1
|
Ritchey ER, Gregory HR, Nti AN, Berntsen DA. Intraocular Straylight and Multifocal Soft Contact Lens Fit With a Myopia Control Approach. Eye Contact Lens 2024; 50:171-176. [PMID: 38345090 PMCID: PMC10963149 DOI: 10.1097/icl.0000000000001069] [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] [Accepted: 12/07/2023] [Indexed: 03/26/2024]
Abstract
OBJECTIVES Center-distance multifocal contact lenses (MFCLs) are used to slow myopia progression. We examined the effect of two MFCLs on intraocular straylight values in myopic individuals. METHODS Twenty-five young myopic adults were enrolled and were fit with three contact lenses (Biofinity sphere, Biofinity Multifocal, and NaturalVue Multifocal) in a random order over two study visits. Pupil size (NeurOptics VIP-300, Laguna Hills, CA) and contact lens centration were measured. Right eye intraocular straylight measurements were collected (OCULUS C-Quant; Wetzlar, Germany) and compared with a spectacle trial lens. Log straylight (LogSL) values and straylight residuals were analyzed using repeated-measures analyses of variance with Tukey-corrected post hoc t -tests. RESULTS The mean participant age (±SD) was 24.1±1.5 years, and right eye spherical equivalent refractive error was -3.38±1.53 DS. There was no difference in mesopic pupil size between visits ( P =0.68) and no difference in contact lens centration between lenses ( P =0.99). LogSL values differed by lens type ( P =0.004). LogSL with the spectacle trial lens was significantly greater than with each contact lens type (all P <0.05), but there were no significant differences in LogSL between the three contact lenses (all P >0.05). There was no difference between the three contact lens designs for straylight residuals ( P =0.33). CONCLUSIONS Measured intraocular straylight for both MFCLs was not different than with a spherical soft contact lens. A significant increase in intraocular straylight with spectacle trial lens correction was observed compared with all contact lenses.
Collapse
|
2
|
Sah RP, Meyer D, Jaskulski M, Rickert M, Cheng X, Brennan N, Kollbaum PS. Impact of zone geometry on the introduction of myopic defocus in young adult eyes wearing multi-zone lenses. Ophthalmic Physiol Opt 2023; 43:1110-1124. [PMID: 37326329 DOI: 10.1111/opo.13182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/22/2023] [Accepted: 05/29/2023] [Indexed: 06/17/2023]
Abstract
PURPOSE Multizone contact lenses control myopia progression by proposed introduction of myopic defocus. This project investigated how much of the pupil area and how many dioptres of myopic defocus are introduced by different lens zone geometries with near- and off-axis viewing. METHODS Ten young myopic adults (18-25 years) binocularly wore four soft contact lenses including a single vision (SV), concentric-ring dual-focus (DF), centre-distance multifocal (MF) and a RingBoost™ (RB) multi-zone design containing a combination of coaxial and non-coaxial zones. A modified aberrometer captured aberrations and pupil sizes at four target vergences between -0.25 and -4.00 D (on-axis) and across the central ±30° of the horizontal retina (off-axis). Defocus was quantified as the difference between the measured refractive state and the target vergence within each zone of a multi-zone design within the pupil and compared with that of equivalent zone areas of the SV lens. The percentage of the pupil containing myopic defocused light for each lens was calculated. RESULTS Defocus within the distance correction zones of multi-zone lenses was similar to that of the SV lens. When viewing on-axis at -0.25 D target vergence, on average 11% of the pupil was myopic with SV, whereas 62%, 84% and 50% of the pupil was myopic for the DF, MF and RB designs, respectively. At -4.00 D target vergence, all lenses exhibited a systematic decrease in the percentage of pupil area having myopic defocus (SV: 3%; DF: 18%; MF: 5% and RB: 26%). The off-axis proportions were similar across multi-zone lenses; however, multi-zone lenses retained approximately 1.25-3.0× more myopic defocus than the SV lens. CONCLUSIONS Subjects accommodated using the distance-correction zones of multi-zone lenses. Multi-zone contact lenses introduced significant myopic defocus on-axis and across the central ±30° retina. However, the magnitude and proportion of defocus were influenced by zone geometry, add power and pupil size.
Collapse
Affiliation(s)
- Raman Prasad Sah
- School of Optometry, Indiana University, Bloomington, Indiana, USA
| | - Dawn Meyer
- School of Optometry, Indiana University, Bloomington, Indiana, USA
| | - Matt Jaskulski
- School of Optometry, Indiana University, Bloomington, Indiana, USA
| | - Martin Rickert
- School of Optometry, Indiana University, Bloomington, Indiana, USA
| | - Xu Cheng
- Johnson & Johnson Vision Care Inc., Jacksonville, Florida, USA
| | - Noel Brennan
- Johnson & Johnson Vision Care Inc., Jacksonville, Florida, USA
| | - Pete S Kollbaum
- School of Optometry, Indiana University, Bloomington, Indiana, USA
| |
Collapse
|
3
|
Hiraoka T, Kiuchi G, Hiraoka R, Maruo K, Oshika T. Multifocal Contact Lenses and 0.01% Atropine Eye Drops for Myopia Control Study: Research Protocol for a 1-Year, Randomized, Four-Arm, Clinical Trial in Schoolchildren. Eye Contact Lens 2023; 49:172-177. [PMID: 36848188 DOI: 10.1097/icl.0000000000000977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2023] [Indexed: 03/01/2023]
Abstract
OBJECTIVES Previous studies have shown that combined use of orthokeratology and 0.01% atropine (AT) eye drops can strongly prevent axial elongation in myopic children. However, the efficacy of combined use with multifocal contact lens (MFCL) and 0.01% AT remains unclear. The aim of this trial is to clarify the efficacy of MFCL+0.01% AT combination therapy for myopia control and safety. METHODS This prospective study is a randomized, double-masked, placebo-controlled trial with four arms. A total of 240 children aged 6 to 12 years with myopia is recruited and randomly assigned to one of the four groups in a ratio of 1:1:1:1 as follows: group 1: MFCL+AT combination therapy, group 2: MFCL monotherapy, group 3: AT monotherapy, and group 4: placebo. The participants will continue the assigned treatment for 1 year. The primary and secondary outcomes are the comparisons of axial elongation and myopia progression in the four groups during the 1-year study period. DISCUSSION The present trial would determine whether the MFCL+AT combination therapy is more effective in slowing axial elongation and myopia progression in schoolchildren as compared with each monotherapy or placebo, and it also confirm acceptable safety of the combination therapy.
Collapse
Affiliation(s)
- Takahiro Hiraoka
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | | | | | | | | |
Collapse
|
4
|
Schmid KL, Gifford KL, Atchison DA. The effect of concentric and aspheric multifocal soft contact lenses on binocular vision in young adult myopes. Cont Lens Anterior Eye 2023; 46:101588. [PMID: 35304065 DOI: 10.1016/j.clae.2022.101588] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Multifocal soft contact lenses (MFCLs) are prescribed to inhibit myopia progression; these include aspheric and concentric designs. The effects of MFCLs on visual quality, accommodation and vergence in young-adult myopes were evaluated. METHODS Participants were twenty-six myopes (19-25 years, spherical equivalent -0.50 to -5.75D), with normal binocular vision and no past myopia control. Pupil sizes were 4.4 ± 0.9 mm during distance viewing and 3.7 ± 0.8 mm at near. In random order, participants wore four MFCLs: Proclear single vision distance, MiSight concentric dual focus (+2.00D), distance center aspheric (Biofinity, +2.50D) (CooperVision lenses), and NaturalVue aspheric (Visioneering Technologies). Testing included visual acuity, contrast sensitivity (Pelli-Robson), stereoacuity, accommodation response, negative and positive relative accommodation, horizontal phorias, horizontal fusional vergence and AC/A ratio, and a visual quality questionnaire. RESULTS The four lenses differed in distance (p = 0.001) and near visual acuity (p = 0.011), and contrast sensitivity (p = 0.001). Compared with the single vision lens, the Biofinity aspheric had the greatest visual impact: 0.19 ± 0.14 logMAR distance acuity reduction, 0.22 ± 0.15 log contrast sensitivity reduction. Near acuity was affected less than distance acuity; the reduction was greatest with the NaturalVue (0.05 ± 0.07 logMAR reduction). The MFCLs altered the autorefraction measure at distance and near (p = 0.001); the accommodation response was less with aspheric lenses. Negative relative accommodation reduced with the aspheric lenses (p = 0.001): by 0.9 ± 0.5D with Biofinity and 0.5 ± 0.7D with NaturalVue. Exophoric shifts were greater with aspheric lenses (1.8 ± 2.4Δ Biofinity, 1.7 ± 1.7Δ NaturalVue) than with the concentric MiSight (0.5 ± 1.3Δ). CONCLUSIONS MFCLs alter visual performance, refraction and vergence; two aspheric lenses had greater effect than a concentric lens.
Collapse
Affiliation(s)
- Katrina L Schmid
- School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Qld 4059, Australia.
| | - Kate L Gifford
- School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Qld 4059, Australia; Myopia Profile Pty Ltd, Australia
| | - David A Atchison
- School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Qld 4059, Australia
| |
Collapse
|
5
|
Erdinest N, London N, Lavy I, Berkow D, Landau D, Morad Y, Levinger N. Peripheral Defocus and Myopia Management: A Mini-Review. KOREAN JOURNAL OF OPHTHALMOLOGY 2023; 37:70-81. [PMID: 36796348 PMCID: PMC9935061 DOI: 10.3341/kjo.2022.0125] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/26/2022] [Indexed: 02/07/2023] Open
Abstract
Myopia is the most common refractive error in the world, and its' prevalence continually increases. The potential pathological and visual complications of progressive myopia have inspired researchers to study the sources of myopia, axial elongation, and explore modalities to arrest progression. Considerable attention has been given over the past few years to the myopia risk factor known as hyperopic peripheral blur, the focus of this review. The primary theories currently believed to be the cause of myopia, the parameters considered to contribute and influence the effect of peripheral blur, such as the surface retinal area or depth of blur will be discussed. The currently available optical devices designed to provide peripheral myopic defocus will be discussed, including bifocal and progressive addition ophthalmic lenses, peripheral defocus single vision ophthalmic lenses, orthokeratology lenses, and bifocal or multifocal center distance soft lenses, as well as their effectivity as mentioned in the literature to date.
Collapse
Affiliation(s)
- Nir Erdinest
- Department of Opthalmology, Hadassah-Hebrew University Medical Center, Jerusalem,
Israel
- The Myopia Center, Rishon LeZion,
Israel
| | | | - Itay Lavy
- Department of Opthalmology, Hadassah-Hebrew University Medical Center, Jerusalem,
Israel
| | | | - David Landau
- Department of Opthalmology, Hadassah-Hebrew University Medical Center, Jerusalem,
Israel
| | - Yair Morad
- The Myopia Center, Rishon LeZion,
Israel
- Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin,
Israel
| | - Nadav Levinger
- Department of Opthalmology, Hadassah-Hebrew University Medical Center, Jerusalem,
Israel
- Department of Ophthalmology, Enaim Refractive Surgery Center, Jerusalem,
Israel
| |
Collapse
|
6
|
London N, Erdinest N, Lavy I, Berkow D, Landau D, Levinger N, Morad Y. Peripheral defocus as it relates to myopia progression: A mini-review. Taiwan J Ophthalmol 2023. [DOI: 10.4103/tjo.tjo-d-22-00100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
|
7
|
Cooper J, O’Connor B, Aller T, Dillehay SM, Weibel K, Benoit D. Reduction of Myopic Progression Using a Multifocal Soft Contact Lens: A Retrospective Cohort Study. Clin Ophthalmol 2022; 16:2145-2155. [PMID: 35814919 PMCID: PMC9270009 DOI: 10.2147/opth.s370041] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/15/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Jeffrey Cooper
- Cooper Eye Care, New York, NY, USA
- State University of New York College of Optometry, New York, NY, USA
| | | | - Thomas Aller
- Dr. Thomas Aller, Optometrist, Inc., San Bruno, CA, USA
- University of California, Berkeley School of Optometry, Berkeley, CA, USA
| | | | - Katherine Weibel
- The Ohio State University College of Medicine, Department of Ophthalmology, Columbus, OH, USA
| | - Douglas Benoit
- Visioneering Technologies, Inc., Alpharetta, GA, USA
- Correspondence: Douglas Benoit, Visioneering Technologies, Inc, Alpharetta, GA, 30009, USA, Email
| |
Collapse
|
8
|
Chang K, Lee WL, Ying YH. The Impact of Cost-Containment Schemes on Outpatient Services for Schoolchildren with Refractive Errors in Taiwan—A Population-Based Study. CHILDREN 2022; 9:children9060880. [PMID: 35740817 PMCID: PMC9221663 DOI: 10.3390/children9060880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/27/2022] [Accepted: 06/09/2022] [Indexed: 11/23/2022]
Abstract
Objectives: Extant research on cost-sharing finds no impact on health care utilization when the amount is insubstantial. This research investigates the effects on nonacute outpatient services for schoolchildren with refractive errors in Taiwan and discusses the potential harm caused by cost sharing and relevant cost containment policies. Methods: Longitudinal claims data from the National Health Insurance database are employed. District demographic information is also used for aggregate-level analyses. Interventional modeling is conducted on pooled individual-level data with a Poisson model and negative binomial models. Generalized least square modeling is performed on aggregate district-level data to elucidate the impacts of cost sharing and the reimbursement rate with controls for patient and institutional characteristics, district socioeconomic factors, and competitiveness among institutions. Results: The findings of this study show that cost sharing does not significantly affect children’s utilization of outpatient services in the patient-level analyses. However, it significantly decreases the service volume based on the results of district aggregate analyses. There are potentially marginal patients in society, and they are more likely to be girls in poorer families, whose chances of seeking medical care significantly decrease when cost sharing increases. Conclusions: The gap in health inequity can be widened when stringent cost-containment policies are implemented. The offset effect caused by delayed care may also result in higher health care expenditures later. Cost sharing for children should be separately and prudently designed to better protect them from deprivations caused by changes in health policies.
Collapse
Affiliation(s)
- Koyin Chang
- Department of Healthcare Information and Management, Ming Chuan University, Taoyuan 33348, Taiwan; (K.C.); (W.-L.L.)
| | - Wen-Li Lee
- Department of Healthcare Information and Management, Ming Chuan University, Taoyuan 33348, Taiwan; (K.C.); (W.-L.L.)
| | - Yung-Hsiang Ying
- Department of Business Administration, National Taiwan Normal University, Taipei 10617, Taiwan
- Correspondence:
| |
Collapse
|
9
|
Westheimer G. Multifocal contact lens myopia control: central and peripheral retinal image quality. Clin Exp Optom 2022:1-6. [PMID: 35533691 DOI: 10.1080/08164622.2022.2074290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
CLINICAL RELEVANCE That myopic defocus, even if restricted to the peripheral retina, inhibits eye growth in young monkey eyes has motivated the therapy of myopia control through multifocal contact lens wear in children. BACKGROUND To understand how eye-length regulating mechanisms are triggered by light requires knowledge of retinal light spread. That is largely lacking for the multifocal contact lenses used in the therapy because empirical methods identifying just the defocus in dioptres are inadequate. METHODS "Through-focus" diffraction computations in contact lens/eye models with typical normal eye parameters, including polychromatic light, the chromatic aberrations and an M-cone phototransduction layer, offer estimates of retinal image spread for a range of viewing distances. RESULTS Point- and edge-spread distributions of activation of phototransduction in the central retina show that the addition of multifocal zones produces some veiling for in-focus viewing and substantial improvement of image quality for near targets in the unaccommodated eye. These effects are much reduced in the retinal periphery. CONCLUSION Whatever therapeutic value there is in prescribing multifocal contact lenses for myopia control, it is not particularly dependent on the precise configuration of the multifocal zones, nor can it be ascribed to changes in image quality specific to the retinal periphery; its origin is more likely less blur for near targets, reducing the stimulus to accommodation.
Collapse
Affiliation(s)
- Gerald Westheimer
- Division of Neurobiology, University of California, Berkeley, Berkeley, CA, USA
| |
Collapse
|
10
|
Nti AN, Gregory HR, Ritchey ER, Wolffsohn JS, Berntsen DA. Contrast Sensitivity with Center-distance Multifocal Soft Contact Lenses. Optom Vis Sci 2022; 99:342-349. [PMID: 35121719 PMCID: PMC8986568 DOI: 10.1097/opx.0000000000001874] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SIGNIFICANCE The contrast sensitivity (CS) function provides a more detailed assessment of vision than visual acuity. It was found that center-distance multifocal contact lens designs that are increasingly being prescribed for myopia control reduce distance photopic and mesopic CS in nonpresbyopic patients across a range of spatial frequencies. PURPOSE This study aimed to determine the effect of center-distance multifocal soft contact lenses (MFCLs) on CS under photopic and mesopic conditions in nonpresbyopic patients. METHODS Twenty-five myopic, nonpresbyopic adults were fitted binocularly with three lenses: Biofinity single vision contact lens (SVCL), Biofinity Multifocal D +2.50 add, and NaturalVue Multifocal in random order. Contrast sensitivity was measured at distance (4 m) under photopic and mesopic conditions and at near under photopic conditions. Log CS by spatial frequency and area under the log contrast sensitivity function (AULCSF) were analyzed between lenses. RESULTS Distance photopic CS at each spatial frequency was higher with the SVCL than the MFCLs (P < .001), but there was no difference between the MFCLs (P = .71). Distance mesopic CS from 1.5 to 12 cycles per degree (cpd) was higher with the SVCL than the MFCLs (all P < .02); however, at 18 cpd, there was no difference in CS between NaturalVue and the SVCL (P = .76), possibly because of spurious resolution. Photopic AULCSF for the SVCL was roughly 10% greater than both MFCLs. Contrast sensitivity at near was generally similar between lenses, only slightly lower with the NaturalVue at 11 and 15.5 cpd, but AULCSF at near was not different between lenses (P > .05). CONCLUSIONS Multifocal contact lenses reduce distance contrast sensitivity under both photopic and mesopic conditions. There is no clinically significant difference in near CS among all three lenses. These data show that MFCLs have effects on vision that are not captured by standard high-contrast visual acuity testing.
Collapse
Affiliation(s)
| | - Hannah R Gregory
- The Ocular Surface Institute, University of Houston College of Optometry, Houston, Texas
| | - Eric R Ritchey
- The Ocular Surface Institute, University of Houston College of Optometry, Houston, Texas
| | - James S Wolffsohn
- Optometry and Vision Science Research Group, College of Health and Life Sciences, Aston University, Birmingham, United Kingdom
| | - David A Berntsen
- The Ocular Surface Institute, University of Houston College of Optometry, Houston, Texas
| |
Collapse
|
11
|
Bao J, Huang Y, Li X, Yang A, Zhou F, Wu J, Wang C, Li Y, Lim EW, Spiegel DP, Drobe B, Chen H. Spectacle Lenses With Aspherical Lenslets for Myopia Control vs Single-Vision Spectacle Lenses: A Randomized Clinical Trial. JAMA Ophthalmol 2022; 140:472-478. [PMID: 35357402 PMCID: PMC8972151 DOI: 10.1001/jamaophthalmol.2022.0401] [Citation(s) in RCA: 80] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance Reducing myopia progression can reduce the risk of associated ocular pathologies. Objective To evaluate whether spectacle lenses with higher lenslet asphericity have a higher myopia control efficacy throughout 2 years. Design, Setting, and Participants This double-masked randomized clinical trial was conducted between July 2018 and October 2020 at the Eye Hospital of Wenzhou Medical University in Wenzhou, China. Children aged 8 to 13 years with a cycloplegic spherical equivalent refraction (SER) of -0.75 D to -4.75 D and astigmatism with less than -1.50 D were recruited. A data and safety monitoring committee reviewed findings from a planned interim analysis in 2019. Interventions Participants were randomly assigned in a 1:1:1 ratio to receive spectacle lenses with highly aspherical lenslets (HAL), spectacle lenses with slightly aspherical lenslets (SAL), or single-vision spectacle lenses (SVL). Main Outcome and Measures Two-year changes in SER and axial length and their differences between groups. Results Of 157 participants who completed each visit (mean [SD] age, 10.4 [1.2] years), 54 were analyzed in the HAL group, 53 in the SAL group, and 50 in the SVL group. Mean (SE) 2-year myopia progression in the SVL group was 1.46 (0.09) D. Compared with SVL, the mean (SE) change in SER was less for HAL (by 0.80 [0.11] D) and SAL (by 0.42 [0.11] D; P ≤ .001). The mean (SE) increase in axial length was 0.69 (0.04) mm for SVL. Compared with SVL, increase in axial length was slowed by a mean (SE) of 0.35 (0.05) mm for HAL and 0.18 (0.05) mm for SAL (P ≤ .001). Compared with SVL, for children who wore HAL at least 12 hours every day, the mean (SE) change in SER was slowed by 0.99 (0.12) D, and increase in axial length slowed by 0.41 (0.05) mm. Conclusions and Relevance In this study, HAL and SAL reduced the rate of myopia progression and axial elongation throughout 2 years, with higher efficacy for HAL. Longer wearing hours resulted in better myopia control efficacy for HAL. Trial Registration Chinese Clinical Trial Registry Identifier: ChiCTR1800017683.
Collapse
Affiliation(s)
- Jinhua Bao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China.,Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yingying Huang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China.,Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xue Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China.,Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Adeline Yang
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China.,R&D AMERA, Essilor International, Singapore, Singapore
| | - Fengchao Zhou
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Junqian Wu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chu Wang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuhao Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ee Woon Lim
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China.,R&D AMERA, Essilor International, Singapore, Singapore
| | - Daniel P Spiegel
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China.,R&D AMERA, Essilor International, Singapore, Singapore
| | - Björn Drobe
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China.,R&D AMERA, Essilor International, Singapore, Singapore
| | - Hao Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| |
Collapse
|
12
|
Sah RP, Jaskulski M, Kollbaum PS. Modelling the refractive and imaging impact of multi-zone lenses utilised for myopia control in children's eyes. Ophthalmic Physiol Opt 2022; 42:571-585. [PMID: 35170789 PMCID: PMC9544677 DOI: 10.1111/opo.12959] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE To develop an optical model of a child's eye to reveal the impact of target distance and accommodative behaviour on retinal image quality when fitted with multi-zone lenses. METHODS Pupil size, aberration levels and accommodative lag were adjusted for models viewing stimuli at 400, 100, 33 and 20 cm. Distributions of defocus across the pupil and simulated retinal images were obtained. An equivalent 16-point letter was imaged at near viewing distances, while a 0.00 logMAR (6/6) letter was imaged at 400 cm. Multi-zone lenses included those clinically utilised for myopia control (e.g., dual-focus, multi-segmented and aspherical optics). RESULTS Viewing distance adjustments to model spherical aberration (SA) and pupil radius resulted in a model eye with wider defocus distributions at closer viewing distances, especially at 20 cm. The increasing negative SA at near reduced the effective add power of dual-focus lenses, reducing the amount of myopic defocus introduced by the centre-distance, 2-zone design. The negative SA at near largely compensated for the high positive SA introduced by the aspheric lens, removing most myopic defocus when viewing at near. A 0.50 D accommodative lag had little impact on the legibility of typical text (16-point) at the closer viewing distances. CONCLUSIONS All four multi-zone lenses successfully generated myopic defocus at greater viewing distances, but two failed to introduce significant amounts of myopic defocus at the nearest viewing distance due to the combined effects of pupil miosis and negative SA. Typical 16-point type is easily legible at near even in presence of the multi-zone optics of lenses utilised for myopia control and accommodative lag.
Collapse
Affiliation(s)
- Raman Prasad Sah
- School of Optometry, Indiana University, Bloomington, Indiana, USA
| | - Matt Jaskulski
- School of Optometry, Indiana University, Bloomington, Indiana, USA
| | - Pete S Kollbaum
- School of Optometry, Indiana University, Bloomington, Indiana, USA
| |
Collapse
|
13
|
Gifford KL, Schmid KL, Collins JM, Maher CB, Makan R, Nguyen E, Parmenter GB, Rolls BM, Zhang XS, Atchison DA. Multifocal contact lens design, not addition power, affects accommodation responses in young adult myopes. Ophthalmic Physiol Opt 2021; 41:1346-1354. [PMID: 34605581 DOI: 10.1111/opo.12892] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE Prolonged nearwork has been implicated in myopia progression. Accommodation responses of young-adult myopes wearing different multifocal contact lenses were compared. METHODS Twenty adults, 18-25 years, with myopia (spherical equivalent refraction -0.50 to -5.50 D, mean -2.1 ± 1.6 D) wore five lens types in random order: Proclear single vision distance (SV), MiSight concentric dual-focus +2.00 D Add (MS), Biofinity aspheric centre distance +1.50 D Add (CD1) and +2.50 D Add (CD2) (all Coopervision), and NaturalVue aspheric (Visioneering Technologies) (NVue). Using a Grand-Seiko WAN-5500 autorefractor with binocular correction and viewing right eye accommodative responses were measured after a 10 min adaptation period at 4.0, 1.0, 0.5, 0.33 and 0.25 m distances. Dynamic measurements were taken for 4 s at 6 Hz. Accommodative stimuli and responses were referenced to 4 m (i.e., refraction differences between 4 m and nearer distances). Accommodation lags and refraction instabilities (standard deviations of dynamic responses) were determined. For comparison, results were obtained for an absolute presbyopic eye, where trial lenses counteracted the accommodation stimulus. RESULTS For SV and MS, accommodation responses were similar to the stimulus values. For aspheric lenses CD1, CD2 and NVue, accommodation responses were approximately 1.0 D lower across the stimulus range than with SV and MS, and rates of change were approximately 0.84 D per 1 D stimulus change. MS produced greater refraction instabilities than other lenses. For the presbyope, changes in refraction matched the trial lenses, indicating that corrections due to measurement through the different lenses were not needed. CONCLUSION Reductions in accommodation response occurred in young myopes wearing aspheric multifocal contact lenses independent of the labelled 'add' power. The concentric dual-focus MS lens produced minimal lags but had greater instability than the other lenses. The results indicate that the mechanism of multifocal contact lenses slowing myopia progression is unlikely to be through relaxing accommodation, at least in young adults.
Collapse
Affiliation(s)
- Kate L Gifford
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Katrina L Schmid
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Josh M Collins
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Clare B Maher
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Riya Makan
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Evonne Nguyen
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Gemma B Parmenter
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Bronte M Rolls
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Xinyue S Zhang
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - David A Atchison
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| |
Collapse
|
14
|
Hair LA, Steffensen EM, Berntsen DA. The Effects of Center-near and Center-distance Multifocal Contact Lenses on Peripheral Defocus and Visual Acuity. Optom Vis Sci 2021; 98:983-994. [PMID: 34393205 PMCID: PMC8405543 DOI: 10.1097/opx.0000000000001753] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Multifocal contact lenses (MFCLs) are being used clinically for myopia control. Center-distance designs caused myopic changes in defocus across the retina that varied by lens design, whereas the center-near design caused peripheral hyperopic changes. Multifocal lenses caused reductions in low-contrast vision that varied by lens design, affecting visual performance. PURPOSE The purpose of this study was to compare changes in defocus with four MFCLs, three center-distance and one center-near. METHODS Two cohorts of 25 nonpresbyopic myopic adults were enrolled. The first cohort was fitted with Proclear D and Biofinity D MFCL (center-distance, +2.50 D add), and the second cohort was fitted with NaturalVue MFCL (center-distance) and Clariti 1-Day MFCL (center-near, high add), both in random order. Overrefraction was performed to maximize visual acuity. Cycloplegic autorefraction was performed with each lens and without a lens along the line of sight and at nasal and temporal retinal locations out to 40°. Data were analyzed with repeated-measures ANOVAs with post hoc t tests, when indicated. RESULTS Changes in defocus at each location differed between MFCL designs (lens by location; both, P < .001). Clariti 1-Day caused peripheral hyperopic retinal changes (40 and 30° nasal, and 20, 30, and 40° temporal; all, P < .05). NaturalVue MFCL caused myopic changes centrally and hyperopic changes at 40° nasal and 30° temporal (all, P < .05). The remaining center-distance designs caused myopic changes at multiple locations (all, P < .05). CONCLUSIONS After overrefraction, the center-near MFCL design caused hyperopic defocus at multiple peripheral locations, which is not hypothesized to slow myopia progression. NaturalVue MFCL caused myopic changes in defocus centrally but hyperopic changes in the far periphery. Biofinity D and Proclear D caused myopic changes in retinal defocus. Further work is warranted to determine whether defocus profile differences between the center-distance designs influence any slowing of myopia progression.
Collapse
Affiliation(s)
- Lea A Hair
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, Texas
| | - Elaine M Steffensen
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, Texas
| | | |
Collapse
|
15
|
Wolffsohn JS, Jong M, Smith EL, Resnikoff SR, Jonas JB, Logan NS, Morgan I, Sankaridurg P, Ohno-Matsui K. IMI 2021 Reports and Digest - Reflections on the Implications for Clinical Practice. Invest Ophthalmol Vis Sci 2021; 62:1. [PMID: 33909037 PMCID: PMC8083124 DOI: 10.1167/iovs.62.5.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The International Myopia Institute's (IMI) mission is to advance research, education, and management of myopia to decrease future vision impairment and blindness associated with increasing myopia. Its approach is to bring together scientists, clinicians, policymakers, government members, and educators into the field of myopia to stimulate collaboration and sharing of knowledge. The latest reports are on pathologic myopia, the impact of myopia, risk factors for myopia, accommodation and binocular vision in myopia development and progression, and the prevention of myopia and its progression. Together with the digest updating the 2019 International Myopia Institute white papers using the research published in the last 18 months, these evidence-based consensus white papers help to clarify the imperative for myopia control and the role of environmental modification initiatives, informing an evidence-based clinical approach. This guidance includes who to treat and when to start or stop treatment, and the advantages and limitations of different management approaches.
Collapse
Affiliation(s)
| | - Monica Jong
- Brien Holden Vision Institute, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.,Discipline of Optometry and Vision Science, University of Canberra, Canberra, Australia
| | - Earl L Smith
- Brien Holden Vision Institute, Sydney, Australia.,College of Optometry, University of Houston, Houston, Texas, United States
| | - Serge R Resnikoff
- Brien Holden Vision Institute, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Nicola S Logan
- School of Optometry, Aston University, Birmingham, United Kingdom
| | - Ian Morgan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yatsen University, Guangzhou, China.,Research School of Biology, College of Medicine, Biology and Environment, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| |
Collapse
|
16
|
Hieda O, Nakamura Y, Hiraoka T, Kojima M, Oshika T, Sotozono C. Clinical study on the effect of multifocal contact lenses on myopia progression in myopia school children : Multifocal contact lens study for suppression of myopia progression. Trials 2021; 22:239. [PMID: 33789735 PMCID: PMC8010274 DOI: 10.1186/s13063-021-05197-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 03/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The efficacy of peripheral low add multifocal soft contact lenses (SCLs) for suppressing the progression of myopia is controversial. The aim of the on-going present clinical study is to investigate whether or not multifocal SCLs with + 0.50 diopters (D) addition suppress the progression of myopia in myopic elementary school children. DESIGN Prospective randomized controlled trial. SUBJECTS AND METHODS The study plans to include a total of 100 myopic school children. Target subjects are primary school male and female students with mild to moderate myopia. Children who have eye-related diseases other than myopia are excluded from the study, because they may affect the evaluation of the outcome. Subjects will be randomly assigned to wear daily disposable multifocal contact lenses with + 0.50D addition or daily disposable SCLs. Subjects will wear contact lenses on both eyes and will be observed for 2 years under a double-masked examination. Primary outcome is a change in the axial length over the 2-year period. OBJECTIVES The purpose of this study is to identify whether or not multifocal SCLs with + 0.5D addition suppress the progression of myopia in myopic elementary school children as compared with standard SCLs. TRIAL REGISTRATION 1. UMIN (University Hospital Medical Information Network) UMIN000027940. Registered on July 21, 2017 2. JRCT (Japan Registry of Clinical Trials) jRCTs052180172. Registered on March 26, 2019.
Collapse
Affiliation(s)
- Osamu Hieda
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Yo Nakamura
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Takahiro Hiraoka
- Department of Ophthalmology, University of Tsukuba, Tsukuba, Japan
| | - Miho Kojima
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Tetsuro Oshika
- Department of Ophthalmology, University of Tsukuba, Tsukuba, Japan
| | - Chie Sotozono
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| |
Collapse
|
17
|
Gregory HR, Nti AN, Wolffsohn JS, Berntsen DA, Ritchey ER. Visual Performance of Center-distance Multifocal Contact Lenses Fit Using a Myopia Control Paradigm. Optom Vis Sci 2021; 98:272-279. [PMID: 33771957 PMCID: PMC8007064 DOI: 10.1097/opx.0000000000001665] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The purpose of this study was to examine the visual performance of center-distance MFCLs in nonpresbyopic adults under different illumination and contrast conditions compared with a single-vision contact lens (SVCL). METHODS Twenty-five adult subjects were fit with three different lenses (CooperVision Biofinity D MFCL +2.50 add, Visioneering Technologies NaturalVue MFCL, CooperVision Biofinity sphere). Acuity and reading performance were evaluated. RESULTS A statistically significant difference in high-contrast distance acuity was observed (Biofinity, -0.18 ± 0.06; Biofinity MFCL, -0.14 ± 0.08; NaturalVue MFCL, -0.15 ± 0.03; repeated-measures [RM] ANOVA, P = .02). Under mesopic, high-contrast conditions, MFCLs performed worse than SVCLs (Biofinity, -0.05 ± 0.091; Biofinity MFCL, +0.03 ± 0.09; NaturalVue MFCL, +0.05 ± 0.091; RM-ANOVA, P < .0001). Under low-contrast conditions, MFCLs performed one line worse in photopic lighting and two lines worse under mesopic conditions (RM-ANOVA, P < .0001). Glare reduced acuity by 0.5 logMAR for all lenses (RM-ANOVA, P < .001). A statistically significant difference in near acuity was observed (RM-ANOVA, P = .02), but all lenses achieved acuity better than -0.1 logMAR (Biofinity, -0.16 ± 0.06; Biofinity MFCL, -0.17 ± 0.04; NaturalVue MFCL, -0.13 ± 0.08). Reading performance in words per minute (wpm) was worse with MFCLs (Biofinity MFCL, 144 ± 22 wpm; NaturalVue MFCL, 150 ± 28 wpm) than with SVCLs (156 ± 23 wpm; RM-ANOVA, P = .02) regardless of letter size (RM-ANOVA, P = .13). No difference in acuity between the MFCLs was detected (RM-ANOVA: all, P > .05). CONCLUSIONS Multifocal contact lenses perform similarly to SVCLs for high-contrast targets and display reduced low-contrast acuity and reading speed. Practitioners should recognize that high-contrast acuity alone does not describe MFCL visual performance.
Collapse
Affiliation(s)
- Hannah R Gregory
- The Ocular Surface Institute, University of Houston College of Optometry, Houston, Texas
| | - Augustine N Nti
- The Ocular Surface Institute, University of Houston College of Optometry, Houston, Texas
| | - James S Wolffsohn
- Optometry and Vision Science Research Group, Department of Life and Health Sciences, Aston University, Birmingham, United Kingdom
| | - David A Berntsen
- The Ocular Surface Institute, University of Houston College of Optometry, Houston, Texas
| | | |
Collapse
|
18
|
Patient experience and physiological response to two commercially available daily disposable myopia control contact lenses. Cont Lens Anterior Eye 2021; 45:101426. [PMID: 33618977 DOI: 10.1016/j.clae.2021.02.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/04/2021] [Accepted: 02/07/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND A range of myopia management (MM) contact lenses are becoming available to practitioners. These lenses are designed to slow myopia progression and axial elongation. This study explored the initial experience of participants wearing daily disposable MM contact lenses to investigate established factors previously associated with successful lens wear. METHODS This was a prospective, double-masked, crossover study. Twenty participants aged 18-30 years old were assigned to wear two daily disposable MM lenses in a randomised order. Visual acuity, contrast sensitivity, and amplitude/lag of accommodation were assessed at baseline, post-insertion, and after 2 and 6 h of lens wear. Self-reported lens comfort and vision quality were recorded at the same timepoints, and at 10 h post-insertion. Pairwise comparisons were performed between the two lenses at each timepoint, as well as assessing changes throughout wear. The relationship of the measured parameters to overall lens satisfaction was also assessed. RESULTS There were no significant differences between the two MM lenses at any timepoint for any of the participant-reported parameters, including overall satisfaction. A small difference in visual acuity was noted at 6 h post-insertion, although this is unlikely to be clinically significant. Comfort decreased throughout the day, most notably at 10 h post-insertion. A moderate positive correlation was observed between participant-reported visual quality and overall satisfaction. A similar pattern was seen for comfort and overall satisfaction. Self-reported vision quality and measured visual acuity were poorly correlated, highlighting the benefit of subjectively assessing the quality of vision with these lenses. CONCLUSIONS The participants demonstrated comparable measures across a range of measures between the two MM lenses. Notably, half of the participants demonstrated a clear lens preference, although the preferred lens varied between individuals. Candidates for MM may benefit from trialling more than one MM lens design, to maximise initial wearing satisfaction.
Collapse
|
19
|
Nti AN, Ritchey ER, Berntsen DA. Power profiles of centre-distance multifocal soft contact lenses. Ophthalmic Physiol Opt 2020; 41:393-400. [PMID: 33295033 DOI: 10.1111/opo.12770] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/13/2020] [Indexed: 02/04/2023]
Abstract
PURPOSE Centre-distance multifocal contact lenses (MFCLs) for myopia control are thought to slow myopia progression by providing both clear foveal vision and myopic defocus. Characterising the power profile of lenses is important to understanding their possible effects on retinal defocus when worn. The power profiles of three commercially available MFCLs were determined. METHODS Three centre-distance MFCL designs were studied: Biofinity Multifocal D +2.50 add (comfilcon A), Proclear Multifocal D +2.50 add (omafilcon A), and NaturalVue Multifocal (etafilcon A). Two lenses each in power from -1.00D to -6.00D in 1D steps were stored in ISO 18369-3:2017 standard phosphate buffered saline for 24 h. Optical power profiles were measured in a wet cell with the SHSOphthalmic profiler accounting for centre thickness and manufacturer-reported material refractive index. Sagittal power maps from the SHSOphthalmic were exported, and custom MATLAB code was used to generate power profiles by averaging along the vertical and horizontal meridians. One-way anova with Tukey's HSD post-hoc t-tests were used to analyse maximum add power by lens design. RESULTS Plus power increased out from the lens centre for all three MFCLs. Power profiles of Biofinity D and Proclear D MFCLs show three distinct areas within the optic zone; the distance zone (from lens centre to about 1.6 mm radius), intermediate zone (about 1.6 mm radius to 2.1 mm) and near zone (about 2 mm radius to 4 mm). For NaturalVue MFCLs, plus power starts increasing almost immediately from the lens centre, reaching maximum measured mean plus power at a radius of 2.7 mm. From 2.7 mm to 3.0 mm, there was a decrease in plus power, which was then generally maintained out to the optic zone edge. Across all lens powers, maximum add power was highest with the NaturalVue MFCL (+3.32 ± 0.44D), then Proclear D (+1.84 ± 0.28D) and Biofinity D (+1.47 ± 0.34D) MFCLs (all p < 0.04). Add power peaked at different locations for different lens powers and designs. CONCLUSIONS Power profiles of MFCLs vary based on lens design and power. These power profiles are consistent with reported myopic and hyperopic changes in peripheral refraction with MFCLs and provide some explanation for reported differences in peripheral refraction with these MFCLs. Further work is needed to determine whether these power profile differences influence myopia progression.
Collapse
Affiliation(s)
- Augustine N Nti
- The Ocular Surface Institute, University of Houston College of Optometry, Houston, USA
| | - Eric R Ritchey
- The Ocular Surface Institute, University of Houston College of Optometry, Houston, USA
| | - David A Berntsen
- The Ocular Surface Institute, University of Houston College of Optometry, Houston, USA
| |
Collapse
|
20
|
Brennan NA, Toubouti YM, Cheng X, Bullimore MA. Efficacy in myopia control. Prog Retin Eye Res 2020; 83:100923. [PMID: 33253901 DOI: 10.1016/j.preteyeres.2020.100923] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 11/17/2020] [Accepted: 11/23/2020] [Indexed: 12/14/2022]
Abstract
There is rapidly expanding interest in interventions to slow myopia progression in children and teenagers, with the intent of reducing risk of myopia-associated complications later in life. Despite many publications dedicated to the topic, little attention has been devoted to understanding 'efficacy' in myopia control and its application. Treatment effect has been expressed in multiple ways, making comparison between therapies and prognosis for an individual patient difficult. Available efficacy data are generally limited to two to three years making long-term treatment effect uncertain. From an evidence-based perspective, efficacy projection should be conservative and not extend beyond that which has been empirically established. Using this principle, review of the literature, data from our own clinical studies, assessment of demonstrated myopia control treatments and allowance for the limitations and context of available data, we arrive at the following important interpretations: (i) axial elongation is the preferred endpoint for assessing myopic progression; (ii) there is insufficient evidence to suggest that faster progressors, or younger myopes, derive greater benefit from treatment; (iii) the initial rate of reduction of axial elongation by myopia control treatments is not sustained; (iv) consequently, using percentage reduction in progression as an index to describe treatment effect can be very misleading and (v) cumulative absolute reduction in axial elongation (CARE) emerges as a preferred efficacy metric; (vi) maximum CARE that has been measured for existing myopia control treatments is 0.44 mm (which equates to about 1 D); (vii) there is no apparent superior method of treatment, although commonly prescribed therapies such as 0.01% atropine and progressive addition spectacles lenses have not consistently provided clinically important effects; (viii) while different treatments have shown divergent efficacy in the first year, they have shown only small differences after this; (ix) rebound should be assumed until proven otherwise; (x) an illusion of inflated efficacy is created by measurement error in refraction, sample bias in only treating 'measured' fast progressors and regression to the mean; (xi) decision to treat should be based on age of onset (or refraction at a given age), not past progression; (xii) the decreased risk of complications later in life provided by even modest reductions in progression suggest treatment is advised for all young myopes and, because of limitations of available interventions, should be aggressive.
Collapse
Affiliation(s)
- Noel A Brennan
- Johnson & Johnson Vision, 7500 Centurion Pkwy, Jacksonville, FL, 32256, USA.
| | - Youssef M Toubouti
- Johnson & Johnson Vision, 7500 Centurion Pkwy, Jacksonville, FL, 32256, USA
| | - Xu Cheng
- Johnson & Johnson Vision, 7500 Centurion Pkwy, Jacksonville, FL, 32256, USA
| | | |
Collapse
|
21
|
Abstract
SIGNIFICANCE The Bifocal & Atropine in Myopia (BAM) study aims to determine whether combining 0.01% atropine and +2.50-diopter add center-distance soft bifocal contact lenses (SBCL) slows myopia progression more than SBCL alone. The results could provide significant information on the myopia control effect of combining optical and pharmacological treatments. PURPOSE This article describes the subject characteristics at baseline, the study methods, and the short-term effects of this combination treatment on visual acuity (VA) and vision-related outcomes. METHODS Subjects from the BAM study who met the baseline eligibility criteria were dispensed the combination treatment for 2 weeks to determine final eligibility. Outcome measures included VA at near and distance (Bailey-Lovie logMAR charts), near phoria (modified Thorington), accommodative lag (Grand Seiko WAM-5500), and pupil size (NeurOptics VIP-200 Pupillometer). Compliance was monitored using surveys. Two subgroups in the Bifocal Lenses In Nearsighted Kids study, single-vision contact lens wearers and those who wore +2.50-diopter add SBCL, will serve as the age-matched historical controls for BAM study. RESULTS Forty-nine BAM subjects (9.6 ± 1.4 years) were enrolled; mean spherical equivalent cycloplegic autorefraction was -2.33 ± 1.03 diopters. After 2 weeks of treatment, the best-corrected low-contrast (10% Michelson) distance VA was reduced (pre-treatment, +0.09 ± 0.07; post-treatment, +0.16 ± 0.08; P < .0001), but the high-contrast VA at near or distance was unaffected. Near phoria increased by approximately 2 in the exo direction (P = .01), but the accommodative lag was unchanged. The pupil size was not significantly different between pre-treatment and post-treatment of either the photopic or mesopic condition. Surveys indicated that the subjects wore SBCL 77 ± 22% of waking hours and used atropine 6.4 ± 0.7 days per week. CONCLUSIONS Two weeks of combination treatment reduced low-contrast distance VA and increased near exophoria slightly, but the subjects were compliant and tolerated the treatment well.
Collapse
|
22
|
Spillmann L. Stopping the rise of myopia in Asia. Graefes Arch Clin Exp Ophthalmol 2019; 258:943-959. [DOI: 10.1007/s00417-019-04555-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 10/16/2019] [Accepted: 11/25/2019] [Indexed: 10/25/2022] Open
|
23
|
Jaisankar D, Leube A, Gifford KL, Schmid KL, Atchison DA. Effects of eye rotation and contact lens decentration on horizontal peripheral refraction. Ophthalmic Physiol Opt 2019; 39:370-377. [PMID: 31482609 DOI: 10.1111/opo.12641] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 08/08/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE Peripheral refraction is important in design of myopia control therapies. The aim was to investigate the influence of contact lens decentration associated with eye rotation on peripheral refraction in the horizontal visual field. METHODS Participants were 10 emmetropes and 10 myopes in good general and ocular health. Right eyes underwent cycloplegic peripheral refraction, using a Grand-Seiko WAM-5500 Autorefractor, in 5° steps to ±35° eccentricities along the horizontal visual field. Targets were fixated using eye rotation only or head rotation only. Refractions were measured without correction and with three types of contact lenses: single vision, a multifocal centre-distance aspheric with +2.50 D add and NaturalVue aspheric. Photographs of eyes during lens wear were taken for each eye rotation. Effects of visual field angle, lens type and test method (head or eye rotation) on vector components of relative peripheral refraction were evaluated using repeated measures anovas. Test method for each visual field angle/lens combination were compared via paired t-tests. RESULTS Horizontal decentration ranges across the visual field were 1.2 ± 0.6 mm for single vision and 1.2 ± 0.4 mm for multifocal lenses but smaller at 0.7 ± 0.4 mm for NaturalVue lenses. There were only two significant effects of test method across the visual field angle/lens type combinations (single vision: for emmetropes horizontal/vertical astigmatism component at 35° nasal with mean difference -0.38 D and for myopes spherical equivalent refraction at 20° temporal with mean difference +0.24 D). CONCLUSION Upon eye rotation the contact lenses decentred on the eye, but not enough to affect peripheral refraction. For the types assessed and for the horizontal visual field out to ±35° when measurements were performed with the Grand-Seiko WAM-5500 autorefractor, it is valid to use eye rotations to investigate peripheral refraction.
Collapse
Affiliation(s)
- Durgasri Jaisankar
- Institute of Health & Biomedical Innovation and School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Alexander Leube
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Germany.,Carl Zeiss Vision International GmbH, Aalen, Germany
| | - Kate L Gifford
- Institute of Health & Biomedical Innovation and School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Katrina L Schmid
- Institute of Health & Biomedical Innovation and School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - David A Atchison
- Institute of Health & Biomedical Innovation and School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| |
Collapse
|
24
|
Gifford KL, Richdale K, Kang P, Aller TA, Lam CS, Liu YM, Michaud L, Mulder J, Orr JB, Rose KA, Saunders KJ, Seidel D, Tideman JWL, Sankaridurg P. IMI - Clinical Management Guidelines Report. Invest Ophthalmol Vis Sci 2019; 60:M184-M203. [PMID: 30817832 DOI: 10.1167/iovs.18-25977] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Best practice clinical guidelines for myopia control involve an understanding of the epidemiology of myopia, risk factors, visual environment interventions, and optical and pharmacologic treatments, as well as skills to translate the risks and benefits of a given myopia control treatment into lay language for both the patient and their parent or caregiver. This report details evidence-based best practice management of the pre-, stable, and the progressing myope, including risk factor identification, examination, selection of treatment strategies, and guidelines for ongoing management. Practitioner considerations such as informed consent, prescribing off-label treatment, and guides for patient and parent communication are detailed. The future research directions of myopia interventions and treatments are discussed, along with the provision of clinical references, resources, and recommendations for continuing professional education in this growing area of clinical practice.
Collapse
Affiliation(s)
- Kate L Gifford
- Private Practice and Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Pauline Kang
- University of New South Wales, Sydney, New South Wales, Australia
| | - Thomas A Aller
- Private Practice and University of California, Berkeley, United States
| | - Carly S Lam
- The Hong Kong Polytechnic University, Hong Kong
| | - Y Maria Liu
- University of California, Berkeley, California, United States
| | | | - Jeroen Mulder
- University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Janis B Orr
- Aston University, Birmingham, United Kingdom
| | - Kathryn A Rose
- University of Technology Sydney, New South Wales, Australia
| | | | - Dirk Seidel
- Glasgow Caledonian University, Glasgow, United Kingdom
| | | | | |
Collapse
|
25
|
Martins C, Amorim-De-Sousa A, Faria-Ribeiro M, Pauné J, González-Méijome JM, Queirós A. Visual Performance and High-Order Aberrations with Different Contact Lens Prototypes with Potential for Myopia Control. Curr Eye Res 2019; 45:24-30. [DOI: 10.1080/02713683.2019.1645182] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Catarina Martins
- Department of Physics (Optometry), Clinical & Experimental Optometry Research Lab (CEORLab), Center of Physics, University of Minho, Braga, Portugal
| | - Ana Amorim-De-Sousa
- Department of Physics (Optometry), Clinical & Experimental Optometry Research Lab (CEORLab), Center of Physics, University of Minho, Braga, Portugal
| | - Miguel Faria-Ribeiro
- Department of Physics (Optometry), Clinical & Experimental Optometry Research Lab (CEORLab), Center of Physics, University of Minho, Braga, Portugal
| | - Jaume Pauné
- Teknon, Barcelona, Spain
- Paunevision, Barcelona, Spain
| | - José M González-Méijome
- Department of Physics (Optometry), Clinical & Experimental Optometry Research Lab (CEORLab), Center of Physics, University of Minho, Braga, Portugal
| | - António Queirós
- Department of Physics (Optometry), Clinical & Experimental Optometry Research Lab (CEORLab), Center of Physics, University of Minho, Braga, Portugal
| |
Collapse
|
26
|
Ji Q, Yoo YS, Alam H, Yoon G. Through-focus optical characteristics of monofocal and bifocal soft contact lenses across the peripheral visual field. Ophthalmic Physiol Opt 2019; 38:326-336. [PMID: 29691930 DOI: 10.1111/opo.12452] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 03/15/2018] [Indexed: 12/17/2022]
Abstract
PURPOSE To characterise the impact of monofocal soft contact lens (SCL) and bifocal SCLs on refractive error, depth of focus (DoF) and orientation of blur in the peripheral visual field. METHODS Monofocal and two bifocal SCLs, Acuvue Bifocal (AVB, Johnson & Johnson) and Misight Dual Focus (DF, CooperVision) with +2.0 D add power were modelled using a ray tracing program (ZEMAX) based on their power maps. These SCLs were placed onto the anterior corneal surface of the simulated Atchison myopic eye model to correct for -3.0 D spherical refractive error at the fovea. To quantify through-focus retinal image quality, defocus from -3.5 D to 1.5 D in 0.5 D steps was induced at each horizontal eccentricity from 0 to 40° in 10° steps. Wavefront aberrations were computed for each visual eccentricity and defocus. The retinal images were simulated using a custom software program developed in Matlab (The MathWorks) by convolving the point spread function calculated from the aberration with a reference image. The convolved images were spatially filtered to match the spatial resolution limit of each peripheral eccentricity. Retinal image quality was then quantified by the 2-D cross-correlation between the filtered convolved retinal images and the reference image. Peripheral defocus, DoF and orientation of blur were also estimated. RESULTS In comparison with the monofocal SCL, the bifocal SCLs degraded retinal image quality while DoF was increased at fovea. From 10 to 20°, a relatively small amount of myopic shift (less than 0.3 D) was induced by bifocal SCLs compared with monofocal. DoF was also increased with bifocal SCLs at peripheral vision of 10 and 20°. The trend of myopic shift became less consistent at larger eccentricity, where at 30° DF showed a 0.75 D myopic shift while AVB showed a 0.2 D hyperopic shift and both AVB and DF exhibited large relative hyperopic defocus at 40°. The anisotropy in orientation of blur was found to increase and change its direction through focus beyond central vision. This trend was found to be less dominant with bifocal SCLs compared to monofocal SCL. CONCLUSIONS Bifocal SCLs have a relatively small impact on myopic shift in peripheral refractive error while DoF is increased significantly. We hypothetically suggest that a mechanism underlying myopia control with these bifocal or multifocal contact lenses is an increase in DoF and a decrease in anisotropy of peripheral optical blur.
Collapse
Affiliation(s)
- Qiuzhi Ji
- Flaum Eye Institute, The Institute of Optics, Center for Visual Science, University of Rochester, Rochester, USA
| | - Young-Sik Yoo
- Flaum Eye Institute, The Institute of Optics, Center for Visual Science, University of Rochester, Rochester, USA.,Department of Convergence Medical Science, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Hira Alam
- Flaum Eye Institute, The Institute of Optics, Center for Visual Science, University of Rochester, Rochester, USA.,Department of Biology, University of Rochester, Rochester, USA
| | - Geunyoung Yoon
- Flaum Eye Institute, The Institute of Optics, Center for Visual Science, University of Rochester, Rochester, USA
| |
Collapse
|
27
|
Zhu Q, Liu Y, Tighe S, Zhu Y, Su X, Lu F, Hu M. Retardation of Myopia Progression by Multifocal Soft Contact Lenses. Int J Med Sci 2019; 16:198-202. [PMID: 30745799 PMCID: PMC6367526 DOI: 10.7150/ijms.30118] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 12/07/2018] [Indexed: 12/13/2022] Open
Abstract
Myopia is an important public health problem due to its prevalence and significant public health cost. Elevating levels of myopia increase the risk of vision impairment, and therefore, high myopia has become one of the main causes of untreatable vision loss throughout the world due to its irreversible complications. At present, many options for slowing progression of myopia have already been proposed and evaluated such as progressive addition of executive bifocal spectacle lenses, peripheral defocusing lenses, overnight orthokeratology, pharmacological agents such as atropine eye drops, and multifocal soft contact lenses (MFSCLs). Use of MFSCLs has especially increased in recent years due to the growing demand to slow myopia progression during patient's adolescent growth period to avoid pathological myopia in adulthood. Compared with the other traditional methods of controlling myopia, MFSCLs allow myopic patients to better maintain their clear visual quality and slow myopia progression. In this manuscript, we aim to review the basics of myopia, recent advances in contact lenses to control myopia with emphasis on MFSCLs, define the elements for proper MFSCL fittings (such as pupil size, aberrations, accommodation and centering), discuss the potential rebound effect after discontinuation of contact lenses, and future directions for improvements of contact lenses for the control of myopia.
Collapse
Affiliation(s)
- Qin Zhu
- Department of Ophthalmology, Fourth Affiliated Hospital of Kunming Medical University (the Second People's Hospital of Yunnan Province); Yunnan Eye Institute; Key Laboratory of Yunnan Province for the Prevention and Treatment of ophthalmology (2017DG008); Provincial Innovation Team for Cataract and Ocular Fundus Disease, The Second People's Hospital of Yunnan Province (2017HC010); Expert Workstation of Yao Ke (2017IC064), Kunming 650021, China
| | - Yongsong Liu
- Yan'An Hospital of Kunming City, Kunming 650051, China
| | - Sean Tighe
- Tissue Tech, Inc., Ocular Surface Center, and Ocular Surface Research & Education Foundation, Miami, FL, 33173 USA
| | - Yingting Zhu
- Tissue Tech, Inc., Ocular Surface Center, and Ocular Surface Research & Education Foundation, Miami, FL, 33173 USA
| | - Xuanbo Su
- Department of Ophthalmology, Fourth Affiliated Hospital of Kunming Medical University (the Second People's Hospital of Yunnan Province); Yunnan Eye Institute; Key Laboratory of Yunnan Province for the Prevention and Treatment of ophthalmology (2017DG008); Provincial Innovation Team for Cataract and Ocular Fundus Disease, The Second People's Hospital of Yunnan Province (2017HC010); Expert Workstation of Yao Ke (2017IC064), Kunming 650021, China
| | - Fabing Lu
- Department of Ophthalmology, Fourth Affiliated Hospital of Kunming Medical University (the Second People's Hospital of Yunnan Province); Yunnan Eye Institute; Key Laboratory of Yunnan Province for the Prevention and Treatment of ophthalmology (2017DG008); Provincial Innovation Team for Cataract and Ocular Fundus Disease, The Second People's Hospital of Yunnan Province (2017HC010); Expert Workstation of Yao Ke (2017IC064), Kunming 650021, China
| | - Min Hu
- Department of Ophthalmology, Fourth Affiliated Hospital of Kunming Medical University (the Second People's Hospital of Yunnan Province); Yunnan Eye Institute; Key Laboratory of Yunnan Province for the Prevention and Treatment of ophthalmology (2017DG008); Provincial Innovation Team for Cataract and Ocular Fundus Disease, The Second People's Hospital of Yunnan Province (2017HC010); Expert Workstation of Yao Ke (2017IC064), Kunming 650021, China
| |
Collapse
|
28
|
Abstract
Myopia occurs in more than 50% of the population in many industrialized countries and is expected to increase; complications associated with axial elongation from myopia are the sixth leading cause of blindness. Thus, understanding its etiology, epidemiology, and the results of various treatment regiments may modify current care and result in a reduction in morbidity from progressive myopia. This rapid increase cannot be explained by genetics alone. Current animal and human research demonstrates that myopia development is a result of the interplay between genetic and the environmental factors. The prevalence of myopia is higher in individuals whose both parents are myopic, suggesting that genetic factors are clearly involved in myopia development. At the same time, population studies suggest that development of myopia is associated with education and the amount time spent doing near work; hence, activities increase the exposure to optical blur. Recently, there has been an increase in efforts to slow the progression of myopia because of its relationship to the development of serious pathological conditions such as macular degeneration, retinal detachments, glaucoma, and cataracts. We reviewed meta-analysis and other of current treatments that include: atropine, progressive addition spectacle lenses, orthokeratology, and multifocal contact lenses.
Collapse
|