Relationship between peripheral refraction, axial lengths and parental myopia of young adult myopes

Natural Course of Refractive Error in Congenital Stationary Night Blindness: Implications for Myopia Treatment

Purpose

A range of pharmacological and optical therapies are being studied and implemented in children with myopia to reduce the progression of myopia. At present, the efficacy of these myopia reduction treatments in children with underlying inherited retinal disorders (IRDs) is largely unknown. To evaluate this efficacy, it is essential to first understand the natural progression of myopia within each distinct underlying IRD. We investigated the natural course of refractive error throughout childhood in patients with congenital stationary night blindness (CSNB) of the Schubert-Bornschein type.

Methods

We retrospectively assessed a total of 295 refraction measurements in 127 patients with CSNB (48 with "complete" CSNB [CSNB1] and 79 with "incomplete" CSNB [CSNB2]) at different ages between 0 and 21 years old. None had a history of myopia control treatment. A linear mixed effects model was fitted on the data to analyze the natural course of refraction in these patients.

Results

The fitted model showed that refractive error in patients with CSNB increases quickly toward myopia in the first years of life. After the age of 4 years, there was a minimal progression of only -0.12 diopters (D) per year up to 15 years, after which the refraction seemed stable. All (43/43) of the patients with CSNB1 aged > 4 years were myopic and 84% (62/74) of the patients with CSNB2 aged > 4 years were myopic at the last refraction measurement.

Conclusions

In general, the refractive error of children with CSNB changes minimally after the age of 4 years old. A critical approach to myopia control interventions in these children is warranted.

Peripheral refraction of young adults with myopia: a cross-sectional study

OBJECTIVE

Peripheral refraction is associated with myopia development. Due to a varying prevalence of myopia across different ethnic groups, the aim of the present study was to investigate the peripheral refraction profile in an Arabic population.

METHODS

Adults attending an optometry clinic were recruited into this cross-sectional study. Peripheral refraction of the right eyes was measured using an open field autorefractor under noncycloplegic conditions along the temporal-nasal meridians (15° and 35°) in participants with emmetropia, or low, moderate, or high myopia. Refractions were converted into power vector components, including the spherical equivalent of central refraction, J0 and J45 astigmatism. STROBE guidelines were followed for study reporting.

RESULTS

A total of 138 adults (aged 20-29 years) were enrolled. Relative peripheral refractive error (RPRE) varied between refractive groups and increased with eccentricity. The RPRE was more hyperopic in myopia groups, with the nasal visual field being more hyperopic. A significant relationship was found between RPRE and central refraction, but not with J0 and J45 scores.

CONCLUSIONS

Participants with moderate myopia exhibited more hyperopic RPRE compared with previous findings in other ethnic groups. Hyperopic RPRE was significantly associated with myopia. Accurate RPRE measurement are essential for designing personalized lenses to slow down myopia progression. This study provides an RPRE baseline in the population investigated, which will be useful for future studies on personalized lens design, including spectacles and contact lenses.

Analysis of the peripheral refraction in myopic adults using a novel multispectral refraction topography

Purpose

To determine the distribution and characteristics of peripheral refraction in adults with myopia using the novel multispectral refraction topography.

Method

A total of 187 adults with myopia were recruited for this study. This study was conducted in two stages. Part I: participants were divided into 6 groups based on the central refraction of the right eyes, Part II: according to the interocular differences in refractive error (IOD) of the central refraction, we divided the participants into isomyopia group (IOD<1.00 D) and anisomyopia group (IOD≥1.0 D). We surveyed the characteristics of peripheral refraction and relative peripheral refraction (RPR), as well as the correlation between RPR and central refraction, age, sex, and axial length.

Result

Part I: With an increase in the degree of myopia, relative peripheral hyperopia developed from the center to the periphery. A statistically significant hyperopia shift compared to the center (P < 0.05) was first observed on the temporal side within a 40° field of view at the posterior pole of the retina. The RPR of the temporal, superior, and inferior retinas positively correlated only with age. Part II: In the isomyopic participants, there was no difference in peripheral refraction between the eyes (P < 0.05). In the anisomyopic participants, the RPR of the more myopic eyes was more hyperopic than that of the less myopic eyes in NRDV40-50, SRDV10-20, SRDV30-50, TRDV20-30, TRDV40-50, and IRDV10-40.

Conclusion

With an increase in the degree of myopia, relative peripheral hyperopia developed from the center to the periphery, and peripheral refraction progressed at different rates in various retinal zones.

Effect of defocus incorporated multiple segments lenses on halting myopia progression not responding to low-concentration atropine (0.01%) eye drops

To assess the effect of defocus incorporated multiple segments (DIMS) (Miyosmart) lenses on myopic progression in children not responding to low-concentration atropine (LCA) (0.01%) eye drops. A total of 10 children not responding to LCA (0.01%) eye drops were advised to start using the DIMS lens to halt the progression of myopia. The children were followed for a period of 1 year. Eight out of 10 children showed a reduction in the progression of myopia. Pre DIMS, the progression was -0.68 D ± 0.3 D sph, which reduced to -0.24 ± 0.2 diopter progression post DIMS lens in the eight children. The remaining two children still progressed by -0.57 ± 0.4 D sph over a year. The axial length growth reduced from 0.28 ± 0.3 mm to 0.16 ± 0.2 mm after using the DIMS lens in these non-responders. The DIMS lens shows initial promise in reducing the progression of myopia even in children not responding to LCA 0.01% eye drops.

Bibliometric analysis of hotspots and trends of global myopia research

AIM

To gain insights into the global research hotspots and trends of myopia.

METHODS

Articles were downloaded from January 1, 2013 to December 31, 2022 from the Science Core Database website and were mainly statistically analyzed by bibliometrics software.

RESULTS

A total of 444 institutions in 87 countries published 4124 articles. Between 2013 and 2022, China had the highest number of publications (n=1865) and the highest H-index (61). Sun Yat-sen University had the highest number of publications (n=229) and the highest H-index (33). Ophthalmology is the main category in related journals. Citations from 2020 to 2022 highlight keywords of options and reference, child health (pediatrics), myopic traction mechanism, public health, and machine learning, which represent research frontiers.

CONCLUSION

Myopia has become a hot research field. China and Chinese institutions have the strongest academic influence in the field from 2013 to 2022. The main driver of myopic research is still medical or ophthalmologists. This study highlights the importance of public health in addressing the global rise in myopia, especially its impact on children's health. At present, a unified theoretical system is still needed. Accurate surgical and therapeutic solutions must be proposed for people with different characteristics to manage and intervene refractive errors. In addition, the benefits of artificial intelligence (AI) models are also reflected in disease monitoring and prediction.

The Prevalence of Optical Coherence Tomography Artifacts in High Myopia and its Influence on Glaucoma Diagnosis

PRCIS

Optical coherence tomography (OCT) artifacts occur much more frequently in highly myopic eyes compared with non-highly myopic eyes. A longer axial length is predictive of having OCT artifacts.

PURPOSE

To investigate the types and prevalence of artifacts on OCT scans in patients with and without high myopia.

MATERIALS AND METHODS

Patients were divided into 4 groups based on whether they had glaucoma and/or high myopia. All peripapillary retinal nerve fiber layer (RNFL) scan images were individually inspected for the presence of artifacts.

RESULTS

Two hundred twenty-six patients were enrolled. The prevalence of OCT artifacts was 18.6% in non-high myopes and 51.9% in high myopes ( P <0.001). Outer RNFL border misidentification was the most common type of artifact for non-high myopes, whereas retinal pathology-related artifact was the most common in high myopes. Univariable regression analysis showed that a longer axial length [odds ratio (OR) 1.815, P <0.001], a higher pattern standard deviation (OR 1.194, P <0.001), and thinner RNFL (OR 0.947, P <0.001) were predictive factors for the presence of OCT artifacts. The diagnostic capability of global RNFL thickness before and after manual correction of segmentation errors did not differ for both non-high myopes [area under the receiver operating curve 0.915-0.913 ( P =0.955)] and high myopes [area under the receiver operating curve 0.906-0.917 ( P =0.806)].

CONCLUSION

The prevalence of OCT artifacts was the highest in patients with both high myopia and glaucoma. The most common type of OCT artifact is different for non-high myopes and high myopes. Physicians need to be aware of a higher likelihood of OCT artifacts, particularly in those with a longer axial length, worse visual field, and thinner RNFL thickness.

Myopia – a 21st-century pandemic leaving our children shortsighted?

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Nasal-temporal asymmetric changes in retinal peripheral refractive error in myopic adolescents induced by overnight orthokeratology lenses

Objective

To observe the changes in peripheral refraction in myopic adolescents after overnight orthokeratology and its influencing factors.

Methods

This was a prospective study among young myopic adolescents aged 8-14 years (n = 21). The peripheral refraction of the subjects was measured at 5, 10, 15, 20, 25, and 30° from the nasal and temporal side to the central fixation by WAM-5500 Open-field refractometer. The axial length, baseline spherical equivalent refraction, and other parameters were measured. The data were measured at baseline and 1, 3, and 12 months after wearing orthokeratology lenses.

Results

The relative peripheral refraction at the nasal and temporal side from central to 30° eccentricity revealed relative hyperopic defocus in all subjects at baseline measurement. One month after wearing the orthokeratology lenses, the relative peripheral refraction changed to myopic defocus, the nasal-temporal relative peripheral refraction was asymmetric, and the observed difference was statistically significant. Positive correlations were found between the change amount of nasal relative peripheral refraction and baseline spherical equivalent refraction, the baseline nasal relative peripheral refraction was higher than that on the temporal side, and after orthokeratology, the value of nasal relative peripheral refraction was lower than that on the temporal side. The changes at 30° on both sides were correlated to the axial elongation (r_Nasal = 0.565, r_Temporal = 0.526, p < 0.05).

Conclusion

This study demonstrated that after orthokeratology, relative peripheral hyperopia in the myopic patients turned into relative peripheral myopia, and the nasal-temporal asymmetry changed significantly after orthokeratology, which was correlated with the baseline refractive state.