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Yu J, Guo Y, Zhou Y. Comparison of the Effects of Orthokeratology and Highly Aspherical Lenselets in Achieving Myopia Control and Defocus in Adolescents. Eye Contact Lens 2024; 50:445-454. [PMID: 39250694 DOI: 10.1097/icl.0000000000001124] [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: 07/25/2024] [Indexed: 09/11/2024]
Abstract
OBJECTIVES To compare the control effectiveness and periretinal defocus between orthokeratology (OK) and highly aspherical lenslets (HAL) in adolescents with myopia. METHODS In this prospective study, 211 children (211 right eyes) were enrolled in Beijing Ming Vision and Ophthalmology between October 2022 and February 2023. Based on the myopia correction method, participants were divided into three groups: OK, HAL, and single-vision spectacles (SVS). They were further divided into two subgroups according to the spherical equivalent (SE), namely, subgroup A with -1.0≤SE≤-2.0 D and subgroup B with -2.0 RESULTS Axial length growth in those with OK lenses and HAL was lower than what was observed for those with SVS after 6, 9, and 12 months. Comparison of the difference in AL change between OK and HAL was not statistically significant with -1.0≤SE≤-2.0 D. The myopic defocus of RDV270° to 300° in group HAL was higher than that in group OK, the difference was statistically significant ( P <0.05), and in other regions, the myopic defocus was higher in the group OK. Em, SRI (corneal regularity index), variation in cell area, and corneal thickness were significantly associated with shaping force. CONCLUSIONS Orthokeratology is one of the most effective optical treatments for controlling myopia, and the factors that affect the corneal shaping force under different corneal parameters are different. For mild myopia, HAL can achieve the same effectiveness as OK.
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Affiliation(s)
- Jia Yu
- Ming Vision and Ophthalmology (J.Y., Y.Z.), Jianguomen Branch Clinic, Beijing, China; and Eye School of Chengdu University of TCM (Y.G., Y.Z.), Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
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Wang J, Cheung SW, Bian S, Wang X, Liu L, Cho P. Anisomyopia and orthokeratology for myopia control - Axial elongation and relative peripheral refraction. Ophthalmic Physiol Opt 2024; 44:1261-1269. [PMID: 38989808 DOI: 10.1111/opo.13365] [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: 11/12/2023] [Revised: 06/29/2024] [Accepted: 06/29/2024] [Indexed: 07/12/2024]
Abstract
PURPOSE To investigate axial elongation (AE) and changes in relative peripheral refraction (RPR) in anisomyopic children undergoing orthokeratology (ortho-k). METHODS Bilateral anisomyopic children, 7-12 years of age, were treated with ortho-k. Axial length (AL) and RPR, from 30° nasal (N30°) to 30° temporal (T30°), were measured at baseline and every 6 months over the study period. AE, changes in RPR and changes in the interocular AL difference were determined over time. RESULTS Twenty-six of the 33 subjects completed the 2-year study. The AE of the higher myopic (HM) eyes (at least 1.50 D more myopia than the other eye) (0.26 ± 0.29 mm) was significantly smaller than for the less myopic (LM) eyes (0.50 ± 0.27 mm; p = 0.003), leading to a reduction in the interocular difference in AL (p = 0.001). Baseline RPR measurements in the HM eyes were relatively more hyperopic at T30°, N20° and N30° (p ≤ 0.02) and greater myopic shifts were observed at T20° (p < 0.001), T30° (p < 0.001), N20° (p = 0.02) and N30° (p = 0.01) after lens wear. After 2 years of ortho-k lens wear, temporal-nasal asymmetry increased significantly, being more myopic at the temporal locations in both eyes (p < 0.001), while AE was associated with the change in RPR at N20° (β = 0.134, p = 0.01). The interocular difference in AE was also positively associated with the interocular difference in RPR change at N30° (β = 0.111, p = 0.02). CONCLUSIONS Ortho-k slowed AE in bilateral anisomyopia, with slower growth in the HM eyes leading to a reduction in interocular AL differences. After ortho-k, RPR changed from hyperopia to myopia, with greater changes induced in the HM eyes, and slower AE was associated with a more myopic shift in RPR, especially in the nasal field of both eyes.
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Affiliation(s)
- Jianglan Wang
- Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu, China
| | - Sin Wan Cheung
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
| | - Siyu Bian
- Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu, China
| | - Xingyu Wang
- Chengdu Huashi Jingwei Science and Technology Co., Ltd, Chengdu, China
| | - Longqian Liu
- Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu, China
| | - Pauline Cho
- Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu, China
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
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Hu HL, Li SZC, Feng AY, Zhong HX, Mu JF, Liu MZ. Relative peripheral refraction in school children with different refractive errors using a novel multispectral refraction topographer. Int J Ophthalmol 2024; 17:1477-1482. [PMID: 39156781 PMCID: PMC11286443 DOI: 10.18240/ijo.2024.08.13] [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: 12/13/2023] [Accepted: 05/10/2024] [Indexed: 08/20/2024] Open
Abstract
AIM To compare relative peripheral refraction (RPR) in Chinese school children with different refractive errors using multispectral refraction topography (MRT). METHODS A total of 713 eyes of primary school children [172 emmetropia (E), 429 low myopia (LM), 80 moderate myopia (MM), and 32 low hypermetropia (LH)] aged 10 to 13y were analyzed. RPRs were measured using MRT without mydriasis. MRT results showed RPR at 0-15° (RPR 0-15), 15°-30° (RPR 15-30), and 30°-45° (RPR 30-45) annular in the inferior (RPR-I), superior (RPR-S), nasal (RPR-N), and temporal (RPR-T) quadrants. Spherical equivalent (SE) was detected and calculated using an autorefractor. RESULTS There were significant differences of RPR 15-30 between groups MM [0.02 (-0.12; 0.18)] and LH [-0.13 (-0.36; 0.12)] (P<0.05), MM and E [-0.06 (-0.20; 0.10)] (P<0.05), and LM [-0.02 (-0.15; 0.15)] and E (P<0.05). There were also significant differences of RPR 30-45 between groups MM [0.45 (0.18; 0.74)] and E [0.29 (-0.09; 0.67)] (P<0.05), and LM [0.44 (0.14; 0.76)] and E (P<0.001). RPR values increased from the hyperopic to medium myopic group in each annular. There were significant differences of RPR-S between groups MM [-0.02 (-0.60; 0.30)] and E [-0.44 (-0.89; -0.04)] (P<0.001), and LM [-0.28 (-0.71; 0.12)] and E (P<0.05). There were also significant differences of RPR-T between groups MM [0.37 (0.21; 0.78)] and LH [0.14 (-0.52; 0.50)] (P<0.05), LM [0.41 (0.06; 0.84)] and LH (P<0.05), and LM and E [0.29 (-0.10; 0.68), P<0.05]. A Spearman's correlation analysis showed a negative correlation between RPR and SE in the 15°-30° (P=0.005), 30°-45° (P<0.05) annular (P=0.002), superior (P<0.001), and temporal (P=0.001) quadrants. CONCLUSION Without pupil dilation, values for RPR 15-30, 30-45, RPR-S, and T shows significant differences between myopic eyes and emmetropia, and the differences are negatively correlated with SE.
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Affiliation(s)
- Hui-Ling Hu
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, Guangdong Province, China
| | | | - Ai-Ying Feng
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, Guangdong Province, China
| | - Hao-Xi Zhong
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, Guangdong Province, China
| | - Jing-Feng Mu
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, Guangdong Province, China
| | - Mei-Zhou Liu
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen 518040, Guangdong Province, China
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Sun Y, Sha Y, Yang J, Fu H, Hou X, Li Z, Xie Y, Wang G. Collagen is crucial target protein for scleral remodeling and biomechanical change in myopia progression and control. Heliyon 2024; 10:e35313. [PMID: 39170348 PMCID: PMC11336648 DOI: 10.1016/j.heliyon.2024.e35313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 07/25/2024] [Accepted: 07/26/2024] [Indexed: 08/23/2024] Open
Abstract
In recent decades, the prevalence of myopia has been on the rise globally, attributed to changes in living environments and lifestyles. This increase in myopia has become a significant public health concern. High myopia can result in thinning of the sclera and localized ectasia of the posterior sclera, which is the primary risk factor for various eye diseases and significantly impacts patients' quality of life. Therefore, it is essential to explore effective prevention strategies and programs for individuals with myopia. Collagen serves as the principal molecule in the extracellular matrix (ECM) of scleral tissue, consisting of irregular collagen fibrils. Collagen plays a crucial role in myopia progression and control. During the development of myopia, the sclera undergoes a thinning process which is primarily influenced by collagen expression decreased and remodeled, thus leading to a decrease in its biomechanical properties. Improving collagen expression and promoting collagen crosslinking can slow down the progression of myopia. In light of the above, improving collagen expression or enhancing the mechanical properties of collagen fibers via medication or surgery represents a promising approach to control myopia.
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Affiliation(s)
- Yun Sun
- School of Life Science and Technology, Shandong Second Medical University, Weifang, 261053, China
| | - Yaru Sha
- School of Life Science and Technology, Shandong Second Medical University, Weifang, 261053, China
| | - Jing Yang
- School of Life Science and Technology, Shandong Second Medical University, Weifang, 261053, China
| | - Hong Fu
- School of Life Science and Technology, Shandong Second Medical University, Weifang, 261053, China
| | - Xinyu Hou
- School of Life Science and Technology, Shandong Second Medical University, Weifang, 261053, China
| | - Zhuozheng Li
- School of Life Science and Technology, Shandong Second Medical University, Weifang, 261053, China
| | - Yongfang Xie
- School of Life Science and Technology, Shandong Second Medical University, Weifang, 261053, China
| | - Guohui Wang
- School of Life Science and Technology, Shandong Second Medical University, Weifang, 261053, China
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Yang Y, Xue M, Hao J, Lin Z, Xi X, Wu H, Wen L, Xu Q, Luo Z, Ran G, Artal P, Lan W, Li X, Yang Z. Frequency-dependent effects of 0.05% atropine eyedrops on myopia progression and peripheral defocus: a prospective study. EYE AND VISION (LONDON, ENGLAND) 2024; 11:26. [PMID: 39085950 PMCID: PMC11293060 DOI: 10.1186/s40662-024-00395-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 06/19/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Atropine, specifically 0.05% eyedrops, has proven effective in slowing myopia progression. This study aims to investigate peripheral refraction (PR) characteristics in myopic children treated with 0.05% atropine eyedrops at different frequencies. METHODS One hundred thirty-eight myopic children completed this one-year prospective study, randomly assigned to once daily (7/7), twice per week (2/7), or once per week (1/7) groups. Spherical equivalent (SE) and axial length (AL) were measured. PR was assessed using a custom-made Hartmann-Shack wavefront peripheral sensor, covering a visual field of horizontal 60° and vertical 36°. Relative peripheral refraction (RPR) was calculated by subtracting central from peripheral measurements. RESULTS After one year, SE increased more significantly in the 1/7 group compared to the 7/7 group (P < 0.001) and 2/7 group (P = 0.004); AL elongation was also greater in the 1/7 group compared to the 7/7 group (P < 0.001). In comparison with higher frequency groups, 1/7 group exhibited more myopic PR in the fovea and its vertical superior, inferior, and nasal retina; and less myopic RPR in the periphery retina after one-year (P < 0.05). Additionally, RPR in the 7/7 group demonstrated myopic shift across the entire retina, the 2/7 group in temporal and inferior retina, while the 1/7 group showed a hyperopic shift in the superior retina (P < 0.05). Moreover, myopic shift of RPR in the temporal retina is related to less myopia progression, notably in the 7/7 group (P < 0.05). CONCLUSIONS Atropine inhibits myopia progression in a frequency-dependent manner. The once-daily group showed the slowest myopia progression but exhibited more myopic shifts in RPR. Additionally, RPR in the temporal retina was related to myopia progression in all groups. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR2100043506. Registered 21 February 2021, https://www.chictr.org.cn/showproj.html?proj=122214.
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Affiliation(s)
- Yuanfang Yang
- Aier School of Ophthalmology, Central South University, Changsha, 410015, China
| | - Minsong Xue
- Aier School of Ophthalmology, Central South University, Changsha, 410015, China
| | - Jiangdong Hao
- Aier School of Ophthalmology, Central South University, Changsha, 410015, China
| | - Zhenghua Lin
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo, 30100, Murcia, Spain
| | - Xiaoyun Xi
- Aier School of Ophthalmology, Central South University, Changsha, 410015, China
| | - Haoran Wu
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
| | - Longbo Wen
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
| | - Qinglin Xu
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
| | - Zhiwei Luo
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
| | - Guangyao Ran
- Aier School of Ophthalmology, Central South University, Changsha, 410015, China
| | - Pablo Artal
- Aier School of Ophthalmology, Central South University, Changsha, 410015, China
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo, 30100, Murcia, Spain
| | - Weizhong Lan
- Aier School of Ophthalmology, Central South University, Changsha, 410015, China
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China
| | - Xiaoning Li
- Changsha Aier Eye Hospital, Changsha, 410015, China.
- School of Stomatology and Ophthalmology, Xianning Medical College, Hubei University of Science and Technology, Xianning, 437000, China.
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China.
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, 410015, China.
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, 410015, China.
| | - Zhikuan Yang
- Aier School of Ophthalmology, Central South University, Changsha, 410015, China.
- Aier Institute of Optometry and Vision Science, Changsha, 410015, China.
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, 410015, China.
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, 410015, China.
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Wu Y, Liu X, Liu Y, Qian W, Huang L, Wu Y, Wang X, Yuan Y, Ke B. Assessment of OCT-Based Macular Curvature and Its Relationship with Macular Microvasculature in Children with Anisomyopia. Ophthalmol Ther 2024; 13:1909-1924. [PMID: 38743158 PMCID: PMC11178709 DOI: 10.1007/s40123-024-00956-5] [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: 03/09/2024] [Accepted: 04/16/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION To evaluate the intraocular differences in optical coherence tomography (OCT)-based macular curvature index (MCI) among children with anisomyopia and to investigate the relationship between MCI and the macular microvasculature. METHODS Fifty-two schoolchildren with anisometropia > 2.00 D were enrolled and underwent comprehensive examinations including cycloplegic refraction, axial length (AL), and swept source OCT/OCT angiography. OCT-based MCIs were determined from horizontal and vertical B-scans by a customized curve fitting model in MATLAB R2022 at 1-mm-, 3-mm-, and 6-mm-diameter circles at fovea. Characteristics and topographic variation of MCI was analyzed, and the relationships with microvascularity and its associated factors were investigated. RESULTS MCI achieved high reliability and repeatability. There were overall larger MCIs in the more myopic eyes than the less myopic eyes in 1-mm-, 3-mm-, and 6-mm-diameter circles at fovea (all p < 0.001). For the topographic variation, horizontal MCI was significantly greater than vertical MCI (all p < 0.001), and was the largest in 6-mm circle, followed by 3-mm and 1-mm circles. Stronger correlation of horizontal MCI with myopic severity than vertical MCI was found. Partial Pearson's correlation found MCI was negatively associated with deep capillary plexus (DCP) vessel density (p = 0.016). Eyes with a higher MCI in a 6-mm circle were more likely to have longer AL (p < 0.001), lower DCP vessel density (p = 0.037), and thinner choroidal thickness (ChT) (p = 0.045). CONCLUSION Larger MCI was found in the more myopic eyes of children with anisomyopia and was significantly associated with smaller DCP density, suggesting that MCI was an important indicator of myopia-related retinal microvascularity change, and it could be a valuable metric for myopia assessment in children.
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Affiliation(s)
- Yue Wu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Xin Liu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Yuying Liu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Wenzhe Qian
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Liandi Huang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Yixiang Wu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Xuetong Wang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Ying Yuan
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Hongkou District, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Bilian Ke
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Hongkou District, Shanghai, China.
- Department of Ophthalmology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
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Wu Y, Kou J, Lei S, Xiong L, Chen Q, Zhang M, Liu L. Effect of Individualized Ocular Refraction Customization Spectacle Lens Wear on Visual Performance in Myopic Chinese Children. Transl Vis Sci Technol 2024; 13:21. [PMID: 38922628 PMCID: PMC11216273 DOI: 10.1167/tvst.13.6.21] [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: 03/19/2024] [Accepted: 05/18/2024] [Indexed: 06/27/2024] Open
Abstract
Purpose Individualized ocular refraction customization (IORC) lenses can be individually adjusted depending on the initial relative peripheral refraction to determine the myopic defocus (MD). We aimed to compare visual performance of children wearing IORC lenses with different amounts of MD to determine whether higher MD resulted in greater visual compromise. Methods This study included 184 myopic children aged eight to 12 years, and 172 completed the trial. The participants were randomly assigned to wear IORC lenses with low (IORC-L, 2.50 D), medium (IORC-M, 3.50 D), or high (IORC-H, 4.50 D) MD or single-vision spectacle lenses (SVL). Distance and near best-corrected visual acuity (BCVA), contrast sensitivity function (CSF) and questionnaires were evaluated at baseline and after six and 12 months. Results CSF over all frequencies and distance and near BCVA were not affected by lens design (all P > 0.05). The SVL group outperformed the three IORC lens groups in terms of ghosting images at baseline, and IORC-H and IORC-M groups outperformed IORC-L group (all P < 0.001); however, no differences were observed at the six- or 12-month visit. There were no significant differences among the four groups for any other subjective variables at any of the follow-up visits regarding vision clarity, vision stability, eyestrain, dizziness, headache, or overall vision satisfaction (all P > 0.05). Conclusions The IORC lenses with an actual MD of 4.50 D provided acceptable objective and subjective visual performance and were well tolerated by children. Translational Relevance IORC lenses with an actual MD of 4.50 D provided acceptable visual performance.
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Affiliation(s)
- Ye Wu
- Department of Ophthalmology, Laboratory of Optometry and Vision Sciences, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Ji Kou
- Department of Ophthalmology, Laboratory of Optometry and Vision Sciences, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Si Lei
- Department of Ophthalmology, Laboratory of Optometry and Vision Sciences, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Ling Xiong
- Department of Ophthalmology, Laboratory of Optometry and Vision Sciences, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Qian Chen
- Center of Biostatistics, Design, Measurement and Evaluation, Department of Clinical Research Management, West China Hospital of Sichuan University, Chengdu, Sichuan, P.R. China
| | - Meixia Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China. Research Laboratory of Macular Disease, West China Hospital, Sichuan University, Chengdu, China
| | - Longqian Liu
- Department of Ophthalmology, Laboratory of Optometry and Vision Sciences, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, Sichuan, P.R. China
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Tang T, Lu Y, Li X, Zhao H, Wang K, Li Y, Zhao M. Comparison of the long-term effects of atropine in combination with Orthokeratology and defocus incorporated multiple segment lenses for myopia control in Chinese children and adolescents. Eye (Lond) 2024; 38:1660-1667. [PMID: 38418604 PMCID: PMC11156845 DOI: 10.1038/s41433-024-02987-5] [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: 09/27/2023] [Revised: 01/13/2024] [Accepted: 02/05/2024] [Indexed: 03/01/2024] Open
Abstract
PURPOSE The aim of this study was to evaluate the efficacy of Orthokeratology (Ortho-K), defocus incorporated multiple segment (DIMS) lens, combined Ortho-K/atropine, and combined DIMS/atropine for myopia control in children. METHODS A retrospective study included 167 myopic children aged 6-14 years with a spherical equivalent refraction (SER) of -0.75 to -4.00 diopter treated with Ortho-K (OK, n = 41), combined Ortho-K/atropine (OKA, n = 43), DIMS (n = 41), or combined DIMS/atropine (DIMSA, n = 42). Axial length (AL) was measured at baseline and at 3, 6, 9 and 12 months. Axial elongation over time and between groups were analysed. RESULTS After 12 months, the AL change was 0.20 ± 0.12 mm, 0.12 ± 0.14 mm, 0.22 ± 0.14 mm, and 0.15 ± 0.15 mm in the OK, OKA, DIMS, and DIMSA, respectively. There was no significant difference in AL change between OK and DIMS. OKA and DIMSA significantly slowed axial elongation compared to OK and DIMS monotherapy. After stratification by age, in the subgroup aged 6-10 years, there was significant difference in AL change between OKA and DIMS (p = 0.013), and no difference between other groups, while in the subgroup aged 10-14 years, the difference between OKA and DIMS became insignificant (p = 0.237), and the difference between OK and OKA, OK and DIMSA, DIMS and DIMSA became significant. CONCLUSIONS Ortho-K and DIMS lenses show similar reductions in myopia progression among children with low initial myopia. Atropine can significantly improve the efficacy of myopia control of both Ortho-K and DIMS lenses, and this add-on effect is better in older children.
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Affiliation(s)
- Tao Tang
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, 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
| | - Yuchang Lu
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, 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
| | - Xuewei Li
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, 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
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, 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
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China.
- Institute of Medical Technology, Peking University Health Science Center, Beijing, 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
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, 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
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, 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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9
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Pan S, Yuan J, Jin Y, Liu X, Wu S, Wang Y, Yao H, Cheng L. Innate immune responsive inflammation in development of progressive myopia. Eye (Lond) 2024; 38:1542-1548. [PMID: 38287111 PMCID: PMC11126664 DOI: 10.1038/s41433-024-02947-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: 03/16/2023] [Revised: 01/06/2024] [Accepted: 01/17/2024] [Indexed: 01/31/2024] Open
Abstract
PURPOSE Inflammation has been implicated for development of myopia. It is not clear when inflammation is kicked in during the course of myopia, and what characteristics of the inflammation. In this study, we tested for cytokines from aqueous humour of eyes with wide spectrum of refractive status for profiling the inflammation. METHODS Aqueous humour of 142 patient eyes were tested for soluble intercellular adhesion molecule 1 (sICAM-1), monocyte chemoattractant protein-1 (MCP-1), and transforming growth factor-beta 2 (TGF-β2) using an enzyme-linked immunosorbent assay (ELISA). Eye globe axial length of these patients ranged from emmetropia to high myopia. RESULTS Of 142 patients, an average axial length is 25.51 ± 3.31 mm, with a range of 21.56-34.37 mm. There are 36 cases in lower 25 percentile, 37 cases in upper 25 percentile, and 69 case in the middle 50 percentile. sICAM-1 and MCP-1 were significantly higher in the eyes with staphyloma (407.48 pg/mL, 312.31 pg/mL, n = 33) or macular schisis (445.86 pg/mL,345.33 pg/mL, n = 19) than that in the eyes without these changes (206.44 pg/mL, 244.76 pg/mL, n = 107). All three cytokines level was significantly associated with eye globe axial in a positive mode while adjusting for the age and sex. Strength of the association was the greatest for sICAM-1 and the weakest for TGF- β2. MCP-1 was in between. CONCLUSION sICAM-1 and MCP-1 in ocular fluid may be indicative biomarkers for progressive high myopia and the underneath autoimmune inflammation. sICAM-1 may be used as a monitoring biomarker for development of pathologic myopia.
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Affiliation(s)
- Suqi Pan
- The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, China
| | - Jianshu Yuan
- The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, China
| | - Yuanhui Jin
- Department of Ophthalmology, Dongyang People's Hospital, Dongyang, China
| | - Xiaotian Liu
- The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, China
| | - Shanjun Wu
- The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, China
| | - Yuwen Wang
- The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, China
| | - Hongyan Yao
- The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, China
| | - Lingyun Cheng
- Jacob's Retina Center at Shiley Eye Institute, Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA.
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10
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Cao K, Tian L, Ma DL, Zhao SQ, Li A, Jin ZB, Jie Y. Daily Low-Level Red Light for Spherical Equivalent Error and Axial Length in Children With Myopia: A Randomized Clinical Trial. JAMA Ophthalmol 2024; 142:560-567. [PMID: 38662345 PMCID: PMC11046409 DOI: 10.1001/jamaophthalmol.2024.0801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 02/19/2024] [Indexed: 04/26/2024]
Abstract
Importance Treatments are needed to slow progression of or reduce incidence of myopia. Objective To evaluate the efficacy and safety of daily 650-nm low-level red light (LLRL) for myopia treatment. Design, Setting, and Participants Single-masked, randomized clinical trial at 1 site in China. Baseline measurements were completed from August to September 2021. Participants were children aged 6 to 12 years with spherical equivalent error (SER) of -6 diopters (D) to 3 D. Data were analyzed from March to July 2023. Interventions Irradiation daily with 650-nm LLRL for 3 minutes twice daily 4 or more hours apart or no intervention. Main Outcomes and Measures Primary outcomes were changes in cycloplegia SER and axial length (AL) at 6- and 12-month follow-up visits. Safety was assessed on masked fundus photograph evaluations. Results A total of 336 children were randomly allocated into the LLRL group or control group in a 1:1 ratio. The control group contained 86 female patients (51.2%), and the treatment group contained 90 female patients (53.6%). The mean (SD) age, SER, and AL were 9.0 (1.9) years, -1.3 (1.5) D, and 23.8 (1.0) mm for all patients. A total of 161 (95.8%) in the LLRL group and 159 (94.6%) in the control group returned for the 6-month follow-up. A total of 157 (93.5%) in the LLRL group and 152 (90.5%) in the control group returned for the 12-month follow-up. Mean (SD) changes in SER were 0.15 (0.16) D and -0.26 (0.21) D for the LLRL group and the control group, respectively (difference, -0.41 D; 95% CI, -0.48 to -0.34 D; P < .001), at 6 months and 0.24 (0.27) D and -0.65 (0.33) D for the LLRL group and the control group, respectively (difference, -0.89 D; 95% CI, -0.95 to -0.83 D; P < .001), at 12 months. Mean (SD) changes in AL were -0.06 (0.08) mm and 0.13 (0.12) mm for the LLRL group and control group, respectively (difference, 0.19 mm; 95% CI, 0.16 to 0.22 mm; P < .001), at 6 months and -0.11 (0.10) mm and 0.26 (0.16) mm for the LLRL group and control group, respectively (difference, 0.37 mm; 95% CI, 0.34 to 0.40 mm; P < .001). Masked fundus photograph review did not identify retinal changes in either group. Conclusions and relevance These findings suggest daily use of 650-nm LLRL for 1 year can slow progression of SER and AL without safety concerns identified. Confirmation of these findings at independent sites seems warranted, as well as determining whether these effects can be sustained with or without continued treatment and whether LLRL has any effect on pathological myopia. Trial Registration ChiCTR2200058963.
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Affiliation(s)
- Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Lei Tian
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Dong-Li Ma
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Shi-Qiang Zhao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ao Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zi-Bing Jin
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ying Jie
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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11
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Eppenberger LS, Grzybowski A, Schmetterer L, Ang M. Myopia Control: Are We Ready for an Evidence Based Approach? Ophthalmol Ther 2024; 13:1453-1477. [PMID: 38710983 PMCID: PMC11109072 DOI: 10.1007/s40123-024-00951-w] [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: 02/19/2024] [Accepted: 04/11/2024] [Indexed: 05/08/2024] Open
Abstract
INTRODUCTION Myopia and its vision-threatening complications present a significant public health problem. This review aims to provide an updated overview of the multitude of known and emerging interventions to control myopia, including their potential effect, safety, and costs. METHODS A systematic literature search of three databases was conducted. Interventions were grouped into four categories: environmental/behavioral (outdoor time, near work), pharmacological (e.g., atropine), optical interventions (spectacles and contact lenses), and novel approaches such as red-light (RLRL) therapies. Review articles and original articles on randomized controlled trials (RCT) were selected. RESULTS From the initial 3224 retrieved records, 18 reviews and 41 original articles reporting results from RCTs were included. While there is more evidence supporting the efficacy of low-dose atropine and certain myopia-controlling contact lenses in slowing myopia progression, the evidence about the efficacy of the newer interventions, such as spectacle lenses (e.g., defocus incorporated multiple segments and highly aspheric lenslets) is more limited. Behavioral interventions, i.e., increased outdoor time, seem effective for preventing the onset of myopia if implemented successfully in schools and homes. While environmental interventions and spectacles are regarded as generally safe, pharmacological interventions, contact lenses, and RLRL may be associated with adverse effects. All interventions, except for behavioral change, are tied to moderate to high expenditures. CONCLUSION Our review suggests that myopia control interventions are recommended and prescribed on the basis of accessibility and clinical practice patterns, which vary widely around the world. Clinical trials indicate short- to medium-term efficacy in reducing myopia progression for various interventions, but none have demonstrated long-term effectiveness in preventing high myopia and potential complications in adulthood. There is an unmet need for a unified consensus for strategies that balance risk and effectiveness for these methods for personalized myopia management.
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Affiliation(s)
- Leila Sara Eppenberger
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Andrzej Grzybowski
- University of Warmia and Mazury, Olsztyn, Poland
- Institute for Research in Ophthalmology, Poznan, Poland
| | - Leopold Schmetterer
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Department, Duke-NUS Medical School, Singapore, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore
- School of Chemical and Biological Engineering, Nanyang Technological University, Singapore, Singapore
- Department of Clinical Pharmacology, Medical University Vienna, Vienna, Austria
- Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
- Ophthalmology and Visual Sciences Department, Duke-NUS Medical School, Singapore, Singapore.
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12
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Atchison DA, Charman WN. Optics of spectacle lenses intended to treat myopia progression. Optom Vis Sci 2024; 101:238-249. [PMID: 38857035 DOI: 10.1097/opx.0000000000002140] [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: 06/11/2024] Open
Abstract
SIGNIFICANCE This is a review of the optics of various spectacle lenses that have been used in myopia control over the last 60 years, with emphasis on approximately the last 15 years.Myopia has become an increasing health problem worldwide, particularly in some East Asian countries. This has led to many attempts to slow its progression in children and reduce its endpoint value. This review is concerned with the optics of spectacle lenses for use in myopia control, from bifocal lenses to multisegment and diffusion optics lenses. Treatments are based on theories of the onset or progression of myopia. These include the hypotheses that eye growth and myopia in susceptible children may be stimulated by (1) poor accommodation response and the consequent hyperopic defocus with near vision tasks, (2) relative hyperopic peripheral refraction, and (3) high retinal image contrast as occurs in urban environments. Using spectacle lenses to slow myopia progression has a history of about 60 years. The review is laid out in approximately the order in which different types of lenses have been introduced: bifocals, conventional progressive addition lenses, undercorrection with single-vision lenses, specialized progressive addition lenses, defocus-incorporated multiple segments, diffusion optics, and concentric bifocals. In the review, some of the lenses are combined with an eye model to determine refractive errors for peripheral vision for the stationary eye and for foveal vision for the rotating eye. Numbers are provided for the reported success of particular designs in retarding myopia progression, but this is not an epidemiological paper, and there is no critical review of the findings. Some of the recent treatments, such as multiple segments, appear to reduce the eye growth and myopia progression by better than 50% over periods of up to 2 years.
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Affiliation(s)
| | - W Neil Charman
- Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
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13
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Ma J, Yang X, Liu Z, Fu H, Fan S, Wang K, Li Y, Huang L, Zhao M. The Impact of Vergence Dysfunction on Myopia Control in Children Wearing Defocus Spectacle Lenses. Clin Ophthalmol 2024; 18:799-807. [PMID: 38495679 PMCID: PMC10944170 DOI: 10.2147/opth.s453731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/28/2024] [Indexed: 03/19/2024] Open
Abstract
Purpose To investigate the impact of vergence dysfunction on myopia progression in children with Defocus incorporated multiple segments (DIMS) spectacle lenses. Patients and Methods We retrospectively enrolled children prescribed DIMS spectacle lenses to slow myopic progression. Baseline vergence dysfunction was determined according to phoria at distance and near. Axial length (AL) measurement and cycloplegic subjective refraction were performed before fitting the lenses and at six-month and one-year follow-ups. The six-month and one-year AL and spherical equivalent (SE) change from baseline were calculated and compared in subgroups stratified with the type of vergence dysfunction. Results Two hundred and ninety-two myopic children were included. Significant AL elongation and SE progression were observed at six months and one year (P < 0.05 for all comparisons). Multiple regression demonstrated that AL elongation at six months (P < 0.001) and one year (P < 0.001) was negatively correlated with age, and SE progression at six months was associated with age (P = 0.002). The AL elongation at six months in children with convergence excess was significantly greater than in normal myopic subjects (P = 0.011) and subjects with convergence insufficiency (P = 0.008), divergence excess (P = 0.007), divergence insufficiency (P = 0.024) and basic esophoria (P = 0.048) at six months. Conclusion The present research demonstrated that vergence dysfunction influences myopia progression for myopic children with DIMS, and the children with convergence excess suffer from the greatest myopia progression among different types of vergence dysfunction.
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Affiliation(s)
- Jiahui Ma
- Department of Ophthalmology, Peking University People’s Hospital, Beijing, People’s Republic of China
- Eye Diseases and Optometry Institute, Peking University People’s Hospital, Beijing, People’s Republic of China
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, People’s Republic of China
- College of Optometry, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Xue Yang
- Department of Ophthalmology, Peking University International Hospital, Beijing, People’s Republic of China
| | - Zhiming Liu
- Department of Ophthalmology, Peking University People’s Hospital, Beijing, People’s Republic of China
- Eye Diseases and Optometry Institute, Peking University People’s Hospital, Beijing, People’s Republic of China
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, People’s Republic of China
- College of Optometry, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Hao Fu
- Department of Ophthalmology, Peking University People’s Hospital, Beijing, People’s Republic of China
- Eye Diseases and Optometry Institute, Peking University People’s Hospital, Beijing, People’s Republic of China
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, People’s Republic of China
- College of Optometry, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Sizhou Fan
- Department of Ophthalmology, Peking University People’s Hospital, Beijing, People’s Republic of China
- Eye Diseases and Optometry Institute, Peking University People’s Hospital, Beijing, People’s Republic of China
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, People’s Republic of China
- College of Optometry, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Kai Wang
- Department of Ophthalmology, Peking University People’s Hospital, Beijing, People’s Republic of China
- Eye Diseases and Optometry Institute, Peking University People’s Hospital, Beijing, People’s Republic of China
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, People’s Republic of China
- College of Optometry, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Yan Li
- Department of Ophthalmology, Peking University People’s Hospital, Beijing, People’s Republic of China
- Eye Diseases and Optometry Institute, Peking University People’s Hospital, Beijing, People’s Republic of China
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, People’s Republic of China
- College of Optometry, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Lvzhen Huang
- Department of Ophthalmology, Peking University People’s Hospital, Beijing, People’s Republic of China
- Eye Diseases and Optometry Institute, Peking University People’s Hospital, Beijing, People’s Republic of China
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, People’s Republic of China
- College of Optometry, Peking University Health Science Center, Beijing, People’s Republic of China
| | - Mingwei Zhao
- Department of Ophthalmology, Peking University People’s Hospital, Beijing, People’s Republic of China
- Eye Diseases and Optometry Institute, Peking University People’s Hospital, Beijing, People’s Republic of China
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, People’s Republic of China
- College of Optometry, Peking University Health Science Center, Beijing, People’s Republic of China
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14
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Wu J, Li X, Huang Y, Luo Y, Zhang S, Cui Z, Hou F, Bao J, Chen H. Effect of myopia-control lenses on central and peripheral visual performance in myopic children. Ophthalmic Physiol Opt 2024; 44:249-257. [PMID: 38071500 DOI: 10.1111/opo.13257] [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: 05/23/2023] [Revised: 11/04/2023] [Accepted: 11/12/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE To evaluate the short-term effects of three myopia-control lenses, which impose peripheral myopic defocus while providing clear central vision, on central and peripheral visual performance in myopic children. METHODS Twenty-one myopic children were enrolled in the study. Central visual performance was assessed using the quick contrast sensitivity function. Peripheral visual performance was evaluated by measuring peripheral contrast threshold and global motion perception, while subjects maintained fixation through the central portion of the lens. Single-vision spectacle lenses (SVL), spectacle lenses with highly aspherical lenslets (HAL) and defocus-incorporated soft contact (DISC) lenses were evaluated in random order, followed by orthokeratology (OK) lenses. All tests were performed monocularly on the right eye. RESULTS The area under the log contrast sensitivity function (AULCSF) with DISC lenses was lower than that with SVL (1.14 vs. 1.40, p < 0.001) and HAL (1.14 vs. 1.33, p = 0.001). HAL increased the temporal visual field contrast threshold compared with OK lenses (p = 0.04), and OK lenses decreased the superior visual field contrast threshold compared with that of SVL (p = 0.04) and HAL (p = 0.005). HAL also increased the peripheral coherence threshold for identifying the contraction movement compared with OK lenses (p = 0.01). CONCLUSIONS The short-term use of these optical interventions for myopia control exhibited measurable differences in central and peripheral visual performance. Relevant attention could be paid to these differences, especially when children switch to different treatments. DISC lenses exhibited worse central contrast sensitivity than SVL and HAL. Imposing peripheral defocus signals did not affect children's peripheral visual performance compared with SVL. However, considering the poorer peripheral visual performance provided by HAL, OK lenses are recommended for children if there are specific demands for global scene recognition and motion perception.
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Affiliation(s)
- Junqian Wu
- National Engineering Research Centre of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xue Li
- National Engineering Research Centre of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yingying Huang
- National Engineering Research Centre of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yifan Luo
- National Engineering Research Centre of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Siqi Zhang
- National Engineering Research Centre of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Zaifeng Cui
- National Engineering Research Centre of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Fang Hou
- National Engineering Research Centre of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jinhua Bao
- National Engineering Research Centre of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Hao Chen
- National Engineering Research Centre of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
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15
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Wang M, Ji N, Yu SA, Liang LL, Ma JX, Fu AC. Comparison of 0.02% atropine eye drops, peripheral myopia defocus design spectacle lenses, and orthokeratology for myopia control. Clin Exp Optom 2023:1-7. [PMID: 38043135 DOI: 10.1080/08164622.2023.2288180] [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: 11/30/2022] [Accepted: 09/22/2023] [Indexed: 12/05/2023] Open
Abstract
CLINICAL RELEVANCE There are many methods to control the progression of myopia. However, it is currently unknown which method could better control myopia progression: 0.02% atropine eye drops, peripheral myopic defocus design spectacle lenses (PMDSL), or orthokeratology (OK). BACKGROUND To compare the efficacy of 0.02% atropine, PMDSL, and OK to control axial length (AL) elongation in children with myopia. METHODS This study was analysed based on a previous cohort study (0.02% atropine group) and retrospective data (PMDSL and OK group). Overall, 387 children aged 6-14 years with myopia - 1.00D to - 6.00D in the three groups were divided into four subgroups according to age and spherical equivalent refraction (SER). The primary outcome was changed in AL over 1-year. RESULTS The mean axial elongation was 0.30 ± 0.21 mm, 0.23 ± 0.16 mm, and 0.17 ± 0.19 mm in the 0.02% atropine, PMDSL, and OK groups, respectively. Multivariate linear regression analyses showed significant differences in axial elongation among the three groups, especially in children aged 6-10, but not in children aged 10.1-14; the corresponding axial elongation was 0.35 ± 0.21 mm, 0.23 ± 0.17 mm, and 0.21 ± 0.20 mm (P < 0.05 between any two groups, except between PMDSL and OK groups at P > 0.05) and 0.22 ± 0.20 mm, 0.21 ± 0.13 mm, and 0.13 ± 0.18 mm (P < 0.05 between any two groups, except between 0.02% atropine and PMDSL groups at P > 0.05) in children with SER from - 1.00D to - 3.00D and from - 3.01D to - 6.00D, respectively. CONCLUSIONS Within the limits of this study design and using only the current brand of PMDSL, OK appeared to be the best method, followed by PMDSL and then 0.02% atropine, for controlling AL elongation over one year. However, different effects were found in the various age and SER subgroups.
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Affiliation(s)
- Ming Wang
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Na Ji
- Department of Optometry, The Affiliated Eye Hospital of Suzhou Vocational Health College, Suzhou, China
| | - Shi-Ao Yu
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ling-Ling Liang
- Department of Ophthalmology, Shi Jiazhuang Aier Eye Hospital, Shi Jiazhuang, China
| | - Jing-Xue Ma
- Department of Ophthalmology, Shi Jiazhuang Aier Eye Hospital, Shi Jiazhuang, China
| | - Ai-Cun Fu
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Kneepkens SCM, Marstal K, Polling JR, Jaddoe VWV, Vernooij MW, Poot DHJ, Klaver CCW, Tideman JWL. Eye Size and Shape in Relation to Refractive Error in Children: A Magnetic Resonance Imaging Study. Invest Ophthalmol Vis Sci 2023; 64:41. [PMID: 38153751 PMCID: PMC10756250 DOI: 10.1167/iovs.64.15.41] [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: 08/15/2023] [Accepted: 11/28/2023] [Indexed: 12/29/2023] Open
Abstract
Purpose The purpose of this study was to determine the association between eye shape and volume measured with magnetic resonance imaging (MRI) and optical biometry and with spherical equivalent (SE) in children. Methods For this study, there were 3637 10-year-old children from a population-based birth-cohort study that underwent optical biometry (IOL-master 500) and T2-weighted MRI scanning (height, width, and volume). Cycloplegic refractive error was determined by automated refraction. The MRI images of the eyes were segmented using an automated algorithm combining atlas registration with voxel classification. Associations among optical biometry, anthropometry, MRI measurements, and RE were tested using Pearson correlation. Differences between refractive error groups were tested using ANOVA. Results The mean volume of the posterior segment was 6350 (±680) mm3. Myopic eyes (SE ≤ -0.5 diopters [D]) had 470 mm3 (P < 0.001) and 970 mm3 (P < 0.001) larger posterior segment volume than emmetropic and hyperopic eyes (SE ≥ +2.0D), respectively. The majority of eyes (77.1%) had an oblate shape, but 47.4% of myopic eyes had a prolate shape versus 3.9% of hyperopic eyes. The correlation between SE and MRI-derived posterior segment length (r -0.51, P < 0.001) was stronger than the correlation with height (r -0.30, P < 0.001) or width of the eye (r -0.10, P < 0.001). Conclusions In this study, eye shape at 10 years of age was predominantly oblate, even in eyes with myopia. Of all MRI measurements, posterior segment length was most prominently associated with SE. Whether eye shape predicts future myopia development or progression should be investigated in longitudinal studies.
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Affiliation(s)
- Sander C. M. Kneepkens
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Kasper Marstal
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jan-Roelof Polling
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Orthoptics, School of Applied Science Utrecht, Utrecht, The Netherlands
| | - Vincent W. V. Jaddoe
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Meike W. Vernooij
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Dirk H. J. Poot
- Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Caroline C. W. Klaver
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - J. Willem L. Tideman
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands
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Huang Y, Zhang J, Yin Z, Yang A, Spiegel DP, Drobe B, Chen H, Bao J, Li X. Effects of Spectacle Lenses With Aspherical Lenslets on Peripheral Eye Length and Peripheral Refraction in Myopic Children: A 2-Year Randomized Clinical Trial. Transl Vis Sci Technol 2023; 12:15. [PMID: 37955608 PMCID: PMC10653269 DOI: 10.1167/tvst.12.11.15] [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: 04/17/2023] [Accepted: 07/27/2023] [Indexed: 11/14/2023] Open
Abstract
Purpose To investigate changes in peripheral eye length (PEL) and peripheral refraction (PR) in myopic children after wearing spectacle lenses with highly or slightly aspherical lenslets (HAL or SAL) for 2 years. Methods We recruited 170 children aged 8 to 13 years with myopia between -0.75 diopters (D) and -4.75 D. Participants were randomized to wear HAL, SAL, or single vision spectacle lenses (SVL). PEL and PR were measured at 0° central and 15° and 30° in the nasal and temporal retina every 6 months for 2 years. The relative PR (RPR) was calculated by subtracting central from peripheral values. Results PELs significantly increased with time (all P < 0.001), with the greatest elongation in the SVL group and the least in the HAL group. In the SVL and SAL groups, axial length elongated faster than the periphery. Whereas in the HAL group, N30 elongated faster than other PELs, axial length elongated less than the periphery. With time, the PR became more negative (all P < 0.001), with the most negative changes in the SVL group and the least negative changes in the HAL group. RPR became more hyperopic in the SVL and SAL groups, but less hyperopic in the HAL group (all P < 0.001). Conclusions Over the 2-year myopia progression, steeper retina and greater peripheral hyperopic defocus were found in the SVL group. In the SAL group, changes were attenuated. In the HAL group, the retina flattened and peripheral defocus became less hyperopic. Translational Relevance HAL and SAL lenses had little impact on PEL elongation.
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Affiliation(s)
- Yingying Huang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jiali Zhang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ziang Yin
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Adeline Yang
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
- R&D Singapore, Essilor International, Singapore, Singapore
| | - Daniel P. Spiegel
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
- R&D Singapore, Essilor International, Singapore, Singapore
| | - Björn Drobe
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
- R&D Singapore, Essilor International, Singapore, Singapore
| | - Hao Chen
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jinhua Bao
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xue Li
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
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Wnękowicz-Augustyn E, Teper S, Wylęgała E. Preventing the Progression of Myopia in Children-A Review of the Past Decade. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1859. [PMID: 37893579 PMCID: PMC10608552 DOI: 10.3390/medicina59101859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/05/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023]
Abstract
The growing incidence of myopia worldwide justifies the search for efficient methods of myopia prevention. Numerous pharmacological, optical, and lifestyle measures have already been utilized, but there remains a need to explore more practical and predictable methods for myopia control. This paper presents a review of the most recent studies on the prevention of myopia progression using defocus-incorporated multiple-segment spectacle lenses (DIMSsl), repeated low-level red-light (RLRL) therapy, and a combination of low-dose atropine (0.01%) with orthokeratology lenses.
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Affiliation(s)
- Emilia Wnękowicz-Augustyn
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Okręgowy Szpital Kolejowy, Panewnicka 65, 40-760 Katowice, Poland; (S.T.); (E.W.)
- Municipal Hospital Group, Truchana 7, 41-500 Chorzów, Poland
- Eye and Optics Center Augmed, Łabędzka 20d, 44-100 Gliwice, Poland
| | - Sławomir Teper
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Okręgowy Szpital Kolejowy, Panewnicka 65, 40-760 Katowice, Poland; (S.T.); (E.W.)
| | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Okręgowy Szpital Kolejowy, Panewnicka 65, 40-760 Katowice, Poland; (S.T.); (E.W.)
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19
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Alvarez-Peregrina C, Sanchez-Tena MA, Martinez-Perez C, Villa-Collar C, Ohlendorf A. Clinical Evaluation of MyoCare in Europe (CEME): study protocol for a prospective, multicenter, randomized, double-blinded, and controlled clinical trial. Trials 2023; 24:674. [PMID: 37848908 PMCID: PMC10580514 DOI: 10.1186/s13063-023-07696-0] [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: 06/29/2023] [Accepted: 10/02/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Myopia prevalence has been increasing in the last decades, and its pathological consequences, including myopic maculopathy and high myopia-associated optic neuropathy, are now one of the most common causes of visual impairment. It is estimated that by 2050, more than 50% of Europeans and Americans will be myopes, which is alarming due to the high morbidity of myopes over - 6.00D. Once myopia has appeared, there are different options with scientific evidence to try to slow the axial length growth. Ophthalmic lenses are the less invasive treatment to control myopia, and there is evidence about the efficacy of different designs, mainly in the Asiatic population. However, new designs have been launched, and it is not known if efficacy is the same between Asiatic and European subjects. Thus, we have set up a randomized, controlled, double-blind, and multicenter trial to investigate the efficacy of a new design of ophthalmic lenses for myopia control in European children. METHODS A 2-year prospective, multicenter, randomized controlled, and double-blind clinical trial is used to investigate the efficacy of a new design of ophthalmic lenses to slow the progression of myopia. Three hundred children aged from 6 to 13 years old will be recruited and randomly assigned to a study or control group. The study group will be composed of 150 children wearing MyoCare while the control group will be composed of 150 children wearing Clearview. The inclusion criteria will be myopia with a spherical equivalent between - 0.75D and - 5.00D, astigmatism < 1.50D, and anisometropia < 1.00D and having a historical evolution of at least - 0.50 The primary outcome is to compare the mean annual progression of the spherical equivalent between both groups. The secondary outcomes are axial length, choroidal thickness, phorias, and accommodative status of both groups. DISCUSSION This study will be the first randomized and controlled clinical trial in European children with spectacle lenses based on simultaneous competing defocus. The results will shed light on the clinical evidence of spectacle lenses relying on this new design for the management of myopia with results of efficacy in the non-Asiatic population. TRIAL REGISTRATION EU Clinical Trials Register (EudraCT) 2022-001696. Registered on 27 April 2022. CLINICALTRIALS gov NCT05919654. Registered on 26 June 2023.
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Affiliation(s)
- Cristina Alvarez-Peregrina
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain.
| | - Miguel Angel Sanchez-Tena
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
- ISEC LISBOA, Instituto Superior de Educação E Ciências, Lisbon, Portugal
| | | | - Cesar Villa-Collar
- Faculty of Biomedical and Health Science, European University of Madrid, Madrid, Spain
| | - Arne Ohlendorf
- ZEISS Group, Carl Zeiss Vision International GmbH, Turnstrasse 27, 73430, Aalen, Germany
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20
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Radhakrishnan H, Lam CSY, Charman WN. Multiple segment spectacle lenses for myopia control. Part 2: Impact on myopia progression. Ophthalmic Physiol Opt 2023; 43:1137-1144. [PMID: 37378880 DOI: 10.1111/opo.13194] [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: 08/15/2022] [Revised: 05/27/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE Initial studies have suggested that multiple segment (MS) spectacle lenses can reduce the progression rate of childhood myopia and axial eye growth. This paper aimed to compare the effectiveness of two different available designs of MS lens and to explore the nature of their control effect. METHOD Published data from the only two clinical trials in which changes in mean spherical equivalent refraction (SER) and axial length (AL) for matched groups of myopic children wearing either MS or single-vision (SV) spectacle corrections, recorded over a period of at least 2 years, were further analysed and compared. Both trials involved Chinese children of similar ages and visual characteristics, but the trials were located in different cities. The two MS lenses examined were MiyoSmart or DIMS (Hoya) and Stellest (Essilor). RESULTS Absolute changes in SER and AL differed over time during the two trials. However, if the results were expressed in terms of efficacy over successive 6-month periods, then the two MS lenses produced broadly similar results (initial efficacy for the control of myopia progression of about 60%-80%, declining over 2 years to about 35%-55%). Control appears to be absolute rather than proportional. DISCUSSION Myopia control may be due to either the additional myopic defocus induced by the MS lenses (i.e., asymmetry of the through-focus image changes about the distance focus) or to the general reduction in image contrast that the lenslets create in the peripheral field. CONCLUSION Multiple segment spectacle lenses offer a valuable new approach to the control of myopia progression in children. Further work is required to clarify their mechanism of action and to optimise their design parameters.
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Affiliation(s)
- Hema Radhakrishnan
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Carly Siu Yin Lam
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- Centre for Eye and Vision Research (CEVR), Hong Kong SAR, China
| | - W Neil Charman
- School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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21
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Leighton RE, Breslin KM, Richardson P, Doyle L, McCullough SJ, Saunders KJ. Relative peripheral hyperopia leads to greater short-term axial length growth in White children with myopia. Ophthalmic Physiol Opt 2023; 43:985-996. [PMID: 37340533 DOI: 10.1111/opo.13185] [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: 03/16/2023] [Revised: 05/18/2023] [Accepted: 06/01/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE Controversy exists regarding the influence of peripheral visual experience on the onset and progression of childhood myopia. This longitudinal, observational study evaluated the relationship between relative peripheral refraction (RPR) and changes in refractive error and axial length (AL) over 12 months in White children aged 6-7 and 12-13 years with a range of baseline refractive errors. METHODS Cycloplegic baseline autorefraction at horizontal retinal eccentricities of 0° and ±30° were recorded with the Shin-Nippon NVision-K 5001 while AL was measured using the Zeiss IOLMaster 700. Measurements were repeated after 12 months on a subgroup. Refractive data were transposed into power vectors as mean spherical equivalent (M), J0 and J45 . RPR was calculated by subtracting central from peripheral measurements. Participants were defined as myopic (M ≤ -0.50 D), premyopic (-0.50 D < M ≤ +0.75 D), emmetropic (+0.75 D < M < +2.00 D) or hyperopic (M ≥ +2.00 D). RESULTS Data were collected from 222 and 245 participants aged 6-7 and 12-13 years, respectively. Myopic eyes demonstrated, on average, more hyperopic RPR. Emmetropes and premyopes displayed emmetropic RPR, and hyperopes showed a myopic RPR. Fifty-six 6- to 7-year-olds and seventy 12- to 13-year-olds contributed 12-month repeated measures. Longitudinal data demonstrated a significant relationship between a more hyperopic RPR in the nasal retina and greater short-term axial elongation in teens with myopia at baseline (β = 0.69; p = 0.04). Each dioptre of relative peripheral hyperopia in the nasal retina was associated with an additional 0.10 mm (95% CI: 0.02-0.18 mm) annual increase in AL. CONCLUSIONS Hyperopic RPR in the nasal retina of myopic children is indicative of increased risk for rapid axial elongation and may be a useful metric to support decision-making in myopia management.
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Affiliation(s)
- Rebecca E Leighton
- Centre for Optometry and Vision Science Research, School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Karen M Breslin
- Centre for Optometry and Vision Science Research, School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Patrick Richardson
- Centre for Optometry and Vision Science Research, School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Lesley Doyle
- Centre for Optometry and Vision Science Research, School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Sara J McCullough
- Centre for Optometry and Vision Science Research, School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Kathryn J Saunders
- Centre for Optometry and Vision Science Research, School of Biomedical Sciences, Ulster University, Coleraine, UK
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22
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Saxena R, Dhiman R, Gupta V, Phuljhele S, Mahajan A, Rakheja V, Swaminathan M, Jethani J, Kesarwani S, Kekunnaya R, Sukhija J, Bhave S, Sharma P, Sinha R, Verma L, Sharma N. Prevention and management of childhood progressive myopia: National consensus guidelines. Indian J Ophthalmol 2023; 71:2873-2881. [PMID: 37417137 PMCID: PMC10491088 DOI: 10.4103/ijo.ijo_387_23] [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: 02/07/2023] [Revised: 05/02/2023] [Accepted: 05/26/2023] [Indexed: 07/08/2023] Open
Abstract
Myopia is a major public health problem worldwide, including India, with the global prevalence of myopia increasing rapidly over decades. The clinical and socioeconomic impact of myopia is also expected to rise with rising prevalence. Therefore, the focus has now been shifted to prevent the incidence and progression of myopia. However, there is lack of any standardized guidelines for myopia management. This document aims to generate a national-level expert consensus statement on the management of childhood myopia in the Indian scenario. The expert panel of pediatric ophthalmologists consisted of 63 members who met in a hybrid meeting. A list of topics deliberating discussion in the meeting was provided to the experts in advance and they were instructed to provide their opinions on the matter during the meet. The panel of experts then gave their views on each of the items presented, deliberated on different aspects of childhood myopia, and reached a consensus regarding the practice patterns in the Indian scenario. In case of opposing views or lack of a clear consensus, we undertook further discussion and evaluated literature to help arrive at a consensus. A written document is prepared based on recommendations explaining definition of myopia, refraction techniques, components and methods of workup, initiation of anti-myopia treatment, type and timing of interventions, follow-up schedule, and indications for revised or combination treatment. This article formulates evidence-based guidelines for progressing myopes and pre-myopes and also establishes uniformity in the management of childhood myopia in the country.
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Affiliation(s)
- Rohit Saxena
- Dr. R. P. Centre for Ophthalmic Sciences, AIIMS New Delhi, India
| | - Rebika Dhiman
- Dr. R. P. Centre for Ophthalmic Sciences, AIIMS New Delhi, India
| | - Vinay Gupta
- Dr. R. P. Centre for Ophthalmic Sciences, AIIMS New Delhi, India
| | - Swati Phuljhele
- Dr. R. P. Centre for Ophthalmic Sciences, AIIMS New Delhi, India
| | - Asmita Mahajan
- Dr. R. P. Centre for Ophthalmic Sciences, AIIMS New Delhi, India
| | - Vaishali Rakheja
- Dr. R. P. Centre for Ophthalmic Sciences, AIIMS New Delhi, India
| | | | - Jitendra Jethani
- Baroda Children Eye Care and Squint Clinic, Vadodara, Gujarat, India
| | | | | | - Jaspreet Sukhija
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
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23
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Zhang HY, Lam CSY, Tang WC, Lee PH, Tse DY, To CH. Changes in relative peripheral refraction in children who switched from single-vision lenses to Defocus Incorporated Multiple Segments lenses. Ophthalmic Physiol Opt 2023; 43:319-326. [PMID: 36583393 DOI: 10.1111/opo.13086] [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: 10/13/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE To investigate changes in relative peripheral refraction (RPR) associated with myopia progression in children who wore single-vision (SV) lenses for 2 years and switched to Defocus Incorporated Multiple Segments (DIMS) lenses in the third year versus children who wore DIMS lenses for 3 years. METHODS In the first 2 years, children were allocated randomly to wear either DIMS or SV lenses. In the third year, children in the DIMS group continued to wear these lenses, while those in the SV group were switched to DIMS lenses (Control-to-DIMS group). Central and peripheral refraction and axial length were monitored every 6 months. RESULTS Over 3 years, the DIMS group (n = 65) showed good myopia control and maintained a relatively constant and symmetrical RPR profile without significant changes. In the first 2 years, children who wore SV lenses (n = 55) showed asymmetrical RPR changes, with significant increases in hyperopic RPR at 20° nasal (N) (mean difference: 0.88 ± 1.06 D, p < 0.0001) and 30N (mean difference: 1.07 ± 1.09 D, p < 0.0001). The Control-to-DIMS group showed significant myopia retardation after wearing DIMS lenses in the third year. When compared with the RPR changes in the first 2 years, significant reductions in hyperopic RPR were observed at 20N (mean difference: -1.14 ± 1.93 D, p < 0.0001) and 30N (mean difference: -1.07 ± 1.17 D, p < 0.0001) in the third year. However, no significant difference between the RPR changes found in the nasal retina and temporal retina (p > 0.05) was noted in the third year. CONCLUSION Symmetrical changes in RPR were found in children switching from SV to DIMS lenses, and a symmetrical pattern of RPR was noted in children who wore DIMS for 3 years. Myopia control using myopic defocus in the mid-periphery influenced the RPR changes and retarded myopia progression by altering the eye's growth pattern.
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Affiliation(s)
- Han Yu Zhang
- School of Medicine, Nankai University, Tianjin, China
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
- Centre for Eye and Vision Research (CEVR), Shatin, Hong Kong SAR
| | - Carly Siu Yin Lam
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
- Centre for Eye and Vision Research (CEVR), Shatin, Hong Kong SAR
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Wing Chun Tang
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Paul H Lee
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Dennis Y Tse
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
- Centre for Eye and Vision Research (CEVR), Shatin, Hong Kong SAR
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Chi Ho To
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
- Centre for Eye and Vision Research (CEVR), Shatin, Hong Kong SAR
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
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Banashefski B, Rhee MK, Lema GMC. High Myopia Prevalence across Racial Groups in the United States: A Systematic Scoping Review. J Clin Med 2023; 12:jcm12083045. [PMID: 37109381 PMCID: PMC10144975 DOI: 10.3390/jcm12083045] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/03/2023] [Accepted: 04/09/2023] [Indexed: 04/29/2023] Open
Abstract
High myopia is a significant public health issue globally and in the United States (US), where it affects ~4% of the population or 13 million people. This is a potentially blinding condition, but complications can be prevented with early intervention in childhood. Several countries have developed robust data on high myopia, but the United States' data on high myopia remains lacking. Further, underrepresented populations are at particular risk of complications due to reduced access to optometric and ophthalmic care. We performed a systematic scoping review of population-based studies that investigated the prevalence of high myopia across racial and ethnic groups in the US to identify the impact of high myopia on underrepresented communities. Only four studies were identified that met inclusion criteria, which highlights the need to further investigate the topic in the United States. The prevalence of high myopia ranged from a low of 1.8% among Hispanic populations to a high of 11.8% among Chinese populations. Our study demonstrated a paucity of high myopia data in the United States and variable rates of high myopia depending on the time and location of each study. More complete prevalence data will help identify opportunities for community-based interventions to prevent debilitating and blinding complications of high myopia.
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Affiliation(s)
- Bryana Banashefski
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Michelle K Rhee
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Gareth M C Lema
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- John J. Peters VA Medical Center, Bronx, NY 10468, USA
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25
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Lam CSY, Tang WC, Zhang HY, Lee PH, Tse DYY, Qi H, Vlasak N, To CH. Long-term myopia control effect and safety in children wearing DIMS spectacle lenses for 6 years. Sci Rep 2023; 13:5475. [PMID: 37015996 PMCID: PMC10073092 DOI: 10.1038/s41598-023-32700-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/31/2023] [Indexed: 04/06/2023] Open
Abstract
This study evaluated the long-term myopia control effect and safety in children wearing Defocus Incorporated Multiple Segments (DIMS) spectacle lenses. Participants who completed the 2-year RCT were followed for a total of 6 years; their cycloplegic refractions and axial length were measured. Group 1 (n = 36) wore DIMS spectacles for 6 years; Group 2 (n = 14) wore DIMS lens for the first 3.5 years and SV spectacles afterwards; Group 3 (n = 22) wore SV spectacles in the first 2 years and switched to DIMS; Group 4 (n = 18) wore SV spectacles in the first 2 years, switched to DIMS for 1.5 years and then SV spectacles again. Group 1 showed no significant differences in myopia progression (- 0.52 ± 0.66 vs. - 0.40 ± 0.72D) and axial elongation (0.32 ± 0.26 vs. 0.28 ± 0.28 mm, both p > 0.05) between the first and the later 3 years. In the last 2.5 years, DIMS lens groups (Groups 1 and 3) had less myopia progression and axial elongation than the single vision groups (Groups 2 and 4). There was no evidence of rebound after stopping the treatment. Post-wear visual functions in all groups were within norms. The results supported that DIMS lenses provided sustained myopia control without adverse effects over the 6-year study period.Trial registration: clinicaltrials.gov; NCT02206217.
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Affiliation(s)
- Carly Siu Yin Lam
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
- Centre for Eye and Vision Research, Sha Tin, Hong Kong.
| | - Wing Chun Tang
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Han Yu Zhang
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- School of Medicine, Nankai University, Tianjin, China
| | - Paul H Lee
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Dennis Yan Yin Tse
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- Centre for Eye and Vision Research, Sha Tin, Hong Kong
| | - Hua Qi
- Technical Research and Development Department, Hoya Vision Care, Tokyo, Japan
| | - Natalia Vlasak
- Technical Research and Development Department, Hoya Vision Care, Amsterdam, The Netherlands
| | - Chi Ho To
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- Centre for Eye and Vision Research, Sha Tin, Hong Kong
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26
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Peripheral Refraction and Visual Function of Novel Perifocal Ophthalmic Lens for the Control of Myopia Progression. J Clin Med 2023; 12:jcm12041435. [PMID: 36835968 PMCID: PMC9964465 DOI: 10.3390/jcm12041435] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023] Open
Abstract
This study aimed to evaluate the peripheral defocus induced with a novel perifocal ophthalmic lens for myopia progression control and the potential impact on visual function. This experimental, non-dispensing crossover study evaluated 17 myopic young adults. The peripheral refraction was measured using an open-field autorefractor, at 2.50 m from the target point, in two eccentric points, 25° temporal, 25° nasal, and central vision. Visual contrast sensitivity (VCS) was measured at 3.00 m with a Vistech system VCTS 6500 in low light conditions. Light disturbance (LD) was assessed with a light distortion analyzer 2.00 m away from the device. Peripheral refraction, VCS, and LD were assessed with a monofocal lens and perifocal lens (with an add power of +2.50 D on the temporal side of the lens, and +2.00 D on the nasal side). The results showed that the perifocal lenses induced an average myopic defocus of -0.42 ± 0.38 D (p-value < 0.001) in the nasal retina, at 25° The changes induced by the lower add power in the nasal part of the lens did not induce statistically significant changes in the refraction of the temporal retina. The VCS and LD showed no significant differences between the monofocal and perifocal lenses.
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Demir P, Macedo AF, Chakraborty R, Baskaran K. Comparison of an open view autorefractor with an open view aberrometer in determining peripheral refraction in children. JOURNAL OF OPTOMETRY 2023; 16:20-29. [PMID: 35022155 PMCID: PMC9811364 DOI: 10.1016/j.optom.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/06/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE The aim of this study was to compare central and peripheral refraction using an open view Shin-Nippon NVision-K 5001 autorefractor and an open view COAS-HD VR aberrometer in young children. METHODS Cycloplegic central and peripheral autorefraction was measured in the right eye of 123 children aged 8 to 16 years. Three measurements each were obtained with both Shin-Nippon NVision-K 5001 autorefractor and COAS-HD VR aberrometer along the horizontal visual field up to 30° (nasal and temporal) in 10° steps. The refraction from the autorefractor was compared with aberrometer refraction for pupil analysis diameters of 2.5-mm and 5.0-mm. RESULTS The Shin-Nippon was 0.30 D more hyperopic than COAS-HD VR at 2.5-mm pupil and 0.50 D more hyperopic than COAS-HD VR at 5-mm pupil for central refraction. For both pupil sizes, the 95% limits of agreement were approximately 0.50 D for central refraction, and limits were wider in the nasal visual field compared to the temporal visual field. The mean difference for both J0 and J45 were within 0.15 D and the 95% limits of agreement within 0.90 D across the horizontal visual field. CONCLUSION Defocus components were similar between the Shin-Nippon autorefractor and the COAS-HD VR aberrometer with a 2.5-mm pupil for most visual field angles. However, there was a significant difference in defocus component between the Shin-Nippon autorefractor and the COAS-HD VR aberrometer with a 5.0-mm pupil, wherein the autorefractor measured more hyperopia. The astigmatic components J0 and J45 were similar between instruments for both central and peripheral refraction.
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Affiliation(s)
- Pelsin Demir
- Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden
| | - Antonio Filipe Macedo
- Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden; Center of Physics, Optometry and Vision Science, University of Minho, Braga, Portugal
| | - Ranjay Chakraborty
- College of Nursing and Health Sciences, Optometry and Vision Science, Sturt North, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia; Caring Futures Institute, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
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Mutti DO, Sinnott LT, Berntsen DA, Jones-Jordan LA, Orr DJ, Walline JJ. The Effect of Multifocal Soft Contact Lens Wear on Axial and Peripheral Eye Elongation in the BLINK Study. Invest Ophthalmol Vis Sci 2022; 63:17. [PMID: 36169949 PMCID: PMC9526360 DOI: 10.1167/iovs.63.10.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 09/05/2022] [Indexed: 01/27/2023] Open
Abstract
Purpose The purpose of this study was to compare axial and peripheral eye elongation during myopia therapy with multifocal soft contact lenses. Methods Participants were 294 children (177 [60.2%] girls) age 7 to 11 years old with between -0.75 diopters (D) and -5.00 D of myopia (spherical component) and less than 1.00 D astigmatism at baseline. Children were randomly assigned to Biofinity soft contact lenses for 3 years: D-designs with a +2.50 D addition, +1.50 D addition, or single vision. Five measurements of eye length were averaged at the fovea, ±20°, and ±30° in the horizontal and vertical meridians of the right eye using the Haag-Streit Lenstar LS 900. Results Axial elongation over 3 years with single vision contact lenses was greater than peripheral elongation in the superior and temporal retinal qeuadrants by 0.07 mm (95% confidence interval [CI] = 0.05 to 0.09 mm) and 0.06 mm (95% CI = 0.03 to 0.09 mm) and similar in the inferior and nasal quadrants. Axial elongation with +2.50 D addition multifocal contact lenses was similar to peripheral elongation in the superior retinal quadrant and less than peripheral elongation in the inferior and nasal quadrants by -0.04 mm (95% CI = -0.06 to -0.01 mm) and -0.06 mm (95% CI = -0.09 to -0.02 mm). Conclusions Wearing +2.50 D addition multifocal contact lenses neutralized or reversed the increase in retinal steepness with single vision lenses. The mismatch between greater inhibition of elongation at the fovea than peripherally despite greater peripheral myopic defocus suggests that optical myopia therapy may operate through extensive spatial integration or mechanisms other than local defocus.
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Affiliation(s)
- Donald O. Mutti
- The Ohio State University College of Optometry, Columbus, Ohio, United States
| | - Loraine T. Sinnott
- The Ohio State University College of Optometry, Columbus, Ohio, United States
| | - David A. Berntsen
- University of Houston College of Optometry, Houston, Texas, United States
| | | | - Danielle J. Orr
- The Ohio State University College of Optometry, Columbus, Ohio, United States
| | - Jeffrey J. Walline
- The Ohio State University College of Optometry, Columbus, Ohio, United States
| | - for the BLINK Study Group
- The Ohio State University College of Optometry, Columbus, Ohio, United States
- University of Houston College of Optometry, Houston, Texas, United States
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Myopia: Mechanisms and Strategies to Slow Down Its Progression. J Ophthalmol 2022; 2022:1004977. [PMID: 35747583 PMCID: PMC9213207 DOI: 10.1155/2022/1004977] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/29/2022] [Indexed: 12/15/2022] Open
Abstract
This topical review aimed to update and clarify the behavioral, pharmacological, surgical, and optical strategies that are currently available to prevent and reduce myopia progression. Myopia is the commonest ocular abnormality; reinstated interest is associated with high and increasing prevalence, especially but not, in the Asian population and progressive nature in children. The growing global prevalence seems to be associated with both genetic and environmental factors such as spending more time indoor and using digital devices, particularly during the coronavirus disease 2019 pandemic. Various options have been assessed to prevent or reduce myopia progression in children. In this review, we assess the effects of several types of measures, including spending more time outdoor, optical interventions such as the bifocal/progressive spectacle lenses, soft bifocal/multifocal/extended depth of focus/orthokeratology contact lenses, refractive surgery, and pharmacological treatments. All these options for controlling myopia progression in children have various degrees of efficacy. Atropine, orthokeratology/peripheral defocus contact and spectacle lenses, bifocal or progressive addition spectacles, and increased outdoor activities have been associated with the highest, moderate, and lower efficacies, respectively.
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Li X, Huang Y, Zhang J, Ding C, Chen Y, Chen H, Bao J. Treatment zone decentration promotes retinal reshaping in Chinese myopic children wearing orthokeratology lenses. Ophthalmic Physiol Opt 2022; 42:1124-1132. [PMID: 35598145 PMCID: PMC9544447 DOI: 10.1111/opo.12996] [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: 12/28/2021] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate whether the treatment zone (TZ) decentration in orthokeratology (OK) lenses affects retinal expansion in Chinese children with myopia. METHODS Children aged 8 to 13 years (n = 30) were assessed over 13 months comprising 12 months of OK lens wear followed by discontinuation of lens wear for 1 month. Corneal topography was measured at 0, 1, 3, 6, 9, 12 and 13 months. TZ decentration of the OK lens was calculated, and subjects were subdivided into a small decentration group (group S) and a large decentration group (group L) based on the median value of the weighted average decentration (dave ). Central axial length (AL) and peripheral eye lengths (PELs) at the central retina, as well as 10°, 20° and 30° nasally and temporally were measured at 0 and 13 months under cycloplegia. Second-order polynomial (y = ax2 + bx + c) and linear fits (y = Kx + B) were applied to the peripheral relative eye length (PREL), and the coefficients 'a' and 'K' were used to describe the shape of the eye. RESULTS Mean AL growth for one year was 0.28 ± 0.17 mm. In a multiple linear regression model, AL elongation was related to the baseline age (β = -0.41, p = 0.01) and the dave (β = -0.37, p = 0.03) (R2 = 0.34, p = 0.002). When compared with smaller dave (0.45 ± 0.15 mm), a larger dave (0.89 ± 0.17 mm) was associated with slower ocular growth (central: 0.20 ± 0.13 mm vs. 0.35 ± 0.17 mm, p = 0.009; 10° nasal: 0.26 ± 0.18 mm vs. 0.45 ± 0.21 mm, p = 0.02; 10° temporal: 0.17 ± 0.14 mm vs. 0.32 ± 0.19 mm, p = 0.02) and more oblate retina shape ('a': -0.13 ± 0.02 vs. -0.14 ± 0.02, p = 0.02; Knasal : 0.35 ± 0.11 vs. 0.39 ± 0.09, p = 0.02; Ktemporal : -0.42 ± 0.08 vs. -0.46 ± 0.08, p = 0.004). CONCLUSIONS Greater TZ decentration with the use of OK lenses was associated with slower axial growth and a more oblate retinal shape. TZ decentration caused local defocusing changes, which may inhibit myopic progression. These findings may have important implications for improving optical designs for myopia control.
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Affiliation(s)
- Xue Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Yingying Huang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Jiali Zhang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Chenglu Ding
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Yunyun Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Hao Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Jinhua Bao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
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Zhang H, Lam CSY, Tang WC, Leung M, Qi H, Lee PH, To CH. Myopia Control Effect Is Influenced by Baseline Relative Peripheral Refraction in Children Wearing Defocus Incorporated Multiple Segments (DIMS) Spectacle Lenses. J Clin Med 2022; 11:jcm11092294. [PMID: 35566423 PMCID: PMC9099701 DOI: 10.3390/jcm11092294] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/12/2022] [Accepted: 04/16/2022] [Indexed: 02/01/2023] Open
Abstract
The aim of this study is to investigate if baseline relative peripheral refraction (RPR) influences the myopia control effects in Chinese myopic children wearing Defocus Incorporated Multiple Segments (DIMS) lenses. Peripheral refraction at 10°, 20°, and 30° nasal (10 N, 20 N, 30 N) and temporal (10 T, 20 T, 30 T) retina were measured at six-month intervals for children who participated in a 2-year randomized controlled trial. The relationship between the baseline peripheral refractions and myopia progression and axial length changes were analysed. A total of 79 children and 81 children in the DIMS and single vision (SV) group were investigated, respectively. In the DIMS group, more baseline myopic RPR spherical equivalent (SE) was associated with more myopic progression (10 N: r = 0.36, p = 0.001; 20 N: r = 0.35, p = 0.001) and greater axial elongation (10 N: r = −0.34, p = 0.001; 20 N: r = −0.29, p = 0.006) after adjusting for co-factors. In the SV group, baseline RPR had association with only myopia progression (10 N: r = 0.37, p = 0.001; 20 N: r = 0.36, p = 0.001; 30 N: r = 0.35, p = 0.002) but not with axial elongation after Bonferroni correction (p > 0.008). No statistically significant relationship was found between temporal retina and myopia progression or axial elongation in both groups. Children with baseline myopic RPR had statistically significant more myopia progression (mean difference around −0.40 D) and more axial elongation (mean difference 0.15 mm) when compared with the children having baseline hyperopic RPR in the DIMS group but not in the SV group. In conclusion, the baseline RPR profile may not influence future myopia progression or axial elongation for the SV lens wearers. However, DIMS lenses slowed down myopia progression and was better in myopia control for the children with baseline hyperopic RPR than the children with myopic RPR. This may partially explain why myopia control effects vary among myopic children. Customised myopic defocus for individuals may optimise myopia control effects, and further research to determine the optimal dosage, with consideration of peripheral retinal profile, is warranted.
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Affiliation(s)
- Hanyu Zhang
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China; (H.Z.); (W.-C.T.); (C.-H.T.)
- Centre for Eye and Vision Research (CEVR), Hong Kong SAR, China
| | - Carly S. Y. Lam
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China; (H.Z.); (W.-C.T.); (C.-H.T.)
- Centre for Eye and Vision Research (CEVR), Hong Kong SAR, China
- Correspondence:
| | - Wing-Chun Tang
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China; (H.Z.); (W.-C.T.); (C.-H.T.)
| | - Myra Leung
- Discipline of Optometry and Vision Science, Faculty of Health, University of Canberra, Canberra 2617, Australia;
| | - Hua Qi
- Hoya Corporation, Tokyo 1608347, Japan;
| | - Paul H. Lee
- Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK;
| | - Chi-Ho To
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China; (H.Z.); (W.-C.T.); (C.-H.T.)
- Centre for Eye and Vision Research (CEVR), Hong Kong SAR, China
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Kaymak H, Neller K, Schütz S, Graff B, Sickenberger W, Langenbucher A, Seitz B, Schwahn H. Vision tests on spectacle lenses and contact lenses for optical myopia correction: a pilot study. BMJ Open Ophthalmol 2022; 7:e000971. [PMID: 35464151 PMCID: PMC8984052 DOI: 10.1136/bmjophth-2022-000971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/28/2022] [Indexed: 11/03/2022] Open
Abstract
ObjectiveVisual performance and short-term tolerability of different designs of myopia correcting options, including therapeutically relevant bifocal contact lenses (CL) and spectacle lenses with ‘defocus incorporated multiple segments (DIMS)’ technology were compared.Methods and analysisIn myopic volunteering subjects (n=8; spherical equivalent range: −1 to −7 D) visual acuity (VA) using Landolt C and contrast sensitivity (CS) using contrast C were assessed at three different gaze positions (−22° nasal, +22° temporal and 0° central), corresponding to a gaze through the DIMS area or the clear area of the DIMS lens design, respectively, after short-term wear of each of single vision spectacle lenses (SV), DIMS spectacle lenses (DIMS), monofocal soft CL and centre-near multifocal soft CL (MCL). Also, CS was assessed under photopic and mesopic light conditions with and without glare using sinusoidal gratings at 1.5, 3, 6, 12 and 18 cpd.ResultsMean VA (Landolt C) was −0.12 to –0.10, −0.05 and 0.10 logMAR (SV, DIMS, CL, MCL) at central gaze (0°). At nasal gaze (−22°), VA differed by 0.12, 0.33, 0.05 and 0.01, and at temporal gaze (+22°) by 0.05, 0.26, 0 and −0.08 compared with central gaze values. Mean CS (Contrast C) was 1.74, 1.73, 1.69 and 1.61 logCS (SV, DIMS, CL, MCL) at central gaze at nasal gaze, CS differed by −0.02 to –0.13, −0.01 and −0.01, and at temporal gaze by −0.02 to –0.16, −0.01 and +0.06 compared with central gaze values.ConclusionWhen compared with SV, MCL leads to a general decrease in VA and CS, while DIMS did not differ from SV at straight gaze (0° gaze). With DIMS, VA and CS are decreased to a similar level as with the MCL, but only at nasal and temporal gaze.
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Affiliation(s)
- Hakan Kaymak
- Institute of Experimental Ophthalmology, Saarland University, Homburg, Germany
| | - Kai Neller
- Institute of Experimental Ophthalmology, Saarland University, Homburg, Germany
| | - Saskia Schütz
- Department of Optometry, Ernst Abbe University of Applied Sciences, Jena, Germany
| | - Birte Graff
- Institute of Experimental Ophthalmology, Saarland University, Homburg, Germany
| | | | - Achim Langenbucher
- Institute of Experimental Ophthalmology, Saarland University, Homburg, Germany
| | - Berthold Seitz
- Dept. of Ophthalmology, Saarland University Hospital and Faculty of Medicine, Homburg, Germany
| | - Hartmut Schwahn
- Institute of Experimental Ophthalmology, Saarland University, Homburg, Germany
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Overview on Defocus Incorporated Multiple Segments Lenses: A Novel Perspective in Myopia Progression Management. Vision (Basel) 2022; 6:vision6020020. [PMID: 35466272 PMCID: PMC9036268 DOI: 10.3390/vision6020020] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/09/2022] [Accepted: 03/30/2022] [Indexed: 11/16/2022] Open
Abstract
Myopia is becoming more common across the world, affecting approximately two billion people and rising. Different kinds of therapies (optical, pharmaceutical, environmental, or behavioral) have been proposed to decrease myopia progression, but with variable results and a lack of standardization. The evidence that targeted myopic defocus inhibits eye length growth has paved the way for several contact and spectacle lense designs to induce a peripheral defocus, thus slowing myopia progression, but the perfect configuration has yet to be defined. One of the newest and more promising approaches in this field is the use of Defocus Incorporated Multiple Segments (DIMS) lenses. These lenses are built from the assumption that targeted myopic defocus, produced by 396 mid-peripheral lenslets with positive power, inhibits eye length growth. Recent studies have highlighted the effectiveness of these lenses compared to children who had worn single vision spectacle lenses, in terms of myopia control and tolerability. Despite the evidence that these lenses can help slow down the progression of myopia, the occasional mid-peripheral aberrations they can induce, as well as the overall eye strain that comes with wearing them, should not be overlooked. The aim of this review is to give attention to the advantages and the shortfalls of this new approach and to evaluate its effectiveness in clinical practice.
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Increase in b-wave amplitude after light stimulation of the blind spot is positively correlated with the axial length of myopic individuals. Sci Rep 2022; 12:4785. [PMID: 35314724 PMCID: PMC8938467 DOI: 10.1038/s41598-022-08319-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 03/01/2022] [Indexed: 12/02/2022] Open
Abstract
Altered retinal dopamine and ON-pathway activity may underlie myopia development. It has been shown that the stimulation of the blind spot with short-wavelength light increases the electroretinogram (ERG) b-wave amplitude of myopic eyes and may engage the retinal dopaminergic system. This study evaluated the impact of various durations of blind spot stimulation on the electrophysiological response of the myopic retina and their relationship to axial length. Six myopic individuals underwent three short-wavelength blue light blind spot stimulation protocols (10 s, 1 min, 10 min) using a virtual reality headset. As a control condition, no stimulation was shown for 1 min. The b-wave amplitude of the photopic full-field ERG was measured at baseline and 10, 20, 30, 40, 50, and 60 min after each condition. A significant increase in b-wave amplitude was observed for all stimulation protocols compared to the control. The peak b-wave amplitude was observed 20 min after the 1-min stimulation protocol and 60 min after the 10-min stimulation protocol. A significant positive correlation was found between axial length of the eye and percent change in b-wave amplitude for the 10-min stimulation protocol. A rapid and a delayed b-wave time course responses were observed following 1 min and 10 min of blind spot stimulation, respectively. Overall, these results indicate that light stimulation of the blind spot for various durations elevates ON-bipolar cell activity in the retina and as such is assumed to reduce the myopic response. These findings could have implications for future myopia treatment.
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Abstract
ABSTRACT Myopia is a global epidemic on the rise, garnering increased attention, particularly in therapeutics and prevention, and the field of myopia control. This study reviews the current management options including contact lenses, spectacles, atropine, and environmental and behavioral modifications. Particular attention is given to the US perspective.
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The Impact of Antibiotic Usage Guidelines, Developed and Disseminated through Internet, on the Knowledge, Attitude and Prescribing Habits of Orthokeratology Contact Lens Practitioners in China. Antibiotics (Basel) 2022; 11:antibiotics11020179. [PMID: 35203782 PMCID: PMC8868172 DOI: 10.3390/antibiotics11020179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/17/2022] [Accepted: 01/24/2022] [Indexed: 01/16/2023] Open
Abstract
It has been previously reported that the improper prescribing of antibiotic eye drops is common among orthokeratology (ortho-k) practitioners. Guidelines have since been developed and disseminated to improve their understanding and implementation of antibiotic prescriptions. This study aimed to investigate the influence of these guidelines on the knowledge, attitude, and prescribing habits of ortho-k practitioners by means of a questionnaire, which was administered nationwide via an official online account to eye care practitioners (ECPs) involved in ortho-k lens fitting, 548 of whom completed the survey. Differences in characteristics before and after the dissemination of the guidelines and between the groups were explored using χ2 tests. The relationship between prescribing habits and demographics was analyzed using stepwise logistic regression models. The implementation of the guidelines significantly improved the overall prescribing habits of ECPs (p < 0.001), especially for prophylactic antibiotic use before and after ortho-k lens wear (p < 0.001). Most ECPs who prescribed antibiotics properly displayed significantly better knowledge of correct antibiotic use, which in turn affected the compliance in their ortho-k patients (p < 0.001). The ECPs’ occupations (professionals other than ophthalmologists and optometrists, including nurses and opticians), clinical setting (distributor fitting centers), and age (younger than 25 years) were risk factors for the misuse of antibiotics. Although the implementation of the antibiotic guidelines significantly improved overall prescribing habits, some practitioners’ prescribing behavior still needs improvement. A limitation of this study was that all questions were mandatory, requiring ECPs to recall information, and therefore was subjected to selection and recall bias.
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Asatryan A, Calandria JM, Kautzmann MAI, Jun B, Gordon WC, Do KV, Bhattacharjee S, Pham TL, Bermúdez V, Mateos MV, Heap J, Bazan NG. New Retinal Pigment Epithelial Cell Model to Unravel Neuroprotection Sensors of Neurodegeneration in Retinal Disease. Front Neurosci 2022; 16:926629. [PMID: 35873810 PMCID: PMC9301569 DOI: 10.3389/fnins.2022.926629] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/30/2022] [Indexed: 01/02/2023] Open
Abstract
Retinal pigment epithelial (RPE) cells sustain photoreceptor integrity, and when this function is disrupted, retinal degenerations ensue. Herein, we characterize a new cell line from human RPE that we termed ABC. These cells remarkably recapitulate human eye native cells. Distinctive from other epithelia, RPE cells originate from the neural crest and follow a neural development but are terminally differentiated into "epithelial" type, thus sharing characteristics with their neuronal lineages counterparts. Additionally, they form microvilli, tight junctions, and honeycomb packing and express distinctive markers. In these cells, outer segment phagocytosis, phagolysosome fate, phospholipid metabolism, and lipid mediator release can be studied. ABC cells display higher resistance to oxidative stress and are protected from senescence through mTOR inhibition, making them more stable in culture. The cells are responsive to Neuroprotectin D1 (NPD1), which downregulates inflammasomes and upregulates antioxidant and anti-inflammatory genes. ABC gene expression profile displays close proximity to native RPE lineage, making them a reliable cell system to unravel signaling in uncompensated oxidative stress (UOS) and retinal degenerative disease to define neuroprotection sites.
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Affiliation(s)
- Aram Asatryan
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA, United States
| | - Jorgelina M Calandria
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA, United States
| | - Marie-Audrey I Kautzmann
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA, United States
| | - Bokkyoo Jun
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA, United States
| | - William C Gordon
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA, United States
| | - Khanh V Do
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA, United States
| | - Surjyadipta Bhattacharjee
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA, United States
| | - Thang L Pham
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA, United States
| | - Vicente Bermúdez
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA, United States
| | - Melina Valeria Mateos
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA, United States
| | - Jessica Heap
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA, United States
| | - Nicolas G Bazan
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA, United States
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Ding C, Chen Y, Li X, Huang Y, Chen H, Bao J. The associations of accommodation and aberrations in myopia control with orthokeratology. Ophthalmic Physiol Opt 2021; 42:327-334. [PMID: 34866209 PMCID: PMC9300108 DOI: 10.1111/opo.12930] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 10/20/2021] [Accepted: 10/23/2021] [Indexed: 11/29/2022]
Abstract
Purpose This study aimed to investigate the effect of orthokeratology (OK) on accommodative function and aberrations, to explore the correlations between them and determine what role they play in myopia control. Methods In this prospective case‐controlled study, 61 children were divided into an OK (n = 30) and a single‐vision spectacles (SVS) (n = 31) group. Accommodation and ocular wavefront aberrations in the OK group were measured at baseline and after 1, 3, 6, 9 and 12 months of OK wear, and again at 1 month after stopping OK (13th month). The same procedure was performed in the SVS group at baseline and at 3, 6 and 12 months. Axial length (AL), accommodative lag area and aberrations including spherical aberration (SA), coma and total higher‐order aberrations (HOAs) were analysed. Results During OK wear, the accommodative lag area at each visit was lower than the baseline level (all p < 0.01); all aberrations at each visit were higher than pre‐treatment (all p < 0.001). After 1 month of OK treatment, changes in accommodative lag area and SA did not show significant correlation (p = 0.16), but after OK cessation these changes were correlated (p = 0.01). In the OK group, multivariate regression analysis showed changes in accommodative lag area were associated with AL progression in the first 6 months but not in the 1‐year analysis. For the SVS group, there were no significant changes in the accommodative lag area or any aberrations during the study period. Conclusions Increased HOAs and improved accommodative accuracy were observed during OK treatment, but began to regress after the cessation of OK. A significant positive correlation between improved accommodative accuracy and slowed axial elongation was only observed during the first 6 months of treatment.
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Affiliation(s)
- Chenglu Ding
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Yunyun Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Xue Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Yingying Huang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Hao Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Jinhua Bao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
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Li X, Ding C, Li Y, Lim EW, Gao Y, Fermigier B, Yang A, Chen H, Bao J. Influence of Lenslet Configuration on Short-Term Visual Performance in Myopia Control Spectacle Lenses. Front Neurosci 2021; 15:667329. [PMID: 34113234 PMCID: PMC8185291 DOI: 10.3389/fnins.2021.667329] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/08/2021] [Indexed: 12/14/2022] Open
Abstract
Purpose: This study aimed to evaluate short-term visual performance and optical quality of three different lenslet configurations on myopia control spectacle lenses. Materials and Methods: This study utilized a cross-over design. Distance visual acuity (VA) was measured in 50 myopic children; contrast sensitivity (CS) was measured in 36 myopic children. For each test, four spectacle lenses were evaluated in a random order: single-vision lens (SVL), lens with concentric rings of highly aspherical lenslets (HAL), lens with concentric rings of slightly aspherical lenslets (SAL), and lens with honeycomb configuration of spherical lenslets (HC). The modulation transfer function (MTF) and MTF area (MTFa) were used to determine optical quality. All tests were performed monocularly on the right eye with full correction. Results: HAL and SAL had larger MTFa than HC. VA in lenses with lenslets was significantly reduced compared to SVL (all p < 0.01). The reduction in VA was worse with HC than with SAL (p = 0.02) and HAL (p = 0.03); no effect of lenslet asphericity was found (p > 0.05). VA changes induced by lenslets showed no correlation with spherical equivalent refraction (all p > 0.05) and were weakly positively associated with age for SAL (r = 0.36, p = 0.01) and HC (r = 0.31, p = 0.03), but not for HAL (p = 0.30). The area under the log contrast sensitivity function (AULCSF) decreased with HAL and HC (all p < 0.001) in all illumination levels, and AULCSF with HAL was higher than that with HC in a photopic condition (1.17 ± 0.10 vs. 1.10 ± 0.13, p = 0.0004). The presence of lenslets did not affect CS at 3 cycles per degree (cpd) (p = 0.80). At 6 to 18 cpd, CS was significantly reduced by HAL and HC (all p < 0.05), but not SAL (p > 0.05) compared to SVL. At high spatial frequencies (>12 cpd) both SAL and HAL reduced CS significantly less than HC (all p < 0.01). Conclusion: Short-term visual performance was minimally impaired by looking through the lenslet structure of myopia control spectacle lenses. Concentric rings with aspherical lenslets had a significantly lower impact on both VA and CS than honeycomb configuration with spherical lenslets.
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Affiliation(s)
- Xue Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China.,Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou, China
| | - Chenglu Ding
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Yuhao Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China
| | - Ee Woon Lim
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou, China.,R&D AMERA, Essilor International, Singapore, Singapore
| | - Yi Gao
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou, China.,R&D AMERA, Essilor International, Singapore, Singapore
| | | | - Adeline Yang
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou, China.,R&D AMERA, Essilor International, Singapore, Singapore
| | - Hao Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China.,Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou, China
| | - Jinhua Bao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, China.,Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou, China
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Ruiz-Pomeda A, Villa-Collar C. Slowing the Progression of Myopia in Children with the MiSight Contact Lens: A Narrative Review of the Evidence. Ophthalmol Ther 2020; 9:783-795. [PMID: 32915454 PMCID: PMC7708530 DOI: 10.1007/s40123-020-00298-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Indexed: 12/16/2022] Open
Abstract
Myopia has become a major public health problem in the world due to the increase in its prevalence in the past few decades and due to sight-threatening pathologies associated with high myopia such as cataracts, glaucoma and especially myopic maculopathy. This article is a narrative review of the evidence that currently exists on a contact lenses (CLs) specifically designed to correct myopia and to slow its progression. To contextualise the topic we discuss the different classifications and definitions that have been used for myopia, the current burden of being myopic, and current treatment options to prevent and control its progression. There is evidence that exposure to sunlight reduces the risk of myopia onset and pharmacological treatment with atropine has been shown to be the most effective therapy for controlling its progression, followed by optical interventions such as CL fitting (orthokeratology or CLs specific for myopia control) designed to decrease retinal peripheral hyperopic defocus that seems to be the theory that suggests that axial elongation is driven by this defocus and explains why the eye continues to grow abnormally after emmetropisation and generates myopia. We will especially focus on MiSight CLs. MiSight is a daily replacement soft contact lens that has been clinically proven and approved by the US Food and Drug Administration (FDA) to control the progression of myopia in children. We analyse the optical design of MiSight CLs, as well as the results of the different efficacy and safety studies that led to the approval of the lens by the FDA. We also expose current knowledge gaps, limitations and future directions.
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Affiliation(s)
- Alicia Ruiz-Pomeda
- Department of Ophthalmology, Hospital Universitario de Mostoles, Mostoles, 28935, Madrid, Spain
| | - César Villa-Collar
- Department of Pharmacy, Biotechnology, Nutrition and Optics and Optometry, Universidad Europea de Madrid, Villaviciosa de Odón, 28670, Madrid, Spain.
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