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Batres L, Valdes-Soria G, Romaguera M, Carracedo G. Accommodation response and spherical aberration during 1-Year of orthokeratology lens wear and after discontinuation. Cont Lens Anterior Eye 2024; 47:102133. [PMID: 38467534 DOI: 10.1016/j.clae.2024.102133] [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: 10/11/2023] [Revised: 02/21/2024] [Accepted: 03/01/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND To assess accommodation and spherical aberration changes during one year of orthokeratology lens wear and one month after lens cessation. METHODS A prospective, randomized, longitudinal study was conducted on forty-seven young healthy subjects at the Optometry Clinic of the Complutense University of Madrid (Spain). Non-cycloplegic refraction, high and low uncorrected visual acuity, high and low best corrected visual acuity, accommodative lag, horizontal near phoria, corneal topography, and high-order aberrations were performed at baseline, 1-day, 1-week, 1-, 6- and 12-months of lens wear and after one month of wash out period. p < 0.05 was considered as statistically significant. RESULTS Spherical equivalent refraction (SE) was -3.23 ± 1.57D at baseline and -0.36 ± 0.64D after 12-months of lens wear, while accommodative lag changed from 0.53 ± 0.39D to 0.15 ± 0.29D after one year of lens wear. No significant differences were found when comparing SE at baseline and after one month of lens cessation (p > 0.05). A high correlation was found between the accommodative lag at baseline and after 12 M of lens wear. 22 out of 25 subjects with exophoria at baseline showed a significant reduction in the deviation at 12-months (p < 0.05). Total spherical aberration increased during all visits due to the lens wear (p < 0.05) although internal spherical aberration showed a significant decrease for 1-week, 1-month and 12-month visits (p < 0,05). CONCLUSION Orthokeratology lenses may change the accommodative response of the patient as a reduction on accommodative lag on exophoric patients and an overall increase on the internal spherical aberrations was found during treatment but return to nearly baseline values when cessation.
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Affiliation(s)
- Laura Batres
- Department of Optometry and Vision, Faculty of Optic and Optometry, Complutense University of Madrid, Spain
| | - Gonzalo Valdes-Soria
- Department of Optometry and Vision, Faculty of Optic and Optometry, Complutense University of Madrid, Spain
| | - María Romaguera
- Department of Optometry and Vision, Faculty of Optic and Optometry, Complutense University of Madrid, Spain
| | - Gonzalo Carracedo
- Department of Optometry and Vision, Faculty of Optic and Optometry, Complutense University of Madrid, Spain.
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Bullimore MA, Jong M, Brennan NA. Myopia control: Seeing beyond efficacy. Optom Vis Sci 2024; 101:134-142. [PMID: 38546754 DOI: 10.1097/opx.0000000000002119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
SIGNIFICANCE The availability of a range of effective myopia control modalities enables the clinician to exercise judgment when discussing the treatment plan with the patient and their parents. This article outlines important considerations beyond efficacy.Clinically meaningful myopia control may be attained with some spectacle lenses, select soft contact lenses, some concentrations of atropine, and overnight orthokeratology. Given that satisfactory efficacy can be achieved with a range of modalities, other factors should be considered when deciding upon the best intervention for a given child. Four key factors-compliance, quality of vision, quality of life, and safety-are discussed in this review. Compliance directly impacts efficacy regardless of the modality and is the most important consideration, as it is influenced by quality of vision and comfort. Daily disposal myopia control contact lenses and overnight orthokeratology are generally associated with high compliance, provide better vision-related quality of life than spectacles, and carry a very low risk when used appropriately. A further benefit of overnight orthokeratology is the elimination of a need for optical correction during the day.
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Mahmood M, Day M, Seidel D, Cameron LA. The effect of multifocal contact lenses on the dynamic accommodation step response. Ophthalmic Physiol Opt 2024; 44:321-333. [PMID: 38303152 DOI: 10.1111/opo.13275] [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: 07/26/2023] [Revised: 12/19/2023] [Accepted: 12/26/2023] [Indexed: 02/03/2024]
Abstract
PURPOSE To measure the dynamic accommodation response (AR) to step stimuli with and without multifocal contact lenses (MFCLs), in emmetropes and myopes. METHODS Twenty-two adult subjects viewed alternating distance (0.25D) and near (3D) Maltese crosses placed in free space, through two contact lens types: single vision (SVCL) or centre-distance multifocal (MFCL; +2.50D add). The AR level was measured along with near to far (N-F) and far to near (F-N) step response characteristics: percentage of correct responses, magnitude, latency, peak velocity and duration of step response. RESULTS There was no difference between N-F and F-N responses, or between refractive groups in any aspect of the accommodation step response dynamics. The percentage of correct responses was unaffected by contact lens type. Through MFCLs, subjects demonstrated smaller magnitude, longer latency, shorter duration and slower peak velocity steps than through SVCLs. When viewing the near target, the AR through MFCLs was significantly lower than through SVCLs. When viewing the distance target with the MFCL, the focal points from rays travelling through the distance and near zones were approximately 0.004D behind and 2.50D in front of the retina, respectively. When viewing the near target, the respective values were approximately 1.89D behind and 0.61D in front of the retina. CONCLUSION The defocus error required for accommodation control appears not to be solely derived from the distance zone of the MFCL. This results in reduced performance in response to abruptly changing vergence stimuli; however, these errors were small and unlikely to impact everyday visual tasks. There was a decrease in ocular accommodation during near tasks, which has previously been correlated with a reduced myopic treatment response through these lenses. With MFCLs, the estimated dioptric myopic defocus was the largest when viewing a distant stimulus, supporting the hypothesis that the outdoors provides a beneficial visual environment to reduce myopia progression.
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Affiliation(s)
- Mubeen Mahmood
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Mhairi Day
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Dirk Seidel
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Lorraine A Cameron
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
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Logan NS, Bullimore MA. Optical interventions for myopia control. Eye (Lond) 2024; 38:455-463. [PMID: 37740053 PMCID: PMC10858277 DOI: 10.1038/s41433-023-02723-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 07/26/2023] [Accepted: 08/25/2023] [Indexed: 09/24/2023] Open
Abstract
A range of optical interventions have been developed to slow the progression of myopia. This review summarizes key studies and their outcomes. Peer-reviewed, randomized controlled clinical trials of at least 18 months duration were identified. Randomized clinical trials were identified and summarised: 13 for spectacles, 5 for overnight orthokeratology, 5 for soft contact lenses, and 3 for orthokeratology combined with low concentration atropine. Overnight orthokeratology trials were the most consistent with 2-year slowing of axial elongation between 0.24 and 0.32 mm. Other modalities were more variable due to the wide range of optical designs. Among spectacle interventions, progressive addition lenses were the least effective, slowing axial elongation and myopia progression by no more than 0.11 mm and 0.31 D, respectively. In contrast, novel designs with peripheral lenslets slow 2-year elongation and progression by up to 0.35 mm and 0.80 D. Among soft contact lens interventions, medium add concentric bifocals slow 3-year elongation and progression by only 0.07 mm and 0.16 D, while a dual-focus design slows 3-year elongation and progression by 0.28 mm and 0.67 D. In summary, all three optical interventions have the potential to significantly slow myopia progression. Quality of vision is largely unaffected, and safety is satisfactory. Areas of uncertainty include the potential for post-treatment acceleration of progression and the benefit of adding atropine to optical interventions.
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Xiang K, Chen J, Zhao W, Zhu Z, Ding L, Bulloch G, Du L, Xu X, Zhu M, He X. Changes of corneal biomechanics in children using orthokeratology and their roles in predicting axial length progression-A prospective 2-year study. Acta Ophthalmol 2023; 101:755-765. [PMID: 36959685 DOI: 10.1111/aos.15662] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/19/2023] [Accepted: 03/08/2023] [Indexed: 03/25/2023]
Abstract
PURPOSE To determine how orthokeratology (ortho-k) affects corneal biomechanical properties in myopia control and whether corneal biomechanical parameters can predict clinical efficacy of ortho-k. METHODS A total of 125 children 7-15 years of age using ortho-k lenses were followed in this clinical practice and data of their right eyes were analysed. Corneal biomechanical parameters and most ocular biometry were measured at baseline, 1 week, and at 1, 3, 6, 12, 18 and 24 months. Axial length (AL) was collected every 6 months after baseline measurements. RESULTS During the 2-year follow up, nine corneal biomechanical parameters, including deformation amplitude maximum (DA), varied between baseline and 1 week (p < 0.05) and stabilized during the rest of wearing period (p > 0.05). The mean AL increased from 25.02 ± 0.84 mm to 25.38 ± 0.81 mm and baseline DA strongly correlated with AL progression (Pearson r = 0.37). In the multiple regression models, baseline age, AL and DA were the independent factors for AL progression (R2 : 0.7849, 0.2180 in low and moderate myopes). The area under the receiver operating characteristic curves using the three variables for predicting excessive AL progression (>0.35 mm during 2 years) in low and moderate myopes was 0.902 and 0.698. CONCLUSIONS Corneal biomechanics firstly fluctuated before becoming stable with long-term ortho-k use. Corneal biomechanics was associated with AL progression in children wearing ortho-k lenses. DA combined with age and AL at baseline could predict AL progression in low myopes using ortho-k.
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Affiliation(s)
- Kaidi Xiang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Chen
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Wenchen Zhao
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhuoting Zhu
- Ophthalmology, Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Li Ding
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Gabriella Bulloch
- Ophthalmology, Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Linlin Du
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Xun Xu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mengjun Zhu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Xiangui He
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University, Shanghai, China
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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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Guo B, Cho P, Cheung SW, Kojima R, Vincent S. Optical changes and association with axial elongation in children wearing orthokeratology lenses of different back optic zone diameter. EYE AND VISION (LONDON, ENGLAND) 2023; 10:25. [PMID: 37391828 DOI: 10.1186/s40662-023-00344-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 04/26/2023] [Indexed: 07/02/2023]
Abstract
PURPOSE To compare changes in ocular aberrations in children wearing orthokeratology (ortho-k) lenses with a back optic zone diameter (BOZD) of 6 mm (6-MM group) or 5 mm (5-MM group) and their associations with axial elongation (AE) over two years. METHODS Seventy Chinese children, aged 6 to < 11 years, with myopia between - 4.00 to - 0.75 D, were randomly allocated to 5-MM and 6-MM groups. Ocular aberrations were measured, rescaled to a 4-mm pupil, and fitted with a 6th order Zernike expansion. Measurements, including axial length, were taken prior to commencing ortho-k treatment and then every six months over two years. RESULTS After two years, the 5-MM group displayed a smaller horizontal treatment zone (TZ) diameter (by 1.14 ± 0.11 mm, P < 0.001) and less AE (by 0.22 ± 0.07 mm, P = 0.002) compared with the 6-MM group. A greater increase in total root mean square (RMS) of higher-order aberrations (HOAs), primary spherical aberration (SA) ([Formula: see text], and coma were also observed in the 5-MM group at all follow-up visits. The horizontal TZ diameter was significantly associated with changes in RMS HOAs, SA (RMS, primary and secondary SA), and RMS coma. After controlling for baseline parameters, RMS HOAs, RMS SA, RMS coma, and primary ([Formula: see text] and secondary ([Formula: see text] SA were significantly associated with AE. CONCLUSIONS Ortho-k lenses with a smaller BOZD created a smaller horizontal TZ diameter and a significant increase in total HOAs, total SA, total coma, and primary SA and a decrease in secondary SA. Of these ocular aberrations, total HOAs, total SA, and primary SA were negatively correlated with AE over two years. TRIAL REGISTRATION ClinicalTrial.gov, NCT03191942. Registered 19 June 2017, https://clinicaltrials.gov/ct2/show/NCT03191942 .
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Affiliation(s)
- Biyue Guo
- Centre for Myopia Research, Optometry Research Clinic, School of Optometry, The Hong Kong Polytechnic University, A136-137, Hung Hum, Kowloon, Hong Kong SAR, China.
| | - Pauline Cho
- Centre for Myopia Research, Optometry Research Clinic, School of Optometry, The Hong Kong Polytechnic University, A136-137, Hung Hum, Kowloon, Hong Kong SAR, China
| | - Sin Wan Cheung
- Centre for Myopia Research, Optometry Research Clinic, School of Optometry, The Hong Kong Polytechnic University, A136-137, Hung Hum, Kowloon, Hong Kong SAR, China
| | - Randy Kojima
- College of Optometry, Pacific University, Oregon, USA
| | - Stephen Vincent
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, QLD, Australia
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Huang Z, Zhao W, Mao YZ, Hu S, Du CX. Factors influencing axial elongation in myopic children using overnight orthokeratology. Sci Rep 2023; 13:7715. [PMID: 37173387 PMCID: PMC10182044 DOI: 10.1038/s41598-023-34580-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
Several factors influence axial length in children with myopia treated using overnight orthokeratology. To identify these factors, this retrospective study collected axial length and corneal aberration data on 78 eyes before and 1-year after orthokeratology. Patients were divided according to axial elongation (cut-off, 0.25 mm/year). Baseline characteristics included age, sex, spherical equivalent refraction, pupil diameter, axial length, and orthokeratology lens type. Corneal shape effects were compared through tangential difference maps. Group differences in higher-order aberrations of a 4 mm zone were compared at baseline and 1-year following therapy. Binary logistic regression analysis was conducted to identify the variables determined for axial elongation. Significant differences between both groups included the initial age of wearing orthokeratology lenses, type of orthokeratology lens, size of central flattening area, corneal total surface C12 (1-year), corneal total surface C8 (1-year), corneal total surface spherical aberration (SA) (1-year root mean square [RMS] values), change in total corneal surface C12, and change in front and total corneal surface SA (RMS values). The age when wearing an orthokeratology lens was the most important factor influencing axial length in children with orthokeratology-treated myopia, followed by lens type and change in the C12 of the total corneal surface.
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Affiliation(s)
- Zhu Huang
- Department of Ophthalmology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Wei Zhao
- College of Medicine, Zhejiang University, Hangzhou, 310030, China
| | - Ying-Zheng Mao
- College of Medicine, Zhejiang University, Hangzhou, 310030, China
| | - Shan Hu
- Department of Ophthalmology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Chi-Xin Du
- Department of Ophthalmology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, China.
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Bullimore MA, Lee SSY, Schmid KL, Rozema JJ, Leveziel N, Mallen EAH, Jacobsen N, Iribarren R, Verkicharla PK, Polling JR, Chamberlain P. IMI-Onset and Progression of Myopia in Young Adults. Invest Ophthalmol Vis Sci 2023; 64:2. [PMID: 37126362 PMCID: PMC10153577 DOI: 10.1167/iovs.64.6.2] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
Myopia typically starts and progresses during childhood, but onset and progression can occur during adulthood. The goals of this review are to summarize published data on myopia onset and progression in young adults, aged 18 to 40 years, to characterize myopia in this age group, to assess what is currently known, and to highlight the gaps in the current understanding. Specifically, the peer-reviewed literature was reviewed to: characterize the timeline and age of stabilization of juvenile-onset myopia; estimate the frequency of adult-onset myopia; evaluate the rate of myopia progression in adults, regardless of age of onset, both during the college years and later; describe the rate of axial elongation in myopic adults; identify risk factors for adult onset and progression; report myopia progression and axial elongation in adults who have undergone refractive surgery; and discuss myopia management and research study design. Adult-onset myopia is common, representing a third or more of all myopia in western populations, but less in East Asia, where onset during childhood is high. Clinically meaningful myopia progression continues in early adulthood and may average 1.00 diopters (D) between 20 and 30 years. Higher levels of myopia are associated with greater absolute risk of myopia-related ocular disease and visual impairment, and thus myopia in this age group requires ongoing management. Modalities established for myopia control in children would be options for adults, but it is difficult to predict their efficacy. The feasibility of studies of myopia control in adults is limited by the long duration required.
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Affiliation(s)
- Mark A Bullimore
- University of Houston, College of Optometry, Houston, Texas, United States
| | - Samantha Sze-Yee Lee
- Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Katrina L Schmid
- School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Jos J Rozema
- Visual Optics Lab Antwerp (VOLANTIS), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium
| | - Nicolas Leveziel
- Department of Ophthalmology, Centre Hospitalier Universitaire de Poitiers, Poitiers, Cedex, France
| | - Edward A H Mallen
- School of Optometry and Vision Science, University of Bradford, Bradford, United Kingdom
| | | | | | - Pavan K Verkicharla
- Myopia Research Lab and Infor Myopia Centre, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Jan Roelof Polling
- Ophthalmology, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands Rotterdam, The Netherlands
- Orthopics & Optometry, University of Applied Science, Utrecht, The Netherlands
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Ruan J, Zhang Y, Chen Y. Influence of overnight orthokeratology on tear film and meibomian glands in myopic children: a prospective study. BMC Ophthalmol 2023; 23:136. [PMID: 37013481 PMCID: PMC10071684 DOI: 10.1186/s12886-023-02883-8] [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: 12/16/2022] [Accepted: 03/24/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Orthokeratology lenses, which are worn overnight, are recommended for reducing myopia progression. They lie on the cornea and can influence the ocular surface by temporarily reshaping the corneal surface through a reverse geometry design. This study investigated the effect of overnight orthokeratology lenses on tear film stability and meibomian gland status in children aged 8-15 years. METHODS This prospective, self-controlled study included 33 children with monocular myopia who were prescribed orthokeratology lenses for at least one year. The experimental group (ortho-k group) comprised 33 myopic eyes. The control group comprised the emmetropic eyes of the same participants. Tear film stability and meibomian gland status were measured using a Keratograph 5M (Oculus, Wetzlar, Germany). Paired t-tests and Wilcoxon signed-rank tests were used to compare the data between the two groups. RESULTS At the one-year visit, the non-invasive first tear film break-up time (NIBUTf) values were 6.15 ± 2.56 s and 6.18 ± 2.61 s in the experimental and control groups, respectively. The lower tear meniscus height was 18.74 ± 0.05 μm and 18.65 ± 0.04 μm in these groups, respectively. No significant difference was observed in loss of meibomian glands or non-invasive average tear film break-up time between the experimental and control groups using Wilcoxon signed-rank tests. CONCLUSIONS The stability of the tear film and meibomian gland status were not significantly affected by wearing orthokeratology lenses overnight, indicating that continuous use of orthokeratology lenses for 12 months has a minimal effect on the ocular surface. This finding can help guide the clinical management of tear film quality with respect to the use of orthokeratology contact lenses.
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Affiliation(s)
- Jing Ruan
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, 49 North Huayuan Road, Haidian District, Beijing, 100191, China
| | - Yu Zhang
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, 49 North Huayuan Road, Haidian District, Beijing, 100191, China.
| | - Yueguo Chen
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, 49 North Huayuan Road, Haidian District, Beijing, 100191, China.
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Gao Y, Lim EW, Drobe B. Impact of myopia control spectacle lenses with highly aspherical lenslets on peripheral visual acuity and central visual acuity with peripheral gaze. Ophthalmic Physiol Opt 2023; 43:566-571. [PMID: 36916874 DOI: 10.1111/opo.13127] [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: 10/03/2022] [Revised: 03/03/2023] [Accepted: 03/04/2023] [Indexed: 03/16/2023]
Abstract
PURPOSE Myopia control spectacle lenses with peripheral lenslets are gaining popularity because they are non-invasive and easy to manage, and ongoing clinical trials have shown promising results. This study aimed to evaluate peripheral and central visual acuity (VA) with peripheral gaze in conditions where the eyes are turned to look obliquely through the lenslets. METHODS High-contrast (100%) VA was measured at 300 cm and 10 lx. For each test, two lens designs were evaluated in counterbalanced order: a spectacle lens with highly aspherical lenslets (HALs) and a standard single-vision lens (SVL). The target screen was placed at a visual angle of 21.6° to the nasal side of the right eye. Sixteen adults (27-52 years of age; spherical equivalent refraction (SER), -8.75 D to +0.50 D) wearing their habitual visual correction performed all tests monocularly. RESULTS Mean (SD) central VAs with peripheral gaze through the SVL and the HAL lens were 0.08 (0.13) and 0.17 (0.12) logMAR, respectively. The HAL lens reduced central VA with peripheral gaze by 0.10 (0.08) logMAR (p = 0.03). No significant correlation was observed between the impact of the HAL lens and other factors, such as age or SER. Peripheral VA was not significantly different through the two lenses (1.09 (0.06) logMAR and 1.09 (0.09) logMAR for the SVL and the HAL lens, respectively; p = 0.86). CONCLUSIONS Under high-contrast and low-luminance conditions, the HAL lens reduced central VA with peripheral gaze by approximately one line compared with the SVL. The impact on central VA did not vary with gaze direction, age or SER. The HAL lens did not affect peripheral VA in this condition.
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Affiliation(s)
- Yi Gao
- Essilor R&D Center Singapore, Singapore, Singapore
| | - Ee Woon Lim
- Essilor R&D Center Singapore, Singapore, Singapore
| | - Björn Drobe
- Essilor R&D Center Singapore, Singapore, Singapore
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12
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Nti AN, Owusu-Afriyie B, Osuagwu UL, Kyei S, Ovenseri-Ogbomo G, Ogbuehi KC, Ouzzani M, Agho KE, Mashige KP, Ekure E, Ekpenyong BN, Ocansey S, Ndep AO, Obinwanne CJ, Berntsen DA, Wolffsohn JS, Naidoo KS. Trends in myopia management attitudes and strategies in clinical practice: Survey of eye care practitioners in Africa. Cont Lens Anterior Eye 2023; 46:101597. [PMID: 35428590 DOI: 10.1016/j.clae.2022.101597] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 04/04/2022] [Accepted: 04/08/2022] [Indexed: 01/18/2023]
Abstract
PURPOSE There remains a lack of information on the perception and adoption of myopia control strategies among African eye care practitioners (ECPs). This study provides an African perspective to similar previous studies conducted in other parts of the world. METHODS A self-administered survey in English and French was distributed to ECPs across Africa. The items on the questionnaire assessed their level of concern about the increasing prevalence of paediatric myopia, perceived efficacy, opinions on, and adoption of various myopia management modalities. RESULTS Responses were obtained from 330 ECPs working in 23 African countries. Respondents were highly concerned about the increasing prevalence of paediatric myopia in their clinic (median 8/10) and perceived approved myopia control soft contact lenses as the most effective at slowing myopia progression (mean perceived reduction in myopia progression ± SD; 53.9 ± 27.1%), followed by single vision spectacles (53.1 ± 30.9%), and orthokeratology (52.8 ± 28.0%). Multifocal soft contact lenses (40.4 ± 25.8%) and pharmaceutical agents such as topical atropine drops (39.5 ± 27.1%) were perceived as least effective in slowing myopia progression. Although ECPs reported being aware of various myopia control strategies, they still mainly prescribed single vision spectacles to a large proportion (64.3 ± 29.9%) of young progressing myopes. Nearly one-third (27%) of ECPs who prescribed single vision lenses stated they were concerned about the cost implications to patients. Other reported concerns included safety of, and inadequate information about myopia control options. CONCLUSIONS African ECPs continue to prescribe single vision lenses for progressing myopes despite being aware of the various myopia control options. Practitioners' perceptions of the efficacy of several modalities to slow myopia progression do not align with the current best evidence. Clear practice guidelines and continuing education on myopia control are warranted to inform and guide the management of myopic patients in Africa.
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Affiliation(s)
- Augustine N Nti
- The Ocular Surface Institute, University of Houston College of Optometry, Houston, TX, United States of America
| | - Bismark Owusu-Afriyie
- Clinical Optometry Programme, School of Optometry and Vision Sciences, Cardiff University, United Kingdom
| | - Uchechukwu Levi Osuagwu
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; African Vision Research Institute, Discipline of Optometry, University of KwaZulu-Natal, Westville Campus, Durban 3629, South Africa
| | - Samuel Kyei
- Department of Optometry and Vision Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Godwin Ovenseri-Ogbomo
- Department of Optometry, Centre for Health Sciences, University of the Highlands and Islands, Inverness IV2 3JH, UK
| | - Kelechi C Ogbuehi
- Department of Medicine, Dunedin School of Medicine, University of Otago, New Zealand
| | - Mhamed Ouzzani
- Optometry Research Group, LPCMME, Université Oran 1, B.P 1524, El M'Naouer 31000 Oran, Algeria; IRLCM: Innovation-Recherche en Lentille cornéenne de l'Université de Montréal, 3744 Rue Jean-Brillant Bureau 110, Montréal, QC H3T 1P1, Canada
| | - Kingsley E Agho
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; School of Health Science, Western Sydney University, Campbelltown, NSW 2560, Australia
| | - Khathutshelo Percy Mashige
- African Vision Research Institute, Discipline of Optometry, University of KwaZulu-Natal, Westville Campus, Durban 3629, South Africa
| | | | - Bernadine N Ekpenyong
- Epidemiology & Medical Statistics Unit, Department of Public Health, University of Calabar, Calabar, Nigeria
| | - Stephen Ocansey
- Department of Optometry and Vision Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Antor O Ndep
- Health Education & Health Promotion Unit, Department of Public Health, University of Calabar, Calabar, Nigeria
| | - Chukwuemeka Junior Obinwanne
- Cornea, Contact Lens, and Myopia Control Unit, De Lens Ophthalmics Family Eye and Vision Care Center, Suite G14, Febson Mall, Plot 2425, Hebert Macaulay Way, Wuse Zone 4, Abuja, Nigeria
| | - David A Berntsen
- The Ocular Surface Institute, University of Houston College of Optometry, Houston, TX, United States of America
| | - James S Wolffsohn
- Optometry and Vision Science Research Group, College of Health and Life Sciences, Aston University, Birmingham, United Kingdom
| | - Kovin S Naidoo
- African Vision Research Institute, Discipline of Optometry, University of KwaZulu-Natal, Westville Campus, Durban 3629, South Africa; School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia.
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13
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Chen C, Ma W, Wang J, Yang B, Liu T, Liu L. Higher-Order Aberrations and Visual Performance in Myopic Children Treated With Aspheric Base Curve-Designed Orthokeratology. Eye Contact Lens 2023; 49:71-76. [PMID: 36694310 DOI: 10.1097/icl.0000000000000961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To investigate the impact of aspheric base curve (BC)-designed orthokeratology (ortho-k) (AOK) lenses on higher-order aberrations (HOA) at different pupil diameters and visual performance. METHODS This prospective clinical study included subjects randomized to wear spherical BC-designed ortho-k (SOK) or AOK lenses. The Pediatric Refractive Error Profile (PREP) questionnaire was completed before and after 3 months of lens wear. The Strehl ratio (SR) and root mean square of ocular higher-order aberrations (HOAs), spherical aberration (SA), coma, and trefoil were measured under 4-mm, 5-mm, and 6-mm pupil diameters at baseline and 3-month visits. Corneal topography, uncorrected low-contrast (LC) visual acuity (VA), and high-contrast (HC) VA were measured at baseline and at 1 day, 1 week, 1 month, and 3 month follow-ups. RESULTS Sixty-five participants completed the study. After 3 months with the ortho-k lens, there were no significant differences in ocular HOA, SA, coma, or trefoil between the SOK group and AOK group at 4-mm, 5-mm, and 6-mm pupil diameters (all P>0.05), except for a significant increase in SA in the AOK group (P=0.01). Stratified analyses showed that the AOK group exhibited greater HOA and SA at 5-mm and 6-mm pupil diameters in the lower myopia subgroup and greater SA at 6 mm in the higher myopia subgroup (all P<0.05). There were no significant differences between the groups in SR, HC VA, LC VA, or PREP scores (all P>0.05). CONCLUSION Aspheric BC-designed ortho-k lenses produced a significantly greater SA than SOK lenses, with more significance at lower diopters, without sacrificing subjective visual performance.
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Affiliation(s)
- Changxu Chen
- Department of Optometry and Vision Sciences, West China School of Medicine, Sichuan University (C.C. and T.L.); Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University (C.C., W.M., J.W., B.Y., T.L. and L.L.) and Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China (W.M., J.W., B.Y., and L.L.)
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14
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Tomiyama ES, Richdale K. Clinical Outcomes of a Randomized Trial with Contact Lenses for Astigmatic Myopia Management. Optom Vis Sci 2023; 100:9-16. [PMID: 36705710 PMCID: PMC9889106 DOI: 10.1097/opx.0000000000001969] [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] [Indexed: 01/28/2023] Open
Abstract
SIGNIFICANCE There are limited treatment options for myopia management of patients with moderate to high astigmatism. This work directly compares toric orthokeratology and soft toric multifocal lenses to show differences in visual acuity and patient satisfaction that could impact clinical care. Toric orthokeratology caused reduced visual acuity but was preferred subjectively for vision and overall. PURPOSE This study aimed to quantify objective and subjective clinical differences between toric orthokeratology and soft toric multifocal contact lenses in the same cohort of myopic wearers with moderate to high astigmatism. METHODS Thirty adults with refractive myopia (plano to -5.00 D) and astigmatism (1.25 to 3.50 D) were fitted empirically with both toric orthokeratology and soft toric multifocal contact lenses. Participants wore lenses for 10 days in random order, separated by a 14-day washout period. High-contrast visual acuity, low-contrast visual acuity, and glare logMAR visual acuity were measured. Surveys ascertained subject preference for comfort, vision, handling, and cost. Friedman, Wilcoxon signed rank, and χ2 tests were performed. RESULTS A subset of participants (n = 17) who achieved good vision with both lens types was analyzed. High-contrast and glare acuity with toric orthokeratology were reduced by one line compared with soft toric multifocal lenses (both 0.00 vs. -0.10, P ≤ .003). Participants preferred toric orthokeratology for vision ( P ≤ .03) but soft toric multifocal lenses for handling ( P ≤ .006). When forced to choose between lens types, participants preferred toric orthokeratology for vision and overall (both P ≤ .007). CONCLUSIONS Participants who achieved good vision with both lens types preferred toric orthokeratology over soft toric multifocal lenses, despite reduced high-contrast and glare visual acuity. Further research is needed to understand the relationship between visual performance and patient satisfaction.
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15
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Huang Y, Li X, Wang C, Zhou F, Yang A, Chen H, Bao J. Visual acuity, near phoria and accommodation in myopic children using spectacle lenses with aspherical lenslets: results from a randomized clinical trial. EYE AND VISION 2022; 9:33. [PMID: 36045391 PMCID: PMC9434851 DOI: 10.1186/s40662-022-00304-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 08/11/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Objectives
To investigate the short- and long-term effects of myopia control spectacle lenses with highly aspherical lenslets (HAL) and slightly aspherical lenslets (SAL) on visual function and visual quality using data obtained from a randomized controlled clinical trial.
Methods
This was a prospective, randomized, controlled, and double-blinded study; 170 myopic children aged 8–13 years were randomly assigned to the HAL, SAL, or single-vision spectacle lenses (SVL) groups. Distance and near visual acuity (VA) at high (100%) and low (10%) contrast in photopic and scotopic conditions, near phoria, stereoacuity, and accommodative lag, microfluctuations (AMFs), amplitude (AA) were measured after wearing lenses for 10 min, 6 months, and 12 months.
Results
In total, 161 subjects completed all follow-up in 12 months and were included in the analysis. After 10 min of wearing, the HAL and SAL groups had lower scotopic and low-contrast VA than the SVL group (decreased 0.03–0.08 logMAR and 0.01–0.04 logMAR in different VAs in the HAL and SAL groups, respectively, all P < 0.05). The reduction in VA was recovered at 12 months as the HAL and SAL groups exhibited significant VA improvements, and the VA was not different among the three groups (all P > 0.05). The HAL and SAL groups had significantly larger AMFs than the SVL group (HAL vs. SAL vs. SVL: 0.21 ± 0.08 D vs. 0.16 ± 0.05 D vs. 0.15 ± 0.06 D at baseline, 0.19 ± 0.07 D vs. 0.17 ± 0.05 D vs. 0.13 ± 0.07 D at 12 months, all P < 0.05). There were no significant differences in accommodative lag, AA, or phoria between the groups (all P > 0.05). The HAL and SAL groups had reduced stereoacuity compared to the SVL group at baseline (70’ vs. 60’ vs. 50’, P = 0.005), but no difference was observed at 12 months (70’ vs. 70’ vs. 70’, P = 0.11).
Conclusions
HAL and SAL have no significant influence on accommodation and phoria except had larger AMF than SVL. Scotopic VA and low-contrast VA are reduced with short-term HAL and SAL use but recovered to be at same level with the SVL after 1 year of use.
Trial registration Chinese Clinical Trial Registry: ChiCTR1800017683. Registered on 9 August 2018. http://www.chictr.org.cn/showproj.aspx?proj=29789
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16
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García-Marqués JV, Macedo-De-Araújo RJ, McAlinden C, Faria-Ribeiro M, Cerviño A, González-Méijome JM. Short-term tear film stability, optical quality and visual performance in two dual-focus contact lenses for myopia control with different optical designs. Ophthalmic Physiol Opt 2022; 42:1062-1073. [PMID: 35801815 PMCID: PMC9540637 DOI: 10.1111/opo.13024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/20/2022] [Accepted: 06/20/2022] [Indexed: 12/14/2022]
Abstract
Purpose To assess and compare short‐term visual and optical quality and tear film stability between two dual‐focus (DF) prototype myopia control contact lenses (CLs) having different inner zone diameters. Methods Twenty‐eight myopic subjects were included in this randomised, double‐masked crossover study. Refraction, best‐corrected visual acuity (VA) and tear film stability were measured at baseline (i.e., when uncorrected). Subjects were then binocularly fitted with the DF CLs, with only the sensorial dominant eye being assessed. Lenses were of the same material and had inner zone diameters of either 2.1 mm (S design) or 4.0 mm (M design). Visual and physical short‐term lens comfort, over‐refraction, best‐corrected VA, stereopsis at 40 cm, best‐corrected photopic and mesopic contrast sensitivity (CS), size and shape of light disturbance (LD), wavefront aberrations, subjective quality of vision (QoV Questionnaire) and tear film stability were measured for each lens. Results Both CL designs decreased tear film stability compared with baseline (p < 0.05). VA and photopic CS were within normal values for the subjects' age with each CL. When comparing lenses, the M design promoted better photopic CS for the 18 cycles per degree spatial frequency (p < 0.001) and better LD (p < 0.02). However, higher‐order aberrations were improved with the S design (p = 0.02). No significant difference between the two CLs was found for QoV scores and tear film stability. Conclusions Both DF CLs provided acceptable visual performance under photopic conditions. The 4.0 mm inner zone gave better contrast sensitivity at high frequencies and lower light disturbance, while the 2.1 mm central diameter induced fewer higher‐order aberrations for a 5 mm pupil diameter. Both CLs produced the same subjective visual short‐term lens comfort.
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Affiliation(s)
- José Vicente García-Marqués
- Optometry Research Group, Department of Optics and Optometry and Vision Sciences, University of Valencia, Valencia, Spain
| | - Rute Juliana Macedo-De-Araújo
- Clinical and Experimental Optometry Research Laboratory (CEORLab) Center of Physics (Optometry), School of Sciences, University of Minho, Braga, Portugal
| | - Colm McAlinden
- Department of Ophthalmology, Royal Gwent Hospital, Newport, UK.,Wenzhou Medical University, Wenzhou, China.,Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Miguel Faria-Ribeiro
- Clinical and Experimental Optometry Research Laboratory (CEORLab) Center of Physics (Optometry), School of Sciences, University of Minho, Braga, Portugal
| | - Alejandro Cerviño
- Optometry Research Group, Department of Optics and Optometry and Vision Sciences, University of Valencia, Valencia, Spain
| | - José Manuel González-Méijome
- Clinical and Experimental Optometry Research Laboratory (CEORLab) Center of Physics (Optometry), School of Sciences, University of Minho, Braga, Portugal
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Li X, Xu J, Hong J, Yao J. The relationship between corneal biomechanical parameters and treatment outcomes of orthokeratology lenses. BMC Ophthalmol 2022; 22:262. [PMID: 35690754 PMCID: PMC9188053 DOI: 10.1186/s12886-022-02480-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 05/03/2022] [Indexed: 11/15/2022] Open
Abstract
Background To evaluate changes in corneal biomechanical properties after long-term orthokeratology (OK) treatment and the factors affecting treatment outcomes. Methods Twenty-four myopic teenagers who wore OK lenses for more than 1 year were included. Twenty-three individuals of the same age and with the same spherical equivalent wearing single-vision spectacles (SVS) were enrolled as controls. After routine eye examinations, corneal biomechanical properties and axial length were measured. Parameters were compared between groups. Results Less axial elongation (AE) occurred in the OK group (P = 0.021). The OK group experienced a statistically significant decrease in the A1 deformation amplitude (P = 0.02), whole eye movement maximum (P = 0.026), and Ambrósio’s relational thickness to the horizontal profile (ARTh) (P < 0.001), and a statistically significant increase in the pachyslope (P < 0.001) and Corvis biomechanical index (P < 0.001). Smaller ARTh and a larger highest concavity deflection area resulted in a better refractive state. The inhibitory effect of AE was better for older patients with smaller ARTh. Conclusions Long-term OK treatment slowed myopia progression by reshaping the cornea. Smaller ARTh after OK lens wear indicated a better refractive state and slower AE and could predict OK lens treatment outcomes.
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Affiliation(s)
- Xia Li
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai, China
| | - Jianjiang Xu
- Department of Ophthalmology and Visual Science, Shanghai Medical College, Eye, Ear, Nose, and Throat Hospital, Fudan University, No. 83 Fenyang Road, Xuhui District, Shanghai, 200031, China.,Key Laboratory of Myopia of State Health Ministry and Key Laboratory of Visual Impairment and Restoration of Shanghai, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Jiaxu Hong
- Department of Ophthalmology and Visual Science, Shanghai Medical College, Eye, Ear, Nose, and Throat Hospital, Fudan University, No. 83 Fenyang Road, Xuhui District, Shanghai, 200031, China. .,Key Laboratory of Myopia of State Health Ministry and Key Laboratory of Visual Impairment and Restoration of Shanghai, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.
| | - Jing Yao
- Department of Ophthalmology and Visual Science, Shanghai Medical College, Eye, Ear, Nose, and Throat Hospital, Fudan University, No. 83 Fenyang Road, Xuhui District, Shanghai, 200031, China. .,Key Laboratory of Myopia of State Health Ministry and Key Laboratory of Visual Impairment and Restoration of Shanghai, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.
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18
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Fitting of Orthokeratology in the United States: A Survey of the Current State of Orthokeratology. Optom Vis Sci 2022; 99:568-579. [PMID: 35657355 DOI: 10.1097/opx.0000000000001911] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SIGNIFICANCE The Fitting of Orthokeratology in the United States (FOKUS) survey provides information about the United States (US) OrthoK market. This independent survey is the first to attain detailed assessment of the OrthoK market. PURPOSE Develop and administer a survey to eye care providers (ECP's) in the US who are managing orthokeratology patients and those who are not to determine a profile of prescribers, patients and overall market. METHODS The FOKUS survey was administered and distributed online. Outcome measures of the FOKUS survey involved general categories of 1) practice and practitioner profiles, 2) clinical prescribing patterns, 3) patient profile, 4) products and marketing, 5) fees and 6) market size and growth. RESULTS The number of ECP's who are actively fitting and managing OrthoK patients in the US is approximately 3,000. 545 responded to the survey, 283 reported they were actively fitting orthokeratology. Orthokeratology is prescribed with the intent of managing myopia by 68% of respondents, 53% monitor axial length, and 61% start OrthoK patients at age 13 years old or under. The mean number of years a patient wears OrthoK is 7.8. A commonly reported complication with orthokeratology is corneal staining. Microbial keratitis (MK) is rarely or never seen by 86% of respondents. Of those currently fitting, 56% anticipate growth of orthokeratology fitting over the next twelve months. Of those not currently fitting orthokeratology, 46% plan to start within two years. CONCLUSIONS Orthokeratology represents a small but growing segment of the US contact lens market. The number of practitioners actively prescribing and fitting orthokeratology in the US is approximately 3,000 with high potential for growth within the next two years. Results of the FOKUS survey are relevant to practitioners currently fitting or considering orthokeratology, manufacturers, educators and researchers as baseline for future orthokeratology market assessment.
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Huang Y, Li X, Ding C, Chen Y, Mao X, Chen H, Bao J. Comparison of peripheral refraction and higher-order aberrations between orthokeratology and multifocal soft contact lens designed with highly addition. Graefes Arch Clin Exp Ophthalmol 2022; 260:1755-1762. [PMID: 35192031 PMCID: PMC9007788 DOI: 10.1007/s00417-022-05573-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/18/2022] [Accepted: 01/21/2022] [Indexed: 01/20/2023] Open
Abstract
Purpose To compare peripheral defocus, higher-order aberrations (HOAs), and contrast visual acuity (CVA) in myopic children wearing orthokeratology (OK) lenses and multifocal soft contact lenses (MSCLs) designed with highly addition. Methods This is a prospective, nonrandomized, controlled study. Subjects at 8 to 13 years of age with spherical equivalent refraction from − 1.00 to − 5.00 dioptres (D) were included in the OK group (n = 30) and MSCL group (n = 23). Relative peripheral corneal defocus (RPCD) and relative peripheral refraction (RPR) were measured before and after wearing lenses. HOAs including spherical aberration (SA), coma, trefoil, and total HOAs, and high (100%) and low (10%) CVA were compared between the groups. Axial length (AL) was measured before and after wearing the lenses for 1 year. Results After wearing the lenses, subjects in the MSCL group had RPCD and RPR values similar to the OK group at the paracentral (within 2 mm of the cornea or 20° of the retina, all p > 0.05) but larger than the OK group at the periphery (all p < 0.05). All HOAs increased after wearing the lenses except the trefoil in the MSCL group (all p < 0.05). HOAs increased more in the OK group (all p < 0.05). The 100% and 10% CVAs were worse in the MSCL group (p = 0.02 and p = 0.004). After 1 year, AL elongation was 0.37 mm (SD = 0.16) in the MSCL group and 0.28 mm (0.16) in the OK group (p = 0.06). Conclusion MSCL produced larger myopic defocus at the periphery, increased less HOAs and had worse CVA than OK lens. The high addition of this MSCL did not result in better myopia control efficacy Trial registration Chinese Clinical Trial Registry: ChiCTR1800018564. Registered 25 September 2018; retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=31376
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Affiliation(s)
- Yingying Huang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, 325027, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Xue Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, 325027, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Chenglu Ding
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, 325027, Zhejiang, China
| | - Yunyun Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, 325027, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Xinjie Mao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, 325027, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Hao Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, 325027, Zhejiang, China. .,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China.
| | - Jinhua Bao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, 325027, Zhejiang, China. .,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China.
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20
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Gao Y, Lim EW, Yang A, Drobe B, Bullimore MA. The impact of spectacle lenses for myopia control on visual functions. Ophthalmic Physiol Opt 2021; 41:1320-1331. [PMID: 34529275 PMCID: PMC9291741 DOI: 10.1111/opo.12878] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/24/2021] [Accepted: 07/25/2021] [Indexed: 11/25/2022]
Abstract
Purpose Spectacle lenses containing multiple small peripheral elements have been developed for myopia control in children. It is important that their effect on vision be quantified by (i) fixation through the peripheral portion, thereby using foveal vision and (ii) by fixation through the central portion and presentation of peripheral targets. Methods The above approaches were used in five studies to evaluate two novel spectacle lens designs: spectacle lenses with Highly Aspherical Lenslets (HAL) and Slightly Aspherical Lenslets (SAL). A single vision lens served as a control. Visually normal adults participated in each study. The first two studies had subjects fixate through the periphery of the lenses. High and low (10%) contrast visual acuity was measured with the Freiburg Vision Test and reading speed for high and low contrast words measured with a sentence generator. The other three studies assessed peripheral vision while subjects fixated through the central portion of the lens. Peripheral contrast sensitivity was measured using two cycles per degree drifting Gabor stimuli. Peripheral motion perception was further evaluated using random dot stimuli. Finally, attention was measured using an established test of useful field of view with three levels of complexity. Results The periphery of the HAL lens significantly reduced low contrast visual acuity, but not high contrast visual acuity, while the effect of the SAL lens was not significant for either. Neither test lens affected reading speed for high contrast words, but the HAL lens significantly affected performance for low contrast words. Neither test lens affected peripheral motion perception or useful field of view. Conclusions Low contrast visual acuity and reading was slightly reduced while high contrast visual acuity was unaffected when fixating through the periphery of the novel lens designs. None of the peripheral measures of vision was affected by the novel lens designs.
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Affiliation(s)
- Yi Gao
- Research & Development, Vision Sciences AMERA, Essilor International, Singapore, Singapore
| | - Ee Woon Lim
- Research & Development, Vision Sciences AMERA, Essilor International, Singapore, Singapore
| | - Adeline Yang
- Research & Development, Vision Sciences AMERA, Essilor International, Singapore, Singapore
| | - Björn Drobe
- Research & Development, Vision Sciences AMERA, Essilor International, Singapore, Singapore
| | - Mark A Bullimore
- College of Optometry, University of Houston, Houston, Texas, USA
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21
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Effect of Orthokeratology Lens on Contrast Sensitivity Function and High-Order Aberrations in Children and Adults. Eye Contact Lens 2021; 46:375-380. [PMID: 31577565 DOI: 10.1097/icl.0000000000000667] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Overnight orthokeratology (OOK) lenses are used to temporarily decrease myopic refractive error and improve uncorrected vision. Overnight orthokeratology lenses significantly increase ocular and corneal high-order aberrations (HOAs) and compromise contrast sensitivity function (CSF) to a degree correlated with myopic correction achieved. In Taiwan, OOK lenses are mainly used in children for myopia control. However, information regarding its effects in this population remains limited. This study discusses the change in HOAs and CSF after 28 nights of OOK lens use in children compared with that in adults. METHODS In total, 46 children (9-18 years) and 26 adults (>18 years) who visited Ophthalmology Department of Mackay Memorial Hospital from October to December 2013 were enrolled. Contrast sensitivity and ocular/corneal total high-order, coma, and spherical aberrations (SA) were tested before OOK treatment. After 28 days of overnight use, CSF and topography were reexamined, and data were collected and analyzed using t test and Pearson correlation coefficients. RESULTS In total, 23 eyes of 23 children and 14 eyes of 14 adults were evaluated. The treatment resulted in a significant increase in ocular total HOA, coma, and SA in both groups. However, CSF declined more in adults than children. CONCLUSION Our study revealed that OOK lenses decrease CSF to a greater extent in adults than that in children despite no significant differences in the change of ocular HOAs between both subject groups. We proposed children may have better neural adaptation to compensate for optical aberrations induced by OOK lens use.
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Tomiyama ES, Hu C, Marsack JD, Richdale K. Greater higher order aberrations induced by toric orthokeratology versus soft toric multifocal contact lens wear. Ophthalmic Physiol Opt 2021; 41:726-735. [PMID: 34076904 PMCID: PMC8217292 DOI: 10.1111/opo.12839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/16/2021] [Indexed: 01/15/2023]
Abstract
PURPOSE Spherical orthokeratology and soft multifocal contact lenses are commonly used for myopia control and correction, but have been shown to increase spherical aberration, coma and total higher order root mean square (HORMS) aberrations. There are limited myopia control contact lens options for patients with moderate to high astigmatism. The purpose of this study was to quantify changes in higher order aberrations (HOA) in myopic astigmatic eyes fitted with toric orthokeratology (TOK) and soft toric multifocal (STM) contact lenses. METHODS Ocular wavefront aberrations were measured in both eyes of 30 adult subjects and are reported through the 6th radial order over a 5 mm, dilated pupil. All eyes met refractive criteria of myopia (-5.00 D to plano) and cylinder (-3.50 to -1.25 D). Three measurements were taken at baseline and after 10 ± 2 days of lens wear (TOK, STM). Sixteen subjects achieved logMAR high contrast visual acuity of 0.30 or better in both eyes and were included in this analysis. Repeated measures analysis of variance and post-hoc paired t-tests were used, as appropriate, with Benjamini-Hochberg correction. RESULTS Higher order root mean square, spherical aberration (C12), and coma RMS (C7, C8) increased with TOK (0.641 [0.222], 0.409 [0.157], 0.426 [0.187] µm, respectively) and STM (0.481 [0.107], 0.223 [0.139], 0.320 [0.130] µm, respectively) from baseline (all p < 0.001). TOK was elevated compared to STM for HORMS (p = 0.03), spherical aberration (p = 0.001) and coma RMS (p = 0.04). CONCLUSIONS Toric orthokeratology induced more HORMS, spherical aberration and coma RMS than STM in myopic astigmats; however, both lens types showed an increase in HOA compared to baseline, which placed patients outside the age and pupil size matched normative ranges. While the optical changes that accompany these modalities are helpful for myopia management, the induction of HOAs may have unintended consequences on visual performance.
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Affiliation(s)
- Erin S Tomiyama
- University of Houston College of Optometry, Houston, Texas, USA
| | - Chuan Hu
- University of Houston College of Optometry, Houston, Texas, USA
| | - Jason D Marsack
- University of Houston College of Optometry, Houston, Texas, USA
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23
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He Y, Liu L, Vincent SJ. Compression Factor and Visual Performance in Adults Treated With Orthokeratology. Eye Contact Lens 2021; 47:413-419. [PMID: 33974574 DOI: 10.1097/icl.0000000000000796] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To investigate the effect of compression factor on visual performance in orthokeratology (ortho-k). METHODS Myopic adults were fitted with ortho-k lenses with either a 0.75 diopter (D) or 1.75 D compression factor. Higher-order aberrations (HOAs), corneal topography, and responses to the National Eye Institute/Refractive Error Quality of Life Instrument-42 questionnaire were measured at baseline and 6-month and 12-month follow-up along with a satisfaction questionnaire. Subjective refraction, high-contrast, and low-contrast visual acuity were measured at baseline and 1-day, 1-week, 6-month, and 12-month follow-up. RESULTS Forty-four myopic (mean spherical equivalent refraction: -3.66±0.84 D) adults (median age 25 years) completed the 12-month follow-up. After ortho-k lens wear, levels of satisfaction of vision after waking were significantly higher than vision before sleep for both compression factors (both P<0.01). The increased compression factor (ICF) resulted in less myopia at the 1-week visit (P=0.04) and better high-contrast unaided visual acuity at the 1-day visit (P=0.03) compared with the conventional compression factor (CCF). No other significant differences were observed for the compression factor for treatment zone diameter, lens decentration, or any subjective measurements. Individual HOA terms , , , and were significantly higher in the CCF group (0.75 D) (all P<0.05). The HOA visual Strehl ratio decreased significantly after lens wear (P<0.001) but did not vary with the compression factor. CONCLUSIONS An ICF did not result in clinically significant differences in subjective refraction, visual acuity, unaided vision, or the total ocular HOA profile compared with a CCF (0.75 D) in myopic adults after long-term ortho-k lens wear.
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Affiliation(s)
- Yuanhao He
- Department of Optometry and Visual Science (Y.H.), West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology (L.L.), West China Hospital, Sichuan University, Chengdu, China; and Contact Lens and Visual Optics Laboratory (S.J.V.), Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
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24
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Nti AN, Berntsen DA. Optical changes and visual performance with orthokeratology. Clin Exp Optom 2021; 103:44-54. [DOI: 10.1111/cxo.12947] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/17/2019] [Accepted: 06/18/2019] [Indexed: 12/24/2022] Open
Affiliation(s)
- Augustine N Nti
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, Texas, USA,
| | - David A Berntsen
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, Texas, USA,
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25
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Vincent SJ, Cho P, Chan KY, Fadel D, Ghorbani-Mojarrad N, González-Méijome JM, Johnson L, Kang P, Michaud L, Simard P, Jones L. CLEAR - Orthokeratology. Cont Lens Anterior Eye 2021; 44:240-269. [DOI: 10.1016/j.clae.2021.02.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 12/25/2022]
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26
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Pereira-da-Mota AF, Costa J, Amorim-de-Sousa A, González-Méijome JM, Queirós A. The Impact of Overnight Orthokeratology on Accommodative Response in Myopic Subjects. J Clin Med 2020; 9:jcm9113687. [PMID: 33213015 PMCID: PMC7698488 DOI: 10.3390/jcm9113687] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/09/2020] [Accepted: 11/12/2020] [Indexed: 12/30/2022] Open
Abstract
This study aimed to evaluate the effects of two months of orthokeratology (OK) treatment in the accommodative response of young adult myopes. Twenty eyes (21.8 ± 1.8 years) were fitted with the Paragon CRT® 100 LENS to treat myopia between −1.00 and −2.00 D. Low- and high-contrast visual acuity (LCDVA and HCDVA), central objective refraction, light disturbance (LD), and objective accommodative response (using the Grand Seiko WAM-5500 open-field autorefractometer coupled with a Badal system) were measured at baseline (BL) before lens wear and after 1, 15, 30, and 60 nights of OK. Refractive error correction was achieved during the first fifty days of OK lens wear, with minimal changes afterwards. LD analysis showed a transient increase followed by a reduction to baseline levels over the first 30 nights of treatment. The accommodative response was lower than expected for all target vergences in all visits (BL: 0.61 D at 1.00 D to 0.96 D at 5.00 D; 60 N: 0.36 D at 1.00 D to 0.79 D at 5.00 D). On average, the accommodative lag decreases over time with OK lens wear. However, these differences were not statistically significant (p > 0.050, repeated-measures ANOVA and Friedman test). This shows that overnight OK treatment does not affect objectively measured the accommodative response of young, low myopic eyes after two months of treatment stabilization.
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Lau JK, Vincent SJ, Cheung SW, Cho P. Higher-Order Aberrations and Axial Elongation in Myopic Children Treated With Orthokeratology. Invest Ophthalmol Vis Sci 2020; 61:22. [PMID: 32068792 PMCID: PMC7326571 DOI: 10.1167/iovs.61.2.22] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose This retrospective longitudinal study aimed to examine the relationship between ocular higher-order aberrations (HOA) and axial eye growth in young myopic children undergoing orthokeratology (ortho-k) treatment. Methods Axial length and ocular HOA, measured under cycloplegia annually over a 2-year period from the right eyes of myopic children, who previously completed ortho-k clinical trials, were retrieved. Linear mixed model analyses were applied to determine the association between ocular HOA, other known confounding variables (age, sex, and refractive error), and axial eye growth. Results Data from 103 subjects were analyzed. The root-mean square (RMS) values of total ocular HOA (third to sixth orders combined), spherical (Z40 and Z60 combined), and comatic (Z3-1, Z31, Z5-1, and Z51 combined) aberrations increased by approximately 3, 9, and 2 times, respectively, after 2 years of ortho-k treatment. After adjusting for age, sex, and refractive error, higher RMS values of total HOA and spherical aberrations were associated with both longer axial length and slower axial elongation (all P < 0.01). For individual Zernike term coefficients, a higher level of positive spherical aberration (Z40) was also associated with longer axial length and slower axial elongation (both P < 0.01), after adjusting for baseline HOA. Conclusions Ortho-k for myopia control significantly increases the Zernike coefficients and therefore the RMS values for a range of total ocular HOA terms or metrics in children. These findings suggest the potential role of HOA, particularly spherical aberration, as the possible mechanism of slowing axial elongation in ortho-k treatment.
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Przekoracka K, Michalak K, Olszewski J, Zeri F, Michalski A, Paluch J, Przekoracka-Krawczyk A. Contrast sensitivity and visual acuity in subjects wearing multifocal contact lenses with high additions designed for myopia progression control. Cont Lens Anterior Eye 2019; 43:33-39. [PMID: 31843372 DOI: 10.1016/j.clae.2019.12.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/30/2019] [Accepted: 12/02/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To assess the visual performance of multifocal contact lenses (MFCLs) with high addition powers designed for myopia control. METHODS Twenty-four non-presbyopic adults (mean age 24 years, range 18-36 years) were fitted with soft MFCLs with add powers of +2.0 D (Add2) and +4.0 D (Add4) (RELAX, SwissLens) and single vision lenses (SVCL; Add0) in a counterbalanced order. In this double-masked study, half of the participants were randomly fitted with 3 mm-distance central zone MFCLs while the other half received 4.5 mm-distance central zone MFCLs. Visual acuity was measured at distance (3.0 m) and at near (0.4 m). Central and peripheral contrast sensitivity was evaluated at distance using the Gabor patch test. The area under the logarithmic contrast sensitivity function curve (ALCSF) was calculated and compared between the groups (i.e. different additions powers used). RESULTS Near and distance visual acuities were not affected by the lenses, neither Add2 nor Add4, when compared to Add0, however, CZ3 significantly reduced distance visual acuity with Add4 when compared to CZ4.5 (-0.08 logMAR vs. for CZ3 and -0.18 logMAR for CZ4.5, p = 0.013). MFCLs impaired central ALCSF only when Add2 was used (15.99 logCS for Add2 and 16.36 logCS for SVCLs, p = 0.021). Peripheral ALCSF was statistically lower for both addition powers of the MFCLs when compared to SVCLs (12.70 for Add2 and Add4, 13.73 for SVCLs, p = 0.009). The above effects were the same for both central zones used. CONCLUSIONS MFCLs with CZ3 diameter and high add power (Add4) slightly reduced distance visual acuity when compared to CZ4.5 but no reduction in this parameter was found with medium add power (Add2). Central contrast sensitivity was impaired only by MFCLs with the lower add power (Add2). Both add powers in the MFCLs reduced peripheral contrast sensitivity to a similar extent.
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Affiliation(s)
- Katarzyna Przekoracka
- Laboratory of Bionics and Experimental Medical Biology, Department of Bionics and Bioimpendance, Poznań University of Medical Sciences, Parkowa 2, 60-775, Poznań, Poland; Laboratory of Vision and Neuroscience, NanoBioMedical Center, Adam Mickiewicz University of Poznań, Umultowska 85, 61-614 Poznań, Poland.
| | - Krzysztof Michalak
- Laboratory of Vision and Neuroscience, NanoBioMedical Center, Adam Mickiewicz University of Poznań, Umultowska 85, 61-614 Poznań, Poland; Laboratory of Vision Science and Optometry, Faculty of Physics, Adam Mickiewicz University of Poznań, Umultowska 85, 61-614 Poznań, Poland.
| | - Jan Olszewski
- Laboratory of Bionics and Experimental Medical Biology, Department of Bionics and Bioimpendance, Poznań University of Medical Sciences, Parkowa 2, 60-775, Poznań, Poland.
| | - Fabrizio Zeri
- University of Milano Bicocca, Department of Materials Science, R. Cozzi 55, I-20125 Milan, Italy; School of Life and Health Sciences, Aston University, Aston Triangle, B4 7ET, Birmingham, UK.
| | - Andrzej Michalski
- Department of Ophthalmology, Chair of Ophthalmology and Optometry, Poznan University of Medical Sciences, Rokietnicka 5D, 60-806 Poznań, Poznań, Poland.
| | - Joanna Paluch
- Laboratory of Vision Science and Optometry, Faculty of Physics, Adam Mickiewicz University of Poznań, Umultowska 85, 61-614 Poznań, Poland.
| | - Anna Przekoracka-Krawczyk
- Laboratory of Vision and Neuroscience, NanoBioMedical Center, Adam Mickiewicz University of Poznań, Umultowska 85, 61-614 Poznań, Poland; Laboratory of Vision Science and Optometry, Faculty of Physics, Adam Mickiewicz University of Poznań, Umultowska 85, 61-614 Poznań, Poland.
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Reducing treatment zone diameter in orthokeratology and its effect on peripheral ocular refraction. Cont Lens Anterior Eye 2019; 43:54-59. [PMID: 31776061 DOI: 10.1016/j.clae.2019.11.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/13/2019] [Accepted: 11/13/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE To determine whether orthokeratology (OK) induced treatment zone (TZ) diameter can be reduced by altering OK lens design, and if so the impact of modifying TZ diameter on relative peripheral refraction (RPR). METHODS 16 subjects (mean age 23.4 ± 1.5 years; 8 female) completed the study. Standard (Control) OK lens design (PJ, Capricornia, Australia) or a modified version (Test) where the back optic zone diameter was reduced, and back optic zone asphericity and intermediate lens curves were altered, were worn overnight only for 7-nights in a randomised double masked order, with a minimum 1-week wash out (no lens wear) between lens designs. Full correction of refractive error was targeted. Refraction; best corrected visual acuity (BCVA); RPR (Shin-Nippon NVision-k 5001) along the horizontal and vertical meridians; and corneal topography (Medmont E300) were measured before starting lens wear and in the morning after lens removal after the seventh night of lens wear for both lens designs. TZ diameter and decentration was calculated from corneal topography. RESULTS After 7-nights of wear both lens designs created -2.00D refraction effect with no significant difference in refractive effect or change to BCVA between the designs. The Test design created a significantly smaller horizontal (4.78 ± 0.37 vs 5.70 ± 0.37 mm, p < 0.001) and vertical (5.09 ± 0.51 vs 5.92 ± 0.51 mm p < 0.001) TZ diameter. The TZ was decentered inferior temporal with no significant difference between designs. There was no significant difference between the lens designs in RPR along the horizontal and vertical meridians at any measurement period. CONCLUSIONS OK induced TZ diameter can be reliably reduced by altering OK lens design without detrimentally effecting lens centration or refractive effect. Reducing TZ diameter did not alter RPR, though measurement artifacts could be responsible for masking an effect. Longitudinal studies are needed to assess whether smaller TZ OK lens designs increase efficacy for slowing progression of myopia.
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Batres L, Peruzzo S, Serramito M, Carracedo G. Accommodation response and spherical aberration during orthokeratology. Graefes Arch Clin Exp Ophthalmol 2019; 258:117-127. [PMID: 31720836 DOI: 10.1007/s00417-019-04504-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 09/12/2019] [Accepted: 10/03/2019] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To evaluate the changes in the accommodative response and in the corneal and internal spherical aberration during 3 months of wear of orthokeratology lenses from the baseline. METHODS Fifty children aged 8 to 17 were recruited for a prospective study and were fitted with orthokeratology lenses. Refraction without cycloplegia, high and low uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), accommodation lag, horizontal near phoria without correction, corneal topography, corneal, and total wavefront aberration were performed at baseline, 1 day, 1 week, 1 month, and 3 months. Data were analyzed by Student's t test for related samples, repeated measures ANOVA test, and Pearson correlation test. RESULTS The spherical equivalent (SE) before and after 3 months was - 3.33 ± 1.60 D and - 0.30 ± 0.46 D, respectively. Accommodation lag was 0.53 ± 0.38 D and 0.20 ± 0.33 D at baseline and at 3 months, respectively. A moderate correlation between lag at the baseline and its change between baseline and the 3-month visit was found (P < 0.05; R = 0.748). The spherical aberration (SA) increased for anterior corneal and total measurement, being statistically significant for all visits (P < 0.05). The internal SA decreased: - 0.105 ± 0.006 at baseline and - 0.196 ± 0.203 at 1 week (P < 0.05). No difference between baseline and the follow-up visits in posterior corneal SA was found (P > 0.05) CONCLUSION: The negative SA of the lens increases during OK treatment compensated for the increase of the anterior corneal surface positive SA, in addition to increasing the accommodative response.
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Affiliation(s)
- L Batres
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos del Jalon 118, 28032, Madrid, Spain
- Ophthalmological Clinic Doctor Lens, Madrid, Spain
| | - S Peruzzo
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos del Jalon 118, 28032, Madrid, Spain
| | - M Serramito
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos del Jalon 118, 28032, Madrid, Spain
| | - G Carracedo
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos del Jalon 118, 28032, Madrid, Spain.
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Lau JK, Vincent SJ, Cheung SW, Cho P. The influence of orthokeratology compression factor on ocular higher-order aberrations. Clin Exp Optom 2019; 103:123-128. [PMID: 31264269 DOI: 10.1111/cxo.12933] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND To investigate the influence of compression factor upon changes in ocular higher-order aberrations (HOAs) in young myopic children undergoing orthokeratology treatment. METHODS Subjects aged between six and < 11 years, with low myopia (0.50-4.00 D inclusive), low astigmatism (≤ 1.25 D), and anisometropia (≤ 1.00 D), were randomly assigned to wear orthokeratology lenses of different compression factors in each eye (one eye 0.75 D and the fellow eye 1.75 D). HOAs were measured weekly over one month of lens wear. Wavefront analysis was conducted over a 5-mm pupil using a sixth order Zernike polynomial expansion. Linear mixed models were used to examine the individual Zernike co-efficients and specific root-mean-square (RMS) error (spherical, comatic, total HOAs) metrics and their changes between the two eyes during the study period. RESULTS Twenty-eight myopic (mean manifest spherical equivalent refraction: -2.10 ± 0.58 D) children (median [range] age: 9.3 [7.8-11.0] years) were analysed. Significant interocular differences in HOAs at baseline were observed for Z 6 - 6 and Z 6 - 4 only (both p < 0.05). During the lens wear period, eyes fitted with the increased compression factor showed greater changes in primary spherical aberration ( Z 4 0 , p = 0.04) and RMS values for spherical and total HOAs (both p < 0.01). Considering data from both eyes together, after adjusting for the paired nature of the data, some other Zernike terms ( Z 3 1 and Z 6 0 , both p < 0.01) and the RMS value of comatic aberrations (p < 0.001) significantly increased after one month of orthokeratology treatment. The increase in primary spherical aberration ( Z 4 0 ) was positively correlated with the reduction in spherical equivalent refractive error, but only in eyes fitted with the increased compression factor (r = 0.69, p < 0.001). CONCLUSIONS Increasing the orthokeratology compression factor by 1.00 D significantly altered some HOAs, particularly spherical aberration. Given the association between positive spherical aberration and eye growth in children, further research investigating the influence of orthokeratology compression factor on axial eye growth is warranted.
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Affiliation(s)
- Jason K Lau
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Stephen J Vincent
- Contact Lens and Visual Optics Laboratory, School of Optometry and Visual Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Sin-Wan Cheung
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
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Vision-Specific Quality of Life: Laser-Assisted in situ Keratomileusis Versus Overnight Contact Lens Wear. Eye Contact Lens 2019; 45:34-39. [PMID: 30048340 DOI: 10.1097/icl.0000000000000538] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To compare the visual-related quality of life in myopic subjects with different refractive treatments such as continuous wear of silicone-hydrogel contact lenses (CL), corneal refractive therapy (CRT), and laser-assisted in situ keratomileusis (LASIK). METHODS The National Eye Institute Refractive Error Quality of Life Instrument (NEI RQL-42) questionnaire was administered to 96 subjects with a mean age of 30.0±7.9 years. There were 72 myopic subjects with a mean spherical equivalent of -2.74±0.98 D (-5.50 to -1.25 D). Subjects were corrected with LASIK (n=24), Paragon CRT orthokeratology lenses (n=24), and lotrafilcon A silicone-hydrogel CL under continuous wear (n=24). The NEI RQL-42 survey was used to compare differences between groups as well as with an emmetropic group (n=24). RESULTS After 1 year of treatment, significant differences were found among all groups in the subscales glare (P=0.017), symptoms (P=0.016), dependence on correction (P<0.001), and worry (P<0.001). The mean difference compared with emmetropes were -5.5% (P=0.063) for LASIK patients, -2.0% (P=0.212) for orthokeratology subjects, and +1.6% (P=0.934) for the silicone-hydrogel CL group. CONCLUSIONS Myopic subjects analyzed in this study reported better vision-related quality of life when they were corrected with continuous wear silicone-hydrogel lenses. The average score reached by CRT was similar to emmetropes, which showed the main disadvantage in worry subscale. The patients who underwent LASIK had the lowest valuation, highlighting the decreases in scores of diurnal fluctuations, glare, and especially in expectations and worry subscales, due to the first and second subscales, but especially to the false expectations created about treatment.
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Impact of Defocus and High-Order Aberrations on Light Disturbance Measurements. J Ophthalmol 2019; 2019:2874036. [PMID: 30719337 PMCID: PMC6334342 DOI: 10.1155/2019/2874036] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 09/28/2018] [Accepted: 12/09/2018] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the impact of different levels of positive and negative defocus on light disturbance (LD) measures and to understand how high-order aberrations (HOAs) and topographic quality parameters may influence the perception of photic phenomena. Methods Thirty young healthy subjects (21 females and 9 males) attended this cross-sectional study. LD was evaluated with the light distortion analyzer (LDA) in natural accommodative and cycloplegic conditions with positive and negative induced defocus of 1.00D. HOAs were taken for a natural mesopic (without cycloplegia) and for fixed 5 mm (with cycloplegia) pupil size. The impact of corneal morphological parameters (SAI, SRI, and Q-value) in LD was also investigated. Results Positive and negative induced defocus of 1.00D significantly increased the size of LD (p < 0.010, Wilcoxon signed rank test) but not its irregularity index. Spherical-like HOAs were associated with the size of LD, while coma-like and total-like HOAs were associated with LD irregularity. Our results showed that SRI was significantly correlated with the size of the disturbance area (r=0.519, p=0.003, Spearman correlation) and SAI with both size (r=0.502, p=0.005, Spearman correlation) and irregularity (r=0.371, p=0.044, Spearman correlation). However, no correlation between the Q-value and LD parameters was found. Conclusions The uncorrected positive and negative refractive errors might increase the size of the LD, such as the spherical-like HOAs, SAI, and SRI, instead of asphericity. Coma-like and total-like HOAs and SAI may influence the perception of irregularities in the LD shape. These results might have an impact on postrefractive surgery visual performance that should be investigated.
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Changes and Diurnal Variation of Visual Quality after Orthokeratology in Myopic Children. J Ophthalmol 2018; 2018:3174826. [PMID: 30410793 PMCID: PMC6205316 DOI: 10.1155/2018/3174826] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 09/18/2018] [Indexed: 11/17/2022] Open
Abstract
Purpose To assess the changes and the diurnal variation of visual quality after orthokeratology in myopic children. Methods Forty-four eyes of 22 subjects with a mean age of 10.55 ± 1.53 years (8 to 14 years) were enrolled in this prospective study. Their spherical equivalent ranged from -1.25 to -4.25 diopters (D) and astigmatism was less than 1.00 D. Parameters including corneal curvature, ocular objective scatter index (OSI), the modulation transfer function (MTF), root mean square of ocular and corneal wavefront aberrations, and contrast sensitivity function (CSF) were measured before and at two time points during the same day after 1 month of orthokeratology. Results After orthokeratology, uncorrected visual acuity (UCVA) and spherical equivalent were significantly improved from baseline (P < 0.001), and their diurnal variation was not significant (P=0.083, 0.568). OSI increased from 0.29 ± 0.15 to 0.65 ± 0.31 (P < 0.001). MTF decreased significantly (P < 0.01). Corneal curvature and ocular total aberration decreased (P < 0.001), while the ocular and corneal higher-order aberration increased significantly (P < 0.01). The CSF under photopic condition decreased at 3 cpd (P=0.006) and increased at 18 cpd (P=0.012). The diurnal variation of CSF at 18 cpd under mesopic and high glare conditions and at 12 cpd under photopic condition was significant (P=0.002, 0.01, 0.017). Conclusions Orthokeratology can effectively improve UCVA and high spatial frequency CSF by decreasing the low-order aberrations. However, MTF and CSF at low spatial frequency decreased because of the increase of intraocular scattering and high-order aberrations. Meanwhile, CSF at high spatial frequency fluctuates significantly at two times during the same day after 1 month orthokeratology.
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Short-Term Effects of Overnight Orthokeratology on Corneal Sub-basal Nerve Plexus Morphology and Corneal Sensitivity. Eye Contact Lens 2018; 44:77-84. [PMID: 27243354 DOI: 10.1097/icl.0000000000000282] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the effects of a short period of orthokeratology (OK) on corneal sub-basal nerve plexus (SBNP) morphology and corneal sensitivity. METHODS Measurements were made in 56 right eyes of 56 subjects with low-to-moderate myopia who wore 2 OK lens designs (Group CRT: HDS 100 Paragon CRT, n=35; Group SF: Seefree; n=21) for a period of 1 month and in 15 right eyes of noncontact lens wearers as controls. The variables determined in each participant were corneal sensitivity using a Cochet-Bonnet esthesiometer and 12 SBNP variables determined on laser scanning confocal microscopy images using 3 different software packages. Correlation between SBNP architecture and corneal sensitivity was also examined. RESULTS Few changes were observed over the 1-month period in the variables examined in the OK treatment and control groups. However, significant reductions were detected over time in the number of nerves in the central cornea in the groups CRT (P=0.029) and SF (P=0.043) and in central corneal sensitivity in CRT (P=0.047) along with significant increases in central and midperipheral corneal Langerhans cell counts in SF (P=0.001 and 0.048, respectively). CONCLUSIONS This study provides useful data to better understand the anatomical changes induced by OK in corneal SBNP. The different response observed to the 2 OK lens designs requires further investigation.
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Schulle KL, Berntsen DA, Sinnott LT, Bickle KM, Gostovic AT, Pierce GE, Jones-Jordan LA, Mutti DO, Walline JJ. Visual Acuity and Over-refraction in Myopic Children Fitted with Soft Multifocal Contact Lenses. Optom Vis Sci 2018; 95:292-298. [PMID: 29561497 PMCID: PMC5880703 DOI: 10.1097/opx.0000000000001207] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
SIGNIFICANCE Practitioners fitting contact lenses for myopia control frequently question whether a myopic child can achieve good vision with a high-add multifocal. We demonstrate that visual acuity is not different than spectacles with a commercially available, center-distance soft multifocal contact lens (MFCL) (Biofinity Multifocal "D"; +2.50 D add). PURPOSE To determine the spherical over-refraction (SOR) necessary to obtain best-corrected visual acuity (BCVA) when fitting myopic children with a center-distance soft MFCL. METHODS Children (n = 294) aged 7 to 11 years with myopia (spherical component) of -0.75 to -5.00 diopters (D) (inclusive) and 1.00 D cylinder or less (corneal plane) were fitted bilaterally with +2.50 D add Biofinity "D" MFCLs. The initial MFCL power was the spherical equivalent of a standardized subjective refraction, rounded to the nearest 0.25 D step (corneal plane). An SOR was performed monocularly (each eye) to achieve BCVA. Binocular, high-contrast logMAR acuity was measured with manifest spectacle correction and MFCLs with over-refraction. Photopic pupil size was measured with a pupilometer. RESULTS The mean (±SD) age was 10.3 ± 1.2 years, and the mean (±SD) SOR needed to achieve BCVA was OD: -0.61 ± 0.24 D/OS: -0.58 ± 0.27 D. There was no difference in binocular high-contrast visual acuity (logMAR) between spectacles (-0.01 ± 0.06) and best-corrected MFCLs (-0.01 ± 0.07) (P = .59). The mean (±SD) photopic pupil size (5.4 ± 0.7 mm) was not correlated with best MFCL correction or the over-refraction magnitude (both P ≥ .09). CONCLUSIONS Children achieved BCVA with +2.50 D add MFCLs that was not different than with spectacles. Children typically required an over-refraction of -0.50 to -0.75 D to achieve BCVA. With a careful over-refraction, these +2.50 D add MFCLs provide good distance acuity, making them viable candidates for myopia control.
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Abstract
SIGNIFICANCE Commercially available aberrometers are essential to clinical studies evaluating refractive error and image quality. The Discovery System (Innovative Visual Systems, Elmhurst, IL) is a promising clinical instrument that allows investigators to export aberration data for research and analysis purposes. An assessment of the Discovery System's performance is essential to the interpretation of the data obtained. PURPOSE The aims of this study were to determine the between-visit repeatability of refractive error and higher-order aberration measurements with the Discovery System and to examine between-instrument agreement of refractive error measurements with the Discovery System and Grand Seiko WAM-5500 open-field autorefractor (Grand Seiko Co., Hiroshima, Japan). METHODS Cycloplegic refractive error values from the Discovery System (over a 3-mm pupil) and the Grand Seiko autorefractor were converted to power vectors (M, J0, and J45), and averaged. Zernike coefficients were also calculated by the Discovery System over a 6-mm pupil through the sixth radial order. Between-visit repeatability and agreement were evaluated using Bland-Altman difference-versus-mean plots. A t-test compared each mean difference (bias) to zero, and the 95% limits of agreement were calculated. RESULTS Twenty-five young adults with a mean (±SD) cycloplegic spherical-equivalent refractive error of -2.91 ± 1.85 diopters (D) (range, -6.96 to +0.74 D) were enrolled. There were no significant between-visit differences with the Discovery System for M, J0, J45, third- through sixth-order root mean square (RMS), higher-order RMS, or spherical aberration (all P > .30), and the repeatability for defocus and higher-order RMS were ±0.31 D and ±0.095 μm, respectively, for a 6-mm pupil. At a 3-mm pupil, the Discovery System, on average, measured slightly more positive values than the Grand Seiko for M (0.28 D), J0 (0.11 D), and J45 (0.12 D; all P < .005). CONCLUSIONS The Discovery System was very repeatable and would be an appropriate instrument to measure cycloplegic refractive error and higher-order aberration changes in adults. Small differences in refractive error were found between the Discovery System and Grand Seiko.
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Affiliation(s)
- Mylan T Nguyen
- The Ocular Surface Institute, University of Houston College of Optometry, Houston, Texas
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Interaction between Corneal and Internal Ocular Aberrations Induced by Orthokeratology and Its Influential Factors. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3703854. [PMID: 28845432 PMCID: PMC5563403 DOI: 10.1155/2017/3703854] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 06/01/2017] [Accepted: 06/18/2017] [Indexed: 12/17/2022]
Abstract
Purpose To investigate the interaction between corneal, internal, and total wavefront aberrations (WAs) and their influential factors during orthokeratology (OK) treatment in Chinese adolescents. Methods Thirty teenagers (n = 30 eyes) were enrolled in the study; spherical equivalent refraction (SE), corneal curvature radius (CCR), central corneal thickness (CCT), WAs, and the difference in limbal transverse diameter and OK lens diameter (ΔLLD) were detected before and after one-month OK treatment. Every component of WAs was measured simultaneously by iTrace aberrometer. The influential factors of OK-induced WAs were analyzed. Results SE and CCT decreased while CCR increased significantly (P < 0.01). Higher-order aberrations (HOAs), Spherical aberrations (SAs), and coma increased significantly (P < 0.01). Corneal horizontal coma (Z31-C) and corneal spherical aberrations (Z40-C) increased (P < 0.01). The HOAs, coma, SAs, Z31-C, Z31-T, Z40-C, and Z40-T were positively correlated with SE and CCR (P < 0.01). Z3−1-C showed negative correlations with (ΔLLD) and positive correlations with SE (P < 0.05). Conclusions The increase in OK-induced HOAs is mainly attributed to Z31 and Z40 of cornea. Z3−1 in the internal component showed a compensative effect on the corneal vertical coma. The degree of myopic correction and increase in CCR may be the essential influential factors of the increase in Z31 and Z40. The appropriate size of the OK lens may be helpful to decrease OK-induced vertical coma.
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Moore KE, Benoit JS, Berntsen DA. Spherical Soft Contact Lens Designs and Peripheral Defocus in Myopic Eyes. Optom Vis Sci 2017; 94:370-379. [PMID: 28225372 PMCID: PMC5324711 DOI: 10.1097/opx.0000000000001053] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Peripheral retinal defocus has been implicated in myopia progression. The effect of commercially available spherical soft contact lenses (SCLs) on peripheral defocus of adult myopic eyes was investigated. METHODS Twenty-five young adults with spherical equivalent (SE) refractions between -0.50D and -6.00D were enrolled. Cycloplegic autorefraction (right eye) was measured centrally and ±20°, ±30°, and ±40° from the line of sight along the horizontal meridian using an autorefractor. Four commercially available spherical SCLs (Biofinity, Acuvue2, PureVision2, and Air Optix Night & Day Aqua) were evaluated. SE defocus (M) was used to calculate relative peripheral defocus (RPD) while wearing each SCL and relative peripheral refraction of the uncorrected eye. Spherical aberration (SA) changes caused by each SCL were measured along the line of sight by aberrometry. Peripheral defocus was analyzed using repeated-measures analyses of variance (RM-ANOVA). The association between changes in axial SA and the change in peripheral defocus was evaluated using linear mixed models. RESULTS The mean age (±SD) and central SE refractive error were 24.0 ± 1.3 years and -3.45 ± 1.42D, respectively. PureVision2 did not change RPD (P = .33). Significant myopic shifts on the temporal retina were found with three lenses: Acuvue 2 (-0.29D at 30°; -0.80D at 40°; both P ≤ .01), Biofinity (-1.21 D at 40°; P = .02), and Air Optix Night & Day Aqua (-0.23D at 20°, -0.48D at 30°, and -1.50D at 40°; all P < .004). All SCLs caused a negative change in SA. SCLs inducing less negative (more positive) SA changes were associated with a less hyperopic change in RPD. CONCLUSIONS Spherical SCL design can influence the peripheral defocus profile experienced by a myopic eye. Several, but not all, SCLs reduced peripheral hyperopia. Differences in how SCL types influence peripheral defocus may have implications for myopia progression.
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Affiliation(s)
- Kelly E Moore
- *OD, MS †PhD ‡OD, PhD, FAAO The Ocular Surface Institute, College of Optometry (KEM, DAB), and College of Optometry & Texas Institute for Measurement, Evaluation, and Statistics (TIMES) (JSB), University of Houston, Houston, Texas
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Yang X, Li Z, Zeng J. A Review of the Potential Factors Influencing Myopia Progression in Children Using Orthokeratology. Asia Pac J Ophthalmol (Phila) 2017; 5:429-433. [PMID: 27898447 DOI: 10.1097/apo.0000000000000242] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Myopia has become a worldwide public health issue. Recent studies have consistently reported that orthokeratology (Ortho-K) significantly inhibits the progression of myopia by slowing the elongation of axial length. It has been hypothesized that this effect results from the induction of peripheral myopic defocus, which is a result of the effects of the Ortho-K lenses on the midperipheral corneal topography. Previous studies have investigated the relationship between predicting factors and the inhibitory effect of Ortho-K for slowing childhood myopic progression and found some meaningful results; however, some of the findings are controversial. To enhance the understanding of the underlying mechanism of Ortho-K in slowing childhood myopic progression, the factors affecting this process were reviewed.
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Affiliation(s)
- Xiao Yang
- From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
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Corneal Aberrations, Contrast Sensitivity, and Light Distortion in Orthokeratology Patients: 1-Year Results. J Ophthalmol 2016; 2016:8453462. [PMID: 27867660 PMCID: PMC5102743 DOI: 10.1155/2016/8453462] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 07/27/2016] [Accepted: 08/30/2016] [Indexed: 11/17/2022] Open
Abstract
Purpose. To evaluate the corneal higher-order aberrations (HOA), contrast sensitivity function (CSF), and light distortion (LD) in patients undergoing orthokeratology (OK). Methods. Twenty healthy subjects (mean age: 21.40 ± 8 years) with mean spherical equivalent refractive error M = −2.19 ± 0.97 D were evaluated at 1 day, 1 month, and 1 year after starting OK treatment. Monocular LD, photopic monocular CSF, and corneal HOA for 6 mm pupil size were measured. Results. LD showed an increase after the first night (p < 0.05) and recovery to baseline after 1 month, remaining stable after 1 year (p > 0.05). Spherical-like, coma-like, and secondary astigmatism HOA RMS increased significantly (p ≤ 0.022) from baseline to 1-month visit, remaining unchanged over the follow-up. Contrast sensitivity for medium frequencies (3.0, 4.24, and 6.00 cpd) was significantly correlated with LD parameters at baseline (r ≤ −0.529, p < 0.001). However, after 1 year of treatment, this correlation was only statistically significant for 12 cpd spatial frequency (r ≤ −0.565, p < 0.001). Spherical-like RMS for 6 mm pupil size correlated with irregularity of the LD (r = −0.420, p < 0.05) at the 1-year visit. Conclusion. LD experienced by OK patients recovers after one month of treatment and remains stable in the long term while optical aberrations remain significantly higher than baseline.
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Lee DH, Lee JE. Correlation among Myopic Correction, Axial Length and Aberration after Orthokeratology Lens Treatment in Myopic Patients. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2016. [DOI: 10.3341/jkos.2016.57.7.1050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Dong Hyun Lee
- Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ji Eun Lee
- Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
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Li SM, Kang MT, Wu SS, Liu LR, Li H, Chen Z, Wang N. Efficacy, Safety and Acceptability of Orthokeratology on Slowing Axial Elongation in Myopic Children by Meta-Analysis. Curr Eye Res 2015; 41:600-8. [PMID: 26237276 DOI: 10.3109/02713683.2015.1050743] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To compare the efficacy, safety and acceptability of a treatment group (Orthokeratology) to a control group (single vision Spectacles) on slowing axial elongation in children. METHODS We searched studies in MEDLINE, EMBASE and the Cochrane Library up to January 2015 for randomized controlled trials (RCTs) and observational studies. We pooled the mean differences between the Orthokeratology and Control groups for axial elongation and the OR for rates of adverse events and dropout. RESULTS Three RCTs and six cohort studies with 667 children aged 6-16 years old were included. Two years' mean differences in axial elongation were -0.27 mm (95% confidence intervals [CI], -0.32 to -0.23) in all studies, -0.28 mm (95% CI, -0.35 to -0.20) in RCTs and -0.27 mm (95% CI, -0.32 to -0.22) in cohort studies (p < 0.01). At 6 months, 1 year, 1.5 years and 2 years, mean differences in axial elongation were -0.13 mm, -0.19 mm, -0.23 mm, and -0.27 mm (p < 0.01), respectively. The effect was greater in Asian children than Caucasian (-0.28 mm versus -0.22 mm) and in children with moderate to high myopia when compared to children with low myopia (-0.35 mm versus -0.25 mm). Orthokeratology had more non-significant adverse events (odd ratio [OR], 8.87; 95% CI, 3.79-20.74; p < 0.01) but comparable dropout rates (OR = 0.84, 95% CI, 0.40-1.74, p = 0.64) than control. CONCLUSION Orthokeratology has significantly greater efficacy in controlling axial elongation in children compared to Spectacle correction. The safety and acceptability results are good, and there appears to be a greater myopia control effect in Chinese children compared to Caucasians, and in those with higher initial myopia.
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Affiliation(s)
- Shi-Ming Li
- a Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University , Beijing , China
| | - Meng-Tian Kang
- a Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University , Beijing , China
| | - Shan-Shan Wu
- b Department of Epidemiology and Health Statistics , Peking University School of Public Health , Beijing , China
| | - Luo-Ru Liu
- c Anyang Eye Hospital, Henan Province , China and
| | - He Li
- c Anyang Eye Hospital, Henan Province , China and
| | - Zhuo Chen
- d Lakewood Eye Care , Houston, TX , USA
| | - Ningli Wang
- a Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University , Beijing , China
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Abstract
PURPOSE To investigate whether significant thickening occurs in the human choroid in response to chronic peripheral myopic defocus during overnight orthokeratology. METHODS Subjects were nine children 11 to 15 years old (mean [±SD] age, 13.61 [±1.25] years). Measurements were taken at baseline and after 1, 3, 6, and 9 months of successful orthokeratology. Choroidal thickness in central, superior, temporal, and nasal gazes were measured using the Zeiss Cirrus HD-OCT. The Lenstar LS 900 biometer provided a secondary measure of subfoveal choroidal thickness. Peripheral ocular length was measured in the same four fields of gaze with the Zeiss IOLMaster. Corneal and optical changes from orthokeratology were monitored throughout the study by corneal topography (Humphrey ATLAS), aberrometry (Complete Ophthalmic Analysis System), and central and peripheral autorefraction (Grand Seiko) after tropicamide 1% cycloplegia. RESULTS All subjects had acceptable acuity and physiologic response to overnight wear. After 1 month, central refractive error (mean ± SD) became significantly less myopic (-2.25 ± 0.95 diopters [D] vs. -0.24 ± 1.03 D), keratometric values flattened by 1.6 D, the shape factor (Q) became more oblate (-0.28 ± 0.05 vs. +0.34 ± 0.41), and spherical aberration became more positive (+0.14 ± 0.08 μm vs. +0.46 ± 0.15 μm; all p = 0.008). Peripheral refractive error remained -1.0 to -3.5 D myopic in all fields of gaze throughout the study. There were no consistent, significant changes in choroidal thickness or ocular length at any retinal location during the study (all p > 0.051). Lenstar measurement of choroidal thickness was unsuccessful because of the absence of choroidal peaks associated with thicker choroids (rs = -0.66, p < 0.0001). CONCLUSIONS The choroid did not show long-term thickening during orthokeratology despite the presence of substantial amounts of peripheral myopic defocus. Apparent inhibition of ocular growth was not attributed to an optical artifact of choroidal thickening, although smaller amounts of thickening or greater biological activity independent of thickening cannot be ruled out.
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Swarbrick HA, Alharbi A, Watt K, Lum E, Kang P. Myopia control during orthokeratology lens wear in children using a novel study design. Ophthalmology 2014; 122:620-30. [PMID: 25439432 DOI: 10.1016/j.ophtha.2014.09.028] [Citation(s) in RCA: 153] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 09/04/2014] [Accepted: 09/20/2014] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To investigate the effect of overnight orthokeratology (OK) contact lens wear on axial length growth in East Asian children with progressive myopia. DESIGN A prospective, randomized, contralateral-eye crossover study conducted over a 1-year period. PARTICIPANTS We enrolled 26 myopic children (age range, 10.8-17.0 years) of East Asian ethnicity. METHODS Subjects were fitted with overnight OK in 1 eye, chosen at random, and conventional rigid gas-permeable (GP) lenses for daytime wear in the contralateral eye. Lenses were worn for 6 months. After a 2-week recovery period without lens wear, lens-eye combinations were reversed and lens wear was continued for a further 6 months, followed by another 2-week recovery period without lens wear. Axial eye length was monitored at baseline and every 3 months using an IOLMaster biometer. Corneal topography (Medmont E300) and objective refraction (Shin-Nippon NVision-K 5001 autorefractor) were also measured to confirm that OK lens wear was efficacious in correcting myopia. MAIN OUTCOME MEASUREMENTS Axial length elongation and myopia progression with OK were compared with conventional daytime rigid contact lens wear. RESULTS After 6 months of lens wear, axial length had increased by 0.04±0.06 mm (mean±standard deviation) in the GP eye (P=0.011) but showed no change (-0.02±0.05 mm) in the OK eye (P=0.888). During the second 6-month phase of lens wear, in the OK eye there was no change from baseline in axial length at 12 months (-0.04±0.08 mm; P=0.218). However, in the GP eye, the 12-month increase in axial length was significant (0.09±0.09 mm; P<0.001). The GP lens-wearing eye showed progressive axial length growth throughout the study. CONCLUSIONS These results provide evidence that, at least in the initial months of lens wear, overnight OK inhibits axial eye growth and myopia progression compared with conventional GP lenses. Apparent shortening of axial length early in OK lens wear may reflect the contribution of OK-induced central corneal thinning, combined with choroidal thickening or recovery due to a reduction or neutralization of the myopiogenic stimulus to eye growth in these myopic children.
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Affiliation(s)
- Helen A Swarbrick
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.
| | - Ahmed Alharbi
- Department of Optometry and Vision Science, King Saud University, Riyadh, Saudi Arabia
| | - Kathleen Watt
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Edward Lum
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Pauline Kang
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Hiraoka T, Kakita T, Okamoto F, Oshika T. Influence of ocular wavefront aberrations on axial length elongation in myopic children treated with overnight orthokeratology. Ophthalmology 2014; 122:93-100. [PMID: 25234013 DOI: 10.1016/j.ophtha.2014.07.042] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 07/08/2014] [Accepted: 07/20/2014] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To determine ocular optical parameters that affect axial length elongation in myopic children undergoing overnight orthokeratology. DESIGN Prospective, noncomparative study. PARTICIPANTS Fifty-nine subjects who met the inclusion criteria were enrolled in this study. METHODS Axial length and ocular wavefront aberration were assessed before and 1 year after the start of orthokeratology. Corneal topography was performed, and then corneal multifocality was calculated for a 4-mm pupil. After evaluating simple correlations between axial elongation and optical parameters, multiple linear regression analysis was performed to identify explanatory variables with a statistically significant contribution to axial elongation. MAIN OUTCOME MEASURES Axial length and ocular wavefront aberration before and 1 year after the start of orthokeratology. RESULTS Fifty-five subjects completed the 1-year follow-up examinations. At baseline, their age ranged from 7.2 to 12.0 years. The manifest spherical equivalent refractive error ranged from -3.50 to -0.75 diopters. The mean axial length significantly increased from 24.20 mm at baseline to 24.43 mm 1 year after treatment. The axial elongation showed significant simple correlations with the change in C2(0), change in second-order aberration, change in coma-like aberration, change in spherical-like aberration, change in total higher-order aberrations, change in corneal multifocality, baseline age, and baseline spherical equivalent refractive error, but not C4(0). Multiple linear regression analysis showed that the change in coma-like aberration was the most relevant variable. CONCLUSIONS Asymmetric corneal shapes, rather than concentric and radially symmetric shapes, have a considerable effect on retardation of axial elongation, suggesting that the inhibitory effect of orthokeratology on myopia progression is caused by mechanisms other than the reduction in peripheral hyperopic defocus.
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Affiliation(s)
- Takahiro Hiraoka
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
| | | | - Fumiki Okamoto
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Tetsuro Oshika
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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Can Manipulation of Orthokeratology Lens Parameters Modify Peripheral Refraction? Optom Vis Sci 2013; 90:1237-48. [DOI: 10.1097/opx.0000000000000064] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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González-Mesa A, Villa-Collar C, Lorente-Velázquez A, Nieto-Bona A. Anterior segment changes produced in response to long-term overnight orthokeratology. Curr Eye Res 2013; 38:862-70. [PMID: 23631807 DOI: 10.3109/02713683.2013.790977] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To evaluate the effect of overnight orthokeratology (OK) on anterior chamber depth (ACD), posterior radius of corneal curvature (PRCC) and axial length (AL) over one year. METHODS In this prospective longitudinal study, measurements were made in 34 right eyes of 34 subjects at baseline, 15 days, 1 and 12 months after starting OK treatment. ACD and PRCC measurements were obtained using a Pentacam system and AL was measured using an IOL-Master. ACD and PRCC were measured along the horizontal and vertical meridians at 1 mm intervals. These measurements were expressed as the distance from the center in the nasal (N), temporal (T), superior (S) and inferior (I) directions. RESULTS A significant reduction in ACD was observed in both meridians during treatment. PRCC flattened significantly in the (T) direction after 15 d (1 mm, p < 0.05), at the corneal center after 15 d (p < 0.01), in the (T) direction after 1 month (1 mm, p < 0.05), in the (S) direction after 12 months (1 mm p < 0.05), in the (N) direction after 12 months (1 mm p < 0.05), in the (N) and (T) directions after 12 months (3 mm, p < 0.05) and in the (T) direction after 12 months (4 mm p < 0.05), at the corneal center after 12 months (p < 0.01). AL was significantly reduced during treatment (p < 0.05). CONCLUSIONS A long period of OK reduces ACD and AL and changes PRCC.
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Affiliation(s)
- Ana González-Mesa
- Department of Optics II, University School of Optics, Madrid, Spain.
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