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Chow AHY, Mungalsingh MA, Thai D, Selimos Z, Yan SK, Xu H, Jones DA. Suitability of multifunction devices Myah and Myopia Master for monitoring myopia progression in children and adults. Ophthalmic Physiol Opt 2024; 44:1017-1030. [PMID: 38760986 DOI: 10.1111/opo.13332] [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: 12/22/2023] [Revised: 04/22/2024] [Accepted: 04/28/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE To assess the feasibility of using multifunction instruments to measure axial length for monitoring myopia progression in children and adults. METHODS Axial length was measured in 60 children (aged 6-18 years) and 60 adults (aged 19-50 years) with multifunction instruments (Myah and Myopia Master) and stand-alone biometers (Lenstar LS900 and IOLMaster 700). Repeatability (measurements by the same examiner) and reproducibility (measurements by different examiners) were computed as the within-subject standard deviation (Sw) and 95% limits of agreement (LoA). Inter-instrument agreement was computed as intraclass correlation coefficients. The threshold for detecting myopic progression was taken as 0.1 mm. Measures were repeated only in children following the administration of 1% tropicamide to determine the impact of cycloplegia on axial length. RESULTS Overall, the IOLMaster 700 had the best repeatability in children (0.014 mm) and adults (0.009 mm). Repeatability Sw values for all devices ranged from 0.005 to 0.021 mm (children) and 0.003 to 0.016 mm (adults). In children, reproducibility fell within 0.1 mm 95% of the time for the Myah, Myopia Master and IOLMaster 700. Agreement among all devices was classified as excellent (ICC 0.999; 95% CI 0.998-0.999), but the 95% LoA among the Myah, Myopia Master and Lenstar LS900 was ≥0.1 mm. Cycloplegia had no statistically significant effect on axial length (all p > 0.13). CONCLUSIONS The Myah and Myopia Master multifunction instruments demonstrated good repeatability and reproducibility, and their accuracy was comparable to stand-alone biometers. Axial length measurements using different instruments can be considered interchangeable but should be compared with some caution. Accurate axial length measurements can be obtained without cycloplegia. The multifunction instruments Myah and Myopia Master are as well suited for monitoring myopia progression in children as the stand-alone biometers IOLMaster 700 and Lenstar LS900.
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Affiliation(s)
- Amy H Y Chow
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
- Centre for Eye and Vision Research, Hong Kong, SAR China
| | - Melanie A Mungalsingh
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Danny Thai
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Zoe Selimos
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Sarah Kathryn Yan
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Hellen Xu
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Deborah A Jones
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
- Centre for Eye and Vision Research, Hong Kong, SAR China
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Rozema JJ, Iribarren R, Hashemi H, Khabazkhoob M, Fotouhi A. Mean cycloplegic refractive error in emmetropic adults - The Tehran Eye Study. JOURNAL OF OPTOMETRY 2024; 17:100512. [PMID: 38244522 PMCID: PMC10832267 DOI: 10.1016/j.optom.2023.100512] [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: 11/29/2023] [Revised: 12/24/2023] [Accepted: 12/27/2023] [Indexed: 01/22/2024]
Abstract
PURPOSE In children under 20 years, refractive development targets a cycloplegic refractive error of +0.5 to +1.5D, while presbyopes over 40 years generally have non-cycloplegic errors of ≥ +1D. Some papers suggest these periods are separated by a period of myopic refractive error (i.e., ≤ -0.50D), but this remains unclear. Hence, this work investigates the mean cycloplegic refractive error in adults aged between 20 - 40 years. METHODS In 2002 a cross-sectional study with stratified cluster sampling was performed on the population of Tehran, providing cycloplegic and non-cycloplegic refractive error data for the right eyes of 3,576 participants, aged 30.6±18.6 years (range: 1-86 years). After grouping these data into age groups of 5 years, the refractive error histogram of each group was fitted to a Bigaussian function. The mean of the central, emmetropized peak was used to estimate the mean refractive error without the influence of myopia. RESULTS The mean cycloplegic refractive error at the emmetropized peak decreased from +1.10±0.11D (95 % confidence interval) to +0.50±0.04D before 20 years and remains stable at that value until the age of 50 years. The non-cycloplegic refractive error also sees a stable phase at 0.00±0.04D between 15 - 45 years. After 45 - 50 years both cycloplegic and non-cycloplegic refractive error become more hypermetropic over time, +1.14±0.12D at 75 years. CONCLUSIONS The cycloplegic refractive error in adults is about +0.50D between 20 - 50 years, disproving the existence of the myopic period at those ages.
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Affiliation(s)
- Jos J Rozema
- Visual Optics Lab Antwerp (VOLANTIS), University of Antwerp, Antwerp, Belgium; Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium; Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany.
| | | | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Xu S, Li L, Han W, Zhu Y, Hu Y, Li Z, Ruan Z, Zhou Z, Zhuo Y, Fu M, Yang X. Association Between Myopia and Pupil Diameter in Preschoolers: Evidence from a Machine Learning Approach Based on a Real-World Large-Scale Dataset. Ophthalmol Ther 2024; 13:2009-2022. [PMID: 38822998 PMCID: PMC11178758 DOI: 10.1007/s40123-024-00972-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 05/14/2024] [Indexed: 06/03/2024] Open
Abstract
INTRODUCTION Previous studies have explored the connections between various ocular biological parameters with myopia. Our previous study also found that pupil data can predict the myopic progression during the interventions for myopia. However, studies exploring the association between pupil diameter and myopia in preschoolers with myopia were lacking. Hence this study was aimed to investigate the association between pupil diameter and myopia in preschoolers with myopia based on a real-world, large-scale dataset. METHODS Data containing 650,671 preschoolers were collected from a total of 1943 kindergartens in Shenzhen, China. Refraction and pupil parameters were collected. After data filtering, the occurrence of myopia and its association with age, gender, pupil diameter, and other variables, were analyzed. Random forest (RF) and eXtreme gradient boosting (XGBoost) were selected from seven machine learning algorithms to build the model. The mean decrease accuracy (MDA), mean decrease Gini (MDG), and gain feature importance (GFI) techniques were employed to quantify the importance of pupil diameter and other features. RESULTS After the assessments, 51,325 valid records with complete pupil data were included, and 3468 (6.76%) were identified as myopia based on the calculated cycloplegic refraction. Preschoolers with myopia presented reduced pupil diameter and greater variation (5.00 ± 0.99 mm) compared to non-myopic preschoolers (6.22 ± 0.67 mm). A nonlinear relationship was found according to the scatterplots between pupil diameter and refraction (R2 = 0.14). Especially preschoolers with myopia had reduced pupil diameter compared to emmetropic preschoolers, but hyperope did not experience additional pupil enlargement. After adjusting for other covariates, this relationship is still consistent (P < 0.001). XGBoost and RF algorithms presented the highest performance and validated the importance of pupil diameter in myopia. CONCLUSIONS Based on a real-world large-scale dataset, the current study illuminated that preschoolers with myopia had a reduced pupil diameter compared to emmetropic preschoolers with a nonlinear pattern. Machine learning algorithms visualized and validated the pivotal role of pupil diameter in myopia. TRIAL REGISTRATION chictr.org Identifier: ChiCTR2200057391.
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Affiliation(s)
- Shengsong Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 Xianlie South Road, Yuexiu District, Guangzhou, China
| | - Linling Li
- Department of Ophthalmology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, 3012 Fuqiang Road, Futian District, Shenzhen, China
| | - Wenjing Han
- Department of Medical Imaging Technology, Yanjing Medical College, Capital Medical University, Beijing, China
| | - Yingting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 Xianlie South Road, Yuexiu District, Guangzhou, China
| | - Yin Hu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 Xianlie South Road, Yuexiu District, Guangzhou, China
| | - Zhidong Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 Xianlie South Road, Yuexiu District, Guangzhou, China
| | - Zhenbang Ruan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 Xianlie South Road, Yuexiu District, Guangzhou, China
| | - Zhuandi Zhou
- Department of Ophthalmology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, 3012 Fuqiang Road, Futian District, Shenzhen, China
| | - Yehong Zhuo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 Xianlie South Road, Yuexiu District, Guangzhou, China
| | - Min Fu
- Department of Ophthalmology, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, 3012 Fuqiang Road, Futian District, Shenzhen, China.
| | - Xiao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 Xianlie South Road, Yuexiu District, Guangzhou, China.
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Nitzan I, Shmueli O, Safir M. Association of myopia with anxiety and mood disorders in adolescents. Eye (Lond) 2024:10.1038/s41433-024-03170-6. [PMID: 38871937 DOI: 10.1038/s41433-024-03170-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 05/03/2024] [Accepted: 06/06/2024] [Indexed: 06/15/2024] Open
Affiliation(s)
- Itay Nitzan
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
- Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Or Shmueli
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
- Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Margarita Safir
- Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Ophthalmology, Shamir Medical Center, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Yang B, Liu L, Cho P. Effectiveness of orthokeratology and myopia control spectacles in a real-world setting in China. Cont Lens Anterior Eye 2024; 47:102167. [PMID: 38609791 DOI: 10.1016/j.clae.2024.102167] [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: 02/08/2024] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE To compare the effectiveness of myopia control in Chinese children, who had been wearing either orthokeratology (ortho-k) lenses or myopia control spectacles (MCS) for one year. METHODS Relevant data were retrieved from 212 patients, with baseline myopia of -5.00 to -0.75 D, astigmatism ≤ 1.50 D, who had been undergoing myopia control treatment with either ortho-k (Euclid (OK1) or CRT (OK2)) or MCS (Stellest (MCS1) or DIMS (MCS2)) for at least one year. Myopia control effectiveness among the four groups was compared based on the change in spherical equivalent refraction (SER) (for the spectacle groups) and axial length (AL) (for all groups). Data retrieved, from the right eye only, included best corrected visual acuity (BCVA), SER, and AL at both the initial clinic visit (baseline) and the one-year visit was analysed. RESULTS Although no significant differences in gender, cylindrical power, or BCVA were observed at the baseline visit (P > 0.05), there were significant differences in baseline age, myopia, and AL among the four groups (P < 0.05). No significant difference in axial elongation (AE) was found among the four groups after one year of treatment (P = 0.49). AE, adjusted for baseline age and spherical power, were 0.19 ± 0.15, 0.18 ± 0.14, 0.19 ± 0.19, 0.20 ± 0.18 mm for OK1, OK2, MCS1, MCS2, respectively. Only age was a significantly factor associated with AE and SER increase (P < 0.05), with negative associations between AE and age in all groups and positive association between SER increase and baseline age in the spectacle groups observed. CONCLUSION Both brands of ortho-k lenses and MCS had similar myopia control effectiveness for mild to moderate myopic children treated in a real-world setting in China. Average AE in one year ranged from 0.18 to 0.20 mm, comparable to previous reports on myopia control using ortho-k.
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Affiliation(s)
- Bi Yang
- Department of Optometry and Vision Sciences, West China School of Medicine, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China School of Medicine, Sichuan University, Chengdu, China.
| | - Longqian Liu
- Department of Optometry and Vision Sciences, West China School of Medicine, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China School of Medicine, Sichuan University, Chengdu, China
| | - Pauline Cho
- Department of Optometry and Vision Sciences, West China School of Medicine, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China School of Medicine, Sichuan University, Chengdu, China
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Machluf Y, Israeli A, Cohen E, Chaiter Y, Mezer E. Dissecting the complex sex-based associations of myopia with height and weight. Eye (Lond) 2024; 38:1485-1495. [PMID: 38242948 PMCID: PMC11126622 DOI: 10.1038/s41433-024-02931-7] [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: 03/30/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 01/21/2024] Open
Abstract
OBJECTIVES To assess height and weight as possible sex-specific risk factors for bilateral myopia among young adults. METHODS We conducted a cross-sectional study including 101,438 pre-enlisted young adult males and females, aged 17.4 ± 0.6 and 17.3 ± 0.5 years, respectively, and born during 1971-1994. Categories of BMI (body mass index) were defined according to sex-related percentiles for 17-year-olds following U.S. Centers for Disease Control and Prevention growth charts, and subjects were divided into five height and weight categories according to sex-adjusted percentiles. Data included best-corrected visual acuity, diverse socio-demographic variables, anthropometric indices, and refractive errors, namely bilateral myopes and emmetropes. RESULTS The prevalence of bilateral myopia in males and females was 19.1% and 26.0%, respectively. Bilateral myopia displayed a J-shaped associated with BMI, achieving statistical significance only among males (p < 0.0001). Weight displayed a U-shaped association with bilateral myopia among both young males (p < 0.0001) and females (p < 0.005). A higher prevalence of bilateral myopia was observed only among males of the lower height category (p < 0.0001), even when controlling for BMI (from normal to obesity). In a multivariable regression model, obesity was associated with higher prevalence of bilateral myopia (OR: 1.21; 95% CI: 1.07-1.38, p = 0.002), only among males. There were no interactions of BMI with height or weight. Bilateral myopia was also associated with prehypertension among males (OR: 1.10, 95% CI: 1.04-1.15, p < 0.001). CONCLUSIONS A higher risk for bilateral myopia was associated with either BMI solely or height and weight, as well as pre-hypertension, in males. The possible association with low height requires further research.
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Affiliation(s)
- Yossy Machluf
- Israel Defense Forces, Medical Corps, Tel Hashomer, Israel.
- Unit of Agrigenomics, Shamir Research Institute, Haifa University, Kazerin, Israel.
| | - Asaf Israeli
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Tel Aviv Medical Center, Tel Aviv, Israel
| | - Eduardo Cohen
- Israel Defense Forces, Medical Corps, Tel Hashomer, Israel
| | - Yoram Chaiter
- Israel Defense Forces, Medical Corps, Tel Hashomer, Israel
- The Israeli Center for Emerging Technologies in Hospitals and Hospital-based Health Technology Assessment, Shamir (Assaf Harofeh) Medical Center, Be'er Ya'akov, Israel
| | - Eedy Mezer
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Department of Ophthalmology, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
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Xiong R, Wang W, Tang X, He M, Hu Y, Zhang J, Du B, Jiang Y, Zhu Z, Chen Y, Zhang S, Kong X, Wei R, Yang X, He M. Myopia Control Effect of Repeated Low-Level Red-Light Therapy Combined with Orthokeratology: A Multicenter Randomized Controlled Trial. Ophthalmology 2024:S0161-6420(24)00308-7. [PMID: 38763303 DOI: 10.1016/j.ophtha.2024.05.015] [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: 01/30/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 05/21/2024] Open
Abstract
PURPOSE To investigate the efficacy and safety of repeated low-level red-light(RLRL) therapy combined with orthokeratology(Ortho-k) among the children who, despite undergoing Ortho-k treatment, exhibited an axial elongation of at least 0.50mm over 1 year. DESIGN Multicenter, randomized, parallel-group, single-blind clinical trial (ClinicaTrials.gov,NCT04722874). PARTICIPANTS Eligible children were aged 8-13 years with a cycloplegic spherical equivalent refraction of -1.00 to -5.00 diopters in the initial Ortho-k fitting examination and had annual axial length (AL) elongation ≥ 0.50 mm despite undergoing Ortho-k for 1 year. A total of 48 children were enrolled from March 2021 to January 2022, and the final follow-up was completed in March 2023. METHODS Children were randomly assigned to the RLRL combined with Ortho-k(RCO) or the Ortho-k group in a 2:1 ratio. The Ortho-k group wore Ortho-k at least 8 hours per night, while the RCO group received daily RLRL therapy twice a day for 3 minutes in addition to Ortho-k wearing. MAIN OUTCOME MEASURES The primary outcome was AL change measured at 12 months relative to baseline. The primary analysis was conducted in children who received the assigned intervention and completed at least 1 post-randomization follow-up using the modified intention-to-treat principle. RESULTS A total of 47(97.9%) children were included in the analysis (30 in the RCO group and 17 in the Ortho-k group). The mean axial elongation rate before the trial was 0.60mm/year in the RCO group and 0.61mm/year in the Ortho-k group. After 12 months following the intended intervention, the adjusted mean AL changes were -0.02mm(95% CI, -0.08 to +0.03 mm) in the RCO group and 0.27mm(0.19-0.34 mm) in the Ortho-k group. The adjusted mean difference in AL change was -0.29mm(-0.44 to -0.14mm) between the RCO and Ortho-k groups. The percentage of children achieving an uncorrected visual acuity greater than 20/25 was similar in the RCO (64.3%) and Ortho-k (65.5%) groups (Chi2 test, P=0.937). CONCLUSIONS Combining RLRL therapy with Ortho-k may offer a promising approach to optimize axial elongation control among myopic children. This approach also potentially allows children to achieve satisfactory visual acuity, reducing the daytime dependence on corrective eyewear.
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Affiliation(s)
- Ruilin Xiong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Xianghua Tang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Meinan He
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yin Hu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Jian Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Bei Du
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yu Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China; Department of Ophthalmology, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Zhuoting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China; Center for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Yanping Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Shiran Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Xiangbin Kong
- Ophthalmology, Department of Surgery, The Second People's Hospital of Foshan, Foshan, Guangdong, China.
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
| | - Xiao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China.
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China; School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong; Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong; Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong.
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Sankaridurg P, Tran H, Tahhan N, Stern J. What can we do about myopia? An evidence-informed approach. COMMUNITY EYE HEALTH 2024; 37:8-9. [PMID: 38827974 PMCID: PMC11141119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Affiliation(s)
- Padmaja Sankaridurg
- Conjoint Professor: School of Optometry and Vision Science, University of New South Wales, Sydney, Australia and Head, Global Myopia Management: ZEISS VisionCare, Aalen, Germany
| | - Huy Tran
- Lecturer: Department of Ophthalmology, University of Medicine and Pharmacy at, Ho Chi Minh City, Vietnam
| | - Nina Tahhan
- Executive Director: International Myopia Institute, Sydney, Australia
| | - Jude Stern
- Head of Knowledge Management: International Agency for the Prevention of Blindness, Sydney, Australia
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She Z, Gawne TJ. The Parameters Governing the Anti-Myopia Efficacy of Chromatically Simulated Myopic Defocus in Tree Shrews. Transl Vis Sci Technol 2024; 13:6. [PMID: 38722277 PMCID: PMC11090138 DOI: 10.1167/tvst.13.5.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/21/2024] [Indexed: 05/15/2024] Open
Abstract
Purpose We previously showed that exposing tree shrews (Tupaia belangeri, small diurnal mammals closely related to primates) to chromatically simulated myopic defocus (CSMD) counteracted small-cage myopia and instead induced hyperopia (approximately +4 diopters [D]). Here, we explored the parameters of this effect. Methods Tree shrews were exposed to the following interventions for 11 days: (1) rearing in closed (n = 7) or open (n = 6) small cages; (2) exposed to a video display of Maltese cross images with CSMD combined with overhead lighting (n = 4); (3) exposed to a video display of Maltese cross images with zero blue contrast ("flat blue," n = 8); and (4) exposed to a video display of black and white grayscale tree images with different spatial filtering (blue pixels lowpass <1 and <2 cycles per degree [CPD]) for the CSMD. Results (1) Tree shrews kept in closed cages, but not open cages, developed myopia. (2) Overhead illumination reduced the hyperopia induced by CSMD. (3) Zero-blue contrast produced hyperopia but slightly less than the CSMD. (4) Both of the CSMD tree images counteracted small cage myopia, but the one low pass filtering blue <1 CPD was more effective at inducing hyperopia. Conclusions Any pattern with reduced blue contrast at and below approximately 1 CPD counteracts myopia/promotes hyperopia, but maximal effectiveness may require that the video display be the brightest object in the environment. Translational Relevance Chromatically simulated myopic blur might be a powerful anti-myopia therapy in children, but the parameter selection could be critical. Issues for translation to humans are discussed.
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Affiliation(s)
- Zhihui She
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Timothy J. Gawne
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, AL, USA
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Iribarren R, Cunha C, Kaymak H, Grzybowski A. Preservatives and pH in low-dose atropine formulations for clinical trials. Acta Ophthalmol 2024; 102:364-366. [PMID: 38131255 DOI: 10.1111/aos.16604] [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: 09/27/2023] [Revised: 10/23/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023]
Abstract
Over a century ago, atropine has been tested to arrest myopia progression with good results. In recent years, many randomized clinical trials have tested different concentrations against placebo. Three recent such studies with low-dose atropine showed that it was less effective than previous studies, even the last one showing no difference in myopia progression between the treated and control group. Previous randomized studies had been performed in Asian populations, and these last three were extended to Western Caucasian populations, based on the initial observation that differences in iris pigmentation could be a factor for a difference in effectiveness. We have noticed that the three last studies in the West have used the same patented formulation, while previous studies have preferred compounded low-dose atropine. Here we review how the power of hydrogen (pH) and preservatives could account for differences in drug penetration to the eye, possibly explaining the differences between studies.
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Affiliation(s)
| | - Celso Cunha
- Oftalmocenter Santa Rosa Cuiabá, Cuiabá, Mato Grosso, Brazil
| | - Hakan Kaymak
- Internationale Innovative Ophthalmochirurgie GbR, Duesseldorf, Germany
- Institute for Experimental Ophthalmology, Saarland University, Homburg, Germany
| | - Andrzej Grzybowski
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
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11
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Liu Z, Herold F, Owen N, Huang Z, Kuang J, Kramer AF, Ng JL, Zou L. Associations of meeting 24-hour movement behavior guidelines with prescribed eyeglasses/contact lenses among children and adolescents. Complement Ther Clin Pract 2024; 55:101844. [PMID: 38521002 DOI: 10.1016/j.ctcp.2024.101844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/25/2024] [Accepted: 03/07/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Vision health is crucial for many aspects of life especially in developing populations such as children and adolescents. However, there is a high proportion of children and adolescents who suffer from visual impairments. Notably, accumulating evidence indicates that meeting the 24-hour movement behaviors (24-HMB) guidelines is associated with positive physical and mental health outcomes in children and adolescents. However, the relationship between being prescribed eyeglasses/contact lenses and meeting the 24-HMB guidelines has yet to be investigated. Thus, this study aimed to address this gap in the existing literature by using the 2021 National Survey of Children's Health (NSCH) dataset. METHODS In this cross-sectional study, data was retrieved from the 2021 NSCH. A total of 14,193 U.S. children and adolescents aged between 6 and 17 years were included for data analyses. We used items of the NSCH concerning the 24-HMB guidelines (i.e., physical activity, screen time, and sleep duration) and prescription of eyeglasses/contact lenses that were answered by the legal guardian of the children. Binary logistic regression was performed to investigate whether meeting the 24-HMB guidelines is associated with prescription eyeglasses/contact lenses and whether wearing eyeglasses/contact lenses predicts adherence to the 24-HMB guidelines among children and adolescents. RESULTS More than half of the participants (59.53%) wore eyeglasses/contact lenses and only 8.40% of them met all three of the 24-HMB guidelines. Compared to meeting none of the 24-HMB guidelines, meeting one (OR = 0.76, 95% CI = 0.62-0.93, p = 0.008), two (OR = 0.54, 95% CI = 0.43-0.67, p < 0.001), and all three 24-HMB guidelines (OR = 0.47, 95% CI = 0.34-0.64, p < 0.001) were associated with a lower risk of being prescribed eyeglasses/contact lenses among children and adolescents. CONCLUSIONS The findings of the current study provided evidence that the prevalence of U.S. children and adolescents aged between 6 and 17 years who wore eyeglasses/contact lenses was relatively high. Furthermore, meeting the 24-HMB guidelines was associated with a lower risk of being prescribed eyeglasses/contact lenses. Future studies focusing on the effects of 24-HMB interventions on vision health among children and adolescents are needed to better inform public health actions.
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Affiliation(s)
- Zijun Liu
- Body-Brain-Mind Laboratory, Shenzhen University, Shenzhen, 518060, China
| | - Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Neville Owen
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia; Physical Activity Laboratory, Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia
| | - Zhenmin Huang
- Shenzhen Institute for Education and Science, Shenzhen, 518060, China
| | - Jin Kuang
- Body-Brain-Mind Laboratory, Shenzhen University, Shenzhen, 518060, China
| | - Arthur F Kramer
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, IL, USA; Center for Cognitive and Brain Health, Northeastern University, Boston, MA, USA; Department of Psychology, Northeastern University, Boston, MA, 02115, USA
| | - Jonathan Leo Ng
- School of Education, College of Design and Social Context, RMIT University, Victoria, Australia
| | - Liye Zou
- Body-Brain-Mind Laboratory, Shenzhen University, Shenzhen, 518060, China.
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12
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Naik A, Karthikeyan SK, Ramesh JJ, Bhaskar S, Ganapathi CA, Biswas S. An Insight into Knowledge, Perspective, and Practices of Indian Optometrists towards Childhood Myopia. Vision (Basel) 2024; 8:22. [PMID: 38651443 PMCID: PMC11036249 DOI: 10.3390/vision8020022] [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: 02/18/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
The current understanding of clinical approaches and barriers in managing childhood myopia among Indian optometrists is limited. This research underscores the necessity and relevance of evidence-based practice guidelines by exploring their knowledge, attitude, and practice towards childhood myopia. A self-administered internet-based 26-item survey was circulated online among practicing optometrists in India. The questions assessed the demographics, knowledge, self-reported clinical practice behavior, barriers, source of information guiding their management, and extent of adult caregiver engagement for childhood myopia. Of 393 responses, a significant proportion of respondents (32.6-92.4%) were unaware of the ocular complications associated with high myopia, with less than half (46.5%) routinely performing ocular biometry in clinical practice. Despite the growing awareness of emerging myopia management options, the uptake remains generally poor, with single-vision distance full-correction spectacles (70.3%) being the most common mode of vision correction. Barriers to adopting optimal myopia care are medicolegal concerns, absence of clinical practice guidelines, and inadequate consultation time. Own clinical experience and original research articles were the primary sources of information supporting clinical practice. Most (>70%) respondents considered involving the adult caregiver in their child's clinical decision-making process. While practitioners' awareness and activity of newer myopia management strategies are improving, there is plenty of scope for its enhancement. The importance of evidence-based practice guidelines and continuing education on myopia control might help practitioners enhance their clinical decision-making skills.
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Affiliation(s)
- Archana Naik
- Department of Optometry, Netra Jyothi Institute of Allied Health Sciences, Udupi 576101, Karnataka, India; (A.N.); (S.K.K.); (S.B.)
- Aloka Vision Programme, Carl Zeiss India Pvt. Ltd., Bangalore 560099, Karnataka, India
| | - Siddharth K. Karthikeyan
- Department of Optometry, Netra Jyothi Institute of Allied Health Sciences, Udupi 576101, Karnataka, India; (A.N.); (S.K.K.); (S.B.)
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India;
| | - Jivitha Jyothi Ramesh
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India;
| | - Shwetha Bhaskar
- Department of Optometry, Netra Jyothi Institute of Allied Health Sciences, Udupi 576101, Karnataka, India; (A.N.); (S.K.K.); (S.B.)
- Aloka Vision Programme, Carl Zeiss India Pvt. Ltd., Bangalore 560099, Karnataka, India
| | - Chinnappa A. Ganapathi
- Department of Paediatric Ophthalmology, Prasad Netralaya, Udupi 576101, Karnataka, India;
| | - Sayantan Biswas
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
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13
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Zhao J, Xiao M, Zhu Y, Gong Q, Qu J, Lu F, Hu L. Degradation of Photopic and Mesopic Contrast Sensitivity Function in High Myopes With Partial Posterior Vitreous Detachment. Transl Vis Sci Technol 2024; 13:3. [PMID: 38564201 PMCID: PMC10996935 DOI: 10.1167/tvst.13.4.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/18/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose The purpose of this study was to evaluate the effects of posterior vitreous detachment (PVD) on visual quality in patients with high myopia, as well as investigate the associated factors of photopic and mesopic contrast sensitivity function (CSF) in high myopia. Methods Visual quality was comprehensively assessed in patients with high myopia. Visual acuity, contrast sensitivity (CS) at four spatial frequencies (3, 6, 12, and 18 cycles per degree [c.p.d.]) under photopic and mesopic conditions, as well as the modulation transfer function cutoff value (MTFcutoff), the objective scatter index (OSI), the Strehl ratio (SR), and internal aberrations, were measured in this cross-sectional study. Results This study included 94 eyes from 47 subjects with bilateral high myopia, including 23 eyes with complete PVD (cPVD), 21 eyes with partial PVD (pPVD), and 50 eyes without PVD (nPVD). There was no significant difference in visual quality between the cPVD group and the nPVD group. Whereas in eyes with pPVD, there was a degradation of overall photopic CSF (versus nPVD, P = 0.048), photopic CS at 3 c.p.d. (versus cPVD, P = 0.009 and versus nPVD, P = 0.032), photopic CS at 18 c.p.d. (versus nPVD, P = 0.033), overall mesopic CSF (versus nPVD, P = 0.033), and secondary astigmatism (versus cPVD, P = 0.044). Under photopic conditions, the factors affecting CSF were pPVD and SR, whereas the factors affecting mesopic CSF were pPVD, OSI, and ganglion cell-inner plexiform layer thickness. Conclusions The pPVD impaired visual quality in patients with high myopia compared to nPVD or cPVD, and pPVD could be a factor explaining CSF at both photopic and mesopic illumination. Translational Relevance Clinicians need to closely monitor patients with high myopia with pPVD due to the potential decline in visual quality and the development of vitreoretinal disorders.
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Affiliation(s)
- Jian Zhao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Minzhi Xiao
- Department of Ophthalmology, the Second People's Hospital of Foshan, Foshan, China
| | - Ye Zhu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Qianwen Gong
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jia Qu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Fan Lu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Liang Hu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
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14
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Díaz-Gómez S, Burgos-Martínez M, Sankaridurg P, Urkia-Solorzano A, Carballo-Álvarez J. Two-Year Myopia Management Efficacy of Extended Depth of Focus Soft Contact Lenses (MYLO) in Caucasian Children. Am J Ophthalmol 2024; 260:122-131. [PMID: 38056608 DOI: 10.1016/j.ajo.2023.11.025] [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: 03/27/2023] [Revised: 11/25/2023] [Accepted: 11/28/2023] [Indexed: 12/08/2023]
Abstract
PURPOSE To evaluate the progression of myopia as assessed by change in axial length (AL) and spherical equivalent (SE) from baseline in Caucasian children wearing extended depth of focus soft contact lenses (CLs) compared to distance single-vision spectacles. DESIGN Prospective non-randomized comparative clinical trial. METHODS A total of 90 children (6-13 years of age) with SE ranging from -0.75 to -10.00 diopters (D) were recruited. Of these children, 45 were fitted with CLs (MYLO, mark´ennovy), whereas 45 children wore spectacles. Cycloplegic refraction was measured with an auto-refractometer (Topcon-TRK-2P) and AL with an IOLMaster-700 (Zeiss) at 6-month intervals. Subjective responses after 1 month of CL wear related to vision and comfort were determined using a questionnaire with a scale from 1 (very poor) to 10 (excellent). High-contrast visual acuity (HCVA) and contrast sensitivity (CS) were evaluated at baseline, 12, and 24 months. RESULTS After 2 years, mean change in SE/AL in the CL group was -0.62 ± 0.30 D/0.37 ± 0.04 mm and -1.13 ± 0.20 D/0.66 ± 0.03 mm in the spectacles group (P < .001). Cumulative absolute reduction in axial elongation (CARE) was 0.29 ± 0.06 mm. Difference in SE change was -0.50 ± 0.34 D. Although 100% of CL group had an AL increase ≤0.50 mm, all participants increased ≥0.50 mm in the spectacles group. In all, 53% of the CL group and 1% in the spectacles group showed a progression in SE ≤ -0.50D. All questionnaire items showed a mean value ≥9. There was a reduction logMAR HCVA in the CL compared to the spectacles group but it was less than 1 line (P < .001). CONCLUSIONS Use of MYLO CLs reduced axial elongation and myopia progression compared to use of distance single-vision spectacles.
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Affiliation(s)
- Sergio Díaz-Gómez
- From the Faculty of Optics and Optometry (S.D.-G., J.C.-A.), Complutense University of Madrid, Madrid, Spain; Miranza Centro Oftalmológico Integral (COI) (S.D.-G., A.U.-S.), Bilbao, Spain
| | | | - Padmaja Sankaridurg
- School of Optometry and Vision Science (P.S.)(,) University of New South Wales(,) Sydney, Australia
| | | | - Jesús Carballo-Álvarez
- From the Faculty of Optics and Optometry (S.D.-G., J.C.-A.), Complutense University of Madrid, Madrid, Spain.
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15
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Li M, Xu H, Ye L, Zhou S, Xie J, Liu C, Zhu J, He J, Fan Y, Xu X. Association of macular outward scleral height with axial length, macular choroidal thickness and morphologic characteristics of the optic disc in Chinese adults. Eye (Lond) 2024; 38:923-929. [PMID: 37898715 PMCID: PMC10966051 DOI: 10.1038/s41433-023-02804-5] [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: 02/12/2023] [Revised: 10/09/2023] [Accepted: 10/18/2023] [Indexed: 10/30/2023] Open
Abstract
PURPOSE To identify the relationship of macular outward scleral height (MOSH) with axial length (AL), macular choroidal thickness (ChT), peripapillary atrophy (PPA), and optic disc tilt in Chinese adults. METHODS In this cross-sectional study, 1088 right eyes of 1088 participants were enrolled and assigned into high myopia (HM) and non-HM groups. MOSH was measured in the nasal, temporal, superior, and inferior directions using swept-source optical coherence tomography images. The clinical characteristics of MOSH and the association of MOSH with AL, macular ChT, PPA, and tilt ratio were analysed. RESULTS The mean age of participants was 37.31 ± 18.93 years (range, 18-86 years), and the mean AL was 25.78 ± 1.79 mm (range, 21.25-33.09 mm). MOSH was the highest in the temporal direction, followed by the superior, nasal, and inferior directions (all p < 0.001). The MOSH of HM eyes was significantly higher than that of non-HM eyes, and it was positively correlated with AL in the nasal, temporal, and superior directions (all p < 0.001). Macular ChT was independently associated with the average MOSH (B = -0.190, p < 0.001). Nasal MOSH was positively associated with the PPA area and the presence of a tilted optic disc (both p < 0.01). Eyes with a higher MOSH in the superior (odds ratio [OR] = 1.008; p < 0.001) and inferior directions (OR = 1.006; p = 0.009) were more likely to have posterior staphyloma. CONCLUSION MOSH is an early indicator of scleral deformation, and it is correlated positively with AL and negatively with ChT. A higher nasal MOSH is associated with a larger PPA area and the presence of a tilted optic disc. Higher MOSH values in the superior and inferior directions were risk factors for posterior staphyloma. CLINICAL TRIAL REGISTRATION The study was registered at www. CLINICALTRIALS gov (Reg. No. NCT03446300).
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Affiliation(s)
- Menghan Li
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, 200040, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200080, China
| | - Hannan Xu
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, 200040, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200080, China
| | - Luyao Ye
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, 200040, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200080, China
| | - Siheng Zhou
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, 200040, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200080, China
| | - Jiamin Xie
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, 200040, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200080, China
| | - Chen Liu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200080, China
| | - Jianfeng Zhu
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, 200040, China
| | - Jiangnan He
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, 200040, China.
| | - Ying Fan
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200080, China.
| | - Xun Xu
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, 200040, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200080, China
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16
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Guo Y, Lu J, Zhu L, Hao X, Huang K. Association between hyperglycemia during pregnancy and offspring's refractive error: A focused review. Eur J Ophthalmol 2024:11206721241238389. [PMID: 38523364 DOI: 10.1177/11206721241238389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
This review article explores the relationship between hyperglycemia during pregnancy and the visual development of offspring, specifically focusing on refractive error. The authors conducted a comprehensive search for relevant articles in various databases and assessed the methodological quality of the included studies. The findings consistently indicate that hyperglycemia during pregnancy can have a detrimental impact on the structural and functional aspects of visual development in offspring. The intrauterine hyperglycemic environment appears to negatively affect the retina and lens, leading to refractive errors. In conclusion, there is likely an association between hyperglycemia during pregnancy and the development of refractive errors in offspring.
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Affiliation(s)
- Yufan Guo
- School of Public Health, Anhui Medical University, Hefei, Anhui Province, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Courset, Hefei, Anhui, China
| | - Jingru Lu
- School of Public Health, Anhui Medical University, Hefei, Anhui Province, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Courset, Hefei, Anhui, China
| | - Linlin Zhu
- School of Public Health, Anhui Medical University, Hefei, Anhui Province, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Courset, Hefei, Anhui, China
| | - Xuemei Hao
- School of Public Health, Anhui Medical University, Hefei, Anhui Province, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Courset, Hefei, Anhui, China
| | - Kun Huang
- School of Public Health, Anhui Medical University, Hefei, Anhui Province, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Courset, Hefei, Anhui, China
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17
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Shen M, Han X, Yang Y, Huang H, Hou J, Jin L, Yu X, Zeng Y, He M. Longitudinal Changes in Choroidal Thickness Varied With Refractive Progression in Myopic and Non-Myopic Children: A Two-Year Cohort Study. Invest Ophthalmol Vis Sci 2024; 65:17. [PMID: 38470328 PMCID: PMC10939140 DOI: 10.1167/iovs.65.3.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/19/2024] [Indexed: 03/13/2024] Open
Abstract
Purpose To evaluate the longitudinal changes in subfoveal choroidal thickness (SFCT) in children with different refractive status. Methods A total of 2290 children 3 to 14 years old who attended the first year of kindergarten (G0), first year of primary school (G1), fourth year of primary school (G4), or first year of junior high school (G7) in Guangzhou, China, were recruited and followed up for 2 years. All participants received cycloplegic autorefraction, axial length measurement and SFCT measurement using a CIRRUS HD-OCT device. Children were divided into groups of persistent non-myopia (PNM), persistent myopia (PM), or newly developed myopia (NDM). Children in the PNM and PM groups were further divided into subgroups of stable refraction (absolute mean annual spherical equivalent refraction [SER] change < 0.5 D) and refractive progression (absolute mean annual SER change ≥ 0.5 D). Results The mean ± SD ages for the G1 to G7 cohorts were 3.89 ± 0.30, 6.79 ± 0.47, 9.71 ± 0.34, and 12.54 ± 0.38, years, respectively. SFCT consistently decreased in the NDM group across the G1 to G7 cohorts (all P < 0.001) and exhibited variability across different age cohorts in the PNM and PM groups. Further subgroup analysis revealed significant thickening of SFCT in the PNM-stable group among the G0, G1, and G7 cohorts (all P < 0.05), whereas it remained stable among all cohorts in the PM-stable group (all P > 0.05). Conversely, SFCT exhibited thinning in the G4 and G7 cohorts in the PM-progressive group (both P < 0.01) and for the entire cohort of children in the PNM-progressive group (P = 0.012). Conclusions SFCT increased in nonmyopic children with stable refraction, remained stable in myopic children maintained stable refraction, and decreased in those with refractive progression, whether they were myopic or not.
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Affiliation(s)
- Menglu Shen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Xiaotong Han
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Yan Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Hailu Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Jinen Hou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Xinping Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Yangfa Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
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Sánchez-Tena MÁ, Ballesteros-Sánchez A, Martinez-Perez C, Alvarez-Peregrina C, De-Hita-Cantalejo C, Sánchez-González MC, Sánchez-González JM. Assessing the rebound phenomenon in different myopia control treatments: A systematic review. Ophthalmic Physiol Opt 2024; 44:270-279. [PMID: 38193312 DOI: 10.1111/opo.13277] [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: 09/29/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE To review the rebound effect after cessation of different myopia control treatments. METHODS A systematic review that included full-length randomised controlled studies (RCTs), as well as post-hoc analyses of RCTs reporting new findings on myopia control treatments rebound effect in two databases, PubMed and Web of Science, was performed according to the PRISMA statement. The search period was between 15 June 2023 and 30 June 2023. The Cochrane risk of bias tool was used to analyse the quality of the selected studies. RESULTS A total of 11 studies were included in this systematic review. Unifying the rebound effects of all myopia control treatments, the mean rebound effect for axial length (AL) and spherical equivalent refraction (SER) were 0.10 ± 0.07 mm [-0.02 to 0.22] and -0.27 ± 0.2 D [-0.71 to -0.03] after 10.2 ± 7.4 months of washout, respectively. In addition, spectacles with highly aspherical lenslets or defocus incorporated multiple segments technology, soft multifocal contact lenses and orthokeratology showed lower rebound effects compared with atropine and low-level light therapy, with a mean rebound effect for AL and SER of 0.04 ± 0.04 mm [0 to 0.08] and -0.13 ± 0.07 D [-0.05 to -0.2], respectively. CONCLUSIONS It appears that the different treatments for myopia control produce a rebound effect after their cessation. Specifically, optical treatments seem to produce less rebound effect than pharmacological or light therapies. However, more studies are required to confirm these results.
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Affiliation(s)
- Miguel Ángel Sánchez-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
| | - Antonio Ballesteros-Sánchez
- Department of Physics of Condensed Matter, Optics Area, University of Seville, Seville, Spain
- Department of Ophthalmology, Clínica Novovisión, Murcia, Spain
| | | | - Cristina Alvarez-Peregrina
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
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19
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Zhang Y, Wang D, Lin F, Song Y, Chen Y, Peng Y, Chen M, Liu Y, Jiang J, Yang Z, Li F, Zhang X. Diagnostic performance of wide-field optical coherence tomography angiography in detecting open-angle glaucoma in high myopia. Acta Ophthalmol 2024; 102:e168-e177. [PMID: 38129974 DOI: 10.1111/aos.16603] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/28/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE To compare the diagnostic performance of the capillary density (CD) of the central 1-6 mm and peripheral 6-12 mm annular regions in detecting open-angle glaucoma in high myopia (HM) using 15 × 12 mm wide-field swept-source optical coherence tomography angiography (WF SS-OCTA). METHODS The study enrolled 206 and 103 eyes with HM and highly myopic open-angle glaucoma (HM-OAG), respectively. WF SS-OCTA images centred on the fovea were obtained to analyse the changes in the CD in the 1-3 mm, 3-6 mm, 6-9 mm, and 9-12 mm annular regions. CD of the superficial capillary plexus (SCP) was measured with the built-in software. The area under the receiver operating characteristic curve (AUROC) of each region was compared. RESULTS The diagnostic performance of the SCP CD in the central 1-6 mm annular region (AUROC = 0.849) was better than that in the peripheral 6-12 mm annular region (AUROC = 0.756, p = 0.001). The annular AUROCs of SCP CD peaked in the 3-6 mm annular region (AUROC = 0.858) and gradually decreased with increasing diameter and were lower than the corresponding AUROCs of the ganglion cell-inner plexiform layer thickness (p < 0.05 for all comparisons). SCP CD of the inferior quadrant in the 3-6 mm annular region had the best diagnostic performance (AUROC = 0.859). CONCLUSION The SCP CD in the central 1-6 mm annular region exhibited better diagnostic performance for the detection of HM-OAG in HM. The assessment of more peripheral regions has no added value in detecting glaucoma in HM.
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Affiliation(s)
- Yinhang Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Deming Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Fengbin Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yunhe Song
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yu Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yuying Peng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Meiling Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yuhong Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Jiaxuan Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Zefeng Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Fei Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiulan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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20
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Chen X, Tong P, Jiang Y, Cheng Z, Zang L, Yang Z, Lan W, Xia K, Hu Z, Tian Q. CCDC66 mutations are associated with high myopia through affected cell mitosis. J Med Genet 2024; 61:262-269. [PMID: 37852749 DOI: 10.1136/jmg-2023-109434] [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: 06/01/2023] [Accepted: 09/25/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND High myopia (HM) refers to an eye refractive error exceeding -5.00 D, significantly elevating blindness risk. The underlying mechanism of HM remains elusive. Given the extensive genetic heterogeneity and vast genetic base opacity, it is imperative to identify more causative genes and explore their pathogenic roles in HM. METHODS We employed exome sequencing to pinpoint the causal gene in an HM family. Sanger sequencing was used to confirm and analyse the gene mutations in this family and 200 sporadic HM cases. Single-cell RNA sequencing was conducted to evaluate the gene's expression patterns in developing human and mouse retinas. The CRISPR/Cas9 system facilitated the gene knockout cells, aiding in the exploration of the gene's function and its mutations. Immunofluorescent staining and immunoblot techniques were applied to monitor the functional shifts of the gene mutations at the cellular level. RESULTS A suspected nonsense mutation (c.C172T, p.Q58X) in CCDC66 was found to be co-segregated with the HM phenotype in the family. Additionally, six other rare variants were identified among the 200 sporadic patients. CCDC66 was consistently expressed in the embryonic retinas of both humans and mice. Notably, in CCDC66-deficient HEK293 cells, there was a decline in cell proliferation, microtube polymerisation rate and ace-tubulin level. Furthermore, the mutated CCDC66 failed to synchronise with the tubulin system during Hela cell mitosis, unlike its wild type counterpart. CONCLUSIONS Our research indicates that the CCDC66 variant c.C172T is associated with HM. A deficiency in CCDC66 might disrupt cell proliferation by influencing the mitotic process during retinal growth, leading to HM.
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Affiliation(s)
- Xiaozhen Chen
- MOE Key Lab of Rare Pediatric Diseases & Hunan Key Laboratory of Medical Genetics of the School of Life Sciences, Central South University, Changsha, Hunan, People's Republic of China
- Hunan Key Laboratory of Animal Models for Human Disease, Central South University, Changsha, Hunan, People's Republic of China
- Furong Laboratory, Central South University, Changsha, Hunan, People's Republic of China
| | - Ping Tong
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Ying Jiang
- MOE Key Lab of Rare Pediatric Diseases & Hunan Key Laboratory of Medical Genetics of the School of Life Sciences, Central South University, Changsha, Hunan, People's Republic of China
- Hunan Key Laboratory of Animal Models for Human Disease, Central South University, Changsha, Hunan, People's Republic of China
- Furong Laboratory, Central South University, Changsha, Hunan, People's Republic of China
| | - Zhe Cheng
- MOE Key Lab of Rare Pediatric Diseases & Hunan Key Laboratory of Medical Genetics of the School of Life Sciences, Central South University, Changsha, Hunan, People's Republic of China
- Hunan Key Laboratory of Animal Models for Human Disease, Central South University, Changsha, Hunan, People's Republic of China
- Furong Laboratory, Central South University, Changsha, Hunan, People's Republic of China
| | - Liyu Zang
- MOE Key Lab of Rare Pediatric Diseases & Hunan Key Laboratory of Medical Genetics of the School of Life Sciences, Central South University, Changsha, Hunan, People's Republic of China
- Hunan Key Laboratory of Animal Models for Human Disease, Central South University, Changsha, Hunan, People's Republic of China
- Furong Laboratory, Central South University, Changsha, Hunan, People's Republic of China
| | - Zhikuan Yang
- Aier Eye Hospital (Hunan), Aier Eye Hospital Group, Changsha, Hunan, People's Republic of China
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, People's Republic of China
| | - Weizhong Lan
- Aier Eye Hospital (Hunan), Aier Eye Hospital Group, Changsha, Hunan, People's Republic of China
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, People's Republic of China
| | - Kun Xia
- MOE Key Lab of Rare Pediatric Diseases & Hunan Key Laboratory of Medical Genetics of the School of Life Sciences, Central South University, Changsha, Hunan, People's Republic of China
- Hunan Key Laboratory of Animal Models for Human Disease, Central South University, Changsha, Hunan, People's Republic of China
- Furong Laboratory, Central South University, Changsha, Hunan, People's Republic of China
- MOE Key Lab of Rare Pediatric Diseases, Hengyang Medical School, University of South China, Hengyang, Hunan, People's Republic of China
| | - Zhengmao Hu
- MOE Key Lab of Rare Pediatric Diseases & Hunan Key Laboratory of Medical Genetics of the School of Life Sciences, Central South University, Changsha, Hunan, People's Republic of China
- Hunan Key Laboratory of Animal Models for Human Disease, Central South University, Changsha, Hunan, People's Republic of China
- Furong Laboratory, Central South University, Changsha, Hunan, People's Republic of China
| | - Qi Tian
- MOE Key Lab of Rare Pediatric Diseases & Hunan Key Laboratory of Medical Genetics of the School of Life Sciences, Central South University, Changsha, Hunan, People's Republic of China
- Hunan Key Laboratory of Animal Models for Human Disease, Central South University, Changsha, Hunan, People's Republic of China
- Furong Laboratory, Central South University, Changsha, Hunan, People's Republic of China
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Chen J, Ikeda SI, Yang Y, Zhang Y, Ma Z, Liang Y, Negishi K, Tsubota K, Kurihara T. Scleral remodeling during myopia development in mice eyes: a potential role of thrombospondin-1. Mol Med 2024; 30:25. [PMID: 38355399 PMCID: PMC10865574 DOI: 10.1186/s10020-024-00795-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 01/30/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Scleral extracellular matrix (ECM) remodeling plays a crucial role in the development of myopia, particularly in ocular axial elongation. Thrombospondin-1 (THBS1), also known as TSP-1, is a significant cellular protein involved in matrix remodeling in various tissues. However, the specific role of THBS1 in myopia development remains unclear. METHOD We employed the HumanNet database to predict genes related to myopic sclera remodeling, followed by screening and visualization of the predicted genes using bioinformatics tools. To investigate the potential target gene Thbs1, we utilized lens-induced myopia models in male C57BL/6J mice and performed Western blot analysis to detect the expression level of scleral THBS1 during myopia development. Additionally, we evaluated the effects of scleral THBS1 knockdown on myopia development through AAV sub-Tenon's injection. The refractive status and axial length were measured using a refractometer and SD-OCT system. RESULTS During lens-induced myopia, THBS1 protein expression in the sclera was downregulated, particularly in the early stages of myopia induction. Moreover, the mice in the THBS1 knockdown group exhibited alterations in myopia development in both refraction and axial length changed compared to the control group. Western blotting analysis confirmed the effectiveness of AAV-mediated knockdown, demonstrating a decrease in COLA1 expression and an increase in MMP9 levels in the sclera. CONCLUSION Our findings indicate that sclera THBS1 levels decreased during myopia development and subsequent THBS1 knockdown showed a decrease in scleral COLA1 expression. Taken together, these results suggest that THBS1 plays a role in maintaining the homeostasis of scleral extracellular matrix, and the reduction of THBS1 may promote the remodeling process and then affect ocular axial elongation during myopia progression.
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Affiliation(s)
- Junhan Chen
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Shin-Ichi Ikeda
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yajing Yang
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yan Zhang
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ziyan Ma
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yifan Liang
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
- Tsubota Laboratory, Inc, 34 Shinanomachi, Shinjuku-ku, Tokyo, 160-0016, Japan.
| | - Toshihide Kurihara
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
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Janarthanan SD, Samiyullah K, Madheswaran G, Ballae Ganeshrao S, Watt K. Exploring the impact of optical corrections on visual functions in myopia control-a scoping review. Int Ophthalmol 2024; 44:47. [PMID: 38337138 PMCID: PMC10858094 DOI: 10.1007/s10792-024-02937-w] [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: 09/25/2023] [Accepted: 12/17/2023] [Indexed: 02/12/2024]
Abstract
PURPOSE Myopia is controlled optically with peripheral defocus spectacles, multifocal contact lenses, or orthokeratology lenses. However, it is unknown which optical correction will improve visual performance. This scoping review aimed to identify and summarize studies on various visual functions using optical corrections for myopia control. METHODS To develop the search strategy, population (Myopia), concept (visual performance), and context (unrestricted race/region) were used. PubMed, SCOPUS, Cochrane Library, and Web of Science databases were searched using the keywords myopia, contrast sensitivity, high and low contrast visual acuity, stereopsis, and optical correction of myopia control. This scoping review protocol was registered in the Open Science Framework registry and followed the framework for scoping review outlined by the Joanna Briggs Institute. RESULTS Eight studies (n = 8) met the inclusion criteria and were included in the review. Four were conducted in Europe, two were conducted in China, and one was conducted in Japan and Singapore. Five studies were randomized controlled trials, out of which three used contact lenses and two studies used peripheral defocus spectacles lenses. Studies ranged from one day to 2 years. Three studies that used orthokeratology lenses were prospective study designs. Among the studies that used orthokeratology lenses and contact lenses, two studies measured the contrast sensitivity function with CSV1000 (Vector Vision) under mesopic and photopic conditions, with and without glare. Two studies measured the central and peripheral contrast sensitivity using psychophysics experiments. High and low contrast visual acuity was measured using the Freiburg Vision Test (n = 1) and ETDRS charts (n = 3), and stereopsis was assessed using a random dot stereogram (n = 1). The studies showed a reduction in central and peripheral contrast sensitivity function and low contrast acuity when treated with multifocal contact lenses, orthokeratology lenses, and peripheral defocus lenses compared with single-vision lenses. CONCLUSION This scoping review found a reduction in central and peripheral contrast sensitivity function, as well as low contrast visual acuity when using various optical corrections for myopia control, while high-contrast visual acuity remained the same. The impact of visual functions may not influence the effectiveness of myopia control. Eye care practitioners should provide awareness to the parent and patient population about the potential visual impact of recent designs for optical corrections of myopia control.
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Affiliation(s)
- Salai Dhavamathi Janarthanan
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Kaleem Samiyullah
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | - Shonraj Ballae Ganeshrao
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Kathleen Watt
- School of Optometry and Vision Science, Faculty of Medicine and Health, Univeristy of New South Wales, Sydney, Australia
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Hussain A, Mohammad A, Tharsis A, Badakere A, Agarkar S. Association of sleep timings, duration, consistency, and chronotype with premyopia and myopia among Indian children. Eur J Ophthalmol 2024:11206721241231335. [PMID: 38332623 DOI: 10.1177/11206721241231335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
BACKGROUND To explore the association of sleep timings, duration, consistency, and chronotype with premyopia and myopia among Indian children. METHODS This hospital-based cross-sectional study included 453 children, aged 6-12 years. Two myopia participants were selected for each individual with the corresponding premyopia or emmetropia. All children underwent cycloplegic autorefraction and ocular biometric tests. The Children's Sleep Habits Questionnaire (CSHQ) and parental information on behavioral habits were used to assess the association of sleep parameters with myopia and premyopia using logistic regression models. RESULTS Both myopia and premyopia exhibited significant late bedtime, short sleep duration, early wakeup time on only weekdays, and longer weekend catch-up sleep than emmetropia children (p < 0.05). In multivariate analysis, late bedtime (more than 24:00 a.m.) on weekdays (Odds ratio, OR = 3.63, 95% CI [0.74, 8.68]) as well as on free days (OR = 1.04, 95% CI [0.02, 8.08]); and early wake-up time only on weekdays (5:00-6:00 a.m., OR = 2.16, 95% CI [0.24, 6.76] and 06:00-07:00 a.m., OR = 2.42, 95% CI [0.51, 8.44]) were associated with increased risk of myopia (all p < 0.05) but not premyopia. After adjusting the confounding factors, when each of the eight CSHQ subscale components was analyzed, only bedtime resistance, night waking, and daytime sleepiness scores were significantly associated with a higher risk for premyopia and myopia (p < 0.05). CONCLUSIONS The sleep quality components, including bedtime resistance, night waking, and daytime sleepiness, equally involve a higher risk for myopia as well as premyopia.
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Affiliation(s)
- Azfira Hussain
- Myopia Clinic, Unit of Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | - Arbaaz Mohammad
- Myopia Clinic, Unit of Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | - Asha Tharsis
- Myopia Clinic, Unit of Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | - Akshay Badakere
- Department of Pediatric Ophthalmology, Unit of Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | - Sumita Agarkar
- Department of Pediatric Ophthalmology, Unit of Medical Research Foundation, Sankara Nethralaya, Chennai, India
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Wang F, Wu G, Xu X, Wu H, Peng Y, Lin Y, Jiang J. Orthokeratology combined with spectacles in moderate to high myopia adolescents. Cont Lens Anterior Eye 2024; 47:102088. [PMID: 37977905 DOI: 10.1016/j.clae.2023.102088] [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: 04/12/2022] [Revised: 10/26/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE Wearing ortho-k lenses overnight may not fully correct their daytime refractory errors of adolescents with moderate to high myopia. There are three common ways to deal with the daytime residual refractive error (RRE): 1) wearing spectacles to correct the RRE; 2) wear ortho-k lenses during the daytime instead of overnight.; 3) not correcting the residual refractive error. According to previous laboratory studies, myopic peripheral refraction is associated with better myopic control. This study had two aims:1) to compare relative peripheral refractive error (RPRE) among these ways after one-month stabilization; 2) to assess the axial length changes over 2 years of ortho-k lens overnight wear combined with spectacle glasses. METHODS This was a prospective, non-controlled, non-randomized, observational study in which a total of 27 subjects (20 females, 7 males, mean age 12.48 ± 2.23Y) with spherical equivalent refractive error from -5.00 to -8.25D were enrolled. All participants in the study wore orthokeratology (ortho-k) lenses overnight for a minimum of one month. Subsequently, their peripheral refractive error (PRE) was assessed using an open-field autorefractor. During the assessment, the participants underwent three conditions in a random order in a same morning: 1) unaided eye after orthokeratology (referred to as the Unaided-eye condition), 2) wearing glasses to correct any remaining refractive errors after orthokeratology (referred to as the Spec-RE condition), and 3) wearing ortho-k lenses during the daytime (referred to as the Continuous OK wear condition). After testing, all subjects were instructed to wear ortho-k lenses overnight and glasses during the daytime to correct their RRE for the next 2 years, during which time the progression of their axial length was followed up. RESULTS 1) RPRE in either Unaided-eye or Spec-RE condition subjects were significantly more myopic than those in the Continuous OK wear condition. 2) No difference in RPRE was seen between Unaided-eye and Spec-RE conditions. 3) Axial length growth was 0.05 ± 0.20 mm and 0.17 ± 0.32 mm (mean ± standard deviation) at 1-year and 2-year follow-ups after the initial visit, respectively, which were comparable to mild myopia patients after orthokeratology. 4) After orthokeratology, axial length change had negative correlation with the initial age (p = 0.001, r = -0.616) and residual diopter (p = 0.022). CONCLUSIONS For myopes above refraction < -5.00D, wearing Ortho-k lenses overnight and glasses to correct the RRE in the daytime is recommended to ensure good visual quality and have more myopic RPRE for potential myopia control.
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Affiliation(s)
- Feifu Wang
- National Clinical Research Centerfor Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Ge Wu
- National Clinical Research Centerfor Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Xindi Xu
- The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Haoran Wu
- National Clinical Research Centerfor Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Yiyi Peng
- National Clinical Research Centerfor Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Yiran Lin
- National Clinical Research Centerfor Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Jun Jiang
- National Clinical Research Centerfor Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China.
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Qi Z, Liu X, Xiong S, Wang J, Chen J, Zhu Z, Brochert G, Zhang B, Deng J, Cheng T, He X, Xu X. Macular and peripapillary Choroidal Vascularity Index in children with different refractive status. Eye (Lond) 2024; 38:606-613. [PMID: 37770533 PMCID: PMC10858217 DOI: 10.1038/s41433-023-02743-1] [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: 12/22/2022] [Revised: 08/24/2023] [Accepted: 09/08/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVES To characterize choroidal vascular changes in children with different refractive status. METHODS A study including 5864 children aged 6-9 years was performed to investigate the choroidal vascular index (CVI) in myopic, emmetropic and hyperopic eyes. Each participant had a comprehensive ocular examination with cycloplegic autorefraction performed, axial length (AL) measured and Swept Source-Optical Coherence Tomography (SS-OCT) scans acquired. Choroidal thickness (ChT) was measured by built-in software, and CVI was calculated using a previously validated self-developed algorithm. RESULTS The mean ChT and CVI were 275.88 ± 53.34 μm and 34.91 ± 3.83 in the macula region, and 191.96 ± 46.28 μm and 32.35 ± 4.21 in the peripapillary region. CVI was significantly lowest for myopes, followed by emmetropes and hyperopes (P < 0.001). CVI varied between different sectors separated by the Early Treatment of Diabetic Retinopathy Study (ETDRS) grid (P < 0.001). Macular CVI decreased horizontally from nasal to temporal quadrant with lowest in center fovea, and vertically from superior to inferior quadrants. Peripapillary CVI was highest in the nasal and lowest in the inferior sector. Multiple regression showed that spherical equivalent (SE), AL, intraocular pressure (IOP), ChT, age, and gender were significantly related to CVI (P < 0.05). CONCLUSIONS In children, the distribution of CVI in the posterior pole is not uniform. A decreased CVI was observed from hyperopia to myopia and was associated with decreased SE, elongated AL, and choroidal thinning. Further study of changes in CVI during myopia onset and progression is required to better understand the role of the choroidal vasculature in myopia development.
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Affiliation(s)
- Ziyi Qi
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Xiaoxiao Liu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Shuyu Xiong
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Jingjing Wang
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Jun Chen
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Zhuoting Zhu
- Centre for Eye Research Australia, Ophthalmology, University of Melbourne, Melbourne, VIC, Australia
| | - Grace Brochert
- Centre for Eye Research Australia, Ophthalmology, University of Melbourne, Melbourne, VIC, Australia
| | - Bo Zhang
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Junjie Deng
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Tianyu Cheng
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Xiangui He
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China.
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
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Biswas S, El Kareh A, Qureshi M, Lee DMX, Sun CH, Lam JSH, Saw SM, Najjar RP. The influence of the environment and lifestyle on myopia. J Physiol Anthropol 2024; 43:7. [PMID: 38297353 PMCID: PMC10829372 DOI: 10.1186/s40101-024-00354-7] [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: 10/23/2023] [Accepted: 01/05/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Myopia, commonly known as near-sightedness, has emerged as a global epidemic, impacting almost one in three individuals across the world. The increasing prevalence of myopia during early childhood has heightened the risk of developing high myopia and related sight-threatening eye conditions in adulthood. This surge in myopia rates, occurring within a relatively stable genetic framework, underscores the profound influence of environmental and lifestyle factors on this condition. In this comprehensive narrative review, we shed light on both established and potential environmental and lifestyle contributors that affect the development and progression of myopia. MAIN BODY Epidemiological and interventional research has consistently revealed a compelling connection between increased outdoor time and a decreased risk of myopia in children. This protective effect may primarily be attributed to exposure to the characteristics of natural light (i.e., sunlight) and the release of retinal dopamine. Conversely, irrespective of outdoor time, excessive engagement in near work can further worsen the onset of myopia. While the exact mechanisms behind this exacerbation are not fully comprehended, it appears to involve shifts in relative peripheral refraction, the overstimulation of accommodation, or a complex interplay of these factors, leading to issues like retinal image defocus, blur, and chromatic aberration. Other potential factors like the spatial frequency of the visual environment, circadian rhythm, sleep, nutrition, smoking, socio-economic status, and education have debatable independent influences on myopia development. CONCLUSION The environment exerts a significant influence on the development and progression of myopia. Improving the modifiable key environmental predictors like time spent outdoors and engagement in near work can prevent or slow the progression of myopia. The intricate connections between lifestyle and environmental factors often obscure research findings, making it challenging to disentangle their individual effects. This complexity underscores the necessity for prospective studies that employ objective assessments, such as quantifying light exposure and near work, among others. These studies are crucial for gaining a more comprehensive understanding of how various environmental factors can be modified to prevent or slow the progression of myopia.
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Affiliation(s)
- Sayantan Biswas
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Antonio El Kareh
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | - Mariyem Qureshi
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | | | - Chen-Hsin Sun
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Janice S H Lam
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Seang-Mei Saw
- Singapore Eye Research Institute, Singapore, Singapore
- Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Raymond P Najjar
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Singapore Eye Research Institute, Singapore, Singapore.
- Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.
- Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore, Singapore.
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Fang H, Li F, Wu J, Fu H, Sun X, Orlando JI, Bogunović H, Zhang X, Xu Y. Open Fundus Photograph Dataset with Pathologic Myopia Recognition and Anatomical Structure Annotation. Sci Data 2024; 11:99. [PMID: 38245589 PMCID: PMC10799845 DOI: 10.1038/s41597-024-02911-2] [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: 10/12/2022] [Accepted: 01/02/2024] [Indexed: 01/22/2024] Open
Abstract
Pathologic myopia (PM) is a common blinding retinal degeneration suffered by highly myopic population. Early screening of this condition can reduce the damage caused by the associated fundus lesions and therefore prevent vision loss. Automated diagnostic tools based on artificial intelligence methods can benefit this process by aiding clinicians to identify disease signs or to screen mass populations using color fundus photographs as inputs. This paper provides insights about PALM, our open fundus imaging dataset for pathological myopia recognition and anatomical structure annotation. Our databases comprises 1200 images with associated labels for the pathologic myopia category and manual annotations of the optic disc, the position of the fovea and delineations of lesions such as patchy retinal atrophy (including peripapillary atrophy) and retinal detachment. In addition, this paper elaborates on other details such as the labeling process used to construct the database, the quality and characteristics of the samples and provides other relevant usage notes.
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Affiliation(s)
- Huihui Fang
- South China University of Technology, Guangzhou, China
- Pazhou Lab., Guangzhou, China
| | - Fei Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Junde Wu
- National University of Singapore, Singapore, Singapore
| | - Huazhu Fu
- Institute of High Performance Computing, Agency for Science, Technology and Research, Singapore, Singapore
| | - Xu Sun
- Pazhou Lab., Guangzhou, China
| | | | - Hrvoje Bogunović
- Christian Doppler Lab for Artificial Intelligence in Retina, Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Xiulan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China.
| | - Yanwu Xu
- South China University of Technology, Guangzhou, China.
- Pazhou Lab., Guangzhou, China.
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Stone RA, Tobias JW, Wei W, Schug J, Wang X, Zhang L, Iuvone PM, Nickla DL. Diurnal retinal and choroidal gene expression patterns support a role for circadian biology in myopia pathogenesis. Sci Rep 2024; 14:533. [PMID: 38177383 PMCID: PMC10767138 DOI: 10.1038/s41598-023-50684-2] [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: 05/10/2023] [Accepted: 12/22/2023] [Indexed: 01/06/2024] Open
Abstract
The prevalence of myopia (nearsightedness) is increasing to alarming levels, but its etiology remains poorly understood. Because both laboratory and clinical findings suggest an etiologic role for circadian rhythms in myopia development, we assayed gene expression by RNA-Seq in retina and choroid at the onset of unilateral experimental myopia in chick, isolating tissues every 4 h during a single 24-h period from myopic and contralateral control eyes. Occluded versus open eye gene expression differences varied considerably over the 24-h sampling period, with some occurring at multiple times of day but with others showing differences at only a single investigated timepoint. Some of the genes identified in retina or choroid of chick myopia were previously identified as candidate genes for common human myopia. Like differentially expressed genes, pathways identified by Gene Set Enrichment Analysis also varied dramatically by sampling time. Considered with other laboratory data, human genetic and epidemiology data, these findings further implicate circadian events in myopia pathogenesis. The present results emphasize a need to include time of day in mechanistic studies of myopia and to assess circadian biology directly in trying to understand better the origin of myopia and to develop more effective therapies.
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Affiliation(s)
- Richard A Stone
- Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - John W Tobias
- Penn Genomics and Sequencing Core, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Wenjie Wei
- Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jonathan Schug
- Penn Genomics and Sequencing Core, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Xia Wang
- Department of Biomedical Sciences and Disease, New England College of Optometry, Boston, MA, USA
| | - Lixin Zhang
- Department of Biomedical Sciences and Disease, New England College of Optometry, Boston, MA, USA
| | - P Michael Iuvone
- Department of Ophthalmology and Department of Pharmacology and Chemical Biology, Emory University School of Medicine, Atlanta, GA, USA
| | - Debora L Nickla
- Department of Biomedical Sciences and Disease, New England College of Optometry, Boston, MA, USA
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Marcellán Vidosa MC, Remón L, Ávila FJ. Peripheral refraction under different levels of illuminance. Ophthalmic Physiol Opt 2024; 44:191-198. [PMID: 37950504 DOI: 10.1111/opo.13244] [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: 06/09/2023] [Revised: 10/21/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Abstract
Peripheral refraction is believed to be involved in the development of myopia. The aim of this study was to compare the relative peripheral refraction (RPR) at four different levels of illuminance, ranging from photopic conditions to complete darkness, using an open-field autorefraction method. The RPR was calculated for each eccentricity by subtracting central from peripheral autorefraction measurements. The study included 114 myopic eyes from 114 subjects (mean age of 21.81 ± 1.91 years) and the mean difference in RPR between scotopic and photopic conditions (0 and 300 lux, respectively) was +0.32 D at 30° temporal and +0.37 D at 30° in the nasal visual field (NVF). Statistically significant differences were observed between 0 and 300 lux at 30° in the temporal visual field and at 30° and 20° in the NVF. Our results revealed a significant increase in relative peripheral hyperopia with increasing visual field eccentricity along the horizontal visual field in myopic eyes of young adults. Furthermore, this relative peripheral hyperopia increased as illumination decreased. These findings suggest that an increase in peripheral illuminance may protect against myopic eye growth.
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Affiliation(s)
| | - Laura Remón
- Department of Applied Physics, Universidad de Zaragoza, Zaragoza, Spain
| | - Francisco J Ávila
- Department of Applied Physics, Universidad de Zaragoza, Zaragoza, Spain
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Martínez-Pérez C, Villa-Collar C, Santodomingo-Rubido J, Wolffsohn JS. Strategies and attitudes on the management of myopia in clinical practice in Spain - 2022 update. JOURNAL OF OPTOMETRY 2024; 17:100496. [PMID: 37879183 PMCID: PMC10618824 DOI: 10.1016/j.optom.2023.100496] [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: 05/31/2023] [Revised: 08/25/2023] [Accepted: 09/19/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE This study analyses strategies and attitudes on myopia management reported by eye care practitioners (ECP) from Spain in 2022. METHODS A questionnaire was distributed to ECPs worldwide via the internet through professional associations. The questionnaire was distributed by email to all registered Spanish optician-optometrists. Questions examined awareness of increasing myopia prevalence; perceived efficacy; uptake of available approaches; and reasons preventing further uptake of specific approaches. RESULTS Of 3,107 practitioners who participated in the study, 380 were Spanish ECPs. Using a 10-point scale, Spanish practitioners reported less concern about increasing pediatric myopia (8.3 ± 1.6) compared to ECP's worldwide (8.5 ± 1.9) (p < 0.001), but similar level of clinical activity in myopia control (7.8 ± 2.3 vs. 7.5 ± 2.5, respectively) (p > 0.05); however, around half of all prescribed treatments were single-vision distance spectacles/contact lenses both in Spain and in most regions, with Spanish practitioners prescribing less single-vision spectacles than African and Asian (p < 0.001), but more than Australasian practitioners (p = 0.04). No significant differences were found between Spain and the other regions in the perceived efficacy of combined therapy, orthokeratology, and outdoor time (p > 0.05), with the former being perceived as the most effective myopia control method followed by orthokeratology. No significant differences were found between Spain and the world's average in factors preventing the prescription of myopia control approaches (p > 0.05). Spanish practitioners reported that embracing myopia management has a positive, but lower impact on customer loyalty, practice revenue and job satisfaction compared with the other regions (all p < 0.001). CONCLUSIONS Myopia control is increasing, although around half of practitioners still prescribe single-vision distance spectacles/contact lenses to young/progressive myopes. Combined therapy followed by orthokeratology were perceived as the most effective treatments. Embracing myopia management improved patient loyalty and job satisfaction.
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Affiliation(s)
- Clara Martínez-Pérez
- ISEC Lisboa-Instituto de Educação e Ciência de Lisboa, 1750-179 Lisboa, Portugal
| | - César Villa-Collar
- Optics & Optometry Department, Faculty of Health Sciences, Universidad Europea, Madrid, Spain
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Osuagwu UL, Ahaiwe KE, Meribe N, Nkanga ED, Ekpenyong BN, Ibanga AA, Goson PC, Nkanga DG. Quality of life and depression among patients with high myopia in Nigeria: a cross sectional study. Int J Ophthalmol 2023; 16:2071-2081. [PMID: 38111950 PMCID: PMC10700079 DOI: 10.18240/ijo.2023.12.21] [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: 11/23/2022] [Accepted: 09/14/2023] [Indexed: 12/20/2023] Open
Abstract
AIM To evaluate the quality of life (QOL) and level of depression among participants with high myopia in Nigeria and the demographic factors associated with these outcomes. METHODS This cross-sectional study was conducted on 100 adult participants with high myopia (defined as refractive error ≤-5.00 D or worse, and uncorrected visual acuity worse than 6/18 in the better seeing eye) attending ophthalmology centres in Nigeria from 2 October 2021 to 30 August 2022. The means and standard deviations were calculated for each of the four domains of World Health Organization Quality of life scale (WHOQOL-BREF) using the transformed scores. The Beck Depression Inventory (BDI) scale was used to assess the level of depression. RESULTS The highest and the lowest mean scores of WHOQOL-BREF domains were found for the psychological and physical health domains (mean percentage scores were 67.0 [95% confidence intervals (CI) 64.1-68.9] and 55.3 (95%CI 51.8-58.8, P<0.001), respectively. One-way analysis of variance (ANOVA) revealed significant differences in physical health with educational status (higher among those with tertiary education: mean difference 0.9, 95%CI -0.2-2.1; P=0.049), differences in psychological health with working status (higher among those who were working 1.2, 95%CI 0.3-2.1; P=0.012). Also, the result showed a statistically significant association between environmental health and marital status (higher among non-married: 1.7, 95%CI -0.9-2.3; P=0.012) while overall health was associated with place of residence (higher in urban areas: 2.3, 95%CI 1.2-3.5; P=0.024). For depression, one in every nine participants reported major depressive symptom, mostly younger people (aged 16-29 vs 30-49y: 17.0% vs 0, P=0.019), and slightly more women than men (14.3% vs 0, P=0.064). There were significant negative correlations between the depression scores and psychological health (r=-0.48, P<0.001), physical health (r=-0.29, P=0.002), social and relationship (r=-0.49, P<0.001), environmental (r=-0.48, P<0.001) and overall health (r=-0.49, P<0.001). CONCLUSION People with high myopia have a relatively moderate QOL, but poor physical health, particularly the younger age group, and women who are more likely to experience clinically relevant depression. Eye care professionals should consider possible referrals for counselling for people with high myopia.
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Affiliation(s)
- Uchechukwu Levi Osuagwu
- Bathurst Rural Clinical School (BRCS), School of Medicine, Western Sydney University, Bathurst, NSW 2795, Australia
- African Vision Research Institute, University of KwaZulu-Natal Durban, Durban 4001, South Africa
| | - Kelechukwu Enyinnaya Ahaiwe
- Department of Ophthalmology, University of Calabar Teaching Hospital, Calabar, Cross River State 540281, Nigeria
| | - Nnaemeka Meribe
- Department of Politics, Media and Philosophy, La Trobe University, Melbourne, Victoria 3086, Australia
| | - Elizabeth Dennis Nkanga
- Department of Ophthalmology, Faculty of Clinical Sciences, University of Calabar, Cross River State 540281, Nigeria
| | - Bernadine Nsa Ekpenyong
- Department of Public Health, University of Calabar, Calabar, Cross River State 540281, Nigeria
| | - Affiong Andem Ibanga
- Department of Ophthalmology, Faculty of Clinical Sciences, University of Calabar, Cross River State 540281, Nigeria
| | - Piwuna Christopher Goson
- Department of Psychiatry, College of Health Sciences, University of Jos, Jos, Plateau 930001, Nigeria
| | - Dennis George Nkanga
- Department of Ophthalmology, Faculty of Clinical Sciences, University of Calabar, Cross River State 540281, Nigeria
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Yin Y, Li L, Wang T, Lin S, Wang J, Wang H, Jiang M, Ma Y, Zhu J. Establishment of noncycloplegic methods for screening myopia and pre-myopia in preschool children. Front Med (Lausanne) 2023; 10:1291387. [PMID: 38173941 PMCID: PMC10764102 DOI: 10.3389/fmed.2023.1291387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024] Open
Abstract
Purpose Pre-myopia, a non-myopic refractive state, is a key concern for myopia prevention because of its association with a significantly higher risk of myopia in children under 3 years of age. Amid the myopia pandemic, its onset at younger ages is increasing, yet research on screening methods for myopia and pre-myopia in preschool children remains limited. This study aimed to establish effective noncycloplegic screening methods for myopia and pre-myopia in preschool children. Methods This cross-sectional study included 16 kindergartens in Shanghai, China. Uncorrected distance visual acuity (UDVA) was recorded using a logMAR visual acuity chart. Pre- and post-cycloplegic refractions were obtained using an auto-refractor (TopconKR-800). Noncycloplegic axial length (AL) and corneal curvature radius (CR) were measured using the IOL Master-700. Logistic regression models were developed to establish accurate noncycloplegic screening methods for myopia and pre-myopia. Results A total of 1,308 children with a mean age of 4.3 ± 0.9 years were included; among them 640 (48.9%) were girls. The myopia prevalence rate was 2.8% (n = 36), and the prevalence of pre-myopia was 21.9% (n = 286). Pre-myopia screening (cycloplegic spherical equivalent [SE] ≤ -0.5 < SE ≤0.75 diopters [D]) using UDVA exhibited an area under the receiver operating curve (AUC) of 0.52, noncycloplegic SE had an AUC of 0.70 and AL had an AUC of 0.63. The accuracy of combining the SE and AL/CR ratio was among the best with the least number of checks used, and the AUC was 0.74 for pre-myopia screening and 0.94 for myopia screening (cycloplegic SE ≤ -0.5 D). The addition of UDVA did not further improve the accuracy. Conclusion Using UDVA alone did not achieve good accuracy in pre-myopia or myopia screening of young children. Under non-cycloplegic conditions, the combination of AL/CR and SE demonstrated favorable results for pre-myopia and myopia screening of preschool children.
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Affiliation(s)
- Yao Yin
- Department of Ophthalmology, Fengcheng Hospital, Fengxian District, Shanghai, China
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Liping Li
- Disease Control and Prevention Center in HongKou District, Shanghai, China
| | - Ting Wang
- Department of Eye Disease Prevention and Treatment, Shanghai Yangpu District Kongjiang Hospital, Shanghai, China
| | - Senlin Lin
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Jia Wang
- Department of Eye Disease Prevention and Treatment, Shanghai Yangpu District Kongjiang Hospital, Shanghai, China
| | - Hong Wang
- Department of Eye Disease Prevention and Treatment, Shanghai Yangpu District Kongjiang Hospital, Shanghai, China
| | - Minmin Jiang
- Department of Eye Disease Prevention and Treatment, Shanghai Yangpu District Kongjiang Hospital, Shanghai, China
| | - Yingyan Ma
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Fundus Diseases, National Clinical Research Center for Eye Diseases, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Jianfeng Zhu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
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Ehongo A. Understanding Posterior Staphyloma in Pathologic Myopia: Current Overview, New Input, and Perspectives. Clin Ophthalmol 2023; 17:3825-3853. [PMID: 38105912 PMCID: PMC10725704 DOI: 10.2147/opth.s405202] [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: 08/02/2023] [Accepted: 12/01/2023] [Indexed: 12/19/2023] Open
Abstract
Posterior staphyloma (PS) is considered the hallmark of pathologic myopia and is defined as an outpouching of a circumscribed portion of the eyeball with a radius of curvature smaller than that of the adjacent zone. Although more common in eyes with high myopia, it can affect those without it. The presence of PS is associated with a structurally and functionally worse course of high myopia that can lead to visual disability. Unfortunately, the pathogenesis of PS is unclear so far. Thus, due to the increasing prevalence of myopia which has been further exacerbated by the advent of COVID-19 lockdown, researchers are eager to elucidate the pathogenesis of pathologic myopia and that of its complications, especially PS, which will allow the development of preventive strategies. The aim of this work was to review the morphological characteristics of PS with emphasis on similarities with peripapillary staphyloma and to discuss the pathogenesis of PS considering recent suggestions about that of peripapillary staphyloma.
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Affiliation(s)
- Adèle Ehongo
- Ophthalmology Department, Erasmus Hospital, Brussels, Belgium
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34
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Qu Y, Huang H, Zhang H. Association between body mass index and myopia in the United States population in the National Health and Nutrition Examination Surveys 1999 to 2008: a cross-sectional study. Eur J Med Res 2023; 28:561. [PMID: 38049883 PMCID: PMC10696841 DOI: 10.1186/s40001-023-01542-4] [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: 06/23/2023] [Accepted: 11/20/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND This study investigated the association between body mass index (BMI) and myopia in the United States. METHODS This cross-sectional study included 8,000 participants from the 1999 to 2008 National Health and Nutrition Examination Survey (NHANES). BMI was classified into four groups: < 18.5, 18.5 - 24.9, 25-29.9, and > 29.9. Three diagnostic thresholds were used for myopia A\B\C: spherical equivalent ≤ -0.5\-0.75\-1 diopters in the right eye. Multivariate logistic regression analysis and smooth curve fitting were performed to evaluate the association between BMI and myopia. RESULTS The incidence of myopia was 39.4%. BMI was correlated with myopia, with each 1 kg/m2 increase in BMI associated with a 1% increase in the risk of myopia (OR, 1.01; 95% CI 1.01 1.02; p < 0.05). In myopia B, after adjusting for confounding factors, compared with the reference group (BMI 18.5-24.9), participants with a BMI of 25-29.9 and greater than 29.9 had a 14% and 25% increased risk of myopia, respectively (OR 1.14; 95% CI 1.01 1.29; p = 0.037, OR 1.25; 95% CI 1.08 1.44; p = 0.003), which was similar to the results for myopic A (OR, 1.15; 95% CI 1.02 1.3; p = 0.027, OR 1.19; 95% CI 1.03 1.37; p = 0.018) and myopia C (OR 1.15; 95% CI 1.01 1.31; p = 0.035, OR 1.18; 95% CI 1.01 1.37; p = 0.032). Moreover, there was a linear relationship between myopia and BMI (p for nonlinearity = 0.767). CONCLUSIONS Myopia using all three diagnostic thresholds was positively associated with higher BMI. This suggests a potential association between myopia and higher BMI in the American population, warranting further investigations.
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Affiliation(s)
- Yaohui Qu
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, 16369 Jingshi Road, Jinan, Shandong, China
| | - Huamin Huang
- The First Affiliated Hospital of Shandong First Medical University &, Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Road, Jinan, Shandong, China
| | - Hongxing Zhang
- The First Affiliated Hospital of Shandong First Medical University &, Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Road, Jinan, Shandong, China.
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Han X, Ruan X, Zhang Y, Lin H, Zhang M, Tan X, Liu Z, Luo L, Liu Y. Effect of Myopia Severity on the Health-Related Quality of Life in Children and Their Parents. Curr Eye Res 2023; 48:1189-1194. [PMID: 37655440 DOI: 10.1080/02713683.2023.2250581] [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: 03/15/2023] [Revised: 07/16/2023] [Accepted: 08/17/2023] [Indexed: 09/02/2023]
Abstract
PURPOSE To investigate the effect of different myopia severity on the health-related quality of life (QOL) in both children and their parents. METHODS Cross-sectional study from October to November, 2021. Age and sex-matched children with binocular emmetropia (-0.5D < spherical equivalence [SE] < 0.5D), low myopia (-5.0D < SE ≤ -0.5D), and high myopia (SE ≤ -5.0D), as well as their parents, were enrolled. All children underwent ocular examinations. The Pediatric Quality of Life Inventory (PedsQL) Generic Core Scales, Version 4 (child-report, 23 items) and the PedsQL Family Impact Module, Version 2 (parent-report, 36 items) was used for QOL assessment of the children and their parents, respectively. RESULTS Forty-one, 48 and 45 age- and sex-matched children with their accompanying parents were included in the emmetropia, low myopia and high myopia group, respectively. Parents in the three groups also did not differ in age, sex, or education level. The median total QOL scores were comparable for emmetropic and low myopic children (96.74 [IQR: 93.48-97.83] vs. 96.74 [IQR: 94.57-98.37]) but were significantly lower for high myopic children (88.04 [IQR: 82.61-92.39], both p < .001). A decreasing trend was observed in the median total QOL for parents in the emmetropia (96.53, IQR: 86.81-100), low myopia (82.30, IQR: 70.83-97.22), and high myopia group (70.83, IQR: 60.42-84.03) (p for trend <.001). The effect of per myopic diopter change on QOL was larger in parents than children (coefficient: 1.48 (95%CI: 1.19-1.78) vs. 2.58 [95%CI: 1.83-3.32]), and parents with higher educational level appeared to have more reduction in QOL (p = .008). CONCLUSIONS More severe myopia resulted in a larger QOL decrease in both children and parents. Significantly reduced QOL were identified in children with high myopia and parents of children with any myopia.
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Affiliation(s)
- Xiaotong Han
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaoting Ruan
- Department of Ophthalmology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| | - Yifan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Haowen Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Miao Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xuhua Tan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Lixia Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
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Nucci P, Liu SH, Villani E. Cochrane corner: interventions for myopia control in children. Eye (Lond) 2023; 37:3526-3527. [PMID: 37142779 PMCID: PMC10686402 DOI: 10.1038/s41433-023-02558-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 04/17/2023] [Accepted: 04/24/2023] [Indexed: 05/06/2023] Open
Affiliation(s)
- Paolo Nucci
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.
| | - Su-Hsun Liu
- Department of Ophthalmology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Edoardo Villani
- Department of Clinical Science and Community Health, University of Milan, San Giuseppe Hospital, IRCCS Multimedica, Milan, Italy
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Song Y, Li F, Chong RS, Wang W, Ran AR, Lin F, Wang P, Wang Z, Jiang J, Kong K, Jin L, Chen M, Sun J, Wang D, Tham CC, Lam DSC, Zangwill LM, Weinreb RN, Aung T, Jonas JB, Ohno-Matsui K, Cheng CY, Bressler NM, Sun X, Cheung CY, Chen S, Zhang X. High Myopia Normative Database of Peripapillary Retinal Nerve Fiber Layer Thickness to Detect Myopic Glaucoma in a Chinese Population. Ophthalmology 2023; 130:1279-1289. [PMID: 37499953 DOI: 10.1016/j.ophtha.2023.07.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/29/2023] Open
Abstract
PURPOSE To develop and validate the performance of a high myopia (HM)-specific normative database of peripapillary retinal nerve fiber layer (pRNFL) thickness in differentiating HM from highly myopic glaucoma (HMG). DESIGN Cross-sectional multicenter study. PARTICIPANTS A total of 1367 Chinese participants (2325 eyes) with nonpathologic HM or HMG were included from 4 centers. After quality control, 1108 eyes from 694 participants with HM were included in the normative database; 459 eyes from 408 participants (323 eyes with HM and 136 eyes with HMG) and 322 eyes from 197 participants (131 eyes with HM and 191 eyes with HMG) were included in the internal and external validation sets, respectively. Only HMG eyes with an intraocular pressure > 21 mmHg were included. METHODS The pRNFL thickness was measured with swept-source (SS) OCT. Four strategies of pRNFL-specified values were examined, including global and quadrantic pRNFL thickness below the lowest fifth or the lowest first percentile of the normative database. MAIN OUTCOMES MEASURES The accuracy, sensitivity, and specificity of the HM-specific normative database for detecting HMG. RESULTS Setting the fifth percentile of the global pRNFL thickness as the threshold, using the HM-specific normative database, we achieved an accuracy of 0.93 (95% confidence interval [CI], 0.90-0.95) and 0.85 (95% CI, 0.81-0.89), and, using the first percentile as the threshold, we acheived an accuracy of 0.85 (95% CI, 0.81-0.88) and 0.70 (95% CI, 0.65-0.75) in detecting HMG in the internal and external validation sets, respectively. The fifth percentile of the global pRNFL thickness achieved high sensitivities of 0.75 (95% CI, 0.67-0.82) and 0.75 (95% CI, 0.68-0.81) and specificities of 1.00 (95% CI, 0.99-1.00) and 1.00 (95% CI, 0.97-1.00) in the internal and external validation datasets, respectively. Compared with the built-in database of the OCT device, the HM-specific normative database showed a higher sensitivity and specificity than the corresponding pRNFL thickness below the fifth or first percentile (P < 0.001 for all). CONCLUSIONS The HM-specific normative database is more capable of detecting HMG eyes than the SS OCT built-in database, which may be an effective tool for differential diagnosis between HMG and HM. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Yunhe Song
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Fei Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Rachel S Chong
- Singapore Eye Research Institute, Singapore National Eye Centre, Yong Loo Lin School of Medicine, National University of Singapore, Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - An Ran Ran
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Fengbin Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Peiyuan Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Zhenyu Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Jingwen Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Kangjie Kong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Meiling Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Jian Sun
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Deming Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Dennis S C Lam
- The International Eye Research Institute of The Chinese University of Hong Kong (Shenzhen), Shenzhen, China
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology, and Shiley Eye Institute, University of California, San Diego, La Jolla, California
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology, and Shiley Eye Institute, University of California, San Diego, La Jolla, California
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Yong Loo Lin School of Medicine, National University of Singapore, Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, Mannheim, Germany; Institute of Molecular and Clinical Ophthalmology IOB, Basel, Switzerland
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Yong Loo Lin School of Medicine, National University of Singapore, Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Neil M Bressler
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Xiaodong Sun
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China.
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Shida Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
| | - Xiulan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
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Wang Y, Du R, Xie S, Chen C, Lu H, Xiong J, Ting DSW, Uramoto K, Kamoi K, Ohno-Matsui K. Machine Learning Models for Predicting Long-Term Visual Acuity in Highly Myopic Eyes. JAMA Ophthalmol 2023; 141:1117-1124. [PMID: 37883115 PMCID: PMC10603576 DOI: 10.1001/jamaophthalmol.2023.4786] [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: 06/27/2023] [Accepted: 09/01/2023] [Indexed: 10/27/2023]
Abstract
Importance High myopia is a global concern due to its escalating prevalence and the potential risk of severe visual impairment caused by pathologic myopia. Using artificial intelligence to estimate future visual acuity (VA) could help clinicians to identify and monitor patients with a high risk of vision reduction in advance. Objective To develop machine learning models to predict VA at 3 and 5 years in patients with high myopia. Design, Setting, and Participants This retrospective, single-center, cohort study was performed on patients whose best-corrected VA (BCVA) at 3 and 5 years was known. The ophthalmic examinations of these patients were performed between October 2011 and May 2021. Thirty-four variables, including general information, basic ophthalmic information, and categories of myopic maculopathy based on fundus and optical coherence tomography images, were collected from the medical records for analysis. Main Outcomes and Measures Regression models were developed to predict BCVA at 3 and 5 years, and a binary classification model was developed to predict the risk of developing visual impairment at 5 years. The performance of models was evaluated by discrimination metrics, calibration belts, and decision curve analysis. The importance of relative variables was assessed by explainable artificial intelligence techniques. Results A total of 1616 eyes from 967 patients (mean [SD] age, 58.5 [14.0] years; 678 female [70.1%]) were included in this analysis. Findings showed that support vector machines presented the best prediction of BCVA at 3 years (R2 = 0.682; 95% CI, 0.625-0.733) and random forest at 5 years (R2 = 0.660; 95% CI, 0.604-0.710). To predict the risk of visual impairment at 5 years, logistic regression presented the best performance (area under the receiver operating characteristic curve = 0.870; 95% CI, 0.816-0.912). The baseline BCVA (logMAR odds ratio [OR], 0.298; 95% CI, 0.235-0.378; P < .001), prior myopic macular neovascularization (OR, 3.290; 95% CI, 2.209-4.899; P < .001), age (OR, 1.578; 95% CI, 1.227-2.028; P < .001), and category 4 myopic maculopathy (OR, 4.899; 95% CI, 1.431-16.769; P = .01) were the 4 most important predicting variables and associated with increased risk of visual impairment at 5 years. Conclusions and Relevance Study results suggest that developing models for accurate prediction of the long-term VA for highly myopic eyes based on clinical and imaging information is feasible. Such models could be used for the clinical assessments of future visual acuity.
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Affiliation(s)
- Yining Wang
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ran Du
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Ophthalmology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Shiqi Xie
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Changyu Chen
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hongshuang Lu
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Jianping Xiong
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Daniel S. W. Ting
- Singapore National Eye Center, Singapore Eye Research Institute, Singapore, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore
| | - Kengo Uramoto
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koju Kamoi
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
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Chen X, Yang B, Wang X, Ma W, Liu L. The alterations in ocular biometric parameters following short-term discontinuation of long-term orthokeratology and prior to subsequent lens fitting: a preliminary study. Ann Med 2023; 55:2282745. [PMID: 37988719 PMCID: PMC10836244 DOI: 10.1080/07853890.2023.2282745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 11/06/2023] [Indexed: 11/23/2023] Open
Abstract
PURPOSE To investigate the alterations in biometric parameters among Chinese adolescents over an extended period of wearing orthokeratology lenses, as well as the subsequent changes after a one-month cessation of lens usage prior to the secondary lens fitting. METHODS Twenty-four myopic patients aged 7-14 were enrolled in this 37-month prospective observational study. Ocular biometric parameters were measured in the study. Ocular biometric parameters were assessed, and the utilization of Generalized Estimating Equations (GEE) was employed in the analysis to address the correlation between the two eyes of each participant. RESULTS The axial length (AL) increased by 0.55 mm after 36 months of lens wearing and further increased to 0.62 mm at the 37-month follow-up compared to the initial measurement. The differences in AL elongation per month between the 37-month time point and the 12-, 24-, and 36-month marks of lens wearing were found to be statistically significant (p12-month = 0.001; p24-month = 0.003; p36-month = 0.001). Following the cessation of lens wear for 1 month, there was no significant complete recovery observed in the flat and steep keratometry values. However, the intraocular pressure and anterior chamber depth returned to their baseline levels. CONCLUSIONS The AL elongation undergoes alterations during temporary discontinuation of lenses, with the flat and steep keratometry measurements remaining significantly flatter compared to the baseline. However, the intraocular pressure and anterior chamber depth return to their initial levels after one month of lens cessation.
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Affiliation(s)
- Xiaohang Chen
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
| | - Bi Yang
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
| | - Xue Wang
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Ma
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
| | - Longqian Liu
- Department of Ophthalmology and Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P.R. China
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu, China
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Chen Z, Gu D, Wang B, Kang P, Watt K, Yang Z, Zhou X. Significant myopic shift over time: Sixteen-year trends in overall refraction and age of myopia onset among Chinese children, with a focus on ages 4-6 years. J Glob Health 2023; 13:04144. [PMID: 37934967 PMCID: PMC10630697 DOI: 10.7189/jogh.13.04144] [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: 11/09/2023] Open
Abstract
Background Myopia or near-sightedness is a major cause of blindness in China and typically develops between the ages of 6-12 years. We aimed to investigate the change in refractive error and the age of myopia onset in Chinese children from 2005 to 2021. Methods We first conducted a series of cross-sectional studies to determine the refractive states and the age of myopia onset over time, after which we analysed longitudinal data to investigate the dose-response relationship between hyperopic reserve and future risk of myopia. The analysis was based on the refraction data of children aged 4-18 years who visited the Fudan University Eye and Ear, Nose, and Throat (FUEENT) Hospital, a large tertiary hospital in Shanghai, China, for eye examinations between 2005 and 2021. We examined the prevalence of hyperopia (spherical equivalent refractive error (SERE) >0.75D), pre-myopia (-0.50D < SERE ≤ 0.75D), and myopia (SERE ≤-0.50D), the average SERE for each age group at the initial visit, the average age of myopia onset, and the safety threshold of hyperopic reserve against myopia onset. Results We included 870 372 eligible patients aged 4-18 years who attended examination between 2005 and 2021, 567 893 (65.2%) of whom were myopic at their initial visit to FUEENT. The mean SERE decreased in most (n/N = 14/15) of the age groups over the 16 calendar years, with a mean SERE for the whole cohort decreasing from -1.01D (standard deviation (SD) = 3.46D) in 2005 to -1.30D (SD = 3.11D) in 2021. The prevalence of pre-myopia increased over the 16 years (P < 0.001), while those of myopia and hyperopia remained largely stable (both P > 0.05). We observed a significant decrease in the prevalence of hyperopia (2005: 65.4% vs 2021: 51.1%; P < 0.001) and a significant increase in the prevalence of pre-myopia (2005: 19.0% vs 2021: 26.5%; P < 0.001) and myopia (2005: 15.6% vs 2021: 22.4%; P < 0.001) in children aged 4-6 years. We found an earlier myopia onset over time, with the mean age of onset decreasing from 10.6 years in 2005 to 7.6 years in 2021 (P < 0.001). Children with a hyperopic reserve of less than 1.50D were at increased risk of developing myopia during a median follow-up of 1.3 years. Conclusions We found an overall myopic shift in SERE in Chinese children aged 4-18 years over the past 16 years, particularly in those aged 4-6 years. The mean age of myopia onset decreased by three years over the same period. The "safety threshold" of hyperopic reserve we identified may help target the high-risk population for early prevention.
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Affiliation(s)
- Zhi Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200031, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Dantong Gu
- Clinical Research and Achievement Translation Center, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Bingjie Wang
- School of Optometry and Vision Science, University of New South Wales, Australia
| | - Pauline Kang
- School of Optometry and Vision Science, University of New South Wales, Australia
| | - Kathleen Watt
- School of Optometry and Vision Science, University of New South Wales, Australia
| | - Zuyao Yang
- Division of Epidemiology, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, 200031, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
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Liu XN, Naduvilath TJ, Sankaridurg PR. Myopia and sleep in children-a systematic review. Sleep 2023; 46:zsad162. [PMID: 37381700 PMCID: PMC10639155 DOI: 10.1093/sleep/zsad162] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 05/22/2023] [Indexed: 06/30/2023] Open
Abstract
Worldwide, approximately one in three people are myopic or short-sighted. Myopia in children is of particular concern as younger onset age implies a higher risk of progression, and consequently greater risk of developing vision-threatening complications. The importance of sleep in children's health has long been acknowledged, but evidence for its role in childhood myopia is fairly new and mixed results were presented across studies. To facilitate better understanding of this relationship, a broad literature search, up to and including October 31, 2022, was performed using three databases (PubMed, Embase, and Scopus). Seventeen studies were included in the review, covering four main aspects of sleep, namely duration, quality, timing, and efficiency, and their associations with myopia in children. The present literature review discussed these studies, revealed potential limitations in their methodologies, and identified gaps that need to be addressed in the future. The review also acknowledges that current evidence is insufficient, and the role of sleep in childhood myopia is far from being fully understood. Future studies that primarily, objectively, and accurately assess sleep and myopia, taking other characteristics of sleep beyond duration into consideration, with a more diverse sample in terms of age, ethnicity, and cultural/environmental background, and control for confounders such as light exposure and education load are much needed. Although more research is required, myopia management should be a holistic approach and the inclusion of sleep hygiene in myopia education targeting children and parents ought to be encouraged.
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Affiliation(s)
- Xiao Nicole Liu
- School of Optometry and Vision Science, University of New South Wales, Sydney, SYD, Australia
- Brien Holden Vision Institute Limited, Sydney, SYD, Australia
| | - Thomas John Naduvilath
- School of Optometry and Vision Science, University of New South Wales, Sydney, SYD, Australia
- Brien Holden Vision Institute Limited, Sydney, SYD, Australia
| | - Padmaja R Sankaridurg
- School of Optometry and Vision Science, University of New South Wales, Sydney, SYD, Australia
- Brien Holden Vision Institute Limited, Sydney, SYD, Australia
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Camellin U, Franchina F, Latino G, Ninotta I, Palino P, Meduri A, Aragona P. Comparison between IOL MASTER 500 and MYAH with vector analysis in low and mild anterior corneal astigmatism. Eur J Ophthalmol 2023:11206721231210895. [PMID: 37919941 DOI: 10.1177/11206721231210895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
PURPOSE Evaluate the agreement between IOL Master 500 (Carl Zeiss Meditec AG, Germany) and MYAH (Topcon EU, Visia Imaging, Japan) in measuring axial length, keratometry, and anterior corneal astigmatism. SETTING Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy. METHODS In this prospective study, 40 eyes (right eye 25, left eye 15) of 40 patients were included. Axial length (AL), keratometry (K1, K2), and anterior corneal astigmatism (ACA) were measured. AL, mean K (Kavg) and magnitude of ACA were compared using Bland - Altman plot analysis, parametric and nonparametric statistical analysis. The difference vector and angle of error of the ACA measured by the two devices were evaluated by vector analysis using polar diagrams. RESULTS Mean and standard deviation with IOL Master and with MYAH device was for AL 24.25 ± 1.22 mm and 24.25 ± 1.22 mm (p = .99), for Kavg 42.75 ± 1.53 D and 42.85 ± 1.52 D (p = .78), for Magnitude of ACA 1.00 ± 0.58 D and 0.89 ± 0.56 D (p = .38) respectively. High correlations were found for AL (R² = 0.999), Kavg (R² = 0.996), and ACA Magnitude (R² = 0.889). Bland-Altman analysis of the two devices found high agreement and absence of proportional bias (MYAH-IOL MASTER) were found between the two assessments for AL (bias = -0.0005 mm, p = .93), Kavg (bias = 0.0955 D, p = .76) and ACA (bias = 0.11 D, p = .41). Limit of agreement (upper/lower LoA, 95%CI) were respectively +0.057/-0.058 mm for AL, + 0.29/-0.09 D for Kavg and +0.49/-0.27 D for ACA. No statistical difference was found between the x-component and y-component of the ACA vector (p > .01), the difference vector (IOL MASTER-MYAH) was +0.14 D axis 159 with an absolute mean angle of error of 7.2 ± 7.5 degree. CONCLUSIONS The instruments appear to be interchangeable for measurements of AL, keratometry, and magnitude of ACA with high agreement between the two devices. Also, in the presence of low astigmatism, the two instruments give the same results in terms of ACA.
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Affiliation(s)
- Umberto Camellin
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy
| | - Francesco Franchina
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy
| | - Gianluigi Latino
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy
| | - Ivan Ninotta
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy
| | - Paola Palino
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy
| | - Alessandro Meduri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy
| | - Pasquale Aragona
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy
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Abdolalizadeh P, Mehrdad R, Saberzadeh-Ardestani B, Pouragha H, Alipour F, Esmaili M. Prevalence of uncorrected distance refractive errors and associated risk factors in employees of an academic centre. Clin Exp Optom 2023; 106:869-875. [PMID: 36372555 DOI: 10.1080/08164622.2022.2133988] [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: 08/03/2021] [Accepted: 03/14/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Uncorrected refractive error (RE) may affect the work performance of adults in the workplace. The aim of current study was to determine the prevalence of corrected and uncorrected RE, and the determinants of uncorrected RE in adult employees of a university. METHODS This was a cross-sectional study of Tehran University Medical Sciences' staff. Besides demographic and some specific questionnaires, ophthalmic examinations including the measurement of uncorrected visual acuity (UCVA), best spectacles corrected visual acuity (BCVA), and presenting visual acuity were performed for all participants. The need for spectacles was defined as UCVA worse than 6/12 in the better eye that could be corrected to better than 6/12 with spectacles based on subjective refraction. RESULTS In total, 4460 individuals with mean age of 42.32 ± 8.80 were included in the study. The VA of the better eye was 0.01 ± 0.05 logMAR for BCVA, 0.13 ± 0.26 for UCVA, and 0.05 ± 0.12 for presenting VA. Prevalence of RE was 15.7%, including uncorrected RE of 5% and spectacles coverage (corrected RE) of 10.7%. The proportion of individuals with elementary education and poor-fair status of general health were 1.62 times higher in the uncorrected group. In the univariate analysis, type of occupation (office versus non-office workers), socioeconomic status, and insurance of employees were not related to uncorrected RE (all P > 0.4). Myopia was the only factor associated with uncorrected RE in logistic regression analysis (odds ratio = 2.73, 95%CI = 1.02-7.31, P = 0.04). CONCLUSION The prevalence of uncorrected RE and spectacle coverage were 5% and 10.7%, respectively. Myopia was almost three times more likely to be associated among employees with uncorrected RE.
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Affiliation(s)
- Parya Abdolalizadeh
- Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ramin Mehrdad
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hamidreza Pouragha
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - Fateme Alipour
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Esmaili
- Optometry Department, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Wang B, Watt K, Chen Z, Kang P. Predicting the child who will become myopic - can we prevent onset? Clin Exp Optom 2023; 106:815-824. [PMID: 37194117 DOI: 10.1080/08164622.2023.2202306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 04/06/2023] [Indexed: 05/18/2023] Open
Abstract
Myopia has become a global epidemic with significant public health impacts. Identifying the child at risk of developing myopia, i.e. the pre-myopic child and implementing strategies to prevent the onset of myopia, could significantly reduce the burden of myopia on an individual and society. This paper is a review of publications that have identified ocular characteristics of children at risk of future myopia development including a lower than age normal amount of hyperopia and accelerated axial length elongation. Risk factors associated with increased risk of myopia development such as education exposure and reduced outdoor time, and strategies that could be implemented to prevent myopia onset in children are also explored. The strong causal role of education and outdoor time on myopia development suggests that lifestyle modifications could be implemented as preventative measures to at-risk children and may significantly impact the myopia epidemic by preventing or delaying myopia onset and its associated ocular health consequences.
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Affiliation(s)
- Bingjie Wang
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Kathleen Watt
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Zhi Chen
- Department of Ophthalmology, Fudan University Eye and ENT Hospital, Shanghai, China
| | - Pauline Kang
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
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45
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Wang Y, Liu Y, Zhu X, Zhou X, He JC, Qu X. Corneal and lenticular biometry in Chinese children with myopia. Clin Exp Optom 2023; 106:836-844. [PMID: 36045001 DOI: 10.1080/08164622.2022.2116269] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 08/15/2022] [Indexed: 10/14/2022] Open
Abstract
CLINICAL RELEVANCE The measurement and simulation of corneal and lenticular curvature radii using a single swept-source biometry device enables a more thorough evaluation of the shape and refractive power of the cornea and lens during emmetropization or myopia progression in children. BACKGROUND This study aimed to evaluate the distribution characteristics of corneal and lenticular parameters in Chinese children with myopia and explored their association with other ocular components. METHODS In this cross-sectional study, all ocular biometric parameters were measured using a Zeiss IOLMaster 700 Biometry. Simulations of the corneal and lenticular curvature radii were implemented using a customised MATLAB program based on cross-sectional swept-source optical coherence tomography images obtained from the same device. The associations of the calculated and simulated refractive powers of the cornea and lens with other ocular parameters were evaluated. RESULTS In total, 119 children with myopia were recruited. Boys had a deeper anterior chamber and longer axial length (AL) than girls, while girls had steeper anterior corneal and lenticular curvatures and greater corneal and lenticular power. Children aged 10 years and older showed a larger anterior lenticular radius of curvature (sRal) and less lenticular power (PL,OCT) than younger participants. There was a significant positive correlation between AL and the anterior corneal radius of curvature, regardless of sex or age. The sRal exhibited a significant increasing trend, and PL,OCT exhibited a declining trend with a longer AL only in children younger than 10 years. CONCLUSION AL is the most influential factor in the determination of spherical equivalent refractive error, while decreases in both corneal and crystalline lens power are significantly inversely correlated with axial elongation.
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Affiliation(s)
- Yuliang Wang
- Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Yujia Liu
- Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xingxue Zhu
- Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Ji C He
- Department of Vision Sciences, New England College of Optometry, Boston, MA, USA
| | - Xiaomei Qu
- Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
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Agyekum S, Chan PP, Adjei PE, Zhang Y, Huo Z, Yip BHK, Ip P, Wong ICK, Zhang W, Tham CC, Chen LJ, Zhang XJ, Pang CP, Yam JC. Cost-Effectiveness Analysis of Myopia Progression Interventions in Children. JAMA Netw Open 2023; 6:e2340986. [PMID: 37917061 PMCID: PMC10623196 DOI: 10.1001/jamanetworkopen.2023.40986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/15/2023] [Indexed: 11/03/2023] Open
Abstract
Importance Several interventions exist for treating myopia progression in children. While these interventions' efficacy has been studied, their cost-effectiveness remains unknown and has not been compared. Objective To determine cost-effective options for controlling myopia progression in children. Design, Setting, and Participants In this cost-effectiveness analysis, a Markov model was designed to compare the cost-effectiveness of interventions for controlling myopia progression over 5 years from a societal perspective in a simulated hypothetical cohort of patients aged 10 years with myopia. Myopia interventions considered included atropine eye drops, 0.05% and 0.01%, defocus incorporated multiple segment spectacles, outdoor activity, soft contact lenses (daily disposable and multifocal), rigid gas-permeable contact lenses, progressive addition lenses, bifocal spectacle lenses, orthokeratology, highly aspherical lenslets (HALs), and red light therapy; all interventions were compared with single-vision lenses. Deterministic and probabilistic sensitivity analysis determined the association of model uncertainties with the cost-effectiveness. Costs were obtained from the charges of the Hospital Authority of Hong Kong and The Chinese University of Hong Kong Eye Center. Main Outcome and Measures The mean costs (in US dollars) per child included the cost of hospital visits, medications, and optical lenses. The outcomes of effectiveness were the annual spherical equivalent refraction (SER) and axial length (AL) reductions. Incremental cost-effectiveness ratios (ICERs) were calculated for each strategy relative to single-vision lenses over a time horizon of 5 years. Results Outdoor activity, atropine (0.05%), red light therapy, HALs, and orthokeratology were cost-effective. The ICER of atropine, 0.05%, was US $220/SER reduction; red light therapy, US $846/SER reduction; and HALs, US $448/SER reduction. Outdoor activity yielded a savings of US $5/SER reduction and US $8/AL reduction. Orthokeratology resulted in an ICER of US $2376/AL reduction. Conclusions and Relevance These findings suggest that atropine eye drops, 0.05%, and outdoor activity are cost-effective for controlling myopia progression in children. Though more expensive, red light therapy, HALs, and orthokeratology may also be cost-effective. The use of these interventions may help to control myopia in a cost-effective way.
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Affiliation(s)
- Sylvia Agyekum
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Poemen P. Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Eye Hospital, Hong Kong SAR, China
- Lam Kin Chung. Jet King-Shing Ho Glaucoma Treatment and Research Centre, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, The Prince of Wales Hospital, Hong Kong SAR, China
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
| | - Prince E. Adjei
- School of Life Science, Department of Biomedical Engineering, University of Electronic Science and Technology, Chengdu, China
- Department of Computer Engineering, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Yuzhou Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zhaohua Huo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Benjamin H. K. Yip
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Patrick Ip
- Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ian C. K. Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Wei Zhang
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology Tianjin Medical University, Tianjin, China
| | - Clement C. Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Eye Hospital, Hong Kong SAR, China
- Lam Kin Chung. Jet King-Shing Ho Glaucoma Treatment and Research Centre, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, The Prince of Wales Hospital, Hong Kong SAR, China
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
- Department of Ophthalmology, Hong Kong Children Hospital, Hong Kong SAR. China
- Hong Kong Hub of Pediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Eye Hospital, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, The Prince of Wales Hospital, Hong Kong SAR, China
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
- Hong Kong Hub of Pediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiu Juan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
- Hong Kong Hub of Pediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jason C. Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Eye Hospital, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, The Prince of Wales Hospital, Hong Kong SAR, China
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
- Department of Ophthalmology, Hong Kong Children Hospital, Hong Kong SAR. China
- Hong Kong Hub of Pediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
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Gawne TJ, Samal AV, She Z. The effects of intensity, spectral purity and duty cycle on red light-induced hyperopia in tree shrews. Ophthalmic Physiol Opt 2023; 43:1419-1426. [PMID: 37431102 PMCID: PMC10592436 DOI: 10.1111/opo.13201] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 06/24/2023] [Accepted: 06/26/2023] [Indexed: 07/12/2023]
Abstract
INTRODUCTION There have recently been several clinical studies suggesting that brief periods of exposure to red light (repeated low-level red light, 'RLRL') may produce a dramatic anti-myopia effect, calling for further investigations into its therapeutic parameters. Unfortunately, many experimental species used in refractive studies develop myopia in response to this wavelength. Tree shrews are the only animal model other than rhesus monkeys that consistently exhibit hyperopic responses to ambient red light. Here, tree shrews were used to study the influence of the spectral purity, duty cycle and intensity of red light on its anti-myopic effect. METHODS Juvenile tree shrews (Tupaia belangeri) were raised from 24 to 35 days after eye opening under ambient lighting that was: standard white colony fluorescent light; pure narrow band red light of either 600, 50-100 or 5 lux; red light that was diluted with 10% white light (by lux) or 50% white and 2 s of pure red light that alternated with 2 s of pure white light (50% duty cycle). Refractive measures were taken with a NIDEK ARK-700 autorefractor and axial dimensions with a LenStar LS-900 Axial Biometer. RESULTS The pro-hyperopia effect of ambient red light was greatly reduced by even small amounts of concurrent white light 'contamination', but remained robust if 2-s periods of pure white light alternated with 2 s of red. Finally, the hyperopic effect of red light was maintained at reduced luminance levels in the 50-100 lux range and only failed at 5 lux. CONCLUSIONS These results have implications for understanding the mechanisms by which ambient red light affects refractive development, and possibly also for clinical therapies using RLRL. Nevertheless, it remains to be determined if the mechanism of the current clinical RLRL therapy is the same as that operating on tree shrews in ambient red light.
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Affiliation(s)
- Timothy J. Gawne
- Department of Optometry and Vision Science, University of Alabama at Birmingham (UAB). USA
| | - Alena V. Samal
- Department of Optometry and Vision Science, University of Alabama at Birmingham (UAB). USA
- Current Location: MyEyeDr., Birmingham, Alabama. USA
| | - Zhihui She
- Department of Optometry and Vision Science, University of Alabama at Birmingham (UAB). USA
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Clark R, Kneepkens SCM, Plotnikov D, Shah RL, Huang Y, Tideman JWL, Klaver CCW, Atan D, Williams C, Guggenheim JA. Time Spent Outdoors Partly Accounts for the Effect of Education on Myopia. Invest Ophthalmol Vis Sci 2023; 64:38. [PMID: 38010695 PMCID: PMC10683767 DOI: 10.1167/iovs.64.14.38] [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: 09/13/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023] Open
Abstract
Purpose The purpose of this study was to investigate if education contributes to the risk of myopia because educational activities typically occur indoors or because of other factors, such as prolonged near viewing. Methods This was a two-sample Mendelian randomization study. Participants were from the UK Biobank, Avon Longitudinal Study of Parents and Children, and Generation R. Genetic variants associated with years spent in education or time spent outdoors were used as instrumental variables. The main outcome measures were: (1) spherical equivalent refractive error attained by adulthood, and (2) risk of an early age-of-onset of spectacle wear (EAOSW), defined as an age-of-onset of 15 years or below. Results Time spent outdoors was found to have a small genetic component (heritability 9.8%) that tracked from childhood to adulthood. A polygenic score for time outdoors was associated with children's time outdoors; a polygenic score for years spent in education was inversely associated with children's time outdoors. Accounting for the relationship between time spent outdoors and myopia in a multivariable Mendelian randomization analysis reduced the size of the causal effect of more years in education on myopia to -0.17 diopters (D) per additional year of formal education (95% confidence interval [CI] = -0.32 to -0.01) compared with the estimate from a univariable Mendelian randomization analysis of -0.27 D per year (95% CI = -0.41 to -0.13). Comparable results were obtained for the outcome EAOSW. Conclusions Accounting for the effects of time outdoors reduced the estimated causal effect of education on myopia by 40%. These results suggest about half of the relationship between education and myopia may be mediated by children not being outdoors during schooling.
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Affiliation(s)
- Rosie Clark
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom
| | - Sander C. M. Kneepkens
- Department of Ophthalmology, Erasmus University Medical Center, CA Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center, CA Rotterdam, The Netherlands
- Generation R Study Group, Erasmus University Medical Center, CA Rotterdam, The Netherlands
| | - Denis Plotnikov
- Central Research Laboratory, Kazan State Medical University, Kazan, Russia
| | - Rupal L. Shah
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, United Kingdom
| | - Yu Huang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - J. Willem L. Tideman
- Department of Ophthalmology, Erasmus University Medical Center, CA Rotterdam, The Netherlands
- Department of Ophthalmology, Martini Hospital, RM Groningen, The Netherlands
| | - Caroline C. W. Klaver
- Department of Ophthalmology, Erasmus University Medical Center, CA Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center, CA Rotterdam, The Netherlands
- Generation R Study Group, Erasmus University Medical Center, CA Rotterdam, The Netherlands
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
- Department of Ophthalmology, Radboud University Medical Center, GA Nijmegen, The Netherlands
| | - Denize Atan
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS81NU, United Kingdom
| | - Cathy Williams
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS81NU, United Kingdom
| | - Jeremy A. Guggenheim
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom
| | - for the UK Biobank Eye and Vision Consortium
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom
- Department of Ophthalmology, Erasmus University Medical Center, CA Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center, CA Rotterdam, The Netherlands
- Generation R Study Group, Erasmus University Medical Center, CA Rotterdam, The Netherlands
- Central Research Laboratory, Kazan State Medical University, Kazan, Russia
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, United Kingdom
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Department of Ophthalmology, Martini Hospital, RM Groningen, The Netherlands
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
- Department of Ophthalmology, Radboud University Medical Center, GA Nijmegen, The Netherlands
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS81NU, United Kingdom
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS81NU, United Kingdom
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Di Pierdomenico J, González-González R, Valiente-Soriano FJ, Galindo-Romero C, García-Ayuso D. Attitudes and knowledge of myopia management by Spanish optometrists. Int Ophthalmol 2023; 43:4247-4261. [PMID: 37596425 PMCID: PMC10520101 DOI: 10.1007/s10792-023-02835-7] [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: 02/07/2023] [Accepted: 07/27/2023] [Indexed: 08/20/2023]
Abstract
PURPOSE To investigate the knowledge, training and clinical practice of Spanish optometrists about preventing and controlling myopia progression. METHODS A web-based questionnaire was distributed to Spanish optometrists through social networks, optometric professional bodies and one of the major Spanish optometrists' associations to assess practitioner perception, understanding, and self-reported clinical practice behavior related to myopia diagnosis and management. RESULTS A total of 534 optometrists with a mean age of 40.8 ± 10.3 years completed the survey. Most respondents have been practicing optometry for more than 20 years (89.8%), report having actively treated childhood myopia (82.4%), and are very concerned about the increasing frequency of pediatric myopia in their daily practice (85.3%). Almost all of the respondents (97.3%) agreed that the efficacy of treatment is related to the age at which it is prescribed, and more than half (53.6%) considered a progression higher than - 0.50 and up to - 1.00D as the minimum necessary to consider a myopia management option. Respondents who reported actively managing childhood myopia considered orthokeratology, atropine and soft-defocus contact lenses the most effective myopia control interventions. However, the most frequently prescribed form of myopia correction by Spanish optometrists was single-vision spectacles, followed by orthokeratology and soft-defocus contact lenses. CONCLUSIONS Spanish optometrists are very active in the management of myopia, especially by fitting orthokeratology lenses or dual-focus soft contact lenses for myopia control, but there is still potential for improvement in the methodology they follow for both the diagnosis and management of myopia.
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Affiliation(s)
- Johnny Di Pierdomenico
- Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain
- Grupo de Investigación Oftalmología Experimental, Departamento de Oftalmología, Optometría, Otorrinolaringología y Anatomía Patológica, Facultad de Medicina, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB), Campus de Ciencias de la Salud, 30120, Murcia, España
| | | | - Francisco J Valiente-Soriano
- Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain
- Grupo de Investigación Oftalmología Experimental, Departamento de Oftalmología, Optometría, Otorrinolaringología y Anatomía Patológica, Facultad de Medicina, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB), Campus de Ciencias de la Salud, 30120, Murcia, España
| | - Caridad Galindo-Romero
- Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain
- Grupo de Investigación Oftalmología Experimental, Departamento de Oftalmología, Optometría, Otorrinolaringología y Anatomía Patológica, Facultad de Medicina, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB), Campus de Ciencias de la Salud, 30120, Murcia, España
| | - Diego García-Ayuso
- Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain.
- Grupo de Investigación Oftalmología Experimental, Departamento de Oftalmología, Optometría, Otorrinolaringología y Anatomía Patológica, Facultad de Medicina, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB), Campus de Ciencias de la Salud, 30120, Murcia, España.
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Liu Y, Liu Y, Zhang W, Xue ZQ, Zhang FX, Xu WG, Zhuang WJ. Screening of genes interacting with high myopia and neuropsychiatric disorders. Sci Rep 2023; 13:18347. [PMID: 37884635 PMCID: PMC10603034 DOI: 10.1038/s41598-023-45463-y] [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: 06/14/2023] [Accepted: 10/19/2023] [Indexed: 10/28/2023] Open
Abstract
Clinical studies have demonstrated an association between high myopia (HM) and neuropsychiatric disorders; however, the underlying mechanism of the association is not clear. We used whole exome sequencing (WES) in combination with the Genetic Variants Classification Criteria and Guidelines published by the American College of Medical Genetics (ACMG) and bioinformatics analysis to clarify the interrelationship between candidate genes. Causative genes for ocular diseases (45.38%) followed by neuropsychiatric disorders (22.69%) accounted for the highest proportion of genes that exhibited high pathogenicity in HM patients were found. Four pathogenic gene mutations were identified according to ACMG guidelines: c.164_165insACAGCA and c.C1760T in POLG, c.G1291A in COL5A1, and c.G10242T in ZNF469. Three causative genes for neuropsychiatric diseases, PTPRN2, PCDH15 and CDH23, were found to fall at the HM locus. The above results suggest that these genes may interact in high myopia and neuropsychiatric diseases.
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Affiliation(s)
- Yang Liu
- People's Hospital of Ningxia Hui Autonomous Region (Ningxia Eye Hospital), Yinchuan, China
| | - Yang Liu
- People's Hospital of Ningxia Hui Autonomous Region (Ningxia Eye Hospital), Yinchuan, China
| | - Wen Zhang
- People's Hospital of Ningxia Hui Autonomous Region (Ningxia Eye Hospital), Yinchuan, China
| | - Zhong-Qi Xue
- Department of Ophthalmology, Affiliated Hospital of Qingdao Binhai University, Qingdao, China
| | - Fang-Xia Zhang
- People's Hospital of Ningxia Hui Autonomous Region (Ningxia Eye Hospital), Yinchuan, China
| | - Wei-Gang Xu
- People's Hospital of Ningxia Hui Autonomous Region (Ningxia Eye Hospital), Yinchuan, China.
| | - Wen-Juan Zhuang
- People's Hospital of Ningxia Hui Autonomous Region (Ningxia Eye Hospital), Yinchuan, China.
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