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Xu S, Li L, Han W, Zhu Y, Hu Y, Li Z, Ruan Z, Zhou Z, Zhuo Y, Fu M, Yang X. Association Between Myopia and Pupil Diameter in Preschoolers: Evidence from a Machine Learning Approach Based on a Real-World Large-Scale Dataset. Ophthalmol Ther 2024; 13:2009-2022. [PMID: 38822998 PMCID: PMC11178758 DOI: 10.1007/s40123-024-00972-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 05/14/2024] [Indexed: 06/03/2024] Open
Abstract
INTRODUCTION Previous studies have explored the connections between various ocular biological parameters with myopia. Our previous study also found that pupil data can predict the myopic progression during the interventions for myopia. However, studies exploring the association between pupil diameter and myopia in preschoolers with myopia were lacking. Hence this study was aimed to investigate the association between pupil diameter and myopia in preschoolers with myopia based on a real-world, large-scale dataset. METHODS Data containing 650,671 preschoolers were collected from a total of 1943 kindergartens in Shenzhen, China. Refraction and pupil parameters were collected. After data filtering, the occurrence of myopia and its association with age, gender, pupil diameter, and other variables, were analyzed. Random forest (RF) and eXtreme gradient boosting (XGBoost) were selected from seven machine learning algorithms to build the model. The mean decrease accuracy (MDA), mean decrease Gini (MDG), and gain feature importance (GFI) techniques were employed to quantify the importance of pupil diameter and other features. RESULTS After the assessments, 51,325 valid records with complete pupil data were included, and 3468 (6.76%) were identified as myopia based on the calculated cycloplegic refraction. Preschoolers with myopia presented reduced pupil diameter and greater variation (5.00 ± 0.99 mm) compared to non-myopic preschoolers (6.22 ± 0.67 mm). A nonlinear relationship was found according to the scatterplots between pupil diameter and refraction (R2 = 0.14). Especially preschoolers with myopia had reduced pupil diameter compared to emmetropic preschoolers, but hyperope did not experience additional pupil enlargement. After adjusting for other covariates, this relationship is still consistent (P < 0.001). XGBoost and RF algorithms presented the highest performance and validated the importance of pupil diameter in myopia. CONCLUSIONS Based on a real-world large-scale dataset, the current study illuminated that preschoolers with myopia had a reduced pupil diameter compared to emmetropic preschoolers with a nonlinear pattern. Machine learning algorithms visualized and validated the pivotal role of pupil diameter in myopia. TRIAL REGISTRATION chictr.org Identifier: ChiCTR2200057391.
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Affiliation(s)
- Shengsong Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 Xianlie South Road, Yuexiu District, Guangzhou, China
| | - Linling Li
- Department of Ophthalmology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, 3012 Fuqiang Road, Futian District, Shenzhen, China
| | - Wenjing Han
- Department of Medical Imaging Technology, Yanjing Medical College, Capital Medical University, Beijing, China
| | - Yingting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 Xianlie South Road, Yuexiu District, Guangzhou, China
| | - Yin Hu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 Xianlie South Road, Yuexiu District, Guangzhou, China
| | - Zhidong Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 Xianlie South Road, Yuexiu District, Guangzhou, China
| | - Zhenbang Ruan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 Xianlie South Road, Yuexiu District, Guangzhou, China
| | - Zhuandi Zhou
- Department of Ophthalmology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, 3012 Fuqiang Road, Futian District, Shenzhen, China
| | - Yehong Zhuo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 Xianlie South Road, Yuexiu District, Guangzhou, China
| | - Min Fu
- Department of Ophthalmology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, 3012 Fuqiang Road, Futian District, Shenzhen, China.
| | - Xiao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 Xianlie South Road, Yuexiu District, Guangzhou, China.
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Chen Y, Gu VY, Xu Y, Ye B, Kang X, Li B. Bilateral axial length growth patterns of myopic anisometropes undergoing sequential monocular to binocular orthokeratology treatment. Cont Lens Anterior Eye 2024:102192. [PMID: 38806328 DOI: 10.1016/j.clae.2024.102192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 04/04/2024] [Accepted: 05/22/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE To investigate bilateral axial length (AL) growth patterns and interactions of myopic eyes in anisometropic children during unilateral orthokeratology (OK) treatment in their singularly myopic eyes (Eyes1), followed by bilateral treatment when their second eyes (Eyes2) developed myopia. METHODS This study enrolled 94 eyes from 47 anisometropes (20 males). All patients had undergone monocular OK treatment for > 1 year followed by binocular treatment for > 1 year. Axial growth of Eyes1 and Eyes2 during the first year of monocular treatment (Stage 1), average annual axial elongation during the monocular treatment period, and axial elongation during the first year of binocular treatment (Stage 2) were respectively termed: S1E1 and S1E2, Annual E1 and Annual E2, and S2E1 and S2E2. Associations between AL growth and age, sex, interval time, and ocular parameters were analysed using correlation and generalised estimating equation (GEE) analysis. RESULTS During the monocular period, Eyes1 showed less AL growth (S1E1: 0.05 ± 0.18 mm; Annual E1: 0.05 ± 0.21 mm) than Eyes2 (S1E2: 0.51 ± 0.24 mm; Annual E2: 0.52 ± 0.25 mm) (all p < 0.001). During the binocular period, there was no significant difference between S2E1 and S2E2(0.21 ± 0.14 mm v. 0.19 ± 0.17 mm, p = 0.951). Between monocular and binocular periods, Eyes1 had significantly higher S2E1 compared to S1E1 and Annual E1 (both p < 0.001), and Eyes2 had significantly lower S2E2 than S1E2 and Annual E2 (both p < 0.001). In the GEE model, spherical equivalent refraction (SER) and between periods interval time showed independently significant associations with AL growth after adjusting for age and sex. CONCLUSION Orthokeratology can significantly control AL growth in unilateral myopia. AL growth of the initial myopic OK-treated eyes accelerated relative to the monocular period when contralateral eyes developed myopia and assumed OK treatment. During the binocular treatment phase, OK lenses showed moderate and comparable effects on AL retardation across both eyes.
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Affiliation(s)
- Yiye Chen
- Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Victoria Y Gu
- Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Yangyang Xu
- Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Ye
- Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoli Kang
- Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Bin Li
- Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Yu D, Wang L, Zhou X, Liu L, Wu S, Tang Q, Zhang X. Sleep Quality is Associated with Axial Length Elongation in Myopic Children Receiving Orthokeratology: A Retrospective Study. Nat Sci Sleep 2023; 15:993-1001. [PMID: 38050564 PMCID: PMC10693766 DOI: 10.2147/nss.s421407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/14/2023] [Indexed: 12/06/2023] Open
Abstract
Purpose To identify potential demographic and lifestyle factors associated with progression of myopia with orthokeratology (ortho-k) treatment via follow-up of axial length (AL). Methods In this retrospective observational study, demographics, ocular parameters, near-work distance, outdoor activities, and sleep quality were analyzed in 134 children with myopia aged 8~15 years using ortho-k and a follow-up for one year. Results Compared with the slow progression group, the participants in the fast progression group were younger in age (10.55 ±1.70 years vs 9.90 ±1.18 years, P = 0.009), demonstrated higher spherical equivalent (SE) value (-2.52 ±0.63 diopters (D) vs -3.05 ±0.89 D, P < 0.001), shorter near-work distance (P = 0.010), and poorer sleep quality (Pittsburgh sleep quality index [PSQI], 4.79 ±1.29 vs 3.81 ±1.38, P < 0.001) in the one-year follow-up. Furthermore, multivariate linear regression analyses showed that baseline age (B =-0.020, P = 0.020), SE (B = 0.0517, P < 0.001), and total PSQI (B=0.026, P = 0.001) were associated with axial elongation. Advanced logistic regression analyses demonstrated that shorter average near-work distance (P = 0.034), higher SE value (P = 0.023), and poorer sleep quality (P = 0.003) were associated with fast axial elongation. Conclusion Sleep quality is one of the key factors associated with axial elongation in children with myopia after using ortho-k for one year. Further studies are required to confirm this observation and expand its practical applications.
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Affiliation(s)
- Dongyi Yu
- Department of Ophthalmology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, 215006, People’s Republic of China
- Department of Ophthalmology, Kunshan First People’s Hospital Affiliated to Jiangsu University, Suzhou, Jiangsu, 215300, People’s Republic of China
| | - Libo Wang
- Department of Ophthalmology, Kunshan First People’s Hospital Affiliated to Jiangsu University, Suzhou, Jiangsu, 215300, People’s Republic of China
| | - Xin Zhou
- Department of Ophthalmology, Kunshan First People’s Hospital Affiliated to Jiangsu University, Suzhou, Jiangsu, 215300, People’s Republic of China
| | - Lili Liu
- Department of Ophthalmology, Kunshan First People’s Hospital Affiliated to Jiangsu University, Suzhou, Jiangsu, 215300, People’s Republic of China
| | - Shuang Wu
- Department of Ophthalmology, Kunshan First People’s Hospital Affiliated to Jiangsu University, Suzhou, Jiangsu, 215300, People’s Republic of China
| | - Qing Tang
- Department of Neurology, Kunshan First People’s Hospital Affiliated to Jiangsu University, Suzhou, Jiangsu, 215300, People’s Republic of China
| | - Xiaofeng Zhang
- Department of Ophthalmology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, 215006, People’s Republic of China
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Chen X, Yang B, Wang X, Ma W, Liu L. The alterations in ocular biometric parameters following short-term discontinuation of long-term orthokeratology and prior to subsequent lens fitting: a preliminary study. Ann Med 2023; 55:2282745. [PMID: 37988719 PMCID: PMC10836244 DOI: 10.1080/07853890.2023.2282745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 11/06/2023] [Indexed: 11/23/2023] Open
Abstract
PURPOSE To investigate the alterations in biometric parameters among Chinese adolescents over an extended period of wearing orthokeratology lenses, as well as the subsequent changes after a one-month cessation of lens usage prior to the secondary lens fitting. METHODS Twenty-four myopic patients aged 7-14 were enrolled in this 37-month prospective observational study. Ocular biometric parameters were measured in the study. Ocular biometric parameters were assessed, and the utilization of Generalized Estimating Equations (GEE) was employed in the analysis to address the correlation between the two eyes of each participant. RESULTS The axial length (AL) increased by 0.55 mm after 36 months of lens wearing and further increased to 0.62 mm at the 37-month follow-up compared to the initial measurement. The differences in AL elongation per month between the 37-month time point and the 12-, 24-, and 36-month marks of lens wearing were found to be statistically significant (p12-month = 0.001; p24-month = 0.003; p36-month = 0.001). Following the cessation of lens wear for 1 month, there was no significant complete recovery observed in the flat and steep keratometry values. However, the intraocular pressure and anterior chamber depth returned to their baseline levels. CONCLUSIONS The AL elongation undergoes alterations during temporary discontinuation of lenses, with the flat and steep keratometry measurements remaining significantly flatter compared to the baseline. However, the intraocular pressure and anterior chamber depth return to their initial levels after one month of lens cessation.
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Affiliation(s)
- Xiaohang Chen
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
| | - Bi Yang
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
| | - Xue Wang
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Ma
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
| | - Longqian Liu
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
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Li X, Xu M, San S, Bian L, Li H. Orthokeratology in controlling myopia of children: a meta-analysis of randomized controlled trials. BMC Ophthalmol 2023; 23:441. [PMID: 37907884 PMCID: PMC10617145 DOI: 10.1186/s12886-023-03175-x] [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: 11/15/2022] [Accepted: 10/13/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Delaying the development and lowering the progression of myopia in children is the focus of current ophthalmology researches. We aimed to evaluate the role of orthokeratology in controlling myopia of children, to provide insights to the clinical treatment and care of children with myopia. METHODS Two investigators searched the The Cochrane Library, Embase, Pubmed, China national knowledge infrastructure, China biomedical literature database, WanFang and Weipu databases for randomized controlled trials(RCTs) on the role of orthokeratology in controlling myopia of children up to November 5, 2022. Two researchers independently searched, screened and extracted the studies according to the inclusion and exclusion standards. RevMan5.3 software was used for statistical analysis. RESULTS A total of 14 RCTs involving 2058 children were included in this meta-analysis. Synthesized outcomes indicated that orthokeratology improved the uncorrected visual acuity(MD = 0.40, 95%CI: 0.05 ~ 0.74), reduced the diopter change(MD=-3.19, 95%CI: -4.42~-1.95), changes of corneal curvature(MD=-3.21, 95%CI: -3.64~-2.79), the length of ocular axis (MD=-0.66, 95%CI: -1.27~-0.06) and amount of ocular axis change(MD=-0.42, 95%CI: -0.64~-0.21) after 1 year of wearing orthokeratology(all P < 0.05). Besides, orthokeratology reduced the diopter change (MD=-3.22, 95%CI: -4.86~-1.58), the length of ocular axis (MD=-1.15, 95%CI: -2.25~-0.06) and the amount of ocular axis change after 2 year of wearing orthokeratology (MD=-0.53, 95%CI: -0.96~-0.11) after 2 year of wearing orthokeratology (all P < 0.05). No publication biases were found amongst the synthesized outcomes (all P > 0.05). CONCLUSIONS Orthokeratology delays the progression of myopia in children, the long-term effects of orthokeratology need further investigations in future studies.
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Affiliation(s)
- Xue Li
- Department of nursing, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, China
| | - Meiling Xu
- Department of nursing, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, China
| | - Shanshan San
- Department of nursing, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, China
| | - Lanzheng Bian
- Department of nursing, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, China.
| | - Hui Li
- Department of nursing, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, China.
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Bullimore MA, Liu M. Efficacy of the Euclid orthokeratology lens in slowing axial elongation. Cont Lens Anterior Eye 2023; 46:101875. [PMID: 37365049 DOI: 10.1016/j.clae.2023.101875] [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: 05/26/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023]
Abstract
PURPOSE The Euclid Emerald lens designs for orthokeratology have been available in global markets for over 20 years and is used extensively by clinicians for slowing myopia progression in children. This paper comprehensively reviews data from published studies of the efficacy of this lens. METHODS A comprehensive systematic search was performed in March 2023 using Medline with the following search terms: orthokeratology AND myopi* AND (axial or elong*) NOT (review or meta). RESULTS The original search identified 189 articles, of which 140 reported axial elongation. Of those, 49 reported data on the Euclid Emerald design. Unique axial elongation data could be extracted from 37 papers-14 of which included an untreated control group. Among these, the mean 12-month efficacy-the difference in axial elongation between orthokeratology wearers and controls-was 0.18 mm (range: 0.05-0.29 mm), and the mean 24-month efficacy was 0.28 mm (range: 0.17-0.38 mm). The orthokeratology wearers in 23 studies without an untreated comparison group showed similar axial elongation to those in the 14 studies with a control group. For example, the mean 12-month axial elongation for the studies with controls was 0.20 ± 0.06 mm compared with 0.20 ± 0.07 mm for the studies without controls. CONCLUSIONS This extensive body of literature on a single device for myopia control is unique and demonstrates the efficacy of this design in slowing axial elongation in myopic children.
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Affiliation(s)
- Mark A Bullimore
- University of Houston, College of Optometry, 4901 Calhoun Rd., Houston, TX 77204, United States.
| | - Maria Liu
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, Berkeley, CA 94720, United States.
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Zhao W, Wang J, Chen J, Xie H, Yang J, Liu K, He X, Xu X. The rate of orthokeratology lens use and associated factors in 33,280 children and adolescents with myopia: a cross-sectional study from Shanghai. Eye (Lond) 2023; 37:3263-3270. [PMID: 37046055 PMCID: PMC10564736 DOI: 10.1038/s41433-023-02503-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 01/21/2023] [Accepted: 03/08/2023] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVES To investigate the rate of orthokeratology lens (ortho-k lens) use and its associated factors in children and adolescents with myopia. METHODS Cross-sectional study. Children from 104 primary and middle schools in Shanghai were enrolled by cluster sampling. Ophthalmic examinations were conducted and information was obtained using questionnaires for associated factors analysis. RESULTS A total of 72,920 children and adolescents were included, among which 32,259 were the potential population for ortho-k lens use. A total of 1021 participants used ortho-k lenses, equating to a use rate of 1.4% in the total population and 3.1% in the potential population. Age (OR 0.91, 95% CI: 0.88-0.95, p < 0.001), BMI (≥95th percentile: OR 0.48, 95% CI: 0.35-0.66, p < 0.001), age at initiation of refractive correction (≤12 years: OR 1.75, 95% CI: 1.31-2.33, p < 0.001), and parental myopia (either: OR 2.09, 95% CI: 1.58-2.75, p < 0.001; both: OR 3.94, 95% CI: 3.04-5.11, p < 0.001) were independently associated with ortho-k lens use. Of the ortho-k lenses users, 12.4% had a logMAR CVA of ≥0.3. A correction target (SE) of ≤-3.0 D (OR 2.05, 95% CI: 1.38-3.05, p < 0.001) and a sleeping duration of ≤6 h (OR 4.19, 95% CI: 2.03-8.64, p < 0.001) were factors independently associated with CVA ≥ 0.3. CONCLUSIONS A certain proportion of children and adolescents in Shanghai chose to wear ortho-k lenses, related to the situation of parents and children themselves. Health education and follow-ups should be strengthened to ensure orthokeratology application quality.
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Affiliation(s)
- Wenchen Zhao
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China
| | - Jingjing Wang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
| | - Jun Chen
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
| | - Hui Xie
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
| | - Jinliuxing Yang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China
| | - Kun Liu
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China
| | - Xiangui He
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China.
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China.
| | - Xun Xu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai Eye Hospital, Shanghai, 200040, China.
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China.
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Bai WL, Gan JH, Wei S, Li SM, An WZ, Liang XT, Tian JX, Yin L, Wang N. Effect of low-dose atropine eyedrops on pupil metrics: results after half a year of treatment and cessation. Graefes Arch Clin Exp Ophthalmol 2022; 261:1177-1186. [PMID: 36401652 PMCID: PMC9676878 DOI: 10.1007/s00417-022-05863-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/27/2022] [Accepted: 10/03/2022] [Indexed: 11/20/2022] Open
Abstract
Abstract
Purpose
To evaluate the effect of low-dose atropine eyedrops on pupil metrics.
Methods
This study was based on a randomized, double-masked, placebo-controlled, and cross-over trial in mainland China. In phase 1, subjects received 0.01% atropine or placebo once nightly. After 1 year, the atropine group switched to placebo (atropine-placebo group), and the placebo group switched to atropine (placebo-atropine group). Ocular parameters were measured at the crossover time point (at the 12th month) and the 18th month.
Results
Of 105 subjects who completed the study, 48 and 57 children were allocated into the atropine-placebo and placebo-atropine groups, respectively. After cessation, the photopic pupil diameter (PD) and mesopic PD both decreased (− 0.46 ± 0.47 mm, P < 0.001; − 0.30 ± 0.74 mm, P = 0.008), and the constriction ratio (CR, %) increased (4.39 ± 7.54, P < 0.001) compared with values at the crossover time point of the atropine-placebo group; pupil metrics of the atropine-placebo group had no difference from the values at the crossover time point of the placebo-atropine group. After 6 months of treatment, the photopic PD and the mesopic PD increased (0.54 ± 0.67 mm, P < 0.001; 0.53 ± 0.89 mm, P < 0.001), the CR (%) decreased (− 2.53 ± 8.64, P < 0.001) compared with values at the crossover time point of the placebo-atropine group. There was no significant relationship between pupil metrics and myopia progression during 0.01% atropine treatment.
Conclusion
Pupil metrics and the CR could return to pre-atropine levels after cessation. Pupil metrics had no significant effect on myopia progression during treatment.
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Chen X, Xiong Y, Qi X, Liu L. Nasal-temporal asymmetric changes in retinal peripheral refractive error in myopic adolescents induced by overnight orthokeratology lenses. Front Neurol 2022; 13:1006112. [PMID: 36938370 PMCID: PMC10017440 DOI: 10.3389/fneur.2022.1006112] [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: 08/02/2022] [Accepted: 10/07/2022] [Indexed: 03/06/2023] Open
Abstract
Objective To observe the changes in peripheral refraction in myopic adolescents after overnight orthokeratology and its influencing factors. Methods This was a prospective study among young myopic adolescents aged 8-14 years (n = 21). The peripheral refraction of the subjects was measured at 5, 10, 15, 20, 25, and 30° from the nasal and temporal side to the central fixation by WAM-5500 Open-field refractometer. The axial length, baseline spherical equivalent refraction, and other parameters were measured. The data were measured at baseline and 1, 3, and 12 months after wearing orthokeratology lenses. Results The relative peripheral refraction at the nasal and temporal side from central to 30° eccentricity revealed relative hyperopic defocus in all subjects at baseline measurement. One month after wearing the orthokeratology lenses, the relative peripheral refraction changed to myopic defocus, the nasal-temporal relative peripheral refraction was asymmetric, and the observed difference was statistically significant. Positive correlations were found between the change amount of nasal relative peripheral refraction and baseline spherical equivalent refraction, the baseline nasal relative peripheral refraction was higher than that on the temporal side, and after orthokeratology, the value of nasal relative peripheral refraction was lower than that on the temporal side. The changes at 30° on both sides were correlated to the axial elongation (rNasal = 0.565, rTemporal = 0.526, p < 0.05). Conclusion This study demonstrated that after orthokeratology, relative peripheral hyperopia in the myopic patients turned into relative peripheral myopia, and the nasal-temporal asymmetry changed significantly after orthokeratology, which was correlated with the baseline refractive state.
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Affiliation(s)
- Xiaohang Chen
- Laboratory of Optometry and Visual Science, Sichuan University, Chengdu, Sichuan, China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yan Xiong
- Department of Pediatrics, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Xinzhou Qi
- School of Management, Fudan University, Shanghai, China
| | - Longqian Liu
- Laboratory of Optometry and Visual Science, Sichuan University, Chengdu, Sichuan, China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- *Correspondence: Longqian Liu ;
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