl ratio value in the SMILE group was higher than that in the TransPRK group (P < .05 for both). At 1, 3, and 6 months postoperatively, coma was greater in the SMILE group than in the TransPRK group (P < .05 for all). Spherical aberrations were lower in the SMILE group than in the TransPRK group at 3 and 6 months postoperatively (P < .05). At 6 months postoperatively, UDVA was -0.09 ± 0.08 and -0.11 ± 0.05 logMAR in the SMILE and TransPRK groups, respectively, which exceeded their preoperative corrected distance visual acuity of -0.05 ± 0.04 and -0.09 ± 0.08 logMAR (all P < .001). Compared with preoperative values, the Strehl ratio, total higher order, coma, and spherical aberration differences were significantly increased postoperatively in both groups (all P < .001). CONCLUSIONS Both surgical methods improved UDVA and each had its advantages. The visual quality of SMILE was superior at 1 week and 1 month postoperatively (Strehl ratio values were higher than those of the TransPRK group), and its spherical aberration was lower than that of the TransPRK group at 3 and 6 months; TransPRK with SmartPulse technology with a 1,050-Hz ablation frequency showed that coma was significantly lower than that of the SMILE group at 1, 3, and 6 months postoperatively. [J Refract Surg. 2024;40(7):e490-e498.].
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Gajjar S, Ostrin LA. Development of the University of Houston near work, environment, activity, and refraction (UH NEAR) survey for myopia. Clin Exp Optom 2024; 107:544-557. [PMID: 37726150 PMCID: PMC10948375 DOI: 10.1080/08164622.2023.2243264] [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: 02/14/2023] [Accepted: 07/27/2023] [Indexed: 09/21/2023] Open
Abstract
CLINICAL RELEVANCE There is a need to better elucidate demographic and behavioural factors that are contributing to the rising prevalence of myopia. Doing so will aid in developing evidence-based recommendations for behavioural modifications to prevent onset and slow progression of myopia in children. BACKGROUND The contributions of environmental and behavioural factors in myopia remain unclear. The goal of this work was to provide a standardised survey to better understand risk factors for myopia. METHODS Development of the survey was carried out in 4 phases. In phase 1, three methods (direct, lay terms, and indirect) of parental reporting for the presence of myopia in their child were investigated through a questionnaire (N = 109) to determine sensitivity and specificity. The best method determined from phase 1 was used in phase 2, where questions regarding demographics, ocular history, and visual behaviour were compiled and refined. In phase 3, the survey was administered to focus groups of parents (N = 9). In phase 4, a scoring system was developed. RESULTS The highest sensitivity for parental reporting for myopia of their child was the indirect method (0.84), and the lowest sensitivity was the direct method (0.41). The highest specificity was the direct method (0.86), once excluding the 'do not know' responses, and the lowest specificity was the indirect method (0.53). The direct method yielded a 53.2% 'do not know' response rate, 50.5% for the lay method, and 1.8% for the indirect method. Time to complete the survey was 10:09 ± 2:45 minutes. CONCLUSION This study provides a comprehensive and up-to-date myopia risk factor survey that can be utilised by researchers and clinicians. Parents found the survey to be easy to understand and relatively quick to answer, and the scoring system allows quantification of behaviours across different categories using provided equations.
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Affiliation(s)
- Shail Gajjar
- University of Houston College of Optometry, Houston, Texas, USA
| | - Lisa A Ostrin
- University of Houston College of Optometry, Houston, Texas, USA
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Li Y, Xu C, Liu Z, Qu Z, Xi W, Zhang X, Gao L. Effects of physical activity patterns on myopia among children and adolescents: A latent class analysis. Child Care Health Dev 2024; 50:e13296. [PMID: 38895956 DOI: 10.1111/cch.13296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 05/03/2024] [Accepted: 06/02/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND The daily physical activity (PA) patterns of children and adolescents are intricate and ambiguous, with varying effects on myopia resulting from different combinations of PA. This study aims to scrutinize the spectrum of PA patterns among children and adolescents and assess their impact on myopia. METHODS Data sourced from the 2014 National Student Physical Fitness Survey (Tianjin segment) encompassed PA records and visual acuity measurements of participants. Latent Class Analysis and a generalized linear model were employed to investigate the relationship between PA categories and visual acuity across different educational stages. RESULTS The study comprised 6465 primary and middle school students, among whom 50.13% were male. PA patterns were categorized into high (27.16%), medium (29.88%) and low visual acuity regulation groups (13.97%) and the nonmainstream group (28.99%). Following adjustments for sex, age, region and BMI, the medium visual acuity regulation group exhibited a lower risk of myopia (OR = 0.617, 95% CI = 0.424-0.897, p = 0.012; OR = 0.654, 95% CI = 0.438-0.976, p = 0.038) compared to the nonmainstream group among junior and senior middle school students. CONCLUSION The efficacy of diverse PA patterns in mitigating myopia risk varies across educational stages and is influenced by sex-specific factors. It is imperative to advance myopia management strategies by emphasizing tailored PA interventions, discerning between PA patterns and delivering timely guidance and interventions tailored to distinct educational stages and sexes.
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Affiliation(s)
- Yin Li
- Department Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Chang Xu
- Department Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhonghui Liu
- Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - Zhiyi Qu
- Department Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wei Xi
- Department Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xin Zhang
- Department Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Lei Gao
- Department Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
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Lan WZ, Tang H, Wen LB, Chen Z, Zhou YL, Dai WW, Wang M, Li XN, Wang WJ, Tang F, Yang ZK, Tang Y. Artificial Intelligence-Assisted Prescription Determination for Orthokeratology Lens Fitting: From Algorithm to Clinical Practice. Eye Contact Lens 2024; 50:297-304. [PMID: 38695745 DOI: 10.1097/icl.0000000000001091] [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] [Accepted: 02/19/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVES To explore the potential of artificial intelligence (AI) to assist prescription determination for orthokeratology (OK) lenses. METHODS Artificial intelligence algorithm development followed by a real-world trial. A total of 11,502 OK lenses fitting records collected from seven clinical environments covering major brands. Records were randomly divided in a three-way data split. Cross-validation was used to identify the most accurate algorithm, followed by an evaluation using an independent test data set. An online AI-assisted system was implemented and assessed in a real-world trial involving four junior and three senior clinicians. RESULTS The primary outcome measure was the algorithm's accuracy (ACC). The ACC of the best performance of algorithms to predict the targeted reduction amplitude, lens diameter, and alignment curve of the prescription was 0.80, 0.82, and 0.83, respectively. With the assistance of the AI system, the number of trials required to determine the final prescription significantly decreased for six of the seven participating clinicians (all P <0.01). This reduction was more significant among junior clinicians compared with consultants (0.76±0.60 vs. 0.32±0.60, P <0.001). Junior clinicians achieved clinical outcomes comparable to their seniors, as 93.96% (140/149) and 94.44% (119/126), respectively, of the eyes fitted achieved unaided visual acuity no worse than 0.8 ( P =0.864). CONCLUSIONS AI can improve prescription efficiency and reduce discrepancies in clinical outcomes among clinicians with differing levels of experience. Embedment of AI in practice should ultimately help lessen the medical burden and improve service quality for myopia boom emerging worldwide.
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Affiliation(s)
- Wei-Zhong Lan
- Guangzhou Aier Eye Hospital (W.-Z.L.), Jinan University, Guanghzou, China; School of Stomatology and Ophthalmology (W.-Z.L., X.L., Z.Y.), Xianning Medical College, Hubei University of Science and Technology, Xianing, China; SoC Design Center (H.T.), University of Electronic Science and Technology of China, Chengdu, China; School of Electronic Science and Engineering (H.T.), University of Electronic Science and Technology of China, Chengdu, China; Aier School of Ophthalmology (L.-B.W., Z.C., Y.Z., Z.Y.), Central South University, Changsha, China; Information Center (W.D., M.W., F.T.), Aier Eye Hospital Group, Changsha, China; School of Information and Software Engineering (W.-J.W.), University of Electronic Science and Technology of China, Chengdu, China; School of Computer Science and Engineering (Y.T.), University of Electronic Science and Technology of China, Chengdu, China; Hunan Province Optometry Engineering and Technology Research Center (W.-Z.L., L.-B.W., Z.C., X.L., Z.Y.), Changsha, China; and Hunan Province International Cooperation Base for Optometry Science and Technology (W.-Z.L., L.-B.W., Z.C., X.L., Z.Y.), Changsha, China
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Wu Y, Liu X, Liu Y, Qian W, Huang L, Wu Y, Wang X, Yuan Y, Ke B. Assessment of OCT-Based Macular Curvature and Its Relationship with Macular Microvasculature in Children with Anisomyopia. Ophthalmol Ther 2024; 13:1909-1924. [PMID: 38743158 PMCID: PMC11178709 DOI: 10.1007/s40123-024-00956-5] [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: 03/09/2024] [Accepted: 04/16/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION To evaluate the intraocular differences in optical coherence tomography (OCT)-based macular curvature index (MCI) among children with anisomyopia and to investigate the relationship between MCI and the macular microvasculature. METHODS Fifty-two schoolchildren with anisometropia > 2.00 D were enrolled and underwent comprehensive examinations including cycloplegic refraction, axial length (AL), and swept source OCT/OCT angiography. OCT-based MCIs were determined from horizontal and vertical B-scans by a customized curve fitting model in MATLAB R2022 at 1-mm-, 3-mm-, and 6-mm-diameter circles at fovea. Characteristics and topographic variation of MCI was analyzed, and the relationships with microvascularity and its associated factors were investigated. RESULTS MCI achieved high reliability and repeatability. There were overall larger MCIs in the more myopic eyes than the less myopic eyes in 1-mm-, 3-mm-, and 6-mm-diameter circles at fovea (all p < 0.001). For the topographic variation, horizontal MCI was significantly greater than vertical MCI (all p < 0.001), and was the largest in 6-mm circle, followed by 3-mm and 1-mm circles. Stronger correlation of horizontal MCI with myopic severity than vertical MCI was found. Partial Pearson's correlation found MCI was negatively associated with deep capillary plexus (DCP) vessel density (p = 0.016). Eyes with a higher MCI in a 6-mm circle were more likely to have longer AL (p < 0.001), lower DCP vessel density (p = 0.037), and thinner choroidal thickness (ChT) (p = 0.045). CONCLUSION Larger MCI was found in the more myopic eyes of children with anisomyopia and was significantly associated with smaller DCP density, suggesting that MCI was an important indicator of myopia-related retinal microvascularity change, and it could be a valuable metric for myopia assessment in children.
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Affiliation(s)
- Yue Wu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Xin Liu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Yuying Liu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Wenzhe Qian
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Liandi Huang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Yixiang Wu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Xuetong Wang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Ying Yuan
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Bilian Ke
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Hongkou District, Shanghai, China.
- Department of Ophthalmology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
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Ortega-Usobiaga J, González-López F, Peng Y, Bilbao-Calabuig R, Beltrán-Sanz J, Larrubia JR, Llovet-Osuna F. Visual outcomes of combined use of implantable collamer lens implantation and laser corneal visual correction for myopia over -18.00 diopters. J Cataract Refract Surg 2024; 50:733-738. [PMID: 38446490 DOI: 10.1097/j.jcrs.0000000000001438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 02/24/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE To explore visual outcomes in patients with extreme myopia receiving an implantable collamer lens (ICL) at -18.00 diopters (D), with central port, followed by bioptics by laser vision correction (laser in situ keratomileusis [LASIK] or photorefractive keratectomy [PRK]) to address residual myopia or myopic astigmatism. SETTING Clínica Baviera (Aier Eye Hospital Group), Bilbao, Spain. DESIGN Retrospective analysis of cases. METHODS The study assessed uncorrected distance visual acuity, corrected distance visual acuity (CDVA), predictability, safety, efficacy, and patient satisfaction after implantation of the ICL and bioptics. The model implanted was V4c and EVO, with a correction of -18.00 D. Bioptics were performed at least 3 months after implantation, and patients were followed up for at least 3 months after LASIK or PRK. RESULTS The analysis included 125 eyes from 90 patients. Of these, 51.2% underwent LASIK and 48.8% PRK. Mean time from implantation to bioptics was 5.9 ± 9.4 months. Patients were followed up for a mean of 40.2 ± 37.9 months after bioptics. Median manifest refractive spherical equivalent was -2.89 D before bioptics and -0.49 D after. Median CDVA was 0.18 logMAR before bioptics and 0.17 after. The mean safety and efficacy indices were 2.22 ± 1.88 and 2.06 ± 1.85, respectively. CONCLUSIONS Visual outcomes and safety indices after ICL implantation and subsequent LASIK or PRK in patients with extreme myopia are excellent.
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Affiliation(s)
- Julio Ortega-Usobiaga
- From the Department of Cataract and Refractive Surgery, Clínica Baviera (Aier Eye Hospital Group), Bilbao, Spain (Ortega-Usobiaga); Department of Cataract and Refractive Surgery, Miranza IOA, Madrid, Spain (González-López); Department of Ophthalmology, Chongqing Aier-Mega Eye Hospital (Aier Eye Hospital Group), Chongqing, China (Peng); Department of Cataract and Refractive Surgery, Clínica Baviera (Aier Eye Hospital Group), Madrid, Spain (Bilbao-Calabuig, Llovet-Osuna); Department of Research and Development, Clínica Baviera (Aier Eye Hospital Group), Valencia, Spain (Beltrán-Sanz); Health Sciences Research Unit, Guadalajara University Hospital, University of Alcalá, Alcalá de Henares, Spain (Larrubia)
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Yii F, Nguyen L, Strang N, Bernabeu MO, Tatham AJ, MacGillivray T, Dhillon B. Factors associated with pathologic myopia onset and progression: A systematic review and meta-analysis. Ophthalmic Physiol Opt 2024; 44:963-976. [PMID: 38563652 DOI: 10.1111/opo.13312] [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: 10/04/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE To synthesise evidence across studies on factors associated with pathologic myopia (PM) onset and progression based on the META-analysis for Pathologic Myopia (META-PM) classification framework. METHODS Findings from six longitudinal studies (5-18 years) were narratively synthesised and meta-analysed, using odds ratio (OR) as the common measure of association. All studies adjusted for baseline myopia, age and sex at a minimum. The quality of evidence was rated using the Grades of Recommendation, Assessment, Development and Evaluation framework. RESULTS Five out of six studies were conducted in Asia. There was inconclusive evidence of an independent effect (or lack thereof) of ethnicity and sex on PM onset/progression. The odds of PM onset increased with greater axial length (pooled OR: 2.03; 95% CI: 1.71-2.40; p < 0.001), older age (pooled OR: 1.07; 1.05-1.09; p < 0.001) and more negative spherical equivalent refraction, SER (OR: 0.77; 0.68-0.87; p < 0.001), all of which were supported by an acceptable level of evidence. Fundus tessellation was found to independently increase the odds of PM onset in a population-based study (OR: 3.02; 2.58-3.53; p < 0.001), although this was only supported by weak evidence. There was acceptable evidence that greater axial length (pooled OR: 1.23; 1.09-1.39; p < 0.001), more negative SER (pooled OR: 0.87; 0.83-0.92; p < 0.001) and higher education level (pooled OR: 3.17; 1.36-7.35; p < 0.01) increased the odds of PM progression. Other baseline factors found to be associated with PM progression but currently supported by weak evidence included age (pooled OR: 1.01), severity of myopic maculopathy (OR: 3.61), intraocular pressure (OR: 1.62) and hypertension (OR: 0.21). CONCLUSIONS Most PM risk/prognostic factors are not supported by an adequate evidence base at present (an indication that PM remains understudied). Current factors for which an acceptable level of evidence exists (limited in number) are unmodifiable in adults and lack personalised information. More longitudinal studies focusing on uncovering modifiable factors and imaging biomarkers are warranted.
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Affiliation(s)
- Fabian Yii
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Curle Ophthalmology Laboratory, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
| | - Linda Nguyen
- MRC Human Genetics Unit, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh, UK
| | - Niall Strang
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Miguel O Bernabeu
- Centre for Medical Informatics, Usher Institute, The University of Edinburgh, Edinburgh, UK
- The Bayes Centre, The University of Edinburgh, Edinburgh, UK
| | - Andrew J Tatham
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Princess Alexandra Eye Pavilion, NHS Lothian, Edinburgh, UK
| | - Tom MacGillivray
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Curle Ophthalmology Laboratory, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
| | - Baljean Dhillon
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Curle Ophthalmology Laboratory, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
- Princess Alexandra Eye Pavilion, NHS Lothian, Edinburgh, UK
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Tong L, Chen J, Liu L, Kang M, Liao X, Ying P, Ling Q, Zou J, Wei H, Wang Y, Shao Y. Temporal effects of an original myopia song on school children's myopia and awareness: a 3-year prospective study. Clin Exp Optom 2024; 107:537-543. [PMID: 37989320 DOI: 10.1080/08164622.2023.2251975] [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: 03/22/2023] [Accepted: 08/22/2023] [Indexed: 11/23/2023] Open
Abstract
CLINICAL RELEVANCE Raising children's myopia prevention awareness and behaviour tends to exhibits a protective effect against myopia among schoolchildren. BACKGROUND To investigate the effect of an original myopia song in raising school children's awareness of healthier eye use behaviour and on myopia prevention. METHODS In this prospective randomised control study, two groups of students from one primary schools in Jiangxi, China, were enrolled and monitored from grade 3 to grade 6 (2016-2019). The primary outcome was the change in axial length (AL) after the intervention. Secondary outcomes included changes in spherical equivalent refraction (SER), near work and outdoor time, corrected near and distant visual acuity, visual discomfort score (VDS) and accommodative lag. RESULTS Four hundred students (193 females, 48.25%) aged 9.3 (range 8-10) years with emmetropia to moderate myopia were enrolled. Children in the myopia song group had a significantly shorter AL and less myopic refractive change than those in the control group (p = 0.04 and 0.02, respectively). Compared with the control group, children in the myopia song group spent less time on near work and more time outdoors (p = 0.04 and 0.04, respectively). At the final follow-up, the proportion of children with myopia was significantly lower in the myopia song group (30.5%) than in the control group (41%) (p = 0.03). No significant differences were found for the secondary outcomes, including corrected near and distant visual acuity, VDS and accommodative lag. CONCLUSIONS An original myopia song performed twice daily in primary schools appeared to have a modest effect on myopia control among school-aged children by changing their lifestyles in the long term.
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Affiliation(s)
- Liyang Tong
- Department of Ophthalmology, The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, Zhejiang, China
| | - Jun Chen
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Liqi Liu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Min Kang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xulin Liao
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin, China
| | - Ping Ying
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Qian Ling
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jie Zou
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Hong Wei
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yixin Wang
- School of optometry and vision science, Cardiff University, Cardiff, Wales, UK
| | - Yi Shao
- Department of Ophthalmology, The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, Zhejiang, China
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China
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Bayram-Suverza M, Pérez-Montaño C, Villafán-Bernal JR, Rojas-Juárez S, Levine-Berebichez A, Ramírez-Estudillo JA. Characteristics and Prognostic Factors Associated With the Progression of Myopic Traction Maculopathy in Mexican Patients. Cureus 2024; 16:e64036. [PMID: 38979028 PMCID: PMC11230611 DOI: 10.7759/cureus.64036] [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] [Accepted: 07/07/2024] [Indexed: 07/10/2024] Open
Abstract
Background In this study, the characteristics and prognostic factors associated with the progression of myopic traction maculopathy (MTM) were evaluated in a Mexican population. Methods This is a retrospective observational study that analyzed patients with MTM who underwent optical coherence tomography (OCT). Clinical-ocular information, the MTM classification, and initial and final visual acuity (VA) were recorded. Results In total, 101 eyes of 84 patients (mean age 63.5 ± 10.7 years) were included (88.1% female and 11.9% male). The mean spherical equivalent was -16.8 ± 6.4 D, axial length was 29.6 ± 2.1 mm, and mean initial VA was 0.8 ± 0.5 logMAR. The mean follow-up time was 25.7 ± 27.6 months. The change in final VA from diagnosis to the last follow-up was +0.1 (0.2) (p = 0.001). Overall, 24.8% of patients progressed, 72.3% did not progress, and 3% showed regression. The patient-year progression rate was 0.20 ± 0.44. Factors associated with progression were initial logMAR VA (p= 0.012) and staphyloma (p= 0.001). Conclusions One in four patients with MTM progressed, and the patient-year progression rate was 0.5. The factors associated with disease progression were initial VA and the presence of staphyloma. The characteristics of Mexican patients with MTM are similar to those described in other populations.
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Zhang S, Zhu H, Zhang L, Gao M, Liu C, Zhao Q. Effects of orthokeratology on corneal reshaping and the delaying of axial eye growth in children. Heliyon 2024; 10:e33341. [PMID: 39022009 PMCID: PMC11253518 DOI: 10.1016/j.heliyon.2024.e33341] [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: 11/01/2023] [Revised: 06/19/2024] [Accepted: 06/19/2024] [Indexed: 07/20/2024] Open
Abstract
Purpose To investigate the inhibition of myopia progression and axial elongation in children wearing orthokeratology (OK) lenses, as well as to evaluate the status of corneal reshaping, this study explores the relationship between changes in central corneal curvature (K-value) and e-value induced by OK lenses and axial elongation. Methods In this study, it is planned to select children aged 8-15 who wear orthokeratology lenses at the Pediatric Ophthalmology and Strabismus Clinic of the Second Affiliated Hospital of Dalian Medical University. All children will undergo slit lamp examination, visual acuity assessment, computerized refraction, intraocular pressure measurement, biometry, and corneal topography examination before lens wear and at 1 month, 3 months, and 6 months after lens wear in the pediatric ophthalmology clinic. Based on age (lower age group (8 < age ≤12 years); higher age group (12 < age ≤15 years)) and baseline equivalent spherical (SE) value (mild myopia group (-1.00 D < SE ≤ -3.25D); moderate myopia group (-3.25 D < SE ≤ -6.00 D)), four groups will be formed by pairing these factors. Suitable data will be selected according to inclusion and exclusion criteria, and different groups will be included. Data will be organized, and statistical analysis will be performed using SPSS software to obtain the results. The expected results will be discussed and analyzed. Results After wearing OK lenses, all four groups achieved good visual acuity at follow-up. At 6 months, there were no significant differences in visual acuity among the four groups (P = 0.149, >0.05). There were no significant differences in refractive error among the four groups (P = 0.066, >0.05). Baseline axial length differed significantly among the four groups (P = 0.000, <0.001), with the LM group having longer axial length than the LL group (P < 0.001, paired samples t-test), and the HM group having longer axial length than the HL group (P < 0.001, paired samples t-test). However, there were no significant differences in axial length change compared to baseline among the groups at 1 month, 3 months, and 6 months (P 1 = 0.053; P 3 = 0.557; P 6 = 0.329, >0.05). Significant differences were observed in corneal flat K-value change compared to baseline among the four groups at 1 month, 3 months, and 6 months (P 1 = 0.001, P 3 = 0.001, P 6 = 0.004, <0.05). There were no significant differences in e-value change among the groups at 1 and 3 months (P 1 = 0.205, P 3 = 0.252, >0.05), but significant differences were found in e-value change compared to baseline at 6 months (P 6 = 0.010, <0.05). Multiple regression analysis with changes in central corneal flat K-value and e-value as independent variables and axial elongation as the dependent variable showed a correlation between e-value change at 6 months and axial elongation (P = 0.004, <0.05), indicating a negative correlation. Conclusion Orthokeratology (OK) lenses effectively improve myopic children's vision by reshaping the cornea, leading to reduced central corneal curvature and flattening of its anterior surface. The effectiveness of OK lenses is not significantly affected by age or initial myopia severity. Children of varying ages and myopia levels experience similar levels of axial length control with OK lens wear. Changes in corneal shape due to OK lenses affect axial elongation, with greater changes in corneal morphology associated with smaller increases in axial length.
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Affiliation(s)
- Siqi Zhang
- Second Affiliated Hospital of Dalian Medical University, China
| | - Huailin Zhu
- Second Affiliated Hospital of Dalian Medical University, China
| | - Lan Zhang
- Second Affiliated Hospital of Dalian Medical University, China
| | - Mingjun Gao
- Second Affiliated Hospital of Dalian Medical University, China
| | - Changyang Liu
- Second Affiliated Hospital of Dalian Medical University, China
| | - Qi Zhao
- Second Affiliated Hospital of Dalian Medical University, China
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Liu H, Meng F, Wang B, Li J, Xi Y, Yi Q, Zhang Y. Fundus morphological characteristics assesment in high myopia patients with or without posterior scleral staphyloma by optical coherence tomography. Photodiagnosis Photodyn Ther 2024; 48:104258. [PMID: 38955256 DOI: 10.1016/j.pdpdt.2024.104258] [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: 01/04/2024] [Revised: 06/05/2024] [Accepted: 06/20/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVE To observe the morphological characteristics of posterior scleral staphyloma (PSS) with or without macular retinoschisis (MRS) using optical coherence tomography (OCT). Additionally, the incidence and severity of other pathologic myopic maculopathy associated with posterior scleral staphyloma was also evaluated. METHODS General information and OCT imaging data from 440 patients with posterior scleral staphyloma (PSS) and the PSS curvature > 20×10-3 μm-1 were collected. These patients visited the Department of Ophthalmology at the First Affiliated Hospital of Harbin Medical University from January 2013 to June 2021. The obtained OCT images of PSS were analyzed using the Image J software to measure the curvature along the Bruch's membrane. The measured curvature was divided into four levels using the quartile method. The classification of macular retinoschisis (MRS) was based on the anatomical structure of the retina and the location of macular retinoschisis. Patients with PSS accompanied by MRS were assigned to the MRS group, while PSS patients without MRS were assigned to the non-MRS group. Additionally, typical OCT changes in other pathologic myopic maculopathy diseases, such as myopic choroidal neovascularization (mCNV), myopic traction maculopathy (MTM), and myopic foveoschisis (MF), were recorded and evaluated. RESULTS A total of 615 eyes (328 right eyes, 287 left eyes) from 440 patients (80 males and 360 females) were recruited in this study. The MRS group consisted of 159 patients (36.1%) with 190 eyes (30.9%), while the non-MRS group consisted of 281 patients (63.9%) with 425 eyes (69.1%). Both groups had a significantly higher proportion of female patients compared to male patients, and the right eye was more commonly affected than the left eye. In the MRS group, the prevalence of MRS increased progressively with the severity of PSS. Among the common posterior pole diseases, epiretinal membrane had the highest prevalence (33.2%), while lamellar macular hole had the lowest prevalence (5.3%). In the non-MRS group, the proportion of PSS in each group decreased progressively (except for an equal prevalence in the third and fourth levels) with increasing severity of PSS. Among the common posterior pole diseases, choroidal neovascularization had the highest prevalence (41.4%), while lamellar macular hole had the lowest prevalence (6.5%). When comparing the two groups, there were no significant differences in age, gender, and eye distribution. The MRS group had a higher prevalence of macular schisis, retinal detachment, and dome-shaped macula (17.9%, 14.2%, 14.8%) compared to the non-MRS group (11.3%, 9.2%, 9.6%). The non-MRS group had a significantly higher prevalence of choroidal neovascularization (41.4%) compared to the MRS group (12.6%), while there were no significant differences in the prevalence of epiretinal membrane and lamellar macular hole between the two groups. CONCLUSION The prevalence of MRS increased progressively with the severity of PSS, and the MRS occurrence was positively correlated with PSS, which indicated that PSS may lead to MRS, while the proportion of PSS in each group decreases gradually with the severity of PSS in the non-MRS group decreased progressively (except for an equal prevalence in the third and fourth levels). In the MRS group, outer macular retinoschisiss were most relevant to posterior scleral staphyloma, and the prevalence of macular holes and retinal detachments was higher in the MRS group compared to the non-MRS group, indicating that MRS may further turn into complications such as macular holes and retinal detachments, which can significantly affect vision or lead to blindness. The prevalence of choroidal neovascularization (CNV) was significantly higher in the non-MRS group compared to the MRS group, suggesting that PSS with lower severity is more prone to develop into CNV. Dome-shaped macula (DSM) seems to play a protective role in the development of pathologic myopia, and abnormal changes in posterior scleral staphyloma curvature may be an important factor affecting the development and shape of DSM.
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Affiliation(s)
- Hongling Liu
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province 150000, PR China; Ankang Center Hospital, Ankang, Shaanxi Province 725000, PR China; Department of Ophthalmology, The Seventh Affiliated Hospital of Zhongshan University, Shenzhen 518000, PR China
| | - Fanwei Meng
- Department of Ophthalmology, The First Hospital of Harbin, Harbin, Heilongjiang Province 150000, PR China
| | - Biying Wang
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province 150000, PR China
| | - Junqi Li
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province 150000, PR China
| | - Yahui Xi
- Ankang Center Hospital, Ankang, Shaanxi Province 725000, PR China
| | - Quanyong Yi
- Ningbo Eye Hospital, Wenzhou Medical University, Ningbo, Zhejiang 315000, PR China.
| | - Yanyan Zhang
- Ningbo Eye Hospital, Wenzhou Medical University, Ningbo, Zhejiang 315000, PR China.
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Zhang X, Zhao J, Li Y, Wu H, Zhou X, Liu J. Efficient pyramid channel attention network for pathological myopia recognition with pretraining-and-finetuning. Artif Intell Med 2024; 154:102926. [PMID: 38964193 DOI: 10.1016/j.artmed.2024.102926] [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: 01/08/2024] [Revised: 06/21/2024] [Accepted: 06/25/2024] [Indexed: 07/06/2024]
Abstract
Pathological myopia (PM) is the leading ocular disease for impaired vision worldwide. Clinically, the characteristics of pathology distribution in PM are global-local on the fundus image, which plays a significant role in assisting clinicians in diagnosing PM. However, most existing deep neural networks focused on designing complex architectures but rarely explored the pathology distribution prior of PM. To tackle this issue, we propose an efficient pyramid channel attention (EPCA) module, which fully leverages the potential of the clinical pathology prior of PM with pyramid pooling and multi-scale context fusion. Then, we construct EPCA-Net for automatic PM recognition based on fundus images by stacking a sequence of EPCA modules. Moreover, motivated by the recent pretraining-and-finetuning paradigm, we attempt to adapt pre-trained natural image models for PM recognition by freezing them and treating the EPCA and other attention modules as adapters. In addition, we construct a PM recognition benchmark termed PM-fundus by collecting fundus images of PM from publicly available datasets. The comprehensive experiments demonstrate the superiority of EPCA-Net over state-of-the-art methods in the PM recognition task. For example, EPCA-Net achieves 97.56% accuracy and outperforms ViT by 2.85% accuracy on the PM-fundus dataset. The results also show that our method based on the pretraining-and-finetuning paradigm achieves competitive performance through comparisons to part of previous methods based on traditional fine-tuning paradigm with fewer tunable parameters, which has the potential to leverage more natural image foundation models to address the PM recognition task in limited medical data regime.
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Affiliation(s)
- Xiaoqing Zhang
- Research Institute of Trustworthy Autonomous Systems and Department of Computer Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China; Center for High Performance Computing and Shenzhen Key Laboratory of Intelligent Bioinformatics, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
| | - Jilu Zhao
- Research Institute of Trustworthy Autonomous Systems and Department of Computer Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Yan Li
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China; State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Hao Wu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China; State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Xiangtian Zhou
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China; State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China; Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences, Wenzhou, 325027, China
| | - Jiang Liu
- Research Institute of Trustworthy Autonomous Systems and Department of Computer Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China; National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China; Singapore Eye Research Institute, 169856, Singapore.
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Lei S, Wu Y, Kou J, Chen Q, Liu L. The effect of individualized ocular refraction customized spectacle lenses on myopia control in schoolchildren: A 1-year randomised clinical trial. Ophthalmic Physiol Opt 2024. [PMID: 38935437 DOI: 10.1111/opo.13354] [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: 02/09/2024] [Revised: 06/07/2024] [Accepted: 06/07/2024] [Indexed: 06/29/2024]
Abstract
PURPOSE The aim of this study was to investigate the effect of individualized ocular refraction customized (IORC) spectacle lenses with different actual amounts of peripheral myopic defocus (MD) on myopia control over 1 year. These lenses compensate for the original peripheral refraction via the free-form surface on the back of the lens. METHODS This 1-year, double-masked randomised clinical trial included 184 myopic schoolchildren aged 8-12 years. Participants were randomised to receive IORC lenses with high (IORC-H group, +4.50 D), medium (IORC-M group, +3.50 D) or low (IORC-L group, +2.50 D) MD or single-vision (SV) lenses. The spherical equivalent refractive error (SER) and axial length (AL) were measured at baseline and 6-monthly intervals. RESULTS After 1 year, the mean (SD) changes in SER were -0.18 (0.37), -0.36 (0.37), -0.52 (0.39) and -0.60 (0.42) D for the IORC-H, IORC-M, IORC-L and SV groups, respectively. Compared with the SV group, the effects of slowing myopia progression were 70%, 40% and 13% for the IORC-H (difference of 0.47 D, p < 0.001), IORC-M (difference of 0.32 D, p = 0.001) and IORC-L (difference of 0.15 D, p > 0.05) groups, respectively. The mean (SD) changes in AL were 0.12 (0.16), 0.23 (0.17), 0.29 (0.17) and 0.36 (0.17) mm for the IORC-H, IORC-M, IORC-L and SV groups, respectively. The axial elongation was 67%, 36% and 19% lower in the IORC-H (difference of 0.25 mm, p < 0.001), IORC-M (difference of 0.15 mm, p < 0.001) and IORC-L (difference of 0.10 mm, p = 0.04) groups, respectively, compared with the SV group. The IORC-H group exhibited significantly less axial elongation than the IORC-M and IORC-L groups (p = 0.01 and p < 0.001, respectively). CONCLUSION Compared with the IORC-M and IORC-L lenses, the IORC-H lens was found to have superior efficacy in inhibiting myopic progression and slowing eye growth in schoolchildren, with better myopia control efficacy in younger children.
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Affiliation(s)
- Si Lei
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Ye Wu
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Ji Kou
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Qian Chen
- Center of Biostatistics, Design, Measurement and Evaluation, Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Longqian Liu
- Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
- Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Chun RKM, Hon Y, Law TK, Wong KYQ, To CH, Shih KC, Leung CKS, Tse DYY. Combination effect of optical defocus and low dose atropine in myopia control: Study protocol for a randomized clinical trial. PLoS One 2024; 19:e0306050. [PMID: 38923965 PMCID: PMC11206955 DOI: 10.1371/journal.pone.0306050] [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] [Received: 06/02/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Myopia, characterized by excessive axial elongation of the eyeball, increases risks of having sight-threatening diseases and impose a financial burden to healthcare system. Although myopic control interventions showed their effectiveness in slowing progression, the efficacy varies between individuals and does not completely halt progression. The study aims to investigate the efficacy of combining 0.01% atropine administered twice daily with optical defocus for myopia control in schoolchildren. METHODS AND DESIGN This is a prospective, parallel-group, single-blinded, randomized, active-control trial (ClinicalTrials.gov identifier: NCT06358755). Myopic schoolchildren with no previous myopic control interventions aged between 7 to 12 years will be recruited. They will be randomly allocated into two groups (n = 56 per group) after baseline measurement. Both groups will receive 0.01% atropine twice per day for 18 months (one drop in the morning and the other drop at night before bedtime). Defocus incorporated multiple segments (DIMS) spectacle lenses will be prescribed in atropine plus optical defocus (ATD) treatment group while single vision spectacle lenses will be given in atropine only (AT) group. Cycloplegic refraction and axial lengths will be monitored every 6 months over 18-month study period. The primary outcomes are changes in cycloplegic refraction and axial lengths relative to the baseline over the study period. DISCUSSION The result will examine the combination effect of low dose atropine and myopic defocus on myopia control in a randomized controlled study. The findings will also explore the potential benefits of applying 0.01% atropine twice per day on myopic control and its potential side effects.
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Affiliation(s)
- Rachel Ka Man Chun
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
- Centre for Eye and Vision Research (CEVR), Shatin, Hong Kong
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Ying Hon
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Tsz Kin Law
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
- Centre for Eye and Vision Research (CEVR), Shatin, Hong Kong
| | - Kryshell Yu Qi Wong
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Chi Ho To
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
- Centre for Eye and Vision Research (CEVR), Shatin, Hong Kong
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong
- School of Optometry & Vision Sciences, Cardiff University, Cardiff, United Kingdom
| | - Kendrick C. Shih
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Christopher Kai Shun Leung
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Dennis Yan Yin Tse
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
- Centre for Eye and Vision Research (CEVR), Shatin, Hong Kong
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Rajavi Z, Khorrame Z, Ashrafi S. The effects of refractive status on the outcomes of strabismus surgery in patients with esotropia. BMC Ophthalmol 2024; 24:271. [PMID: 38918731 PMCID: PMC11197173 DOI: 10.1186/s12886-024-03531-5] [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: 10/12/2023] [Accepted: 06/19/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND The success of the strabismus surgery can hinge on several factors. One of these factors is refractive condition like hyperopia or myopia. Our study seeks to evaluate the surgical outcomes in patients with esotropia and myopia. METHODS This case-control study encompassed all surgical cases of esotropia at Torfe and Negah Hospital between 2016 and 2021, which satisfied our specified inclusion criteria. The initial variables from electronic medical records were collected, including demographic, clinical, and surgery-related factors. At the final follow-up appointment, the level of eye deviation, both at distance and near, was recorded. We considered the operation a "success" for patients with a post-surgery distance eye deviation of 10(Pd) or less. Patients with greater deviation were classified as surgery failure. Statistical analyses were executed using SPSS software (version 16.0), and a P-value less than 0.05 was considered significant. RESULTS Of the 194 patients evaluated, 112 were incorporated into the study. Surgical failure was observed in 14.29% of myopic patients, 29.79% of hyperopic patients, and 31.82% of emmetropic patients. The myopia group displayed a 0.19 odd ratio for surgical failure compared to the combined hyperopia and emmetropia groups, not statistically significant (OR: 0.19, CI 95%: 0.03-1.02). Additionally, patients diagnosed with Lateral Rectus Under-action were found to be 6.85 times more likely to experience surgery failure(OR: 6.85, CI 95%: 1.52-30.94). An elevated risk of surgical failure was also identified in patients who underwent Inferior Oblique Weakening procedure, indicated by a 3.77-fold increase in the odds ratio for failure(OR: 3.77, CI 95%: 1.08-13.17). CONCLUSION In our study, despite numerical disparities, there was no statistical difference among the success rates of all esotropia patients with different refractive errors. The patients with LRUA or IOOA showed lower success rates. Myopic patients had higher post-op overcorrection with lower reoperation rates compared to hyperopic or emmetropic patients.
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Affiliation(s)
- Zhale Rajavi
- Negah Aref Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Ophthalmology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Khorrame
- Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sadra Ashrafi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Wu H, Wang Z, Wang P, Meng Y, Wang Z, Xue Y, Jiang B, Pan S, Yan Z. Repeatability and Agreement of Central Vault for Implantable Collamer Lens Obtained by the Tomey OA-2000 Biometer and Spectralis OCT. J Ophthalmol 2024; 2024:3684626. [PMID: 38957378 PMCID: PMC11217569 DOI: 10.1155/2024/3684626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 04/04/2024] [Accepted: 06/15/2024] [Indexed: 07/04/2024] Open
Abstract
Objective To assess repeatability and agreement of central vault for implantable collamer lens (ICL) measured by the Tomey OA-2000 biometry and Spectralis optical coherence tomography (OCT). Methods In this prospective study, the central vault was measured by the Tomey OA-2000 biometer and Spectralis OCT in 84 eyes (43 patients) after ICL implantation at six month follow-up. Three consecutive scans were obtained by one experienced technician using Tomey OA-2000 and the Spectralis OCT in the same day. The coefficient of variation (CoV), intraclass correlation coefficient (ICC), within-subject standard deviation (Sw), and 2.77 Sw were calculated to assess the repeatability and reproducibility. The paired t-test and Bland-Altman plots were used to analyze the differences and agreements of central vault measured by two devices. Results Repeatability of the central vault measured by Tomey OA-2000 biometer and Spectralis OCT showed that the CoV was 2.71% and 1.66%, respectively. The ICC for both devices was 0.996 and 0.999, respectively. The paired t-test showed that central vault measured by Tomey OA-2000 biometer was -7.25 ± 23.57 microns lower than that measured by Spectralis OCT (P = 0.006). The mean difference between measurements for Tomey OA-2000 and ASM-OCT with 95% limits of agreement (LoAs) was -38.94 to 53.44 μm. Conclusion Both Tomey OA-2000 biometer and Spectralis OCT displayed good repeatability for the measurement of central vault of ICL. Good reliability and agreement were observed between Tomey OA-2000 biometer and Spectralis OCT. Both instruments are useful but not replaced each other for central vault measurements.
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Affiliation(s)
- Hao Wu
- Department of OphthalmologyBengbu First People's Hospital, 229 Tushan Road, Bengbu 233000, China
- Department of OphthalmologyThe Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050000, China
| | - Zuocheng Wang
- School of ManagementShijiazhuang Tiedao University, Shijiazhuang 050043, China
| | - Pengfei Wang
- Department of OphthalmologyThe Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050000, China
| | - Yifei Meng
- Department of OphthalmologyThe Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050000, China
| | - Zengying Wang
- Department of OphthalmologyThe Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050000, China
| | - Yuhong Xue
- Department of OphthalmologyThe Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050000, China
| | - Bohua Jiang
- Department of OphthalmologyThe Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050000, China
| | - Shuaixi Pan
- Department of OphthalmologyThe Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050000, China
| | - Zhipeng Yan
- Department of OphthalmologyThe Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050000, China
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Lai X, Liu X, Zeng T, Huang Y, Yang X. Comparison of visual outcomes and optical aberrations after SMILE with intraoperative Kappa angle adjustments between small and large Kappa angles. Sci Rep 2024; 14:14551. [PMID: 38914606 PMCID: PMC11196622 DOI: 10.1038/s41598-024-65366-w] [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: 09/16/2023] [Accepted: 06/19/2024] [Indexed: 06/26/2024] Open
Abstract
This study compares postoperative visual outcomes and optical aberrations after Small Incision Lenticule Extraction (SMILE) in patients with both small (S-Kappa: Kappa angle < 0.2 mm) and large Kappa (L-Kappa: Kappa angle ≥ 0.2 mm) angles. The evaluated aberrations include total higher-order aberrations (HOAs), horizontal coma (HC), vertical coma (VC), and spherical aberrations (SA), with procedures incorporating intraoperative Kappa angle adjustments. We retrospectively analyzed patient records undergoing SMILE utilizing linear mixed models (LMM). We assessed adjusted mean uncorrected distance visual acuity (UDVA), Strehl ratio (SR), total HOAs, VC, and SA at pupils of 3 mm and 6 mm for both S-Kappa and L-Kappa. The disparities between S-Kappa and L-Kappa were evaluated by LMM's adjusted mean differences. The differences in optical metrics were also assessed in eyes grouped by myopia levels: low, moderate, and high. A sensitivity analysis was conducted on a threshold of Kappa angle at 0.3 mm. Eight-five patients (169 eyes) were analyzed, and no significant pre-operative difference was found in UDVA (p = .222) or spherical equivalent (p = .433). Post-operative differences were found in SR at 3 mm pupil size (-0.06, p = .022), total HOA 3 mm (0.15, p = .022), HC 3 mm (0.04, p = .042), VC 3 mm and 6 mm (-0.08, p = .041; 0.04, p = .041). The stratified analysis for high myopia revealed significant differences in UDVA (-0.04, p = .037), HC 3 mm (0.07, p = .03), VC 6 mm (-0.21, p = .001), and SA 3 mm and 6 mm (0.07, p = .037; -0.09, p = .037). Sensitivity analysis showed no significant difference using a 0.3 mm Kappa threshold. While some optical aberrations exhibited statistical differences between S-Kappa and L-Kappa, their clinical significance is limited. Thus, a large Kappa angle might not substantially influence post-operative optical aberrations when intraoperative Kappa angle adjustments are implemented.
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Affiliation(s)
- Xiaojuan Lai
- Department of Ophthalmology, The Second People's Hospital of Yibin, Yi'bin, 644000, China
| | - Xi Liu
- Department of Ophthalmology, The Second People's Hospital of Yibin, Yi'bin, 644000, China.
| | - Tao Zeng
- Department of Ophthalmology, The Second People's Hospital of Yibin, Yi'bin, 644000, China
| | - Yi Huang
- Department of Ophthalmology, The Second People's Hospital of Yibin, Yi'bin, 644000, China
| | - Xin Yang
- The University of Alabama, Tuscaloosa, AL, 35487, USA
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Yan Y, Xia X, Zhang Q, Li X. Characteristics of refractive development in children aged 4 months to 8 years in urban China: A retrospective screening analysis. Ophthalmic Physiol Opt 2024. [PMID: 38923044 DOI: 10.1111/opo.13355] [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: 09/06/2023] [Revised: 06/06/2024] [Accepted: 06/08/2024] [Indexed: 06/28/2024]
Abstract
PURPOSE To conduct a large retrospective study of screening refractive error in young children. METHODS This retrospective study included children aged from 4 months to 8 years in Daxing District, Beijing, who underwent refractive examinations without cycloplegia. It included a cross-sectional assessment of refractive error screening for all children, and a longitudinal component for a subgroup with data available for two to five visits. RESULTS A total of 14,987 children were included in the cross-sectional study. In the group <1 year of age, the percentage of children with a spherical equivalent (SE) >+2.00 D or with cylinder <-1.50 D was 15.25% and 33.24%, respectively. These were significantly higher than for the 1- to 4-year-old group (SE 8.1% higher, cylinder 13.2% higher) (χ2 = 53.57, p < 0.001; χ2 = 790.39, p < 0.001). Furthermore, 34.83% of children in the 0-year-old group had amblyopia risk factors (ARFs). In the 4-year-old group, boys had a significantly longer axial length (AL) than girls (differences in the right and left eyes were 0.53 and 0.56 mm, respectively; z = 5.48 p < 0.001, z = 5.80, p < 0.001). AL increased with age, while the AL difference between boys and girls remained stable at 4-8 years of age. The percentage of children aged 5-8 years with myopia in 2020-2021 was significantly higher than that in 2018-2019 (H = 12.44, p = 0.006). In the longitudinal study of 4406 children (up to 12-month follow-up), annual changes in SE were -0.27, -0.06, 0.19 and 0.13 D between 0 and 3 years, and -0.38, -0.58, -0.70 and -0.75 D between 5 and 8 years. CONCLUSIONS Children's refractive error varied significantly from ages 4 months to 1 year, with a high proportion having ARFs. Children aged 5-8 years showed a trend towards myopia. The prevalence of myopia in the cross-sectional analysis in 2020-2021 was greater than in 2018-2019. Screening refraction changed minimally over a 12-month period for children aged 1-3 years, but became more myopic for children aged 5-8 years.
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Affiliation(s)
- Yarong Yan
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin, China
| | - Xuewen Xia
- Beijing Daxing Maternal and Child Care Hospital, Beijing, China
| | - Qinghui Zhang
- Beijing Daxing Maternal and Child Care Hospital, Beijing, China
| | - Xuan Li
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin, China
- Affiliated Eye Hospital, Nankai University, Tianjin, China
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Lu C, Miao Y, Yao X, Wang Z, Wei R, Du B, Liu Y, He J, Sun H, Liu Y, Yan J, Huang G, Chen X, Tang NJ, Yan H. Socioeconomic disparities and green space associated with myopia among Chinese school-aged students: A population-based cohort study. J Glob Health 2024; 14:04140. [PMID: 38898796 PMCID: PMC11187523 DOI: 10.7189/jogh.14.04140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
Background There is increasing evidence on the link between environmental factors and myopia in children and adolescents, yet with inconsistent conclusions. We investigated the associations between socioeconomic inequalities and green space with myopia in school-aged students participating in the Tianjin Child and Adolescent Research of Eye (TCARE) study. Methods We obtained data from a population-based dynamic cohort study conducted in Tianjin, China, in 2021 and followed up in 2022. We included 1 245 271 participants from 16 districts with an average age of 11.6 years (standard deviation = 3.3) in our analysis. We synthesized their area-level SES through a prediction model that combined economic, educational, and health care variables and assessed the greenness levels surrounding the school using the Normalized Difference Vegetation Index (NDVI) based on data obtained through satellite remote sensing. We performed generalised linear mixed effects analyses for each myopia outcome separately, with adjustments for students' sex, years of education completed, and the school's geographical location. Results We observed that students living in low SES areas had the highest prevalence of myopia (60.7%) in the last screening in 2022, as well as a higher incidence of one-year myopia (26.4%) compared to those residing in middle SES areas (22.7%). With a 0.1 increase in the 250, 500, and 1000 m buffer NDVI, the prevalence of myopia dropped by 6.3% (odds ratio (OR) = 0.937; 95% confidence interval (CI) = 0.915, 0.960), 7.7% (OR = 0.923; 95% CI = 0.900, 0.946), and 8.7% (OR = 0.913; 95% CI = 0.889, 0.937), respectively. The interaction analysis showed that low SES and low greenness exacerbate the prevalence of myopia. Findings from longitudinal analyses consistently demonstrated a correlation between higher values of NDVI and a slower progression of myopia. These findings remained robust across sensitivity analyses, including for variables on parental myopia and students' behaviors. Conclusions Exposure to green spaces could play a crucial role in slowing the progression of myopia among school-aged students. Myopia control policies should prioritise young populations residing in low SES areas with limited access to green spaces, as they face the highest potential risks.
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Affiliation(s)
- Congchao Lu
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, China
| | - Yuyang Miao
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
| | - Xuyang Yao
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
| | - Zinuo Wang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, China
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Bei Du
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yifan Liu
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, China
| | - Jiayu He
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, China
| | - Hongyue Sun
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, China
| | - Yuanyuan Liu
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
| | - Jing Yan
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Guowei Huang
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xi Chen
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, China
| | - Nai-jun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin Medical University, Tianjin, China
| | - Hua Yan
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
- School of Medicine, Nankai University, Tianjin, China
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