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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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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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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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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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Sartor L, Hunter DS, Vo ML, Samarawickrama C. Benefits and risks of orthokeratology treatment: a systematic review and meta-analysis. Int Ophthalmol 2024; 44:239. [PMID: 38904856 PMCID: PMC11192849 DOI: 10.1007/s10792-024-03175-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 06/15/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND This meta-analysis reviews the evidence for the risks and benefits associated with orthokeratology (OK) treatment compared with other methods of myopia control in children and adults. METHODS A systematic search of Cochrane Central Register of Controlled Trials, Pubmed, Embase and Ovid was conducted from database inception to 22nd August 2021. Studies that reported on risks, visual and ocular biometric effects of OK in patients > 5 years of age with myopia (- 0.75 to - 6.00D) were included. Main outcomes are change in axial length and any adverse event. RESULTS Fourty-five papers were included in this systematic review and meta-analysis. The quality of data was variable and of moderate certainty, and selection bias likely skewed the results towards a relative benefit for OK. The rate of axial elongation in children was lower for OK treatment compared to other treatment modalities at one year (MD - 0.16 mm, 95% CI - 0.25 to - 0.07). Rate of change in axial length in children rebounded after OK discontinuation compared to participants who continued treatment (MD 0.10 mm, 95% CI 0.06 to 0.14). Adults and children wearing OK were up to 3.79 times more likely to experience an adverse event when compared with conventional contact lenses (OR 3.79, 95% CI 1.24 to ll.), though this evidence base is underdeveloped and requires additional well-designed studies for substantial conclusions to be drawn. CONCLUSIONS OK arrests myopia progression while in use, however, there remain unanswered questions about the optimal duration of treatment, discontinuation effects and long-term risk for adverse events.
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Affiliation(s)
- Lauren Sartor
- Centre for Vision Research, Westmead Institute of Medical Research, Sydney, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Department of Ophthalmology, Westmead Hospital, Sydney, NSW, Australia
| | - Damien S Hunter
- Centre for Vision Research, Westmead Institute of Medical Research, Sydney, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Mai Linh Vo
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Chameen Samarawickrama
- Centre for Vision Research, Westmead Institute of Medical Research, Sydney, Australia.
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
- Department of Ophthalmology, Westmead Hospital, Sydney, NSW, Australia.
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Zhou Y, Li H, Hao J, Pan W, Yang Z, Lan W. The efficacy of orthokeratology lenses with smaller back optic zone diameter in myopia control. A meta-analysis. Ophthalmic Physiol Opt 2024. [PMID: 38881171 DOI: 10.1111/opo.13347] [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: 01/22/2024] [Revised: 05/29/2024] [Accepted: 05/31/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE This study was conducted to determine whether orthokeratology (OK) lenses with a smaller back optic zone diameter (BOZD) could exhibit stronger myopia control effects. METHOD A meta-analysis was registered in PROSPERO (CRD42023408184). A comprehensive systematic database search was conducted, encompassing PubMed, Cochrane Library, EMBASE, MEDLINE, Web of Science, Ovid, CNKI and CBM, to identify relevant studies up to 25 March 2023. The primary inclusion criteria for this meta-analysis were studies that investigated the myopia control effect of OK lenses with a small optical treatment area (≤5 mm). To assess the quality of the retrieved articles, two researchers evaluated them using the Cochrane bias risk assessment criteria. The primary outcome measures were the changes in axial length (AL) and refractive error, using the weighted mean differences (WMD) and 95% confidence intervals (CI) to assess differences between small and traditional back optical treatment zone groups in terms of these outcomes. RESULTS The analysis encompassed five eligible studies, with a 1 year duration. The average difference in AL between the groups was 0.12 mm (WMD = -0.12, 95% CI [-0.16, -0.09], p < 0.00001). Likewise, the average difference in refractive error between the two groups was 0.44 D (WMD = 0.44, 95% CI [0.30, 0.57], p < 0.00001). None of the studies reported severe adverse events. CONCLUSIONS Current evidence suggests that OK lenses with smaller back optical treatment zone are more effective in preventing myopia progression than traditional lenses. However, a longer-term evaluation is warranted.
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Affiliation(s)
- Yongli Zhou
- Aier Academy of Ophthalmology, Central South University, Changsha, Hunan, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, Hunan, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, Hunan, China
| | - Huan Li
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, Hunan, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, Hunan, China
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jiangdong Hao
- Aier Academy of Ophthalmology, Central South University, Changsha, Hunan, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, Hunan, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, Hunan, China
| | - Wei Pan
- Aier Academy of Ophthalmology, Central South University, Changsha, Hunan, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, Hunan, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, Hunan, China
| | - Zhikuan Yang
- Aier Academy of Ophthalmology, Central South University, Changsha, Hunan, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, Hunan, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, Hunan, China
- Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Xianning, Hubei, China
| | - Weizhong Lan
- Aier Academy of Ophthalmology, Central South University, Changsha, Hunan, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, Hunan, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, Hunan, China
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Xianning, Hubei, China
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Chen Y, Yang S, Liu R, Xiong R, Wang Y, Li C, Zheng Y, He M, Wang W. Forecasting Myopic Maculopathy Risk Over a Decade: Development and Validation of an Interpretable Machine Learning Algorithm. Invest Ophthalmol Vis Sci 2024; 65:40. [PMID: 38935031 PMCID: PMC11216278 DOI: 10.1167/iovs.65.6.40] [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: 03/20/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
Purpose The purpose of this study was to develop and validate prediction model for myopic macular degeneration (MMD) progression in patients with high myopia. Methods The Zhongshan High Myopia Cohort for model development included 660 patients aged 7 to 70 years with a bilateral sphere of ≤-6.00 diopters (D). Two hundred twelve participants with an axial length (AL) ≥25.5 mm from the Chinese Ocular Imaging Project were used for external validation. Thirty-four clinical variables, including demographics, lifestyle, myopia history, and swept source optical coherence tomography data, were analyzed. Sequential forward selection was used for predictor selection, and binary classification models were created using five machine learning algorithms to forecast the risk of MMD progression over 10 years. Results Over a median follow-up of 10.9 years, 133 patients (20.2%) showed MMD progression in the development cohort. Among them, 69 (51.9%) developed newly-onset MMD, 11 (8.3%) developed patchy atrophy from diffuse atrophy, 54 (40.6%) showed an enlargement of lesions, and 9 (6.8%) developed plus signs. Top six predictors for MMD progression included thinner subfoveal choroidal thickness, longer AL, worse best-corrected visual acuity, older age, female gender, and shallower anterior chamber depth. The eXtreme Gradient Boosting algorithm yielded the best discriminative performance (area under the receiver operating characteristic curve [AUROC] = 0.87 ± 0.02) with good calibration in the training cohort. In a less myopic external validation group (median -5.38 D), 48 patients (22.6%) developed MMD progression over 4 years, with the model's AUROC validated at 0.80 ± 0.008. Conclusions Machine learning model effectively predicts MMD progression a decade ahead using clinical and imaging indicators. This tool shows promise for identifying "at-risk" high myopes for timely intervention and vision protection.
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Affiliation(s)
- Yanping Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Shaopeng Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Riqian Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Ruilin Xiong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yueye Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Cong Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yingfeng Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
- Center for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Haikou, Hainan Province, China
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Eppenberger LS, Grzybowski A, Schmetterer L, Ang M. Myopia Control: Are We Ready for an Evidence Based Approach? Ophthalmol Ther 2024; 13:1453-1477. [PMID: 38710983 PMCID: PMC11109072 DOI: 10.1007/s40123-024-00951-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/11/2024] [Indexed: 05/08/2024] Open
Abstract
INTRODUCTION Myopia and its vision-threatening complications present a significant public health problem. This review aims to provide an updated overview of the multitude of known and emerging interventions to control myopia, including their potential effect, safety, and costs. METHODS A systematic literature search of three databases was conducted. Interventions were grouped into four categories: environmental/behavioral (outdoor time, near work), pharmacological (e.g., atropine), optical interventions (spectacles and contact lenses), and novel approaches such as red-light (RLRL) therapies. Review articles and original articles on randomized controlled trials (RCT) were selected. RESULTS From the initial 3224 retrieved records, 18 reviews and 41 original articles reporting results from RCTs were included. While there is more evidence supporting the efficacy of low-dose atropine and certain myopia-controlling contact lenses in slowing myopia progression, the evidence about the efficacy of the newer interventions, such as spectacle lenses (e.g., defocus incorporated multiple segments and highly aspheric lenslets) is more limited. Behavioral interventions, i.e., increased outdoor time, seem effective for preventing the onset of myopia if implemented successfully in schools and homes. While environmental interventions and spectacles are regarded as generally safe, pharmacological interventions, contact lenses, and RLRL may be associated with adverse effects. All interventions, except for behavioral change, are tied to moderate to high expenditures. CONCLUSION Our review suggests that myopia control interventions are recommended and prescribed on the basis of accessibility and clinical practice patterns, which vary widely around the world. Clinical trials indicate short- to medium-term efficacy in reducing myopia progression for various interventions, but none have demonstrated long-term effectiveness in preventing high myopia and potential complications in adulthood. There is an unmet need for a unified consensus for strategies that balance risk and effectiveness for these methods for personalized myopia management.
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Affiliation(s)
- Leila Sara Eppenberger
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Andrzej Grzybowski
- University of Warmia and Mazury, Olsztyn, Poland
- Institute for Research in Ophthalmology, Poznan, Poland
| | - Leopold Schmetterer
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Department, Duke-NUS Medical School, Singapore, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore
- School of Chemical and Biological Engineering, Nanyang Technological University, Singapore, Singapore
- Department of Clinical Pharmacology, Medical University Vienna, Vienna, Austria
- Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
- Ophthalmology and Visual Sciences Department, Duke-NUS Medical School, Singapore, Singapore.
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Chen Y, Gu VY, Xu Y, Ye B, Kang X, Li B. Bilateral axial length growth patterns of myopic anisometropes undergoing sequential monocular to binocular orthokeratology treatment. Cont Lens Anterior Eye 2024:102192. [PMID: 38806328 DOI: 10.1016/j.clae.2024.102192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 04/04/2024] [Accepted: 05/22/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE To investigate bilateral axial length (AL) growth patterns and interactions of myopic eyes in anisometropic children during unilateral orthokeratology (OK) treatment in their singularly myopic eyes (Eyes1), followed by bilateral treatment when their second eyes (Eyes2) developed myopia. METHODS This study enrolled 94 eyes from 47 anisometropes (20 males). All patients had undergone monocular OK treatment for > 1 year followed by binocular treatment for > 1 year. Axial growth of Eyes1 and Eyes2 during the first year of monocular treatment (Stage 1), average annual axial elongation during the monocular treatment period, and axial elongation during the first year of binocular treatment (Stage 2) were respectively termed: S1E1 and S1E2, Annual E1 and Annual E2, and S2E1 and S2E2. Associations between AL growth and age, sex, interval time, and ocular parameters were analysed using correlation and generalised estimating equation (GEE) analysis. RESULTS During the monocular period, Eyes1 showed less AL growth (S1E1: 0.05 ± 0.18 mm; Annual E1: 0.05 ± 0.21 mm) than Eyes2 (S1E2: 0.51 ± 0.24 mm; Annual E2: 0.52 ± 0.25 mm) (all p < 0.001). During the binocular period, there was no significant difference between S2E1 and S2E2(0.21 ± 0.14 mm v. 0.19 ± 0.17 mm, p = 0.951). Between monocular and binocular periods, Eyes1 had significantly higher S2E1 compared to S1E1 and Annual E1 (both p < 0.001), and Eyes2 had significantly lower S2E2 than S1E2 and Annual E2 (both p < 0.001). In the GEE model, spherical equivalent refraction (SER) and between periods interval time showed independently significant associations with AL growth after adjusting for age and sex. CONCLUSION Orthokeratology can significantly control AL growth in unilateral myopia. AL growth of the initial myopic OK-treated eyes accelerated relative to the monocular period when contralateral eyes developed myopia and assumed OK treatment. During the binocular treatment phase, OK lenses showed moderate and comparable effects on AL retardation across both eyes.
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Affiliation(s)
- Yiye Chen
- Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Victoria Y Gu
- Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Yangyang Xu
- Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Ye
- Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoli Kang
- Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Bin Li
- Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Lin S, Zhang C, Chen X, Jiang D, Wang Y, Sun B, He J, Chen Y. Development and psychometric evaluation of beliefs about the orthokeratology lens compliance scale (BOLCS): Based on the theory of planned behavior. Cont Lens Anterior Eye 2024:102186. [PMID: 38782621 DOI: 10.1016/j.clae.2024.102186] [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: 01/17/2024] [Revised: 05/07/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE Non-adherence to standard wear, care, and follow-up procedures is a major risk factor for contact lens-related complications. The effectiveness of orthokeratology largely depends on the wearer's adherence. However, a deficiency in scales capturing adherence beliefs pertinent to orthokeratology exacerbates the lack of guidance for effective intervention strategies. The purpose of this study is to develop and evaluate the psychometric properties of a new scale based on the Theory of Planned Behavior that assesses the level of adherence among ortho-k wearers. METHODS This study involved three stages following the STROBE checklist: (1) developing initial scale items based on the Theory of Planned Behavior, a literature review, and a qualitative study; (2) evaluation of content and face validity; (3) psychometric testing on 296 participants. Item analysis, based on Classical Test Theory, assessed the overall consistency, reliability, and validity of the scale. RESULTS The final 37-item Beliefs about the Orthokeratology Lens Compliance Scale (BOLCS) comprises 11 dimensions. The Cronbach's alpha coefficients for each dimension ranged from 0.560 to 0.798. The folded half reliabilities were 0.845, and the combined reliabilities ranged from 0.676 to 0.793, indicating strong reliability. Item-level CVI (I-CVI) and scale-level CVI/average (S-CVI/Ave) values, assessed by the panel, ranged from 0.71 to 1 and 0.954, respectively. Exploratory and confirmatory factor analyses supported a factor structure consistent with the theoretical model. CONCLUSIONS The scale's construction adhered to a standardized process, yielding preliminary validation results with satisfactory reliability and validity.
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Affiliation(s)
- Shudan Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Chunhua Zhang
- School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, 325027, Wenzhou, Zhejiang, China
| | - Xiaojun Chen
- School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, 325027, Wenzhou, Zhejiang, China
| | - Dandan Jiang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Yanhui Wang
- School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, 325027, Wenzhou, Zhejiang, China
| | - Bing Sun
- School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, 325027, Wenzhou, Zhejiang, China
| | - Juan He
- School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, 325027, Wenzhou, Zhejiang, China
| | - Yanyan Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China.
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11
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Zhang XJ, Zaabaar E, French AN, Tang FY, Kam KW, Tham CC, Chen LJ, Pang CP, Yam JC. Advances in myopia control strategies for children. Br J Ophthalmol 2024:bjo-2023-323887. [PMID: 38777389 DOI: 10.1136/bjo-2023-323887] [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: 05/05/2023] [Accepted: 03/19/2024] [Indexed: 05/25/2024]
Abstract
Myopia has long been a global threat to public health. Timely interventions are likely to reduce the risk of vision-threatening complications. There are both established and rapidly evolving therapeutic approaches to slow myopia progression and/or delay its onset. The effective methods for slowing myopia progression include atropine eye-drops, defocus incorporated multiple segments (DIMS) spectacle lenses, spectacle lenses with highly aspherical lenslets target (HALT), diffusion optics technology (DOT) spectacle lenses, red light therapy (RLT), multifocal soft contact lenses and orthokeratology. Among these, 0.05% atropine, HALT lenses, RLT and +3.00 peripheral addition soft contact lenses yield over 60% reduction in myopia progression, whereas DIMS, DOT and MiSight contact lenses demonstrate at least 50% myopia control efficacy. 0.05% atropine demonstrates a more optimal balance of efficacy and safety than 0.01%. The efficacy of 0.01% atropine has not been consistent and requires further validation across diverse ethnicities. Combining atropine 0.01% with orthokeratology or DIMS spectacles yields better outcomes than using these interventions as monotherapies. Increased outdoor time is an effective public health strategy for myopia prevention while recent studies suggest that 0.05% low-concentration atropine and RLT therapy have promising potential as clinical myopia prevention interventions for high-risk groups. Myopia control spectacle lenses, being the least invasive, are safe for long-term use. However, when considering other approaches, it is essential to ensure proper instruction and regular follow-ups to maintain safety and monitor any potential complications. Ultimately, significant advances have been made in myopia control strategies, many of which have shown meaningful clinical outcomes. However, regular use and adequate safety monitoring over extended durations are imperative to foster confidence that can only come from extensive clinical experience.
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Affiliation(s)
- Xiu Juan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ebenezer Zaabaar
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Amanda Nicole French
- Discipline of Orthoptics, University of Sydney, Sydney, New South Wales, Australia
| | - Fang Yao Tang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ka Wai Kam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, The Prince of Wales Hospital, Hong Kong SAR, China
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, The Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Eye Hospital, Hong Kong SAR, China
- Lam Kin Chung. Jet King-Shing Ho Glaucoma Treatment and Research Centre, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology, Hong Kong Children Hospital, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, The Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Eye Hospital, Hong Kong SAR, China
- Lam Kin Chung. Jet King-Shing Ho Glaucoma Treatment and Research Centre, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Lam Kin Chung. Jet King-Shing Ho Glaucoma Treatment and Research Centre, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, The Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Eye Hospital, Hong Kong SAR, China
- Department of Ophthalmology, Hong Kong Children Hospital, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
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12
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Xiong R, Wang W, Tang X, He M, Hu Y, Zhang J, Du B, Jiang Y, Zhu Z, Chen Y, Zhang S, Kong X, Wei R, Yang X, He M. Myopia Control Effect of Repeated Low-Level Red-Light Therapy Combined with Orthokeratology: A Multicenter Randomized Controlled Trial. Ophthalmology 2024:S0161-6420(24)00308-7. [PMID: 38763303 DOI: 10.1016/j.ophtha.2024.05.015] [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: 01/30/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 05/21/2024] Open
Abstract
PURPOSE To investigate the efficacy and safety of repeated low-level red-light(RLRL) therapy combined with orthokeratology(Ortho-k) among the children who, despite undergoing Ortho-k treatment, exhibited an axial elongation of at least 0.50mm over 1 year. DESIGN Multicenter, randomized, parallel-group, single-blind clinical trial (ClinicaTrials.gov,NCT04722874). PARTICIPANTS Eligible children were aged 8-13 years with a cycloplegic spherical equivalent refraction of -1.00 to -5.00 diopters in the initial Ortho-k fitting examination and had annual axial length (AL) elongation ≥ 0.50 mm despite undergoing Ortho-k for 1 year. A total of 48 children were enrolled from March 2021 to January 2022, and the final follow-up was completed in March 2023. METHODS Children were randomly assigned to the RLRL combined with Ortho-k(RCO) or the Ortho-k group in a 2:1 ratio. The Ortho-k group wore Ortho-k at least 8 hours per night, while the RCO group received daily RLRL therapy twice a day for 3 minutes in addition to Ortho-k wearing. MAIN OUTCOME MEASURES The primary outcome was AL change measured at 12 months relative to baseline. The primary analysis was conducted in children who received the assigned intervention and completed at least 1 post-randomization follow-up using the modified intention-to-treat principle. RESULTS A total of 47(97.9%) children were included in the analysis (30 in the RCO group and 17 in the Ortho-k group). The mean axial elongation rate before the trial was 0.60mm/year in the RCO group and 0.61mm/year in the Ortho-k group. After 12 months following the intended intervention, the adjusted mean AL changes were -0.02mm(95% CI, -0.08 to +0.03 mm) in the RCO group and 0.27mm(0.19-0.34 mm) in the Ortho-k group. The adjusted mean difference in AL change was -0.29mm(-0.44 to -0.14mm) between the RCO and Ortho-k groups. The percentage of children achieving an uncorrected visual acuity greater than 20/25 was similar in the RCO (64.3%) and Ortho-k (65.5%) groups (Chi2 test, P=0.937). CONCLUSIONS Combining RLRL therapy with Ortho-k may offer a promising approach to optimize axial elongation control among myopic children. This approach also potentially allows children to achieve satisfactory visual acuity, reducing the daytime dependence on corrective eyewear.
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Affiliation(s)
- Ruilin Xiong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Xianghua Tang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Meinan 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, China
| | - Yin Hu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Jian Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - 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
| | - Yu Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China; Department of Ophthalmology, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Zhuoting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China; Center for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Yanping Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Shiran Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Xiangbin Kong
- Ophthalmology, Department of Surgery, The Second People's Hospital of Foshan, Foshan, Guangdong, 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.
| | - Xiao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China.
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China; School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong; Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong; Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong.
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13
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Liang L, Hu Y, Hong Y, Wu Z, Chen H, Lin Q. POSS and PEG Contained Copolymer for Antibioadhesive Rigid Contact Lenses Materials Application. Biomacromolecules 2024; 25:2728-2739. [PMID: 38563621 DOI: 10.1021/acs.biomac.3c01317] [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: 04/04/2024]
Abstract
Myopia is a global public health issue. Rigid contact lenses (RCLs) are an effective way to correct or control myopia. However, bioadhesion issues remain one of the significant obstacles limiting its clinical application. Although enhancing hydrophilicity through various surface treatments can mitigate this problem, the duration of effectiveness is short-lived and the processing involved is complex and costly. Herein, an antiadhesive RCLs material was designed via 8-armed methacrylate-POSS (8MA-POSS), and poly(ethylene glycol) methacrylate (PEGMA) copolymerization with 3-[tris(trimethylsiloxy)silyl] propyl methacrylate (TRIS). The POSS and PEG segments incorporated P(TRIS-co-PEGMA-co-8MA-POSS) (PTPM) material was obtained and their optical transparency, refractive index, resolution, hardness, surface charge, thermal features, and wettability were tested and optimized. The antibioadhesion activities, including protein, lipid, and bacteria, were evaluated as well. In vitro and in vivo results indicated that the optimized antibioadhesive PTPM materials present good biocompatibility and biosafety. Thus, such POSS and PEG segments containing material were a potential antibioadhesive RCL material option.
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Affiliation(s)
- Lin Liang
- National Engineering Research Center of Ophthalmology and Optometry, School of Biomedical Engineering, School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Yulin Hu
- National Engineering Research Center of Ophthalmology and Optometry, School of Biomedical Engineering, School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Yueze Hong
- National Engineering Research Center of Ophthalmology and Optometry, School of Biomedical Engineering, School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Zhihui Wu
- National Engineering Research Center of Ophthalmology and Optometry, School of Biomedical Engineering, School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Hao Chen
- National Engineering Research Center of Ophthalmology and Optometry, School of Biomedical Engineering, School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Quankui Lin
- National Engineering Research Center of Ophthalmology and Optometry, School of Biomedical Engineering, School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
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14
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Amaral DC, Batista S, Dos Santos-Neto E, Manso JEF, Rodrigues MPM, Monteiro MLR, Alves MR, Louzada RN. Low-level red-light therapy for myopia control in children: A systematic review and meta-analysis. Clinics (Sao Paulo) 2024; 79:100375. [PMID: 38723579 PMCID: PMC11101697 DOI: 10.1016/j.clinsp.2024.100375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 03/11/2024] [Accepted: 04/18/2024] [Indexed: 05/21/2024] Open
Abstract
INTRODUCTION Low-Level Red-Light (LLRL) Therapy is a safe and natural way to promote healing and reduce inflammation in the body. When it comes to treating myopia in children, LLRL therapy is recent, and its efficacy and safety still are not clear. METHODS A systematic review and meta-analysis of the literature for LLRL was conducted in accordance with the PRISMA guidelines on November 5, 2022. Databases, including PUBMED, Cochrane Library, Web of Science, and Embase were queried. A meta-analysis of random effects was conducted. Inclusion criteria included Randomized Controlled Trials (RCTs) or observational studies where LLRL therapy was used in children (3‒15 years old) with myopia. Exclusion criteria were studies with other ocular abnormalities. Efficacy was evaluated through the mean change in Axial Length (AL) and cycloplegic Spherical Equivalent Error (SER), while safety was evaluated by monitoring adverse effects. RESULTS A total of 5 final studies were included (4 RCTs, and 1 observational), in which 685 total patients were analyzed. The mean age was 9.7 ± 0.66 years, with 48,2% female patients. The number of eyes in the LRLL arm is 714 and, in the control, arm is 656. LLRL showed better results in SER and AL mean change (OR = 0.58; 95% CI 0.33 to 0.83; p < 0.00001, and MD -0.33; 95% CI -0.52 to -0.13; p = 0.001, respectively), in comparison to the control group. There was no significant difference in adverse effects between groups (MD = 5.76; 95% CI 0.66 to 50.14; p = 0.11). CONCLUSION LLRL therapy is a non-invasive, effective, and safe short-term treatment option; however, long-term evaluation, particularly in comparison to other therapies, requires additional investigation.
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Affiliation(s)
- Dillan Cunha Amaral
- Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Sávio Batista
- Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Edson Dos Santos-Neto
- Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | | | | | - Mário Luiz Ribeiro Monteiro
- Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Milton Ruiz Alves
- Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Ricardo Noguera Louzada
- Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
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15
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Guo Y, Zhang M, Tong Y, Ma X, Wang S, Li Y, Du Y, Zhou Y. Impact of pupil and defocus ring intersection area on retinal defocus. Ophthalmic Physiol Opt 2024; 44:472-480. [PMID: 38234008 DOI: 10.1111/opo.13276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/19/2024]
Abstract
PURPOSE With the rising prevalence of myopia, especially among the young, orthokeratology (Ortho-K) stands out as a promising approach, not only to reduce myopia but also to control the progression of axial length (AL). This study examined how the intersection area between the pupil and defocus ring influenced retinal defocus and axial growth after Ortho-K. METHODS A case-control study was conducted with 100 participants (100 eyes). Both AL and the refraction difference value (RDV), that is, the peripheral refractive error measured with respect to the central value after wearing Ortho-K lenses, were determined. Subjects were categorised into two groups based on the size of the intersection area after 3 months of lens wear: Group A (<4.58 mm2 ) and Group B (≥4.58 mm2 ). RESULTS Group B demonstrated significantly lower changes in AL and RDV at 30-40° and 40-53° compared with Group A after 3 months of lens wear (all p < 0.05). After 6 months of lens wear, Group B showed significantly lower changes in AL and RDV in the 40-53° region compared with Group A (all p < 0.05). Correlation analysis revealed that as the intersection area increased, the changes in AL and RDV at 0-53°, 30-40° and 40-53° eccentricity decreased after both 3 and 6 months of lens wear (all p < 0.01). CONCLUSIONS A larger intersection area between the pupil and defocus ring within a certain time period can cause a greater amount of myopic defocus at 30-53° from the fovea. The results suggest that a larger intersection area might lead to more effective control of axial growth.
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Affiliation(s)
- Yujuan Guo
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
- Ophthalmology Beijing Ming Vision, Beijing, China
- Ineye Hospital of Chengdu University of Traditional Medicine, Chengdu, China
| | - Mingxu Zhang
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
| | - Yuting Tong
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
| | - Xiaoqi Ma
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
| | - Siyao Wang
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
| | - Yu Li
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
- Ineye Hospital of Chengdu University of Traditional Medicine, Chengdu, China
| | - Yuqin Du
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
- Ophthalmology Beijing Ming Vision, Beijing, China
| | - Yuehua Zhou
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
- Ophthalmology Beijing Ming Vision, Beijing, China
- Ineye Hospital of Chengdu University of Traditional Medicine, Chengdu, China
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16
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Zhang M, Guo Y, Zhou C, Zhang J, Zhang M, Huang J, Du Y, Ge S, Zhou C, Zhou Y. Deep neural network with self-attention based automated determination system for treatment zone and peripheral steepened zone in Orthokeratology for adolescent myopia. Cont Lens Anterior Eye 2024; 47:102081. [PMID: 37957085 DOI: 10.1016/j.clae.2023.102081] [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: 03/18/2023] [Revised: 10/27/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE The aim of this study is to develop an automatic model based on deep learning techniques for determining the Treatment Zone (TZ) and Peripheral Steepened Zone (PSZ) following Orthokeratology (OK) treatment. METHODS A total of 1346 corneal topography maps were included in the study. A deep neural network based on the Segformer architecture was constructed to automatically detect TZ and PSZ. The model was optimized and trained multiple times, and the areas of TZ, PSZ, and TZ decentration were calculated based on the segmentation results. RESULTS The mean Intersection over Union (mIoU) of the overall segmentation results of the model reached over 97% after multiple training with different optimization methods, and the IoU for the TZ and PSZ segmentation tasks were 98.08% and 94.54% in test set, respectively. Moreover, the model demonstrated high consistency with the expert annotation for the TZ segmentation, while a significant difference was found in the PSZ segmentation and expert annotation due to several interference factors. CONCLUSION This study presents an efficient and repeatable system for clinical research, based on a deep neural network that accurately determines TZ and PSZ after OK treatment using the Segformer architecture. However, further deployment validation may be necessary.
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Affiliation(s)
- Mingxu Zhang
- Eye School of Chengdu University of T.C.M, Shierqiao Road 37(th), Jinniu District, Chengdu, Sichuan Province 610032, China; Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, Shierqiao Road 37th, Jinniu District, Chengdu, Sichuan Province 610032, China; Beijing Ming Vision & Ophthalmology, Chongwenwai Street16(th), Dongcheng District, Beijing 100062, China.
| | - Yujuan Guo
- Eye School of Chengdu University of T.C.M, Shierqiao Road 37(th), Jinniu District, Chengdu, Sichuan Province 610032, China; Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, Shierqiao Road 37th, Jinniu District, Chengdu, Sichuan Province 610032, China
| | - Chengwei Zhou
- International School of Beijing, Anhua Street 10(th), Shunyi District, Beijing 101300, China
| | - Jing Zhang
- Beijing Ming Vision & Ophthalmology, Chongwenwai Street16(th), Dongcheng District, Beijing 100062, China
| | - Meimei Zhang
- Eye School of Chengdu University of T.C.M, Shierqiao Road 37(th), Jinniu District, Chengdu, Sichuan Province 610032, China; Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, Shierqiao Road 37th, Jinniu District, Chengdu, Sichuan Province 610032, China; Beijing Ming Vision & Ophthalmology, Chongwenwai Street16(th), Dongcheng District, Beijing 100062, China
| | - Ju Huang
- Hospital of Chengdu University of T.C.M, Shierqiao Road 41(st), Jinniu District, Chengdu, Sichuan Province 610032, China
| | - Yuqin Du
- Eye School of Chengdu University of T.C.M, Shierqiao Road 37(th), Jinniu District, Chengdu, Sichuan Province 610032, China; Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, Shierqiao Road 37th, Jinniu District, Chengdu, Sichuan Province 610032, China; Beijing Ming Vision & Ophthalmology, Chongwenwai Street16(th), Dongcheng District, Beijing 100062, China
| | - Shanshan Ge
- Eye School of Chengdu University of T.C.M, Shierqiao Road 37(th), Jinniu District, Chengdu, Sichuan Province 610032, China; Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, Shierqiao Road 37th, Jinniu District, Chengdu, Sichuan Province 610032, China; Beijing Ming Vision & Ophthalmology, Chongwenwai Street16(th), Dongcheng District, Beijing 100062, China
| | - Chunyang Zhou
- Eye School of Chengdu University of T.C.M, Shierqiao Road 37(th), Jinniu District, Chengdu, Sichuan Province 610032, China; Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, Shierqiao Road 37th, Jinniu District, Chengdu, Sichuan Province 610032, China
| | - Yuehua Zhou
- Eye School of Chengdu University of T.C.M, Shierqiao Road 37(th), Jinniu District, Chengdu, Sichuan Province 610032, China; Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, Shierqiao Road 37th, Jinniu District, Chengdu, Sichuan Province 610032, China; Beijing Ming Vision & Ophthalmology, Chongwenwai Street16(th), Dongcheng District, Beijing 100062, China.
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Koo S, Kim WK, Park YK, Jun K, Kim D, Ryu IH, Kim JK, Yoo TK. Development of a Machine-Learning-Based Tool for Overnight Orthokeratology Lens Fitting. Transl Vis Sci Technol 2024; 13:17. [PMID: 38386347 PMCID: PMC10896231 DOI: 10.1167/tvst.13.2.17] [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: 06/10/2023] [Accepted: 01/15/2024] [Indexed: 02/23/2024] Open
Abstract
Purpose Orthokeratology (ortho-K) is widely used to control myopia. Overnight ortho-K lens fitting with the selection of appropriate parameters is an important technique for achieving successful reductions in myopic refractive error. In this study, we developed a machine-learning model that could select ortho-K lens parameters at an expert level. Methods Machine-learning models were established to predict the optimal ortho-K parameters, including toric lens option (toric or non-toric), overall diameter (OAD; 10.5 or 11.0 mm), base curve (BC), return zone depth (RZD), landing zone angle (LZA), and lens sagittal depth (LensSag). The analysis included 547 eyes of 297 Korean adolescents with myopia or astigmatism. The dataset was randomly divided into training (80%, n = 437 eyes) and validation (20%, n = 110 eyes) sets at the patient level. The model was trained based on clinical ortho-K lens fitting performed by highly experienced experts and ophthalmic measurements. Results The final machine-learning models showed accuracies of 92.7% and 86.4% for predicting the toric lens option and OAD, respectively. The mean absolute errors for the BC, RZD, LZA, and LensSag predictions were 0.052 mm, 2.727 µm, 0.118°, and 5.215 µm, respectively. The machine-learning model outperformed the manufacturer's conventional initial lens selector in predicting BC and RZD. Conclusions We developed an expert-level machine-learning-based model for determining comprehensive ortho-K lens parameters. We also created a web-based application. Translational Relevance This model may provide more accurate fitting parameters for lenses than those of conventional calculations, thus reducing the need to rely on trial and error.
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Affiliation(s)
| | - Wook Kyum Kim
- Contact Lens Clinic, B&VIIT Eye Center, Seoul, South Korea
| | - Yoo Kyung Park
- Contact Lens Clinic, B&VIIT Eye Center, Seoul, South Korea
| | - Kiwon Jun
- Myopia Research Lab, VISUWORKS, Seoul, South Korea
| | | | - Ik Hee Ryu
- Myopia Research Lab, VISUWORKS, Seoul, South Korea
- Department of Ophthalmology and Vision Science, B&VIIT Eye Center, Seoul, South Korea
| | - Jin Kuk Kim
- Myopia Research Lab, VISUWORKS, Seoul, South Korea
- Department of Ophthalmology and Vision Science, B&VIIT Eye Center, Seoul, South Korea
| | - Tae Keun Yoo
- Myopia Research Lab, VISUWORKS, Seoul, South Korea
- Department of Ophthalmology and Vision Science, B&VIIT Eye Center, Seoul, South Korea
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Zhang P, Wu J, Jiang J, Zhang X, Ran Z, Jiang F, Zheng X, Wang J, Elsheikh A, Bao F. Evaluation of changes in corneal biomechanics after orthokeratology using Corvis ST. Cont Lens Anterior Eye 2024; 47:102100. [PMID: 38072740 DOI: 10.1016/j.clae.2023.102100] [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: 08/17/2023] [Revised: 11/25/2023] [Accepted: 11/27/2023] [Indexed: 01/22/2024]
Abstract
PURPOSE To investigate the alterations in corneal biomechanical metrics induced by orthokeratology (ortho-k) using Corvis ST and to determine the factors influencing these changes. METHOD A prospective observational study was conducted to analyze various Corvis ST parameters in 32 children with low to moderate myopia who successfully underwent ortho-k lens fitting. Corneal biomechanical measurements via Corvis ST were acquired at six distinct time points: baseline (pre) and 2 h (pos2h), 6 h (pos6h), and 10 h (pos10h) following the removal of the first overnight wear ortho-k, one week (pos1w) and one month (pos1m) subsequent to the initiation of ortho-k. RESULT Significant differences were observed in Corvis ST Biomechanical parameters DAR2, IIR, CBI, and cCBI post ortho-k intervention. The integration of covariates (CCT, SimK, and bIOP) mitigated the differences in DAR2, IIR, and cCBI, but not in CBI. Initially, the stiffness parameter at first applanation, SP-A1, did not demonstrate significant variations, but after adjusting for covariates, noticeable differences over time were observed. The Stress-Strain Indeces, SSIv1 and SSIv2, did not manifest considerable changes over time, irrespective of the adjustment for covariates. No significant disparities were identified among different ortho-k lens brands. CONCLUSION Corneal biomechanics remained consistent throughout the one-month period of ortho-k lens wear. The observed changes in Corvis ST parameters subsequent ortho-k are primarily attributable to alterations in corneal pachymetry and morphology, rather than actual alterations in corneal biomechanics. The stability of corneal biomechanics post ortho-k treatment suggests the safety of this approach for adolescents from a corneal biomechanics perspective.
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Affiliation(s)
- PeiPei Zhang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University, Wenzhou 325027, China
| | - JinFang Wu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
| | - Jun Jiang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University, Wenzhou 325027, China
| | - XinYu Zhang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University, Wenzhou 325027, China
| | - ZiYing Ran
- School of Engineering, University of Liverpool, Liverpool L69 3GH, UK
| | - Fan Jiang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University, Wenzhou 325027, China.
| | - XiaoBo Zheng
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University, Wenzhou 325027, China; National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; The Institute of Ocular Biomechanics, Wenzhou Medical University, Wenzhou 325027, China
| | - JunJie Wang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University, Wenzhou 325027, China; National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; The Institute of Ocular Biomechanics, Wenzhou Medical University, Wenzhou 325027, China
| | - Ahmed Elsheikh
- School of Engineering, University of Liverpool, Liverpool L69 3GH, UK; National Institute for Health Research (NIHR) Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK; Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, China
| | - FangJun Bao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University, Wenzhou 325027, China; National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China; The Institute of Ocular Biomechanics, Wenzhou Medical University, Wenzhou 325027, China.
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19
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Cao J, Sun X, Sun L, Song H, Niu K, He Z. Deep Learning Based Prediction of Myopia Control Effect in Children Treated With Overnight Orthokeratology. Eye Contact Lens 2024; 50:41-47. [PMID: 37934166 DOI: 10.1097/icl.0000000000001054] [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: 09/17/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVES To develop and validate a deep learning-based model for predicting 12-month axial length (AL) elongation using baseline factors and early corneal topographic changes in children treated with orthokeratology (Ortho-K) and to investigate the association between these factors and myopia control impact. METHODS A total of 115 patients with Ortho-K were enrolled. Influential baseline factors that have a statistically significant correlation with 12-month AL from medical records were selected using Pearson correlation coefficients. Simultaneously, the height, area, and volume of the defocus region were directly calculated from the corneal topography. Then, the prediction model was developed by combining multiple linear regression and deep neural network and evaluated in an independent group (83 patients for developing the algorithm and 32 patients for evaluation). RESULTS Age ( r= -0.30, P <0.001), spherical equivalent refractive (SE; r =0.20, P =0.032), and sex ( r =0.19, P =0.032) were significantly correlated with the AL elongation while pupil diameter, flat k, steep k, horizontal corneal diameter (white to white), anterior chamber depth, and cell density were not ( P >0.1). The prediction model was developed using age, SE, and corneal topographic variation, and the validation of the model demonstrated its effectiveness in predicting AL elongation. CONCLUSIONS The AL elongation was accurately predicted by the deep learning model, which effectively incorporated both baseline factors and corneal topographic variation.
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Affiliation(s)
- Jingwen Cao
- Key Laboratory of Universal Wireless Communications (J.C., K.N., Z.H.), Ministry of Education, Beijing University of Posts and Telecommunications, Beijing, China; Department of Ophthalmology (X.S.), the PLA General Hospital, Beijing, China; and Beijing Tongren Eye Center (L.S., H.S.), Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, National Engineering Research Center for Ophthalmology, Beijing, China
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20
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Zhou W, Liao Y, Wang W, Sun Y, Li Q, Liu S, Tang J, Li L, Wang X. Efficacy of Different Powers of Low-Level Red Light in Children for Myopia Control. Ophthalmology 2024; 131:48-57. [PMID: 37634757 DOI: 10.1016/j.ophtha.2023.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 08/08/2023] [Accepted: 08/21/2023] [Indexed: 08/29/2023] Open
Abstract
PURPOSE To compare the efficacy and safety of low-level red light (LRL) in controlling myopia progression at 3 different powers: 0.37 mW, 0.60 mW, and 1.20 mW. DESIGN Single-center, single-masked, randomized controlled trial. PARTICIPANTS Two hundred children aged 6-15 with myopia of -0.50 diopter (D) or more and astigmatism of -2.50 D or less were enrolled from April to May 2022. Follow-up ended in December 2022. METHODS Participants were assigned randomly to 3 intervention groups and 1 control group (1:1:1:1). All participants wore single-vision spectacles. Moreover, the intervention group randomly received LRL at 3 different powers twice daily for 3 minutes per session, with a minimum 4-hour interval. MAIN OUTCOME MEASURES Changes in spherical equivalent (SE), axial length (AL), and subfoveal choroidal thickness (SFCT) were measured. RESULTS After 6 months, SE progression was significantly lower in the 0.37-mW group (0.01 D; 95% confidence interval [CI], -0.12 to 0.15), 0.60-mW group (-0.05 D; 95% CI, -0.18 to 0.07), and 1.20-mW group (0.16 D; 95% CI, 0.03 to 0.30) compared to the control group (-0.22 D; 95% CI, -0.50 to 0.30; adjusted P < 0.001 for all). AL changes in the 0.37-mW group (0.04 mm; 95% CI, -0.01 to 0.08), 0.60-mW group (0.00 mm; 95% CI, -0.05 to 0.05), and 1.20-mW group (-0.04 mm; 95% CI, -0.08 to 0.01) were significantly smaller than the control group (0.27 mm; 95% CI, 0.22 to 0.33; adjusted P < 0.001 for all). Similarly, increases in SFCT were significantly greater in the 0.37-mW group (22.63 μm; 95% CI, 12.13 to 33.34 μm), 0.60-mW group (36.17 μm; 95% CI, 24.37 to 48.25 μm), and 1.20-mW group (42.59 μm; 95% CI, 23.43 to 66.24 μm) than the control group (-5.07 μm; 95% CI, -10.32 to -0.13 μm; adjusted P < 0.001 for all). No adverse events were observed. CONCLUSIONS LRL effectively controlled myopia progression at 0.37 mW, 0.60 mW, and 1.20 mW. Further research is required. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Wen Zhou
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China; First School of Clinical Medicine of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Ya Liao
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Wei Wang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yanmei Sun
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Qin Li
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Siqi Liu
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Jie Tang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Lin Li
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China; Medical Technology School of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xiaojuan Wang
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China; First School of Clinical Medicine of Xuzhou Medical University, Xuzhou, Jiangsu, China; Suzhou Vocational Health College, Suzhou, Jiangsu, China.
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Chiu YC, Tsai PC, Lee SH, Wang JH, Chiu CJ. Systematic Review of Myopia Progression after Cessation of Optical Interventions for Myopia Control. J Clin Med 2023; 13:53. [PMID: 38202060 PMCID: PMC10779574 DOI: 10.3390/jcm13010053] [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: 11/20/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Despite high discontinuation rates for myopia optical interventions, limited attention has been given to the potential rebound effects post-discontinuation. This systematic review aims to assess the extent of the rebound effects following the cessation of common clinical optical myopia-control interventions in children. A comprehensive search of PubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov was conducted from inception to October 2023. The rebound effects, defined as changes in the axial length or spherical equivalent during and after treatment cessation, were categorized into four levels. These studies encompassed 703 participants and spanned from 2019 to 2023, with durations of treatment and cessation ranging from 6 months to 3.5 years and from 2 weeks to 5 years, respectively. This review, encompassing 14 studies, revealed a predominant strong rebound effect in orthokeratology (8 studies), a weak rebound effect in multifocal soft contact lenses (4 studies), and a variable rebound effect in peripheral-plus spectacle lenses (2 studies). Notably, with the increasing cessation duration, the rebound effects diminished, potentially linked to the reversal of choroidal thickening and the disappearance of peripheral myopic defocus. In conclusion, a temporal trend of rebound effects exists in all three myopia optical interventions, possibly contributing to their myopia control mechanisms.
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Affiliation(s)
- Yu-Chieh Chiu
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (Y.-C.C.); (P.-C.T.); (S.-H.L.)
| | - Ping-Chiao Tsai
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (Y.-C.C.); (P.-C.T.); (S.-H.L.)
| | - Ssu-Hsien Lee
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan; (Y.-C.C.); (P.-C.T.); (S.-H.L.)
| | - Jen-Hung Wang
- Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien 970, Taiwan;
| | - Cheng-Jen Chiu
- Department of Ophthalmology and Visual Science, Tzu Chi University, Hualien 970, Taiwan
- Department of Ophthalmology, Hualien Tzu Chi Hospital, the Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan
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22
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Wang M, Ji N, Yu SA, Liang LL, Ma JX, Fu AC. Comparison of 0.02% atropine eye drops, peripheral myopia defocus design spectacle lenses, and orthokeratology for myopia control. Clin Exp Optom 2023:1-7. [PMID: 38043135 DOI: 10.1080/08164622.2023.2288180] [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: 11/30/2022] [Accepted: 09/22/2023] [Indexed: 12/05/2023] Open
Abstract
CLINICAL RELEVANCE There are many methods to control the progression of myopia. However, it is currently unknown which method could better control myopia progression: 0.02% atropine eye drops, peripheral myopic defocus design spectacle lenses (PMDSL), or orthokeratology (OK). BACKGROUND To compare the efficacy of 0.02% atropine, PMDSL, and OK to control axial length (AL) elongation in children with myopia. METHODS This study was analysed based on a previous cohort study (0.02% atropine group) and retrospective data (PMDSL and OK group). Overall, 387 children aged 6-14 years with myopia - 1.00D to - 6.00D in the three groups were divided into four subgroups according to age and spherical equivalent refraction (SER). The primary outcome was changed in AL over 1-year. RESULTS The mean axial elongation was 0.30 ± 0.21 mm, 0.23 ± 0.16 mm, and 0.17 ± 0.19 mm in the 0.02% atropine, PMDSL, and OK groups, respectively. Multivariate linear regression analyses showed significant differences in axial elongation among the three groups, especially in children aged 6-10, but not in children aged 10.1-14; the corresponding axial elongation was 0.35 ± 0.21 mm, 0.23 ± 0.17 mm, and 0.21 ± 0.20 mm (P < 0.05 between any two groups, except between PMDSL and OK groups at P > 0.05) and 0.22 ± 0.20 mm, 0.21 ± 0.13 mm, and 0.13 ± 0.18 mm (P < 0.05 between any two groups, except between 0.02% atropine and PMDSL groups at P > 0.05) in children with SER from - 1.00D to - 3.00D and from - 3.01D to - 6.00D, respectively. CONCLUSIONS Within the limits of this study design and using only the current brand of PMDSL, OK appeared to be the best method, followed by PMDSL and then 0.02% atropine, for controlling AL elongation over one year. However, different effects were found in the various age and SER subgroups.
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Affiliation(s)
- Ming Wang
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Na Ji
- Department of Optometry, The Affiliated Eye Hospital of Suzhou Vocational Health College, Suzhou, China
| | - Shi-Ao Yu
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ling-Ling Liang
- Department of Ophthalmology, Shi Jiazhuang Aier Eye Hospital, Shi Jiazhuang, China
| | - Jing-Xue Ma
- Department of Ophthalmology, Shi Jiazhuang Aier Eye Hospital, Shi Jiazhuang, China
| | - Ai-Cun Fu
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Yoshida M, Tomita K, Akimoto M. Two Cases of Bilateral Rhegmatogenous Retinal Detachment During Orthokeratology Treatment. Cureus 2023; 15:e50958. [PMID: 38249232 PMCID: PMC10800152 DOI: 10.7759/cureus.50958] [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: 12/22/2023] [Indexed: 01/23/2024] Open
Abstract
Orthokeratology may be effective in slowing myopic progression. However, whether orthokeratology is beneficial enough to prevent rhegmatogenous retinal detachment formation remains unclear. Two cases of bilateral rhegmatogenous retinal detachment were seen during orthokeratology treatment and corrected with scleral buckling and cryopexy under general anesthesia. This is the first report of bilateral retinal detachment found during orthokeratology treatment. Although orthokeratology is effective for myopic correction and prevents axial length elongation, patients still have a risk of rhegmatogenous retinal detachment. Careful follow-up not only of the anterior segment but also of the peripheral retina is necessary.
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Affiliation(s)
- Miyo Yoshida
- Ophthalmology, Osaka Red Cross Hospital, Osaka, JPN
| | - Kosei Tomita
- Ophthalmology, Osaka Red Cross Hospital, Osaka, JPN
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Meng Z, Chen S, Zhe N, Cao T, Li Z, Zhang Y, Wei R. Short-term Changes in Epithelial and Optical Redistribution Induced by Different Orthokeratology Designs. Eye Contact Lens 2023; 49:528-534. [PMID: 37902624 PMCID: PMC10659253 DOI: 10.1097/icl.0000000000001045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 10/31/2023]
Abstract
OBJECTIVES This study aimed to investigate corneal epithelial and topographic changes caused by two commercial myopia orthokeratology (ortho-k) designs. METHODS Twenty-six subjects fitted with vision shape treatment (VST) lenses and 30 subjects fitted with corneal reshaping therapy (CRT) lenses were reviewed 1 day, 1 week, and 1 month after lens initiation. A spectral-domain optical coherence tomography system was used to create epithelial maps that were in turn used to determine the average epithelial thickness of each zone and the diameter of treatment zone. By measuring the topographic tangential differential map, the treatment zone diameter and the power and width of the high convex zone (HCZ) were obtained. All epithelial thicknesses and topographic corneal variations recorded were analyzed. RESULTS At the central zone, the epithelial thickness changes (△ET) decreased significantly after 1 day of ortho-k in two groups. At 2- to 9-mm peripheral zone, ortho-k increased △ET until 1 week in the VST group, whereas it kept increasing in the CRT group after 1 week. At 1 month, the central △ET is -9.51±2.38 mm in the VST group, which was comparable to -8.72±3.43 mm in the CRT group. The nasal HCZ power and the △ET of nasal and inferior nasal were significantly larger in the CRT group. A positive correlation was found between the HCZ power and △ET generated by VST-type lenses inferiorly and temporally. For the CRT group, a positive correlation was found between inferior HCZ power and △ET. CONCLUSIONS At the early stage of ortho-k, epithelial thickness and topography change quickly and simultaneously. Epithelial changes were in line with corneal topography reshaping. Epithelial and optical remodelling were affected by different lens types.
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Affiliation(s)
- Ziqi Meng
- Tianjin Key Laboratory of Retinal Functions and Diseases (Z.M., R.W.), Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China; Eye Hospital and School of Ophthalmology and Optometry (Z.M., S.C., N.Z., Z.L., Y.Z.), Wenzhou Medical University, Wenzhou, China; National Clinical Research Center for Ocular Diseases, Wenzhou, China; Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China; and Mailman School of Public Health (T.C.), Columbia University Irving Medical Center, New York, NY
| | - Siping Chen
- Tianjin Key Laboratory of Retinal Functions and Diseases (Z.M., R.W.), Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China; Eye Hospital and School of Ophthalmology and Optometry (Z.M., S.C., N.Z., Z.L., Y.Z.), Wenzhou Medical University, Wenzhou, China; National Clinical Research Center for Ocular Diseases, Wenzhou, China; Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China; and Mailman School of Public Health (T.C.), Columbia University Irving Medical Center, New York, NY
| | - Nan Zhe
- Tianjin Key Laboratory of Retinal Functions and Diseases (Z.M., R.W.), Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China; Eye Hospital and School of Ophthalmology and Optometry (Z.M., S.C., N.Z., Z.L., Y.Z.), Wenzhou Medical University, Wenzhou, China; National Clinical Research Center for Ocular Diseases, Wenzhou, China; Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China; and Mailman School of Public Health (T.C.), Columbia University Irving Medical Center, New York, NY
| | - Tongxin Cao
- Tianjin Key Laboratory of Retinal Functions and Diseases (Z.M., R.W.), Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China; Eye Hospital and School of Ophthalmology and Optometry (Z.M., S.C., N.Z., Z.L., Y.Z.), Wenzhou Medical University, Wenzhou, China; National Clinical Research Center for Ocular Diseases, Wenzhou, China; Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China; and Mailman School of Public Health (T.C.), Columbia University Irving Medical Center, New York, NY
| | - Zhangliang Li
- Tianjin Key Laboratory of Retinal Functions and Diseases (Z.M., R.W.), Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China; Eye Hospital and School of Ophthalmology and Optometry (Z.M., S.C., N.Z., Z.L., Y.Z.), Wenzhou Medical University, Wenzhou, China; National Clinical Research Center for Ocular Diseases, Wenzhou, China; Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China; and Mailman School of Public Health (T.C.), Columbia University Irving Medical Center, New York, NY
| | - Yunjie Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases (Z.M., R.W.), Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China; Eye Hospital and School of Ophthalmology and Optometry (Z.M., S.C., N.Z., Z.L., Y.Z.), Wenzhou Medical University, Wenzhou, China; National Clinical Research Center for Ocular Diseases, Wenzhou, China; Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China; and Mailman School of Public Health (T.C.), Columbia University Irving Medical Center, New York, NY
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases (Z.M., R.W.), Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China; Eye Hospital and School of Ophthalmology and Optometry (Z.M., S.C., N.Z., Z.L., Y.Z.), Wenzhou Medical University, Wenzhou, China; National Clinical Research Center for Ocular Diseases, Wenzhou, China; Eye Hospital of Wenzhou Medical University Hangzhou Branch, Hangzhou, China; and Mailman School of Public Health (T.C.), Columbia University Irving Medical Center, New York, NY
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Kou S, Ren Y, Zhuang X, Chen Y, Zhang X. Study on Related Factors of the Treatment Zone After Wearing Paragon CRT and Euclid Orthokeratology Lenses. Eye Contact Lens 2023; 49:521-527. [PMID: 37707469 PMCID: PMC10659246 DOI: 10.1097/icl.0000000000001035] [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] [Accepted: 08/06/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE To explore the influence factors of the treatment zone diameter (TZD) and its relationship with axial length growth (ALG) after wearing Paragon CRT and Euclid orthokeratology lenses. METHODS The right eye data of myopic patients wearing Paragon CRT and Euclid orthokeratology in the ophthalmology department of The First Affiliated Hospital of Soochow University were retrospectively reviewed from April 2019 to October 2022. The TZD and ALG were compared between the Paragon CRT and Euclid groups. The correlation factors of TZD after wearing lens for 1 month and the relationship between the overlapping treatment zone-to-pupil area ratio and the ALG after wearing lens for 1 year were analyzed between the two groups. RESULTS There were 160 patients (160 eyes) in the Paragon CRT group and 155 patients (155 eyes) in the Euclid group. After wearing lens for 1 month, the TZD in the Paragon CRT group (3.72±0.37 mm) was larger than that in the Euclid group (3.26±0.37 mm) ( P <0.001). The stepwise multivariate linear regression analysis showed that the eccentricity at the flattest meridians (Em) and the central corneal thickness were correlated with the TZD in both groups ( P <0.05). After wearing lens for 1 year, the ALG in the Paragon CRT group (0.32±0.20 mm) was larger than that in the Euclid group (0.25±0.20 mm) ( P =0.001). The stepwise multivariate linear regression analysis showed that the initial wearing age and the overlapping treatment zone area-to-pupil area ratio were correlated with the ALG in both groups ( P <0.05). CONCLUSION For both the Paragon CRT and Euclid orthokeratology, the wearers with thicker central corneal thickness and smaller Em usually had a smaller TZD. In both groups, the overlapping treatment zone area-to-pupil area ratio was correlated with the ALG.
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Affiliation(s)
- Sasa Kou
- Department of Ophthalmology (S.K., Y.R., Xinyu Zhuang, Xiaofeng Zhang), The First Affiliated Hospital of Soochow University, Suzhou, China; and Department of Ophthalmology (Y.C., Xiaofeng Zhang), Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
| | - Yaru Ren
- Department of Ophthalmology (S.K., Y.R., Xinyu Zhuang, Xiaofeng Zhang), The First Affiliated Hospital of Soochow University, Suzhou, China; and Department of Ophthalmology (Y.C., Xiaofeng Zhang), Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
| | - Xinyu Zhuang
- Department of Ophthalmology (S.K., Y.R., Xinyu Zhuang, Xiaofeng Zhang), The First Affiliated Hospital of Soochow University, Suzhou, China; and Department of Ophthalmology (Y.C., Xiaofeng Zhang), Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
| | - Yingjie Chen
- Department of Ophthalmology (S.K., Y.R., Xinyu Zhuang, Xiaofeng Zhang), The First Affiliated Hospital of Soochow University, Suzhou, China; and Department of Ophthalmology (Y.C., Xiaofeng Zhang), Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
| | - Xiaofeng Zhang
- Department of Ophthalmology (S.K., Y.R., Xinyu Zhuang, Xiaofeng Zhang), The First Affiliated Hospital of Soochow University, Suzhou, China; and Department of Ophthalmology (Y.C., Xiaofeng Zhang), Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
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Rappon J, Chung C, Young G, Hunt C, Neitz J, Neitz M, Chalberg T. Control of myopia using diffusion optics spectacle lenses: 12-month results of a randomised controlled, efficacy and safety study (CYPRESS). Br J Ophthalmol 2023; 107:1709-1715. [PMID: 36126105 PMCID: PMC10646852 DOI: 10.1136/bjo-2021-321005] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 08/16/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Mutations in the L/M cone opsin gene array cause abnormally high perceived retinal contrast and the development of myopia. Environmental factors may also lead to high visual contrast and cause myopia. Diffusion optics technology (DOT) lenses are designed to reduce contrast signalling in the retina and slow myopia progression. METHODS The Control of Myopia Using Peripheral Diffusion Lenses Efficacy and Safety Study (CYPRESS, NCT03623074) is a 36-month, multicentre, randomised, controlled, double-masked trial evaluating two investigational spectacle lenses versus control lenses in myopic children aged 6-10, with a planned interim analysis at 12 months. The primary endpoints are change from baseline in axial length (AL) and spherical equivalent refraction (SER). RESULTS 256 children (58% female; mean age at screening, 8.1 years) were dispensed spectacles. Across all groups, baseline averages were AL 24.02 mm (SD±0.77 mm), SER -2.01 D (SD±0.9 D) using manifest refraction, and SER -1.94 D (SD±1.0 D) using cycloplegic autorefraction. At 12 months, mean difference in SER progression for test 1 versus control was -0.40 D (p<0.0001), representing a 74% reduction and -0.32 D for Test 2 (p<0.0001), representing a 59% reduction. The difference in AL progression for test 1 versus control was 0.15 mm (p<0.0001) and test 2 versus control was 0.10 mm (p=0.0018). CONCLUSION 12-month results from this ongoing trial demonstrate the safety and effectiveness of DOT spectacles for reducing myopic progression.
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Affiliation(s)
- Joe Rappon
- SightGlass Vision Inc, Palo Alto, California, USA
| | - Carol Chung
- Carol Chung Statistics Consulting Inc, Pacifica, California, USA
| | | | | | - Jay Neitz
- Department of Ophthalmology, University of Washington, Seattle, Washington, USA
| | - Maureen Neitz
- Department of Ophthalmology, University of Washington, Seattle, Washington, USA
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Vinod K, Salim S. Addressing Glaucoma in Myopic Eyes: Diagnostic and Surgical Challenges. Bioengineering (Basel) 2023; 10:1260. [PMID: 38002384 PMCID: PMC10669452 DOI: 10.3390/bioengineering10111260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 10/23/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023] Open
Abstract
Epidemiological and genetic studies provide strong evidence supporting an association between myopia and glaucoma. The accurate detection of glaucoma in myopic eyes, especially those with high myopia, remains clinically challenging due to characteristic morphologic features of the myopic optic nerve in addition to limitations of current optic nerve imaging modalities. Distinguishing glaucoma from myopia is further complicated by overlapping perimetric findings. Therefore, longitudinal follow-up is essential to differentiate progressive structural and functional abnormalities indicative of glaucoma from defects that may result from myopia alone. Highly myopic eyes are at increased risk of complications from traditional incisional glaucoma surgery and may benefit from newer microinvasive glaucoma surgeries in select cases.
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Affiliation(s)
- Kateki Vinod
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA
| | - Sarwat Salim
- Department of Ophthalmology, Tufts University School of Medicine, Boston, MA 02116, USA
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Xue M, Lin Z, Wu H, Xu Q, Wen L, Luo Z, Hu Z, Li X, Yang Z. Two-Dimensional Peripheral Refraction and Higher-Order Wavefront Aberrations Induced by Orthokeratology Lenses Decentration. Transl Vis Sci Technol 2023; 12:8. [PMID: 37824110 PMCID: PMC10587852 DOI: 10.1167/tvst.12.10.8] [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: 01/19/2023] [Accepted: 07/27/2023] [Indexed: 10/13/2023] Open
Abstract
Purpose The purpose of this study was to explore two-dimensional peripheral refraction and higher-order aberrations (HOAs) induced by orthokeratology lens decentration. Methods Two-dimensional peripheral refraction and HOAs in a rectangular field (horizontally 60 degrees and vertically 36 degrees) were obtained using an open-view Hartmann-Shack wavefront sensor. The peripheral field was divided into 8 regions according to a combination of superior (UZ) or inferior (LZ) and a value, 1 (T25 to T30), 2 (T20 to T25), 3 (N20 to N25), or 4 (N25 to N30). The decentration of the lens was evaluated based on the change of power in the front of the tangential corneal map. All measurements were taken at the baseline and 1 month after lens fitting. Results In total, 134 myopic children (age = 12.47 ± 1.70 years, SER = -2.44 ± 1.10 diopters [D]) were recruited. In general, horizontally asymmetrical change was observed in relative peripheral refraction (RPR), spherical aberration (SA), and horizontal coma. The root-mean square of higher order aberration (RMSHOA) and vertical coma demonstrated radial symmetrical change and vertically asymmetric change, respectively. Relative peripheral myopia was significantly increased after the treatment, with more myopic refraction in the temporal side. RPR changes in UZ2, UZ3, UZ4, LZ1, and LZ2 were related to the amount of lens decentration (r ≈ 0.4, P < 0.05). All HOAs increased after lens fitting (around 0.03 um, 0.02 um, 0.04 um, and 0.41 um for SA, horizontal COMA, vertical COMA, and RMSHOA in the periphery region). Conclusions RPR and HOAs are related to lens decentration, which might contribute to the efficacy of orthokeratology. Translational Relevance The study found a decentration-related optical feature after 1 month of lens wear, which is a suggested protective factor in myopia treatment. The findings might provide new insights for customized contact lens myopia treatment based on optics.
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Affiliation(s)
- Minsong Xue
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Zhenghua Lin
- Aier School of Ophthalmology, Central South University, Changsha, China
- Aier Eye Hospital Group, Changsha, China
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo, Murcia, Spain
| | - Haoran Wu
- Aier Eye Hospital Group, Changsha, China
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Hunan Province, China
| | - QingLin Xu
- Jinan University, Guangzhou, China
- Changsha Aier Eye Hospital, Changsha, China
| | - Longbo Wen
- Aier Eye Hospital Group, Changsha, China
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Hunan Province, China
| | - Zhiwei Luo
- Aier Institute of Optometry and Vision Science, Changsha, China
| | - Ziqi Hu
- Aier Institute of Optometry and Vision Science, Changsha, China
| | - Xiaoning Li
- Changsha Aier Eye Hospital, Changsha, China
- Aier Institute of Optometry and Vision Science, Changsha, China
- Aier College of Ophthalmology & Optometry, Hubei University of Science and Technology, Xianning, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China
| | - Zhikuan Yang
- Aier School of Ophthalmology, Central South University, Changsha, China
- Changsha Aier Eye Hospital, Changsha, China
- Aier Institute of Optometry and Vision Science, Changsha, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China
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Zhao W, Wang J, Chen J, Xie H, Yang J, Liu K, He X, Xu X. The rate of orthokeratology lens use and associated factors in 33,280 children and adolescents with myopia: a cross-sectional study from Shanghai. Eye (Lond) 2023; 37:3263-3270. [PMID: 37046055 PMCID: PMC10564736 DOI: 10.1038/s41433-023-02503-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 01/21/2023] [Accepted: 03/08/2023] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVES To investigate the rate of orthokeratology lens (ortho-k lens) use and its associated factors in children and adolescents with myopia. METHODS Cross-sectional study. Children from 104 primary and middle schools in Shanghai were enrolled by cluster sampling. Ophthalmic examinations were conducted and information was obtained using questionnaires for associated factors analysis. RESULTS A total of 72,920 children and adolescents were included, among which 32,259 were the potential population for ortho-k lens use. A total of 1021 participants used ortho-k lenses, equating to a use rate of 1.4% in the total population and 3.1% in the potential population. Age (OR 0.91, 95% CI: 0.88-0.95, p < 0.001), BMI (≥95th percentile: OR 0.48, 95% CI: 0.35-0.66, p < 0.001), age at initiation of refractive correction (≤12 years: OR 1.75, 95% CI: 1.31-2.33, p < 0.001), and parental myopia (either: OR 2.09, 95% CI: 1.58-2.75, p < 0.001; both: OR 3.94, 95% CI: 3.04-5.11, p < 0.001) were independently associated with ortho-k lens use. Of the ortho-k lenses users, 12.4% had a logMAR CVA of ≥0.3. A correction target (SE) of ≤-3.0 D (OR 2.05, 95% CI: 1.38-3.05, p < 0.001) and a sleeping duration of ≤6 h (OR 4.19, 95% CI: 2.03-8.64, p < 0.001) were factors independently associated with CVA ≥ 0.3. CONCLUSIONS A certain proportion of children and adolescents in Shanghai chose to wear ortho-k lenses, related to the situation of parents and children themselves. Health education and follow-ups should be strengthened to ensure orthokeratology application quality.
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Affiliation(s)
- Wenchen Zhao
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China
| | - Jingjing Wang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
| | - Jun Chen
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
| | - Hui Xie
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
| | - Jinliuxing Yang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
| | - Kun Liu
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China
| | - Xiangui He
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China.
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China.
| | - Xun Xu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China.
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China.
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30
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Li T, Chen Z, She M, Zhou X. Relative peripheral refraction in myopic children wearing orthokeratology lenses using a novel multispectral refraction topographer. Clin Exp Optom 2023; 106:746-751. [PMID: 36126304 DOI: 10.1080/08164622.2022.2113330] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/03/2022] [Accepted: 08/09/2022] [Indexed: 10/14/2022] Open
Abstract
CLINICAL RELEVANCE Orthokeratology (OK) lens is commonly used to control myopia progression of children. Understanding the relationship between relative peripheral refraction (RPR) and the growth rate of axial length (AL) may assist in explaining myopic progression. BACKGROUND The aim of this work is to investigate the RPR in myopic children wearing OK lenses, and to evaluate its relationship with the growth rate of AL. METHODS RPRs of 31 children wearing OK lenses and 31 children wearing single-vision glasses were measured with multispectral refraction topography (MRT). MRT shows the total RPR (TRPR), RPR in the superior area (RPR-S), RPR in the inferior area (RPR-I), RPR in the temporal area (RPR-T) and RPR in the nasal area (RPR-N), respectively. It also shows RPR in the visual field of 15° (RPR-15), 30° (RPR-30) and 45° (RPR-45), respectively. RPRs in the visual field from 15° to 30°, 30° to 45° and 15° to 45° are recorded as RPR-(30-15), RPR-(45-30) and RPR-(45-15), respectively. According to the growth rate of AL, children wearing OK lenses were further divided into slow and fast growth groups. RESULTS TRPR, RPR-I, RPR-T, RPR-N, RPR-15, RPR-30, RPR-45, RPR-(30-15), RPR-(45-30), and RPR-(45-15) of children in the OK lens group were significantly smaller than in the control group (all P < 0.05). TRPR, RPR-N, RPR-15, RPR-30, RPR-45, RPR-(30-15), and RPR-(45-15) of the slow growth group were significantly smaller than in the fast growth group (all P < 0.05). The growth rate of AL were positively correlated with TRPR (R = 0.383, P = 0.040), RPR-N (R = 0.395, P = 0.034), RPR-30 (R = 0.408, P = 0.028), RPR-45 (R = 0.377, P = 0.044), RPR-(30-15) (R = 0.390, P = 0.036). CONCLUSIONS RPRs of children show relative myopic defocus after wearing OK lenses. Furthermore, the growth rate of AL is smaller with more negative RPR.
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Affiliation(s)
- Tao Li
- Department of Ophthalmology, Jinshan Hospital of Fudan University, Shanghai, China
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Zhuoyi Chen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Man She
- Department of Ophthalmology, Jinshan Hospital of Fudan University, Shanghai, China
| | - Xiaodong Zhou
- Department of Ophthalmology, Jinshan Hospital of Fudan University, Shanghai, China
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Geng C, Liu S, Wang J, Wang S, Zhang W, Rong H, Cao Y, Wang S, Li Z, Zhang Y. Targeting the cochlin/SFRP1/CaMKII axis in the ocular posterior pole prevents the progression of nonpathologic myopia. Commun Biol 2023; 6:884. [PMID: 37644183 PMCID: PMC10465513 DOI: 10.1038/s42003-023-05267-2] [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: 10/18/2022] [Accepted: 08/21/2023] [Indexed: 08/31/2023] Open
Abstract
Myopia is a major public health issue. However, interventional modalities for nonpathologic myopia are limited due to its complicated pathogenesis and the lack of precise targets. Here, we show that in guinea pig form-deprived myopia (FDM) and lens-induced myopia (LIM) models, the early initiation, phenotypic correlation, and stable maintenance of cochlin protein upregulation at the interface between retinal photoreceptors and retinal pigment epithelium (RPE) is identified by a proteomic analysis of ocular posterior pole tissues. Then, a microarray analysis reveals that cochlin upregulates the expression of the secreted frizzled-related protein 1 (SFRP1) gene in human RPE cells. Moreover, SFRP-1 elevates the intracellular Ca2+ concentration and activates Ca2+/calmodulin-dependent protein kinase II (CaMKII) signaling in a simian choroidal vascular endothelial cell line, and elicits vascular endothelial cell dysfunction. Furthermore, genetic knockdown of the cochlin gene and pharmacological blockade of SFRP1 abrogates the reduced choroidal blood perfusion and prevents myopia progression in the FDM model. Collectively, this study identifies a novel signaling axis that may involve cochlin in the retina, SFRP1 in the RPE, and CaMKII in choroidal vascular endothelial cells and contribute to the pathogenesis of nonpathologic myopia, implicating the potential of cochlin and SFRP1 as myopia interventional targets.
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Affiliation(s)
- Chao Geng
- 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, 300384, Tianjin, China
| | - Siyi Liu
- 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, 300384, Tianjin, China
| | - Jindan Wang
- 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, 300384, Tianjin, China
| | - Sennan Wang
- 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, 300384, Tianjin, China
| | - Weiran Zhang
- 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, 300384, Tianjin, China
| | - Hua Rong
- 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, 300384, Tianjin, China
| | - Yunshan Cao
- Department of Cardiology, Gansu Provincial Hospital, Lanzhou University, 730000, Lanzhou, Gansu Province, China
| | - Shuqing Wang
- School of Pharmacy, Tianjin Medical University, 300070, Tianjin, China
| | - Zhiqing 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, 300384, Tianjin, China
| | - Yan Zhang
- 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, 300384, Tianjin, China.
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Tariq F, Mobeen R, Wang X, Lin X, Bao Q, Liu J, Gao H. Advances in myopia prevention strategies for school-aged children: a comprehensive review. Front Public Health 2023; 11:1226438. [PMID: 37655278 PMCID: PMC10466414 DOI: 10.3389/fpubh.2023.1226438] [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: 05/21/2023] [Accepted: 07/24/2023] [Indexed: 09/02/2023] Open
Abstract
Myopia has significantly risen in East and Southeast Asia, and the pathological outcomes of this condition, such as myopic maculopathy and optic neuropathy linked to high myopia, have emerged as leading causes of irreversible vision loss. Addressing this issue requires strategies to reduce myopia prevalence and prevent progression to high myopia. Encouraging outdoor activities for schoolchildren and reducing near-work and screen time can effectively prevent myopia development, offering a safe intervention that promotes healthier habits. Several clinical approaches can be employed to decelerate myopia progression, such as administering low-dose atropine eye drops (0.05%), utilizing orthokeratology lenses, implementing soft contact lenses equipped with myopia control features, and incorporating spectacle lenses with aspherical lenslets. When choosing an appropriate strategy, factors such as age, ethnicity, and the rate of myopia progression should be considered. However, some treatments may encounter obstacles such as adverse side effects, high costs, complex procedures, or limited effectiveness. Presently, low-dose atropine (0.05%), soft contact lenses with myopia control features, and orthokeratology lenses appear as promising options for managing myopia. The measures mentioned above are not necessarily mutually exclusive, and researchers are increasingly exploring their combined effects. By advocating for a personalized approach based on individual risk factors and the unique needs of each child, this review aims to contribute to the development of targeted and effective myopia prevention strategies, thereby minimizing the impact of myopia and its related complications among school-aged children in affected regions.
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Affiliation(s)
- Farheen Tariq
- Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Rabia Mobeen
- School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, Australia
| | - Xinhai Wang
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Xiao Lin
- Shandong University of Traditional Chinese Medicine, Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Qingdong Bao
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Jinhui Liu
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Hua Gao
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
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Mahmoud O, Andrews C, Soeken T, Nallasamy S, Nallasamy N. Optical Biometry Changes Throughout Childhood and Adolescence in Patients Wearing Ortho-K Lenses. Clin Ophthalmol 2023; 17:1919-1927. [PMID: 37425028 PMCID: PMC10329451 DOI: 10.2147/opth.s413810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/08/2023] [Indexed: 07/11/2023] Open
Abstract
Background Orthokeratology has been shown to suppress progressive myopia in some children. We examine the changes in optical biometry parameters in orthokeratology (Ortho-K) patients, in a retrospective longitudinal study at a tertiary eye care center in Ann Arbor, MI, USA. Methods Optical biometry measurements obtained with the Lenstar LS 900 (Haag-Streit USA Inc, EyeSuite software version i9.1.0.0) were aggregated from 170 patients who had undergone Ortho-K for myopia correction between 5 and 20 years of age. Pre-intervention biometry measurements were compared with follow-up measurements done 6-18 months after initiation of Ortho-K. Linear mixed models were used to quantify associations in biometry changes with age of intervention allowing for correlation between measurements on two eyes of the same patient. Results A total of 91 patients were included in the study. Axial length increased through the age of 15.7 ± 0.84 years for Ortho-K patients at our center. The growth curve in our Ortho-K population was comparable to previously published normal growth curves in Wuhan and Germany populations. Corneal thickness and keratometry decreased at a stable rate regardless of age of intervention (-7.9 µm, 95% CI [-10.2, -5.7], p < 0.001). Conclusion In our population, Ortho-K did not appear to affect the overall trajectory of axial length progression when compared to normal growth curves, despite showing a previously described reduction in corneal thickness. As Ortho-K has been shown to have varying effects that differ from individual to individual, it continues to be important to reassess its effects on new populations to better understand its ideal uses.
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Affiliation(s)
- Ossama Mahmoud
- Kellogg Eye Center Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
- School of Medicine, Wayne State University, Detroit, MI, USA
| | - Chris Andrews
- Kellogg Eye Center Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Timothy Soeken
- Kellogg Eye Center Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Sudha Nallasamy
- The Vision Center, Children’s Hospital Los Angeles, Los Angeles, CA, USA
- USC Roski Eye Institute, Keck School of Medicine of the University of Southern California, LA, California, USA
| | - Nambi Nallasamy
- Kellogg Eye Center Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
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Bullimore MA, Richdale K. Incidence of Corneal Adverse Events in Children Wearing Soft Contact Lenses. Eye Contact Lens 2023; 49:204-211. [PMID: 36877990 PMCID: PMC10503544 DOI: 10.1097/icl.0000000000000976] [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] [Accepted: 01/14/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVES There is increasing interest in fitting children with soft contact lenses, in part due to the increase in prescribing of designs to slow the progression of myopia. This literature review summarizes large prospective and retrospective studies that include data on the incidence of microbial keratitis and corneal infiltrative events (CIEs) in children wearing soft contact lenses. METHODS Peer-reviewed prospective and retrospective studies that report contact lens-related complications in children with at least one year of wear and at least 100 patient years of wear were identified. RESULTS Seven prospective studies published between 2004 and 2022 were identified representing 3,752 patient years of wear in 1,756 children, nearly all of whom were fitted at age 12 years or younger. Collectively, they report one case of microbial keratitis and 53 CIEs, of which 16 were classified as symptomatic. The overall incidence of microbial keratitis was 2.7 per 10,000 patient years (95% CI: 0.5-15), and the incidence of symptomatic CIEs was 42 per 10,000 patient years (95% CI: 26-69). Two retrospective studies were identified representing 2,545 patient years of wear in 1,025 children, fitted at age 12 years or younger. One study reports two cases of microbial keratitis giving an incidence of 9.4 per 10,000 patient years (95% CI: 0.5-15). CONCLUSIONS Accurate classification of CIEs is challenging, particularly in retrospective studies. The incidence of microbial keratitis in children wearing soft lenses is no higher than in adults, and the incidence of CIEs seems to be markedly lower.
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Banashefski B, Rhee MK, Lema GMC. High Myopia Prevalence across Racial Groups in the United States: A Systematic Scoping Review. J Clin Med 2023; 12:jcm12083045. [PMID: 37109381 PMCID: PMC10144975 DOI: 10.3390/jcm12083045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/03/2023] [Accepted: 04/09/2023] [Indexed: 04/29/2023] Open
Abstract
High myopia is a significant public health issue globally and in the United States (US), where it affects ~4% of the population or 13 million people. This is a potentially blinding condition, but complications can be prevented with early intervention in childhood. Several countries have developed robust data on high myopia, but the United States' data on high myopia remains lacking. Further, underrepresented populations are at particular risk of complications due to reduced access to optometric and ophthalmic care. We performed a systematic scoping review of population-based studies that investigated the prevalence of high myopia across racial and ethnic groups in the US to identify the impact of high myopia on underrepresented communities. Only four studies were identified that met inclusion criteria, which highlights the need to further investigate the topic in the United States. The prevalence of high myopia ranged from a low of 1.8% among Hispanic populations to a high of 11.8% among Chinese populations. Our study demonstrated a paucity of high myopia data in the United States and variable rates of high myopia depending on the time and location of each study. More complete prevalence data will help identify opportunities for community-based interventions to prevent debilitating and blinding complications of high myopia.
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Affiliation(s)
- Bryana Banashefski
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Michelle K Rhee
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Gareth M C Lema
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- John J. Peters VA Medical Center, Bronx, NY 10468, USA
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Zhai J, Hou L, Yao Y, Lian H, Chen S, Xu Y, Dai Q. The influence of overnight orthokeratology and soft contact lens on the meibomian gland evaluated using an artificial intelligence analytic system. Cont Lens Anterior Eye 2023; 46:101841. [PMID: 37076421 DOI: 10.1016/j.clae.2023.101841] [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: 11/14/2022] [Revised: 03/20/2023] [Accepted: 03/29/2023] [Indexed: 04/21/2023]
Abstract
PURPOSE To test the changes of meibomian gland (MG) morphology using an artificial intelligence (AI) analytic system in asymptomatic children wearing overnight orthokeratology (OOK) and soft contact lens (SCL). METHODS A retrospective study was conducted including 89 participants treated with OOK and 70 participants with SCL. Tear meniscus height (TMH), noninvasive tear breakup time (NIBUT), and meibography were obtained using Keratograph 5 M. MG tortuosity, height, width, density, and vagueness value were measured using an artificial intelligence (AI) analytic system. RESULTS In an average of 20.80 ± 10.83 months follow-up, MG width of the upper eyelid significantly increased and MG vagueness value significantly decreased after OOK and SCL treatment (all P < 0.05). MG tortuosity of the upper eyelid significantly increased after OOK treatment (P < 0.05). TMH and NIBUT did not differ significantly pre- and post- OOK and SCL treatment (all P > 0.05). The results from the GEE model demonstrated that OOK treatment positively affected MG tortuosity of both upper and lower eyelids (P < 0.001; P = 0.041, respectively) and MG width of the upper eyelid (P = 0.038), while it negatively affected MG density of the upper eyelid (P = 0.036) and MG vagueness value of both upper and lower eyelids (P < 0.001; P < 0.001, respectively). SCL treatment positively affected MG width of both upper and lower eyelids (P < 0.001; P = 0.049, respectively) as well as MG height of the lower eyelid (P = 0.009) and tortuosity of the upper eyelid, (P = 0.034) while it negatively affected MG vagueness value of both upper and lower eyelids (P < 0.001; P < 0.001, respectively). However, no significant relationship was found between the treatment duration and TMH, NIBUT, MG morphological parameters in OOK group. SCL treatment duration negatively affected MG height of the lower eyelid (P = 0.002). CONCLUSIONS OOK and SCL treatment in asymptomatic children can influence MG morphology. The AI analytic system may be an effective method to facilitate the quantitative detection of MG morphological changes.
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Affiliation(s)
- Jing Zhai
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Lijie Hou
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yixuan Yao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Hengli Lian
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Siping Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yeqing Xu
- Zhejiang Provincial Center for Medical Science Technology and Education Development, Hangzhou 310009, China
| | - Qi Dai
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China.
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Li T, Zuo X, Zhang T, Liu L, Wang Z, Han L, Liu H, Wang Z. Patients with Intermittent Exotropia and Exophoria Exhibit Non-aggravated Lens Decentration After Orthokeratology Application: The Nanjing Strabismus Cohort. Ophthalmol Ther 2023; 12:1535-1545. [PMID: 36856977 PMCID: PMC10164214 DOI: 10.1007/s40123-023-00685-1] [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: 01/14/2023] [Accepted: 02/07/2023] [Indexed: 03/02/2023] Open
Abstract
INTRODUCTION There is a high prevalence of intermittent exotropia and exophoria in myopic populations, and orthokeratology is one of the effective interventions to control myopia progression in children. However, it is still obscure whether intermittent exotropia and exophoria children could wear orthokeratology without experiencing aggravated lens decentration. METHODS This was a multi-center, prospective cohort study. A total of 123 myopic participants aged 8-14 years were recruited, where conditions of deviation included intermittent exotropia, exophoria, and orthophoria. Uncorrected visual acuity and corneal topography data were obtained at baseline and after 1 month of wearing orthokeratology lens. Lens decentration was analyzed in a MATLAB program. Magnitude of deviation and refractive errors were evaluated prior to orthokeratology treatment. Fisher's exact test, ANOVA test, and univariate and multivariate linear regression models were established to evaluate the role of magnitude of deviation in lens decentration. RESULTS There was no significant difference in magnitude and direction of lens decentration among three groups (magnitude: F = 1.25, P = 0.289; direction: Fisher = 9.91, P = 0.078). According to scale division of decentration, 1 (2.6%) intermittent exotropia subject, 2 (3.8%) exophoria subjects, and 1 (3.0%) orthophoria subject experienced severe decentration (Fisher = 1.10, P = 0.947). Inferotemporal decentration was most common among all subjects (intermittent exotropia 50.0%, exophoria 76.9%, orthophoria 72.7%). Univariate and multivariate linear regression analyses revealed that magnitude of deviation was not an independent risk factor for lens decentration [β = -0.00, 95% confidence interval (CI) -0.01-0.00, P = 0.180], while surface asymmetry index (SAI) (β = 0.21, 95% CI 0.02-0.40, P = 0.028) and surface regularity index (SRI) (β = -0.39, 95% CI -0.66 to -0.13, P = 0.004) had significant correlation with polar decentration. CONCLUSION Patients with intermittent exotropia and exophoria exhibit non-aggravated lens decentration after orthokeratology application. Thus, lens decentration is not the concern for orthokeratology prescription.
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Affiliation(s)
- Tianxi Li
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xiaoxia Zuo
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Tong Zhang
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Lei Liu
- School of Medical Technology, Jiangsu College of Nursing, Huai'an, China
| | | | - Lin Han
- Nanjing Orange Optometry Clinic, Nanjing, China
| | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
| | - Zijin Wang
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
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Wang J, Han Y, Musch DC, Li Y, Wei N, Qi X, Ding G, Li X, Li J, Song L, Zhang Y, Ning Y, Zeng X, Li Y, Sun L, Hua N, Li S, Jardines S, Qian X. Evaluation and Follow-up of Myopia Prevalence Among School-Aged Children Subsequent to the COVID-19 Home Confinement in Feicheng, China. JAMA Ophthalmol 2023; 141:333-340. [PMID: 36821130 PMCID: PMC9951104 DOI: 10.1001/jamaophthalmol.2022.6506] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Importance Progression of myopia in a school-aged population due to home confinement (January to May 2021) during the COVID-19 pandemic has been previously reported. A key remaining question was whether the myopia spike in children aged 6 to 8 years persisted. Objective To investigate the changes in refractive status and prevalence of myopia in school-aged children 1 year after home confinement ended in China. Design, Setting, and Participants This cross-sectional study with a cohort substudy prospectively evaluated data from school-based photoscreening in Feicheng, China. Children aged 6 to 13 years participated in 8 screenings from 2015 to 2021. Exposures Noncycloplegic photorefraction was conducted using the Spot Vision photoscreener. Main Outcomes and Measures The main outcomes were the differences in spherical equivalent refraction (SER) and prevalence of myopia between 2020 (during home confinement) and 2021 (after home confinement). The SER was recorded for each child, and the prevalence of myopia was calculated annually for each age group. Results A total of 325 443 children participated in the study (51.4% boys, 48.6% girls; age range, 6 to 13 years). Compared with 2020, the mean SER of children in 2021 increased significantly for those aged 6 (0.42 diopters [D]), 7 (0.41 D), and 8 (0.33 D) years. The prevalence of myopia in 2021 was similar to in 2019 for each age group (aged 6 years: 7.9% vs 5.7%; aged 7 years: 13.9% vs 13.6%; aged 8 years: 29.5% vs 26.2%). Both the prevalence of myopia and mean SER for these children returned to their prepandemic levels. Conclusions and Relevance Compared with 2020, the prevalence of myopia among children aged 6 to 8 years in the 2021 screenings decreased, and the mean SER returned to prepandemic level. The refractive development in children aged 6 to 8 years may be most susceptible to environmental changes. These findings support the premise that age 6 to 8 years is a critical period for myopia development and suggest a need to focus preventive interventions for myopia control on children in this age range.
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Affiliation(s)
- Jiaxing Wang
- Department of Ophthalmology, Emory University, Atlanta, Georgia
| | - Yujie Han
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of the National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - David C. Musch
- Departments of Ophthalmology and Visual Sciences and Epidemiology, University of Michigan, Ann Arbor, Michigan
| | - Ying Li
- Department of Ophthalmology, Emory University, Atlanta, Georgia
| | - Nan Wei
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xiaoli Qi
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Gang Ding
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xue Li
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Jing Li
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Linlin Song
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Ying Zhang
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yuxian Ning
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xiaoyu Zeng
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yaoling Li
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Ling Sun
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of the National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Ning Hua
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Shuo Li
- Department of Respiratory and Critical Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Sandra Jardines
- Department of Ophthalmology, Emory University, Atlanta, Georgia
| | - Xuehan Qian
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
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Lawrenson JG, Shah R, Huntjens B, Downie LE, Virgili G, Dhakal R, Verkicharla PK, Li D, Mavi S, Kernohan A, Li T, Walline JJ. Interventions for myopia control in children: a living systematic review and network meta-analysis. Cochrane Database Syst Rev 2023; 2:CD014758. [PMID: 36809645 PMCID: PMC9933422 DOI: 10.1002/14651858.cd014758.pub2] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND Myopia is a common refractive error, where elongation of the eyeball causes distant objects to appear blurred. The increasing prevalence of myopia is a growing global public health problem, in terms of rates of uncorrected refractive error and significantly, an increased risk of visual impairment due to myopia-related ocular morbidity. Since myopia is usually detected in children before 10 years of age and can progress rapidly, interventions to slow its progression need to be delivered in childhood. OBJECTIVES To assess the comparative efficacy of optical, pharmacological and environmental interventions for slowing myopia progression in children using network meta-analysis (NMA). To generate a relative ranking of myopia control interventions according to their efficacy. To produce a brief economic commentary, summarising the economic evaluations assessing myopia control interventions in children. To maintain the currency of the evidence using a living systematic review approach. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register), MEDLINE; Embase; and three trials registers. The search date was 26 February 2022. SELECTION CRITERIA: We included randomised controlled trials (RCTs) of optical, pharmacological and environmental interventions for slowing myopia progression in children aged 18 years or younger. Critical outcomes were progression of myopia (defined as the difference in the change in spherical equivalent refraction (SER, dioptres (D)) and axial length (mm) in the intervention and control groups at one year or longer) and difference in the change in SER and axial length following cessation of treatment ('rebound'). DATA COLLECTION AND ANALYSIS: We followed standard Cochrane methods. We assessed bias using RoB 2 for parallel RCTs. We rated the certainty of evidence using the GRADE approach for the outcomes: change in SER and axial length at one and two years. Most comparisons were with inactive controls. MAIN RESULTS We included 64 studies that randomised 11,617 children, aged 4 to 18 years. Studies were mostly conducted in China or other Asian countries (39 studies, 60.9%) and North America (13 studies, 20.3%). Fifty-seven studies (89%) compared myopia control interventions (multifocal spectacles, peripheral plus spectacles (PPSL), undercorrected single vision spectacles (SVLs), multifocal soft contact lenses (MFSCL), orthokeratology, rigid gas-permeable contact lenses (RGP); or pharmacological interventions (including high- (HDA), moderate- (MDA) and low-dose (LDA) atropine, pirenzipine or 7-methylxanthine) against an inactive control. Study duration was 12 to 36 months. The overall certainty of the evidence ranged from very low to moderate. Since the networks in the NMA were poorly connected, most estimates versus control were as, or more, imprecise than the corresponding direct estimates. Consequently, we mostly report estimates based on direct (pairwise) comparisons below. At one year, in 38 studies (6525 participants analysed), the median change in SER for controls was -0.65 D. The following interventions may reduce SER progression compared to controls: HDA (mean difference (MD) 0.90 D, 95% confidence interval (CI) 0.62 to 1.18), MDA (MD 0.65 D, 95% CI 0.27 to 1.03), LDA (MD 0.38 D, 95% CI 0.10 to 0.66), pirenzipine (MD 0.32 D, 95% CI 0.15 to 0.49), MFSCL (MD 0.26 D, 95% CI 0.17 to 0.35), PPSLs (MD 0.51 D, 95% CI 0.19 to 0.82), and multifocal spectacles (MD 0.14 D, 95% CI 0.08 to 0.21). By contrast, there was little or no evidence that RGP (MD 0.02 D, 95% CI -0.05 to 0.10), 7-methylxanthine (MD 0.07 D, 95% CI -0.09 to 0.24) or undercorrected SVLs (MD -0.15 D, 95% CI -0.29 to 0.00) reduce progression. At two years, in 26 studies (4949 participants), the median change in SER for controls was -1.02 D. The following interventions may reduce SER progression compared to controls: HDA (MD 1.26 D, 95% CI 1.17 to 1.36), MDA (MD 0.45 D, 95% CI 0.08 to 0.83), LDA (MD 0.24 D, 95% CI 0.17 to 0.31), pirenzipine (MD 0.41 D, 95% CI 0.13 to 0.69), MFSCL (MD 0.30 D, 95% CI 0.19 to 0.41), and multifocal spectacles (MD 0.19 D, 95% CI 0.08 to 0.30). PPSLs (MD 0.34 D, 95% CI -0.08 to 0.76) may also reduce progression, but the results were inconsistent. For RGP, one study found a benefit and another found no difference with control. We found no difference in SER change for undercorrected SVLs (MD 0.02 D, 95% CI -0.05 to 0.09). At one year, in 36 studies (6263 participants), the median change in axial length for controls was 0.31 mm. The following interventions may reduce axial elongation compared to controls: HDA (MD -0.33 mm, 95% CI -0.35 to 0.30), MDA (MD -0.28 mm, 95% CI -0.38 to -0.17), LDA (MD -0.13 mm, 95% CI -0.21 to -0.05), orthokeratology (MD -0.19 mm, 95% CI -0.23 to -0.15), MFSCL (MD -0.11 mm, 95% CI -0.13 to -0.09), pirenzipine (MD -0.10 mm, 95% CI -0.18 to -0.02), PPSLs (MD -0.13 mm, 95% CI -0.24 to -0.03), and multifocal spectacles (MD -0.06 mm, 95% CI -0.09 to -0.04). We found little or no evidence that RGP (MD 0.02 mm, 95% CI -0.05 to 0.10), 7-methylxanthine (MD 0.03 mm, 95% CI -0.10 to 0.03) or undercorrected SVLs (MD 0.05 mm, 95% CI -0.01 to 0.11) reduce axial length. At two years, in 21 studies (4169 participants), the median change in axial length for controls was 0.56 mm. The following interventions may reduce axial elongation compared to controls: HDA (MD -0.47mm, 95% CI -0.61 to -0.34), MDA (MD -0.33 mm, 95% CI -0.46 to -0.20), orthokeratology (MD -0.28 mm, (95% CI -0.38 to -0.19), LDA (MD -0.16 mm, 95% CI -0.20 to -0.12), MFSCL (MD -0.15 mm, 95% CI -0.19 to -0.12), and multifocal spectacles (MD -0.07 mm, 95% CI -0.12 to -0.03). PPSL may reduce progression (MD -0.20 mm, 95% CI -0.45 to 0.05) but results were inconsistent. We found little or no evidence that undercorrected SVLs (MD -0.01 mm, 95% CI -0.06 to 0.03) or RGP (MD 0.03 mm, 95% CI -0.05 to 0.12) reduce axial length. There was inconclusive evidence on whether treatment cessation increases myopia progression. Adverse events and treatment adherence were not consistently reported, and only one study reported quality of life. No studies reported environmental interventions reporting progression in children with myopia, and no economic evaluations assessed interventions for myopia control in children. AUTHORS' CONCLUSIONS Studies mostly compared pharmacological and optical treatments to slow the progression of myopia with an inactive comparator. Effects at one year provided evidence that these interventions may slow refractive change and reduce axial elongation, although results were often heterogeneous. A smaller body of evidence is available at two or three years, and uncertainty remains about the sustained effect of these interventions. Longer-term and better-quality studies comparing myopia control interventions used alone or in combination are needed, and improved methods for monitoring and reporting adverse effects.
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Affiliation(s)
- John G Lawrenson
- Centre for Applied Vision Research, School of Health & Psychological Sciences , City, University of London, London, UK
| | - Rakhee Shah
- Centre for Applied Vision Research, School of Health & Psychological Sciences , City, University of London, London, UK
| | - Byki Huntjens
- Centre for Applied Vision Research, School of Health & Psychological Sciences , City, University of London, London, UK
| | - Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia
| | - Gianni Virgili
- Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Rohit Dhakal
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Pavan K Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Dongfeng Li
- Centre for Public Health, Queen's University Belfast, Belfast, UK
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Sonia Mavi
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Ashleigh Kernohan
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Tianjing Li
- Department of Ophthalmology, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Jeffrey J Walline
- College of Optometry, The Ohio State University, Columbus, Ohio, USA
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Aschauer J, Klimek M, Donner R, Lammer J, Roberts P, Schmidinger G. Akanthamöbenkeratitiden in Jugendlichen mit Orthokeratologielinsen. SPEKTRUM DER AUGENHEILKUNDE 2023. [DOI: 10.1007/s00717-023-00536-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Zusammenfassung
Hintergrund
Durch die rasant steigende Prävalenz der Myopie kommen zunehmend progressionshemmende Verfahren zum Einsatz. Auch die Orthokeratologie, basierend auf dem Ansatz des peripheren Defokus, erlebt eine Renaissance. Die gefährlichste Nebenwirkung der Orthokeratologie ist die mikrobielle Keratitis, unter ihnen eine Infektion mit Akanthamöben, welche oft spät diagnostiziert wird und potenziell visusbedrohende Verläufe nehmen kann.
Material und Methode
Diese Fallserie beschreibt die Diagnosefindung und den Behandlungsverlauf der Akanthamöbenkeratitis bei jugendlichen Patient*innen mit Orthokeratologielinsen, welche an der Spezialambulanz für Hornhauterkrankungen der Universitätsklinik für Augenheilkunde und Optometrie an der Medizinischen Universität Wien im Zeitraum eines Jahres betreut wurden.
Resultate
Vier Fälle von orthokeratologieassoziierten Akanthamöbenkeratitiden wurden mittels kornealer Konfokalmikroskopie und mikrobiologischer Verfahren zwischen August 2021 und August 2022 diagnostiziert. Die intensive Stufentherapie umfasste ein hochdosiertes, topisches Biguanid in Kombination mit einem Diamidinderivat, welches in der ersten Therapiephase mit antibakteriellen und antifungalen Augentropfen kombiniert wurde. Der Therapieverlauf und -erfolg wurde mittels der kornealen Konfokalmikroskopie beurteilt, und entsprechend angepasst.
Schlussfolgerung
Die Akanthamöbenkeratitis ist ein ernst zu nehmendes Erkrankungsbild im Zusammenhang mit Orthokeratologielinsen. Im Hinblick auf das Alter der Zielgruppe dieser myopieprogressionshemmenden Therapie sollte, neben sorgfältiger Patientenselektion, auf eine detaillierte Schulung der Kontaktlinsenträger in der Handhabung der Linsen sowie auf ein erhöhtes Bewusstsein für Zeichen einer frühen Infektion besonderes Augenmerk gelegt werden. Da alternative Möglichkeiten zur Myopieprophylaxe bestehen, müssen PatentInnen auf das Risiko der jeweiligen Methode hingewiesen werden.
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41
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Sun L, Li X, Zhao H, Li Y, Wang K, Qu J, Zhao M. Biometric factors and orthokeratology lens parameters can influence the treatment zone diameter on corneal topography in Corneal Refractive Therapy lens wearers. Cont Lens Anterior Eye 2023; 46:101700. [PMID: 35501251 DOI: 10.1016/j.clae.2022.101700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 04/20/2022] [Accepted: 04/24/2022] [Indexed: 01/18/2023]
Abstract
PURPOSE To investigate the relationship between patients' baseline biometric factors or lens parameters and the diameter of the treatment zone in young myopic children undergoing Corneal Refractive Therapy. METHODS The data of patients undergoing Corneal Refractive Therapy lens treatment within two years were retrospectively reviewed. Baseline clinical data, including sex, age, refractive power, corneal topography readings, ocular optical biometric measurements, and Corneal Refractive Therapy lens parameters, were subjected to Pearson, Spearman, and partial correlation analyses to identify the potential factors that may influence treatment zone diameter on corneal topography. Logistic and linear regression analyses were used to predict the treatment zone size. RESULTS The Right eyes of 309 patients were included in this study. The spherical refraction, flat keratometric reading, Reverse Zone Depth 2, Landing Zone Angle 1, and lens diameter were independent factors of treatment zone diameter. In the multivariate analyses, Landing Zone Angle 1 was positively correlated, while Reverse Zone Depth 2 and lens diameter were negatively correlated with the size of the treatment area. The accuracy of logistic regression in predicting the treatment zone size was 71.5%. CONCLUSION Adjustments to Corneal Refractive Therapy lens parameters may influence the treatment zone diameter on corneal topography. A higher Reverse Zone Depth 2, smaller Landing Zone Angle 1, and larger lens diameter can lead to a smaller treatment zone for Corneal Refractive Therapy lens treatment.
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Affiliation(s)
- Liyuan Sun
- Institute of Medical Technology, Peking University Health Science Center, Beijing 100044, China; Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Eye Disease and Optometry Institute, Peking University People's Hospital, China; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China.
| | - Xuewei Li
- Institute of Medical Technology, Peking University Health Science Center, Beijing 100044, China; Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Eye Disease and Optometry Institute, Peking University People's Hospital, China; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China
| | - Heng Zhao
- Institute of Medical Technology, Peking University Health Science Center, Beijing 100044, China; Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Eye Disease and Optometry Institute, Peking University People's Hospital, China; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China
| | - Yan Li
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Eye Disease and Optometry Institute, Peking University People's Hospital, China; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China
| | - Kai Wang
- Institute of Medical Technology, Peking University Health Science Center, Beijing 100044, China; Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Eye Disease and Optometry Institute, Peking University People's Hospital, China; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China.
| | - Jia Qu
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, China
| | - Mingwei Zhao
- Institute of Medical Technology, Peking University Health Science Center, Beijing 100044, China; Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Eye Disease and Optometry Institute, Peking University People's Hospital, China; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China.
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42
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Guo Y, Liu L, Peng L, Fu J, Guo W, Tang P. Effect of overnight orthokeratology lenses on tear film stability in children. Cont Lens Anterior Eye 2023; 46:101592. [PMID: 35393267 DOI: 10.1016/j.clae.2022.101592] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 03/26/2022] [Accepted: 03/28/2022] [Indexed: 01/18/2023]
Abstract
PURPOSE To assess the tear film surface quality after orthokeratology using an automated Medmont E300 corneal topographer. METHODS Children who wore orthokeratology lenses for more than one year were selected in this retrospective study. Tear film disruption (TFD) and central tear film disruption (cTFD) were measured with Medmont E300 corneal topographer at initial and each follow-up visit after fitting with orthokeratology lenses, providing a nominal value from 0 (perfect) to 1 (poor). Tear film surface quality before and after ortho-k treatment was compared. RESULTS 145 children using orthokeratology lenses were observed. TFD and cTFD significantly increased at 1-day follow up (TFD, t = -17.3, P < 0.001; cTFD, t = -10.4, P < 0.001). This change remained consistent through to 12-months visit (TFD, F = 51.1, P < 0.001; cTFD, F = 28.0, P < 0.001). A sub-group of n = 11 children were discontinued for 1-month before being refit with OrthoK lenses of a different design. Similarly, there was a significant increase in TFD compared to pre-orthoK scans (0.172 ± 0.161), but this returned to baseline levels after ceasing lens wear (0.084 ± 0.059). A sub-group of monocular OrthoK wearers (n = 23) found that TFD and cTFD values increased in eyes with monocular lens-wearing but remained stable in the lateral eyes. CONCLUSIONS Objective measurements of tear-film quality are reduced in children after fitting with orthokeratology lenses, but return to baseline after 1-month of lens cessation. It is of importance to ensure tear film surface quality is continuously monitored throughout use of orthoK lenses.
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Affiliation(s)
- Yin Guo
- Department of Ophthalmology, Beijing Haidian Hospital and Beijing Haidian Section of Peking University Third Hospital, Beijing, China.
| | - Lizhou Liu
- Tongren Eye Care Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Li Peng
- Tongren Eye Care Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jia Fu
- Tongren Eye Care Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wei Guo
- Tongren Eye Care Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ping Tang
- Tongren Eye Care Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Liu J, Lu Y, Huang D, Yang J, Fan C, Chen C, Li J, Wang Q, Li S, Jiang B, Jiang H, Li X, Yang Z, Lan W. The Efficacy of Defocus Incorporated Multiple Segments Lenses in Slowing Myopia Progression: Results from Diverse Clinical Circumstances. Ophthalmology 2023; 130:542-550. [PMID: 36642334 DOI: 10.1016/j.ophtha.2023.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/30/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
PURPOSE Defocus incorporated multiple segments (DIMS) spectacle lenses were reported to slow myopia progression significantly in a randomized controlled trial (RCT). The study evaluated their effectiveness in clinical settings. DESIGN Retrospective study. PARTICIPANTS Patient records involving use of DIMS and single-vision (SV) spectacle lenses were collected from subsidiary hospitals of Aier Eye Hospital Group. METHODS The spherical equivalent (SE), determined by subjective refraction, was adopted to assess the myopia progression. The strategy of propensity score matching (PSM) was applied to match the confounding baseline characteristics between the 2 groups. The effectiveness was calculated based on the difference of myopia progression of these 2 approaches. MAIN OUTCOME MEASURES Change in SE. RESULTS Three thousand six hundred thirty-nine patients with DIMS and 6838 patients with SV spectacles were included. The age of the patients was 6 to 16 years (mean ± standard deviation: 11.02 ± 2.53 years). The baseline SE was between 0.00 and -10.00 diopters (D) (mean ± standard deviation: -2.78 ± 1.74 D). After the PSM, data on 2240 pairs with 1-year follow-up and on 735 pairs with 2-year follow-up were obtained. Significantly slower progression was seen in the DIMS group at both the 1-year (DIMS, -0.50 ± 0.43 D; SV, -0.77 ± 0.58 D; P < 0.001) and 2-year (DIMS, -0.88 ± 0.62 D; SV, -1.23 ± 0.76 D; P < 0.001) subdataset. In the 1-year subdataset, 40% and 19% showed myopia progression of no more than 0.25 D for the DIMS and SV groups, respectively (chi-square, 223.43; P < 0.001), whereas 9% and 22% showed myopia progression of more than 1.00 D for the DIMS and SV groups, respectively (chi-square, 163.38; P < 0.001). In the 2-year subdataset, 33% and 20% showed myopia progression of no more than 0.50 D for the DIMS and SV groups, respectively (chi-square, 31.15; P < 0.001), whereas 12% and 29% showed myopia progression of more than 1.50 D for the DIMS and SV groups (chi-square, 65.60; P < 0.001). CONCLUSIONS Although the magnitude was lower than that reported in the previous RCT, this large-scale study with diversity of the data sources confirmed the effectiveness of DIMS spectacles to slow myopia progression in clinical practice. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Jiaxin Liu
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Yiqiu Lu
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Dan Huang
- Changsha Aier Eye Hospital, Beijing, China
| | - Jiwen Yang
- Shenyang Aier Eye Hospital, Shenyang, China
| | - Chunlei Fan
- Beijing Aier Intech Eye Hospital, Beijing, China
| | - Chunmei Chen
- Chongqing Aier-Mega Eye Hospital, Chongqing, China
| | - Jianhua Li
- Guangzhou Aier Eye Hospital, Jinan University, Guangzhou, China
| | | | - Shan Li
- Shenzhen Aier Eye Hospital, Huzhou, China
| | | | | | - Xiaoning Li
- Aier School of Ophthalmology, Central South University, Changsha, China; School of Stomatology and Ophthalmology, Xianning Medical College, Hubei University of Science and Technology, Xianning, China; Hunan Province Optometry Engineering and Technology Research Center, Changsha, China; Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China
| | - Zhikuan Yang
- Aier School of Ophthalmology, Central South University, Changsha, China; School of Stomatology and Ophthalmology, Xianning Medical College, Hubei University of Science and Technology, Xianning, China; Hunan Province Optometry Engineering and Technology Research Center, Changsha, China; Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China
| | - Weizhong Lan
- Aier School of Ophthalmology, Central South University, Changsha, China; Guangzhou Aier Eye Hospital, Jinan University, Guangzhou, China; School of Stomatology and Ophthalmology, Xianning Medical College, Hubei University of Science and Technology, Xianning, China; Hunan Province Optometry Engineering and Technology Research Center, Changsha, China; Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China.
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Abstract
ABSTRACT Contact lenses are a safe and effective method for correction of refractive error and worn by an estimated 45 million Americans. Because of the widespread availability and commercial popularity of contact lenses, it is not well appreciated by the public that contact lenses are U.S. Food and Drug Administration (FDA)-regulated medical devices. Contact lenses are marketed in numerous hard and soft materials that have been improved over decades, worn in daily or extended wear, and replaced in range of schedules from daily to yearly or longer. Lens materials and wear and care regimens have impact on the risks of contact lens-related corneal inflammatory events and microbial keratitis. This article reviews contact lens safety, with specific focus on the correction of refractive error in healthy eyes.
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45
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López García Rosuero M, Arranz Bombin A, Romero R, Hornero R, Martin R. Clinical tool to measure fluorescein patterns in orthokeratology. PeerJ 2022; 10:e14068. [PMID: 36172500 PMCID: PMC9512001 DOI: 10.7717/peerj.14068] [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: 07/28/2022] [Accepted: 08/26/2022] [Indexed: 01/20/2023] Open
Abstract
Background Orthokeratology (ortho-k) is an overnight clinical contact lens wear technique to correct myopia and to reduce myopia progression wearing reverse-geometry rigid gas-permeable lenses. The lens fitting procedure in clinical practice usually requires subjective assessment of fluorescein pattern (fluorescein "bull's eye" pattern). The aim of this study was to develop a novel tool for fluorescein pattern measurements to reduce subjective practitioner dependency, especially in inexperienced practitioners, in ortho-k practice. Methods A new MATLAB customized algorithm to measure the horizontal width of the four main zones of ortho-k fluorescein patterns (central bearing, tear reservoir, mid-peripheral bearing and edge lift) was designed. The algorithm was tested on a small image database consisting of 26 ortho-k fluorescein pattern images of 13 volunteers fitted with reverse geometry lenses (Seefree, Conoptica-Hecht Contactlinsen). The agreement between two independent observers and the ImageJ measurements was determined. Results The new clinical tool provided similar measurements to ImageJ software for the central bearing (4.20 ± 0.74 and 4.27 ± 0.69 mm; P = 0.21), tear reservoir (1.69 ± 0.41 and 1.69 ± 0.45 mm; P = 0.69), mid-peripheral bearing (1.17 ± 0.11 and 1.13 ± 0.10 mm; P < 0.01) and edge lift (0.48 ± 0.06 and 0.48 ± 0.06 mm; P = 0.81) zones. Good agreement between the software (limits of agreement lower than ±0.55 mm) and inter-observer measurements (limits of agreement lower than ±0.66 mm) was found. Conclusions The proposed clinical tool for semiautomatic fluorescein pattern measurements in ortho-k could help to reduce practitioner dependency in fluorescein pattern assessment with future potential to introduce prediction algorithms or artificial intelligence methods in myopia control management.
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Affiliation(s)
| | | | - Roberto Romero
- Biomedical Engineering Group, Universidad de Valladolid, Valladolid, Spain
| | - Roberto Hornero
- Biomedical Engineering Group, Universidad de Valladolid, Valladolid, Spain
| | - Raul Martin
- School of Optometry, Universidad de Valladolid, Valladolid, Spain,Biomedical Engineering Group, Universidad de Valladolid, Valladolid, Spain,IOBA Eye Institute, Universidad de Valladolid, Valladolid, Spain
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46
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Zhu MJ, Ding L, Du LL, Chen J, He XG, Li SS, Zou HD. Photopic pupil size change in myopic orthokeratology and its influence on axial length elongation. Int J Ophthalmol 2022; 15:1322-1330. [PMID: 36017053 DOI: 10.18240/ijo.2022.08.15] [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: 06/28/2021] [Accepted: 02/25/2022] [Indexed: 11/23/2022] Open
Abstract
AIM To explore the photopic pupil size behavior in myopic children undergoing overnight orthokeratology (ortho-k) over 1-year period and its effects on the axial elongation. METHODS A total of 202 Chinese myopic children were enrolled in this prospective clinical trial. Ninety-five subjects in ortho-k group and eighty-eight subjects in spectacle group completed the 1-year study. Axial length (AL) was measured before enrollment and every 6mo after the start of ortho-k. The photopic pupil diameter (PPD) was determined using the Pentacam AXL and measured in an examination room with lighting of 300-310 Lx. Stepwise multiple linear regression analysis was used to identify variables contribution to axial elongation. RESULTS Compared with spectacle group, the average 1-year axial elongation was significantly slower in the ortho-k group (0.25±0.27 vs 0.44±0.23 mm, P<0.0001). In ortho-k group, PPDs significantly decreased from 4.21±0.62 mm to 3.94±0.53 mm after 1mo of lens wear (P=0.001, Bonferroni correction) and the change lasts for 3-month visit. No significantly change during the other follow-up visits was found (P>0.05, Bonferroni correction). The 4.81 mm PPD may be a possible cutoff point in the ortho-k group. Subjects with PPD below or equal to 4.81 mm tended to have smaller axial elongation compared to subjects with PPD above 4.81 mm after 1-year period (t=-3.09, P=0.003). In ortho-k group, univariate analyses indicated that those with older age, greater degree of myopia, longer AL, smaller baseline PPD (PPDbaseline) experienced a smaller change in AL. In multivariate analyses, older age, greater AL and smaller PPDbaseline were associated with smaller increases in AL. In spectacle group, PPD tended to be stable (P>0.05, Bonferroni correction) and did not affect axial growth. CONCLUSION PPDs experience significantly decreases at 1-month and 3-month ortho-k treatment. Children with smaller PPD tend to experience slower axial elongation and may benefit more from ortho-k.
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Affiliation(s)
- Meng-Jun Zhu
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Li Ding
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Lin-Lin Du
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Jun Chen
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Xian-Gui He
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Shan-Shan Li
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Hai-Dong Zou
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China.,Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai 200080, China
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47
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Fan Y, Zuo L, Ma J, Peng Z, Li Y, Wang K, Zhao M. An investigation into the causes of abnormal waste of Ortho-K lenses. Front Public Health 2022; 10:981573. [PMID: 36045728 PMCID: PMC9421076 DOI: 10.3389/fpubh.2022.981573] [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: 06/29/2022] [Accepted: 07/28/2022] [Indexed: 01/25/2023] Open
Abstract
Purpose To investigate the reasons for wasting orthokeratology (OK) lenses due to breakage or loss, provide more comprehensive guidelines for the clinical care of lenses and minimize time and costs for patients due to excessive broken and lost lenses. Methods A survey was administered to clinic outpatients who had broken or lost their OK lenses before the regularly scheduled replacement cycle (1-1.5 years). The association between the frequency of OK lens breakage and daily care was assessed using Fisher's exact test and multivariable ordered logistic regression analysis. Results A total of 306 valid questionnaires were collected. Among the subjects, 141 were male, and 165 were female, with a mean age of 10.57 ± 2.00 years (range: 6-18 years). In the investigation of the causes of OK lens waste, 81.4% of the patients reported lens breakage, 13.1% lost their lenses, and 5.6% of patients experienced both fragmentation and lens loss. More than half of the patients (52.90%) used incorrect lens cleaning techniques. In further analysis of the relationship between the frequency of OK lens fragmentation within a year and daily care habits, a significant difference was observed between the caregiver (P = 0.03) and whether the lenses were cleaned promptly after removal (P < 0.001). Mothers as daily caregivers of OK lenses had a lower frequency of fragmentation in a year compared to nanny or grandparents (P = 0.014, OR = 0.33, 95% CI = 0.13, 0.80). The failure to clean the lenses according to eye care practitioners' guidance was a risk factor for the frequent breakage of OK lenses (P < 0.001. OR = 5.29, 95% CI = 3.15, 8.89). Conclusions The causes of OK lens waste were mainly attributed to caregivers, care practices and some unexpected situations that can be avoided through optometrists' reminders. Regardless of the reasons for noncompliant behavior leading to breakage or loss of OK lenses, all of the complications can probably be addressed by better and more frequent reinforcement of care procedures by practitioners. Better clinical guidance measures and more frequent reminders could prevent a large proportion of abnormal waste of OK lenses.
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Affiliation(s)
- Yuzhuo Fan
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China,Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing, China,College of Optometry, Peking University Health Science Center, Beijing, China,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Lili Zuo
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing, China,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Jiahui Ma
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing, China,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Zisu Peng
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing, China,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Yan Li
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing, China,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Kai Wang
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China,Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing, China,College of Optometry, Peking University Health Science Center, Beijing, China,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China,*Correspondence: Kai Wang
| | - Mingwei Zhao
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China,Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing, China,College of Optometry, Peking University Health Science Center, Beijing, China,Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China,Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
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48
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Wang W, Peng S, Zhang F, Zhu B, Zhang L, Tan X. Progression of Vision in Chinese School-Aged Children Before and After COVID-19. Int J Public Health 2022; 67:1605028. [PMID: 36032274 PMCID: PMC9402781 DOI: 10.3389/ijph.2022.1605028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/14/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives: To investigate the changes of vision, including the prevalence of myopia, hyperopia, poor vision, and the spherical equivalent refraction (SER), in school-aged children before and after the pandemic of Coronavirus Disease 2019 (COVID-19). Methods: A school-based vision screening study was performed on children in 133 primary schools in Wuhan. This study was conducted in 4 consecutive years (2018–2021). Results: A total of 468,094 children (936,188 eyes) were recruited, 255,863 (54.7%) were boys. The SER decreased in 2020 compared to other years after the age of 10. A positive myopia shift was found in younger children aged 6 (0.1 D), 7 (0.05D), and 8 (0.03 D) in 2020 compared to 2019. The progression of vision has improved slightly in 2021. Among the students included in the study, 33.7% were myopia. Conclusion: The vision of older children decreased significantly during the COVID-19. After the pandemic, there is still a high risk for them. In the future, the focus on vision prevention and control should move forward to preschool children.
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Affiliation(s)
- Wenjing Wang
- School of Public Health, Wuhan University, Wuhan, China
| | | | - Faxue Zhang
- School of Public Health, Wuhan University, Wuhan, China
| | - Boya Zhu
- School of Public Health, Wuhan University, Wuhan, China
| | | | - Xiaodong Tan
- School of Public Health, Wuhan University, Wuhan, China
- *Correspondence: Xiaodong Tan,
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49
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Ma J, Wu F, Liu Z, Fang Y, Chu X, Zheng L, Xue A, Nan K, Qu J, Cheng L. Biomechanical Considerations of Patching Material for Posterior Scleral Reinforcement Surgery. Front Med (Lausanne) 2022; 9:888542. [PMID: 35652073 PMCID: PMC9149161 DOI: 10.3389/fmed.2022.888542] [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: 03/03/2022] [Accepted: 04/22/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To characterize biomechanical properties of genipin-crosslinked human dura mater as reinforcing material for posterior scleral reinforcement (PSR) and to compare it with crosslinked human sclera. Methods Donor dura mater and sclera were crosslinked in the same optimized genipin solution. Resistance to enzyme degradation for both materials were investigated by exposing the materials to accelerated enzyme degrading. Elastic modulus and tensile strength were measured by biomechanics testing equipment. Crosslinked human dura mater was used as reinforcing patch in PSR on 57 adult pathologic myopic eyes. The patients were followed up for an average 3 years. The main outcome was eye globe axial length change and safety profile of the reinforcing material. Results Crosslinked dura mater demonstrated similar percentage weight loss to crosslinked sclera when exposed to enzymatic solution. Dura mater has higher density than sclera. The retaining elastic modulus after enzyme exposure was 72.02 MPa for crosslinked dura mater while 53.88 MPa for crosslinked sclera, 34% greater for crosslinked dura mater, P = 0.0186). At the end of 3 years follow-up, the mean globe axis of the surgery eyes was reduced by 1.29 mm (from 30.81 to 29.51 mm, P < 0.0001, paired t-test). Visual acuity (BCVA logMar) improved by 0.10 logMar unit which is an improvement of five letters (P = 0.0184, paired t-test). No material specific complication was noted. Conclusion Crosslinked human dura mater may be superior to crosslinked human sclera as reinforcing material for PSR to manage progression of high myopia. This material was well tolerated on human eye.
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Affiliation(s)
- Jinlei Ma
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Fangyuan Wu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Zhiyong Liu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Yijiong Fang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Xu Chu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Linyan Zheng
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Anquan Xue
- Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Kaihui Nan
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Jia Qu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Lingyun Cheng
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,Jacobs Retina Center at Shiley Eye Institute, University of California, San Diego, La Jolla, La Jolla, CA, United States
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50
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Tsai HR, Wang JH, Huang HK, Chen TL, Chen PW, Chiu CJ. Efficacy of atropine, orthokeratology, and combined atropine with orthokeratology for childhood myopia: A systematic review and network meta-analysis. J Formos Med Assoc 2022; 121:2490-2500. [DOI: 10.1016/j.jfma.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 04/27/2022] [Accepted: 05/10/2022] [Indexed: 11/26/2022] Open
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