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Tomiyama ES, Kobia-Acquah E, Ansari SM, Logan AK, Gialousakis J, Ng S, Wagner H. Scoping review: Reporting characteristics for the safety of contact lenses in the pediatric population. Optom Vis Sci 2024:00006324-990000000-00210. [PMID: 38950144 DOI: 10.1097/opx.0000000000002156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2024] Open
Abstract
SIGNIFICANCE Contact lenses are an increasingly popular option for correcting pediatric refractive error due to increased awareness of interventions to slow myopia progression. With limited information on the safety profiles of contact lenses in children, it is important to characterize the current understanding and promote this device's safe and effective use. PURPOSE This scoping review evaluates characteristics of the current literature that have examined the safety of contact lenses in pediatric patients. It provides future directions for systematic reviews and identifies any gaps in the current literature or areas for future research. METHODS Literature searches in MEDLINE via PubMed, EMBASE, The Cochrane Library, trial registries, and U.S. Food and Drug Administration clinical trial documentation were performed. Included studies (i.e., experimental and quasi-experimental studies; observational studies including prospective and retrospective cohort, case-control, and analytical cross-sectional studies, and case series of 30 or more participants) reported safety and/or complications of the use of any contact lens for correcting refractive error in children (0 to 18 years). Two independent reviewers first screened the titles and abstracts, and then full-text reports for eligibility. Conflicts in eligibility were resolved by discussions with a third reviewer. Two independent reviewers extracted data, including details about the participants, context, study methods, and key findings relevant to the review question. RESULTS This scoping review included 73 studies from 10 countries using different contact lens modalities, primarily orthokeratology and soft contact lenses, in children (6 to 18 years). The most common adverse event reported by the studies was corneal staining (60% orthokeratology, 45% soft contact lens). CONCLUSIONS The need for uniform reporting standards for adverse events poses challenges for comprehensive data synthesis. However, this scoping review identified a sufficient number of studies for a future systematic review to quantify the risks associated with orthokeratology and soft contact lens use in children.
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Affiliation(s)
| | | | - Shora M Ansari
- Southern California College of Optometry, Marshall B. Ketchum University, Fullerton, California
| | | | - John Gialousakis
- Midwestern University Chicago College of Optometry, Downers Grove, IL
| | - Sueko Ng
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Heidi Wagner
- Southern California College of Optometry, Marshall B. Ketchum University, Fullerton, California
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Xiao J, Pan X, Hou C, Wang Q. Changes in Subfoveal Choroidal Thickness after Orthokeratology in Myopic Children: A Systematic Review and Meta-Analysis. Curr Eye Res 2024; 49:683-690. [PMID: 38305231 DOI: 10.1080/02713683.2024.2310618] [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: 02/02/2023] [Accepted: 01/22/2024] [Indexed: 02/03/2024]
Abstract
AIMS This study aimed to synthesize the variations in subfoveal choroidal thickness (SFCT) observed at different follow-up intervals in myopic children undergoing orthokeratology treatment. MATERIALS AND METHODS Relevant articles were systematically retrieved from databases such as PubMed, EMBASE, Web of Science, and Cochrane Library. The retrieval period extended from the inception of these databases to November 2023. Means and standard deviations (SD) of baseline and post-treatment SFCT were selected as the results for analysis and calculation. RESULTS A total of eight articles involving 478 eyes fulfilled the inclusion criteria. At 1 month, 3 months, and 6 months intervals, the SFCT demonstrated significant increases by 16.74 μm (95% CI: 8.66, 24.82; p < 0.0001), 13.41 μm (95% CI: 4.36, 22.45; p = 0.004), and 17.57 μm (95% CI: 8.41, 26.73; p = 0.0002), respectively. Besides, children treated with orthokeratology exhibited a notably thicker change of SFCT in comparison with children with single-vision spectacles (SVL) (WMD = 13.50, 95% CI: 11.69, 15.13; p < 0.0001). CONCLUSION Myopic children undergoing orthokeratology treatment experience a discernible increase in SFCT at 1 month, 3 months, and 6 months. Furthermore, compared to children utilizing SVL, those undergoing orthokeratology manifest a more pronounced thickening of SFCT.
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Affiliation(s)
- Jie Xiao
- Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xinghui Pan
- Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chenting Hou
- Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Qing Wang
- Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao, China
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Zhang S, Zhu H, Zhang L, Gao M, Liu C, Zhao Q. Effects of orthokeratology on corneal reshaping and the delaying of axial eye growth in children. Heliyon 2024; 10:e33341. [PMID: 39022009 PMCID: PMC11253518 DOI: 10.1016/j.heliyon.2024.e33341] [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: 11/01/2023] [Revised: 06/19/2024] [Accepted: 06/19/2024] [Indexed: 07/20/2024] Open
Abstract
Purpose To investigate the inhibition of myopia progression and axial elongation in children wearing orthokeratology (OK) lenses, as well as to evaluate the status of corneal reshaping, this study explores the relationship between changes in central corneal curvature (K-value) and e-value induced by OK lenses and axial elongation. Methods In this study, it is planned to select children aged 8-15 who wear orthokeratology lenses at the Pediatric Ophthalmology and Strabismus Clinic of the Second Affiliated Hospital of Dalian Medical University. All children will undergo slit lamp examination, visual acuity assessment, computerized refraction, intraocular pressure measurement, biometry, and corneal topography examination before lens wear and at 1 month, 3 months, and 6 months after lens wear in the pediatric ophthalmology clinic. Based on age (lower age group (8 < age ≤12 years); higher age group (12 < age ≤15 years)) and baseline equivalent spherical (SE) value (mild myopia group (-1.00 D < SE ≤ -3.25D); moderate myopia group (-3.25 D < SE ≤ -6.00 D)), four groups will be formed by pairing these factors. Suitable data will be selected according to inclusion and exclusion criteria, and different groups will be included. Data will be organized, and statistical analysis will be performed using SPSS software to obtain the results. The expected results will be discussed and analyzed. Results After wearing OK lenses, all four groups achieved good visual acuity at follow-up. At 6 months, there were no significant differences in visual acuity among the four groups (P = 0.149, >0.05). There were no significant differences in refractive error among the four groups (P = 0.066, >0.05). Baseline axial length differed significantly among the four groups (P = 0.000, <0.001), with the LM group having longer axial length than the LL group (P < 0.001, paired samples t-test), and the HM group having longer axial length than the HL group (P < 0.001, paired samples t-test). However, there were no significant differences in axial length change compared to baseline among the groups at 1 month, 3 months, and 6 months (P 1 = 0.053; P 3 = 0.557; P 6 = 0.329, >0.05). Significant differences were observed in corneal flat K-value change compared to baseline among the four groups at 1 month, 3 months, and 6 months (P 1 = 0.001, P 3 = 0.001, P 6 = 0.004, <0.05). There were no significant differences in e-value change among the groups at 1 and 3 months (P 1 = 0.205, P 3 = 0.252, >0.05), but significant differences were found in e-value change compared to baseline at 6 months (P 6 = 0.010, <0.05). Multiple regression analysis with changes in central corneal flat K-value and e-value as independent variables and axial elongation as the dependent variable showed a correlation between e-value change at 6 months and axial elongation (P = 0.004, <0.05), indicating a negative correlation. Conclusion Orthokeratology (OK) lenses effectively improve myopic children's vision by reshaping the cornea, leading to reduced central corneal curvature and flattening of its anterior surface. The effectiveness of OK lenses is not significantly affected by age or initial myopia severity. Children of varying ages and myopia levels experience similar levels of axial length control with OK lens wear. Changes in corneal shape due to OK lenses affect axial elongation, with greater changes in corneal morphology associated with smaller increases in axial length.
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Affiliation(s)
- Siqi Zhang
- Second Affiliated Hospital of Dalian Medical University, China
| | - Huailin Zhu
- Second Affiliated Hospital of Dalian Medical University, China
| | - Lan Zhang
- Second Affiliated Hospital of Dalian Medical University, China
| | - Mingjun Gao
- Second Affiliated Hospital of Dalian Medical University, China
| | - Changyang Liu
- Second Affiliated Hospital of Dalian Medical University, China
| | - Qi Zhao
- Second Affiliated Hospital of Dalian Medical University, China
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Ostrin LA, Sah RP, Queener HM, Patel NB, Tran R, Shukla D, Mirhajianmoghadam H. Short-Term Myopic Defocus and Choroidal Thickness in Children and Adults. Invest Ophthalmol Vis Sci 2024; 65:22. [PMID: 38597724 PMCID: PMC11008753 DOI: 10.1167/iovs.65.4.22] [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: 09/11/2023] [Accepted: 03/20/2024] [Indexed: 04/11/2024] Open
Abstract
Purpose Studies report conflicting findings regarding choroidal thickness changes in response to myopic defocus in humans. This study aimed to investigate the choroidal response to myopic defocus in children and adults using automated analysis. Methods Participants (N = 46) were distance-corrected in both eyes and viewed a movie on a screen for 10 minutes. Two optical coherence tomography (OCT) radial scans were collected for each eye, then +3 diopters was added to one eye. Participants continued to watch the movie, OCT scans were repeated every 10 minutes for 50 minutes, and then recovery was assessed at 60 and 70 minutes. Defocus was interrupted for approximately two out of each 10 minutes for OCT imaging. OCT images were analyzed using an automated algorithm and trained neural network implemented in MATLAB to determine choroidal thickness at each time point. Repeated-measures ANOVA was used to assess changes with time in three age groups (6-17, 18-30, and 31-45 years) and by refractive error group (myopic and nonmyopic). Results Choroidal thickness was significantly associated with spherical equivalent refraction, with the myopic group having a thinner choroid than the nonmyopic group (P < 0.001). With imposed myopic defocus, there were no significant changes in choroidal thickness at any time point for any age group and for either refractive error group (P > 0.05 for all). Conclusions Findings demonstrate that, using the described protocol, the choroidal thickness of children and adults does not significantly change in response to short-term, full-field myopic defocus, in contrast to several previously published studies.
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Affiliation(s)
- Lisa A. Ostrin
- University of Houston College of Optometry, Houston, TX, United States
| | - Raman P. Sah
- University of Houston College of Optometry, Houston, TX, United States
| | - Hope M. Queener
- University of Houston College of Optometry, Houston, TX, United States
| | - Nimesh B. Patel
- University of Houston College of Optometry, Houston, TX, United States
| | - Raphaella Tran
- University of Houston College of Optometry, Houston, TX, United States
| | - Divya Shukla
- University of Houston College of Optometry, Houston, TX, United States
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Xu S, Wang M, Lin S, Jiang J, Yu M, Tang X, Xie D, Lu M, Li Z, Yang X. Long-term effect of orthokeratology on choroidal thickness and choroidal contour in myopic children. Br J Ophthalmol 2023:bjo-2023-323764. [PMID: 38164558 DOI: 10.1136/bjo-2023-323764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 11/05/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE To investigate the long-term effect of orthokeratology (ortho-k) on the choroidal thickness and choroidal contour in myopic children. METHODS Subjects were from a conducted 2-year randomised clinical trial. Children (n=80) aged 8-12 years with spherical equivalent refraction of -1.00 to -6.00D were randomly assigned to the control group (n=40) and ortho-k group (n=40). Optical coherence tomography images were collected at the baseline, 1-month, 6-month, 12-month, 18-month and 24-month visits, then the choroidal thickness and choroid contour were calculated. Axial length (AL) and other ocular biometrics were also measured. RESULTS During 2 years, in the control group, the choroidal thickness became thinning and the choroidal contour became prolate with time at all visits (all p<0.001). Ortho-k can improve the choroidal thickness (all p<0.001) and maintain the choroidal contour at all visits (all p<0.05). In the ortho-k group, the choroidal contour was less changed in the temporal than nasal (p=0.008), and the choroidal thickness was more thickening in the temporal 3 mm (p<0.001). Two-year change in choroidal thickness was significantly associated with the 2-year AL change in the control group (r=-0.52, p<0.001), however, this trend was broken by ortho-k (r=-0.05, p=0.342). After being adjusted by other variables in the multivariable regression model, the effect of ortho-k on choroidal thickness was stable. CONCLUSIONS In the current 2-year prospective study, ortho-k can improve the choroidal thickness and maintain the choroidal contour, but this effect diminished in a long term. Further study with larger sample size and longer follow-up is warranted to refine this issue.
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Affiliation(s)
- Shengsong Xu
- Sun Yat-Sen University Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Guangzhou, Guangdong, China
| | - Mengyi Wang
- Sun Yat-Sen University Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Guangzhou, Guangdong, China
| | - Sijia Lin
- Sun Yat-Sen University Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Guangzhou, Guangdong, China
| | - Jinyun Jiang
- Sun Yat-Sen University Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Guangzhou, Guangdong, China
| | - Mengting Yu
- Sun Yat-Sen University Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Guangzhou, Guangdong, China
| | - Xianghua Tang
- Sun Yat-Sen University Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Guangzhou, Guangdong, China
| | - Danxi Xie
- Sun Yat-Sen University Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Guangzhou, Guangdong, China
| | - Mingxin Lu
- Sun Yat-Sen University Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Guangzhou, Guangdong, China
| | - Zhouyue Li
- Sun Yat-Sen University Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Guangzhou, Guangdong, China
| | - Xiao Yang
- Sun Yat-Sen University Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Guangzhou, Guangdong, China
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Chun RKM, Zhang H, Liu Z, Tse DYY, Zhou Y, Lam CSY, To CH. Defocus incorporated multiple segments (DIMS) spectacle lenses increase the choroidal thickness: a two-year randomized clinical trial. EYE AND VISION (LONDON, ENGLAND) 2023; 10:39. [PMID: 37715201 PMCID: PMC10502972 DOI: 10.1186/s40662-023-00356-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 08/22/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND Myopia control interventions, such as defocus incorporated multiple segments (DIMS) spectacle lenses, have been adopted in school-aged children to reduce the prevalence of myopia and its complications. This study aimed to investigate the effect of DIMS spectacle lenses on subfoveal choroidal thickness (SfChT) over a period of two years, as the choroidal response to myopic control is a crucial factor in exploring its potential effect on predicting myopia progression. METHODS This study involved a secondary analysis of our previous randomized clinical trial. Myopic school-aged children aged 8-13 years were recruited in a two-year study investigating the effect of DIMS spectacle lenses on myopia progression. The treated group received DIMS spectacle lenses (n = 78), while the control group was treated with a pair of single vision (SV) spectacle lenses (n = 80). SfChT was monitored at 1 week, 1, 3, 6, 12, 18 and 24 months post lens wear using spectral-domain optical coherence tomography and a custom made auto-segmentation algorithm utilizing convolutional neural networks. RESULTS SfChT increased significantly after one week of DIMS spectacle lens wear compared to those wearing SV spectacle lenses (adjusted mean change relative to baseline ± SEM at one week; DIMS vs. SV, 6.75 ± 1.52 µm vs. - 3.17 ± 1.48 µm; P < 0.0001, general linear model). The thickness of choroid increased to 13.64 ± 2.62 µm after 12 months of DIMS lens wear while the choroid thinned in SV group (- 9.46 ± 2.55 µm). Choroidal changes demonstrated a significant negative association with axial elongation over two years in both the DIMS and SV groups. Choroidal change at three months significantly predicted the changes in AL at 12 months after controlling the effect of age and gender. CONCLUSIONS Our study demonstrated a significant choroidal thickening in response to myopic defocus incorporated in a spectacle lens after one week of lens wear, sustained over the two-year study period. The results suggested that choroidal changes at three months may help predict changes in axial length after one year. Trial registration ClinicalTrials.gov. Myopia control with the multi-segment lens. NCT02206217. Registered 29 July 2014, https://clinicaltrials.gov/ct2/show/study/NCT02206217.
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Affiliation(s)
- Rachel Ka Man Chun
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China.
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong, China.
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Shatin, Hong Kong, China.
| | - Hanyu Zhang
- School of Medicine, Nankai University, Tianjin, China
| | - Zhengji Liu
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Dennis Yan Yin Tse
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Shatin, Hong Kong, China
| | - Yongjin Zhou
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
- School of Biomedical Engineering, Department of Medical Electronics, Shenzhen University, Shenzhen, China
| | - Carly Siu Yin Lam
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Shatin, Hong Kong, China
| | - Chi Ho To
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Shatin, Hong Kong, China
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Lian Y, Lu W, Xu A, Chen R, Lu Q, Zhou W, Mei L, Jin W. The correlation between modifications to corneal topography and changes in retinal vascular density and retinal thickness in myopic children after undergoing orthokeratology. Front Med (Lausanne) 2023; 10:1166429. [PMID: 37457580 PMCID: PMC10338965 DOI: 10.3389/fmed.2023.1166429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/09/2023] [Indexed: 07/18/2023] Open
Abstract
Purpose This study aimed to investigate the relationship among changes in corneal topography, retinal vascular density, and retinal thickness in myopic children who underwent orthokeratology for 3 months. Method Thirty children with myopia wore orthokeratology lenses for 3 months. Using optical coherence tomography angiography (OCTA), the retina was imaged as 6 × 6 mm en-face images at baseline and 3 months after orthokeratology. Cornea data was acquired by topography and analyzed by customer MATLAB software. The cornea was divided into 3 zones and 9 sectors. The relative corneal refractive power shift (RCRPS) was used in this study. Changes in retinal vascular density (RVDC) and retinal thickness change (RTC) were associated with RCRPS by using spearman test. Statistical significance was set at p < 0.05. Result A significant correlation was observed between the RVDC and the RCRPS in many regions (the r was 0.375 ~ 0.548, all p value <0.05). Significant positive correlations were found between RVDC in inner and outer temple regions with RCRPS at inner and outer nasal sectors. There were no significant correlations between RTC and RCRPS in other sectors except in the central cornea and the outer nasal retina (r:0.501, p:0.006). At baseline and 3 months after wearing the orthokeratology lens, no significant differences in the retinal microvasculature or thickness (p > 0.05) were observed at any regions. Conclusion The correlation between the cornea and the retina was observed after orthokeratology. Cornea changes may affect regional retinal responses accordingly,which may explain how orthokeratology delays myopia progression partially.
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Affiliation(s)
- Yan Lian
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Weiwei Lu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Aiqin Xu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Renai Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Qingqing Lu
- School of Ophthalmology, Optometry, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Weihe Zhou
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Lili Mei
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Wanqing Jin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- The First People’s Hospital of Aksu District in Xinjiang, Aksu City, China
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Nilsen NG, Gilson SJ, Pedersen HR, Hagen LA, Knoblauch K, Baraas RC. Seasonal Variation in Diurnal Rhythms of the Human Eye: Implications for Continuing Ocular Growth in Adolescents and Young Adults. Invest Ophthalmol Vis Sci 2022; 63:20. [PMID: 36282117 PMCID: PMC9617503 DOI: 10.1167/iovs.63.11.20] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Purpose To investigate the diurnal rhythms in the human eye in winter and summer in southeast Norway (latitude 60°N). Methods Eight measures (epochs) of intraocular pressure, ocular biometry, and optical coherence tomography were obtained from healthy participants (17–24 years of age) on a mid-winter's day (n = 35; 6 hours of daylight at solstice) and on a day the following summer (n = 24; 18 hours of daylight at solstice). Participants wore an activity monitor 7 days before measurements. The epochs were scheduled relative to the individual's habitual wake and sleep time: two in the day (morning and midday) and six in the evening (every hour until and 1 hour after sleep time). Saliva was collected for melatonin. A linear mixed-effects model was used to determine significant diurnal variations, and a sinusoid with a 24-hour period was fitted to the data with a nonlinear mixed-effects model to estimate rhythmic statistics. Results All parameters underwent significant diurnal variation in winter and summer (P < 0.002). A 1-hour phase advance was observed for melatonin and ocular axial length in the summer (P < 0.001). The degree of change in axial length was associated with axial length phase advance (R2 = 0.81, P < 0.001) and choroidal thickening (R2 = 0.54, P < 0.001) in summer. Conclusions Diurnal rhythms in ocular biometry appear to be synchronized with melatonin secretion in both winter and summer, revealing seasonal variation of diurnal rhythms in young adult eyes. The association between axial length and seasonal changes in the phase relationships between ocular parameters and melatonin suggests a between-individual variation in adaptation to seasonal changes in ocular diurnal rhythms.
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Affiliation(s)
- Nickolai G Nilsen
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Stuart J Gilson
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Hilde R Pedersen
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Lene A Hagen
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Kenneth Knoblauch
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway.,Stem-Cell and Brain Research Institute, INSERM U1208, Bron, France.,Université de Lyon, Université Lyon I, Lyon, France
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
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Chen X, Li Q, Liu L. Personalized Predictive Modeling of Subfoveal Choroidal Thickness Changes for Myopic Adolescents after Overnight Orthokeratology. J Pers Med 2022; 12:jpm12081316. [PMID: 36013265 PMCID: PMC9410041 DOI: 10.3390/jpm12081316] [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: 07/18/2022] [Revised: 08/09/2022] [Accepted: 08/13/2022] [Indexed: 11/16/2022] Open
Abstract
The changes in subfoveal choroidal thickness after orthokeratology are crucial in myopia retardation; this study aimed to identify the risk factors that could be incorporated into a predictive model for subfoveal choroidal thickness (SFChT) that would provide further personalized and clinically specific information for myopia control. A one-year prospective study was conducted in the West China Hospital, Sichuan University. Basic information (age, gender, and height) was collected from all subjects. Initial spherical equivalent, axial length, intraocular pressure, central corneal thickness, and subfoveal choroidal thickness were measured, and the ocular environmental factors were also collected. All the measured parameters were recorded in the follow-up period for one year. After the analysis of univariate analysis, statistically significant factors were substituted into the multivariate three-level model. Thirty-three adolescents aged 8−14 years old were enrolled in this study; the results show that the subfoveal choroidal thickness in both eyes changed significantly after 12 months of lens wearing (pR < 0.0001, pL < 0.0001). The axial length was negatively correlated with the change in the SFChT after 12 months of lens wearing (r = −0.511, p = 0.002). After multilevel model analysis, the statistically significant factor was shown to have an important influence on the changes in the subfoveal choroidal thickness, which was the average near-work time. This suggested that the SFChT personal predictions can be made regarding changes in myopic adolescents after orthokeratology using the factor of daily average near-work time. Clinical practitioners will benefit from the results by obtaining a better understanding of the effects of orthokeratology on choroid and myopia progression.
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Affiliation(s)
- Xiaohang Chen
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu 610041, China
- The Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qiushi Li
- Department of Outpatient, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Longqian Liu
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu 610041, China
- The Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu 610041, China
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, China
- Correspondence:
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Prieto-Garrido FL, Villa-Collar C, Hernandez-Verdejo JL, Alvarez-Peregrina C, Ruiz-Pomeda A. Changes in the Choroidal Thickness of Children Wearing MiSight to Control Myopia. J Clin Med 2022; 11:jcm11133833. [PMID: 35807117 PMCID: PMC9267297 DOI: 10.3390/jcm11133833] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 01/27/2023] Open
Abstract
Background: Due to the importance of choroidal thickness in the development of myopia, this study examined the effect of MiSight contact lenses (CLs) on the choroidal thickness of myopic children and the differences between responders and non-responders to the treatment with these CLs. Methods: A total of 41 myopic children were fitted with MiSight CLs and 33 with single-vision spectacles. They were followed up for two years. Subfoveal choroidal thickness and choroidal thickness 1 and 3 mm temporal and nasal to the fovea were measured by OCT at baseline and one and two years after the treatment. Differences in all the choroidal thickness parameters were assessed in each group over time. Patients from the MiSight group were classified based on a specific range of changes in axial length at the end of the second year of treatment as “responders” (AL change < 0.22 mm/per year) and “non-responders”, and the choroidal thickness of both groups was analyzed. Results: The subfoveal choroidal thickness of the MiSight and single-vision spectacle groups did not show any changes over time. Wearing MiSight CLs induced relative choroidal thickening in the responder group in the first year of treatment. Conclusion: Choroidal thickness might work as a predictor of the effectiveness of MiSight in myopia treatment.
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Affiliation(s)
- Francisco Luis Prieto-Garrido
- Hospital Universitario del Henares, Fundación para la Investigación e Innovación Biomédica, FIIB HUIS HHEN, 28822 Madrid, Spain;
- Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain;
| | - Cesar Villa-Collar
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain;
| | | | | | - Alicia Ruiz-Pomeda
- Ophthalmology Department, Hospital Universitario de Móstoles, 28935 Madrid, Spain;
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11
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Wang A, Yang C, Shen L, Wang J, Zhang Z, Yang W. Axial length shortening after orthokeratology and its relationship with myopic control. BMC Ophthalmol 2022; 22:243. [PMID: 35659643 PMCID: PMC9164339 DOI: 10.1186/s12886-022-02461-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 05/18/2022] [Indexed: 02/07/2023] Open
Abstract
Purpose To determine the pattern of axial variation in subjects with initial shortened axial length during the entire period of orthokeratology and to discuss the possibility of shortened AL after one month of orthokeratology becoming a predictor of myopia control. Method This study retrospectively included 106 children with myopia aged 8 to 14 wearing OK lenses. Fifty-four eyes with shortened axial length (AL) at the first-month visit were enrolled in the axial length shortening (ALS) group, and fifty-two eyes without shortened AL were enrolled in the no axial length shortening (NALS) group. Axial length and refractive error at baseline and within the entire period of orthokeratology (20 months), including fitting, washout period and re-wear, were measured. Eighty-five children who started wearing single vision spectacle were also included as a control group. Results In the ALS group, AL became longer after shortening and slowly exceeded baseline; afterward, AL experienced a rebound during the washout period and shortened again if OK lenses were re-worn. After washout period, significant difference in AL (ALS:0.28 ± 0.19 mm, NALS: 0.52 ± 0.17 mm) and spherical equivalent (ALS:-0.43 ± 0.44D, NALS:-0.91 ± 0.40D) between the two groups were found(P<0.05). The changes in AL and SE were both significantly correlated with the changes in AL at the first-month visit (P<0.05). Conclusion After AL is shortened in the initial stage of orthokeratology, it will experience a rapid rebound during the washout period, and the shortening can reappear when re-wearing OK lenses. Hence, the evaluation of orthokeratology will be more objective and accurate after the wash-out period. In addition, the existence and degree of axial shortening can be used as a predictor of long-term myopia development. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-022-02461-4.
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Tarutta EP, Milash SV, Epishina MV, Eliseeva EK. [Changes in subfoveal choroidal thickness in myopic children who wear bifocal soft contact lenses]. Vestn Oftalmol 2022; 138:16-22. [PMID: 35488558 DOI: 10.17116/oftalma202213802116] [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: 11/17/2022]
Abstract
PURPOSE To study the changes in subfoveal choroidal thickness in children with progressive myopia who have been wearing bifocal soft contact lenses (BSCL) with an ADD power of +4.0 D for 3 months. MATERIAL AND METHODS The study included 40 patients (80 eyes) with progressive myopia of low and moderate degrees. The main group consisted of 23 patients aged 10.04±1.5 years with an average myopia of -3.06±1.17 D, they were examined before and 3 months after vision correction with bifocal soft contact lenses Prima BIO Bi-focal («OkVision Retail», Russia). The control group consisted of 17 patients (34 eyes) aged 9.29±0.92 years with an average myopia of -3.05±1.5 D using single vision spectacle lenses. Cycloplegic refraction, choroidal thickness and axial length were measured in all patients before and after 3 months. Choroidal thickness was measured using the semi-automatic method on the optical coherent tomography system RS-3000 Advance 2 («Nidek», Japan). Axial length was measured using the optical biometer IOL Master 500 («Carl Zeiss», Germany). RESULTS In the main group, subfoveolar choroidal thickness increased on average by 15.3±24.3 μm after 3 months of wearing BSCL, and in the control group it decreased on average by 9.03±28.65 μm. Comparison of changes in choroidal thickness between the main and the control groups revealed a significant difference (p<0.001). Increase in axial length of the eye in the main group was significantly less than in the control group (0.005±0.08 mm vs 0.07±0.06 mm; p<0.001). A strong negative correlation was found between changes in the axial length and subfoveolar choroidal thickness in the main group (r= -0.67), but no similar relationship was found in the control group (r= -0.13). CONCLUSION Subfoveolar choroidal thickness increases in children wearing bifocal soft contact lenses for myopia correction.
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Affiliation(s)
- E P Tarutta
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - S V Milash
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - M V Epishina
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - E K Eliseeva
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
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Aldakhil S. The Effect of Optical Defocus on the Choroidal Thickness: A Review. Open Ophthalmol J 2021. [DOI: 10.2174/1874364102115010283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The choroid is a heavily vascularized tissue located between the retina and sclera and plays a primary role in ocular metabolism. It has recently been suggested that the choroid has the ability to change its thickness and secretion of growth factors. This may play an important role during visual development by adjusting retinal position during growth to support emmetropisation; however, the mechanism by which changes in choroidal thickness (ChT) occur is unclear.
This relationship becomes an interesting topic in the clinical field, although conflicting evidence found that these changes in the choroidal thickness may not be associated with the development of refractive errors. Many reports have investigated the changes in the choroid and related factors that affect the ChT. Thus, this review will summarize the current literature related to choroidal thickness in different refractive error groups, determine the factors that influence the thickness of the choroid, and discuss in detail the relationship between the changes in the ChT and ocular elongation, and therefore, the effect of optical defocus on ChT and the development of the refractive error.
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Queirós A, Cerviño A, González-Méijome JM. Peripheral refraction of myopic eyes with spectacle lenses correction and lens free emmetropes during accommodation. EYE AND VISION (LONDON, ENGLAND) 2021; 8:45. [PMID: 34847960 PMCID: PMC8638353 DOI: 10.1186/s40662-021-00267-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 10/25/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE To measure axial and off-axis refraction patterns in myopic eyes with spectacle lenses correction and lens free emmetropes in young healthy subjects at different target distances from 2.00 m (0.50 D) to 0.20 m (5.00 D) in terms of sphere, astigmatism, and spherical equivalent refraction. METHODS Refraction was measured at the center, 20 and 40 degrees from the line of sight both nasally and temporally in 15 emmetropic and 25 myopic young healthy subjects with an open field, binocular, infrared autorefractor (Grand Seiko WAM-5500, Hiroshima, Japan). Fixation target was a Maltese cross set at 2.00, 0.50, 0.33 and 0.20 m from the corneal plane. Changes in off-axis refraction with accommodation level were normalized with respect to distance axial values and compared between myopic eyes with spectacle lenses correction and lens free emmetropes. RESULTS Off-axis refraction in myopic eyes with spectacle lenses correction was significantly more myopic in the temporal retina compared to lens free emmetropes except for the closest target distance. Relative off-axis refractive error changed significantly with accommodation when compared to axial refraction particularly in the myopic group. This change in the negative direction was due to changes in the spherical component of refraction that became more myopic relative to the center at the 0.20 m distance as the J0 component of astigmatism was significantly reduced in both emmetropes and myopes for the closest target. CONCLUSION Accommodation to very near targets (up to 0.20 m) makes the off-axis refraction of myopes wearing their spectacle correction similar to that of lens free emmetropes. A significant reduction in off-axis astigmatism was also observed for the 0.20 m distance.
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Affiliation(s)
- António Queirós
- Clinical & Experimental Optometry Research Lab (CEORLab), Center of Physics (Optometry), University of Minho, Campus de Gualtar, 4710-057, 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 & Experimental Optometry Research Lab (CEORLab), Center of Physics (Optometry), University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
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Huang Y, Li X, Ding C, Chen Y, Chen H, Bao J. Orthokeratology reshapes eyes to be less prolate and more symmetric. Cont Lens Anterior Eye 2021; 45:101532. [PMID: 34736858 DOI: 10.1016/j.clae.2021.101532] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 10/11/2021] [Accepted: 10/21/2021] [Indexed: 01/12/2023]
Abstract
PURPOSE This prospective study assessed the influence of wearing and then discontinuing orthokeratology (OK) lenses on retinal shape and peripheral refraction in myopic children. METHODS Fifty-eight myopic children (age 8-12 years) were equally divided into an OK group and a single vision spectacles (SVS) group. After 12 months of OK, it was discontinued for 1 month. Peripheral eye length (PEL), relative peripheral refraction (RPR), and corneal parameters were measured in the right eye on the nasal and temporal retinal sides at baseline, 6 months, and 12 months (13 months in OK group) visits. RESULTS In the SVS group, faster elongation of the temporal side PEL made the eyes more asymmetric and prolate, developing a temporal pointed shape. In the OK group, the nasal retinal side PEL grew faster, the nasal RPR developed less hyperopic defocus, and the eye shape became more symmetric and less prolate. The central cornea became thinner and flattened, while the peripheral cornea became steeper. Changes in corneal thickness, relative peripheral corneal power, and K-values were no significant differences for the OK and SVS groups at 12 months. CONCLUSIONS The cornea reverted to be no difference with myopic children with SVS after 1 month discontinuation of OK. The retinal shape of SVS eyes became more asymmetric and prolate with myopia progression. OK remodelled retinal shape to be less asymmetric and less prolate.
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Affiliation(s)
- Yingying Huang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China; Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China
| | - Xue Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China; Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China
| | - Chenglu Ding
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yunyun Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hao Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Jinhua Bao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China; Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China.
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16
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Wu J, Fang W, Xu H, Liu X, Zhao D, Rong Q. The Biomechanical Response of the Cornea in Orthokeratology. Front Bioeng Biotechnol 2021; 9:743745. [PMID: 34708026 PMCID: PMC8542762 DOI: 10.3389/fbioe.2021.743745] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Orthokeratology has been widely used to control myopia, but the mechanism is still unknown. To further investigate the underlying mechanism of corneal reshaping using orthokeratology lenses via the finite element method, numerical models with different corneal curvatures, corneal thicknesses, and myopia reduction degrees had been developed and validated to simulate the corneal response and quantify the changes in maximum stress in the central and peripheral corneal areas during orthokeratology. The influence of the factors on corneal response had been analyzed by using median quantile regression. A partial eta squared value in analysis of variance models was established to compare the effect size of these factors. The results showed central and peripheral corneal stress responses changed significantly with increased myopia reduction, corneal curvature, and corneal thickness. The target myopia reduction had the greatest effect on the central corneal stress value (partial eta square = 0.9382), followed by corneal curvature (partial eta square = 0.5650) and corneal thickness (partial eta square = 0.1975). The corneal curvature had the greatest effect on the peripheral corneal stress value (partial eta square = 0.5220), followed by myopia reduction (partial eta square = 0.2375) and corneal thickness (partial eta square = 0.1972). In summary, the biomechanical response of the cornea varies significantly with the change in corneal conditions and lens designs. Therefore, the orthokeratology lens design and the lens fitting process should be taken into consideration in clinical practice, especially for patients with high myopia and steep corneas.
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Affiliation(s)
- Jinfang Wu
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Wenxuan Fang
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Huiwen Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Xiaode Liu
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China.,X Lab, the Second Academy of CASIC, Beijing, China
| | - Dongliang Zhao
- School of Chemical Biology and Biotechnology, Peking University Shenzhen Graduate School, Shenzhen, China
| | - Qiguo Rong
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
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17
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Guo B, Lau JK, Cheung SW, Cho P. Repeatability and reproducibility of manual choroidal thickness measurement using Lenstar images in children before and after orthokeratology treatment. Cont Lens Anterior Eye 2021; 45:101484. [PMID: 34303626 DOI: 10.1016/j.clae.2021.101484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE To investigate the repeatability and reproducibility of choroidal thickness measurements using Lenstar images in young myopic children before and after one-month orthokeratology (ortho-k) treatment. METHOD Ocular biometry of 39 subjects were performed using the Lenstar 900. The first five measurements with maximum differences of 0.02 mm in axial length in the right eyes were saved and used for measurement of choroidal thickness. Subfoveal choroidal thickness were manually measured by identifying the signals from the retinal pigmented epithelium layer and chorioscleral interface. Repeatability was determined by comparing measurements of the same images made by the same observer on two separate occasions (four weeks apart), while reproducibility was calculated by comparing measurements of the same images made by two independent observers. Data was analysed using intra-class correlation coefficients (ICC) and non-parametric Bland and Altman plots. RESULTS The choroidal peaks could not be identified in all five measurements in all subjects. On average, only 71% subjects had at least four definable images. Compared with the use of fewer than four images, reliability using an average of four definable images improved statistically, but remained clinically unacceptable (>10 µm), although pre- and post-ortho-k ICC values were good to excellent for repeatability (0.867 and 0.975, respectively) and excellent and good for reproducibility (0.959 and 0.868, respectively). Non-parametric pre- and post-ortho-k limits of agreement (2.5% and 97.5% percentiles) obtained were -45.8 to 79.3 µm and -30.3 to 9.5 µm, respectively for repeatability, and -29.0 to 33.5 µm and -21.8 to 70.0 µm, respectively for reproducibility. CONCLUSION Choroidal thickness measurements using the Lenstar did not show good reliability, despite the high ICC values, non-parametric Bland and Altman plots demonstrated a wide variability of measurement errors. Any changes in subfoveal choroidal thickness, measured by Lenstar, of <80 µm may not represent real changes.
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Affiliation(s)
- Biyue Guo
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region.
| | - Jason K Lau
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region
| | - Sin Wan Cheung
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region
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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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Is It Possible to Predict Progression of Childhood Myopia Using Short-Term Axial Change After Orthokeratology? Eye Contact Lens 2021; 46:136-140. [PMID: 31842031 DOI: 10.1097/icl.0000000000000665] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To investigate changes in axial length in children undergoing orthokeratology (OK) and evaluate short-term axial change in predicting post-OK myopia progression. METHODS In this retrospective study, the subjects included 70 myopic children aged 8 to 15 years wearing OK contact lenses for more than 3 years. Axial length changes at 0.5, 1, 2, and 3 years relative to the baseline were measured. Patients were evaluated for age, spherical equivalent refraction (SER), pupil size, and half-year axial change using repeated analysis of variance and multivariate linear regression analysis to predict half to 3 year-axial elongation (AE, seventh-36th month post-OK). RESULTS The axial length grew significantly during the 3 years; the mean annual axial growth was 0.20±0.12 mm. The half-year axial change was 0.04±0.12 mm. The univariate linear analyses showed that half to 3-year AE was correlated with baseline age (r=-0.393, P<0.001) and half-year axial change (r=0.379, P=0.001), but not pupil diameter (P=0.692) or SER (P=0.673). In a multiple linear regression model, the half to 3-year AE was related with the baseline age (standardized β=-0.312, P=0.007) and half-year axial change (standardized β=0.293, P=0.01). The model was fair (adjusted R=0.21) and statistically significant (F=10.24, P<0.001). CONCLUSIONS It is practical to predict long-term AE with half-year axial change for children with OK correction. Therefore, this may aid in fast and timely measures in children who are predicted to have rapid myopia progression.
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Orthokeratology and Low-Intensity Laser Therapy for Slowing the Progression of Myopia in Children. BIOMED RESEARCH INTERNATIONAL 2021; 2021:8915867. [PMID: 33575355 PMCID: PMC7861936 DOI: 10.1155/2021/8915867] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/02/2020] [Accepted: 01/15/2021] [Indexed: 12/21/2022]
Abstract
Orthokeratology (OK) is widely used to slow the progression of myopia. Low-level laser therapy (LLLT) provides sufficient low energy to change the cellular function. This research is aimed at verifying the hypothesis that LLLT treatment could control myopia progression and comparing the abilities of OK lenses and LLLT to control the refractive error of myopia. Eighty-one children (81 eyes) who wore OK lenses, 74 children (74 eyes) who underwent LLLT treatment, and 74 children (74 eyes) who wore single-vision distance spectacles for 6 months were included. Changes in axial length (AL) were 0.23 ± 0.06 mm for children wearing spectacles, 0.06 ± 0.15 mm for children wearing OK lens, and -0.06 ± 0.15 mm for children treated with LLLT for 6 months. Changes in subfoveal choroidal thickness (SFChT) observed at the 6-month examination were -16.84 ± 7.85 μm, 14.98 ± 22.50 μm, and 35.30 ± 31.75 μm for the control group, OK group, and LLLT group, respectively. Increases in AL at 1 month and 6 months were significantly associated with age at LLLT treatment. Changes in AL were significantly correlated with the baseline spherical equivalent refraction (SER) and baseline AL in the OK and LLLT groups. Increases in SFChT at 1 month and 6 months were positively associated with age at enrolment for children wearing OK lens. At 6 months, axial elongation had decelerated in OK lens-wearers and LLLT-treated children. Slightly better myopia control was observed with LLLT treatment than with overnight OK lens-wearing. Evaluations of age, SER, and AL can enhance screening for high-risk myopia, improve the myopia prognosis, and help determine suitable control methods yielding the most benefits.
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Abstract
The review summarizes experimental and clinical data attesting to the important role the choroid plays in the development of refraction through optically oriented thickness changes and the release of growth factors. Because of its unique anatomical position, the choroid can influence the transmission of a cascade of chemical signals from the retina to the sclera and thereby affect the growth of the eye. Understanding the relationship between the optical defocus and the response of the choroid to it will help uncover the fundamental mechanisms for controlling eye growth and develop new strategies for preventing the progression of myopia.
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Affiliation(s)
- E P Tarutta
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - S V Milash
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - G A Markosyan
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
| | - N A Tarasova
- Helmholtz National Medical Research Center of Eye Diseases, Moscow, Russia
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22
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Lee JH, Hong IH, Lee TY, Han JR, Jeon GS. Choroidal Thickness Changes after Orthokeratology Lens Wearing in Young Adults with Myopia. Ophthalmic Res 2020; 64:121-127. [PMID: 32759609 DOI: 10.1159/000510715] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 08/05/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Recently in South Korea, there are increasing number of young adults undergoing orthokeratology treatment for myopia control. They prefer orthokeratology treatment more than wearing spectacles or having a refractive surgery for several reasons. However, there is little research on the effect of orthokeratology treatment on choroids. OBJECTIVE The aim of this study was to analyze the change in choroidal thickness (CT) in the horizontal axis in young myopic adults after orthokeratology treatment. METHODS This was a retrospective research among young myopic patients (-1.0 to -5.0 diopters) aged 19-29 years (n = 36; 23.6 ± 2.5 years). We selected patients who were treated with orthokeratology for 12 months. CT values of the horizontal axis near the fovea before and after orthokeratology treatment were analyzed using optical coherence tomography. The value was measured at the beginning of treatment and at 3, 6, and 12 months after orthokeratology treatment. Three regional areas of choroid on the horizontal plane including fovea were analyzed. RESULT AND CONCLUSIONS In the beginning of orthokeratology treatment, CT of the horizontal axis was 248.9 ± 45.7 μm in the temporal region, 259.9 ± 55.3 μm in the macular region, and 219.2 ± 46.4 μm in the nasal region. Three months after orthokeratology treatment, thickness values of choroids in the 3 divided areas increased significantly (p < 0.05). Mean CT at 6 or 12 months after orthokeratology treatment was greater than before ortho<X00_Del_TrennDivis>--</X00_Del_TrennDivis>keratology treatment. CT increased after 3 months of orthokeratology treatment in each regional area. In young myopic adults, CT in nasal area was thinner than that in foveal or temporal area before treatment. CT recovered to near baseline when it was observed for more than 6 months after orthokeratology treatment.
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Affiliation(s)
- Jang Hun Lee
- Department of Ophthalmology, Dasan Samsung Bright Eye Clinic, Gyeonggi-do, Republic of Korea
| | - In Hwan Hong
- Department of Ophthalmology, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University, Gyeonggi-do, Republic of Korea
| | - Tae Yeem Lee
- Galmae Samsung Bright Clinic, Gyeonggi-do, Republic of Korea
| | - Jae Ryong Han
- Department of Ophthalmology, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University, Gyeonggi-do, Republic of Korea
| | - Gang Seok Jeon
- Department of Ophthalmology, Dasan Samsung Bright Eye Clinic, Gyeonggi-do, Republic of Korea,
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Measurement of the peripheral aberrations of human eyes: A comprehensive review. NANOTECHNOLOGY AND PRECISION ENGINEERING 2020. [DOI: 10.1016/j.npe.2020.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Zhang J, He FL, Liu Y, Fan XQ. Comparison of choroidal thickness in high myopic eyes after FS-LASIK versus implantable collamer lens implantation with swept-source optical coherence tomography. Int J Ophthalmol 2020; 13:773-781. [PMID: 32420225 DOI: 10.18240/ijo.2020.05.12] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 03/15/2020] [Indexed: 01/22/2023] Open
Abstract
AIM To investigate the changes in choroidal thickness (CT) in high myopic eyes after femtosecond laser-assisted in situ keratomileusis (FS-LASIK) surgery or central hole implantable collamer lens (ICL V4c) implantation using swept-source optical coherence tomography (SS-OCT). METHODS We examined the right eyes of 116 patients with high myopia who were candidates for FS-LASIK surgery and ICL implantation. Sixty eyes underwent ICL V4c implantation and 56 eyes were subjected to FS-LASIK surgery. The CT was measured with SS-OCT. All data were recorded preoperatively and 2h, 1wk, 1 and 3mo postoperatively. Other demographic information was collected, including age, sex, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), spherical equivalent (SE), intraocular pressure (IOP) and axial length (AL). RESULTS The UCVA improved in both groups and showed no significant differences between groups. There also were no significant differences between the two groups in postoperative BCVA and SE (P=0.581 and 0.203, respectively). The foveal CTs, inner nasal and outer nasal CTs were significantly thicker at 2h postoperatively in both groups (P<0.05) but returned to baseline levels in 1wk; after 1mo, no significant differences were found relative to the preoperative values. At 3mo in each group, nine regions showed variations in the CT as compared with preoperative thickening, but only the foveal and nasal area CTs preoperative differences were statistically significant (P<0.05). In addition, there was no significant difference in 9 regions of CT between the two groups at all follow-up times (P>0.05). CONCLUSION The CTs after ICL implantation and FS-LASIK surgery are significantly thicker than those before operation, especially in the foveal and nasal areas, but there is no significant difference between the two methods.
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Affiliation(s)
- Jing Zhang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.,Shanghai Key Laboratory of Orbital Disease and Ocular Oncology, Shanghai 200011, China
| | - Fang-Lin He
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.,Shanghai Key Laboratory of Orbital Disease and Ocular Oncology, Shanghai 200011, China
| | - Yan Liu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.,Shanghai Key Laboratory of Orbital Disease and Ocular Oncology, Shanghai 200011, China
| | - Xian-Qun Fan
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.,Shanghai Key Laboratory of Orbital Disease and Ocular Oncology, Shanghai 200011, China
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Ren Q, Yang B, Liu L, Cho P. Orthokeratology in adults and factors affecting success: Study design and preliminary results. Cont Lens Anterior Eye 2020; 43:595-601. [PMID: 32371038 DOI: 10.1016/j.clae.2020.03.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To report the study design and one month's preliminary results of a randomized, single-masked, one-year prospective study of orthokeratology (ortho-k) in adults wearing lenses of different compression factors. METHODS Adults aged 18-38 years, with myopia of -0.75 to -5.00 D and astigmatism < 1.50 D, were recruited and randomly assigned into two groups: a conventional compression factor or Jessen Factor (CCF) group (compression factor = 0.75 D) and an increased (extra 1.00D) compression factor (ICF) group. Clinical outcomes, including spherical equivalent refraction (SER) reduction, visual acuity, corneal hysteresis (CH) and corneal resistance factor (CRF), and signs and symptoms were collected at the one-month follow-up visit. Indicators of the level of satisfaction and quality of life after commencing treatment were determined via a satisfaction questionnaire and the NEI-RQL-42 questionnaire. RESULTS Baseline data from 26 CCF and 24 ICF participants were analysed and no significant differences were observed between the two groups (p > 0.05). The first fit success rates were 90 % for CCF group and 83 % for the ICF group, SER reductions were 97 % and 95 % for the CCF and ICF group, respectively, with uncorrected high-contrast visual acuity of -0.06 (-0.18 to 0.42) and 0.00 (-0.16 to 0.52), respectively (p > 0.05) at the 1-month visit. Overall, the incidence of corneal staining was 77 % in the CCF and 79 % in ICF group; central corneal staining was 15 % and 33 %, respectively. However, the differences of corneal staining between the groups did not reach significance in any visit (p > 0.05). The main complaint from participants was glare (both groups). No significant differences in CRF and CH were found in the first month (p > 0.05). Both groups recorded high scores in the level of satisfaction questionnaire, with no significant differences between groups (p > 0.05). Compared with baseline scores, 1-month NEI-RQL-42 subscales of dependence on correction, appearance, and satisfaction with correction significantly increased, and the glare score significantly decreased in both groups (all p < 0.05). CONCLUSIONS The majority of participants were satisfied with the treatment and no serious corneal adverse effects were observed. These results demonstrate that ortho-k lenses of default and increased compression factor (1D) demonstrated similar clinical performance and ortho-k can be a safe and well-accepted option for myopia correction in adults, but long-term observation is warranted.
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Affiliation(s)
- Qiangemai Ren
- Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu, China.
| | - Bi Yang
- Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu, China
| | - Longqian Liu
- Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu, China
| | - Pauline Cho
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
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Lam AKC, Hon Y, Leung SYY, Shu-Ho L, Chong J, Lam DCC. Association between long-term orthokeratology responses and corneal biomechanics. Sci Rep 2019; 9:12566. [PMID: 31467346 PMCID: PMC6715748 DOI: 10.1038/s41598-019-49041-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 08/19/2019] [Indexed: 12/22/2022] Open
Abstract
Myopia is very prevalent worldwide, especially among Asian populations. Orthokeratology is a proven intervention to reduce myopia progression. The current study investigated association between baseline corneal biomechanics and orthokeratology responses, and changes of corneal biomechanics from long-term orthokeratology. We fitted 59 adult subjects having myopia between −4.00D to −5.00D with overnight orthokeratology. Corneal biomechanics was measured through dynamic bidirectional corneal applanation (in terms of corneal hysteresis, CH and corneal resistance factor, CRF) and corneal indentation (in terms of corneal stiffness, S and tangent modulus, E). Subjects with poor orthokeratology responses had lower E (mean 0.474 MPa) than subjects with good orthokeratology responses (mean 0.536 MPa). Successful orthokeratology for 6 months resulted in reducing CH (reduced by 5.8%) and CRF (reduced by 8.7%). Corneal stiffness was stable, but E showed an increasing trend. Among subjects with successful orthokeratology, a higher baseline S resulted in greater myopia reduction (Pearson correlation coefficient, r = 0.381, p = 0.02).
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Affiliation(s)
- Andrew K C Lam
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Ying Hon
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
| | - Stanley Y Y Leung
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Lu Shu-Ho
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Jones Chong
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - David C C Lam
- Department of Mechanical and Aerospace Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
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Lau JK, Wan K, Cheung SW, Vincent SJ, Cho P. Weekly Changes in Axial Length and Choroidal Thickness in Children During and Following Orthokeratology Treatment With Different Compression Factors. Transl Vis Sci Technol 2019; 8:9. [PMID: 31360614 PMCID: PMC6656409 DOI: 10.1167/tvst.8.4.9] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 05/13/2019] [Indexed: 12/13/2022] Open
Abstract
Purpose To determine the influence of compression factor upon changes in axial length and choroidal thickness during and following orthokeratology treatment. Methods Orthokeratology lenses of different compression factors (one eye with 0.75 D and the fellow eye with 1.75 D) were randomly assigned to 28 subjects (median [range] age: 9.3 [7.8–11.0] years). Ocular biometrics were measured weekly for 1 month of lens wear and after lens cessation until the refraction stabilized (mean duration: 2.8 ± 0.4 weeks). Changes between eyes, and the associations between axial shortening and choroidal thickening with other ocular biometrics were analyzed. Results There were no significant between-eye differences in the changes of ocular biometrics (all P > 0.05). After adjusting for paired-eye data, axial length initially decreased by 26 ± 41 μm (P = 0.03) at week 1, then gradually returned to its original length. An approximate antiphase relationship of choroidal thickness (mean change: 9 ± 12 μm, P < 0.001) with axial length was observed. A significant rebound in axial length, but not choroidal thickness, occurred during the cessation period. Central corneal thinning and choroidal thickening accounted for 70% of initial axial shortening. Conclusions Increasing the compression factor by 1.00 D did not affect changes in ocular biometrics in short-term orthokeratology. Significant axial shortening and choroidal thickening were observed during early treatment period. Axial shortening could not be entirely explained by central corneal thinning and choroidal thickening, which warrants further investigation. Translational Relevance Initial axial shortening in orthokeratology is transient and therefore axial length remains useful for long-term monitoring of axial elongation in children.
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Affiliation(s)
- Jason K Lau
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Kin Wan
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Sin-Wan Cheung
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Stephen J Vincent
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
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Li Z, Hu Y, Cui D, Long W, He M, Yang X. Change in subfoveal choroidal thickness secondary to orthokeratology and its cessation: a predictor for the change in axial length. Acta Ophthalmol 2019; 97:e454-e459. [PMID: 30288939 DOI: 10.1111/aos.13866] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 06/01/2018] [Indexed: 12/29/2022]
Abstract
PURPOSE To investigate changes in subfoveal choroidal thickness (SFChT) during orthokeratology (Ortho-K) lens wear and after its cessation and the association of short-term change in SFChT with the long-term eye elongation in Ortho-K subjects. DESIGN A prospective clinical trial. METHODS Fifty myopic children aged between 9 and 14 years were enrolled. Twenty-nine subjects continuously wore Ortho-K lens for 12 months and discontinued for 1 month. Twenty-one subjects wearing single vision distance spectacles for 12 months were included as the control group. SFChT was assessed using optical coherence tomography. Ocular parameters, including axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT) and apical corneal power (ACP), were also measured. RESULTS After 12 months of follow-up, AL elongation was larger and SFChT change was smaller in the control group compared to the Ortho-K group (both p < 0.001). In the Ortho-K group, SFChT increased by 16 μm from baseline at the 1-month visit (p < 0.001), and the magnitude of choroidal thickening remained unchanged at the 6- and 12-month visit (p = 0.289). One month after discontinuation of Ortho-K lens, SFChT and ocular parameters of the anterior segment, including ACP, CCT and ACD recovered to baseline level (All p > 0.05), and AL increased by 0.23 ± 0.18 mm compared to baseline (p = 0.018). SFChT change at 1-month was negatively associated with AL change at 13-month (standard β, -0.581, p = 0.001) after adjusting for other influencing factors, including baseline age and the ocular parameters. CONCLUSION Subfoveal ChT (SFChT) significantly increased after short-term Ortho-K lens treatment and the increase maintained throughout the period of treatment. One month after Ortho-K lens cessation, SFChT, ACP, CCT and ACD returned to baseline. Short-term response in SFChT is associated with long-term change in AL in children undergoing Ortho-K lens and may be a predictor for the effectiveness of the treatment.
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Affiliation(s)
- Zhouyue Li
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
| | - Yin Hu
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
| | - Dongmei Cui
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
| | - Wen Long
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
| | - Mingguang He
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
- Centre for Eye Research Australia Royal Victorian Eye and Ear Hospital University of Melbourne Melbourne VIC Australia
| | - Xiao Yang
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center Sun Yat‐sen University Guangzhou China
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Lau JK, Cheung SW, Collins MJ, Cho P. Repeatability of choroidal thickness measurements with Spectralis OCT images. BMJ Open Ophthalmol 2019; 4:e000237. [PMID: 31179391 PMCID: PMC6528750 DOI: 10.1136/bmjophth-2018-000237] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 02/21/2019] [Accepted: 04/06/2019] [Indexed: 11/22/2022] Open
Abstract
Objective To investigate the repeatability of choroidal thickness measurements determined from enhanced depth imaging optical coherence tomography (EDI-OCT) images of eyes after wearing single-vision spectacles (SV) and orthokeratology (ortho-k) lenses. Methods and analysis Two EDI-OCT images of 40 children (SV: 20, ortho-k: 20) taken at a single visit were analysed twice. Subjects in the ortho-k group had been wearing ortho-k for 1–4 weeks. The choroidal thickness was determined from each image using a graph theory-based software and, where appropriate, manual correction of choroidal boundaries was undertaken by an experienced examiner. Results The mean (±SD) choroidal thickness was 227.3±42.2 µm for the SV subjects and 251.1±54.4 µm for the ortho-k subjects. The interimage differences in choroidal thickness were −0.99±3.54 and −1.14±5.03 µm for the SV and ortho-k subjects, respectively, and the limits of agreement were +5.96 to −7.93 and +8.72 to −11.00 µm, respectively. Conclusion The coefficients of repeatability of choroidal thickness measurements from two EDI-OCT images taken at a single visit were 7.08 µm (SV) and 10.06 µm (ortho-k), suggesting that a change in choroidal thickness of less than 10 µm may not indicate a real change resulting from ortho-k lens wear.
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Affiliation(s)
- Jason K Lau
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Sin Wan Cheung
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Michael J Collins
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Pauline Cho
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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Milash SV, Tarutta EP, Epishina MV, Markossian GA, Ramazanova KA. Evaluation of choroidal thickness and anatomical and optical parameters of the eye in the early period after orthokeratology myopia correction. ACTA ACUST UNITED AC 2019. [DOI: 10.21516/2072-0076-2019-12-1-26-33] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Purpose: to evaluate subfoveal choroidal thickness (SFCT) and other anatomical parameters of the eye in the early stages after orthokeratological correction of myopia. Material and Methods. The study was conducted on 20 myopic Caucasian patients (40 eyes) with moderate myopia. The main group consisted of 10 children with myopia -4.5 ± 1.03 D aged 11 ± 2.26 years, who were examined before the correction with orthokeratological lenses (OK-lenses) ESA-DL (Dr Lens Tehno, Russia) and 3 weeks after it. The control group comprised 10 patients (20 eyes) with myopia -3.84 ± 1.12 D aged 11.6 ± 1.17 years, who wore monofocal glasses as a correction. SFCT was measured with RS-3000 Advance optical coherent tomograph (OCT) (Nidek, Japan), while axial length (AL), peripheral eye length (PEL), and anterior chamber depth (ACD) was measured with IOL Master 500 optical biometer (Carl Zeiss, Germany), and central cornea thickness (CCT), epithelial thickness (ET) and corneal stroma (ST) thickness, with OCT Avanti Rtvue XR (Optovue, USA). All patients were tested before and 3 weeks after the start of wearing lenses or glasses. Results. SFCF increased by 24.25 ± 19 μm as compared with changes in the control group (p < 0.001) after 3 weeks of wearing OK-lenses. A notable negative correlation of changes in AL and SFCT was revealed in the main group (r = -0.48). CCT decreased by 14.6 ± 2.54 μm in the group wearing OKlenses. The main OK-lens contribution to the statistically significant change in the CCT concerned the epithelium, whose thickness showed a 12.7 ± 1.58 μm (22.6 %) change as compared with the initial data (p < 0.001) and with the change in the control group (p < 0.001). The decrease in AL showed an insignificant correlation with the decrease in the CCT: r = 0.16. ACD, PEL and ST did not change significantly (p > 0.05). Conclusion. SFCT shows an increase in the early stages after OK correction. When controlling the growth of the eye in patients with OK lenses, we need to take into account the impact of the choroid on the results of AL measurement.
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Affiliation(s)
- S. V. Milash
- Moscow Helmholtz Research Institute of Eye Diseases
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Tan Q, Ng AL, Cheng GP, Woo VC, Cho P. Combined Atropine with Orthokeratology for Myopia Control: Study Design and Preliminary Results. Curr Eye Res 2019; 44:671-678. [PMID: 30632410 DOI: 10.1080/02713683.2019.1568501] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Purpose: The purpose of this study is to present the study design and one month's preliminary results of a 2-year randomized trial, Combined Atropine with Orthokeratology (AOK), for myopia control study. Methods: Children aged 6 to <11 years and with 1.00-4.00 D myopia were randomly assigned to AOK group or ortho-k alone (OK) group. Subjects are required to attend routine ortho-k aftercare visits (first-overnight, 1 week, 2 weeks, 3 weeks, 1 month, and every 3 months after commencement of lens wear). Clinical outcomes, including lens performance, changes in refractive error, unaided vision, ocular adverse events, corneal staining, lens binding and centration, and axial length, are also assessed at 6-monthly data collection visit. Results: Data of 30 AOK and 34 OK subjects who had completed the 1-month visit were analyzed. No significant differences in baseline data were found between the two groups (P > 0.05). At the 1-month visit, first-fit success rate was 95%, with full myopia reduction. Mild corneal staining was observed in 23.3% and 30.9% and mild self-reported lens binding in 50% and 41% in AOK and OK groups, respectively, after 1-month lens wear. Mean (±standard deviation) change in axial length was significantly higher in AOK than OK subjects (AOK: -0.05 ± 0.05 mm; OK: -0.02 ± 0.03 mm) (P = 0.003). Conclusions: After 1 month of treatment, first-fit success rate of ortho-k lenses was high in both groups of subjects; addition of 0.01% atropine in AOK subjects did not affect the lens performance or clinical responses. These results provide the assurance that it is acceptable to continue this longitudinal study, as longer study duration, usually 2 years, is required to determine the effectiveness of treatment for myopia control.
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Affiliation(s)
- Qi Tan
- a School of Optometry , The Hong Kong Polytechnic University , Hung Hom , Hong Kong
| | - Alex Lk Ng
- b Department of Ophthalmology , The University of Hong Kong , Hong Kong.,c Hong Kong Ophthalmic Associates , Hong Kong
| | | | - Victor Cp Woo
- b Department of Ophthalmology , The University of Hong Kong , Hong Kong.,c Hong Kong Ophthalmic Associates , Hong Kong
| | - Pauline Cho
- a School of Optometry , The Hong Kong Polytechnic University , Hung Hom , Hong Kong
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Read SA, Fuss JA, Vincent SJ, Collins MJ, Alonso-Caneiro D. Choroidal changes in human myopia: insights from optical coherence tomography imaging. Clin Exp Optom 2018; 102:270-285. [PMID: 30565333 DOI: 10.1111/cxo.12862] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 10/23/2018] [Accepted: 11/12/2018] [Indexed: 01/05/2023] Open
Abstract
The choroid is a vascular tissue which plays a range of critical roles in the normal physiology of the eye, such as supplying the outer retina with oxygen and nutrients and the regulation of intraocular pressure. There is also substantial evidence, particularly from animal studies, that the choroid plays an important role in the regulation of eye growth and the development of common refractive errors like myopia. In recent years, advances in optical coherence tomography technology have improved our ability to image and measure the choroid in the human eye. Research using this technology over the past decade has dramatically improved our knowledge of the normal choroid, and its potential role in the regulation of eye growth and refractive error development. This review aims to provide an overview of recent work examining the normal human choroid, its changes with myopia and the possible role of the choroid in the mechanism regulating eye growth. Studies have demonstrated that choroidal thinning accompanies the development and progression of myopia, and have established a close link between eye growth and choroidal thickness changes. Dramatic thinning of the choroid is seen with high myopia, and associations are also observed between choroidal thinning and reduced vision, and the development of retinal pathology associated with high myopia. In the short-term, environmental factors known to be associated with myopia development and more rapid eye growth typically lead to a thinning of the choroid, whereas factors linked to a slowing of eye growth are typically associated with short-term choroidal thickening. Collectively, these findings suggest that the choroid is an important biomarker of eye growth in the human eye, and additional research to better understand the human choroid is likely to further our knowledge of the signals and pathways regulating eye growth, myopia development and progression.
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Affiliation(s)
- Scott A Read
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - James A Fuss
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Stephen J Vincent
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Michael J Collins
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - David Alonso-Caneiro
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
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33
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Cho P, Tan Q. Myopia and orthokeratology for myopia control. Clin Exp Optom 2018; 102:364-377. [PMID: 30380591 DOI: 10.1111/cxo.12839] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 08/17/2018] [Accepted: 08/20/2018] [Indexed: 12/18/2022] Open
Abstract
The prevalence of myopia in children is increasing worldwide and is viewed as a major public health concern. This increase has driven interest in research into myopia prevention and control in children. Although there is still uncertainty in the risk factors underlying differences in myopia prevalence between ethnic groups, rates in children of East Asian descent are typically higher regardless of where they live. Mounting evidence also suggests that myopia prevalence in children increases with age. Earlier commencement and more rigorous education systems in these countries, resulting in more time spent on near-work activities and less time on outdoor activities, may be responsible for the earlier age of myopia onset. However, to date, the mechanisms regulating myopia onset and progression are still poorly understood. Findings from several studies have shown orthokeratology to be effective in slowing axial elongation and it is a well-accepted treatment, particularly in East Asian regions. While our understanding of this treatment has increased in the last decade, more work is required to answer questions, including: How long should the treatment be continued? Is there a rebound effect? Should the amount of myopia control be increased? To whom and when should the treatment be offered? Practitioners are now faced with the need to carefully guide and advise parents on whether and when to undertake a long somewhat complex intervention, which is costly, both in time and money. In the near future, a greater demand for effective prophylaxis against childhood myopia is envisaged. Other than orthokeratology, atropine therapy has been shown to be effective in slowing myopia progression. While its mechanism of control is also not fully understood, it is likely that it acts via a different mechanism from orthokeratology. Thus, a combined treatment of orthokeratology and atropine may have great potential to maximise the effectiveness of myopia control interventions.
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Affiliation(s)
- Pauline Cho
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
| | - Qi Tan
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
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Investigation of the Effect of Orthokeratology Lenses on Quality of Life and Behaviors of Children. Eye Contact Lens 2018; 44:335-338. [DOI: 10.1097/icl.0000000000000529] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jin WQ, Huang SH, Jiang J, Mao XJ, Shen MX, Lian Y. Short term effect of choroid thickness in the horizontal meridian detected by spectral domain optical coherence tomography in myopic children after orthokeratology. Int J Ophthalmol 2018; 11:991-996. [PMID: 29977813 DOI: 10.18240/ijo.2018.06.16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 04/03/2018] [Indexed: 12/18/2022] Open
Abstract
AIM To investigate choroidal thickness changes in the horizontal meridian after orthokeratology. METHODS This is a prospective cross-sectional observed study. Subjects (n=30; 11.3±1.7y) with low-to-moderate myopia (-1.0 to -6.0 diopters), wore orthokeratology (Ortho-K) lenses for 3mo. Before and after Ortho-K, OCT scans were made through the fovea in the horizontal meridian. Choroid thickness around the fovea was acquired by custom software. The analyzed regions along the horizontal meridian were divided into 7 equal zones. Ocular parameters were measured by Lenstar LS 900 non-contact biometry. RESULTS Only the right eye ocular parameters were analyzed in this study. Before Ortho-K, choroidal thickness along the horizontal meridian was 273.7±31.8 µm in the temporal zone, 253.1±38.6 µm in the macula zone, and 194.8±52.2 µm in the nasal zone. After Ortho-K, the choroid was thicker in each horizontal zone (P<0.05). The increased thickness was greatest in the temporal zone (13.5±22.5 µm) and least in the nasal zone (8.4±14.2 µm). The axial length (AL) increased 0.02 mm (P>0.05). The choroid thickness change in each horizontal zone was negatively correlated with AL (r, -0.3 to -0.4; P<0.05) except one of the nasal zones. CONCLUSION In myopic children, the thickness of the choroid is greatest in the temporal zone and thinnest in the nasal zone. After nightly Ortho-K for 3mo, the thickness increase along the horizontal meridian. The choroid thickness changes are negatively correlated with the change of AL.
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Affiliation(s)
- Wan-Qing Jin
- Eye Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,Optometry Academy of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Sheng-Hai Huang
- Eye Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,Optometry Academy of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Jun Jiang
- Eye Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,Optometry Academy of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Xin-Jie Mao
- Eye Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,Optometry Academy of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Mei-Xiao Shen
- Optometry Academy of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Yan Lian
- Eye Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,Optometry Academy of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
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Li Z, Cui D, Hu Y, Ao S, Zeng J, Yang X. Choroidal thickness and axial length changes in myopic children treated with orthokeratology. Cont Lens Anterior Eye 2017; 40:417-423. [PMID: 28935528 DOI: 10.1016/j.clae.2017.09.010] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 09/01/2017] [Accepted: 09/11/2017] [Indexed: 12/22/2022]
Abstract
PURPOSE To analyze the change in subfoveal choroidal thickness (SFChT) and its relationship with changes in axial length (AL) in myopic children treated with Orthokeratology (Ortho-k). METHODS Fifty myopic children participated in this study: 29 subjects were treated with Ortho-k lenses and 21 with single vision distance spectacles. The SFChT and ocular biometrics, including AL, were measured at baseline, one month, and six months after lens wear in both groups. RESULTS AL significantly increased in both groups over time. In the Ortho-k group, SFChT also increased; however, there was no significant change in SFChT in the control group over time. At the six-month visit, the magnitude of eye growth was significantly reduced in the Ortho-k group compared to the control group (0.06±0.10mm vs. 0.17±0.10mm, P<0.001). SFChT was significantly thicker in the Ortho-k group compared to the control group at the one-month and six-month visits (15.78±11.37μm vs. -2.98±8.96μm, P<0.001 (one-month visit); 21.03±12.74μm vs. -2.50±14.43μm, P<0.001 (six-month visit)), although there was no significant difference between the two follow-up visits (P=0.102 for the Ortho-k group; P=0.898 for the control group). Changes in the large choroidal vascular layer (LCVL) accounted for the majority of subfoveal choroidal thickening (approximately 77% and 80% at one-month and six-month visits, respectively). CONCLUSION Ortho-k treatment induced significant choroidal thickening and a slowing of eye growth. LCVL thickening accounted for the majority of SFChT thickening. However, its potential mechanism in myopia control requires further investigation.
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Affiliation(s)
- Zhouyue Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Dongmei Cui
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yin Hu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Sichun Ao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Junwen Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
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Validation of Macular Choroidal Thickness Measurements from Automated SD-OCT Image Segmentation. Optom Vis Sci 2017; 93:1387-1398. [PMID: 27668634 DOI: 10.1097/opx.0000000000000985] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Spectral domain optical coherence tomography (SD-OCT) imaging permits in vivo visualization of the choroid with micron-level resolution over wide areas and is of interest for studies of ocular growth and myopia control. We evaluated the speed, repeatability, and accuracy of a new image segmentation method to quantify choroid thickness compared to manual segmentation. METHODS Two macular volumetric scans (25 × 30°) were taken from 30 eyes of 30 young adult subjects in two sessions, 1 hour apart. A single rater manually delineated choroid thickness as the distance between Bruch's membrane and sclera across three B-scans (foveal, inferior, and superior-most scan locations). Manual segmentation was compared to an automated method based on graph theory, dynamic programming, and wavelet-based texture analysis. Segmentation performance comparisons included processing speed, choroid thickness measurements across the foveal horizontal midline, and measurement repeatability (95% limits of agreement (LoA)). RESULTS Subjects were healthy young adults (n = 30; 24 ± 2 years; mean ± SD; 63% female) with spherical equivalent refractive error of -3.46 ± 2.69D (range: +2.62 to -8.50D). Manual segmentation took 200 times longer than automated segmentation (780 vs. 4 seconds). Mean choroid thickness at the foveal center was 263 ± 24 μm (manual) and 259 ± 23 μm (automated), and this difference was not significant (p = 0.10). Regional segmentation errors across the foveal horizontal midline (±15°) were ≤9 μm (median) except for nasal-most regions closest to the nasal peripapillary margin-15 degrees (19 μm) and 12 degrees (16 μm) from the foveal center. Repeatability of choroidal thickness measurements had similar repeatability between segmentation methods (manual LoA: ±15 μm; automated LoA: ±14 μm). CONCLUSIONS Automated segmentation of SD-OCT data by graph theory and dynamic programming is a fast, accurate, and reliable method to delineate the choroid. This approach will facilitate longitudinal studies evaluating changes in choroid thickness in response to novel optical corrections and in ocular disease.
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Abstract
PURPOSE To investigate the effect of orthokeratology (ortho-k) treatment on choroidal thickness and its relationship with axial length change. METHODS Seventy-seven myopic subjects aged between 7 and 17 years were treated with ortho-k lenses (n = 39) or single-vision spectacle lenses (SVL, n = 38). Choroidal thickness and axial length measurements were taken at baseline and repeated 1 week and 3 weeks after lens wear for the ortho-k group and at 3 weeks for the SVL group. Parafoveal choroidal thickness was assessed using optical coherence tomography and segmented into nine regions according to the Early Treatment Diabetic Retinopathy Study (ETDRS) within a 6 × 6 mm circular zone centered on the fovea. Axial length was measured using partial coherence interferometry. The changes in subfoveal choroidal thickness were compared to the changes in axial length in both study groups. RESULTS The change in axial length was significantly correlated with the change in choroidal thickness in both groups at 3 weeks (ortho-k, r = -0.351, p = 0.028 vs. SVL, r = -0.408, p = 0.011). Parafoveal choroidal thickness increased after 3 weeks of lens wear in the ortho-k group (mean, 21.8 ± 25.2 μm) but did not change in the SVL group (mean, 0.1 ± 19.7 μm). Choroidal thickness significantly varied across the posterior retinal regions (F = 82.14, p < 0.001), with the temporal regions being thickest and nasal regions being thinnest. After 3 weeks of ortho-k treatment, the magnitude of change (range, 14.1-27.6 μm) in choroidal thickness of the nine ETDRS regions was proportional to the baseline choroidal thickness in those regions (r = 0.88, p = 0.002). Axial length did not significantly change over time (F = 0.001, p = 0.975) and did not differ between the two treatment modalities (F = 0.305, p = 0.582). CONCLUSIONS Choroidal thickness increases after short-term ortho-k treatment. Regional choroidal thickening after ortho-k treatment may be attributable to the altered retinal defocus profile associated with ortho-k lens wear.
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Li Z, Zeng J, Jin W, Long W, Lan W, Yang X. Time-Course of Changes in Choroidal Thickness after Complete Mydriasis Induced by Compound Tropicamide in Children. PLoS One 2016; 11:e0162468. [PMID: 27622495 PMCID: PMC5021335 DOI: 10.1371/journal.pone.0162468] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 08/22/2016] [Indexed: 12/11/2022] Open
Abstract
PURPOSE The aim of this study was to investigate the time-course of changes in choroidal thickness (ChT) following complete mydriasis induced by compound tropicamide. METHODS ChT was measured by OCT with the enhanced-depth imaging technique (Spectralis HRA+OCT, Heidelberg Engineering, Germany) at nine locations of the fundus: subfoveal ChT (SFChT) and ChT at 1 mm and 3 mm from the fovea in four quadrants. Mydriasis was induced with compound tropicamide (0.5% tropicamide plus 0.5% phenylephrine hydrochloride, three doses at 5-minute intervals). Measurements were conducted prior to the instillation and at 0, 30, and 60 min following complete mydriasis. Results at different time-points were compared using repeated-measures ANOVA to investigate the time-course of the changes. RESULTS Thirty-nine subjects (mean age 11.9±2 years; 16 males and 23 females) were enrolled in the study. Compound tropicamide resulted in a statistically significant decrease in SFChT at 0, 30, and 60 min after complete mydriasis, as compared to baseline (-5±4 μm, -12±4 μm, and -13±4 μm, respectively; all P<0.0001). No significant changes were detected in the parafoveal choroid except at 1 mm temporal (T1mm) and nasal (N1mm) to the fovea at 30 and 60 min (T1mm: -6±4 μm and -7±5 μm at 30 and 60 min; N1mm: -6±4 μm and -7±5 μm at 30 and 60 min, respectively; all P<0.0001). Repeated-measures ANOVA showed a significant interaction between the time after complete mydriasis and the effect of the mydriasis agent. CONCLUSIONS Complete mydriasis induced by compound tropicamide led to choroidal thinning, and the magnitude varied over time.
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Affiliation(s)
- Zhouyue Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Junwen Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wei Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wen Long
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Weizhong Lan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Optometry and Visual Science Institute, Aier Eye Hospital Group, Changsha, Hunan Province, China
| | - Xiao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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