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Yu J, Zhou Y. Effect of Lens Deviation on Peripheral Defocus and Optic Quality in Adolescents With Moderate and Severe Myopia. Eye Contact Lens 2024; 50:375-383. [PMID: 39133174 DOI: 10.1097/icl.0000000000001104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2024] [Indexed: 08/13/2024]
Abstract
OBJECTIVES The aim of this study was to analyze the effects of lens deviation on peripheral defocus and optic quality in adolescents with moderate and severe myopia. METHODS This prospective study enrolled 81 children (81 eyes). The spherical equivalent was -5.0≤SE≤-6.0 diopter. The participants were divided into two subgroups based on their eccentricity (inferior temporal) after wearing the lenses for 12 months. Between them, the low eccentric subgroup (A) had a total eccentric distance of less than 0.5 mm, and the moderate and severe eccentric subgroup (B) had a total eccentric distance of ≥0.5 mm. Peripheral defocus and eccentricity were measured before and after wearing the lenses, and the Spearman test was used to compare the parameters. RESULTS Parameters such as the total peripheral defocus (TRDV) were significantly lower in subgroup B than in subgroup A after 12 months of orthokeratology lens usage. The axial length growth (ΔAL) in subgroup A was higher than that in subgroup B. Axial length growth, TRDV, and other parameters were significantly associated with eccentricity. The modulation transfer function cutoff and Strehl ratio were also significantly associated with eccentricity. CONCLUSIONS Greater eccentricity within a certain range can induce greater periretinal defocus and improve the ΔAL.
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Affiliation(s)
- Jia Yu
- Department of Optometry, Ming Vision and Ophthalmology (J.Y., Y.Z.), Jianguomen Branch Clinic, Beijing, China; and Ineye Hospital of Chengdu University of TCM (Y.Z.), Chengdu, China
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Wang A, Zang W, Shen L, Gao L, Yang C. Comparison of three VST orthokeratology lenses in axial length growth and average corneal reshaping in myopia children: A retrospective self-controlled study. Heliyon 2024; 10:e27562. [PMID: 38515728 PMCID: PMC10955324 DOI: 10.1016/j.heliyon.2024.e27562] [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: 06/14/2023] [Revised: 02/19/2024] [Accepted: 03/01/2024] [Indexed: 03/23/2024] Open
Abstract
Purpose To determine the differences in myopia control efficiency and corneal reshaping between three different brands of orthokeratology (OK) lenses (Lucid, Euclid, and Alpha). Method We retrospectively reviewed subjects who started simultaneously using different brands of OK lenses. For each participant, every 6 months in the 19 months of following, the changes in axial length (AL), horizontal and vertical maximum distances of the treatment zone (HMDTZ and VMDTZ), width of the high convex zone (WHCZ), distance of decentration, and horizontal and vertical components of the decentration vector were measured. The average values of the above data, the average value of the decentration vector (ADV), and the average value of decentration calculated algebraically (ADA) were calculated. Results All the three pairs (Lucid (n = 46) vs. Euclid (n = 46): groups Lucid-versus-Euclid-Lucid (LE-L) and LE-E), Lucid (n = 50) vs. Alpha (n = 50): groups LA-L and LA-A), and Euclid (n = 17) vs. Alpha (n = 17): groups EA-E and EA-A) showed good comparability. Regarding the change in AL during 19 months, none of the pairs showed significant differences (LE-L:0.27 ± 0.24 mm, LE-E:0.31 ± 0.24 mm (p = 0.68); LA-L:0.36 ± 0.26 mm, LA-A:0.36 ± 0.27 mm (p = 0.85); EA-E:0.34 ± 0.27 mm, EA-A:0.41 ± 0.28 mm (p = 0.63)). Regarding treatment zone, Lucid showed the largest HMDTZ and VMDTZ (both p < 0.05). Regarding the WHCZ, none of the pairs showed significant differences. For the ADV and ADA, Lucid had more ADV and ADA than Euclid (ADV: LE-L:0.73 ± 0.44 mm, LE-E:0.55 ± 0.45 mm, p < 0.05; ADA: LE-L:0.80 ± 0.41 mm, LE-E:0.63 ± 0.44 mm, p < 0.05), and the remaining pairs showed no significant difference. For the overall cohort with 113 eyes, the change in AL was weakly correlated with both ADV and ADA (both p < 0.05). Regarding the ADV/ADA, all pairs showed no significant differences, indicating equal lens position stability. Conclusion After OK, there were no significant differences between the different pairs of the three brands in AL growth, WHCZ, or lens position stability, although Lucid had a larger treatment zone than Euclid and Alpha, and Lucid had more decentration than Euclid. A larger lens decentration were weakly related to less AL growth.
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Affiliation(s)
- Anken Wang
- Children's hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Wansheng Zang
- Children's hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Li Shen
- Children's hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Lu Gao
- Children's hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Chenhao Yang
- Children's hospital of Fudan University, National Children's Medical Center, Shanghai, China
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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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Zhang J, Li Z, Cheng Z, Wang T, Shi W. Comparison of the clinical efficacy of orthokeratology and 0.01% atropine for retardation of myopia progression in myopic children. Cont Lens Anterior Eye 2024; 47:102094. [PMID: 37985346 DOI: 10.1016/j.clae.2023.102094] [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: 06/22/2023] [Revised: 11/02/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE To compare the clinical efficacy of orthokeratology (ortho-k) and 0.01% atropine for retardation of myopia progression in myopic children. METHODS This was a retrospective cohort study. A total of 282 patients, aged 8-17 years, were enrolled, including 100 children treated with ortho-k, 84 with 0.01% atropine, and 98 with single-vision spectacles. During the follow-up of 1 year, ortho-k wearers were examined at 1 day, 1 week, 1 month, 3 months after treatment, and thereafter every 3 months, while the others were examined every 3 months by measurements of uncorrected vision, intraocular pressure, refractive power, slit-lamp microscopy, corneal topography, and the lens fitting when necessary. The axial length was measured every 6 months. RESULTS Patients with ortho-k had stable uncorrected vision after 1 month of lens wear, all reaching 0 logMAR. The annual axial elongation was 0.23 ± 0.19 mm, 0.22 ± 0.20 mm, and 0.39 ± 0.27 mm in the ortho-k, atropine, and spectacle groups, respectively, with significant difference (F = 23.251, P = 0.000). The axial length was delayed to increase by 41.03% and 43.59% within a year in patients with ortho-k and atropine, respectively, as compared to patients with spectacles (F = 0.006, P = 0.936). The elongation was ≤ 0.3 mm in 69.0% and 66.7% of patients in the two groups, respectively, versus 38.8% in the spectacle group (χ2 = 17.251, P = 0.000). During the follow-up, the rate of corneal staining was 11.0% and 2.0% in the ortho-k and spectacle groups, respectively (χ2 = 8.076, P = 0.003). The use of atropine did not increase corneal staining, but the incidence of related photophobia was 4.8%. No other serious complications were observed. CONCLUSION Ortho-k lenses and 0.01% atropine can achieve similar efficacy of myopia retardation, which was significantly better than that obtained with single-vision spectacles, in myopic children. The risk of corneal staining after ortho-k wear may be slightly higher than that with spectacles, but could be well controlled.
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Affiliation(s)
- Ju Zhang
- Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China; Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, Shandong, China; School of Ophthalmology, Shandong First Medical University, Jinan, Shandong, China
| | - Zhenzhen Li
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, Shandong, China
| | - Zhiwei Cheng
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, Shandong, China
| | - Ting Wang
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, Shandong, China; School of Ophthalmology, Shandong First Medical University, Jinan, Shandong, China.
| | - Weiyun Shi
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, Shandong, China; School of Ophthalmology, Shandong First Medical University, Jinan, Shandong, China.
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Kuo YK, Chuang LH, Lai CC, Wu PC, Chen SY, Chen HC, Yeung L, Wang NK, Hwang YS, Liu CF. Exploring the Location of Corneal Pigmented Arc and Myopia Control Efficacy in Orthokeratology-Treated Children Using Pentacam Measurements. Eye Contact Lens 2024; 50:84-90. [PMID: 38193846 DOI: 10.1097/icl.0000000000001048] [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: 08/19/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVES To determine the location and intensity of the corneal pigmented arc in orthokeratology (ortho-k)-treated children and its relationship with annual axial length (AL) change using Pentacam. METHODS This retrospective cohort study enrolled children aged 9 to 15 years who had been followed up for at least one year after ortho-k treatment for myopia control. A Pentacam was used to determine the location and intensity of pigmented arc after lens wear. Annual AL changes were further used as the outcome measurement to determine their relationships with the location and intensity of pigmented arc using generalized estimating equations (GEE). RESULTS In total, 62 eyes from 33 patients (mean age 10.9 years) were included in our final analysis. The mean follow-up time was 30.6 months. The mean annual AL changes were 0.10 mm. Age statistically correlated with annual AL change (GEE, P= 0.033). In addition, the annual AL change was negatively associated with the relative vertical distance of the lowest density of pigmented arc point based on the visual center, pupil center, and corneal thinnest point after adjustment with age ( P =0.005, P =0.004, and P< 0.001, respectively). CONCLUSIONS Pentacam could be a useful tool for evaluating the location and intensity of the corneal pigmented arc. In addition, there was a negative correlation between the vertical distance of the pigmented arc and annual AL change. These findings may provide important information regarding myopia control, next-generation ortho-k design, and prescription.
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Affiliation(s)
- Yu-Kai Kuo
- Department of Ophthalmology (Y.-K.K., L.-H.C., C.-C.L., S.-Y.C., L.Y., C.-F.L.), Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine (Y.-K.K., L.-H.C., C.-C.L., P.-C.W., S.-Y.C., H.-C.C., L.Y., Y.-S.H., C.-F.L.), Chang Gung University, Taoyuan, Taiwan; Taiwan Myopia Disease Society (L.-H.C., C.-C.L., P.-C.W., C.-F.L.), Kaohsiung, Taiwan; Department of Ophthalmology (P.-C.W.), Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Department of Ophthalmology (H.-C.C., Y.-S.H.), Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Ophthalmology (N.-K.W.), Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, Columbia University, New York, NY; Department of Ophthalmology (Y.-S.H.), Chang Gung Memorial Hospital, Xiamen Branch, Xiamen, China; Department of Ophthalmology (Y.-S.H.), Jen-Ai Hospital Dali Branch, Taichung, Taiwan; and Institute of Biochemistry and Molecular Biology (C.-F.L.), National Yang-Ming University, Taipei, Taiwan
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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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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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Bullimore MA, Liu M. Efficacy of the Euclid orthokeratology lens in slowing axial elongation. Cont Lens Anterior Eye 2023; 46:101875. [PMID: 37365049 DOI: 10.1016/j.clae.2023.101875] [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: 05/26/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023]
Abstract
PURPOSE The Euclid Emerald lens designs for orthokeratology have been available in global markets for over 20 years and is used extensively by clinicians for slowing myopia progression in children. This paper comprehensively reviews data from published studies of the efficacy of this lens. METHODS A comprehensive systematic search was performed in March 2023 using Medline with the following search terms: orthokeratology AND myopi* AND (axial or elong*) NOT (review or meta). RESULTS The original search identified 189 articles, of which 140 reported axial elongation. Of those, 49 reported data on the Euclid Emerald design. Unique axial elongation data could be extracted from 37 papers-14 of which included an untreated control group. Among these, the mean 12-month efficacy-the difference in axial elongation between orthokeratology wearers and controls-was 0.18 mm (range: 0.05-0.29 mm), and the mean 24-month efficacy was 0.28 mm (range: 0.17-0.38 mm). The orthokeratology wearers in 23 studies without an untreated comparison group showed similar axial elongation to those in the 14 studies with a control group. For example, the mean 12-month axial elongation for the studies with controls was 0.20 ± 0.06 mm compared with 0.20 ± 0.07 mm for the studies without controls. CONCLUSIONS This extensive body of literature on a single device for myopia control is unique and demonstrates the efficacy of this design in slowing axial elongation in myopic children.
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Affiliation(s)
- Mark A Bullimore
- University of Houston, College of Optometry, 4901 Calhoun Rd., Houston, TX 77204, United States.
| | - Maria Liu
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, CA 94720, United States.
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Li J, Hu J, Li X, Tang J, Li Y, Wang K, Zhao M. Long-term variations and influential factors of the treatment zone of wearing orthokeratology lenses. Cont Lens Anterior Eye 2023; 46:101867. [PMID: 37286433 DOI: 10.1016/j.clae.2023.101867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/01/2023] [Accepted: 05/23/2023] [Indexed: 06/09/2023]
Abstract
PURPOSE To investigate the variation trend of the treatment zone (TZ) during 12 months of Orthokeratology (Ortho-K) from the perspective of the treatment zone size (TZS), decentration (TZD) and the weighted Zernike defocus coefficient of the treatment zone (Cweighteddefocus). METHODS 94 patients were included in this retrospective study, who were fitted with a 5-curve vision shaping treatment (VST) lens (n = 44) or a 3-zone corneal refractive therapy (CRT) lens (n = 50). The TZS, TZD and Cweighteddefocus up to 12 months were analyzed. RESULTS TZS (F(4,372) = 10.167, P<0.001), TZD (F(4,372) = 8.083, P<0.001) and Cweighteddefocus (F(4,372) = 7.100, P<0.001) were significantly increased with time during overnight Ortho-K treatment. The TZS increased sharply from 1 week to 1 month of overnight Ortho-K (F = 25.479, P <.001) and stayed smooth then. It showed growing tendency from 6 to 12 months (F = 8.407, P =.005). The TZD (F = 16.637, P <.001) and Cweighteddefocus (F = 13.401, P <.001) increased significantly until 1 month and kept stable until 12 months (all P>0.05). The univariant linear regression analysis showed that TZS of the last visit was correlated with baseline myopia (β = 0.219, P =.034). Also, the greater final Cweighteddefocus was correlated with higher baseline myopia (β = -0.589, P<0.001) and higher corneal astigmatism (β = -0.228, P =.007) at the onset of lens wear with the multiple linear regression. CONCLUSION The TZS, TZD and Cweighteddefocus kept stable after 1 month of Ortho-K while the TZS had an increasing trend after 6 months. Children with higher myopic eyes or higher corneal astigmatism at baseline tended to have smaller TZS and greater Cweighteddefocus at 12 months.
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Affiliation(s)
- Jingxin 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; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China
| | - Jie Hu
- 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; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China
| | - Xuewei 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; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China; Department of Optometry, Institute of Medical Technology, Peking University Health Science Center, Beijing 100044, China
| | - Jiyang Tang
- 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; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, 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; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China; Department of Optometry, Institute of Medical Technology, Peking University Health Science Center, Beijing 100044, China
| | - Kai Wang
- 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; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China; Department of Optometry, Institute of Medical Technology, Peking University Health Science Center, Beijing 100044, China.
| | - Mingwei Zhao
- 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; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China; Department of Optometry, Institute of Medical Technology, Peking University Health Science Center, Beijing 100044, 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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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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Zhang S, Zhang H, Li L, Yang X, Li S, Li X. Effect of treatment zone decentration on axial length growth after orthokeratology. Front Neurosci 2022; 16:986364. [PMID: 36340764 PMCID: PMC9630831 DOI: 10.3389/fnins.2022.986364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/29/2022] [Indexed: 11/14/2022] Open
Abstract
Objective To study the effect of treatment zone (TZ) decentration on axial length growth (ALG) in adolescents after wearing the orthokeratology lenses (OK lenses). Materials and methods This retrospective clinical study selected 251 adolescents who were fitted OK lenses at the Clinical College of Ophthalmology, Tianjin Medical University (Tianjin, China) from January 2018–December 2018 and wore them continuously for >12 months. The age of the subjects was 8–15 years, spherical equivalent (SE): −1.00 to −5.00 diopter (D), and astigmatism ≤ 1.50 D. The corneal topography were recorded at baseline and 1-, 6-, and 12-month visits, and the axial length (AL) were recorded at baseline and 6-, 12-month visits. The data of the right eye were collected for statistical analysis. Results The subjects were divided into three groups according to the decentration distance of the TZ after wearing lenses for 1 month: 56 cases in the mild (<0.5 mm), 110 in the moderate (0.5–1.0 mm), and 85 in the severe decentration group (>1.0 mm). A significant difference was detected in the ALG between the three groups after wearing lenses for 6 and 12 months (F = 10.223, P < 0.001; F = 13.380, P < 0.001, respectively). Among these, the 6- and 12-month ALG of the mild decentration group was significantly higher than that of the other two groups. Multivariable linear regression analysis showed that age, baseline SE, and 1-month decentration distance associated with the 12-month ALG (P < 0.001, P < 0.001, and P = 0.001, respectively). Conclusion The decentration of the TZ of the OK lens affected the growth of the AL in adolescents, i.e., the greater the decentration, the slower the ALG.
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Affiliation(s)
- Shuxian Zhang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin, China
- Tianjin Eye Hospital Optometric Center, Tianjin, China
- Nankai University Affiliated Eye Hospital, Nankai University, Tianjin, China
| | - Hui Zhang
- Tianjin Eye Hospital Optometric Center, Tianjin, China
| | - Lihua Li
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin, China
- Tianjin Eye Hospital Optometric Center, Tianjin, China
| | - Xiaoyan Yang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin, China
- Tianjin Eye Hospital Optometric Center, Tianjin, China
| | - Shumao Li
- Tianjin Eye Hospital Optometric Center, Tianjin, China
| | - Xuan Li
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin, China
- Nankai University Affiliated Eye Hospital, Nankai University, Tianjin, China
- *Correspondence: Xuan Li,
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The Effect of Corneal Refractive Power Area Changes on Myopia Progression during Orthokeratology. J Ophthalmol 2022; 2022:5530162. [PMID: 35757379 PMCID: PMC9225887 DOI: 10.1155/2022/5530162] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/28/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose To investigate the effect of corneal refractive power area changes on myopia progression during orthokeratology. Methods One hundred and sixteen children who met the inclusion criteria and insisted on wearing orthokeratology lenses for two years were retrospectively assessed. Seventy-two children with the orthokeratology lens decentration distance more than 0.5 mm but less than 1.5 mm were in the decentered group, and forty-four children with the orthokeratology lens decentration distance less than 0.5 mm were in the centric group. The orthokeratology decentration via tangential difference topography was analyzed. This study calculated the different power areas in the central 4 mm pupillary area by axial-difference corneal topography, compared the differences of the different power areas between these two groups, and evaluated the relationships between corneal positive-power area, orthokeratology decentration, and AL changes. Results The axial length changes of the centric group presented a statistical difference with the decentered group (0.52 ± 0.37 mm vs. 0.38 ± 0.26 mm; t = 2.403, p=0.018). For all children, both the AL changes (0.43 ± 0.31 mm) and decentration distance (0.64 ± 0.33 mm) showed a significant correlation with the positive-power area (r = −0.366, p < 0.001 and r = 0.624, p < 0.001); AL changes also presented a statistical correlation with decentration distance (r = −0.343, p < 0.001), baseline age (r = −0.329, p < 0.001), and baseline spherical equivalent refractive power (r = 0.335, p < 0.001). In the centric group and decentered group, the AL changes (centric group: r = −0.319, p=0.035; decentered group: r = −0.332, p=0.04) and decentration distance (centric group: r = 0.462, p=0.002; decentered group: r = 0.524, p < 0.001) had a significant correlation with the positive-power area yet. In the multiple regression analysis, AL changes were increased with less baseline age (beta, 0.015; p < 0.001), positive-power area (beta, 0.021; p=0.002), and larger SER (beta, 0.025; p=0.018). Conclusions The corneal positive-power area had a positive impact on affirming AL changes during orthokeratology. This area might be formed by lens decentration to provide an additional myopia-defocusing influence on the retina to achieve better myopia control.
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Li X, Huang Y, Zhang J, Ding C, Chen Y, Chen H, Bao J. Treatment zone decentration promotes retinal reshaping in Chinese myopic children wearing orthokeratology lenses. Ophthalmic Physiol Opt 2022; 42:1124-1132. [PMID: 35598145 PMCID: PMC9544447 DOI: 10.1111/opo.12996] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate whether the treatment zone (TZ) decentration in orthokeratology (OK) lenses affects retinal expansion in Chinese children with myopia. METHODS Children aged 8 to 13 years (n = 30) were assessed over 13 months comprising 12 months of OK lens wear followed by discontinuation of lens wear for 1 month. Corneal topography was measured at 0, 1, 3, 6, 9, 12 and 13 months. TZ decentration of the OK lens was calculated, and subjects were subdivided into a small decentration group (group S) and a large decentration group (group L) based on the median value of the weighted average decentration (dave ). Central axial length (AL) and peripheral eye lengths (PELs) at the central retina, as well as 10°, 20° and 30° nasally and temporally were measured at 0 and 13 months under cycloplegia. Second-order polynomial (y = ax2 + bx + c) and linear fits (y = Kx + B) were applied to the peripheral relative eye length (PREL), and the coefficients 'a' and 'K' were used to describe the shape of the eye. RESULTS Mean AL growth for one year was 0.28 ± 0.17 mm. In a multiple linear regression model, AL elongation was related to the baseline age (β = -0.41, p = 0.01) and the dave (β = -0.37, p = 0.03) (R2 = 0.34, p = 0.002). When compared with smaller dave (0.45 ± 0.15 mm), a larger dave (0.89 ± 0.17 mm) was associated with slower ocular growth (central: 0.20 ± 0.13 mm vs. 0.35 ± 0.17 mm, p = 0.009; 10° nasal: 0.26 ± 0.18 mm vs. 0.45 ± 0.21 mm, p = 0.02; 10° temporal: 0.17 ± 0.14 mm vs. 0.32 ± 0.19 mm, p = 0.02) and more oblate retina shape ('a': -0.13 ± 0.02 vs. -0.14 ± 0.02, p = 0.02; Knasal : 0.35 ± 0.11 vs. 0.39 ± 0.09, p = 0.02; Ktemporal : -0.42 ± 0.08 vs. -0.46 ± 0.08, p = 0.004). CONCLUSIONS Greater TZ decentration with the use of OK lenses was associated with slower axial growth and a more oblate retinal shape. TZ decentration caused local defocusing changes, which may inhibit myopic progression. These findings may have important implications for improving optical designs for myopia control.
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Affiliation(s)
- Xue Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Yingying Huang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Jiali Zhang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Chenglu Ding
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Yunyun Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Hao Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Jinhua Bao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
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Lin W, Gu T, Bi H, Du B, Zhang B, Wei R. The treatment zone decentration and corneal refractive profile changes in children undergoing orthokeratology treatment. BMC Ophthalmol 2022; 22:177. [PMID: 35436922 PMCID: PMC9016930 DOI: 10.1186/s12886-022-02396-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 04/11/2022] [Indexed: 01/21/2023] Open
Abstract
Background To confirm the association between treatment-zone (TZ) decentration and axial length growth (ALG) in children who underwent orthokeratology; and to explore the association between TZ decentration and relative corneal refractive power (RCRP) profile, which was known to be significantly associated with ALG retardation. Methods Four hundred myopic children of age 12 years participated in the study, with 200 wearing orthokeratology lenses and the other 200 wearing single-vision spectacle as the controls. Cycloplegic refraction was performed at baseline. Axial length was measured at baseline and 12 months after initial lens wear, and ALG was defined as the difference. In the ortho-k group, TZ decentration and the RCRP map were calculated from the topography map obtained at the 12-month visit. RCRP were summed within various chord radii from the cornea center, and the association to TZ decentration, spherical equivalent (SE), ALG were analyzed with linear regressions. Results Compared to the controls, children wearing orthokeratology lenses had significantly smaller ALG over 1 year (0.1 ± 0.15 mm vs. 0.32 ± 0.17 mm, p < 0.001). ALG was significantly and negatively associated with summed RCRP within the central cornea of 2 mm in radius. The mean TZ decentration was 0.62 ± 0.25 mm, and the mean direction was 214.26 ± 7.39 degrees. ALG was negatively associated with the TZ decentration magnitude (p < 0.01), but not the direction (p = 0.905). TZ decentration caused an asymmetrical distribution of the RCRP with the nasal side plus power shifting towards the corneal center. For chord radius ranging 1-2 mm, the association between TZ decentration and the summed RCRP were significant, and the proportion of variance accountable increased with chord radius. For chord radius beyond 1.5 mm, the association between baseline spherical equivalent (SE) and summed RCRP was significant. The portion of variance accountable by SE increased and peaked in 2.5 mm chord radius. Conclusions A larger TZ decentration was associated with a larger summed RCRP in the central cornea. It may be one of the possible reasons why TZ decentration is beneficial to retarding myopia progression.
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Affiliation(s)
- Weiping Lin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, People's Republic of China
| | - Tianpu Gu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, People's Republic of China
| | - Hua Bi
- College of Optometry, Nova Southeastern University, Davie, FL, 33314, USA
| | - 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, 300384, People's Republic of China
| | - Bin Zhang
- College of Optometry, Nova Southeastern University, Davie, FL, 33314, USA.
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, People's Republic of China.
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Guo B, Wu H, Cheung SW, Cho P. Manual and software-based measurements of treatment zone parameters and characteristics in children with slow and fast axial elongation in orthokeratology. Ophthalmic Physiol Opt 2022; 42:773-785. [PMID: 35366332 DOI: 10.1111/opo.12981] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/06/2022] [Accepted: 03/06/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE To compare the treatment zone (TZ) measurements obtained using manual and software-based methods in orthokeratology (ortho-k) subjects and explore the TZ characteristics of children with slow and fast axial elongation after ortho-k. METHODS Data from 69 subjects (aged 7 to <13 years old), who participated in three 24-month longitudinal orthokeratology studies, showing fast (>0.27 mm, n = 38) and slow (<0.09 mm, n = 31) axial elongation, were retrieved. The TZ after ortho-k was defined as the central flattened area enclosed by points with no refractive power change. TZ parameters, including decentration, size, width of the peripheral steepened zone (PSZ), central and peripheral refractive power changes and peripheral rate of power change, were determined manually and using python-based software. TZ parameters were compared between measurement methods and between groups. RESULTS Almost all TZ parameters measured manually and with the aid of software were significantly different (p < 0.05). Differences in decentration, size and the PSZ width were not clinically significant, but differences (0.45 to 0.92 D) in refractive power change in the PSZ were significant, although intraclass coefficients (0.95 to 0.98) indicated excellent agreement between methods. Significantly greater TZ decentration, smaller TZ size and greater inferior rate of power change (relative to the TZ centre) were observed in slow progressors using both methods, suggesting a potential role of TZ in regulating myopia progression in ortho-k. CONCLUSION TZ measurements using manual and software-based methods differed significantly and cannot be used interchangeably. The combination of TZ decentration, TZ size and peripheral rate of power change may affect myopia control effect in ortho-k.
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Affiliation(s)
- Biyue Guo
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Huihuan Wu
- Department of Electrical Engineering, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Sin Wan Cheung
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Sun L, Li ZX, Chen Y, He ZQ, Song HX. The effect of orthokeratology treatment zone decentration on myopia progression. BMC Ophthalmol 2022; 22:76. [PMID: 35164702 PMCID: PMC8845411 DOI: 10.1186/s12886-022-02310-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/10/2022] [Indexed: 12/18/2022] Open
Abstract
Background This study aimed to compare the changes in the axial length (AL) in myopic children that wear centered and decentered orthokeratology (Ortho-K). Methods This retrospective study included 217 subjects who were treated with an Ortho-K lens for >12 months. The subjects were divided into three groups based on the magnitude of the Ortho-K lens treatment zone decentration: mildly, moderately, and severely decentered groups. Distance and direction of treatment zone decentration were calculated using software that was developed in-house. The AL changes in different groups were compared. Results Based on the distance of the treatment zone decentration, 65 children (65 eyes) were included in the mildly decentered group, 114 children (114 eyes) in the moderately decentered group, and 38 children (38 eyes) in the severely decentered group. The mean decentration distance in the three groups was 0.35 ± 0.11 mm, 0.71 ± 0.13 mm, and 1.21 ± 0.22 mm, respectively. The mean AL increase in the three groups after 12 months of Ortho-K lens wear was 0.24 ± 0.21 mm, 0.23 ± 0.18 mm, and 0.19 ± 0.20 mm, respectively. There were no significant differences in AL changes among the three groups. Conclusions Ortho-K lens decentration is common in clinical practice. The AL change after Ortho-K lens wear was not significantly different in subjects with different magnitudes of Ortho-K lens decentration. Fitting the Ortho-K lens in the properly centered zone is recommended to ensure the safety of Ortho-K lens wear and to maintain visual quality.
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Affiliation(s)
- Lu Sun
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and visual Sciences, National Engineering Research Center for Ophthalmology, #1 Dong Jiao Min Xiang, Beijing, 100730, China
| | - Zheng-Xuan Li
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and visual Sciences, National Engineering Research Center for Ophthalmology, #1 Dong Jiao Min Xiang, Beijing, 100730, China
| | - Yun Chen
- Key Laboratory of Universal Wireless Communications, Ministry of Education, Beijing University of Posts and Telecommunications, Beijing, 100876, China
| | - Zhi-Qiang He
- Key Laboratory of Universal Wireless Communications, Ministry of Education, Beijing University of Posts and Telecommunications, Beijing, 100876, China
| | - Hong-Xin Song
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and visual Sciences, National Engineering Research Center for Ophthalmology, #1 Dong Jiao Min Xiang, Beijing, 100730, China.
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Kuo YK, Chen YT, Chen HM, Wu PC, Sun CC, Yeung L, Lin KK, Chen HC, Chuang LH, Lai CC, Chen YH, Liu CF. Efficacy of Myopia Control and Distribution of Corneal Epithelial Thickness in Children Treated with Orthokeratology Assessed Using Optical Coherence Tomography. J Pers Med 2022; 12:jpm12020278. [PMID: 35207766 PMCID: PMC8875657 DOI: 10.3390/jpm12020278] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/07/2022] [Accepted: 01/25/2022] [Indexed: 12/16/2022] Open
Abstract
The association between myopia control efficacy in children treated with orthokeratology and corneal epithelial thickness is still unknown. The aim of this study was to explore the corneal epithelial thickness and its association with axial length changes in children treated with orthokeratology. This retrospective cohort study enrolled children aged from 9 to 15 years who had received orthokeratology for myopia control and had been followed up for at least 1 year. Anterior segment optical coherence tomography was performed to generate wide epithelial thickness maps of the patients. Annual axial length changes were calculated from the axial length at 6 months after the initiation of orthokeratology lens wear and at final measurements. Corneal epithelial thickness data were obtained from 24 sectors and a central 2 mm zone of the wide epithelial thickness map. Associations between annual axial length changes and corneal epithelial thickness for each sector/zone of the wide epithelial thickness map, and orthokeratology treatment data were determined by generalized estimating equations. Finally, a total of 83 eyes of 43 patients (mean age 11.2 years) were included in the analysis. The mean annual axial length change was 0.169 mm; when regressing demographic and ortho-k parameters to mean annual axial length changes, age and target power were both negatively associated with them (β = −14.43, p = 0.008; β = −0.26, p = 0.008, respectively). After adjusting for age and target power, the annual axial length changes were positively associated with the corneal epithelium thickness of IT1, I1, SN2, and S2 sectors of the wide epithelial thickness map, and negatively with that of the I3 sector. In conclusion, we identified associations between annual axial length changes and the corneal epithelium thickness of certain sectors in children treated with orthokeratology. This may facilitate the design of orthokeratology lenses with enhanced efficacy for myopia control.
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Affiliation(s)
- Yu-Kai Kuo
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 20401, Taiwan; (Y.-K.K.); (H.-M.C.); (C.-C.S.); (L.Y.); (L.-H.C.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
| | - Yen-Ting Chen
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou 33305, Taiwan
| | - Ho-Min Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 20401, Taiwan; (Y.-K.K.); (H.-M.C.); (C.-C.S.); (L.Y.); (L.-H.C.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
| | - Pei-Chang Wu
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Chi-Chin Sun
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 20401, Taiwan; (Y.-K.K.); (H.-M.C.); (C.-C.S.); (L.Y.); (L.-H.C.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
| | - Ling Yeung
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 20401, Taiwan; (Y.-K.K.); (H.-M.C.); (C.-C.S.); (L.Y.); (L.-H.C.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
| | - Ken-Kuo Lin
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou 33305, Taiwan
| | - Hung-Chi Chen
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou 33305, Taiwan
- Center for Tissue Engineering, Chang Gung Memorial Hospital, Linkou 33305, Taiwan
| | - Lan-Hsin Chuang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 20401, Taiwan; (Y.-K.K.); (H.-M.C.); (C.-C.S.); (L.Y.); (L.-H.C.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
| | - Chi-Chun Lai
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 20401, Taiwan; (Y.-K.K.); (H.-M.C.); (C.-C.S.); (L.Y.); (L.-H.C.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
| | - Yau-Hung Chen
- Department of Chemistry, Tamkang University, Tamsui 251301, Taiwan;
| | - Chun-Fu Liu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 20401, Taiwan; (Y.-K.K.); (H.-M.C.); (C.-C.S.); (L.Y.); (L.-H.C.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (Y.-T.C.); (P.-C.W.); (K.-K.L.); (H.-C.C.)
- Program in Molecular Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
- Correspondence: ; Tel.: +886-2-2431-3131
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Huang Y, Li X, Ding C, Chen Y, Chen H, Bao J. Orthokeratology reshapes eyes to be less prolate and more symmetric. Cont Lens Anterior Eye 2021; 45:101532. [PMID: 34736858 DOI: 10.1016/j.clae.2021.101532] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 10/11/2021] [Accepted: 10/21/2021] [Indexed: 01/12/2023]
Abstract
PURPOSE This prospective study assessed the influence of wearing and then discontinuing orthokeratology (OK) lenses on retinal shape and peripheral refraction in myopic children. METHODS Fifty-eight myopic children (age 8-12 years) were equally divided into an OK group and a single vision spectacles (SVS) group. After 12 months of OK, it was discontinued for 1 month. Peripheral eye length (PEL), relative peripheral refraction (RPR), and corneal parameters were measured in the right eye on the nasal and temporal retinal sides at baseline, 6 months, and 12 months (13 months in OK group) visits. RESULTS In the SVS group, faster elongation of the temporal side PEL made the eyes more asymmetric and prolate, developing a temporal pointed shape. In the OK group, the nasal retinal side PEL grew faster, the nasal RPR developed less hyperopic defocus, and the eye shape became more symmetric and less prolate. The central cornea became thinner and flattened, while the peripheral cornea became steeper. Changes in corneal thickness, relative peripheral corneal power, and K-values were no significant differences for the OK and SVS groups at 12 months. CONCLUSIONS The cornea reverted to be no difference with myopic children with SVS after 1 month discontinuation of OK. The retinal shape of SVS eyes became more asymmetric and prolate with myopia progression. OK remodelled retinal shape to be less asymmetric and less prolate.
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Affiliation(s)
- Yingying Huang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China; Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China
| | - Xue Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China; Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China
| | - Chenglu Ding
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yunyun Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hao Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Jinhua Bao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China; Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China.
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20
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Lin W, Li N, Gu T, Tang C, Liu G, Du B, Wei R. The treatment zone size and its decentration influence axial elongation in children with orthokeratology treatment. BMC Ophthalmol 2021; 21:362. [PMID: 34641799 PMCID: PMC8513184 DOI: 10.1186/s12886-021-02123-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 09/30/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND To investigate whether the treatment zone size (TZS) and treatment zone decentration (TZD) will affect the axial elongation in myopic children undergoing orthokeratology treatment. METHODS A self-controlled retrospective study was conducted on 352 children who met the inclusion criteria. Axial length was measured before and at 12 months after the initial lens wear. Corneal topography was measured at baseline and at each follow-up after lens wear. The Corneal topography obtained from the 12-month visit was used to quantify TZS and TZD for each subject. Cycloplegic refraction was required for all children before fitting the orthokeratology lenses. RESULTS Axial elongation was significantly associated with age, baseline spherical equivalent (SE), TZS, and TZD with univariate linear regression. In groups with both small and large TZS, axial elongation was significantly decreased with large TZD (both P < 0.01). In groups with both small and large TZD, axial elongation was significantly decreased with small TZS (P = 0.03 for small TZD, P = 0.01 for large TZD). Age, SE, and TZD were significantly associated with axial elongation in multiple regression (all P < 0.01). CONCLUSION Relatively smaller TZS and larger TZD may be beneficial in slowing myopia progression in children with orthokeratology treatment.
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Affiliation(s)
- Weiping Lin
- Eye Institute and School of Optometry, Tianjin, China.,Tianjin Medical University Eye Hospital, Tianjin, China
| | - Na Li
- Eye Institute and School of Optometry, Tianjin, China.,Tianjin Medical University Eye Hospital, Tianjin, China
| | - Tianpu Gu
- Eye Institute and School of Optometry, Tianjin, China.,Tianjin Medical University Eye Hospital, Tianjin, China
| | - Chunyu Tang
- Eye Institute and School of Optometry, Tianjin, China.,Tianjin Medical University Eye Hospital, Tianjin, China
| | - Guihua Liu
- Eye Institute and School of Optometry, Tianjin, China.,Tianjin Medical University Eye Hospital, Tianjin, China
| | - Bei Du
- Eye Institute and School of Optometry, Tianjin, China.,Tianjin Medical University Eye Hospital, Tianjin, China.,Tianjin Key Laboratory of Retinal Functions and Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Ruihua Wei
- Eye Institute and School of Optometry, Tianjin, China. .,Tianjin Medical University Eye Hospital, Tianjin, China. .,Tianjin Key Laboratory of Retinal Functions and Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China.
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21
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The Role of Back Optic Zone Diameter in Myopia Control with Orthokeratology Lenses. J Clin Med 2021; 10:jcm10020336. [PMID: 33477514 PMCID: PMC7831104 DOI: 10.3390/jcm10020336] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/08/2021] [Accepted: 01/14/2021] [Indexed: 12/14/2022] Open
Abstract
We compared the efficacy of controlling the annual increase in axial length (AL) in myopic Caucasian children based on two parameters: the back optic zone diameter (BOZD) of the orthokeratology (OK) lens and plus power ring diameter (PPRD) or mid-peripheral annular ring of corneal steepening. Data from 71 myopic patients (mean age, 13.34 ± 1.38 years; range, 10-15 years; 64% male) corrected with different BOZD OK lenses (DRL, Precilens) were collected retrospectively from a Spanish optometric clinic. The sample was divided into groups with BOZDs above or below 5.00 mm and the induced PPRD above or below 4.5 mm, and the relation to AL and refractive progression at 12 months was analyzed. Three subgroups were analyzed, i.e., plus power ring (PPR) inside, outside, or matching the pupil. The mean baseline myopia was -3.11 ± 1.46 D and the AL 24.65 ± 0.88 mm. Significant (p < 0.001) differences were found after 12 months of treatment in the refractive error and AL for the BOZD and PPRD. AL changes in subjects with smaller BOZDs decreased significantly regarding larger diameters (0.09 ± 0.12 and 0.15 ± 0.11 mm, respectively); in subjects with a horizontal sector of PPRD falling inside the pupil, the AL increased less (p = 0.035) than matching or outside the pupil groups by 0.04 ± 0.10 mm, 0.10 ± 0.11 mm, and 0.17 ± 0.12 mm, respectively. This means a 76% lesser AL growth or 0.13 mm/year in absolute reduction. OK corneal parameters can be modified by changing the OK lens designs, which affects myopia progression and AL elongation. Smaller BOZD induces a reduced PPRDs that slows AL elongation better than standard OK lenses. Further investigations should elucidate the effect of pupillary diameter, PPRD, and power change on myopia control.
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Visual quality of juvenile myopes wearing multifocal soft contact lenses. EYE AND VISION 2020; 7:41. [PMID: 32699804 PMCID: PMC7368986 DOI: 10.1186/s40662-020-00204-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 06/16/2020] [Indexed: 12/20/2022]
Abstract
Background It is unclear whether multifocal soft contact lenses (MFSCLs) affect visual quality when they are used for myopia control in juvenile myopes. The aim of this study was, therefore, to investigate the effect of MFSCLs on visual quality among juvenile myopia subjects. Methods In a prospective, intervention study, thirty-three juvenile myopes were enrolled. Visual perception was assessed by a quality of vision (QoV) questionnaire with spectacles at baseline and after 1 month of MFSCL wear. At the one-month visit, the high (96%) contrast distance visual acuity (distance HCVA) and low (10%) contrast distance visual acuity (distance LCVA) were measured with single vision spectacle lenses, single vision soft contact lenses (SVSCLs) and MFSCLs in a random order. Wavefront aberrations were measured with SVSCLs, with MFSCLs, and without any correction. Results Neither distance HCVA (p > 0.05) nor distance LCVA (p > 0.05) revealed any significant difference between MFSCLs, SVSCLs and single vision spectacle lenses. The overall score (the sum of ten symptoms) of the QoV questionnaire did not show a statistically significant difference between spectacles at baseline and after 1 month of MFSCL wear (p = 0.357). The results showed that the frequency (p < 0.001), severity (p = 0.001) and bothersome degree (p = 0.016) of halos were significantly worse when wearing MFSCLs than when wearing single vision spectacle lenses. In contrast, the bothersome degree caused by focusing difficulty (p = 0.046) and the frequency of difficulty in judging distance or depth perception (p = 0.046) were better when wearing MFSCLs than when wearing single vision spectacle lenses. Compared with the naked eye, MFSCLs increased the total aberrations (p < 0.001), higher-order aberrations (p < 0.001), trefoil (p = 0.023), coma aberrations (p < 0.001) and spherical aberrations (SA) (p < 0.001). Compared with the SVSCLs, MFSCLs increased the total aberrations (p < 0.001), higher-order aberrations (p < 0.001), coma aberrations (p < 0.001) and SA (p < 0.001). The direction of SA was more positive (p < 0.001) with the MFSCLs and more negative (p = 0.001) with the SVSCLs compared with the naked eye. Conclusions Wearing MFSCLs can provide satisfactory corrected visual acuity (both distance HCVA and distance LCVA). Although the lenses increased the aberrations, such as total aberrations and higher-order aberrations, there were few adverse effects on the distance HCVA, distance LCVA and visual perception after 1 month of MFSCL use. Trial registration Chinese Clinical Trial Registry: ChiCTR-OOC-17012103. Registered 23 July 2017, http://www.chictr.org.cn/usercenter.aspx
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Lin Z, Duarte-Toledo R, Manzanera S, Lan W, Artal P, Yang Z. Two-dimensional peripheral refraction and retinal image quality in orthokeratology lens wearers. BIOMEDICAL OPTICS EXPRESS 2020; 11:3523-3533. [PMID: 33014548 PMCID: PMC7510915 DOI: 10.1364/boe.397077] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/26/2020] [Accepted: 05/26/2020] [Indexed: 05/28/2023]
Abstract
Orthokeratology (O-K) is a common procedure that uses rigid contact lenses to reshape the cornea while worn overnight. Beyond the correction of refractive error, it has been suggested that this approach can also be used to reduce myopia progression, possibly because it induces changes in peripheral optics. As this hypothesis remains unproven, the aim of the present study was to explore changes in peripheral retinal optical quality in a group of myopic children following O-K treatment. We provide a comprehensive description of optical characteristics in a group of myopes before and after achieving stable corneal reshaping using overnight O-K lenses. These characteristics extended across the central visual field (60° horizontal x 36° vertical) as measured with a custom Hartmman-Shack wavefront sensor. After corneal reshaping, peripheral refraction was found to be asymmetrically distributed, with a myopic relative refraction of approximately 3D in the temporal retina. Astigmatism and higher order aberrations also increased in the temporal side. Based on corneal topography following treatment, subjects were divided into two groups: Centred Treatment (CT, decentration ∈ [-0.5 + 0.5] mm) and Slightly Decentred Treatment (subjects with more decentred lenses). The process was also modelled by ray-tracing simulation. The results indicate that increased myopia in the temporal retina is caused by the decentration of lenses towards the temporal side. Peripheral optics differ significantly following O-K lens treatment, but further research is required to determine whether this is likely to affect myopia progression.
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Affiliation(s)
- Zhenghua Lin
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Raul Duarte-Toledo
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo, 30100, Murcia, Spain
| | - Silvestre Manzanera
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo, 30100, Murcia, Spain
| | - Weizhong Lan
- Aier School of Ophthalmology, Central South University, Changsha, China
- Aier School of Optometry, Hubei University of Science and Technology, Xianning, China
| | - Pablo Artal
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo, 30100, Murcia, Spain
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Zhikuan Yang
- Aier School of Ophthalmology, Central South University, Changsha, China
- Aier School of Optometry, Hubei University of Science and Technology, Xianning, China
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