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Lin W, Li N, Liu J, Zhang B, Wei R. Relative corneal refractive power shift and inter-eye differential axial growth in children with myopic anisometropia treated with bilateral orthokeratology. Graefes Arch Clin Exp Ophthalmol 2024; 262:1203-1213. [PMID: 37930444 PMCID: PMC10994874 DOI: 10.1007/s00417-023-06301-z] [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: 07/03/2023] [Revised: 10/19/2023] [Accepted: 10/26/2023] [Indexed: 11/07/2023] Open
Abstract
PURPOSE To investigate the relationship between relative corneal refractive power shift (RCRPS) and axial length growth (ALG) in bilateral myopic anisometropes treated with orthokeratology. METHODS A total of 102 children with myopic anisometropia in this prospective interventional study were randomly assigned to the spectacle group and orthokeratology group. Axial length (AL) and corneal topography was measured at baseline and the 12-month follow-up visit. ALG was defined as the difference between the two measurements, and RCRPS profiles were calculated from two axial maps obtained. RESULTS In the orthokeratology group, the ALG in the more myopic eye (0.06 ± 0.15 mm) was significantly smaller than that in the less myopic eye (0.15 ± 0.15 mm, p < 0.001), and the interocular difference in AL significantly decreased following 1-year treatment, from 0.47 ± 0.32 to 0.38 ± 0.28 mm (p < 0.001). However, in the spectacle group, the ALG was similar between the two eyes, and the interocular difference in AL did not change significantly over one year (all p > 0.05). The interocular difference in ALG in the orthokeratology group was significantly correlated with the interocular difference in RCRPS (dRCRPS, β=-0.003, p < 0.001) and the interocular difference in baseline AL (β=-0.1179, p < 0.001), with R2 being 0.6197. CONCLUSION Orthokeratology was effective in decreasing the magnitude of anisometropia. The interocular variation in RCRPS is an important factor accounting for the reduction of interocular ALG difference in anisomyopic children post-orthokeratology. These results provide insight into establishing eye-specific myopia control guidelines during orthokeratology treatment for myopic anisometropes.
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Affiliation(s)
- 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
| | - 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
| | - Jiahe Liu
- 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
| | - Bin Zhang
- College of Optometry, Nova Southeastern University, Davie, FL, USA.
| | - 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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Guo Y, Zhang M, Tong Y, Ma X, Wang S, Li Y, Du Y, Zhou Y. Impact of pupil and defocus ring intersection area on retinal defocus. Ophthalmic Physiol Opt 2024; 44:472-480. [PMID: 38234008 DOI: 10.1111/opo.13276] [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: 08/09/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/19/2024]
Abstract
PURPOSE With the rising prevalence of myopia, especially among the young, orthokeratology (Ortho-K) stands out as a promising approach, not only to reduce myopia but also to control the progression of axial length (AL). This study examined how the intersection area between the pupil and defocus ring influenced retinal defocus and axial growth after Ortho-K. METHODS A case-control study was conducted with 100 participants (100 eyes). Both AL and the refraction difference value (RDV), that is, the peripheral refractive error measured with respect to the central value after wearing Ortho-K lenses, were determined. Subjects were categorised into two groups based on the size of the intersection area after 3 months of lens wear: Group A (<4.58 mm2 ) and Group B (≥4.58 mm2 ). RESULTS Group B demonstrated significantly lower changes in AL and RDV at 30-40° and 40-53° compared with Group A after 3 months of lens wear (all p < 0.05). After 6 months of lens wear, Group B showed significantly lower changes in AL and RDV in the 40-53° region compared with Group A (all p < 0.05). Correlation analysis revealed that as the intersection area increased, the changes in AL and RDV at 0-53°, 30-40° and 40-53° eccentricity decreased after both 3 and 6 months of lens wear (all p < 0.01). CONCLUSIONS A larger intersection area between the pupil and defocus ring within a certain time period can cause a greater amount of myopic defocus at 30-53° from the fovea. The results suggest that a larger intersection area might lead to more effective control of axial growth.
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Affiliation(s)
- Yujuan Guo
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
- Ophthalmology Beijing Ming Vision, Beijing, China
- Ineye Hospital of Chengdu University of Traditional Medicine, Chengdu, China
| | - Mingxu Zhang
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
| | - Yuting Tong
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
| | - Xiaoqi Ma
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
| | - Siyao Wang
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
| | - Yu Li
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
- Ineye Hospital of Chengdu University of Traditional Medicine, Chengdu, China
| | - Yuqin Du
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
- Ophthalmology Beijing Ming Vision, Beijing, China
| | - Yuehua Zhou
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
- Ophthalmology Beijing Ming Vision, Beijing, China
- Ineye Hospital of Chengdu University of Traditional Medicine, Chengdu, China
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Xue M, Lin Z, Wu H, Xu Q, Wen L, Luo Z, Hu Z, Li X, Yang Z. Two-Dimensional Peripheral Refraction and Higher-Order Wavefront Aberrations Induced by Orthokeratology Lenses Decentration. Transl Vis Sci Technol 2023; 12:8. [PMID: 37824110 PMCID: PMC10587852 DOI: 10.1167/tvst.12.10.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 07/27/2023] [Indexed: 10/13/2023] Open
Abstract
Purpose The purpose of this study was to explore two-dimensional peripheral refraction and higher-order aberrations (HOAs) induced by orthokeratology lens decentration. Methods Two-dimensional peripheral refraction and HOAs in a rectangular field (horizontally 60 degrees and vertically 36 degrees) were obtained using an open-view Hartmann-Shack wavefront sensor. The peripheral field was divided into 8 regions according to a combination of superior (UZ) or inferior (LZ) and a value, 1 (T25 to T30), 2 (T20 to T25), 3 (N20 to N25), or 4 (N25 to N30). The decentration of the lens was evaluated based on the change of power in the front of the tangential corneal map. All measurements were taken at the baseline and 1 month after lens fitting. Results In total, 134 myopic children (age = 12.47 ± 1.70 years, SER = -2.44 ± 1.10 diopters [D]) were recruited. In general, horizontally asymmetrical change was observed in relative peripheral refraction (RPR), spherical aberration (SA), and horizontal coma. The root-mean square of higher order aberration (RMSHOA) and vertical coma demonstrated radial symmetrical change and vertically asymmetric change, respectively. Relative peripheral myopia was significantly increased after the treatment, with more myopic refraction in the temporal side. RPR changes in UZ2, UZ3, UZ4, LZ1, and LZ2 were related to the amount of lens decentration (r ≈ 0.4, P < 0.05). All HOAs increased after lens fitting (around 0.03 um, 0.02 um, 0.04 um, and 0.41 um for SA, horizontal COMA, vertical COMA, and RMSHOA in the periphery region). Conclusions RPR and HOAs are related to lens decentration, which might contribute to the efficacy of orthokeratology. Translational Relevance The study found a decentration-related optical feature after 1 month of lens wear, which is a suggested protective factor in myopia treatment. The findings might provide new insights for customized contact lens myopia treatment based on optics.
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Affiliation(s)
- Minsong Xue
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Zhenghua Lin
- Aier School of Ophthalmology, Central South University, Changsha, China
- Aier Eye Hospital Group, Changsha, China
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo, Murcia, Spain
| | - Haoran Wu
- Aier Eye Hospital Group, Changsha, China
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Hunan Province, China
| | - QingLin Xu
- Jinan University, Guangzhou, China
- Changsha Aier Eye Hospital, Changsha, China
| | - Longbo Wen
- Aier Eye Hospital Group, Changsha, China
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Hunan Province, China
| | - Zhiwei Luo
- Aier Institute of Optometry and Vision Science, Changsha, China
| | - Ziqi Hu
- Aier Institute of Optometry and Vision Science, Changsha, China
| | - Xiaoning Li
- Changsha Aier Eye Hospital, Changsha, China
- Aier Institute of Optometry and Vision Science, Changsha, China
- Aier College of Ophthalmology & Optometry, Hubei University of Science and Technology, Xianning, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China
| | - Zhikuan Yang
- Aier School of Ophthalmology, Central South University, Changsha, China
- Changsha Aier Eye Hospital, Changsha, China
- Aier Institute of Optometry and Vision Science, Changsha, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China
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Zhao GP, Zhai HT, Xiang HZ, Wu LM, Chen QO, Chen C, Zhou M. Biomechanical study of cornea response under orthokeratology lens therapy: A finite element analysis. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2023; 39:e3691. [PMID: 36799066 DOI: 10.1002/cnm.3691] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Orthokeratology (OK) is becoming a mainstream modality for myopia correction and control, but its underlying mechanism is not yet fully understood. In this study, the biomechanical response of cornea under the OK lens was investigated to further understand the mechanism of OK therapy. Numerical models of the cornea and OK lens with different corneal refractive powers and myopia degrees were established to analyze features and differences of the spatial displacement and stress distribution in different areas of the anterior corneal surface by finite element method. Displacement distributions on the anterior cornea surface with refractive powers of 39.5, 43, 46 D, and myopia degrees of -1.0, -3.0, -6.0 D demonstrate similar deformation trends and nearly rotationally symmetrical attributes of different corneal parameters. Displacement of mid-peripheral cornea was significantly high compared with that of the central and peripheral cornea, peaking at ~2.4 mm off the corneal apex. The stress increased with the increase in myopia degrees and was significantly large for the myopia degrees of -6.0 D at S1; the stress at S2 and S6 was low and stable and did not differ much at S3; the stress at S4 and S5, however, was extremely high. In summary, simulation result of orthokeratology can effectively evaluate the performance of OK lens and it properly associates with the differential map of the corneal topography. The base curve of the OK lens may also play a role in mid-peripheral corneal steepening. The design around the OK lens' alignment curve needs to be optimized.
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Affiliation(s)
- Gai-Ping Zhao
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Hai-Tao Zhai
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Hua-Zhong Xiang
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Li-Ming Wu
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Qi-Ou Chen
- MicroPort Vision Power MedTech (Shanghai) Co., Ltd, Shanghai, China
| | - Chi Chen
- MicroPort Vision Power MedTech (Shanghai) Co., Ltd, Shanghai, China
| | - Meng Zhou
- MicroPort Vision Power MedTech (Shanghai) Co., Ltd, Shanghai, China
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