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Wang Z, Chen J, Kang J, Niu T, Guo L, Fan L. Axial Length Control Is Associated With a Choroidal Thickness Increase in Myopic Adolescents After Orthokeratology. Eye Contact Lens 2023; 49:512-520. [PMID: 37728877 PMCID: PMC10659250 DOI: 10.1097/icl.0000000000001025] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE To investigate the changes in choroidal thickness and axial length after orthokeratology in adolescents with low-to-moderate myopia and to explore the relationship between choroidal thickness and axial length variation. METHODS Thirty eyes with low-to-moderate myopia were retrospectively studied, and optometric data were collected before and after 6 months of continuous orthokeratology. Axial length and choroidal and foveal thicknesses were measured using optical biometry and enhanced depth imaging-spectral domain optical coherence tomography, respectively. RESULTS Axial length in the low myopia group increased ( P <0.001) after 6 months of orthokeratology, and the variation was greater than that in the moderate myopia group ( P <0.05). The subfoveal choroidal thickness in low and moderate myopia groups increased ( P <0.01), and the variation was greater in the moderate myopia group ( P <0.05). Choroidal thickness in all seven measured spots increased, with the variation of subfovea, nasal 1 mm to fovea, and temporal 1 mm to fovea being statistically significant ( P <0.001, P <0.05, and P <0.05). The change in axial length was negatively associated with subfoveal and average choroidal thicknesses ( P <0.01). CONCLUSION Adolescents with moderate myopia presented better axial length control after 6 months of orthokeratology. The choroidal thickness of low and moderate myopic eyes increased, and the variation was more significant in moderate myopic eyes. The axial length control effects can be associated with an increase in the subfoveal and average choroidal thickness.
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Affiliation(s)
- Zhiqian Wang
- Department of Optometry (Z.W., L.F.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.C.), Shengjing Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.K., T.N.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Liaoning, China; and Department of Ophthalmology (L.G.), Shenyang Sinqi Eye Hospital, Shenyang, Liaoning, China
| | - Jingyi Chen
- Department of Optometry (Z.W., L.F.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.C.), Shengjing Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.K., T.N.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Liaoning, China; and Department of Ophthalmology (L.G.), Shenyang Sinqi Eye Hospital, Shenyang, Liaoning, China
| | - Jingxiong Kang
- Department of Optometry (Z.W., L.F.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.C.), Shengjing Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.K., T.N.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Liaoning, China; and Department of Ophthalmology (L.G.), Shenyang Sinqi Eye Hospital, Shenyang, Liaoning, China
| | - Tongtong Niu
- Department of Optometry (Z.W., L.F.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.C.), Shengjing Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.K., T.N.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Liaoning, China; and Department of Ophthalmology (L.G.), Shenyang Sinqi Eye Hospital, Shenyang, Liaoning, China
| | - Lei Guo
- Department of Optometry (Z.W., L.F.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.C.), Shengjing Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.K., T.N.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Liaoning, China; and Department of Ophthalmology (L.G.), Shenyang Sinqi Eye Hospital, Shenyang, Liaoning, China
| | - Liying Fan
- Department of Optometry (Z.W., L.F.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.C.), Shengjing Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China; Department of Ophthalmology (J.K., T.N.), Shenyang Eye Institute, The 4th People's Hospital of Shenyang, China Medical University, Liaoning, China; and Department of Ophthalmology (L.G.), Shenyang Sinqi Eye Hospital, Shenyang, Liaoning, China
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Peng T, Jiang J. Efficiency and Related Factors of Multifocal Soft Contact Lenses in Controlling Myopia. Eye Contact Lens 2023; 49:535-541. [PMID: 37990441 DOI: 10.1097/icl.0000000000001043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE To evaluate ocular changes in Chinese myopic children wearing multifocal soft contact lenses and explore their efficiency and related factors. METHOD This was a prospective, double-blind, randomized controlled study. A total of 36 myopic children aged 7 to 12 years were randomly divided into groups wearing multifocal soft contact lenses (MFCLs) or single-vision soft contact lenses (SVCLs) and followed up for 12 months. The spherical equivalent (SE), axial length (AL), choroidal thickness, and vascularity were measured before commencement and after 6 and 12 months of lens wear. Correlation between ocular changes and myopia progression was determined. RESULTS A total of 32 subjects (6 males and 26 females) completed the study and were included in the analysis. After 12 months of lens wear, both the AL elongation (0.25±0.22 vs. 0.43±0.16 mm, P=0.011) and the SE progression (-0.69±0.69 D vs. -1.45±0.56 D, P=0.002) of the MFCL group were significantly lower than those of the SVCL group. After 12 months, the progression of myopia was significantly correlated with changes of the choroid in the MFCL wearers, whereas no such correlation was observed in the SVCL group. CONCLUSION Multifocal soft contact lens can slow myopia progression, and this effect may be related to the changes of the choroid.
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Affiliation(s)
- Tianli Peng
- National Clinical Research Center for Ocular Diseases (T.P., J.J.), Eye Hospital, Wenzhou Medical University, Wenzhou, China; and State Key Laboratory of Ophthalmology (T.P., J.J.), Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
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Lian Y, Lu W, Xu A, Chen R, Lu Q, Zhou W, Mei L, Jin W. The correlation between modifications to corneal topography and changes in retinal vascular density and retinal thickness in myopic children after undergoing orthokeratology. Front Med (Lausanne) 2023; 10:1166429. [PMID: 37457580 PMCID: PMC10338965 DOI: 10.3389/fmed.2023.1166429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/09/2023] [Indexed: 07/18/2023] Open
Abstract
Purpose This study aimed to investigate the relationship among changes in corneal topography, retinal vascular density, and retinal thickness in myopic children who underwent orthokeratology for 3 months. Method Thirty children with myopia wore orthokeratology lenses for 3 months. Using optical coherence tomography angiography (OCTA), the retina was imaged as 6 × 6 mm en-face images at baseline and 3 months after orthokeratology. Cornea data was acquired by topography and analyzed by customer MATLAB software. The cornea was divided into 3 zones and 9 sectors. The relative corneal refractive power shift (RCRPS) was used in this study. Changes in retinal vascular density (RVDC) and retinal thickness change (RTC) were associated with RCRPS by using spearman test. Statistical significance was set at p < 0.05. Result A significant correlation was observed between the RVDC and the RCRPS in many regions (the r was 0.375 ~ 0.548, all p value <0.05). Significant positive correlations were found between RVDC in inner and outer temple regions with RCRPS at inner and outer nasal sectors. There were no significant correlations between RTC and RCRPS in other sectors except in the central cornea and the outer nasal retina (r:0.501, p:0.006). At baseline and 3 months after wearing the orthokeratology lens, no significant differences in the retinal microvasculature or thickness (p > 0.05) were observed at any regions. Conclusion The correlation between the cornea and the retina was observed after orthokeratology. Cornea changes may affect regional retinal responses accordingly,which may explain how orthokeratology delays myopia progression partially.
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Affiliation(s)
- Yan Lian
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Weiwei Lu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Aiqin Xu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Renai Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Qingqing Lu
- School of Ophthalmology, Optometry, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Weihe Zhou
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Lili Mei
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Wanqing Jin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- The First People’s Hospital of Aksu District in Xinjiang, Aksu City, China
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Amorim-de-Sousa A, Pauné J, Silva-Leite S, Fernandes P, Gozález-Méijome JM, Queirós A. Changes in Choroidal Thickness and Retinal Activity with a Myopia Control Contact Lens. J Clin Med 2023; 12:jcm12113618. [PMID: 37297813 DOI: 10.3390/jcm12113618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
PURPOSE The axial elongation in myopia is associated with some structural and functional retinal changes. The purpose of this study was to investigate the effect of a contact lens (CL) intended for myopia control on the choroidal thickness (ChT) and the retinal electrical response. METHODS Ten myopic eyes (10 subjects, 18-35 years of age) with spherical equivalents from -0.75 to -6.00 diopters (D) were enrolled. The ChT at different eccentricities (3 mm temporal, 1.5 mm temporal, sub-foveal ChT, 1.5 mm nasal, and 3 mm nasal), the photopic 3.0 b-wave of ffERG and the PERG were recorded and compared with two material-matched contact lenses following 30 min of wear: a single-vision CL (SV) and a radial power gradient CL with +1.50 D addition (PG). RESULTS Compared with the SV, the PG increased the ChT at all eccentricities, with statistically significant differences at 3.0 mm temporal (10.30 ± 11.51 µm, p = 0.020), in sub-foveal ChT (17.00 ± 20.01 µm, p = 0.025), and at 1.5 mm nasal (10.70 ± 14.50 µm, p = 0.044). The PG decreased significantly the SV amplitude of the ffERG photopic b-wave (11.80 (30.55) µV, p = 0.047), N35-P50 (0.90 (0.96) µV, p = 0.017), and P50-N95 (0.46 (2.50) µV, p = 0.047). The amplitude of the a-wave was negatively correlated with the ChT at 3.0T (r = -0.606, p = 0.038) and 1.5T (r = -0.748, p = 0.013), and the amplitude of the b-wave showed a negative correlation with the ChT at 1.5T (r = -0.693, p = 0.026). CONCLUSIONS The PG increased the ChT in a similar magnitude observed in previous studies. These CLs attenuated the amplitude of the retinal response, possibly due to the combined effect of the induced peripheral defocus high-order aberrations impacting the central retinal image. The decrease in the response of bipolar and ganglion cells suggests a potential retrograde feedback signaling effect from the inner to outer retinal layers observed in previous studies.
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Affiliation(s)
- Ana Amorim-de-Sousa
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
| | - Jaume Pauné
- Teknon Medical Center, 08022 Barcelona, Spain
- Faculty of Optics and Optometry Polytechnic, University of Catalonia, 08222 Terrassa, Spain
| | - Sara Silva-Leite
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
| | - Paulo Fernandes
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
- Physics Center of Minho and Porto Universities, CF-UM-UP, 4710-057 Braga, Portugal
| | - José Manuel Gozález-Méijome
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
- Physics Center of Minho and Porto Universities, CF-UM-UP, 4710-057 Braga, Portugal
| | - António Queirós
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
- Physics Center of Minho and Porto Universities, CF-UM-UP, 4710-057 Braga, Portugal
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Wang XQ, Chen M, Zeng LZ, Liu LQ. Investigation of retinal microvasculature and choriocapillaris in adolescent myopic patients with astigmatism undergoing orthokeratology. BMC Ophthalmol 2022; 22:382. [PMID: 36151522 PMCID: PMC9508713 DOI: 10.1186/s12886-022-02572-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/08/2022] [Indexed: 11/22/2022] Open
Abstract
Background To observe alterations of fundus microcirculation and retinal thickness in adolescent myopic patients with astigmatism after toric and spherical orthokeratology using optical coherence tomography angiography (OCTA), to explore the effects of orthokeratology on the retinal thickness and choroidal blood flow. Methods A total of 48 patients were enrolled and divided into two group (toric orthokeratology (T) group and spherical orthokeratology (S) group) according to the type of lens design. OCTA was used to measure the superficial and deep retinal vessel densities at the macular region, radial peripapillary capillary (RPC) density, foveal avascular zone (FAZ) area, and choriocapillaris (ChC) perfusion area before and after orthokeratology for 3 months. The data were statistically analyzed by SPSS 19.0 software. Results Compared with before orthokeratology, the superficial vessel density in the fovea and parafovea in the T group significantly increased, and the deep vessel density in the whole area and fovea were significantly elevated after 3 months (P < 0.05). The superficial vessel density was significantly higher only in the parafovea in the S group after 3 months than that before orthokeratology (P < 0.05), deep vessel density in the whole area and parafovea after 3 months was significantly higher than that before orthokeratology (P < 0.05). RPC density in the two groups increased after 3 months of orthokeratology in the whole area and inside the disc area (P < 0.05). Three months after toric orthokeratology, FAZ area in the T group was significantly reduced by 0.05 (− 0.41 to + 0.08) mm2, while ChC perfusion area was enlarged by 0.06 ± 0.12 mm2. FAZ area in the S group significantly decreased by 0.01 (− 0.19 to + 0.01) mm2, whereas ChC perfusion area increased by 0.06 (− 0.07 to + 0.50) mm2. Retinal thickness in the two groups increased after 3 months of orthokeratology in the whole area and parafoveal area (P < 0.05). Conclusion Orthokeratology improved retinal blood flow in macular area and RPC while controlling myopia. The changes in FAZ and ChC perfusion areas did not significantly differ between toric and spherical orthokeratology.
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Affiliation(s)
- Xiao-Qin Wang
- Department of Ophthalmology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, Sichuan Province, 610041, China.,The Department of Ophthalmology, Chengdu First People's Hospital/Chengdu Integrated TCM & Western Medicine Hospital, Chengdu, Sichuan Province, 610041, China
| | - Ming Chen
- The Department of Ophthalmology, Chengdu First People's Hospital/Chengdu Integrated TCM & Western Medicine Hospital, Chengdu, Sichuan Province, 610041, China
| | - Liu-Zhi Zeng
- The Department of Ophthalmology, Chengdu First People's Hospital/Chengdu Integrated TCM & Western Medicine Hospital, Chengdu, Sichuan Province, 610041, China
| | - Long-Qian Liu
- Department of Ophthalmology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, Sichuan Province, 610041, China.
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Chen X, Li Q, Liu L. Personalized Predictive Modeling of Subfoveal Choroidal Thickness Changes for Myopic Adolescents after Overnight Orthokeratology. J Pers Med 2022; 12:jpm12081316. [PMID: 36013265 PMCID: PMC9410041 DOI: 10.3390/jpm12081316] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/09/2022] [Accepted: 08/13/2022] [Indexed: 11/16/2022] Open
Abstract
The changes in subfoveal choroidal thickness after orthokeratology are crucial in myopia retardation; this study aimed to identify the risk factors that could be incorporated into a predictive model for subfoveal choroidal thickness (SFChT) that would provide further personalized and clinically specific information for myopia control. A one-year prospective study was conducted in the West China Hospital, Sichuan University. Basic information (age, gender, and height) was collected from all subjects. Initial spherical equivalent, axial length, intraocular pressure, central corneal thickness, and subfoveal choroidal thickness were measured, and the ocular environmental factors were also collected. All the measured parameters were recorded in the follow-up period for one year. After the analysis of univariate analysis, statistically significant factors were substituted into the multivariate three-level model. Thirty-three adolescents aged 8−14 years old were enrolled in this study; the results show that the subfoveal choroidal thickness in both eyes changed significantly after 12 months of lens wearing (pR < 0.0001, pL < 0.0001). The axial length was negatively correlated with the change in the SFChT after 12 months of lens wearing (r = −0.511, p = 0.002). After multilevel model analysis, the statistically significant factor was shown to have an important influence on the changes in the subfoveal choroidal thickness, which was the average near-work time. This suggested that the SFChT personal predictions can be made regarding changes in myopic adolescents after orthokeratology using the factor of daily average near-work time. Clinical practitioners will benefit from the results by obtaining a better understanding of the effects of orthokeratology on choroid and myopia progression.
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Affiliation(s)
- Xiaohang Chen
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu 610041, China
- The Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qiushi Li
- Department of Outpatient, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Longqian Liu
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu 610041, China
- The Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu 610041, China
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, China
- Correspondence:
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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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Choroidal thickness and choriocapillaris vascular density in myopic anisometropia. EYE AND VISION (LONDON, ENGLAND) 2021; 8:48. [PMID: 34857053 PMCID: PMC8638271 DOI: 10.1186/s40662-021-00269-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/11/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND This study aims to examine interocular differences in the choroidal thickness and vascular density of the choriocapillaris in anisometropic myopes and to further explore the relationship between choroidal blood flow and myopia. METHODS The sample comprised 44 participants with anisometropic myopia, aged 9 to 18 years, with normal best-corrected visual acuity. All participants underwent a series of examinations, including spherical equivalent refraction (SER) and axial length (AL), measured by a Lenstar optical biometer and optical coherence tomography angiography (OCTA) scanner. OCT measured the choroidal thickness, vascular density, and flow voids of the choriocapillaris, and a customized algorithm was implemented in MATLAB R2017a with the post-correction of AL. The choroidal thickness was measured at the fovea and 0.5, 1.0, 1.5, 2.0, 2.5, and 3.0 mm nasally, temporally, inferiorly, and superiorly to the fovea. The vascular density and the flow voids of the choriocapillaris were measured at a 0.6-mm-diameter central circle, and the 0.6-2.5 mm diameter circle in the nasal, temporal, inferior, and superior regions. Repeated-measured ANOVAs were used to analyze the interocular differences. Partial correlations with the K value and age adjustments were used to study the relationships between the choroidal thickness, the choriocapillaris vascular density and flow voids, the SER and AL. RESULTS The choroidal thickness of the more myopic eyes was significantly thinner than less myopic eyes (P ≤ 0.001), and the flow voids in the more myopic eyes were more than less myopic eyes (P = 0.002). There was no significant difference in the vascular density of the choriocapillaris between the more and less myopic eyes (P = 0.525). However, when anisometropia was more than 1.50 D, the vascular density of choriocapillaris in the more myopic eyes was significantly less than the less myopic eyes (P = 0.026). The interocular difference of the choroidal thickness was significantly correlated with the interocular difference in SER and AL in the center, superior, and inferior regions but not in the nasal or temporal regions. The interocular differences of the vascular density and the flow voids of the choriocapillaris were not correlated with the interocular difference of SER and AL. CONCLUSIONS The choroidal thickness is thinner in the more myopic eyes. The flow void is increased, and the vascular density of the choriocapillaris is reduced in the more myopic eyes of children with anisometropia exceeding 1.50 D.
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Loertscher M, Backhouse S, Phillips JR. Multifocal Orthokeratology versus Conventional Orthokeratology for Myopia Control: A Paired-Eye Study. J Clin Med 2021; 10:jcm10030447. [PMID: 33498877 PMCID: PMC7865534 DOI: 10.3390/jcm10030447] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 12/25/2022] Open
Abstract
We conducted a prospective, paired-eye, investigator masked study in 30 children with myopia (-1.25 D to -4.00 D; age 10 to 14 years) to test the efficacy of a novel multifocal orthokeratology (MOK) lens compared to conventional orthokeratology (OK) in slowing axial eye growth. The MOK lens molded a center-distance, multifocal surface onto the anterior cornea, with a concentric treatment zone power of +2.50 D. Children wore an MOK lens in one eye and a conventional OK lens in the fellow eye nightly for 18 months. Eye growth was monitored with non-contact ocular biometry. Over 18 months, MOK-treated eyes showed significantly less axial expansion than OK-treated eyes (axial length change: MOK 0.173 mm less than OK; p < 0.01), and inner axial length (posterior cornea to anterior sclera change: MOK 0.156 mm less than OK, p < 0.01). The reduced elongation was constant across different baseline progression rates (range -0.50 D/year to -2.00 D/year). Visual acuity was less in MOK vs. OK-treated eyes (e.g., at six months, MOK: 0.09 ± 0.01 vs. OK: 0.02 ± 0.01 logMAR; p = 0.01). We conclude that MOK lenses significantly reduce eye growth compared to conventional OK lenses over 18 months.
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Affiliation(s)
- Martin Loertscher
- School of Optometry and Vision Science, The University of Auckland, Auckland 1023, New Zealand;
- Institute für Optometrie, Fachhochschule Nordwestschweiz, 4600 Olten, Switzerland
| | - Simon Backhouse
- School of Medicine—Optometry, Deakin University, Geelong, VIC 3220, Australia;
| | - John R. Phillips
- School of Optometry and Vision Science, The University of Auckland, Auckland 1023, New Zealand;
- Department of Optometry, Asia University, Taichung 41354, Taiwan
- Correspondence: ; Tel.: +64-9-923-6073
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