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Gu Z, Yang R, Wang C, Luo M, Chen X, Piao H, Liao X. Impact of back optic zone diameter (BOZD) in orthokeratology on axial length elongation: A meta-analysis and systematic review. Cont Lens Anterior Eye 2024:102316. [PMID: 39414492 DOI: 10.1016/j.clae.2024.102316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 10/06/2024] [Accepted: 10/07/2024] [Indexed: 10/18/2024]
Abstract
PURPOSE Myopia has emerged as a significant public health concern. Recent studies have demonstrated that Orthokeratology (Ortho-K) can effectively decelerate axial length (AL) growth, with eyes possessing smaller back optical zone diameters (BOZD) exhibiting greater effectiveness compared to those with larger BOZD. This study aims to analyze the impact of Ortho-K with varying BOZD. METHOD This systematic review involved the retrieval of articles from eight databases: PubMed, Embase, Web of Science, Cochrane, CNKI, Wanfang, Sinomed, and VIP, covering the period from each database's inception to January 2024. It compared axial length (AL) changes between smaller and larger back optic zone diameters (BOZD). Review Manager 5.4 was used to statistical analysis and the results presented as weighted mean differences and 95% confidence intervals (CI). This review adheres to the PRISMA guidelines. RESULT This systematic review included two randomized controlled trials (RCTs) and five cohort studies (CS), analyzing a total of 702 eyes (352 eyes are treated with Ortho-K and BOZD ≤ 5.5 mm, 350 eyes are treated with Ortho-K and BOZD ≥ 6.0 mm). The findings indicate that the Ortho-K with smaller BOZD significantly reduces AL growth [WMD = -0.13, 95 %CI (-0.16 to -0.10), P < 0.001]. CONCLUSION The Ortho-K with smaller BOZD prove more effective in controlling myopic AL growth compared with larger BOZD. However, in clinical practice, it is necessary to comprehensively evaluating factors such as patient age, myopia diopter, pupil diameter, higher-order aberration, treatment zone area, and corneal eccentricity to achieve optimized outcomes in improving naked-eye vision and myopia controlling.
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Affiliation(s)
- Zhiming Gu
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China; Medical School of Ophthalmology & Optometry, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Ruiyu Yang
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China; Medical School of Ophthalmology & Optometry, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Canyu Wang
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China; Medical School of Ophthalmology & Optometry, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Mengxiong Luo
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China; Medical School of Ophthalmology & Optometry, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Xiangyu Chen
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China; Medical School of Ophthalmology & Optometry, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Helong Piao
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China; Medical School of Ophthalmology & Optometry, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Xuan Liao
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China; Medical School of Ophthalmology & Optometry, North Sichuan Medical College, Nanchong, Sichuan, China.
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Yu J, Guo Y, Zhou Y. Comparison of the Effects of Orthokeratology and Highly Aspherical Lenselets in Achieving Myopia Control and Defocus in Adolescents. Eye Contact Lens 2024; 50:445-454. [PMID: 39250694 DOI: 10.1097/icl.0000000000001124] [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: 07/25/2024] [Indexed: 09/11/2024]
Abstract
OBJECTIVES To compare the control effectiveness and periretinal defocus between orthokeratology (OK) and highly aspherical lenslets (HAL) in adolescents with myopia. METHODS In this prospective study, 211 children (211 right eyes) were enrolled in Beijing Ming Vision and Ophthalmology between October 2022 and February 2023. Based on the myopia correction method, participants were divided into three groups: OK, HAL, and single-vision spectacles (SVS). They were further divided into two subgroups according to the spherical equivalent (SE), namely, subgroup A with -1.0≤SE≤-2.0 D and subgroup B with -2.0 RESULTS Axial length growth in those with OK lenses and HAL was lower than what was observed for those with SVS after 6, 9, and 12 months. Comparison of the difference in AL change between OK and HAL was not statistically significant with -1.0≤SE≤-2.0 D. The myopic defocus of RDV270° to 300° in group HAL was higher than that in group OK, the difference was statistically significant ( P <0.05), and in other regions, the myopic defocus was higher in the group OK. Em, SRI (corneal regularity index), variation in cell area, and corneal thickness were significantly associated with shaping force. CONCLUSIONS Orthokeratology is one of the most effective optical treatments for controlling myopia, and the factors that affect the corneal shaping force under different corneal parameters are different. For mild myopia, HAL can achieve the same effectiveness as OK.
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Affiliation(s)
- Jia Yu
- Ming Vision and Ophthalmology (J.Y., Y.Z.), Jianguomen Branch Clinic, Beijing, China; and Eye School of Chengdu University of TCM (Y.G., Y.Z.), Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
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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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Qiuxin W, Xiuyan Z, Qingmei T, jiaojiao F, Xiaoxiao G, yijie L, Dadong G, Jike S, Hongsheng B. Analysis of the peripheral refraction in myopic adults using a novel multispectral refraction topography. Heliyon 2024; 10:e36020. [PMID: 39229498 PMCID: PMC11369475 DOI: 10.1016/j.heliyon.2024.e36020] [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: 09/16/2023] [Revised: 08/05/2024] [Accepted: 08/08/2024] [Indexed: 09/05/2024] Open
Abstract
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.
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Affiliation(s)
- Wu Qiuxin
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, No.48#, Yingxiongshan Road, Jinan, 250002, PR China
- Shandong University of Traditional Chinese Medicine, No. 16369#, Jingshi Road, Jinan, 250014, PR China
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Shandong Academy of Eye Disease Prevention and Therapy , No. 48#, Yingxiongshan Road, Jinan, 250002, PR China
| | - Zhang Xiuyan
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, No.48#, Yingxiongshan Road, Jinan, 250002, PR China
- Shandong University of Traditional Chinese Medicine, No. 16369#, Jingshi Road, Jinan, 250014, PR China
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Shandong Academy of Eye Disease Prevention and Therapy , No. 48#, Yingxiongshan Road, Jinan, 250002, PR China
| | - Tian Qingmei
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, No.48#, Yingxiongshan Road, Jinan, 250002, PR China
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Shandong Academy of Eye Disease Prevention and Therapy , No. 48#, Yingxiongshan Road, Jinan, 250002, PR China
| | - Feng jiaojiao
- Shandong University of Traditional Chinese Medicine, No. 16369#, Jingshi Road, Jinan, 250014, PR China
| | - Guo Xiaoxiao
- Shandong University of Traditional Chinese Medicine, No. 16369#, Jingshi Road, Jinan, 250014, PR China
| | - Liu yijie
- Shandong University of Traditional Chinese Medicine, No. 16369#, Jingshi Road, Jinan, 250014, PR China
| | - Guo Dadong
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Shandong Academy of Eye Disease Prevention and Therapy , No. 48#, Yingxiongshan Road, Jinan, 250002, PR China
| | - Song Jike
- Shandong University of Traditional Chinese Medicine, No. 16369#, Jingshi Road, Jinan, 250014, PR China
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Shandong Academy of Eye Disease Prevention and Therapy , No. 48#, Yingxiongshan Road, Jinan, 250002, PR China
| | - Bi Hongsheng
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, No.48#, Yingxiongshan Road, Jinan, 250002, PR China
- Shandong University of Traditional Chinese Medicine, No. 16369#, Jingshi Road, Jinan, 250014, PR China
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Shandong Academy of Eye Disease Prevention and Therapy , No. 48#, Yingxiongshan Road, Jinan, 250002, PR China
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Tong G, Jin Y, Wu H, Zhou Y. Characteristics of peripheral refractive errors in eyes of patients with non-amblyopic myopic anisometropia. BMC Ophthalmol 2024; 24:266. [PMID: 38907184 PMCID: PMC11191220 DOI: 10.1186/s12886-024-03527-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 06/17/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND This study aims to investigate relative peripheral refractive (RPR) characteristics in children with non-amblyopic myopic anisometropia and explore potential associations between relative peripheral refractive errors (RPRE) and myopia. METHODS Relative peripheral refractive errors were assessed in 64 children diagnosed with non-amblyopic myopic anisometropia utilizing multispectral refraction topography (MRT). Two eyes of each patient were divided into into the more myopia eyes group (ME) and the fellow eyes group (FE). Evaluated parameters encompassed total defocus values (TRDV), defocus values at eccentricities spanning 0 to 15 degrees (RDV-15), 0 to 30 degrees (RDV-30), 0 to 45 degrees (RDV-45), as well as superior (RDV-S), inferior (RDV-I), temporal (RDV-T), and nasal (RDV-N) positions. RESULTS The study revealed a noteworthy contrast in TRDV values between Group ME (0.52 ± 0.36) and Group FE (0.17 ± 0.41), with a substantial significance (P < 0.0001). While no significant RDV-15 difference emerged between Group ME (0.01 ± 0.05) and Group FE (-0.01 ± 0.07) (P > 0.05), a meaningful RDV-30 difference existed between Group ME (0.11 ± 0.14) and Group FE (0.03 ± 0.19) (P = 0.0017). A significant discrepancy in RDV-45 was also observed between Group ME (0.39 ± 0.29) and Group FE (0.13 ± 0.34) (P < 0.001). Notably, RDV-I and RDV-T positions demonstrated marked differences between Group ME and Group FE (P < 0.0001), whereas no significant disparity was noted in RDV-S and RDV-N positions (P > 0.05). CONCLUSION Eyes exhibiting greater myopia manifested more hyperopic peripheral defocus in the context of anisometropia. MRT as a novel ophthalmic evaluation technique, holds promising potential for broader clinical applications in the future.
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Affiliation(s)
- Gengmin Tong
- Dongyang people's Hospital, Dongyang, 322100, China.
| | - Yuanhui Jin
- Dongyang people's Hospital, Dongyang, 322100, China
| | - Hongyan Wu
- Dongyang people's Hospital, Dongyang, 322100, China
| | - Yao Zhou
- Dongyang people's Hospital, Dongyang, 322100, China
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Wu Y, Kou J, Lei S, Xiong L, Chen Q, Zhang M, Liu L. Effect of Individualized Ocular Refraction Customization Spectacle Lens Wear on Visual Performance in Myopic Chinese Children. Transl Vis Sci Technol 2024; 13:21. [PMID: 38922628 PMCID: PMC11216273 DOI: 10.1167/tvst.13.6.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/18/2024] [Indexed: 06/27/2024] Open
Abstract
Purpose Individualized ocular refraction customization (IORC) lenses can be individually adjusted depending on the initial relative peripheral refraction to determine the myopic defocus (MD). We aimed to compare visual performance of children wearing IORC lenses with different amounts of MD to determine whether higher MD resulted in greater visual compromise. Methods This study included 184 myopic children aged eight to 12 years, and 172 completed the trial. The participants were randomly assigned to wear IORC lenses with low (IORC-L, 2.50 D), medium (IORC-M, 3.50 D), or high (IORC-H, 4.50 D) MD or single-vision spectacle lenses (SVL). Distance and near best-corrected visual acuity (BCVA), contrast sensitivity function (CSF) and questionnaires were evaluated at baseline and after six and 12 months. Results CSF over all frequencies and distance and near BCVA were not affected by lens design (all P > 0.05). The SVL group outperformed the three IORC lens groups in terms of ghosting images at baseline, and IORC-H and IORC-M groups outperformed IORC-L group (all P < 0.001); however, no differences were observed at the six- or 12-month visit. There were no significant differences among the four groups for any other subjective variables at any of the follow-up visits regarding vision clarity, vision stability, eyestrain, dizziness, headache, or overall vision satisfaction (all P > 0.05). Conclusions The IORC lenses with an actual MD of 4.50 D provided acceptable objective and subjective visual performance and were well tolerated by children. Translational Relevance IORC lenses with an actual MD of 4.50 D provided acceptable visual performance.
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Affiliation(s)
- Ye Wu
- Department of Ophthalmology, Laboratory of Optometry and Vision Sciences, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Ji Kou
- Department of Ophthalmology, Laboratory of Optometry and Vision Sciences, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Si Lei
- Department of Ophthalmology, Laboratory of Optometry and Vision Sciences, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Ling Xiong
- Department of Ophthalmology, Laboratory of Optometry and Vision Sciences, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Qian Chen
- Center of Biostatistics, Design, Measurement and Evaluation, Department of Clinical Research Management, West China Hospital of Sichuan University, Chengdu, Sichuan, P.R. China
| | - Meixia Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China. Research Laboratory of Macular Disease, West China Hospital, Sichuan University, Chengdu, China
| | - Longqian Liu
- Department of Ophthalmology, Laboratory of Optometry and Vision Sciences, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan, P.R. 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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Liu T, Chen C, Ma W, Yang B, Wang X, Liu L. One-year results for myopia control with aspheric base curve orthokeratology lenses: A prospective randomised clinical trial. Ophthalmic Physiol Opt 2023; 43:1469-1477. [PMID: 37584271 DOI: 10.1111/opo.13213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 08/17/2023]
Abstract
PURPOSE To compare the effect of orthokeratology (ortho-k) using aspheric or spherical base curve (BCA vs. BCS) contact lenses on axial elongation and the relative peripheral refraction change (RPRC) in Chinese children. METHODS Children aged 8-12 years with myopia between -0.75 and -4.00 D and astigmatism ≤1.00 D were randomly assigned to the BCA or BCS group. Peripheral refraction was assessed at 10°, 20° and 30° along the temporal and nasal retina at baseline and at the 12-month visit. Axial length (AL) was measured under cycloplegia at baseline and at the 6- and 12-month visits. Only right eye data were analysed. Repeated-measures analysis of covariance was performed to examine the differences in axial elongation and the RPRC between the BCA and BCS groups. RESULTS The 1-year results from 31 BCA and 32 BCS subjects were analysed. No significant between-group differences were found at baseline (p ≥ 0.28). At the 12-month visit, the BCA lens produced a greater absolute RPRC along the horizontal meridian than the BCS lens (p < 0.001). Axial elongation was slower in the BCA group (0.19 ± 0.20 mm) than in the BCS group (0.29 ± 0.14 mm; p = 0.03). Axial elongation was correlated with the RPRC at 10° (r = 0.43, p = 0.02) and 20° (r = 0.39, p = 0.03) along the temporal retina in the BCA group; however, these correlations were not observed in the BCS group. CONCLUSION The BCA ortho-k lens could improve the efficacy of slowing axial elongation in children. The improved myopia control observed in the BCA group may be the result of a larger myopic shift in relative peripheral refraction within 20° along the temporal retina.
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Affiliation(s)
- Tong Liu
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Changxu Chen
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Ma
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Bi Yang
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Xi Wang
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Longqian Liu
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
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Wu H, Peng T, Zhou W, Huang Z, Li H, Wang T, Zhang J, Zhang K, Li H, Zhao Y, Qu J, Lu F, Zhou X, Jiang J. Choroidal vasculature act as predictive biomarkers of long-term ocular elongation in myopic children treated with orthokeratology: a prospective cohort study. EYE AND VISION (LONDON, ENGLAND) 2023; 10:27. [PMID: 37280689 DOI: 10.1186/s40662-023-00345-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 05/03/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Despite receiving orthokeratology (ortho-k), the efficacy of retarding ocular elongation during myopia varies among myopic children. The current study aimed to investigate the early changes of choroidal vasculature at one month after ortho-k treatment and its association with one-year ocular elongation, as well as the role of such choroidal responses in predicting the one-year control efficacy of ortho-k treatment. METHODS A prospective cohort study was conducted in myopic children treated with ortho-k. Myopic children aged between 8 and 12 years who were willing to wear ortho-k lenses were recruited consecutively from the Eye Hospital of Wenzhou Medical University. Subfoveal choroidal thickness (SFCT), submacular total choroidal luminal area (LA), stromal area (SA), choroidal vascularity index (CVI), choriocapillaris flow deficit (CcFD) were evaluated by optical coherence tomography (OCT) and OCT angiography over a one-year period. RESULTS Fifty eyes from 50 participants (24 males) who finished one-year follow-ups as scheduled were included, with a mean age of 10.31 ± 1.45 years. The one-year ocular elongation was 0.19 ± 0.17 mm. The LA (0.03 ± 0.07 mm2), SA (0.02 ± 0.05 mm2) increased proportionally after one-month of ortho-k wear (both P < 0.01), as did the SFCT (10.62 ± 19.98 μm, P < 0.001). Multivariable linear regression analyses showed that baseline CVI (β = - 0.023 mm/1%, 95% CI: - 0.036 to - 0.010), one-month LA change (β = - 0.009 mm/0.01 mm2, 95% CI: - 0.014 to - 0.003), one-month SFCT change (β = - 0.035 mm/10 µm, 95% CI: - 0.053 to - 0.017) were independently associated with one-year ocular elongation during ortho-k treatment after adjusting with age and sex (all P < 0.01). The area under the receiver operating characteristic curve of prediction model including baseline CVI, one-month SFCT change, age, and sex achieved 0.872 (95% CI: 0.771 to 0.973) for discriminating children with slow or fast ocular elongation. CONCLUSIONS Choroidal vasculature is associated with ocular elongation during ortho-k treatment. Ortho-k treatment induces increases in choroidal vascularity and choroidal thickness as early as one month. Such early changes can act as predictive biomarkers of myopia control efficacy over a long term. The utilization of these biomarkers may help clinicians identify children who can benefit from ortho-k treatment, and thus has critical implications for the management strategies towards myopia control.
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Affiliation(s)
- Hao Wu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Tianli Peng
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Weihe Zhou
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Zihan Huang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Hongyu Li
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Tengfei Wang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Jingwei Zhang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Kou Zhang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Haoer Li
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Yunpeng Zhao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Jia Qu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, Zhejiang, China
| | - Fan Lu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, Zhejiang, China
| | - Xiangtian Zhou
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
- Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, Zhejiang, China.
| | - Jun Jiang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
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Liu T, Ma W, Wang J, Yang B, Dong G, Chen C, Wang X, Liu L. The effects of base curve aspheric orthokeratology lenses on corneal topography and peripheral refraction: A randomized prospective trial. Cont Lens Anterior Eye 2023; 46:101814. [PMID: 36681621 DOI: 10.1016/j.clae.2023.101814] [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: 09/15/2022] [Revised: 12/12/2022] [Accepted: 01/12/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND To investigate the effects of orthokeratology (ortho-k) lenses with aspheric and spherical base curve designs on corneal refractive power (CRP) and peripheral refraction. METHODS Children aged 8 to 12 years with myopia between -0.75 D to -4.00 D, astigmatism ≤1.00 D, and corneal astigmatism ≤1.50 D were randomly assigned to the base curve aspheric (BCA) and base curve spherical (BCS) ortho-k lens groups. CRP was assessed for the central 8 mm cornea along horizontal and vertical meridians, and peripheral refraction was measured at 10°, 20°, and 30° along the nasal and temporal retina. Primary measurements included relative corneal refractive power change (RCRPC) and relative peripheral refraction change (RPRC). RESULTS The 3-month results of the 33 and 29 subjects (right eye only) in the BCA and BCS groups, respectively, were obtained. Nonsignificant differences were found in the baseline data between the two groups (p > 0.05). At the 3-month follow-up visit, the mean RCRPC in the BCA group (2.08 ± 0.65 D) was significantly greater than that in the BCS group (1.32 ± 0.81 D) (F1,51 = 25.25, p < 0.001). The BCA group (-1.82 ± 0.65 D) exhibited a larger absolute RPRC than the BCS group (-0.98 ± 0.54 D) (F1,57 = 33.73, p < 0.001). CONCLUSIONS It was found that the BCA ortho-k lens resulted in a more aspheric treatment zone and a more myopic relative peripheral refraction (RPR) along the horizontal meridian. The more myopic RPR was contributed by a more hyperopic central refraction and a more myopic peripheral refraction in the BCA group.
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Affiliation(s)
- Tong Liu
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China
| | - Wei Ma
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Jianglan Wang
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Bi Yang
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Guangjing Dong
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Changxu Chen
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China
| | - Xi Wang
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China.
| | - Longqian Liu
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China.
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