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Effect of Myopic Undercorrection on Habitual Reading Distance in Schoolchildren: The Hong Kong Children Eye Study. Ophthalmol Ther 2023; 12:925-938. [PMID: 36574139 PMCID: PMC10011230 DOI: 10.1007/s40123-022-00628-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/28/2022] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION This study aimed to evaluate the habitual reading distance among non-myopic children and also myopic children with undercorrection and with full correction. METHODS This was a population-based cross-sectional study with a total of 2363 children aged 6-8 years who were recruited from the Hong Kong Children Eye Study. Cycloplegic autorefraction, subjective refraction, habitual visual acuity, and best corrected visual acuity were measured. The entire reading process (9 min) was recorded using a hidden video camera placed 5 m away from the reading desk. Reading distances were taken at 6, 7, 8, and 9 min after the child began reading and were measured using a customized computer program developed in MATLAB. The main outcome was the association of habitual reading distances with refraction status. Habitual reading distances of children were documented via video camera footage. RESULTS The habitual reading distances of undercorrected myopic children (23.37 ± 4.31 cm) were the shortest when compared to non-myopic children (24.20 ± 4.73 cm, P = 0.002) and fully corrected myopic children (24.81 ± 5.21 cm, P < 0.001), while there was no significant difference between the last two children groups (P = 0.17). A shorter reading distance was associated with myopia (OR 1.67; 95% CI 1.11-2.51; P = 0.013) after adjusting for age, sex, height, near work time, outdoor time, and parental myopia. The association of reading distance with myopia did not hold after undercorrected myopic children were excluded (OR 0.97, 95% CI 0.55-1.73; P = 0.92). A shorter reading distance correlated with poorer vision under habitual correction (β = - 0.003, P < 0.001). CONCLUSION A shorter reading distance was present among undercorrected myopic children. Myopia undercorrection is not recommended as a strategy for slowing myopic progression.
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Yi Z, Jie G, Kai C, Jing S, Wei Z, Yun D. Theoretical derivation and clinical validation of the resolution limit of human eye to spherical lens change: a self-controlled study. Int Ophthalmol 2022; 43:1387-1394. [PMID: 36167944 PMCID: PMC10113289 DOI: 10.1007/s10792-022-02538-5] [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: 05/23/2022] [Accepted: 09/15/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of this study was to deduce theoretically and verify the resolution limit of human eye to spherical lens change for more reasonable design of the trial lenses. METHODS A total of 119 normal subjects with different myopia (not more than - 6D) were included. First, the resolution limit of discernible change in spherical power was derived based on the optical model. Then, the subjects were observed to see if they could perceive the changes in spherical power as per the resolution limit and compare the difference in the best-corrected visual acuity obtained with the resolution limit and interval of 0.25D. RESULTS Assuming that the cone cell diameter is 3 μm and the pupil diameter of 4 mm, the theoretically resolution limit was 0.05D. When the diopter of spherical power was increased, the ratios of ability to perceive 0.05D spherical lens change were 98.3% and 96.7% in right and left eyes. When the diopter of spherical power was decreased, the ratios of ability to perceive 0.05D spherical lens change were 78.9% and 83.2% in right and left eyes. The best-corrected visual acuity obtained with the 0.05 D interval trial lens was significantly better than in the 0.25 D interval on both eyes (Right eye - 0.04 ± 0.07 vs - 0.02 ± 0.06, p < 0.001; Left eye - 0.07 ± 0.06 vs - 0.04 ± 0.06, t = 8.825, p < 0.001). CONCLUSION The resolution limit of human eye to spherical lens change was about 0.05D and the better corrected visual acuity can be obtained by adjusting the spherical power at an interval of 0.05D. TRIAL REGISTRATION NUMBER ChiCTR2100047074. Date of registration: 2021/6/7.
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Affiliation(s)
- Zhen Yi
- National Engineering Research Center for Ophthalmology, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang, Beijing, 100730, Dongcheng, China.
| | - Gao Jie
- National Engineering Research Center for Ophthalmology, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang, Beijing, 100730, Dongcheng, China
| | - Cao Kai
- National Engineering Research Center for Ophthalmology, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang, Beijing, 100730, Dongcheng, China
| | - Shen Jing
- National Engineering Research Center for Ophthalmology, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang, Beijing, 100730, Dongcheng, China
| | - Zhang Wei
- National Engineering Research Center for Ophthalmology, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang, Beijing, 100730, Dongcheng, China
| | - Dai Yun
- Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection With TCM, Eye School of Chengdu University of TCM, Jinniu District, No. 8, Xinghui West Road, Chengdu, 610084, China
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Myopia: Mechanisms and Strategies to Slow Down Its Progression. J Ophthalmol 2022; 2022:1004977. [PMID: 35747583 PMCID: PMC9213207 DOI: 10.1155/2022/1004977] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/29/2022] [Indexed: 12/15/2022] Open
Abstract
This topical review aimed to update and clarify the behavioral, pharmacological, surgical, and optical strategies that are currently available to prevent and reduce myopia progression. Myopia is the commonest ocular abnormality; reinstated interest is associated with high and increasing prevalence, especially but not, in the Asian population and progressive nature in children. The growing global prevalence seems to be associated with both genetic and environmental factors such as spending more time indoor and using digital devices, particularly during the coronavirus disease 2019 pandemic. Various options have been assessed to prevent or reduce myopia progression in children. In this review, we assess the effects of several types of measures, including spending more time outdoor, optical interventions such as the bifocal/progressive spectacle lenses, soft bifocal/multifocal/extended depth of focus/orthokeratology contact lenses, refractive surgery, and pharmacological treatments. All these options for controlling myopia progression in children have various degrees of efficacy. Atropine, orthokeratology/peripheral defocus contact and spectacle lenses, bifocal or progressive addition spectacles, and increased outdoor activities have been associated with the highest, moderate, and lower efficacies, respectively.
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Prousali E, Haidich AB, Dastiridou A, Tzamalis A, Ziakas N, Mataftsi A. Part-time Versus Full-time Spectacles for Myopia Control (ParMA Study): A Randomized Clinical Trial. Cureus 2022; 14:e25995. [PMID: 35720776 PMCID: PMC9202340 DOI: 10.7759/cureus.25995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2022] [Indexed: 11/05/2022] Open
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Noi S, Shikano A, Imai N, Tamura F, Tanaka R, Kidokoro T, Yoshinaga M. The Changes in Visual Acuity Values of Japanese School Children during the COVID-19 Pandemic. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9030342. [PMID: 35327714 PMCID: PMC8947095 DOI: 10.3390/children9030342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 02/26/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic may result in a greater decrease in visual acuity (VA) among Japanese children. Our study aimed to examine Japanese children’s VA during the pandemic. VA data were collected using standard eye tests during school health check-ups conducted in 2019 and 2020 on 5893 children, in seven public elementary schools and four public junior high schools in Tokyo, Saitama, Kanagawa, and Shizuoka. VA changes were statistically analyzed. The relationship between the survey year and poor VA yielded a significant regression coefficient for the surveyed years in elementary and junior high school students. The 2019 VA value and VA change from 2019 to 2020 demonstrated a significant regression coefficient in elementary school students with VAs of “B (0.7−0.9)” and “C (0.3−0.6)”, and junior high school students with VAs of “B”, “C”, and “D (<0.3)”. An analysis of the relationship between the survey year and eye laterality of VA yielded a significant regression coefficient in the surveyed years for elementary (OR, 1.516; 95% CI, 1.265−1.818) and junior high school students (OR, 1.423; 95% CI, 1.136−1.782). Lifestyle changes during the COVID-19 pandemic might have affected VA and eye laterality in Japanese children.
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Affiliation(s)
- Shingo Noi
- Research Institute for Health and Sport Science, Nippon Sport Science University, Tokyo 158-8508, Japan; (A.S.); (R.T.); (T.K.)
- Correspondence:
| | - Akiko Shikano
- Research Institute for Health and Sport Science, Nippon Sport Science University, Tokyo 158-8508, Japan; (A.S.); (R.T.); (T.K.)
| | - Natsuko Imai
- Doctoral Program in Health and Sport Science, Nippon Sport Science University, Tokyo 158-8508, Japan;
| | - Fumie Tamura
- Masterl Program in Health and Sport Science, Nippon Sport Science University, Tokyo 158-8508, Japan;
| | - Ryo Tanaka
- Research Institute for Health and Sport Science, Nippon Sport Science University, Tokyo 158-8508, Japan; (A.S.); (R.T.); (T.K.)
- School of Health and Sport Sciences, Osaka University of Health and Sport Sciences, Osaka 590-0496, Japan
| | - Tetsuhiro Kidokoro
- Research Institute for Health and Sport Science, Nippon Sport Science University, Tokyo 158-8508, Japan; (A.S.); (R.T.); (T.K.)
| | - Mari Yoshinaga
- Faculty of Pharmaceutical Science, Showa Pharmaceutical University, Tokyo 194-8543, Japan;
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Rasmussen SB, Møller F, Jakobsen TM. Achieving Optimal Correction for Young Myopic Children: A Concept Study. Biomed Hub 2022; 7:17-23. [DOI: 10.1159/000521135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 11/19/2021] [Indexed: 11/19/2022] Open
Abstract
The purpose of this article is to explore alternative ways of achieving optimal correction for myopic children who cannot cooperate to subjective manifest refraction (SR). The study included myopic children aged 9–12 years who underwent non-cycloplegic SR and autorefraction with and without cycloplegia using the Shin-Nippon Nvision-K 5001 autorefractor (AR) as well as non-cycloplegic autorefraction using the Topcon KR-800S AR. There were 21 children (mean age, 10.62 years) included. The spherical equivalent refractive error of SR was not significantly different from that of non-cycloplegic AR measurements, but it was significantly different from that of cycloplegic Shin-Nippon Nvision-K 5001 measurements (<i>p</i> < 0.001). Compared with SR, cycloplegic Shin-Nippon Nvision-K 5001 measured a less myopic refractive error (median: −2.44 D vs. −2.88 D, <i>p</i> < 0.001). For both ARs, the axis measurements and astigmatic dioptre values between SR and autorefraction were not significantly different. Compared with non-cycloplegic SR, cycloplegic measurements showed a lesser degree of myopic refractive error. There was no significant difference between SR and non-cycloplegic autorefraction. Therefore, the Topcon KR-800S and the Shin-Nippon Nvision-K 5001 ARs may be useful for prescribing glasses in myopic children who cannot cooperate during SR. However, caution should be taken with cylinders <0.75 D because the agreement in axis between SR and AR measurement is poor. Therefore, in such cases, we suggest to add half the cylinder to the spherical component.
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Jiménez R, Redondo B, Galán T, Machado P, Molina R, Vera J. Impact of dual-focus soft contact lens wear on near work-induced transient myopia. Clin Exp Optom 2022; 106:296-302. [PMID: 35073496 DOI: 10.1080/08164622.2022.2029684] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
CLINICAL RELEVANCE Dual-focus soft contact lenses are effective in slowing myopia progression; however, their influence on near work-induced transient myopia (NITM) remains unknown. When performing a 5-min near task at 20 cm, we observed that dual-focus soft contact lens wear induced greater lags of accommodation and a lower initial NITM than single-vision soft contact lenses, which provides relevant information for better understanding the impact of using this optical design on the accommodative function. BACKGROUND NITM has been proposed as a myogenic factor, although it is a matter of debate by the scientific community. The main objective of this study was to assess the short-term effect of wearing dual-focus soft contact lenses for myopia control on the steady-state accommodative response and NITM. METHODS Twenty-four young myope adults wore, on two different days, dual-focus and single-vision soft contact lenses, while the accommodative response was dynamically measured with an open-field autorefractor during the execution of the NITM task. The shift and the time required to recover baseline levels in the refractive state after performing the 5-min near task (20 cm) were the main dependent variables. RESULTS We found a lower magnitude of accommodation during the execution of the near task with the dual-focus in comparison to the single-vision soft contact lenses (p < 0.001). There was a lower initial NITM with the dual-focus when compared to the single-vision lenses (corrected p-value = 0.003, Cohen's d = 0.68), but no statistically significant differences were observed for decay duration (p = 0.984). CONCLUSIONS Dual-focus soft contact lens wear causes a reduced accommodative response during a near task, and an initial small myopic shift at distance after a 5-min period of near viewing. The current findings may help to understand the mechanisms involved in myopia control with this optical strategy.
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Affiliation(s)
- Raimundo Jiménez
- Claro (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Beatriz Redondo
- Claro (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Tomás Galán
- Claro (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Pedro Machado
- Claro (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Rubén Molina
- Claro (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
| | - Jesús Vera
- Claro (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Granada, Spain
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Medina A. The cause of myopia development and progression: Theory, evidence, and treatment. Surv Ophthalmol 2021; 67:488-509. [PMID: 34181975 DOI: 10.1016/j.survophthal.2021.06.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 10/21/2022]
Abstract
I review the key findings and our current knowledge of the cause of myopia, making the connections among the reliable observations on myopia development and theory to arrive at a summary of what we know about myopia, the proposed prevailing theory, and applicable action. Myopia is reaching epidemic proportions. It is estimated that half of the world's population will be myopic by 2050 unless new strategies to fight myopia are developed. Our high-level mathematical description of myopia is translated into clinical applications involving effective treatment and prevention. A regulating mechanism controlling the refraction of the eye is intimately related to myopia. The approach at hand is to review our knowledge about emmetropization, connecting myopia and emmetropization feedback theory to unveil the cause of myopia. Many observations discussed here test the validity of feedback theory positively. The cause of human myopia fits perfectly with the idea that emmetropization, in particular its feedback theory implementation, is the controlling mechanism behind myopia. They include near work, atropine, lenses, defocus, and outdoor versus indoor activities. The key findings in myopia research point the same way: myopia is the result of corrective lenses interfering with emmetropization. We have enough knowledge to answer the question of whether myopia can be reversed or prevented. There is no need to have mathematical skills to apply theory to real cases. It is enough to know the predictions of the feedback theory of emmetropization.
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Affiliation(s)
- Antonio Medina
- Massachusetts Institute of Technology, Cambridge, Massachusetts, USA; Multivision Research, California, USA.
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Morgan IG, Rose KA. Myopia: is the nature‐nurture debate finally over? Clin Exp Optom 2021; 102:3-17. [DOI: 10.1111/cxo.12845] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 09/10/2018] [Accepted: 09/12/2018] [Indexed: 02/06/2023] Open
Affiliation(s)
- Ian G Morgan
- Research School of Biology, Australian National University, Canberra, Australian Capital Territory, Australia,
- State Key Laboratory of Ophthalmology and Division of Preventive Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‐Sen University, Guangzhou, China,
| | - Kathryn A Rose
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia,
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Lin Z, Vasudevan B, Gao T, Zhou H, Ciuffreda KJ, Liang Y. Refractive change and incidence of myopia among rural Chinese children: the Handan Offspring Myopia Study. Br J Ophthalmol 2021; 106:628-632. [PMID: 33441318 DOI: 10.1136/bjophthalmol-2020-317811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/03/2020] [Accepted: 12/07/2020] [Indexed: 11/04/2022]
Abstract
PURPOSE To assess the refractive change and incidence of myopia, as well as their risk factors, among Chinese rural children aged 6-17 years. METHODS Children who completed the baseline vision examination of the Handan Offspring Myopia Study were re-examined, including both cycloplegic and non-cyloplegic autorefraction, with a mean follow-up time of 42.4±1.47 months. RESULTS A total of 601 children (68.5%) who completed both baseline and the follow-up examinations were enrolled. The cumulative refractive change and axial length change were -0.53±1.03 diopter and 0.39±0.46 mm (-0.15 diopter/year and 0.11 mm/year), respectively. A hundred and five out of the 469 non-myopic children at baseline become myopic at the follow-up, yielding a cumulative myopia incidence of 22.4% (95% CI: 18.6% to 26.2%), or annual myopia incidence of 6.3%. After adjustment, younger age (β=0.08, p<0.001), more myopic baseline refraction (β=0.31, p<0.001), larger difference between cycloplegic and non-cycloplegic refraction (β=-0.20, p=0.007) and more myopic paternal refraction (β=0.09, p=0.007) were found to be associated with more rapid myopic refractive change. More myopic baseline refraction (relative risk (RR), 95% CI: 0.19, 0.13-0.28, p<0.001) and more myopic paternal refraction (RR, 95% CI: 0.92, 0.84-1.00, p=0.039) were also associated with myopia incidence. CONCLUSION Relatively low myopic refractive change and myopia incidence were found in this study cohort. Children's refraction and paternal refraction were associated with both myopic refractive change and myopia incidence. Such information will be helpful for further comparisons in other rural versus urban areas of China, and other countries.
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Affiliation(s)
- Zhong Lin
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | | | | | - Hongjia Zhou
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Kenneth J Ciuffreda
- Department of Biological and Vision Sciences, SUNY College of Optometry, New York, NY, USA, New York, NY, USA
| | - Yuanbo Liang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China .,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
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Yazdani N, Sadeghi R, Ehsaei A, Taghipour A, Hasanzadeh S, Zarifmahmoudi L, Heravian Shandiz J. Under-correction or full correction of myopia? A meta-analysis. JOURNAL OF OPTOMETRY 2021; 14:11-19. [PMID: 32507615 PMCID: PMC7752985 DOI: 10.1016/j.optom.2020.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 03/23/2020] [Accepted: 04/11/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE To compare the effect of full-correction versus under-correction on myopia progression. METHODS A literature search was performed in PubMed, Scopus, Science Direct, Ovid, Web of Science and Cochrane library. Methodological quality assessment of the literature was evaluated according to the Critical Appraisal Skills Program. Statistical analysis was performed using Comprehensive Meta-Analysis (version 2, Biostat Inc., USA). RESULTS The present meta-analysis included six studies (two randomized controlled trials [RCTs] and four non-RCTs) with 695 subjects (full-correction group, n=371; under-correction group, n=324) aged 6 to 33 years. Using cycloplegic refraction, the pooled difference in mean of myopia progression was - 0.179 D [lower and higher limits: -0.383, 0.025], which was higher but not in full correction group as compared to under correction group (p=0.085). Regarding studies using non-cycloplegic subjective refraction according to maximum plus for maximum visual acuity, the pooled difference in myopia progression was 0.128 D [lower and higher limits: -0.057, 0.312] higher in under-correction group compared with full-correction group (p=0.175). Although, difference in myopia progression did not reach significant level in either cycloplegic or non-cycloplegic refraction. CONCLUSIONS Our findings suggest that, myopic eyes which are fully corrected with non-cycloplegic refraction with maximum plus sphere, are less prone to myopia progression, in comparison to those which were under corrected. However, regarding cycloplegic refraction, further studies are needed to better understand these trends.
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Affiliation(s)
- Negareh Yazdani
- Refractive Errors Research Center, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ramin Sadeghi
- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Asieh Ehsaei
- Refractive Errors Research Center, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Taghipour
- Health Sciences Research Centre, Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Samira Hasanzadeh
- Refractive Errors Research Center, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Leili Zarifmahmoudi
- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Javad Heravian Shandiz
- Refractive Errors Research Center, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran.
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Ma Y, Zhang X, Li H, Ma X, Friesen D, Rozelle S, Pang X, Zhou M, Congdon N. Safety of eyeglasses wear for visual acuity among middle school students in northwestern rural China: a cluster-randomised controlled trial. BMJ Open Ophthalmol 2020; 5:e000572. [PMID: 33083554 PMCID: PMC7528428 DOI: 10.1136/bmjophth-2020-000572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 09/03/2020] [Accepted: 09/05/2020] [Indexed: 11/04/2022] Open
Abstract
Objective To assess the effect of free eyeglasses provision on visual acuity among middle school students in northwestern rural China. Methods and analysis Among 31 middle schools randomly selected from 47 middle schools in northwestern rural China, students were randomly allocated by school to one of two interventions: free eyeglasses (intervention group), and eyeglasses prescriptions given only to the parents (control group). The main outcome of this study is uncorrected visual acuity after 9 months, adjusted for baseline visual acuity. Results Among 2095 students from 31 middle schools, 995 (47.5%) failed the visual acuity screening, 515 (51.8%, 15 schools) of which were randomly assigned to the intervention group, with the remaining 480 students (48.2%, 16 schools) assigned to the control group. Among these, a total of 910 students were followed up and analysed. Endline eyeglasses wear in the intervention group was 44%, and 36% in the control group. Endline visual acuity of students in the intervention group was significantly better than students in the control group, adjusting for other variables (0.045 LogMAR units, 95% CI 0.006 to 0.084, equivalent to 0.45 lines, p=0.027), and insignificantly better only for baseline visual acuity (difference of 0.008 LogMAR units, 95% CI -0.018 to 0.034, equivalent to 0.08 lines). Conclusion We found no evidence that receiving free eyeglasses worsened visual acuity among middle school students in northwestern rural China. Trial registration number ISRCTN17141957.
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Affiliation(s)
- Yue Ma
- Rural Education Action Program, Stanford University Freeman Spogli Institute for International Studies, Stanford, California, USA
| | - Xinwu Zhang
- School of Public Administration, Northwest University, Xi'an, Shaanxi, China
| | - Haoyang Li
- Rural Education Action Program, Stanford University Freeman Spogli Institute for International Studies, Stanford, California, USA
| | - Xiaochen Ma
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Dimitris Friesen
- Rural Education Action Program, Stanford University Freeman Spogli Institute for International Studies, Stanford, California, USA
| | - Scott Rozelle
- Rural Education Action Program, Stanford University Freeman Spogli Institute for International Studies, Stanford, California, USA
| | - Xiaopeng Pang
- School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China
| | - Ming Zhou
- School of Public Administration, Northwest University, Xi'an, Shaanxi, China
| | - Nathan Congdon
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.,Centre for Public Health, School of Medicine, Dentistry, and Biomedical Sciences, Queen's University Belfast, Ireland, England
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13
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Zhang X, Zhou M, Ma X, Yi H, Zhang H, Wang X, Jin L, Naidoo K, Minto H, Zou H, Rozelle S, Congdon N, Ma Y. Impact of spectacles wear on uncorrected visual acuity among urban migrant primary school children in China: a cluster-randomised clinical trial. Br J Ophthalmol 2020; 105:761-767. [PMID: 32727732 DOI: 10.1136/bjophthalmol-2020-316213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/27/2020] [Accepted: 06/13/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To estimate the effect of providing free spectacles on uncorrected visual acuity (VA) among urban migrant Chinese school children. DESIGN Exploratory analysis from a parallel cluster-randomised clinical trial. METHODS After baseline survey and VA screening, eligible children were randomised by school to receive one of the two interventions: free glasses and a teacher incentive (tablet computer if ≥80% of children given glasses were wearing them on un-announced examination) (treatment group) or glasses prescription and letter to parents (control group). The primary outcome was uncorrected logarithm of the minimal angle of resolution (LogMAR) VA at study closeout, adjusted for baseline uncorrected VA. RESULTS Among 4376 randomly selected children, 728 (16.6%, mean age 10.9 years, 51.0% boys) at 94 schools failed VA screening and met eligibility criteria. Of these, 358 children (49.2%) at 47 schools were randomised to treatment and 370 children (50.8%) at 47 schools to control. Among these, 679 children (93.3%) completed follow-up and underwent analysis. Spectacle wear in the treatment and control groups was 68.3% and 29.3% (p<0.001), respectively. Uncorrected final VA for eyes of treatment children was significantly better than control children, adjusting only for baseline VA (difference of 0.039 LogMAR units, 95% CI: 0.008, 0.070, equivalent to 0.39 lines, p=0.014) or baseline VA and other baseline factors (0.040 LogMAR units, 95% CI 0.007 to 0.074, equivalent to 0.40 lines, p=0.020). CONCLUSION We found no evidence that spectacles wear worsens children's uncorrected VA among urban migrant Chinese school children.
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Affiliation(s)
- Xinwu Zhang
- School of Public Administration, Northwest University, Xi'an, China
| | - Ming Zhou
- School of Public Administration, Northwest University, Xi'an, China
| | - Xiaochen Ma
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Hongmei Yi
- Center for Chinese Agricultural Policy, Peking University, Beijing, China
| | - Haiqing Zhang
- College of Economics and Management, Shanghai Ocean University, Shanghai, China
| | - Xiuqin Wang
- Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Ling Jin
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Kovin Naidoo
- African Vision Research Institute, University of Kwazulu-Natal, Durban, South Africa.,Brien Holden Vision Institute, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Hasan Minto
- Brien Holden Vision Institute, Sydney, Australia
| | - Haidong Zou
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
| | - Scott Rozelle
- Rural Education Action Program, Freeman Spogli Institute for International Studies, Stanford University, CA, USA
| | - Nathan Congdon
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Centre for Public Health, School of Medicine, Dentistry, and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Yue Ma
- Rural Education Action Program, Freeman Spogli Institute for International Studies, Stanford University, CA, USA
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14
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Liu X, Ye L, Chen C, Chen M, Wen S, Mao X. Evaluation of the Necessity for Cycloplegia During Refraction of Chinese Children Between 4 and 10 Years Old. J Pediatr Ophthalmol Strabismus 2020; 57:257-263. [PMID: 32687211 DOI: 10.3928/01913913-20200407-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/30/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine the effect of atropine cycloplegia on the refractive status of children aged 4 to 10 years and to evaluate the necessity of cycloplegia for different refractive states and ages during refractive correction. METHODS This retrospective study included patients with low, moderate, and high myopia and hyperopia who were divided into two groups by age: 4 to 6 years (n = 5,320) and 7 to 10 years (n = 6,475). Every patient underwent cycloplegia with atropine sulphate. Refractive errors were measured by retinoscopy. RESULTS Within each group, the differences between cycloplegic and non-cycloplegic refractive errors (DIFFC-N) were significant. DIFFC-N was negatively correlated with age (r = -0.356, P < .001). The differences in refractive error between prescribed glasses and non-cycloplegic refraction (DIFFG-N) were largest in the groups with high myopia (0.83 ± 1.15 diopters [D] in the 4 to 6 years group and 0.60 ± 1.47 D in the 7 to 10 years group). After cycloplegia, 62.5% of the patients with mild myopia became emmetropic or hyperopic in the 4 to 6 years group, and 11.3% of the patients with mild myopia became emmetropic or hyperopic in the 7 to 10 years group. CONCLUSIONS Without cycloplegia, autorefraction tends to overestimate refractive error in children with myopia. For accurate glasses prescriptions, cycloplegia should be used for children between 4 and 10 years, especially for children with high myopia. [J Pediatr Ophthalmol Strabismus. 2020;57(4):257-263.].
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15
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García García M, Breher K, Ohlendorf A, Wahl S. To Correct or Not Correct? Actual Evidence, Controversy and the Questions That Remain Open. J Clin Med 2020; 9:jcm9061975. [PMID: 32599775 PMCID: PMC7356996 DOI: 10.3390/jcm9061975] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 06/19/2020] [Accepted: 06/23/2020] [Indexed: 12/31/2022] Open
Abstract
Clinical studies and basic research have attempted to establish a relationship between myopia progression and single vision spectacle wear, albeit with unclear results. Single vision spectacle lenses are continuously used as the control group in myopia control trials. Hence, it is a matter of high relevance to investigate further whether they yield any shift on the refractive state, which could have been masked by being used as a control. In this review, eye development in relation to eyes fully corrected versus those under-corrected is discussed, and new guidelines are provided for the analysis of structural eye changes due to optical treatments. These guidelines are tested and optimised, while ethical implications are revisited. This newly described methodology can be translated to larger clinical trials, finally exerting the real effect of full correction via single vision spectacle lens wear on eye growth and myopia progression.
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Affiliation(s)
- Miguel García García
- Carl Zeiss Vision International GmbH, ZEISS Group, Turnstrasse 27, 73430 Aalen, Germany; (A.O.); (S.W.)
- Ophthalmic Research Institute, Elfriede-Aulhorn-Straße 7, 72076 Tuebingen, Germany;
- Correspondence:
| | - Katharina Breher
- Ophthalmic Research Institute, Elfriede-Aulhorn-Straße 7, 72076 Tuebingen, Germany;
| | - Arne Ohlendorf
- Carl Zeiss Vision International GmbH, ZEISS Group, Turnstrasse 27, 73430 Aalen, Germany; (A.O.); (S.W.)
- Ophthalmic Research Institute, Elfriede-Aulhorn-Straße 7, 72076 Tuebingen, Germany;
| | - Siegfried Wahl
- Carl Zeiss Vision International GmbH, ZEISS Group, Turnstrasse 27, 73430 Aalen, Germany; (A.O.); (S.W.)
- Ophthalmic Research Institute, Elfriede-Aulhorn-Straße 7, 72076 Tuebingen, Germany;
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16
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Wang R, Wu H. Re: Role of un-correction, under-correction and over-correction of myopia as a strategy for slowing myopic progression. Clin Exp Optom 2020; 103:397. [PMID: 32270522 DOI: 10.1111/cxo.13071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
- Ruiqing Wang
- Department of Optometry, The Second Hospital of Jilin University, Changchun, China
| | - Huang Wu
- Department of Optometry, The Second Hospital of Jilin University, Changchun, China
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17
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Logan NS, Wolffsohn JS. Role of un-correction, under-correction and over-correction of myopia as a strategy for slowing myopic progression. Clin Exp Optom 2019; 103:133-137. [PMID: 31854025 DOI: 10.1111/cxo.12978] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 09/09/2019] [Indexed: 12/14/2022] Open
Abstract
This systematic review investigates the association between un-, under- and over-correction of myopic refractive error and myopia progression in children and adolescents (up to 18 years of age). The literature search included three databases (PubMed, Web of Science, and Cochrane Central Register of Controlled Trials [CENTRAL]), and reference lists of retrieved studies in any language. Eight prospective cohort studies and one retrospective analysis of clinical data provided comparison data on un- and under-correction of myopia versus full-correction of myopia; however, the quality of studies and length of follow-up times varied. A forest plot showed no beneficial effect of under-correction with some studies finding an increase in myopia progression. While one study suggested that myopia progression is slower in an un-corrected cohort compared to those who are fully corrected, another study suggests the opposite. One study utilised anisomyopes to allow comparison of under-correction of one eye with full-correction of the fellow eye indicating that under-correction in one eye appears to slow the rate of myopia progression in that eye. Another study on full-correction only in one eye found that progression was faster in the un-corrected eye. No benefits of over-correction of myopia was found. The overall findings are equivocal with under-correction causing a faster rate of myopia progression. There is no strong evidence of benefits from un-correction, monovision or over-correction. Hence, current clinical advice advocates for the full-correction of myopia. Further studies are warranted to determine the level of myopia that can be left uncorrected without impacting on myopia progression and how this changes with time.
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Affiliation(s)
- Nicola S Logan
- Aston Optometry School, Aston University, Birmingham, UK
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18
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Prousali E, Haidich AB, Fontalis A, Ziakas N, Brazitikos P, Mataftsi A. Efficacy and safety of interventions to control myopia progression in children: an overview of systematic reviews and meta-analyses. BMC Ophthalmol 2019; 19:106. [PMID: 31072389 PMCID: PMC6506938 DOI: 10.1186/s12886-019-1112-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 04/22/2019] [Indexed: 02/07/2023] Open
Abstract
Background Myopia is a common visual disorder with increasing prevalence. Halting progression of myopia is critical, as high myopia can be complicated by a number of vision-compromising conditions. Methods Literature search was conducted in the following databases: Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica dataBASE (EMBASE), Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE) and Centre for Reviews and Dissemination (CRD) Health Technology Assessment (HTA) database. Systematic reviews and meta-analyses investigating the efficacy and safety of multiple myopia interventions vs control conditions, were considered. Methodological quality and quality of evidence of eligible studies were assessed using the ROBIS tool and GRADE rating. The degree of overlapping of index publications in the eligible reviews was calculated with the corrected covered area (CCA). Results Forty-four unique primary studies contained in 18 eligible reviews and involving 6400 children were included in the analysis. CCA was estimated as 6.2% and thus considered moderate. Results demonstrated the superior efficacy of atropine eyedrops; 1% atropine vs placebo (change in refraction: -0.78D, [− 1.30 to − 0.25] in 1 year), 0.025 to 0.05% atropine vs control (change in refraction: -0.51D, [− 0.60 to − 0.41] in 1 year), 0.01% atropine vs control (change in refraction: -0.50D, [− 0.76 to − 0.24] in 1 year). Atropine was followed by orthokeratology (axial elongation: − 0.19 mm, [− 0.21 to − 0.16] in 1 year) and novel multifocal soft contact lenses (change in refraction: -0.15D, [− 0.27 to − 0.03] in 1 year). As regards adverse events, 1% atropine induced blurred near vision (odds ratio [OR] 9.47, [1.17 to 76.78]) and hypersensitivity reactions (OR 8.91, [1.04 to 76.03]). Conclusions Existing evidence has failed to convince doctors to uniformly embrace treatments for myopic progression control, possibly due to existence of some heterogeneity, reporting of side effects and lack of long-term follow-up. Research geared towards efficient interventions is still necessary. Electronic supplementary material The online version of this article (10.1186/s12886-019-1112-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Efthymia Prousali
- 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Department of Hygiene, Social-Preventive Medicine and Medical Statistics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anna-Bettina Haidich
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Fontalis
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Herries Rd, Sheffield, UK
| | - Nikolaos Ziakas
- 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Periklis Brazitikos
- 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Asimina Mataftsi
- 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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19
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Omar IAN. Effect of bilberry extract on slowing high-myopia progression in children: 2-year follow-up study. Clin Ophthalmol 2018; 12:2575-2579. [PMID: 30587903 PMCID: PMC6296196 DOI: 10.2147/opth.s187949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Aim To evaluate the effect of oral Difrarel on progression of high myopia in children and to study myopia course after its discontinuation. Methods A total of 64 highly myopic children were enrolled in this study. Patients were divided into two equal groups: group 1 was administered Difrarel for 1 year and stopped its intake for another year, and group 2 (control) did not take Difrarel. Refraction and axial length of the right eye of every subject were measured every 6 months in both groups. Results Each group had 32 eyes of 32 patients. The mean age was 9.34±2.27 years in group 1 and 9.33±2.2 years in group 2. Mean refraction and axial length at the start of the study were −10.78±2.6 D and 23.7±1.2 mm, respectively, in group 1, and −10.5±2.55 D and 23.9±1.4 mm in group 2. Refraction and axial length measurements every 6 months revealed statistically significant lower numbers in group 1 than group 2 after 1 year. After discontinuation of the drug, the difference between both groups remained significant. Conclusion Oral Difrarel slowed axial elongation and stopped myopia progression in children with high myopia. The drug effect was consistent after its discontinuation for 1 year.
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20
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Kang P. Optical and pharmacological strategies of myopia control. Clin Exp Optom 2018; 101:321-332. [PMID: 29488240 DOI: 10.1111/cxo.12666] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 11/21/2017] [Accepted: 01/04/2018] [Indexed: 12/21/2022] Open
Abstract
Recent increases in global myopia prevalence rates have raised significant concerns as myopia increases the lifelong risk of various sight-threatening ocular conditions. This growing public health burden has generated significant research interests into understanding both its aetiology and developing effective methods to slow down or stop its development, methods collectively termed 'myopia control'. The growing body of research has demonstrated benefits of various optical and pharmacological treatments resulting in myopia control management increasingly becoming a part of main stream clinical practice. This review will discuss the peer-reviewed literature on the efficacy of various myopia control interventions including multifocal spectacles and contact lenses, orthokeratology and pharmaceutical eye drops, as well as potential future research directions.
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Affiliation(s)
- Pauline Kang
- School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia
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21
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Refractive Errors & Refractive Surgery Preferred Practice Pattern®. Ophthalmology 2018; 125:P1-P104. [DOI: 10.1016/j.ophtha.2017.10.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 10/02/2017] [Indexed: 11/19/2022] Open
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22
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Kim JH, Kim CR, Yoo JM. Myopia Progression of Full Correction and Undercorrection with Myopic Anisometropia. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.2.164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Ji Hye Kim
- Department of Ophthalmology, Gyeongsang National University College of Medicine, Jinju, Korea
| | | | - Ji Myong Yoo
- Department of Ophthalmology, Gyeongsang National University College of Medicine, Jinju, Korea
- Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, Korea
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23
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Arumugam B, Hung LF, To CH, Sankaridurg P, Smith EL. The Effects of the Relative Strength of Simultaneous Competing Defocus Signals on Emmetropization in Infant Rhesus Monkeys. Invest Ophthalmol Vis Sci 2017; 57:3949-60. [PMID: 27479812 PMCID: PMC4978150 DOI: 10.1167/iovs.16-19704] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Purpose We investigated how the relative surface area devoted to the more positive-powered component in dual-focus lenses influences emmetropization in rhesus monkeys. Methods From 3 to 21 weeks of age, macaques were reared with binocular dual-focus spectacles. The treatment lenses had central 2-mm zones of zero-power and concentric annular zones that had alternating powers of either +3.0 diopters (D) and 0 D (+3 D/pL) or −3.0 D and 0 D (−3 D/pL). The relative widths of the powered and plano zones varied from 50:50 to 18:82 between treatment groups. Refractive status, corneal curvature, and axial dimensions were assessed biweekly throughout the lens-rearing period. Comparison data were obtained from monkeys reared with binocular full-field single-vision lenses (FF+3D, n = 6; FF−3D, n = 10) and from 35 normal controls. Results The median refractive errors for all of the +3 D/pL lens groups were similar to that for the FF+3D group (+4.63 D versus +4.31 D to +5.25 D; P = 0.18–0.96), but significantly more hyperopic than that for controls (+2.44 D; P = 0.0002–0.003). In the −3 D/pL monkeys, refractive development was dominated by the zero-powered portions of the treatment lenses; the −3 D/pL animals (+2.94 D to +3.13 D) were more hyperopic than the FF−3D monkeys (−0.78 D; P = 0.004–0.006), but similar to controls (+2.44 D; P = 0.14–0.22). Conclusions The results demonstrate that even when the more positive-powered zones make up only one-fifth of a dual-focus lens' surface area, refractive development is still dominated by relative myopic defocus. Overall, the results emphasize that myopic defocus distributed across the visual field evokes strong signals to slow eye growth in primates.
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Affiliation(s)
- Baskar Arumugam
- College of Optometry, University of Houston, Texas, United States 2Brien Holden Vision Institute, Sydney, Australia
| | - Li-Fang Hung
- College of Optometry, University of Houston, Texas, United States 2Brien Holden Vision Institute, Sydney, Australia
| | - Chi-Ho To
- Center for Myopia Research, School of Optometry, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong 4State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat Sen University, Guangzhou, People's Republic of China
| | | | - Earl L Smith
- College of Optometry, University of Houston, Texas, United States 2Brien Holden Vision Institute, Sydney, Australia
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24
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Lin Z, Vasudevan B, Ciuffreda KJ, Zhou HJ, Mao GY, Wang NL, Liang YB. The difference between cycloplegic and non-cycloplegic autorefraction and its association with progression of refractive error in Beijing urban children. Ophthalmic Physiol Opt 2017; 37:489-497. [PMID: 28503812 DOI: 10.1111/opo.12381] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 02/20/2017] [Indexed: 01/18/2023]
Abstract
PURPOSE To investigate the difference between cycloplegic and non-cycloplegic autorefraction and its association with the progression of refractive error in Beijing urban children. METHODS A total of 386 children aged 6-17 years were enrolled in the baseline investigation of the Beijing Myopia Progression Study in 2010. They were invited for follow-up vision examinations in the years 2011, 2012, and 2013, including cycloplegic (cyclopentolate 1%, three times) autorefraction. We investigated the difference between the cycloplegic spherical equivalent (SE) and the non-cycloplegic SE (DSE) provided by autorefraction and its association with refractive error progression. The progression of refractive error was defined as the difference between the cycloplegic SE at follow-up and at baseline. RESULTS Two hundred and nineteen children (57%) with completed refractive data (mean ± standard deviation: -1.36 ± 2.44 D at baseline) were ultimately enrolled. The DSE reduced from 0.51 ± 0.72 D at baseline to 0.19 ± 0.43 D in the third year of follow-up (p = 0.01). The baseline DSE was positively associated with the children's baseline cycloplegic refraction (β = 0.193 dioptre dioptre-1 , p < 0.001). After further divided by refractive status, the DSE was consistently higher in the hyperopic group than in either the emmetropic or myopic groups at each follow-up (all p < 0.001). In the multivariate regression analysis, the myopic children with larger baseline DSE (β = -0.404 dioptre dioptre-1 , p = 0.01) exhibited more myopic refractive change. However, baseline DSE was not found to be a significant risk factor (relative risk, 95% confidence interval: 1.06, 0.79-1.41) for those with newly developed myopia. CONCLUSION In this sample, the children's DSE was found to be increased as the hyperopic refraction increased. Furthermore, greater the DSE was associated with the progression of refractive error among the myopic children, but not with the onset of myopia.
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Affiliation(s)
- Zhong Lin
- School of Ophthalmology and Optometry, The Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | | | - Kenneth J Ciuffreda
- Department of Biological and Vision Sciences, SUNY College of Optometry, New York, USA
| | - Hong Jia Zhou
- School of Ophthalmology and Optometry, The Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Guang Yun Mao
- School of Ophthalmology and Optometry, The Eye Hospital, Wenzhou Medical University, Wenzhou, China.,School of Environmental Science & Public Health, Wenzhou Medical University, Wenzhou, China
| | - Ning Li Wang
- Beijing Ophthalmology & Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yuan Bo Liang
- School of Ophthalmology and Optometry, The Eye Hospital, Wenzhou Medical University, Wenzhou, China.,Centre for Public Health, Queen's University, Belfast, UK
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25
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Changes in Peripheral Refraction, Higher-Order Aberrations, and Accommodative Lag With a Radial Refractive Gradient Contact Lens in Young Myopes. Eye Contact Lens 2017; 42:380-387. [PMID: 26808699 DOI: 10.1097/icl.0000000000000222] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE To evaluate changes in the peripheral refraction (PR), visual quality, and accommodative lag with a novel soft radial refractive gradient (SRRG) experimental contact lens that produces peripheral myopic defocus. METHODS 59 myopic right eyes were fitted with the lens. The PR was measured up to 30° in the nasal and temporal horizontal visual fields and compared with values obtained without the lens. The accommodative lag was measured monocularly using the distance-induced condition method at 40 cm, and the higher-order aberrations (HOAs) of the entire eye were obtained for 3- and 5-mm pupils by aberrometry. Visual performance was assessed through contrast sensitivity function (CSF). RESULTS With the lens, the relative PR became significantly less hyperopic from 30° to 15° temporally and 30° nasally in the M and J0 refractive components (P<0.05). Cylinder foci showed significant myopization from 30° to 15° temporally and 30° to 25° nasally (P<0.05). The HOAs increased significantly, the CSF decreased slightly but reached statistical significance for 6 and 12 cycles per degree (P<0.05), and the accommodative lag decreased significantly with the SRRG lens (P=0.0001). There was a moderate correlation between HOAs and CSF at medium and high spatial frequencies. CONCLUSION The SRRG lens induced a significant change in PR, particularly in the temporal retina. Tangential and sagittal foci changed significantly in the peripheral nasal and temporal retina. The decreased accommodative lag and increased HOAs particularly in coma-like aberration may positively affect myopia control. A longitudinal study is needed to confirm this potential.
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26
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Bio-environmental factors associated with myopia: An updated review. ACTA ACUST UNITED AC 2017; 92:307-325. [PMID: 28162831 DOI: 10.1016/j.oftal.2016.11.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 11/27/2016] [Accepted: 11/29/2016] [Indexed: 12/12/2022]
Abstract
Experimental studies in animals, as well as observational and intervention studies in humans, seem to support the premise that the development of juvenile myopia is promoted by a combination of the effect of genetic and environmental factors, with a complex interaction between them. The very rapid increase in myopia rates in some parts of the world, such as Southeast Asia, supports a significant environmental effect. Several lines of evidence suggest that humans might respond to various external factors, such as increased activity in near vision, increased educational pressure, decreased exposure to sunlight outdoors, dietary changes (including increased intake of carbohydrates), as well as low light levels indoors. All these factors could be associated with a higher prevalence of myopia.
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27
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Greene PR, Medina A. Juvenile Myopia. Predicting the Progression Rate. MATHEWS JOURNAL OF OPHTHALMOLOGY 2017; 2:012. [PMID: 30701217 PMCID: PMC6349255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Regression plots are generated showing the strong correlation of myopia onset age with its progression rate, r = -0.77, p<0.0025, and strong correlation of accumulated myopia 5 years after onset, r = -0.78, p < 0.001. Theory is confirmed, with all subjects showing excellent correlation coefficients, <r> = -0.971, p < 0.005. Myopia progression rates vary from 0.2 to 1.0 diopters (D) per year from one individual to the next. Age of onset for myopia is 10.6 yrs. +/-5.4 yrs. Initial refraction at onset is -1.14 D +/-0.55 D. Practical applications of this work include delaying correction for myopes, and juvenile susceptibility to myopia at various age levels. Feedback Theory predicts the results.
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Affiliation(s)
- Peter R Greene
- B.G.K.T. Consulting Ltd. Bioengineering Huntington, New York
| | - Antonio Medina
- Massachusetts Institute of Technology, Research Laboratory of Electronics, Cambridge, Mass, 02139
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Sun YY, Li SM, Li SY, Kang MT, Liu LR, Meng B, Zhang FJ, Millodot M, Wang N. Effect of uncorrection versus full correction on myopia progression in 12-year-old children. Graefes Arch Clin Exp Ophthalmol 2016; 255:189-195. [DOI: 10.1007/s00417-016-3529-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 09/04/2016] [Accepted: 10/17/2016] [Indexed: 11/25/2022] Open
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Galvis V, Tello A, Parra MM. Safety of Spectacles for Children's Vision: A Cluster-Randomized Controlled Trial. Am J Ophthalmol 2016; 163:196. [PMID: 26920622 DOI: 10.1016/j.ajo.2015.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 12/18/2015] [Indexed: 10/22/2022]
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Galvis V, Tello A, Blanco O, Parra MM. Refractive correction and myopia progression. Graefes Arch Clin Exp Ophthalmol 2016; 254:407-8. [PMID: 26228439 DOI: 10.1007/s00417-015-3108-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 07/18/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
- Virgilio Galvis
- Centro Oftalmologico Virgilio Galvis, Floridablanca, Colombia.,Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia
| | - Alejandro Tello
- Centro Oftalmologico Virgilio Galvis, Floridablanca, Colombia. .,Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia. .,Centro Oftalmologico Virgilio Galvis, Centro Medico Ardila Lulle, Torre A, Piso 3, Modulo 7. Floridablanca, Santander, Colombia.
| | - Oscar Blanco
- Centro Oftalmologico Virgilio Galvis, Floridablanca, Colombia.,Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia
| | - M Margarita Parra
- Centro Oftalmologico Virgilio Galvis, Floridablanca, Colombia.,Universidad Autonoma de Bucaramanga, Bucaramanga, Colombia
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Detecting the effect of under-correcting myopia. Graefes Arch Clin Exp Ophthalmol 2015; 254:409-10. [DOI: 10.1007/s00417-015-3111-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 07/18/2015] [Indexed: 10/23/2022] Open
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Medina A. The progression of corrected myopia. Graefes Arch Clin Exp Ophthalmol 2015; 253:1273-7. [PMID: 25863670 DOI: 10.1007/s00417-015-2991-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 03/04/2015] [Accepted: 03/13/2015] [Indexed: 10/23/2022] Open
Abstract
PURPOSE This study seeks to demonstrate the existence of a feedback loop controlling myopia by comparing the prediction of a feedback model to the actual progression of corrected myopia. In addition to theoretical results, confirming clinical data are presented. METHODS The refraction of 13 continuously corrected myopic eyes was collected over a period of time ranging from 4 to 9 years from the time of their first correction. Refractive data was collected in an optometry office from myopic young subjects from the general population in Boston. Subjects were myopes, ages 2 to 22 at the time of first correction selected randomly from a larger population. All individuals were fully corrected with lenses; new lenses were prescribed every time that their myopia increased by 0.25 diopters or more. Subjects wore their spectacle lenses during the followed period. RESULTS Subjects exhibit a linear time course of myopia progression when corrected with lenses. The observed rate of myopia increase is 0.2 to 1.0 diopters/year, with a mean correlation coefficient r = -0.971, p < 0.005. CONCLUSIONS This report establishes that feedback control theory applies to the clinical phenomenon of progressive myopia. Continuous correction of myopia results in a linear progression that increases myopia. The Laplace transformation of temporal refractive data to the s-domain simplifies the study of myopia and emmetropia. The feedback transfer function predicts that continuous correction of myopia results in a linear progression because continuous correction opens the feedback loop. This prediction is confirmed with all subjects.
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Affiliation(s)
- Antonio Medina
- Massachusetts Institute of Technology, Research Laboratory of Electronics, Cambridge, MA, 02139, USA,
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Abstract
Purpose Myopia has increased worldwide during recent years and is becoming a serious public health problem. In East Asia, the prevalence can reach 80% of the population. The focus for screening and interventions should be on early life during childhood when myopia progression is faster. Methods Review and discussion of the recent literature on potential interventions for preventing the development of myopia or slowing its progression. Results Increased time spent outdoors is a protective factor for myopia progression. Undercorrection increased myopia progression and optimal correction is mandatory. The use of progressive or bifocal lenses (spectacles or contact lenses) may yield a slowing of myopia by limiting eye accommodation. Rigid gas permeable contact lenses were found to have few effects on myopic eye growth. A marked slowing of myopia was observed with orthokeratology by temporarily changing the curvature radius of the cornea. The largest positive effects for slowing myopia progression were observed with atropine eyedrops with an interesting dose effect. The benefit of surgical scleral reinforcement is reserved for severe and progressive myopia. Conclusions In this review, we discuss optical and pharmacologic interventions that can be used in myopia management.
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