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Tang T, Li X, Chen S, Xu Q, Zhao H, Wang K, Li Y, Zhao M. Long-term follow-up of changes in ocular biometric parameters in orthokeratology lens wearers with relatively large-scale axial length reduction. EYE AND VISION (LONDON, ENGLAND) 2023; 10:6. [PMID: 36726171 PMCID: PMC9893609 DOI: 10.1186/s40662-022-00324-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 12/26/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND To investigate ocular biological characteristics for myopic children with axial length (AL) reduction during orthokeratology (Ortho-K) treatment and provide clinical clues for better myopia control effects. METHODS Changes in ocular parameters and treatment zone (TZ) in 75 subjects who completed one-year Ortho-K treatment were retrospectively reviewed. The subjects were divided into two groups according to one-year AL change: the AL reduction group (n = 37) and the AL elongation group (n = 38). Univariate and multivariate regression analyses were performed to determine the association between TZ, ocular parameters, and AL change. RESULTS There was no significant difference in baseline between the two groups (all P > 0.05). After one year of Ortho-K treatment, compared with those in the AL elongation group, children in the AL reduction group had a decreased anterior chamber depth (ACD) (P < 0.001), thickened crystalline lens thickness (CLT) (P = 0.002), thinned vitreous chamber depth (VCD) (P < 0.001) and smaller TZ (P = 0.03), but no difference in central corneal thickness (CCT) and pupil diameter (PD). In the multivariable analyses, AL reduction was negatively associated with baseline age (beta: - 0.048; 95% CI: - 0.083 to - 0.013; P = 0.009) and positively associated with the TZ (beta: 0.024; 95% CI: 0.009 to 0.040; P = 0.003). CONCLUSIONS In AL reduction eyes, thickened CLT, decreased ACD and thinned VCD were observed during Ortho-K treatment, which could be suggested as indicators for better myopia control effects in the clinic. Older baseline age and smaller TZ wearing Ortho-K were also associated with AL change. Thickened CLT may be a result of compensation for AL-reduction eyes.
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Affiliation(s)
- Tao Tang
- grid.11135.370000 0001 2256 9319Institute of Medical Technology, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Department of Ophthalmology and Clinical Centre of Optometry, Peking University People’s Hospital, Beijing, China ,grid.11135.370000 0001 2256 9319College of Optometry, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Eye Disease and Optometry Institute, Peking University People’s Hospital, Beijing, China ,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Xuewei Li
- grid.11135.370000 0001 2256 9319Institute of Medical Technology, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Department of Ophthalmology and Clinical Centre of Optometry, Peking University People’s Hospital, Beijing, China ,grid.11135.370000 0001 2256 9319College of Optometry, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Eye Disease and Optometry Institute, Peking University People’s Hospital, Beijing, China ,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Sitong Chen
- grid.11135.370000 0001 2256 9319Institute of Medical Technology, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Department of Ophthalmology and Clinical Centre of Optometry, Peking University People’s Hospital, Beijing, China ,grid.11135.370000 0001 2256 9319College of Optometry, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Eye Disease and Optometry Institute, Peking University People’s Hospital, Beijing, China ,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Qiong Xu
- grid.411634.50000 0004 0632 4559Department of Ophthalmology and Clinical Centre of Optometry, Peking University People’s Hospital, Beijing, China ,grid.11135.370000 0001 2256 9319College of Optometry, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Eye Disease and Optometry Institute, Peking University People’s Hospital, Beijing, China ,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Heng Zhao
- grid.11135.370000 0001 2256 9319Institute of Medical Technology, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Department of Ophthalmology and Clinical Centre of Optometry, Peking University People’s Hospital, Beijing, China ,grid.11135.370000 0001 2256 9319College of Optometry, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Eye Disease and Optometry Institute, Peking University People’s Hospital, Beijing, China ,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Kai Wang
- grid.11135.370000 0001 2256 9319Institute of Medical Technology, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Department of Ophthalmology and Clinical Centre of Optometry, Peking University People’s Hospital, Beijing, China ,grid.11135.370000 0001 2256 9319College of Optometry, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Eye Disease and Optometry Institute, Peking University People’s Hospital, Beijing, China ,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Yan Li
- grid.411634.50000 0004 0632 4559Department of Ophthalmology and Clinical Centre of Optometry, Peking University People’s Hospital, Beijing, China ,grid.11135.370000 0001 2256 9319College of Optometry, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Eye Disease and Optometry Institute, Peking University People’s Hospital, Beijing, China ,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Mingwei Zhao
- grid.11135.370000 0001 2256 9319Institute of Medical Technology, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Department of Ophthalmology and Clinical Centre of Optometry, Peking University People’s Hospital, Beijing, China ,grid.11135.370000 0001 2256 9319College of Optometry, Peking University Health Science Center, Beijing, China ,grid.411634.50000 0004 0632 4559Eye Disease and Optometry Institute, Peking University People’s Hospital, Beijing, China ,Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
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Schmid KL, Gifford KL, Atchison DA. The effect of concentric and aspheric multifocal soft contact lenses on binocular vision in young adult myopes. Cont Lens Anterior Eye 2023; 46:101588. [PMID: 35304065 DOI: 10.1016/j.clae.2022.101588] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Multifocal soft contact lenses (MFCLs) are prescribed to inhibit myopia progression; these include aspheric and concentric designs. The effects of MFCLs on visual quality, accommodation and vergence in young-adult myopes were evaluated. METHODS Participants were twenty-six myopes (19-25 years, spherical equivalent -0.50 to -5.75D), with normal binocular vision and no past myopia control. Pupil sizes were 4.4 ± 0.9 mm during distance viewing and 3.7 ± 0.8 mm at near. In random order, participants wore four MFCLs: Proclear single vision distance, MiSight concentric dual focus (+2.00D), distance center aspheric (Biofinity, +2.50D) (CooperVision lenses), and NaturalVue aspheric (Visioneering Technologies). Testing included visual acuity, contrast sensitivity (Pelli-Robson), stereoacuity, accommodation response, negative and positive relative accommodation, horizontal phorias, horizontal fusional vergence and AC/A ratio, and a visual quality questionnaire. RESULTS The four lenses differed in distance (p = 0.001) and near visual acuity (p = 0.011), and contrast sensitivity (p = 0.001). Compared with the single vision lens, the Biofinity aspheric had the greatest visual impact: 0.19 ± 0.14 logMAR distance acuity reduction, 0.22 ± 0.15 log contrast sensitivity reduction. Near acuity was affected less than distance acuity; the reduction was greatest with the NaturalVue (0.05 ± 0.07 logMAR reduction). The MFCLs altered the autorefraction measure at distance and near (p = 0.001); the accommodation response was less with aspheric lenses. Negative relative accommodation reduced with the aspheric lenses (p = 0.001): by 0.9 ± 0.5D with Biofinity and 0.5 ± 0.7D with NaturalVue. Exophoric shifts were greater with aspheric lenses (1.8 ± 2.4Δ Biofinity, 1.7 ± 1.7Δ NaturalVue) than with the concentric MiSight (0.5 ± 1.3Δ). CONCLUSIONS MFCLs alter visual performance, refraction and vergence; two aspheric lenses had greater effect than a concentric lens.
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Affiliation(s)
- Katrina L Schmid
- School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Qld 4059, Australia.
| | - Kate L Gifford
- School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Qld 4059, Australia; Myopia Profile Pty Ltd, Australia
| | - David A Atchison
- School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Qld 4059, Australia
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Liu Y, Li X, Zhang L, Yi X, Xing Y, Li K, Wang Y. Comparison of wavefront aberrations in the object and image spaces using wide-field individual eye models. BIOMEDICAL OPTICS EXPRESS 2022; 13:4939-4953. [PMID: 36187261 PMCID: PMC9484411 DOI: 10.1364/boe.464781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/06/2022] [Accepted: 08/08/2022] [Indexed: 06/16/2023]
Abstract
Wavefront aberrations in the image space are critical for visual perception, though the clinical available instruments usually give the wavefront aberrations in the object space. This study aims to compare the aberrations in the object and image spaces. With the measured wavefront aberrations over the horizontal and vertical ±15° visual fields, the in-going and out-going wide-field individual myopic eye models were constructed to obtain the wavefront aberrations in the object and image spaces of the same eye over ±45° horizontal and vertical visual fields. The average differences in the mean sphere and astigmatism were below 0.25 D between the object and image spaces over the horizontal and vertical ±45° visual fields under 3 mm and 6 mm pupil diameter. The wavefront aberrations in the object space are a proper representation of the aberrations in the image space at least for horizontal visual fields ranging from -35°to +35° and vertical visual fields ranging from -15°to +15°.
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Affiliation(s)
- Yongji Liu
- Tianjin Key Laboratory of Micro-scale Optical Information Science and Technology, Institute of Modern Optics, Nankai University, 38 Tongyan Road, Haihe Education Park, Tianjin, 300350, China
- Nankai University Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, 38 Tongyan Road, Haihe Education Park, Tianjin, 300350, China
| | - Xiaolan Li
- Tianjin Key Laboratory of Micro-scale Optical Information Science and Technology, Institute of Modern Optics, Nankai University, 38 Tongyan Road, Haihe Education Park, Tianjin, 300350, China
| | - Lin Zhang
- Nankai University Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, 38 Tongyan Road, Haihe Education Park, Tianjin, 300350, China
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, 4 Gansu Rd, Tianjin 300020, China
| | - Xianglong Yi
- Nankai University Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, 38 Tongyan Road, Haihe Education Park, Tianjin, 300350, China
| | - Yuwei Xing
- Tianjin Key Laboratory of Micro-scale Optical Information Science and Technology, Institute of Modern Optics, Nankai University, 38 Tongyan Road, Haihe Education Park, Tianjin, 300350, China
| | - Kunqi Li
- Tianjin Key Laboratory of Micro-scale Optical Information Science and Technology, Institute of Modern Optics, Nankai University, 38 Tongyan Road, Haihe Education Park, Tianjin, 300350, China
| | - Yan Wang
- Nankai University Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, 38 Tongyan Road, Haihe Education Park, Tianjin, 300350, China
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, 4 Gansu Rd, Tianjin 300020, China
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Chang K, Lee WL, Ying YH. The Impact of Cost-Containment Schemes on Outpatient Services for Schoolchildren with Refractive Errors in Taiwan—A Population-Based Study. CHILDREN 2022; 9:children9060880. [PMID: 35740817 PMCID: PMC9221663 DOI: 10.3390/children9060880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/27/2022] [Accepted: 06/09/2022] [Indexed: 11/23/2022]
Abstract
Objectives: Extant research on cost-sharing finds no impact on health care utilization when the amount is insubstantial. This research investigates the effects on nonacute outpatient services for schoolchildren with refractive errors in Taiwan and discusses the potential harm caused by cost sharing and relevant cost containment policies. Methods: Longitudinal claims data from the National Health Insurance database are employed. District demographic information is also used for aggregate-level analyses. Interventional modeling is conducted on pooled individual-level data with a Poisson model and negative binomial models. Generalized least square modeling is performed on aggregate district-level data to elucidate the impacts of cost sharing and the reimbursement rate with controls for patient and institutional characteristics, district socioeconomic factors, and competitiveness among institutions. Results: The findings of this study show that cost sharing does not significantly affect children’s utilization of outpatient services in the patient-level analyses. However, it significantly decreases the service volume based on the results of district aggregate analyses. There are potentially marginal patients in society, and they are more likely to be girls in poorer families, whose chances of seeking medical care significantly decrease when cost sharing increases. Conclusions: The gap in health inequity can be widened when stringent cost-containment policies are implemented. The offset effect caused by delayed care may also result in higher health care expenditures later. Cost sharing for children should be separately and prudently designed to better protect them from deprivations caused by changes in health policies.
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Affiliation(s)
- Koyin Chang
- Department of Healthcare Information and Management, Ming Chuan University, Taoyuan 33348, Taiwan; (K.C.); (W.-L.L.)
| | - Wen-Li Lee
- Department of Healthcare Information and Management, Ming Chuan University, Taoyuan 33348, Taiwan; (K.C.); (W.-L.L.)
| | - Yung-Hsiang Ying
- Department of Business Administration, National Taiwan Normal University, Taipei 10617, Taiwan
- Correspondence:
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Gifford KL, Schmid KL, Collins JM, Maher CB, Makan R, Nguyen E, Parmenter GB, Rolls BM, Zhang XS, Atchison DA. Multifocal contact lens design, not addition power, affects accommodation responses in young adult myopes. Ophthalmic Physiol Opt 2021; 41:1346-1354. [PMID: 34605581 DOI: 10.1111/opo.12892] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE Prolonged nearwork has been implicated in myopia progression. Accommodation responses of young-adult myopes wearing different multifocal contact lenses were compared. METHODS Twenty adults, 18-25 years, with myopia (spherical equivalent refraction -0.50 to -5.50 D, mean -2.1 ± 1.6 D) wore five lens types in random order: Proclear single vision distance (SV), MiSight concentric dual-focus +2.00 D Add (MS), Biofinity aspheric centre distance +1.50 D Add (CD1) and +2.50 D Add (CD2) (all Coopervision), and NaturalVue aspheric (Visioneering Technologies) (NVue). Using a Grand-Seiko WAN-5500 autorefractor with binocular correction and viewing right eye accommodative responses were measured after a 10 min adaptation period at 4.0, 1.0, 0.5, 0.33 and 0.25 m distances. Dynamic measurements were taken for 4 s at 6 Hz. Accommodative stimuli and responses were referenced to 4 m (i.e., refraction differences between 4 m and nearer distances). Accommodation lags and refraction instabilities (standard deviations of dynamic responses) were determined. For comparison, results were obtained for an absolute presbyopic eye, where trial lenses counteracted the accommodation stimulus. RESULTS For SV and MS, accommodation responses were similar to the stimulus values. For aspheric lenses CD1, CD2 and NVue, accommodation responses were approximately 1.0 D lower across the stimulus range than with SV and MS, and rates of change were approximately 0.84 D per 1 D stimulus change. MS produced greater refraction instabilities than other lenses. For the presbyope, changes in refraction matched the trial lenses, indicating that corrections due to measurement through the different lenses were not needed. CONCLUSION Reductions in accommodation response occurred in young myopes wearing aspheric multifocal contact lenses independent of the labelled 'add' power. The concentric dual-focus MS lens produced minimal lags but had greater instability than the other lenses. The results indicate that the mechanism of multifocal contact lenses slowing myopia progression is unlikely to be through relaxing accommodation, at least in young adults.
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Affiliation(s)
- Kate L Gifford
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Katrina L Schmid
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Josh M Collins
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Clare B Maher
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Riya Makan
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Evonne Nguyen
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Gemma B Parmenter
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Bronte M Rolls
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Xinyue S Zhang
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - David A Atchison
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
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Guo B, Cheung SW, Kojima R, Cho P. One-year results of the Variation of Orthokeratology Lens Treatment Zone (VOLTZ) Study: a prospective randomised clinical trial. Ophthalmic Physiol Opt 2021; 41:702-714. [PMID: 33991112 PMCID: PMC8251614 DOI: 10.1111/opo.12834] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 12/11/2022]
Abstract
Purpose To present the 1‐year results of the Variation of Orthokeratology Lens Treatment Zone (VOLTZ) Study, which aims to investigate the myopia control effect of orthokeratology (ortho‐k) lenses with different back optic zone diameters (BOZD). Method Children, aged 6 to <11 years, having myopia −4.00 D to −0.75 D, were randomly assigned to wear ortho‐k lenses with 6 mm (6‐MM group) or 5 mm (5‐MM group) BOZD. Data collection included changes in refraction, vision, lens performance and binding, ocular health conditions, axial length and characteristics of the treatment zone (TZ) area. Results The 1‐year results of 34 and 36 subjects (right eye only) in the 6‐MM and 5‐MM groups, respectively, are presented. No significant differences in baseline demographics were found between the groups (p > 0.05). The first‐fit success rates, based on satisfactory centration at the 1‐month visit, were 100% and 94% respectively. Horizontal TZ size was 0.92 mm and 0.72 mm smaller in the 5‐MM group at the 6‐month and 12‐month visits, respectively (p < 0.05). At the 12‐month visit, no significant between‐group differences were found in the incidence of corneal staining (low grade only), lens binding and visual performance (all p > 0.05). Axial elongation was slower in the 5‐MM group (0.04 ± 0.15 mm) than the 6‐MM group (0.17 ± 0.13 mm) (p = 0.001). A significant positive correlation was observed between the horizontal TZ size and axial elongation (r = 0.36, p = 0.006). Conclusion Clinical performance of the two ortho‐k lenses was similar, indicating that a smaller BOZD (5 mm) did not affect lens performance or ocular integrity. However, a smaller BOZD led to a reduced TZ, with retardation of axial elongation by 0.13 mm compared to conventional 6 mm BOZD ortho‐k lenses after one year of lens wear.
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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, China
| | - Sin Wan Cheung
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region, China
| | - Randy Kojima
- College of Optometry, Pacific University, Oregon, USA
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region, China
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Abstract
PURPOSE To examine the zone of clear single binocular vision (ZCSBV) in myopic children and young adults after 12 months of orthokeratology (OK) wear, in comparison with single-vision soft contact lens (SCL) wear. METHODS Twelve children (8-16 years) and 8 adults (18-29 years) were assessed with a series of near-point binocular vision tests when myopia was corrected using single-vision SCLs and again after 1 and 12 months of OK wear, and axial length was measured. The ZCSBV was constructed for baseline SCL wear and after 12 months of OK wear. RESULTS After 1 month of OK wear, increased accommodative responses were noted in children (C) and adults (A) as increased binocular amplitude (C:P=0.03, A:P=0.04) and reduced accommodative lag (C:P=0.01, A:P=0.01). Divergence reserves improved after 1 month in both groups (P<0.04), and a near exophoric shift was evident at 12 months (C:P=0.01, A:P=0.04). All changes at 1 month maintained stability at 12 months. An increase in accommodation and vergence responses without reduction in range resulted in an expansion of the ZCSBV in both age groups. Axial length did not significantly change in either children (P=0.25) or adults (P=0.72). CONCLUSION In both pediatric and young adult myopes, the ZCSBV expands toward a more divergent, increased accommodation response in OK compared with SCL wear. This occurs without a corresponding loss of convergence or accommodation deactivation, indicating improved depth of focus. These findings are relevant to visual acceptance and possible mechanisms of OK's efficacy for myopia control.
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Nichols JJ, Jones L, Morgan PB, Efron N. Bibliometric analysis of the orthokeratology literature. Cont Lens Anterior Eye 2020; 44:101390. [DOI: 10.1016/j.clae.2020.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/17/2020] [Accepted: 11/19/2020] [Indexed: 12/19/2022]
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Cheng HC, Chang K, Shen E, Luo KS, Ying YH. Risk Factors and Behaviours of Schoolchildren with Myopia in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061967. [PMID: 32192125 PMCID: PMC7142869 DOI: 10.3390/ijerph17061967] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/03/2020] [Accepted: 03/10/2020] [Indexed: 02/06/2023]
Abstract
Importance: Because of the high prevalence of myopia in Taiwan, understanding the risk factors for its development and progression is important to public health. Background: This study investigated the risk factors for myopia and their influence on the progression of myopia in schoolchildren in Taiwan. Design: Patients’ clinical records were obtained retrospectively from ophthalmologists. Questionnaires were given to collect demographic information, family background, hours spent on daily activities, myopia progression, and treatment methods. Participants: From a regional medical hospital in northern Taiwan, 522 schoolchildren with myopia participated in the study. Written informed consent was obtained from participants of legal age or the parents or legal guardians of younger children. Methods: Multivariable regression analyses were performed. Myopia measured in cycloplegic spherical equivalent (SE) was analysed, controlling for patients’ family and demographic information as well as their daily activity behaviours. Main Outcome Results: Children with high myopic parents were more myopic. Earlier onset age of myopia was associated with a higher level of myopia and greater annual myopic progression. Children reporting longer time usage of electronic devices had greater progression of myopia. Boys tended to be more myopic than girls. Lower levels of myopia were associated with more outdoor activities, and better vision care knowledge in children and parents. Conclusions and Relevance: In addition to genetics, education and environment can influence the development of myopia. Health policies for schoolchildren should promote protective activities and vision care knowledge at a young age, to protect the eyesight of schoolchildren.
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Affiliation(s)
- Han-Chih Cheng
- Department of Ophthalmology, Taipei Tzu-chi Hospital, New Taipei City 231, Taiwan; (H.-C.C.); (E.S.); (K.-S.L.)
- Department of Ophthalmology, Tzu-chi University, Huanlien County 907, Taiwan
| | - Koyin Chang
- Dept. of Healthcare Information and Management, Ming Chuan University, Taoyuan City 333, Taiwan
- Correspondence: (K.C.); (Y.-H.Y.); Tel.: +886-2-7749-3291 (K.C.)
| | - Elizabeth Shen
- Department of Ophthalmology, Taipei Tzu-chi Hospital, New Taipei City 231, Taiwan; (H.-C.C.); (E.S.); (K.-S.L.)
- Department of Ophthalmology, Tzu-chi University, Huanlien County 907, Taiwan
- Department of Ophthalmology, National Taiwan University Hospital, Medical College, National Taiwan University, Taipei 100, Taiwan
| | - Kai-Shin Luo
- Department of Ophthalmology, Taipei Tzu-chi Hospital, New Taipei City 231, Taiwan; (H.-C.C.); (E.S.); (K.-S.L.)
| | - Yung-Hsiang Ying
- Department of Business Administration, National Taiwan Normal University, Taipei 106, Taiwan
- Correspondence: (K.C.); (Y.-H.Y.); Tel.: +886-2-7749-3291 (K.C.)
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Gifford KL, Richdale K, Kang P, Aller TA, Lam CS, Liu YM, Michaud L, Mulder J, Orr JB, Rose KA, Saunders KJ, Seidel D, Tideman JWL, Sankaridurg P. IMI - Clinical Management Guidelines Report. Invest Ophthalmol Vis Sci 2019; 60:M184-M203. [PMID: 30817832 DOI: 10.1167/iovs.18-25977] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Best practice clinical guidelines for myopia control involve an understanding of the epidemiology of myopia, risk factors, visual environment interventions, and optical and pharmacologic treatments, as well as skills to translate the risks and benefits of a given myopia control treatment into lay language for both the patient and their parent or caregiver. This report details evidence-based best practice management of the pre-, stable, and the progressing myope, including risk factor identification, examination, selection of treatment strategies, and guidelines for ongoing management. Practitioner considerations such as informed consent, prescribing off-label treatment, and guides for patient and parent communication are detailed. The future research directions of myopia interventions and treatments are discussed, along with the provision of clinical references, resources, and recommendations for continuing professional education in this growing area of clinical practice.
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Affiliation(s)
- Kate L Gifford
- Private Practice and Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Pauline Kang
- University of New South Wales, Sydney, New South Wales, Australia
| | - Thomas A Aller
- Private Practice and University of California, Berkeley, United States
| | - Carly S Lam
- The Hong Kong Polytechnic University, Hong Kong
| | - Y Maria Liu
- University of California, Berkeley, California, United States
| | | | - Jeroen Mulder
- University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Janis B Orr
- Aston University, Birmingham, United Kingdom
| | - Kathryn A Rose
- University of Technology Sydney, New South Wales, Australia
| | | | - Dirk Seidel
- Glasgow Caledonian University, Glasgow, United Kingdom
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The Topographical Effect of Optical Zone Diameter in Orthokeratology Contact Lenses in High Myopes. J Ophthalmol 2019; 2019:1082472. [PMID: 30719336 PMCID: PMC6334375 DOI: 10.1155/2019/1082472] [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: 10/18/2018] [Revised: 11/29/2018] [Accepted: 12/16/2018] [Indexed: 12/27/2022] Open
Abstract
Purpose To evaluate the effect of the optical zone diameter (OZ) in orthokeratology contact lenses regarding the topographical profile in patients with high myopia (−4.00 D to −7.00 D) and to study its effect over the visual quality. Materials and Methods Twelve patients (18 eyes) were fitted with overnight orthokeratology (OrthoK) with a randomized 6 mm or 5 mm OZ lens worn for 2 weeks, followed by a 2-week washout period, between both designs. Keratometry (K) readings, optical zone treatment diameter (OZT), peripheral ring width (PRW), higher-order aberrations (HOA), high (HC) and low contrast (LC) visual acuity, and subjective vision and comfort were measured at baseline and after 2 weeks of OrthoK lens wear of each contact lens. Results No significant differences were found between any measurements for the same subject at both baselines (p value > 0.05). There was no difference between OZ lens designs found in refraction, subjective vision or comfort, and HC and LC visual acuity. Contrast sensitivity was decreased in the 5 mm OZ lens design compared with 6 mm OZ design (p-value < 0.05). 5 mm OZ design provoked a greater flattening, more powerful midperipheral ring and 4th-order corneal and total spherical aberration than the 6 mm OZ design, being statistically significant after 7 days, for corneal aberration, and 15 days, for corneal and total, of wearing the lens (p-value < 0.05). The OZT obtained were 2.8 ± 0.2 mm and 3.1 ± 0.1 mm for 5 mm and 6 mm OZ design, respectively (p-value < 0.05). Regarding PRW, the 5 mm OZ design had a wider ring width in both the nasal and temporal zones (p-value < 0.05). Conclusions A smaller diameter optical zone (5 mm) in orthokeratology lenses produces a smaller treatment area and a larger and more powerful midperipheral ring, increasing the 4th-order spherical aberration that affects only the contrast sensitivity but without differences in visual acuity and subjective vision compared with a larger OZ diameter (6 mm).
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Case Series Analysis of Myopic Progression Control With a Unique Extended Depth of Focus Multifocal Contact Lens. Eye Contact Lens 2018; 44:e16-e24. [PMID: 29053555 DOI: 10.1097/icl.0000000000000440] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To determine the rate of myopia progression in children fit with a commercially available extended depth of focus (center distance) multifocal soft contact lens with attributes theoretically expected to slow the progression of myopia. METHODS A retrospective case series analysis of 32 patients (ages 6-19 years, mean 10.98±2.95) from 10 practice locations was performed. At initial presentation, 44% wore spectacles, 37.5% spherical soft contact lenses, 15.6% a different soft multifocal contact lens, and 3% orthokeratology lenses. All participants showed progression of at least -0.50 diopter with current corrections and were fit with an extended depth of focus (center distance) multifocal soft contact lens (NaturalVue Multifocal 1 Day Contact Lenses; Visioneering Technologies, Inc., Alpharetta, GA). Follow-up time was 6 to 25 months (mean: 10.94±4.76). RESULTS Reductions in the annualized rate of myopic progression from -0.85 D per year ±0.43 D to -0.04 D per year ±0.18 D (P<0.00000) OD, -0.90 D per year ±0.57 D to -0.03 D per year ±0.17 D (P<0.00000) OS were observed. These data represent a reduction of 95.4% OD and 96.25% OS. Approximately 98.4% of the children showed reduction of annualized myopic progression; 91% showed a decrease of 70% or greater. Overall, 81.25% showed complete halting of myopic progression, including 6.25% demonstrating myopic regression. CONCLUSIONS This unique extended depth of focus (center distance) daily disposable multifocal contact lens was effective in slowing myopic progression in these children. These findings add to the growing evidence that center distance multifocal soft contact lenses may slow the progression of myopia.
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Kang P. Optical and pharmacological strategies of myopia control. Clin Exp Optom 2018; 101:321-332. [PMID: 29488240 DOI: 10.1111/cxo.12666] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 11/21/2017] [Accepted: 01/04/2018] [Indexed: 12/21/2022] Open
Abstract
Recent increases in global myopia prevalence rates have raised significant concerns as myopia increases the lifelong risk of various sight-threatening ocular conditions. This growing public health burden has generated significant research interests into understanding both its aetiology and developing effective methods to slow down or stop its development, methods collectively termed 'myopia control'. The growing body of research has demonstrated benefits of various optical and pharmacological treatments resulting in myopia control management increasingly becoming a part of main stream clinical practice. This review will discuss the peer-reviewed literature on the efficacy of various myopia control interventions including multifocal spectacles and contact lenses, orthokeratology and pharmaceutical eye drops, as well as potential future research directions.
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Affiliation(s)
- Pauline Kang
- School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia
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Ruiz-Pomeda A, Pérez-Sánchez B, Valls I, Prieto-Garrido FL, Gutiérrez-Ortega R, Villa-Collar C. MiSight Assessment Study Spain (MASS). A 2-year randomized clinical trial. Graefes Arch Clin Exp Ophthalmol 2018; 256:1011-1021. [PMID: 29396662 DOI: 10.1007/s00417-018-3906-z] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 12/05/2017] [Accepted: 01/10/2018] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To compare myopia progression in children randomized to MiSight contact lenses (CLs) versus children corrected with single-vision spectacles (SV) over a 2-year period. METHODS Subjects aged 8 to 12 with myopia (-0.75 to -4.00 D sphere) and astigmatism (< -1.00 D cylinder) were assigned to the lens study group (MiSight) or the control group (single vision). Measurements of visual acuity and subjective refraction were taken at 6-month intervals, and axial length, anterior chamber, corneal power, and cycloplegic autorefraction were measured at the baseline, 12-month, and 24-month visits. RESULTS Eighty-nine subjects were recruited. Forty-fix children were assigned to the MiSight group, and 33 to the single-vision spectacle group. In total, 74 children completed the clinical trial, with the following parameters at the beginning of the study: n = 41 in the MiSight group (age: 11.01 ± 1.23 years, spherical equivalent: -2.16 ± 0.94 D, gender: male: 21, female: 20) and n = 33 in the single-vision group (age: 10.12 ± 1.38 years, spherical equivalent: -1.75 ± 0.94 D, gender: male: 12, female: 21). After 2 years of follow-up, myopia progressed slowly in the MiSight group compared to the control group (0.45 D vs 0.74 D, p < 0.001) and there was less axial elongation in the MiSight group compared to the single-vision group (0.28 mm vs 0.44 mm, p < 0.001). Therefore, use of MiSight CLs produced lower myopia progression (39.32%) and lower axial growth of the eye (36.04%) at 2 years compared to spectacle use. CONCLUSIONS MiSight contact lens wear reduces axial elongation and myopia progression in comparison to distance single-vision spectacles in children. ClinicalTrials.gov Identifier: NCT01917110.
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Affiliation(s)
- Alicia Ruiz-Pomeda
- Department of Pharmacy, Biotechnology, Optics and Optometry, European University of Madrid, C/Tajo s/n, Villaviciosa de Odón, 28670, Madrid, Spain.
| | - Belén Pérez-Sánchez
- Department of Statistics, Mathematics and Informatics. Area of Languages and Computer Systems, Miguel Hernández University of Elche, Elche, Alicante, Spain
| | | | | | | | - César Villa-Collar
- Doctoral and Research School, European University of Madrid, Madrid, Spain
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Maiello G, Kerber KL, Thorn F, Bex PJ, Vera-Diaz FA. Vergence driven accommodation with simulated disparity in myopia and emmetropia. Exp Eye Res 2017; 166:96-105. [PMID: 29051012 DOI: 10.1016/j.exer.2017.10.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 08/25/2017] [Accepted: 10/08/2017] [Indexed: 11/24/2022]
Abstract
The formation of focused and corresponding foveal images requires a close synergy between the accommodation and vergence systems. This linkage is usually decoupled in virtual reality systems and may be dysfunctional in people who are at risk of developing myopia. We study how refractive error affects vergence-accommodation interactions in stereoscopic displays. Vergence and accommodative responses were measured in 21 young healthy adults (n=9 myopes, 22-31 years) while subjects viewed naturalistic stimuli on a 3D display. In Step 1, vergence was driven behind the monitor using a blurred, non-accommodative, uncrossed disparity target. In Step 2, vergence and accommodation were driven back to the monitor plane using naturalistic images that contained structured depth and focus information from size, blur and/or disparity. In Step 1, both refractive groups converged towards the stereoscopic target depth plane, but the vergence-driven accommodative change was smaller in emmetropes than in myopes (F1,19=5.13, p=0.036). In Step 2, there was little effect of peripheral depth cues on accommodation or vergence in either refractive group. However, vergence responses were significantly slower (F1,19=4.55, p=0.046) and accommodation variability was higher (F1,19=12.9, p=0.0019) in myopes. Vergence and accommodation responses are disrupted in virtual reality displays in both refractive groups. Accommodation responses are less stable in myopes, perhaps due to a lower sensitivity to dioptric blur. Such inaccuracies of accommodation may cause long-term blur on the retina, which has been associated with a failure of emmetropization.
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Affiliation(s)
- Guido Maiello
- UCL Institute of Ophthalmology, University College London, London, UK; Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA.
| | - Kristen L Kerber
- New England College of Optometry, 424 Beacon Street, Boston, MA 02115, USA
| | - Frank Thorn
- New England College of Optometry, 424 Beacon Street, Boston, MA 02115, USA
| | - Peter J Bex
- Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA
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Interaction between Corneal and Internal Ocular Aberrations Induced by Orthokeratology and Its Influential Factors. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3703854. [PMID: 28845432 PMCID: PMC5563403 DOI: 10.1155/2017/3703854] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 06/01/2017] [Accepted: 06/18/2017] [Indexed: 12/17/2022]
Abstract
Purpose To investigate the interaction between corneal, internal, and total wavefront aberrations (WAs) and their influential factors during orthokeratology (OK) treatment in Chinese adolescents. Methods Thirty teenagers (n = 30 eyes) were enrolled in the study; spherical equivalent refraction (SE), corneal curvature radius (CCR), central corneal thickness (CCT), WAs, and the difference in limbal transverse diameter and OK lens diameter (ΔLLD) were detected before and after one-month OK treatment. Every component of WAs was measured simultaneously by iTrace aberrometer. The influential factors of OK-induced WAs were analyzed. Results SE and CCT decreased while CCR increased significantly (P < 0.01). Higher-order aberrations (HOAs), Spherical aberrations (SAs), and coma increased significantly (P < 0.01). Corneal horizontal coma (Z31-C) and corneal spherical aberrations (Z40-C) increased (P < 0.01). The HOAs, coma, SAs, Z31-C, Z31-T, Z40-C, and Z40-T were positively correlated with SE and CCR (P < 0.01). Z3−1-C showed negative correlations with (ΔLLD) and positive correlations with SE (P < 0.05). Conclusions The increase in OK-induced HOAs is mainly attributed to Z31 and Z40 of cornea. Z3−1 in the internal component showed a compensative effect on the corneal vertical coma. The degree of myopic correction and increase in CCR may be the essential influential factors of the increase in Z31 and Z40. The appropriate size of the OK lens may be helpful to decrease OK-induced vertical coma.
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Bio-environmental factors associated with myopia: An updated review. ACTA ACUST UNITED AC 2017; 92:307-325. [PMID: 28162831 DOI: 10.1016/j.oftal.2016.11.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 11/27/2016] [Accepted: 11/29/2016] [Indexed: 12/12/2022]
Abstract
Experimental studies in animals, as well as observational and intervention studies in humans, seem to support the premise that the development of juvenile myopia is promoted by a combination of the effect of genetic and environmental factors, with a complex interaction between them. The very rapid increase in myopia rates in some parts of the world, such as Southeast Asia, supports a significant environmental effect. Several lines of evidence suggest that humans might respond to various external factors, such as increased activity in near vision, increased educational pressure, decreased exposure to sunlight outdoors, dietary changes (including increased intake of carbohydrates), as well as low light levels indoors. All these factors could be associated with a higher prevalence of myopia.
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Morgan IG, He M, Saw SM, Krueger RR, Lam DSC. Myopia: From Research to Practice. Asia Pac J Ophthalmol (Phila) 2017; 5:383-385. [PMID: 27898440 DOI: 10.1097/apo.0000000000000239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Ian G Morgan
- From the *Research School of Biology, Australian National University, Canberra, ACT, Australia; †State Key Laboratory of Ophthalmology and Division of Preventive Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China; ‡Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; §Singapore Eye Research Institute; ¶Saw Swee Hock School of Public Health, National University of Singapore; ∥Duke-NUS Medical School, Singapore; **Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine, Cleveland, OH; ††Dennis Lam & Partners Eye Center, Hong Kong; and ‡‡C-MER (Shenzhen) Dennis Lam Eye Hospital, Shenzhen, China
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