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Sánchez-García A, Molina-Martin A, Ariza-Gracia MÁ, Piñero DP. Analysis of Treatment Discontinuation in Orthokeratology: Studying Efficacy, Safety, and Patient Adherence Over Six Months. Eye Contact Lens 2024; 50:395-400. [PMID: 38886923 DOI: 10.1097/icl.0000000000001110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
PURPOSE This study aimed to evaluate the efficacy, safety, and participant compliance of orthokeratology treatment for the correction of myopic refractive errors over a six-month prospective study and to define the potential reasons for early treatment discontinuation. METHODS A total of 32 participants with low-to-moderate myopia were fitted with the spherical model of corneal refractive therapy (CRT) orthokeratology lenses (Paragon Vision Sciences) and followed over six months, with specific attention to alterations in refractive error, corneal topography, and epithelial thickness. Concurrently, participant feedback and reasons for any treatment discontinuation were documented. RESULTS Significant changes in refractive error and in corneal topography were observed, with approximately 50% of the refractive error being corrected on the first night of use and 100% by the first two weeks ( P <0.001). Central epithelial thickness experienced substantial thinning, reducing to 15.65±4.49 μm (67.38%) ( P <0.001) after 6 months of lens use. Six participants withdrew from this study for varied reasons, including unmet visual expectations and difficulty adhering to the lens-wearing regimen. Notably, the dropout group exhibited higher baseline low-order aberrations and less prolate corneas than those who persisted with the treatment ( P <0.05). CONCLUSIONS Orthokeratology with CRT is efficacious and safe for the correction of low-to-moderate myopia in adults, but a portion of patients discontinue the treatment in the first 6 months of contact lens wear. Special care should be taken when recommending orthokeratology in patients with higher levels of myopia and corneas with less prolate shape, providing more realistic expectations and even changing to dual axis or more sophisticated designs.
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Affiliation(s)
- Alicia Sánchez-García
- Department of Optics (A.S.-G., A.M.-M., D.P.P.), Pharmacology and Anatomy, University of Alicante, Alicante, Spain; ARTORG Center for Biomedical Engineering Research (M.Á.A.-G), University of Bern, Bern, Switzerland; and Department of Ophthalmology (IMQO-Oftalmar) (D.P.P.), Vithas Medimar International Hospital, Alicante, Spain
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Tapasztó B, Flitcroft DI, Aclimandos WA, Jonas JB, De Faber JTHN, Nagy ZZ, Kestelyn PG, Januleviciene I, Grzybowski A, Vidinova CN, Guggenheim JA, Polling JR, Wolffsohn JS, Tideman JWL, Allen PM, Baraas RC, Saunders KJ, McCullough SJ, Gray LS, Wahl S, Smirnova IY, Formenti M, Radhakrishnan H, Resnikoff S, Németh J. Myopia management algorithm. Annexe to the article titled Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute. Eur J Ophthalmol 2024; 34:952-966. [PMID: 38087768 PMCID: PMC11295429 DOI: 10.1177/11206721231219532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/23/2023] [Indexed: 02/06/2024]
Abstract
Myopia is becoming increasingly common in young generations all over the world, and it is predicted to become the most common cause of blindness and visual impairment in later life in the near future. Because myopia can cause serious complications and vision loss, it is critical to create and prescribe effective myopia treatment solutions that can help prevent or delay the onset and progression of myopia. The scientific understanding of myopia's causes, genetic background, environmental conditions, and various management techniques, including therapies to prevent or postpone its development and slow its progression, is rapidly expanding. However, some significant information gaps exist on this subject, making it difficult to develop an effective intervention plan. As with the creation of this present algorithm, a compromise is to work on best practices and reach consensus among a wide number of specialists. The quick rise in information regarding myopia management may be difficult for the busy eye care provider, but it necessitates a continuing need to evaluate new research and implement it into daily practice. To assist eye care providers in developing these strategies, an algorithm has been proposed that covers all aspects of myopia mitigation and management. The algorithm aims to provide practical assistance in choosing and developing an effective myopia management strategy tailored to the individual child. It incorporates the latest research findings and covers a wide range of modalities, from primary, secondary, and tertiary myopia prevention to interventions that reduce the progression of myopia.
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Affiliation(s)
- Beáta Tapasztó
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
- Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Daniel Ian Flitcroft
- Temple Street Children's Hospital, Dublin, Ireland
- Centre for Eye Research Ireland (CERI) Technological University, Dublin, Ireland
| | | | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | | | | | - Andrzej Grzybowski
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
| | - Christina Nicolaeva Vidinova
- Department of Ophthalmology, Military Medical Academy, Sofia, Bulgaria
- Department of Optometry, Sofia University “St. Kliment Ohridski“, Sofia, Bulgaria
| | | | - Jan Roelof Polling
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Optometry and Orthoptics, University of Applied Science, Utrecht, The Netherlands
| | - James S Wolffsohn
- Optometry and Vision Science Research Group, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - J Willem L Tideman
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department Ophthalmology, Martini Hospital, Groningen, The Netherlands
| | - Peter M Allen
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, University of South-Eastern Norway, Kongsberg, Norway
| | - Kathryn J Saunders
- Centre for Optometry and Vision Science, Ulster University, Coleraine, UK
| | - Sara J McCullough
- Centre for Optometry and Vision Science, Ulster University, Coleraine, UK
| | | | - Siegfried Wahl
- Institute for Ophthalmic Research, University Tübingen, Tübingen, Germany
- Carl Zeiss Vision International GmbH, Tübingen, Germany
| | | | - Marino Formenti
- Department of Physics, School of Science, University of Padova, Padova, Italy
| | - Hema Radhakrishnan
- Division of Pharmacy and Optometry, University of Manchester, Manchester, UK
| | - Serge Resnikoff
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Brien Holden Vision Institute, Sydney, Australia
| | - János Németh
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
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Wu J, Zhang X, Wang L, Zhang P, Guo X, Xie P. Altering optical zone diameter, reverse curve width, and compression factor: impacts on visual performance and axial elongation in orthokeratology. Cont Lens Anterior Eye 2024; 47:102136. [PMID: 38503665 DOI: 10.1016/j.clae.2024.102136] [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: 05/04/2023] [Revised: 02/08/2024] [Accepted: 03/04/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE To investigate the effects of modifications in back optical zone diameter (BOZD), reverse curve width (RCW), and compression factor (CF) on refractive error changes and axial elongation in myopic children undergoing orthokeratology (ortho-k) over a 12-month period. METHOD In this retrospective study, data from 126 myopic children undergoing ortho-k fitting were analyzed. Subjects were categorized into four distinct groups based on lens design parameters: Group A (BOZD 6.0 mm, RCW 0.6 mm, CF 0.75 D); Group B (BOZD 6.0 mm, RCW 0.6 mm, CF 1.25 D); Group C (BOZD 5.4 mm, RCW 0.9 mm, CF 1.25 D); and Group D (BOZD 5.0 mm, RCW 1.1 mm, CF 1.25 D). The study evaluated uncorrected visual acuity (UCVA), corneal topography, and axial length (AL) at intervals, using Linear Mixed Models (LMMs) for time-based changes, and ANOVA or Kruskal-Wallis tests for group differences in AL elongation. A multivariable regression analysis identified factors independently associated with AL elongation. RESULTS Within the first day and week, all four groups displayed significant improvements in UCVA and alterations in corneal curvature, which subsequently stabilized. Although UCVA variations between groups were subtle, Group D had less corneal curvature change than Groups A and B initially and exhibited significantly less AL elongation after one year. No significant difference in corneal curvature change or AL elongation was observed between Group C and the other groups. Multiple regression analysis indicated that older baseline age, greater baseline spherical equivalent refractive error, and smaller BOZD were associated with less AL elongation. CONCLUSION The study reveals a positive correlation between BOZD and axial length growth over the 12-month period. A pure 0.5 D CF increment demonstrates a nonsignificant impact. This study provides new ideas into optimizing the parameters of ortho-k lenses.
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Affiliation(s)
- Jinfang Wu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Xinyu Zhang
- Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Linlin Wang
- Beijing Internet Eyecare Optometry & Ophthalmology Clinic, Beijing, 100027, China
| | - Peipei Zhang
- Eye Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Xi Guo
- Beijing Internet Eyecare Optometry & Ophthalmology Clinic, Beijing, 100027, China.
| | - Peiying Xie
- Beijing Internet Eyecare Optometry & Ophthalmology Clinic, Beijing, 100027, China.
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Wang W, Deng J, Yin C, Wang F, Zhang C, Yu C, Gong S, Zhan X, Chen S, Shen D. Study of association between corneal shape parameters and axial length elongation during orthokeratology using image-pro plus software. BMC Ophthalmol 2024; 24:163. [PMID: 38609888 PMCID: PMC11010382 DOI: 10.1186/s12886-024-03398-6] [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: 03/01/2023] [Accepted: 03/14/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND The aim was to validate the correlation between corneal shape parameters and axial length growth (ALG) during orthokeratology using Image-Pro Plus (IPP) 6.0 software. METHODS This retrospective study used medical records of myopic children aged 8-13 years (n = 104) undergoing orthokeratology. Their corneal topography and axial length were measured at baseline and subsequent follow-ups after lens wear. Corneal shape parameters, including the treatment zone (TZ) area, TZ diameter, TZ fractal dimension, TZ radius ratio, eccentric distance, pupil area, and pupillary peripheral steepened zone(PSZ) area, were measured using IPP software. The impact of corneal shape parameters at 3 months post-orthokeratology visit on 1.5-year ALG was evaluated using multivariate linear regression analysis. RESULTS ALG exhibited significant associations with age, TZ area, TZ diameter, TZ fractal dimension, and eccentric distance on univariate linear regression analysis. Multivariate regression analysis identified age, TZ area, and eccentric distance as significantly correlated with ALG (all P < 0.01), with eccentric distance showing the strongest correlation (β = -0.370). The regressive equation was y = 1.870 - 0.235a + 0.276b - 0.370c, where y represents ALG, a represents age, b represents TZ area, and c represents eccentric distance; R2 = 0.27). No significant relationships were observed between the TZ radius ratio, pupillary PSZ area, and ALG. CONCLUSIONS IPP software proves effective in capturing precise corneal shape parameters after orthokeratology. Eccentric distance, rather than age or the TZ area, significantly influences ALG retardation.
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Affiliation(s)
- W Wang
- Hangzhou Xihu Zhijiang Eye Hospital, Hangzhou, China.
| | - J Deng
- Hangzhou Xihu Zhijiang Eye Hospital, Hangzhou, China
- School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - C Yin
- Hangzhou Xihu Zhijiang Eye Hospital, Hangzhou, China
| | - F Wang
- Hangzhou Xihu Zhijiang Eye Hospital, Hangzhou, China
| | - C Zhang
- Hangzhou Xihu Zhijiang Eye Hospital, Hangzhou, China
| | - C Yu
- Hangzhou Xihu Zhijiang Eye Hospital, Hangzhou, China
| | - S Gong
- Hangzhou Xihu Zhijiang Eye Hospital, Hangzhou, China
| | - X Zhan
- Hangzhou Xihu Zhijiang Eye Hospital, Hangzhou, China
| | - S Chen
- Hangzhou Xihu Zhijiang Eye Hospital, Hangzhou, China
| | - D Shen
- Hangzhou Xihu Zhijiang Eye Hospital, Hangzhou, China
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Kou S, Ren Y, Zhuang X, Chen Y, Zhang X. Study on Related Factors of the Treatment Zone After Wearing Paragon CRT and Euclid Orthokeratology Lenses. Eye Contact Lens 2023; 49:521-527. [PMID: 37707469 PMCID: PMC10659246 DOI: 10.1097/icl.0000000000001035] [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] [Accepted: 08/06/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE To explore the influence factors of the treatment zone diameter (TZD) and its relationship with axial length growth (ALG) after wearing Paragon CRT and Euclid orthokeratology lenses. METHODS The right eye data of myopic patients wearing Paragon CRT and Euclid orthokeratology in the ophthalmology department of The First Affiliated Hospital of Soochow University were retrospectively reviewed from April 2019 to October 2022. The TZD and ALG were compared between the Paragon CRT and Euclid groups. The correlation factors of TZD after wearing lens for 1 month and the relationship between the overlapping treatment zone-to-pupil area ratio and the ALG after wearing lens for 1 year were analyzed between the two groups. RESULTS There were 160 patients (160 eyes) in the Paragon CRT group and 155 patients (155 eyes) in the Euclid group. After wearing lens for 1 month, the TZD in the Paragon CRT group (3.72±0.37 mm) was larger than that in the Euclid group (3.26±0.37 mm) ( P <0.001). The stepwise multivariate linear regression analysis showed that the eccentricity at the flattest meridians (Em) and the central corneal thickness were correlated with the TZD in both groups ( P <0.05). After wearing lens for 1 year, the ALG in the Paragon CRT group (0.32±0.20 mm) was larger than that in the Euclid group (0.25±0.20 mm) ( P =0.001). The stepwise multivariate linear regression analysis showed that the initial wearing age and the overlapping treatment zone area-to-pupil area ratio were correlated with the ALG in both groups ( P <0.05). CONCLUSION For both the Paragon CRT and Euclid orthokeratology, the wearers with thicker central corneal thickness and smaller Em usually had a smaller TZD. In both groups, the overlapping treatment zone area-to-pupil area ratio was correlated with the ALG.
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Affiliation(s)
- Sasa Kou
- Department of Ophthalmology (S.K., Y.R., Xinyu Zhuang, Xiaofeng Zhang), The First Affiliated Hospital of Soochow University, Suzhou, China; and Department of Ophthalmology (Y.C., Xiaofeng Zhang), Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
| | - Yaru Ren
- Department of Ophthalmology (S.K., Y.R., Xinyu Zhuang, Xiaofeng Zhang), The First Affiliated Hospital of Soochow University, Suzhou, China; and Department of Ophthalmology (Y.C., Xiaofeng Zhang), Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
| | - Xinyu Zhuang
- Department of Ophthalmology (S.K., Y.R., Xinyu Zhuang, Xiaofeng Zhang), The First Affiliated Hospital of Soochow University, Suzhou, China; and Department of Ophthalmology (Y.C., Xiaofeng Zhang), Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
| | - Yingjie Chen
- Department of Ophthalmology (S.K., Y.R., Xinyu Zhuang, Xiaofeng Zhang), The First Affiliated Hospital of Soochow University, Suzhou, China; and Department of Ophthalmology (Y.C., Xiaofeng Zhang), Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
| | - Xiaofeng Zhang
- Department of Ophthalmology (S.K., Y.R., Xinyu Zhuang, Xiaofeng Zhang), The First Affiliated Hospital of Soochow University, Suzhou, China; and Department of Ophthalmology (Y.C., Xiaofeng Zhang), Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
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Li X, Zuo L, Zhao H, Hu J, Tang T, Wang K, Li Y, Zhao M. Efficacy of small back optic zone design on myopia control for corneal refractive therapy (CRT): a one-year prospective cohort study. EYE AND VISION (LONDON, ENGLAND) 2023; 10:47. [PMID: 37986014 PMCID: PMC10658859 DOI: 10.1186/s40662-023-00364-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: 06/15/2023] [Accepted: 10/26/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND To investigate the control effect on the axial length elongation using corneal refractive therapy (CRT) with different optical zone diameters (BOZDs). We also sought to compare the difference in higher-order aberrations (HOAs), treatment zone (TZ) size and Zernike defocus coefficient with different BOZDs and seek the optimal parameter for predicting axial elongation. METHODS This prospective cohort study included 7- to 14-year-olds fitted with orthokeratology (ortho-K) lenses of 5-mm (5-mm group) or 6-mm BOZD (6-mm group). Axial length (AL), corneal topography, HOAs and Zernike defocus coefficient were obtained at baseline, and 1, 3, 6, 9 and 12 months follow-up visits. Multivariate regression analyses were used to explore the association between AL change and ocular biometric parameters. Receiver operating characteristic (ROC) curve analysis was used to determine the best diagnostic value for AL change in ocular biometric parameters. RESULTS In total, 301 participants completed the one-year follow-up. The mean AL change in the 5-mm group (0.13 ± 0.18 mm) was less than that in the 6-mm group (0.27 ± 0.15 mm) at the 12 months visit. The TZ size and decentration were smaller, while the Zernike defocus coefficient and HOAs were higher in the 5-mm group (all P < 0.05). Older age and smaller TZ size were protective factors against AL elongation in multiple regression. In predicting AL elongation, TZ diameter yielded an area under the ROC curve of 0.684 with a cut-off value of 3.82 mm. CONCLUSION The 5-mm group showed 0.14 mm (51.8%) less axial elongation than the 6-mm group. The 5-mm BOZD produced a smaller TZ size, higher Zernike defocus coefficient and higher HOA after reshaping of the cornea. TZ size was the best predictor of AL elongation. TZ diameter less than 3.82 mm may lead to AL elongation less than 0.2 mm in one year.
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Affiliation(s)
- Xuewei Li
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye 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
| | - Lili Zuo
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye 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
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye 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
| | - Jie Hu
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye 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
| | - Tao Tang
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye 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
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China.
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044, China.
- College of Optometry, Peking University Health Science Center, Beijing, China.
- Eye 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
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye 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
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 100044, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye 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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Li N, Lin W, Zhang K, Li B, Su Q, Du B, Wei R. The effect of back optic zone diameter on relative corneal refractive power distribution and corneal higher-order aberrations in orthokeratology. Cont Lens Anterior Eye 2023; 46:101755. [PMID: 36088210 DOI: 10.1016/j.clae.2022.101755] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 08/29/2022] [Indexed: 01/18/2023]
Abstract
PURPOSE To compare axial elongation, relative corneal refractive power (RCRP) distribution within the pupillary diameter, and corneal higher-order aberrations (HOAs) in myopic children wearing orthokeratology (ortho-k) lenses with different back optic zone diameters (BOZD). METHODS Children aged 8-11 years were fitted with 5.0 or 6.2 mm-BOZD ortho-k lenses (groups A and B, respectively). Axial length (AL) and corneal topography were measured at baseline and during the annual visit. RCRP and corneal HOAs were compared between the two groups after one-year treatment. Multivariate linear regression analysis was performed to determine the association between AL elongation and RCRP parameters, corneal HOAs, and other variables between the groups. RESULTS After one-year treatment, axial elongation was slower in group A than in group B, with a difference of 0.15 mm. Children in group A showed smaller treatment zone size, smaller 3/4X value (describing the distance from the apex RCRP profile rising to its three-quarter-peak level), greater RCRP sum value within the pupillary area, and higher increases in corneal total HOAs and horizontal coma (Z31). AL elongation was significantly correlated with baseline age, baseline spherical equivalent refraction (SER), treatment zone size, and 3/4X value. CONCLUSIONS Ortho-k lenses designed with smaller BOZD increased myopia control efficacy, induced a steeper distribution of the RCRP profile within the pupillary diameter, and induced greater increases in corneal total HOAs and horizontal coma (Z31). Lens-induced RCRP profile within pupillary diameter, rising to its three-quarter-peak level at a smaller distance, may show a better myopia control effect.
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Affiliation(s)
- Na Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Weiping Lin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Kailang Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Bingqin Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Qiang Su
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Bei Du
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
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Huang Y, Li X, Fang W, Luo W, Ye H, Du X, Di Y, Qiao T. Development and Validation of a Simple Nomogram for Predicting Rapid Myopia Progression in Children with Orthokeratology Management. Curr Eye Res 2023; 48:465-473. [PMID: 36622263 DOI: 10.1080/02713683.2023.2167212] [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: 01/10/2023]
Abstract
PURPOSE To develop and validate an ideal nomogram and an online calculator for predicting rapid myopia progression risk in children managed with orthokeratology (ortho-k). METHODS Data of children undergoing ortho-k treatment at Shanghai Children's Hospitals between January 2018 and April 2021 were retrospectively assessed. Potential predictors were screened using univariable analyses and a bidirectional stepwise procedure based on Akaike's information criterion. The final model was constructed using multivariable logistic regression and validated using an internal validation cohort. A nomogram and an online calculator were used to present the final model. RESULTS In this retrospective study with 1051 eyes of 560 myopia patients, the training cohort included 735 eyes, and the validation cohort included 316 eyes. Among 11 potential predictors of rapid myopia progression considered, the following four variables identified as independent predictive factors were included in the nomogram: age (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.61-0.79), baseline spherical equivalent (OR, 1.53; 95% CI, 1.31-1.79), pupil diameter (OR, 0.56; 95% CI, 0.32-0.97), and horizontal visible iris diameter (OR, 0.57; 95% CI, 0.33-0.97). The mean concordance statistics for the training and validation cohorts were 0.705 (95% CI 0.664-0.747) and 0.707 (95% CI 0.639-0.774), respectively. The online calculator is publicly available (https://hycalculatoronline.shinyapps.io/dynnomapp/). CONCLUSION This study developed a simple-to-use nomogram and online calculator that predicted rapid myopia progression risk in children treated with ortho-k, who will likely benefit from early intervention and improved surveillance.
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Affiliation(s)
- Ying Huang
- Department of Ophthalmology, Shanghai Children's Hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xinyue Li
- Department of Ophthalmology, Shanghai Children's Hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Wangyi Fang
- Department of Ophthalmology, Shanghai Children's Hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Wenting Luo
- Department of Ophthalmology, Shanghai Children's Hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Han Ye
- Department of Ophthalmology, Shanghai Children's Hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xiaodong Du
- Department of Ophthalmology, Shanghai Children's Hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yue Di
- Department of Ophthalmology, Shanghai Children's Hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
| | - Tong Qiao
- Department of Ophthalmology, Shanghai Children's Hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China
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Lu W, Song G, Zhang Y, Lian Y, Ma K, Lu Q, Jin Y, Zhao Y, Zhang S, Lv F, Jin W. The effect of orthokeratology lenses on optical quality and visual function in children. Front Neurosci 2023; 17:1142524. [PMID: 37123367 PMCID: PMC10140410 DOI: 10.3389/fnins.2023.1142524] [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: 01/11/2023] [Accepted: 03/27/2023] [Indexed: 05/02/2023] Open
Abstract
Purpose To assess changes in optical quality and visual function in children after 3 months of wearing orthokeratology (OK) lenses. Methods A total of 25 myopic children aged 8-12 years were recruited and completed the follow-up study. Optical quality, visual function and corneal morphology were assessed at baseline and at follow-ups 1 and 3 months after wearing OK lenses. Optical quality parameters mainly included the modulation transfer function (MTF) cutoff, objective scattering index (OSI), Strehl ratio (SR) and the predicted visual acuities (PVAs). Visual function was assessed by visual acuity, monocular contrast sensitivity function (CSF) across five spatial frequencies and the area under the log contrast sensitivity function (AULCSF) that was also computed as an index for overall CSF. Results The MTF cutoff and SR values both increased after 1 month of wearing the OK lenses (baseline vs. 1 month: P MTF = 0.008 and P SR = 0.049); this improvement plateaued after 3 months of lens wear (1 month vs. 3 months: P MTF = 0.626, P SR = 0.428). The corneal morphology also showed the similar change trend. The OSI showed the opposite change trend (baseline vs. 1 month: P OSI < 0.001; 1 month vs. 3 months: P OSI = 0.720). The mean CSF at 1.5 cpd decreased significantly after 1 month of wearing the lenses (baseline vs. 1 month: p = 0.001) and recovered after 3 months of lens wear (baseline vs. 3 months: p = 0.076). CSF at spatial frequencies of 3, 6, 12 and 18 cpd as well as the AULCSF did not significantly differ between any two timepoints (all Ps > 0.05). Conclusion After 3 months of wearing OK lenses, the subjects exhibited a decrease in optical quality, similar to corneal morphology, whereas their visual function remained largely unchanged. Thus, the optical quality was more susceptible to OK lenses than visual function in children. The initial month of OK treatment of children is a key period to be paid close attention to deterioration of optical quality and visual function.
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Affiliation(s)
- Weiwei Lu
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Guanxin Song
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yuhan Zhang
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Yan Lian
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Ke Ma
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Qingqing Lu
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yiyu Jin
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yang Zhao
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Shuyu Zhang
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Fan Lv
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- *Correspondence: Fan Lv,
| | - Wanqing Jin
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Wanqing Jin,
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Leroux C, Fontvieille C, Leahy C, Marc I, Bardin F. Predicting the effects of defocus blur on contrast sensitivity with a model-based metric of retinal image quality. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2022; 39:1866-1873. [PMID: 36215559 DOI: 10.1364/josaa.464034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
We measure the effect of defocus blur on contrast sensitivity with Sloan letters in the 0.75-2.00 arc min range of letter gaps. We compare our results with the prediction of the Dalimier and Dainty model [J. Opt. Soc. Am. A25, 2078 (2008)JOAOD60740-323210.1364/JOSAA.25.002078] and propose a new metric of retinal image quality that we define as the model limit for very small letters. The contrast sensitivity is measured for computationally blurred Sloan letters (0, 0.25, and 0.50 diopters for a 3 mm pupil) of different sizes (20/40 to 20/15 visual acuity), and subjects look through a small (2 mm) diaphragm to limit the impact of their own aberration on measurements. Measurements and model predictions, which are normalized by the blur-free condition, weakly depend on letter size and are in good agreement with our metric of retinal image quality. Our metric relates two approaches of modeling visual performance: complete modeling of the optotype classification task and calculation of retinal image quality with a descriptive metric.
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Zhu MJ, Ding L, Du LL, Chen J, He XG, Li SS, Zou HD. Photopic pupil size change in myopic orthokeratology and its influence on axial length elongation. Int J Ophthalmol 2022; 15:1322-1330. [PMID: 36017053 DOI: 10.18240/ijo.2022.08.15] [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: 06/28/2021] [Accepted: 02/25/2022] [Indexed: 11/23/2022] Open
Abstract
AIM To explore the photopic pupil size behavior in myopic children undergoing overnight orthokeratology (ortho-k) over 1-year period and its effects on the axial elongation. METHODS A total of 202 Chinese myopic children were enrolled in this prospective clinical trial. Ninety-five subjects in ortho-k group and eighty-eight subjects in spectacle group completed the 1-year study. Axial length (AL) was measured before enrollment and every 6mo after the start of ortho-k. The photopic pupil diameter (PPD) was determined using the Pentacam AXL and measured in an examination room with lighting of 300-310 Lx. Stepwise multiple linear regression analysis was used to identify variables contribution to axial elongation. RESULTS Compared with spectacle group, the average 1-year axial elongation was significantly slower in the ortho-k group (0.25±0.27 vs 0.44±0.23 mm, P<0.0001). In ortho-k group, PPDs significantly decreased from 4.21±0.62 mm to 3.94±0.53 mm after 1mo of lens wear (P=0.001, Bonferroni correction) and the change lasts for 3-month visit. No significantly change during the other follow-up visits was found (P>0.05, Bonferroni correction). The 4.81 mm PPD may be a possible cutoff point in the ortho-k group. Subjects with PPD below or equal to 4.81 mm tended to have smaller axial elongation compared to subjects with PPD above 4.81 mm after 1-year period (t=-3.09, P=0.003). In ortho-k group, univariate analyses indicated that those with older age, greater degree of myopia, longer AL, smaller baseline PPD (PPDbaseline) experienced a smaller change in AL. In multivariate analyses, older age, greater AL and smaller PPDbaseline were associated with smaller increases in AL. In spectacle group, PPD tended to be stable (P>0.05, Bonferroni correction) and did not affect axial growth. CONCLUSION PPDs experience significantly decreases at 1-month and 3-month ortho-k treatment. Children with smaller PPD tend to experience slower axial elongation and may benefit more from ortho-k.
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Affiliation(s)
- Meng-Jun Zhu
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Li Ding
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Lin-Lin Du
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Jun Chen
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Xian-Gui He
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Shan-Shan Li
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Hai-Dong Zou
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China.,Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai 200080, China
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12
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Quantitative changes in iris vasculature and blood flow in patients with different refractive errors. Graefes Arch Clin Exp Ophthalmol 2022; 260:3123-3129. [DOI: 10.1007/s00417-022-05632-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/01/2022] [Accepted: 03/10/2022] [Indexed: 11/04/2022] Open
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Zhang Z, Chen Z, Chen Z, Zhou J, Zeng L, Xue F, Qu X, Zhou X. Change in Corneal Power Distribution in Orthokeratology: A Predictor for the Change in Axial Length. Transl Vis Sci Technol 2022; 11:18. [PMID: 35142785 PMCID: PMC8842419 DOI: 10.1167/tvst.11.2.18] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate the correlation between the change in spatial corneal power distribution and axial length (AL) elongation during orthokeratology (Ortho-k) treatment using mathematical methods. Methods Seventy-six subjects aged from eight to 13 years were fitted with Paragon CRT ortho-k lenses. Manifest refraction and corneal topography were checked at baseline and one day, one week, two weeks, one month, three months, six months, nine months, and one year after lens wear. AL was measured at baseline and the six-month and one-year follow-up visits. Relative corneal refractive power change (RCRPC) was calculated by a polynomial function and a monomial function. Factors including age, baseline spherical equivalent refractive error (SER), power exponent and RCRPC were tested against one-year AL growth in a stepwise multiple linear regression model. Results A total of 67 subjects completed the one-year study, with nine dropouts. The SER significantly reduced after the first month of lens wear (P < 0.001). AL significantly changed over time (P = 0.0003) with the annual growth being 0.32 ± 0.18 mm. Power exponent and RCRPC were stable throughout the follow-up visits (all P > 0.05). Change of AL was significantly correlated with baseline age (standardized β = −0.292, P < 0.001) and power exponent (standardized β = 0.691, P < 0.001), but not with the other factors being analyzed. The regression equation using baseline age (X1) and power exponent (X2) as functions for 1-year AL change (Y) was Y = 0.438-0.034X1 + 0.309X2, with R2 being 0.752. Conclusions The asphericity of the treatment zone may affect axial elongation in children undergoing ortho-k therapy. Translational Relevance Because the ortho-k lens design may affect myopia control effect in children undergoing ortho-k therapy, future ortho-k lenses should consider applying these designs to obtain a better myopia control effect in children.
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Affiliation(s)
- Zhe Zhang
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Zhi Chen
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Zhuoyi Chen
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Jiaqi Zhou
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Li Zeng
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Feng Xue
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xiaomei Qu
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
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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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Lin W, Li N, Gu T, Tang C, Liu G, Du B, Wei R. The treatment zone size and its decentration influence axial elongation in children with orthokeratology treatment. BMC Ophthalmol 2021; 21:362. [PMID: 34641799 PMCID: PMC8513184 DOI: 10.1186/s12886-021-02123-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 09/30/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND To investigate whether the treatment zone size (TZS) and treatment zone decentration (TZD) will affect the axial elongation in myopic children undergoing orthokeratology treatment. METHODS A self-controlled retrospective study was conducted on 352 children who met the inclusion criteria. Axial length was measured before and at 12 months after the initial lens wear. Corneal topography was measured at baseline and at each follow-up after lens wear. The Corneal topography obtained from the 12-month visit was used to quantify TZS and TZD for each subject. Cycloplegic refraction was required for all children before fitting the orthokeratology lenses. RESULTS Axial elongation was significantly associated with age, baseline spherical equivalent (SE), TZS, and TZD with univariate linear regression. In groups with both small and large TZS, axial elongation was significantly decreased with large TZD (both P < 0.01). In groups with both small and large TZD, axial elongation was significantly decreased with small TZS (P = 0.03 for small TZD, P = 0.01 for large TZD). Age, SE, and TZD were significantly associated with axial elongation in multiple regression (all P < 0.01). CONCLUSION Relatively smaller TZS and larger TZD may be beneficial in slowing myopia progression in children with orthokeratology treatment.
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Affiliation(s)
- Weiping Lin
- Eye Institute and School of Optometry, Tianjin, China.,Tianjin Medical University Eye Hospital, Tianjin, China
| | - Na Li
- Eye Institute and School of Optometry, Tianjin, China.,Tianjin Medical University Eye Hospital, Tianjin, China
| | - Tianpu Gu
- Eye Institute and School of Optometry, Tianjin, China.,Tianjin Medical University Eye Hospital, Tianjin, China
| | - Chunyu Tang
- Eye Institute and School of Optometry, Tianjin, China.,Tianjin Medical University Eye Hospital, Tianjin, China
| | - Guihua Liu
- Eye Institute and School of Optometry, Tianjin, China.,Tianjin Medical University Eye Hospital, Tianjin, China
| | - Bei Du
- Eye Institute and School of Optometry, Tianjin, China.,Tianjin Medical University Eye Hospital, Tianjin, China.,Tianjin Key Laboratory of Retinal Functions and Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China
| | - Ruihua Wei
- Eye Institute and School of Optometry, Tianjin, China. .,Tianjin Medical University Eye Hospital, Tianjin, China. .,Tianjin Key Laboratory of Retinal Functions and Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300384, China.
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Predicting corneal refractive power changes after orthokeratology. Sci Rep 2021; 11:16681. [PMID: 34404885 PMCID: PMC8371104 DOI: 10.1038/s41598-021-96213-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 08/03/2021] [Indexed: 12/29/2022] Open
Abstract
This study aimed to characterise corneal refractive power (CRP) changes along the principal corneal meridians during orthokeratology (OK). Nineteen myopes (mean age 28 ± 7 years) were fitted with OK lenses in both eyes. Corneal topography was captured before and after 14 nights of OK lens wear. CRP was calculated for the central 8 mm cornea along the horizontal and vertical meridians. The central-paracentral (CPC) power ratio was calculated as the ratio between maximum central and paracentral CRP change from individual data. There was a significant reduction in CRP at all locations in the central 4 mm of the cornea (all p < 0.001) except at 2 mm on the superior cornea (p = 0.071). A significant increase in CRP was evident in the paracentral zone at 2.5, 3 and 3.5 mm on the nasal and superior cornea and at 3.5 and 4 mm on the temporal cornea (all p < 0.05). No significant change in CRP was measured in the inferior cornea except decreased CRP at 2.5 mm (p < 0.001). CPC power ratio in the nasal and temporal paracentral regions was 2.49 and 2.23, respectively, and 2.09 for both the inferior and superior paracentral corneal regions. Our results demonstrates that OK induced significant changes in CRP along the horizontal and vertical corneal meridians. If peripheral defocus changes are inferred from corneal topography, this study suggests that the amount of myopia experienced on the peripheral retina was greater than twice the amount of central corneal power reduction achieved after OK. However, this relationship may be dependent on lens design and vary with pupil size. CPC power ratios may provide an alternative method to estimate peripheral defocus experienced after OK.
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Li Q, Fang F. Retinal contour modelling to reproduce two-dimensional peripheral spherical equivalent refraction. BIOMEDICAL OPTICS EXPRESS 2021; 12:3948-3964. [PMID: 34457391 PMCID: PMC8367254 DOI: 10.1364/boe.426413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/13/2021] [Accepted: 05/16/2021] [Indexed: 05/17/2023]
Abstract
Reproduction of the peripheral spherical equivalent refraction (SER) in the eye model is critical for investigations in myopia control. Based on the derivation of a linear relationship between SER and the vergence of the wavefront at exit pupil center, a computing method is proposed to locate the retinal points to reproduce the two-dimensional (2D) distribution of SER. The method is validated by reproducing SER maps measured on both emmetropic and myopic eyes in a realistic eye model based on measurement data. By fitting the retinal points to a general ellipsoid, the limited capability of the general ellipsoid model in reproducing the 2D map of SER is calculated and compared with original data. The high accuracy in SER reproduction and low time-cost of the proposed retinal-locating method can help significantly improve the precision and accuracy of customized wide-angle eye modelling.
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Affiliation(s)
- Qing Li
- Center of Micro/Nano Manufacturing Technology (MNMT-Dublin), University College Dublin, Dublin 4, Ireland
| | - Fengzhou Fang
- Center of Micro/Nano Manufacturing Technology (MNMT-Dublin), University College Dublin, Dublin 4, Ireland
- State Key Laboratory of Precision Measuring Technology and Instruments, Laboratory of Micro/Nano Manufacturing Technology (MNMT), Tianjin University, Tianjin 300072, China
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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: 44] [Impact Index Per Article: 14.7] [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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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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20
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The Role of Back Optic Zone Diameter in Myopia Control with Orthokeratology Lenses. J Clin Med 2021; 10:jcm10020336. [PMID: 33477514 PMCID: PMC7831104 DOI: 10.3390/jcm10020336] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/08/2021] [Accepted: 01/14/2021] [Indexed: 12/14/2022] Open
Abstract
We compared the efficacy of controlling the annual increase in axial length (AL) in myopic Caucasian children based on two parameters: the back optic zone diameter (BOZD) of the orthokeratology (OK) lens and plus power ring diameter (PPRD) or mid-peripheral annular ring of corneal steepening. Data from 71 myopic patients (mean age, 13.34 ± 1.38 years; range, 10-15 years; 64% male) corrected with different BOZD OK lenses (DRL, Precilens) were collected retrospectively from a Spanish optometric clinic. The sample was divided into groups with BOZDs above or below 5.00 mm and the induced PPRD above or below 4.5 mm, and the relation to AL and refractive progression at 12 months was analyzed. Three subgroups were analyzed, i.e., plus power ring (PPR) inside, outside, or matching the pupil. The mean baseline myopia was -3.11 ± 1.46 D and the AL 24.65 ± 0.88 mm. Significant (p < 0.001) differences were found after 12 months of treatment in the refractive error and AL for the BOZD and PPRD. AL changes in subjects with smaller BOZDs decreased significantly regarding larger diameters (0.09 ± 0.12 and 0.15 ± 0.11 mm, respectively); in subjects with a horizontal sector of PPRD falling inside the pupil, the AL increased less (p = 0.035) than matching or outside the pupil groups by 0.04 ± 0.10 mm, 0.10 ± 0.11 mm, and 0.17 ± 0.12 mm, respectively. This means a 76% lesser AL growth or 0.13 mm/year in absolute reduction. OK corneal parameters can be modified by changing the OK lens designs, which affects myopia progression and AL elongation. Smaller BOZD induces a reduced PPRDs that slows AL elongation better than standard OK lenses. Further investigations should elucidate the effect of pupillary diameter, PPRD, and power change on myopia control.
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Pereira-da-Mota AF, Costa J, Amorim-de-Sousa A, González-Méijome JM, Queirós A. The Impact of Overnight Orthokeratology on Accommodative Response in Myopic Subjects. J Clin Med 2020; 9:jcm9113687. [PMID: 33213015 PMCID: PMC7698488 DOI: 10.3390/jcm9113687] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/09/2020] [Accepted: 11/12/2020] [Indexed: 12/30/2022] Open
Abstract
This study aimed to evaluate the effects of two months of orthokeratology (OK) treatment in the accommodative response of young adult myopes. Twenty eyes (21.8 ± 1.8 years) were fitted with the Paragon CRT® 100 LENS to treat myopia between −1.00 and −2.00 D. Low- and high-contrast visual acuity (LCDVA and HCDVA), central objective refraction, light disturbance (LD), and objective accommodative response (using the Grand Seiko WAM-5500 open-field autorefractometer coupled with a Badal system) were measured at baseline (BL) before lens wear and after 1, 15, 30, and 60 nights of OK. Refractive error correction was achieved during the first fifty days of OK lens wear, with minimal changes afterwards. LD analysis showed a transient increase followed by a reduction to baseline levels over the first 30 nights of treatment. The accommodative response was lower than expected for all target vergences in all visits (BL: 0.61 D at 1.00 D to 0.96 D at 5.00 D; 60 N: 0.36 D at 1.00 D to 0.79 D at 5.00 D). On average, the accommodative lag decreases over time with OK lens wear. However, these differences were not statistically significant (p > 0.050, repeated-measures ANOVA and Friedman test). This shows that overnight OK treatment does not affect objectively measured the accommodative response of young, low myopic eyes after two months of treatment stabilization.
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Vincent SJ, Tan Q, Ng ALK, Cheng GPM, Woo VCP, Cho P. Higher order aberrations and axial elongation in combined 0.01% atropine with orthokeratology for myopia control. Ophthalmic Physiol Opt 2020; 40:728-737. [PMID: 32888318 DOI: 10.1111/opo.12730] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/30/2020] [Accepted: 08/03/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE To compare the changes in higher order aberrations (HOA's) for photopic and mesopic pupil diameters in children undergoing orthokeratology treatment (OK) or combined 0.01% atropine with orthokeratology treatment (AOK), and their association with axial elongation. METHODS Children aged 6 to <11 years with 1.00-4.00 D of myopia were randomly assigned to each treatment group. Photopic and mesopic pupil diameters were quantified using automated pupillometry and HOA's were measured with a Hartmann-Shack aberrometer and Badal system to control for accommodation. HOA's were rescaled to photopic and mesopic pupil diameters and fitted with a 6th order Zernike polynomial expansion. Axial length was measured using an optical biometer under cycloplegia. RESULTS Baseline and six-month data from 25 AOK and 28 OK participants were analysed. At the six-month visit, pupil diameter was larger in the AOK group under photopic conditions (3.70 ± 0.42 vs 3.12 ± 0.33 mm, p < 0.001), along with a range of HOA metrics [3rd to 6th order and higher order root mean square error values (HO RMS), all p ≤ 0.003] and individual Zernike terms (primary spherical aberration, and oblique quadrafoil, both p ≤ 0.03). Axial elongation was greater in the OK treatment group (0.05 ± 0.08 vs -0.01 ± 0.12 mm, p = 0.02). In the AOK group, axial elongation was correlated with the increase in photopic pupil diameter (r = -0.45, p = 0.02) and with several HOA metrics; however, these associations were not observed in the OK group. CONCLUSION AOK treatment resulted in increased photopic pupil size and HOA's, and significantly less axial elongation over a six-month period compared to OK treatment alone. The improved myopia control observed with combination 0.01% atropine and orthokeratology may be a result of an enhanced optical effect due to a larger photopic pupil size.
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Affiliation(s)
- Stephen J Vincent
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| | - Qi Tan
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Alex L K Ng
- Department of Ophthalmology, The University of Hong Kong, Hong Kong, Hong Kong.,Hong Kong Ophthalmic Associates, Hong Kong, Hong Kong
| | | | - Victor C P Woo
- Department of Ophthalmology, The University of Hong Kong, Hong Kong, Hong Kong.,Hong Kong Ophthalmic Associates, Hong Kong, Hong Kong
| | - Pauline Cho
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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Lau JK, Vincent SJ, Cheung SW, Cho P. Higher-Order Aberrations and Axial Elongation in Myopic Children Treated With Orthokeratology. Invest Ophthalmol Vis Sci 2020; 61:22. [PMID: 32068792 PMCID: PMC7326571 DOI: 10.1167/iovs.61.2.22] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose This retrospective longitudinal study aimed to examine the relationship between ocular higher-order aberrations (HOA) and axial eye growth in young myopic children undergoing orthokeratology (ortho-k) treatment. Methods Axial length and ocular HOA, measured under cycloplegia annually over a 2-year period from the right eyes of myopic children, who previously completed ortho-k clinical trials, were retrieved. Linear mixed model analyses were applied to determine the association between ocular HOA, other known confounding variables (age, sex, and refractive error), and axial eye growth. Results Data from 103 subjects were analyzed. The root-mean square (RMS) values of total ocular HOA (third to sixth orders combined), spherical (Z40 and Z60 combined), and comatic (Z3-1, Z31, Z5-1, and Z51 combined) aberrations increased by approximately 3, 9, and 2 times, respectively, after 2 years of ortho-k treatment. After adjusting for age, sex, and refractive error, higher RMS values of total HOA and spherical aberrations were associated with both longer axial length and slower axial elongation (all P < 0.01). For individual Zernike term coefficients, a higher level of positive spherical aberration (Z40) was also associated with longer axial length and slower axial elongation (both P < 0.01), after adjusting for baseline HOA. Conclusions Ortho-k for myopia control significantly increases the Zernike coefficients and therefore the RMS values for a range of total ocular HOA terms or metrics in children. These findings suggest the potential role of HOA, particularly spherical aberration, as the possible mechanism of slowing axial elongation in ortho-k treatment.
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Hughes RP, Vincent SJ, Read SA, Collins MJ. Higher order aberrations, refractive error development and myopia control: a review. Clin Exp Optom 2019; 103:68-85. [PMID: 31489693 DOI: 10.1111/cxo.12960] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 07/01/2019] [Accepted: 07/28/2019] [Indexed: 01/25/2023] Open
Abstract
Evidence from animal and human studies suggests that ocular growth is influenced by visual experience. Reduced retinal image quality and imposed optical defocus result in predictable changes in axial eye growth. Higher order aberrations are optical imperfections of the eye that alter retinal image quality despite optimal correction of spherical defocus and astigmatism. Since higher order aberrations reduce retinal image quality and produce variations in optical vergence across the entrance pupil of the eye, they may provide optical signals that contribute to the regulation and modulation of eye growth and refractive error development. The magnitude and type of higher order aberrations vary with age, refractive error, and during near work and accommodation. Furthermore, distinctive changes in higher order aberrations occur with various myopia control treatments, including atropine, near addition spectacle lenses, orthokeratology and soft multifocal and dual-focus contact lenses. Several plausible mechanisms have been proposed by which higher order aberrations may influence axial eye growth, the development of refractive error, and the treatment effect of myopia control interventions. Future studies of higher order aberrations, particularly during childhood, accommodation, and treatment with myopia control interventions are required to further our understanding of their potential role in refractive error development and eye growth.
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Affiliation(s)
- Rohan Pj Hughes
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Stephen J Vincent
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
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Wolffsohn JS, Kollbaum PS, Berntsen DA, Atchison DA, Benavente A, Bradley A, Buckhurst H, Collins M, Fujikado T, Hiraoka T, Hirota M, Jones D, Logan NS, Lundström L, Torii H, Read SA, Naidoo K. IMI - Clinical Myopia Control Trials and Instrumentation Report. Invest Ophthalmol Vis Sci 2019; 60:M132-M160. [PMID: 30817830 DOI: 10.1167/iovs.18-25955] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The evidence-basis based on existing myopia control trials along with the supporting academic literature were reviewed; this informed recommendations on the outcomes suggested from clinical trials aimed at slowing myopia progression to show the effectiveness of treatments and the impact on patients. These outcomes were classified as primary (refractive error and/or axial length), secondary (patient reported outcomes and treatment compliance), and exploratory (peripheral refraction, accommodative changes, ocular alignment, pupil size, outdoor activity/lighting levels, anterior and posterior segment imaging, and tissue biomechanics). The currently available instrumentation, which the literature has shown to best achieve the primary and secondary outcomes, was reviewed and critiqued. Issues relating to study design and patient selection were also identified. These findings and consensus from the International Myopia Institute members led to final recommendations to inform future instrumentation development and to guide clinical trial protocols.
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Affiliation(s)
- James S Wolffsohn
- Ophthalmic Research Group, Aston University, Birmingham, United Kingdom
| | - Pete S Kollbaum
- Indiana University, School of Optometry, Bloomington, Indiana, United States
| | - David A Berntsen
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, Texas, United States
| | - David A Atchison
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | | | - Arthur Bradley
- Indiana University, School of Optometry, Bloomington, Indiana, United States
| | - Hetal Buckhurst
- School of Health Professions, Peninsula Allied Health Centre, Plymouth University, Plymouth, United Kingdom
| | - Michael Collins
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | - Takashi Fujikado
- Department of Applied Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takahiro Hiraoka
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masakazu Hirota
- Department of Applied Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Debbie Jones
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Nicola S Logan
- Ophthalmic Research Group, Aston University, Birmingham, United Kingdom
| | | | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Scott A Read
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | - Kovin Naidoo
- African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa
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26
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Liu Y, Wang Y. Optical quality comparison between laser ablated myopic eyes with centration on coaxially sighted corneal light reflex and on entrance pupil center. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2019; 36:B103-B109. [PMID: 31044979 DOI: 10.1364/josaa.36.00b103] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 02/24/2019] [Indexed: 06/09/2023]
Abstract
This paper aims to compare the image quality between centration on the coaxially sighted corneal light reflex (CSCLR) and on the entrance pupil center (EPC). Myopic laser ablation was simulated on eye models, and the optical performances were compared. Centration on the EPC leads to higher wavefront aberrations and lower modulation transfer function. The two centration methods give nearly identical retinal images for angle kappa less than 5°. Because of less tissue removal, centration on the EPC is probably preferable for angle kappa less than 5°, but CSCLR centration may be preferable for angle kappa larger than 5°. The degree of tilt of the post-surgery anterior corneal surface explains the differences between the two methods.
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Putnam NM, Vasudevan B, Juarez A, Le CT, Sam K, de Gracia P, Hoppert A. Comparing habitual and i. Scription refractions. BMC Ophthalmol 2019; 19:49. [PMID: 30755182 PMCID: PMC6373049 DOI: 10.1186/s12886-019-1053-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 01/29/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Many patients voice concerns regarding poor night vision, even when they see 20/20 or better in the exam room. During mesopic and scotopic conditions the pupil size increases, increasing the effects on visual performance of uncorrected (residual) refractive errors. The i.Scription refraction method claims to optimize traditional refractions for mesopic and scotopic conditions, by using the information that the Zeiss i.Profilerplus gathers of ocular aberrations (low and high order). The aim of this study was to investigate any differences between habitual and i.Scription refractions and their relationship to night vision complaints. METHODS Habitual, subjective, and i.Scription refractions were obtained from both eyes of eighteen subjects. Low and high order aberrations of the subjects were recorded with the Zeiss i.Profilerplus. The root mean square (RMS) metric was calculated for small (3 mm) and maximum pupil sizes. Subjects rated their difficulty with driving at night on a scale of 1-10. RESULTS There was a statistically significant difference between the habitual and i.Scription refractions on both the sphere and cylinder values [(t = 3.12, p < 0.01), (t = 5.39, p < 0.01)]. The same was found when comparing the subjective and i.Scription refractions [(t = 2.31, p = 0.03), (t = 2.54, p = 0.02)]. There were no significant differences found when comparing the sphere and cylinder values between the habitual and subjective refractions or on any combination of spherical equivalent refraction. The maximum pupil size of the subject population on this study, measured with the i.Profilerplus, was 4.8 ± 1.04 mm. Ten out of the eighteen subjects had discomfort at night with an average magnitude of 4 ± 2.7. Ratings of difficulty with night vision correlated with the change in spherical equivalent correction between the habitual and i.Scription refractions (p = 0.01). A sub-analysis of myopic subjects (n = 15) showed an increase in the significance of this relationship (p = 0.002). CONCLUSIONS The i.Scription method improves night vision by correcting the sphere and cylinder more precisely. There was a correlation between the amount of change in the cylinder value between habitual and i.Scription prescriptions and the magnitude of the reported visual discomfort at night.
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Affiliation(s)
- Nicole M. Putnam
- Midwestern University, College of Optometry, 19555 N 59th Ave, Glendale, Arizona 85308 USA
| | - Balamurali Vasudevan
- Midwestern University, College of Optometry, 19555 N 59th Ave, Glendale, Arizona 85308 USA
| | - Andre Juarez
- Midwestern University, College of Optometry, 19555 N 59th Ave, Glendale, Arizona 85308 USA
| | - Cam Tu Le
- Midwestern University, College of Optometry, 19555 N 59th Ave, Glendale, Arizona 85308 USA
| | - Kristine Sam
- Midwestern University, College of Optometry, 19555 N 59th Ave, Glendale, Arizona 85308 USA
| | - Pablo de Gracia
- Midwestern University, College of Optometry, 19555 N 59th Ave, Glendale, Arizona 85308 USA
| | - Allissun Hoppert
- Midwestern University, College of Optometry, 19555 N 59th Ave, Glendale, Arizona 85308 USA
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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: 27] [Impact Index Per Article: 5.4] [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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Liu G, Jin N, Bi H, Du B, Gu T, Zhang B, Wei R. Long-Term Changes in Straylight Induced by Overnight Orthokeratology: An Objective Measure Using the Double-Pass System. Curr Eye Res 2018; 44:11-18. [PMID: 30198800 DOI: 10.1080/02713683.2018.1514056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Purpose: To map the time course of changes in intraocular straylight of the human eye 1 year after initial lens wearing for orthokeratology treatment using the objective double-pass technique. Materials and Methods: A total of 35 subjects (19 males and 16 females) completed the study. The mean age was 11.46 ± 2.33 years (range, 8-16 years). All subjects were fitted with spherical four-zone orthokeratology lenses following the procedures recommended by the lens manufacturer. The subjects were required to wear the lens for at least eight consecutive hours at night. After lens removal during the daytime, objective scattering index (OSI) was evaluated using the double-pass technique (OQAS-II, Visiometrics, Terrassa, Spain) prior to lens dispatch (baseline), followed by evaluations at 1 week, 1 month, 6 months, and 12 months after the initial lens wearing. Longitudinal changes were fitted to a model containing both an impairing and recovery component, and the results were based on an extrapolation between the visits. Results: OSI rose quickly following lens wearing, reaching its highest level (double that of baseline values) by approximately 1.47 months. However, the recovery phase was slow and modest. One year after the initial lens wearing, OSI exhibited a 20% recovery from the peak level, but remained 63% higher than the baseline level. Conclusions: Intraocular straylight immediately increased flowing lens wearing, and this change reaches maximal level around 1 month after lens wearing. Slow but significant recoveries of optical quality subsequently followed.
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Affiliation(s)
- Guihua Liu
- a School of Optometry and Ophthalmology , Tianjin Medical University Eye Hospital , Tianjin , China
| | - Nan Jin
- a School of Optometry and Ophthalmology , Tianjin Medical University Eye Hospital , Tianjin , China
| | - Hua Bi
- b College of Optometry , Nova Southeastern University , Davie , FL , USA
| | - Bei Du
- a School of Optometry and Ophthalmology , Tianjin Medical University Eye Hospital , Tianjin , China
| | - Tianpu Gu
- a School of Optometry and Ophthalmology , Tianjin Medical University Eye Hospital , Tianjin , China
| | - Bin Zhang
- b College of Optometry , Nova Southeastern University , Davie , FL , USA
| | - Ruihua Wei
- a School of Optometry and Ophthalmology , Tianjin Medical University Eye Hospital , Tianjin , China
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Faria-Ribeiro M, Amorim-de-Sousa A, González-Méijome JM. Predicted accommodative response from image quality in young eyes fitted with different dual-focus designs. Ophthalmic Physiol Opt 2018; 38:309-316. [PMID: 29383756 DOI: 10.1111/opo.12443] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/01/2017] [Indexed: 12/22/2022]
Abstract
PURPOSE To investigate the separated and combined influences of inner zone (IZ) diameter and effective add power of dual-focus contact lenses (CL) in the image quality at distance and near viewing, in a functional accommodating model eye. METHODS Computational wave-optics methods were used to define zonal bifocal pupil functions, representing the optic zones of nine dual-focus centre-distance CLs. The dual-focus pupil functions were defined having IZ diameters of 2.10 mm, 3.36 mm and 4.00 mm, with add powers of 1.5 D, 2.0 D and 2.5 D (dioptres), for each design, that resulted in a ratio of 64%/36% between the distance and treatment zone areas, bounded by a 6 mm entrance pupil. A through-focus routine was implemented in MATLAB to simulate the changes in image quality, calculated from the Visual Strehl ratio, as the eye with the dual-focus accommodates, from 0 to -3.00 D target vergences. Accommodative responses were defined as the changes in the defocus coefficient, combined with a change in fourth and sixth order spherical aberration, which produced a peak in image quality at each target vergence. RESULTS Distance viewing image quality was marginally affected by IZ diameter but not by add power. Near image quality obtained when focussing the image formed by the near optics was only higher by a small amount compared to the other two IZ diameters. The mean ± standard deviation values obtained with the three adds were 0.28 ± 0.02, 0.23 ± 0.02 and 0.22 ± 0.02, for the small, medium and larger IZ diameters, respectively. On the other hand, near image quality predicted by focussing the image formed by the distance optics was considerably lower relatively to the other two IZ diameters. The mean ± standard deviation values obtained with the three adds were 0.15 ± 0.01, 0.38 ± 0.00 and 0.54 ± 0.01, for the small, medium and larger IZ diameters, respectively. CONCLUSIONS During near viewing through dual-focus CLs, image quality depends on the diameter of the most inner zone of the CL, while add power only affects the range of clear focus when focussing the image formed by the CL near optics. When only image quality gain is taken into consideration, medium and large IZ diameters designs are most likely to promote normal accommodative responses driven by the CL distance optics, while a smaller IZ diameter design is most likely to promote a reduced accommodative response driven by the dual-focus CL near optics.
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Affiliation(s)
- Miguel Faria-Ribeiro
- Clinical & Experimental Optometry Research Lab (CEORLab), Center of Physics, University of Minho, Braga, Portugal
| | - Ana Amorim-de-Sousa
- Clinical & Experimental Optometry Research Lab (CEORLab), Center of Physics, University of Minho, Braga, Portugal
| | - José M González-Méijome
- Clinical & Experimental Optometry Research Lab (CEORLab), Center of Physics, University of Minho, Braga, Portugal
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