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Zeng D, Yang Y, Tang Y, Zhao L, Wang X, Yun D, Chen W, Shang Y, Xu A, Liao H, Zhang X, Lin D, Lin H. Shaping school for childhood myopia: the association between floor area ratio of school environment and myopia in China. Br J Ophthalmol 2024:bjo-2024-325448. [PMID: 38955480 DOI: 10.1136/bjo-2024-325448] [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: 02/29/2024] [Accepted: 05/27/2024] [Indexed: 07/04/2024]
Abstract
AIM To investigate the association of floor area ratio (FAR), an indicator of built environments, and myopia onset. METHODS This prospective cohort study recruited 136 753 children aged 6-10 years from 108 schools in Shenzhen, China at baseline (2016-2017). Refractive power was measured with non-cycloplegic autorefraction over a 2-year follow-up period. FAR was objectively evaluated using geographical information system technology. Mixed-effects logistic regression models were constructed to examine the association of FAR with a 2-year cumulative incidence of myopia among individuals without baseline myopia; multiple linear regression model, with a 2-year cumulative incidence rate of myopia at each school. RESULTS Of 101 624 non-myopic children (56.3% boys; mean (SE) age, 7.657±1.182 years) included in the study, 26 391 (26.0%) of them developed myopia after 2 years. In the individual-level analysis adjusting for demographic, socioeconomic and greenness factors, an IQR in FAR was associated with a decreased risk of 2-year myopia incidence (OR 0.898, 95% CI 0.866 to 0.932, p<0.001). Similar findings were observed in the analysis additionally adjusted for genetic and behavioural factors (OR 0.821, 95% CI 0.766 to 0.880, p<0.001). In the school-level, an IQR increase in FAR was found to be associated with a 2.0% reduction in the 2-year incidence rate of myopia (95% CI 1.3% to 2.6%, p<0.001). CONCLUSIONS Exposure to higher FAR was associated with a decreased myopia incidence, providing insights into myopia prevention through school built environments in China.
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Affiliation(s)
- Danqi Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Yahan Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Yang Tang
- Department of Civil, Environmental and Geodetic Engineering, The Ohio State University, Columbus, Ohio, USA
| | - Lanqin Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Xun Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Dongyuan Yun
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Wenben Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Yuanjun Shang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Andi Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Huipeng Liao
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Xingying Zhang
- Key Laboratory of Radiometric Calibration and Validation for Environmental Satellites, Beijing, China
| | - Duoru Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou, Hainan, China
- Center for Precision Medicine and Department of Genetics and Biomedical Informatics, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China
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Ihesiulor CG, Alzahrani K, Rhadhakrishnan H. A review of mechanism of action of outdoor exposure in preventing myopia incidence and progression. Int J Ophthalmol 2024; 17:1144-1155. [PMID: 38895671 PMCID: PMC11144779 DOI: 10.18240/ijo.2024.06.21] [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: 03/10/2023] [Accepted: 01/30/2024] [Indexed: 06/21/2024] Open
Abstract
Various studies have suggested several environmental, pharmacological, medical, and optical interventions and some are in use but their efficacy in myopia control may be transient, and the cellular, molecular, and biochemical mechanisms involved unclear. Daylight exposure is currently regarded as an effective and enduring strategy in the control of myopia development and progression. However, the mechanism behind the effect of outdoor exposure and its association with genetic predisposition and other relatively more significant environmental factors on myopia is still a conundrum. This review focuses on survey-based and intervention-based studies carried out to propose a mechanism that accounts for myopia development and important for its control.
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Affiliation(s)
- Chikezie Grand Ihesiulor
- Division of Pharmacy & Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M139PL, United Kingdom
| | - Khaled Alzahrani
- Department of Ophthalmology, King Fahad Armed Forces Hospital, Jeddah 23311, Saudi Arabia
| | - Hema Rhadhakrishnan
- Division of Pharmacy & Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M139PL, United Kingdom
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Zhu S, Song Y, Yang B, Wang X, Ma W, Dong G, Liu L. The relationship between accommodative and binocular function with myopia progression in myopic children undergoing orthokeratology. Cont Lens Anterior Eye 2024; 47:102171. [PMID: 38631934 DOI: 10.1016/j.clae.2024.102171] [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] [Revised: 04/11/2024] [Accepted: 04/11/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE To determine the relationship between changes in accommodative and binocular function with myopia progression in myopic children over a two-year follow-up period, and to determine when changes in visual functions stabilized after switching from spectacles to orthokeratology (Ortho-K). METHODS This prospective, self-controlled study followed thirty-six participants (aged 8-14 years) for two years after they switched from spectacles to Ortho-K. Accommodative and binocular function were assessed prior to and 1, 3, 6, 12, 18 and 24 months after commencing Ortho-K. Measurements included accommodative amplitude, accommodative response, accommodative facility, accommodative convergence/accommodation (AC/A), ocular alignment, positive relative accommodation (PRA), negative relative accommodation (NRA), horizontal vergence range, reading ability and stereoacuity. Myopia progression was quantified by the change in axial length. RESULTS Ocular alignment, monocular and binocular accommodative facility, and PRA stabilized after 1 month. The distance blur point in the convergence range, the distance break and recovery point in the divergence range, accommodative amplitude, calculated AC/A, stereoacuity and reading ability stabilized within 6 months. After two years of Ortho-K, NRA significantly increased (p = 0.044), while it showed no significant difference after one-year of lens wear (p = 0.49). The distance break point in the convergence range showed no significant difference (p = 0.20), but significantly decreased after one-year (p = 0.005). There were no significant correlations between the change in axial length with changes in accommodative or binocular function (p > 0.05). CONCLUSION Accommodative and binocular function changed significantly after switching from spectacles to Ortho-K and most of the parameters stabilized within the first 6 months. There was no association between the change in accommodative or binocular function and myopia progression.
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Affiliation(s)
- Shenlin Zhu
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Yutong Song
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Bi Yang
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Xue Wang
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Ma
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Guangjing Dong
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China
| | - Longqian Liu
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu, China.
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Xie R, Zhao F, Yu J, Luo B, Jiang Z, Qiu X, Cao Y, Yang Y, Chen K, Zhang Y, Luo X, Wang Z, Zhu Y, Zhuo Y. Naked-Eye 3-Dimensional Vision Training for Myopia Control: A Randomized Clinical Trial. JAMA Pediatr 2024; 178:533-539. [PMID: 38587852 PMCID: PMC11148688 DOI: 10.1001/jamapediatrics.2024.0578] [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] [Indexed: 04/09/2024]
Abstract
Importance Early onset of myopia increases the risk of high myopia, which can lead to irreversible retinal damage and even loss of central vision. Objective To investigate the efficacy and safety of naked-eye 3-dimensional vision training (NVT) in preventing the progression of myopia in children. Design, Setting, and Participants This randomized clinical trial was conducted in 3 hospitals from May 25, 2022, to February 24, 2023. Participants were children (aged 6-18 years) who had a diagnosis of myopia with a spherical equivalent refraction of -0.75 to -6.00 diopters (D). Intervention Children in the intervention group received 20 minutes of NVT treatment every day, whereas children in the control group lived as usual without vision training. Main Outcome and Measure The primary outcome was the change in axial length at 6 months. Spherical equivalent refraction (SER) was included as a secondary outcome. Results Among 263 participants, 125 (47.5%) were male and 138 (52.5%) were female; the mean (SD) age was 10.3 (1.9) years (range, 6.1-15.6 years). A total of 227 patients (86.3%) completed the 6-month follow-up, including 102 in the intervention group and 125 in the control group. In the intervention group, the changes in axial length and SER at 6 months were 0.18 mm (95% CI, 0.16 to 0.20 mm) and -0.25 D (95% CI, -0.31 to -0.19 D), respectively. In the control group, the changes in axial length and SER at 6 months were 0.23 mm (95% CI, 0.21 to 0.25 mm) and -0.35 D (95% CI, -0.41 to -0.30 D), respectively. The differences in AL and SER between the 2 groups were significant (AL difference: -0.06 mm; 95% CI, -0.09 to -0.03; P < .001; SER difference: 0.10 D; 95% CI, 0.02 to 0.19; P = .02). No study-related adverse reactions were reported during follow-up. Conclusions and Relevance NVT is a safe and promising means to control myopia progression in children with good adherence. Trial Registration ClinicalTrials.gov Identifier: NCT05468775.
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Affiliation(s)
- Rui Xie
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, China
| | - Feng Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, China
| | - Jianhong Yu
- Foshan Women and Children's Hospital, Foshan, Guangdong, China
| | - Bin Luo
- Department of Ophthalmology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University), Shenzhen, Guangdong, China
| | - Zhidong Jiang
- Foshan Women and Children's Hospital, Foshan, Guangdong, China
| | - Xiaoyun Qiu
- Foshan Women and Children's Hospital, Foshan, Guangdong, China
| | - Yingpin Cao
- Department of Ophthalmology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University), Shenzhen, Guangdong, China
| | - Yuxia Yang
- Department of Ophthalmology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University), Shenzhen, Guangdong, China
| | - Kezhe Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, China
| | - Yuan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, China
| | - Xiaoling Luo
- Department of Ophthalmology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University), Shenzhen, Guangdong, China
| | - Zhirong Wang
- Foshan Women and Children's Hospital, Foshan, Guangdong, China
| | - Yingting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, China
| | - Yehong Zhuo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, China
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Eppenberger LS, Grzybowski A, Schmetterer L, Ang M. Myopia Control: Are We Ready for an Evidence Based Approach? Ophthalmol Ther 2024; 13:1453-1477. [PMID: 38710983 PMCID: PMC11109072 DOI: 10.1007/s40123-024-00951-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/11/2024] [Indexed: 05/08/2024] Open
Abstract
INTRODUCTION Myopia and its vision-threatening complications present a significant public health problem. This review aims to provide an updated overview of the multitude of known and emerging interventions to control myopia, including their potential effect, safety, and costs. METHODS A systematic literature search of three databases was conducted. Interventions were grouped into four categories: environmental/behavioral (outdoor time, near work), pharmacological (e.g., atropine), optical interventions (spectacles and contact lenses), and novel approaches such as red-light (RLRL) therapies. Review articles and original articles on randomized controlled trials (RCT) were selected. RESULTS From the initial 3224 retrieved records, 18 reviews and 41 original articles reporting results from RCTs were included. While there is more evidence supporting the efficacy of low-dose atropine and certain myopia-controlling contact lenses in slowing myopia progression, the evidence about the efficacy of the newer interventions, such as spectacle lenses (e.g., defocus incorporated multiple segments and highly aspheric lenslets) is more limited. Behavioral interventions, i.e., increased outdoor time, seem effective for preventing the onset of myopia if implemented successfully in schools and homes. While environmental interventions and spectacles are regarded as generally safe, pharmacological interventions, contact lenses, and RLRL may be associated with adverse effects. All interventions, except for behavioral change, are tied to moderate to high expenditures. CONCLUSION Our review suggests that myopia control interventions are recommended and prescribed on the basis of accessibility and clinical practice patterns, which vary widely around the world. Clinical trials indicate short- to medium-term efficacy in reducing myopia progression for various interventions, but none have demonstrated long-term effectiveness in preventing high myopia and potential complications in adulthood. There is an unmet need for a unified consensus for strategies that balance risk and effectiveness for these methods for personalized myopia management.
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Affiliation(s)
- Leila Sara Eppenberger
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Andrzej Grzybowski
- University of Warmia and Mazury, Olsztyn, Poland
- Institute for Research in Ophthalmology, Poznan, Poland
| | - Leopold Schmetterer
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Department, Duke-NUS Medical School, Singapore, Singapore
- SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore
- School of Chemical and Biological Engineering, Nanyang Technological University, Singapore, Singapore
- Department of Clinical Pharmacology, Medical University Vienna, Vienna, Austria
- Center for Medical Physics and Biomedical Engineering, Medical University Vienna, Vienna, Austria
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
- Ophthalmology and Visual Sciences Department, Duke-NUS Medical School, Singapore, Singapore.
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Davies LN, Biswas S, Bullimore M, Cruickshank F, Estevez JJ, Khanal S, Kollbaum P, Marcotte-Collard R, Montani G, Plainis S, Richdale K, Simard P, Wolffsohn JS. BCLA CLEAR presbyopia: Mechanism and optics. Cont Lens Anterior Eye 2024:102185. [PMID: 38796331 DOI: 10.1016/j.clae.2024.102185] [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: 05/28/2024]
Abstract
With over a billion adults worldwide currently affected, presbyopia remains a ubiquitous, global problem. Despite over a century of study, the precise mechanism of ocular accommodation and presbyopia progression remains a topic of debate. Accordingly, this narrative review outlines the lenticular and extralenticular components of accommodation together with the impact of age on the accommodative apparatus, neural control of accommodation, models of accommodation, the impact of presbyopia on retinal image quality, and both historic and contemporary theories of presbyopia.
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Affiliation(s)
- Leon N Davies
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK.
| | - Sayantan Biswas
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | | | - Fiona Cruickshank
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Jose J Estevez
- Caring Futures Institute, College of Nursing and Health Sciences, Optometry and Vision Science, Flinders University, Adelaide, Australia; Flinders Centre for Ophthalmology, Eye and Vision Research, Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Safal Khanal
- Department of Optometry and Vision Science, The University of Alabama at Birmingham, USA
| | | | | | | | - Sotiris Plainis
- Laboratory of Optics and Vision, School of Medicine, University of Crete, Greece
| | | | - Patrick Simard
- School of Optometry, Universite de Montreal, Montreal, Quebec, Canada
| | - James S Wolffsohn
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
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Sun W, Yu M, Wu J, Han X, Jan C, Song J, Jiang W, Xu Z, Wu Z, Xu J, Hu Y, Bi H. Pseudomyopia as an independent risk factor for myopia onset: a prospective cohort study among school-aged children. Br J Ophthalmol 2024; 108:873-878. [PMID: 37541767 PMCID: PMC11137461 DOI: 10.1136/bjo-2022-322330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 07/09/2023] [Indexed: 08/06/2023]
Abstract
AIM To investigate whether pseudomyopia is an independent risk factor for myopia onset based on a population-based cohort study. METHODS Non-myopic children were recruited from schools in rural and urban settings of Shangdong province, China. Baseline examinations started in September 2020 and all participants were invited for a 6-month follow-up. Pseudomyopia was defined as spherical equivalent (SE) ≤-0.50 diopters (D) before cycloplegia and >-0.50D after cycloplegia. Myopia was defined as cycloplegic SE ≤-0.50D. RESULTS A total of 2328 children (baseline age: 4-17 years) were included in the final analysis. During the 6-month follow-up, 21.1% (355/1680) pseudomyopic eyes developed myopia, and 3.8% (110/2879) non-myopic and non-pseudomyopic eyes developed myopia. After adjusting for multiple myopia risk factors, including baseline cycloplegic SE, near work and outdoor time, pseudomyopia was found to be an independent risk factor for myopia onset (relative risk=2.52, 95% CI 1.86 to 3.42). Additionally, pseudomyopic children with more myopic cycloplegic SE (p<0.001), smaller difference between cycloplegic and non-cycloplegic SE (DIFF, p<0.001), and higher binocular amplitude of accommodation (p<0.001) had higher risk of myopia development. CONCLUSION This is an important longitudinal study to prove that pseudomyopia is an independent risk factor for myopia development among school-aged children.
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Affiliation(s)
- Wei Sun
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
- Affiliated Eye Hospital, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Mingkun Yu
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jianfeng Wu
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
- Shandong Institute of Children Health and Myopia Prevention and Control, Jinan, Shandong, China
| | - Xiaotong Han
- 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
| | - Catherine Jan
- Department of Ophthalmology and Surgery, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia
| | - Jike Song
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
- Shandong Institute of Eye Disease, Jinan, Shandong, China
| | - Wenjun Jiang
- Shandong Institute of Eye Disease, Jinan, Shandong, China
| | - Zihang Xu
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Ziyun Wu
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Jing Xu
- Affiliated Eye Hospital, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Yuanyuan Hu
- Affiliated Eye Hospital, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
- Shandong Institute of Children Health and Myopia Prevention and Control, Jinan, Shandong, China
| | - Hongsheng Bi
- Affiliated Eye Hospital, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
- Shandong Institute of Eye Disease, Jinan, Shandong, China
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Jabeen A, Luensmann D, Woods J, Hill JS, Jones L. Evaluation of Lag of Accommodation with Full-Field Diffusion Optics Technology™ (DOT) Contrast Management Spectacle Lenses in Emmetropic Children. Clin Ophthalmol 2024; 18:1181-1190. [PMID: 38711574 PMCID: PMC11073533 DOI: 10.2147/opth.s453790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/24/2024] [Indexed: 05/08/2024] Open
Abstract
Purpose To evaluate the impact on the lag of accommodation (LOA) in emmetropic children after short-term wear of full-field Diffusion Optics TechnologyTM (DOT) spectacle lenses, designed to modulate retinal contrast to control myopia progression. Patients and Methods This was a single-visit, prospective, randomized, subject-masked study of emmetropes (ametropes ±1.00D or less in each meridian) with no history of myopia control treatment. Unaided logMAR visual acuity was measured, and ocular dominance was determined using the sighting method. In a randomized order, participants wore plano full-field contrast management (DOT) spectacles (no clear central aperture) or control spectacles (standard single vision spectacle lenses). Each participant was given 5 minutes for adaptation to the respective lenses before open field autorefraction measurements were taken at 6 meters and 40 cm. Ten measurements were taken for each eye. Data were evaluated from the right eye and the dominant eye separately. Results A total of 30 participants (20 females and 10 males) with a mean age of 10.4 ± 2.8 (7 to 17) years completed the study. There was no significant difference in right eye mean LOA with contrast management spectacles 0.57 ± 0.39D versus control spectacles 0.62 ± 0.34D; Wilcoxon test, p = 0.37. For dominant eyes, LOA values were 0.60 ± 0.40D and 0.68 ± 0.33D with contrast management spectacles and control spectacles, respectively (p = 0.14). Additionally, no significant difference was observed in mean LOA between males and females or between age groups (7-11 years vs 12-17 years) for either right or dominant eyes with contrast management or control spectacles (all p > 0.05). Conclusion Full-field contrast management spectacle lenses had no significant effect on LOA compared to standard single vision spectacle lenses, indicating no differential impact on accommodative response over the short period of lens wear tested.
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Affiliation(s)
- Asiya Jabeen
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, ON, Canada
| | - Doerte Luensmann
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, ON, Canada
| | - Jill Woods
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, ON, Canada
| | | | - Lyndon Jones
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, ON, Canada
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Chen AM, Erzurum SA, Chandler DL, Hercinovic A, Wu R, Vricella M, Waters AL, Ticho BH, Erickson JW, Han S, McDowell PS, Li Z, Kraker RT, Holmes JM, Cotter SA. Refractive Error Change and Overminus Lens Therapy for Childhood Intermittent Exotropia. JAMA Ophthalmol 2024; 142:417-428. [PMID: 38536764 PMCID: PMC10958385 DOI: 10.1001/jamaophthalmol.2024.0276] [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: 12/01/2023] [Accepted: 01/14/2024] [Indexed: 05/22/2024]
Abstract
Importance Increased myopic shift was found to be associated with 1 year of overminus spectacle treatment for children with intermittent exotropia (IXT). Persistence of myopic shift after discontinuing overminus spectacles is unknown. Objective To compare refractive error change over 3 years in children with IXT originally treated with overminus vs nonoverminus spectacles. Design, Setting, and Participants This study was an 18-month extension of the Trial of Overminus Spectacle Therapy for Intermittent Exotropia cohort, which previously randomized children aged 3 to 10 years with IXT and baseline spherical equivalent refractive error (SER) between -6.00 diopters (D) and 1.00 D to overminus spectacles (-2.50 D for 12 months, -1.25 D for 3 months, and nonoverminus for 3 months) or nonoverminus spectacles. Children were recruited from 56 sites from July 2010 to February 2022. Data were analyzed from February 2022 to January 2024. Interventions After trial completion at 18 months, participants were followed up at 24 and 36 months. Treatment was at investigator discretion from 18 to 36 months. Main Outcomes and Measures Change in SER (cycloplegic retinoscopy) from baseline to 36 months. Results Of 386 children in the Trial of Overminus Spectacle Therapy for Intermittent Exotropia, 223 (57.8%) consented to 18 months of additional follow-up, including 124 of 196 (63.3%) in the overminus treatment group and 99 of 190 (52.1%) in the nonoverminus treatment group. Of 205 children who completed 36-month follow-up, 116 (56.6%) were female, and the mean (SD) age at randomization was 6.2 (2.1) years. Mean (SD) SER change from baseline to 36 months was greater in the overminus group (-0.74 [1.00] D) compared with the nonoverminus group (-0.44 [0.85] D; adjusted difference, -0.36 D; 95% CI, -0.59 to -0.12; P = .003), with 30 of 112 (26.8%) in the overminus group having more than 1 D of myopic shift compared with 14 of 91 (15%) in the nonoverminus group (risk ratio, 1.8; 95% CI, 1.0-3.0). From 12 to 36 months, mean (SD) myopic shift was -0.34 (0.67) D and -0.36 (0.66) D in the overminus and nonoverminus groups, respectively (adjusted difference, -0.001 D; 95% CI, -0.18 to 0.18; P = .99). Conclusions and Relevance The greater myopic shift observed after 1 year of -2.50-D overminus lens treatment remained at 3 years. Both groups had similar myopic shift during the 2-year period after treatment weaning and cessation. The risk of myopic shift should be discussed with parents when considering overminus lens treatment. Trial Registration ClinicalTrials.gov Identifier: NCT02807350.
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Affiliation(s)
- Angela M Chen
- Southern California College of Optometry at Marshall B. Ketchum University, Fullerton
| | | | | | | | - Rui Wu
- Jaeb Center for Health Research, Tampa, Florida
| | | | - Amy L Waters
- Children's Mercy Hospitals and Clinics, Kansas City, Missouri
| | | | | | - Silvia Han
- Southern California College of Optometry at Marshall B. Ketchum University, Fullerton
| | - Paula S McDowell
- Michigan College of Optometry at Ferris State University, Big Rapids
| | - Zhuokai Li
- Jaeb Center for Health Research, Tampa, Florida
| | | | | | - Susan A Cotter
- Southern California College of Optometry at Marshall B. Ketchum University, Fullerton
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Modrzejewska M, Durajczyk M. The Relationship between Selected Parameters and the Occurrence of Premyopia in a Group of 1155 Children Aged 8 in Northwestern Poland. J Clin Med 2024; 13:1977. [PMID: 38610742 PMCID: PMC11012722 DOI: 10.3390/jcm13071977] [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: 01/04/2024] [Revised: 03/17/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Determination of the number of pupils at risk of developing pre-myopia and selected ophthalmic parameters in a group of 1155 children aged 8. Material: Ophthalmic examinations were performed in Polish 8-year-old, /1518 individuals/; 1155 of whom presented complete data for analysis. There was a total of 554 (47.9%) girls and 602 (52.1%) boys. Examination of the anterior and posterior segment of the eye, evaluation of accommodation, convergence, heterophoria, alignment of the eyeball, muscular balance with ocular mobility in 9 directions of gaze, and spatial vision were tested. Refraction was obtained under cycloplegia. Refractions (spherical equivalent, SE). were categorized as pre-myopia (-0.50 D-+0.75 D), myopia (≤-0.5 D), emmetropia (>-0.5 D to ≤+0.5 D), mildly hyperopia (>+0.5 D to ≤+2.0 D) and hyperopia (>+2.0 D). Data analysis was performed using Statistica 13.5 software: chi-squared, Pearson's, t-Student, and U Mann-Whitney tests. p-values of <0.05 were considered statistically significant. Results: Pre-myopia was diagnosed in as many as 704 subjects (60.9%) with a similar frequency among both girls-328 (46.6%)-and boys with 376 (53.4%). Conclusions: Current data indicates that the growing group of myopic individuals in many industrialized countries is the sixth most common cause of blindness. Further research is crucial to understand the factors underlying accommodative and binocular mechanisms for myopia development and progression and to make recommendations for targeted interventions to slow the progression of myopia in a group of early school children.
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11
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Norazman FNN, Mohd-Ali B, Syed Mohd Dardin SF, Mohamad Shahimin M, Mohamad Fadzil N, Mohd Saman MN, Mohidin N. Baseline Accommodation and Binocular Vision Measures in Malay Schoolchildren Enrolled in the Myopia Control Study Using Spectacle Lenses in Kuala Lumpur. CLINICAL OPTOMETRY 2024; 16:45-52. [PMID: 38405333 PMCID: PMC10893784 DOI: 10.2147/opto.s432496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 01/22/2024] [Indexed: 02/27/2024]
Abstract
Myopia control lenses have been shown to modify visual function; however, it is arguable if these changes are short-term or long-term. We investigated the changes in accommodative behaviour and binocular vision functions of Malay myopic children who participated in a myopia control trial utilising spectacle lenses (n = 40). This article presents baseline accommodation and binocular vision measurements. The mean (± SD) age, spherical equivalent measured by cycloplegic autorefraction, and axial length (AL) for the right eyes were 10.00 ± 1.47 years, -3.02 ± 1.20 D, and 24.42 ± 0.93 mm, respectively. All participants had good distance and near visual acuities with high-contrast charts (100%), which were significantly better than low-contrast charts (10%) (p < 0.001). The mean (± SD) accommodative lag at baseline was 1.14 ± 0.35 D, while monocular and binocular accommodative amplitudes were 15.35 ± 2.07 D and 16.82 ± 2.27 D, respectively. Malay schoolchildren in this study were more esophoric at near compared to distance, with an accommodative-convergence over accommodation (AC/A) ratio of 5.64 ± 0.66 ∆/D. A higher degree of myopia was found to be associated with a longer AL (r = -0.49, p < 0.05) and higher esophoria at near (r = -0.46, p < 0.05). These baseline measures are consistent with data from other studies showing that myopic children have a high accommodative lag, an elevated AC/A ratio, a longer AL, and are more esophoric at near. The measures reported herein will serve as a basis for examining changes that occur within 12 months of wearing myopia control spectacle lenses.
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Affiliation(s)
- Fatin Nur Najwa Norazman
- Optometry and Vision Science Program and Research Centre for Community Health (Reach), Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Centre for Optometry Studies, Faculty of Health Sciences, Universiti Teknologi MARA Cawangan Selangor, Kampus Puncak Alam, Selangor, 42300, Malaysia
| | - Bariah Mohd-Ali
- Optometry and Vision Science Program and Research Centre for Community Health (Reach), Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Syarifah Faiza Syed Mohd Dardin
- Optometry and Vision Science Program and Research Centre for Community Health (Reach), Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mizhanim Mohamad Shahimin
- Optometry and Vision Science Program and Research Centre for Community Health (Reach), Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norliza Mohamad Fadzil
- Optometry and Vision Science Program and Research Centre for Community Health (Reach), Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Norhafizun Mohd Saman
- Optometry and Vision Science Program and Research Centre for Community Health (Reach), Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norhani Mohidin
- Optometry and Vision Science Program and Research Centre for Community Health (Reach), Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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12
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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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13
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Zhuang CC, Zhang L, Pan SS, Wang YN, Guo JX. Accommodation and Binocular Vision in Children with Myopic Anisometropia. J Ophthalmol 2024; 2024:6525136. [PMID: 38264273 PMCID: PMC10805551 DOI: 10.1155/2024/6525136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/25/2024] Open
Abstract
Purpose To assess the differences in accommodation and binocular vision in children with myopic anisometropia and determine the correlation with anisometropia. Method A total of 110 patients with myopia aged 8-15 years were recruited from June 2021 to February 2022 from the Affiliated Hospital of Xuzhou Medical University. Based on the interocular differences of spherical equivalent refraction, patients were divided into the isometropia (35 children), low anisometropia (LA group, 42 children), and high anisometropia (HA group, 33 children). The variables assessed were refraction, heterophoria, amplitude of accommodation (AMP), accommodative response (AR), gradient AC/A, positive and negative relative accommodation (PRA/NRA), and near stereopsis in the three groups. Pearson's correlation coefficient tests were used to investigate the possible association between each parameter and interocular differences (IODs). Results Among 110 subjects, there were 49 males and 61 females with a mean age of 11.39 ± 2.28 years. Compared with those in the isometropia group, AMP was lower and near stereopsis was higher in the LA group, and the distance and near heterophoria, PRA, AR, and near stereopsis were higher, and PRA, AMP, and gradient AC/A were lower in the HA group (all P < 0.05). Compared with those in the LA group, the near stereopsis, AR, and the near stereopsis were higher in the HA group, and the gradient AC/A was lower (all P < 0.05). However, no significant differences existed in the negative relative accommodation (P > 0.05). The distance and near heterophoria, AR, AMP, and near stereopsis were observed to be correlated with IODs, respectively (r = -0.259, p = 0.006; r = -0.201, p = 0.036; r = 0.306, p = 0.001; r = -0.315, p = 0.001; r = 0.535, p < 0.001). Conclusion Our results suggested that with the increase of anisometropia, distance and near heterophoria, AR, AMP, and near stereopsis had a tendency to get worse in children with myopic anisometropia.
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Affiliation(s)
- Chu-chu Zhuang
- The First Medicine College, Xuzhou Medical University, Xuzhou 221004, China
| | - Ling Zhang
- The First Medicine College, Xuzhou Medical University, Xuzhou 221004, China
| | - Shan-shan Pan
- Department of Ophthalmology, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221004, China
| | - Yi-ning Wang
- The First Medicine College, Xuzhou Medical University, Xuzhou 221004, China
| | - Jian-xin Guo
- Department of Ophthalmology, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221004, China
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14
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Xu Y, Han Y, Lv X, Li J, Zhai C, Zhang F. Associations of Near Work, Time Outdoors, and Sleep Duration With Myopic Regression 5 Years After SMILE and FS-LASIK: A Cross-sectional Study. J Refract Surg 2024; 40:e10-e19. [PMID: 38190564 DOI: 10.3928/1081597x-20231212-04] [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: 01/10/2024]
Abstract
PURPOSE To investigate the association of near work, time outdoors, and sleep duration with myopic regression 5 years after small incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) . METHODS This cross-sectional study included patients who received SMILE or FS-LASIK at Beijing Tongren Hospital 5 years ago. The patients underwent ophthalmic examinations including visual acuity, intraocular pressure, subjective refraction, slit-lamp examination, keratometry, corneal topography, optical coherence tomography, and fundus examination from January 2020 to March 2023. Fluorescein break-up time was measured and the Ocular Surface Disease Index questionnaire was completed to exclude dry eye. A self-administered questionnaire was used to collect data on near work exposure, physical activities, and sleep duration. RESULTS A total of 323 eyes were included in the analysis, with a 5-year incidence rate of myopic regression after SMILE or FSLASIK of 16.1%. After adjusted for all confounders, total near work more than 8 hours/day revealed a significant association with myopic regression (odds ratio: 2.461; 95% CI: 1.143 to 5.298, P = .021), particularly in younger adults, women, and patients with high myopia and FS-LASIK treatment. The significant association between sleep duration 8 hours/day or more and myopic regression was restricted to women and patients with FS-LASIK (near significant). However, no significant associations were observed between continuous near work or time outdoors and myopic regression. CONCLUSIONS Excessive near work exposure was associated with greater myopic regression 5 years after SMILE or FS-LASIK. It is crucial to maintain good visual behavior and care for preventing regression after SMILE or FS-LASIK, especially for younger patients and eyes with high myopia. [J Refract Surg. 2024;40(1):e10-e19.].
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15
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Wolffsohn JS. 2022 Glenn A. Fry Award lecture: Enhancing clinical assessment for improved ophthalmic management. Optom Vis Sci 2024; 101:12-24. [PMID: 38350054 DOI: 10.1097/opx.0000000000002102] [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: 02/15/2024] Open
Abstract
ABSTRACT Detailed clinical assessment is critical to allow sensitive evaluation of the eye and its management. As technology advances, these assessment techniques can be adapted and refined to improve the detection of pathological changes of ocular tissue and their impact on visual function. Enhancements in optical medical devices including spectacle, contact, and intraocular lenses have allowed for a better understanding of the mechanism and amelioration of presbyopia and myopia control. Advancements in imaging technology have enabled improved quantification of the tear film and ocular surface, informing diagnosis and treatment strategies. Miniaturized electronics, large processing power, and in-built sensors in smartphones and tablets capacitate more portable assessment tools for clinicians, facilitate self-monitoring and treatment compliance, and aid communication with patients. This article gives an overview of how technology has been used in many areas of eye care to improve assessments and treatment and provides a snapshot of some of my studies validating and using technology to inform better evidence-based patient management.
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Tapasztó B, Flitcroft DI, Aclimandos WA, Jonas JB, De Faber JTHN, Nagy ZZ, Kestelyn PG, Januleviciene I, Grzybowski A, Vidinova CN, Guggenheim JA, Polling JR, Wolffsohn JS, Tideman JWL, Allen PM, Baraas RC, Saunders KJ, McCullough SJ, Gray LS, Wahl S, Smirnova IY, Formenti M, Radhakrishnan H, Resnikoff S, Németh J. Myopia management algorithm. Annexe to the article titled Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute. Eur J Ophthalmol 2023:11206721231219532. [PMID: 38087768 DOI: 10.1177/11206721231219532] [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: 02/06/2024]
Abstract
Myopia is becoming increasingly common in young generations all over the world, and it is predicted to become the most common cause of blindness and visual impairment in later life in the near future. Because myopia can cause serious complications and vision loss, it is critical to create and prescribe effective myopia treatment solutions that can help prevent or delay the onset and progression of myopia. The scientific understanding of myopia's causes, genetic background, environmental conditions, and various management techniques, including therapies to prevent or postpone its development and slow its progression, is rapidly expanding. However, some significant information gaps exist on this subject, making it difficult to develop an effective intervention plan. As with the creation of this present algorithm, a compromise is to work on best practices and reach consensus among a wide number of specialists. The quick rise in information regarding myopia management may be difficult for the busy eye care provider, but it necessitates a continuing need to evaluate new research and implement it into daily practice. To assist eye care providers in developing these strategies, an algorithm has been proposed that covers all aspects of myopia mitigation and management. The algorithm aims to provide practical assistance in choosing and developing an effective myopia management strategy tailored to the individual child. It incorporates the latest research findings and covers a wide range of modalities, from primary, secondary, and tertiary myopia prevention to interventions that reduce the progression of myopia.
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Affiliation(s)
- Beáta Tapasztó
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
- Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Daniel Ian Flitcroft
- Temple Street Children's Hospital, Dublin, Ireland
- Centre for Eye Research Ireland (CERI) Technological University, Dublin, Ireland
| | | | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | | | | | - Andrzej Grzybowski
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
| | - Christina Nicolaeva Vidinova
- Department of Ophthalmology, Military Medical Academy, Sofia, Bulgaria
- Department of Optometry, Sofia University "St. Kliment Ohridski", Sofia, Bulgaria
| | | | - Jan Roelof Polling
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Optometry and Orthoptics, University of Applied Science, Utrecht, The Netherlands
| | - James S Wolffsohn
- Optometry and Vision Science Research Group, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - J Willem L Tideman
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department Ophthalmology, Martini Hospital, Groningen, The Netherlands
| | - Peter M Allen
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, University of South-Eastern Norway, Kongsberg, Norway
| | - Kathryn J Saunders
- Centre for Optometry and Vision Science, Ulster University, Coleraine, UK
| | - Sara J McCullough
- Centre for Optometry and Vision Science, Ulster University, Coleraine, UK
| | | | - Siegfried Wahl
- Institute for Ophthalmic Research, University Tübingen, Tübingen, Germany
- Carl Zeiss Vision International GmbH, Tübingen, Germany
| | | | - Marino Formenti
- Department of Physics, School of Science, University of Padova, Padova, Italy
| | - Hema Radhakrishnan
- Division of Pharmacy and Optometry, University of Manchester, Manchester, UK
| | - Serge Resnikoff
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Brien Holden Vision Institute, Sydney, Australia
| | - János Németh
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
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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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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: 3] [Impact Index Per Article: 3.0] [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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Erdinest N, London N, Morad Y, Naroo SA. Myopia management -A survey of optometrists and ophthalmologists in Israel. Eur J Ophthalmol 2023:11206721231211465. [PMID: 37899737 DOI: 10.1177/11206721231211465] [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: 10/31/2023]
Abstract
PURPOSE Myopia management is practiced by ophthalmologists and optometrists. This study evaluated the approach and standard of myopia management among eye-care practitioners (ECPs) in Israel. The findings may ultimately affect the quality of care. METHODS A questionnaire was sent to 954 optometrists and 365 ophthalmologists, including demographic questions; whether they owned any devices to monitor myopia progression; the lowest progression they considered significant; various questions pertaining to myopia management and treatment methods. RESULTS Responses from 135 optometrists and 126 ophthalmologists were collected, the majority practicing more than five years; 94% of optometrists, and 64% of ophthalmologists. Around 53% of optometrists and 27% of the ophthalmologists proclaimed to practice myopia management. ECPs primary parameters influencing risk assessment for progression were age, genetic background and history of progression. Time outdoors, during daylight hours, is advised by ophthalmologists (97%) and optometrists (78%). Limiting screentime is encouraged by 87% of ophthalmologists and 69% of optometrists. Myopia progression of 0.50D-0.75D after six months is regarded to require intervention by 93% of ophthalmologists and 83% of optometrists. Optometrists selected multiple myopia management treatments, primarily optical (ophthalmic myopia management lenses 40%, multifocal ophthalmic lenses 24%, peripheral blur contact lenses 38%, orthokeratology 11%), while 95% of ophthalmologists chose atropine and only 3-11% selected any additional treatments to consider. CONCLUSION This study highlighted ECPs' agreement on the principles, importance of, and timeline of intervention with myopia management. The disconnect between the two professions lies in management methods. Genuine dialogue and co-management should be encouraged for maximum implementation, benefit and effectiveness of available patient treatments.
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Affiliation(s)
- Nir Erdinest
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Yair Morad
- Department of Ophthalmology, Shamir Medical Center, Tzrifin, Israel
| | - Shehzad A Naroo
- College of Health and Life Sciences, Aston University, Birmingham, UK
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20
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Shen T, Liang M, Chen L. Myopic progression in school-aged children with moderate intermittent exotropia. Front Pediatr 2023; 11:1192387. [PMID: 37654689 PMCID: PMC10466788 DOI: 10.3389/fped.2023.1192387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 08/07/2023] [Indexed: 09/02/2023] Open
Abstract
Objective It is still controversial whether intermittent exotropia (IXT) affects myopic progression during the critical period of visual development. This study retrospectively analyzed the long-term myopic changes and the impact of IXT surgery on myopic progression in school-aged children with moderate IXT. Methods The medical records of 65 children from 5 to 13 years old with or without IXT between 2015 and 2021 were retrospectively reviewed. Patients whose spherical equivalent refraction (SER) were less than -3.00 diopter (D) were included and divided into three groups: IXT surgery group (Group A), which comprised 22 IXT patients who received IXT surgery, IXT observation group (Group B), which comprises 19 IXT patients who only received long-term observational follow-up; and normal control group (Group C), which comprised 24 normal controls without IXT. The main outcome measurement was the rate of myopic progression, which was defined as the mean myopic shift in SER per year. Results The 3- and 5-years long-term follow-up rates of myopic progression were -0.47 ± 0.28 D per year and -0.48 ± 0.23 D per year respectively in Group B, and those were significantly slower than that in Group C (-0.73 ± 0.32 D per year and -0.76 ± 0.19 D per year respectively). However, there was no significant difference in the rate of myopic progression between Group A and B or between Group A and C. Conclusion Moderate IXT may have lower rate of myopic progression in school-aged children. Whether IXT surgery influence the rate of myopic progression still needs further study.
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Affiliation(s)
- Tao Shen
- State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
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21
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Luo F, Hao J, Li L, Liu J, Chen W, Fu J, Congdon N. Baseline Refractive Error, Habitual Accommodative Tone, and Its Association With Myopia in Children: The Lhasa Childhood Eye Study. Invest Ophthalmol Vis Sci 2023; 64:4. [PMID: 37535008 PMCID: PMC10408770 DOI: 10.1167/iovs.64.11.4] [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: 09/05/2022] [Accepted: 07/13/2023] [Indexed: 08/04/2023] Open
Abstract
PURPOSE The purpose of this study was to describe the baseline refractive error, habitual accommodative tone (HAT) in Tibetan children and its longitudinal association with incident myopia and myopia progression. METHODS This was a prospective cohort study. From 7 elementary schools, 1440 children with mean age of 6.83 ± 0.46 years were included with full noncycloplegic and cycloplegic refraction data at baseline, 1-year and 2-year follow-up in the Lhasa Childhood Eye Study. Noncycloplegic and cycloplegic automated refraction were performed at baseline and annually over the next 2 years. HAT was measured as the difference in spherical equivalent (DSE) between noncycloplegic and cycloplegic refraction. RESULTS The mean HAT decreased from a baseline value of 0.92 ± 0.82 diopters (D) to 0.55 ± 0.65 D, P < 0.0001 at 2 years. In multivariable logistic regression models, only baseline spherical equivalent (SE; P < 0.0001) was significantly (negatively) associated with 1- and 2-year incident myopia. Among 1386 children without myopia at baseline, 271 developed myopia over 2 years. For hyperopic children, baseline HAT was significantly associated with the incidence of myopia over 2 years (odds ratio [OR] = 0.43, P < 0.001), and the incidence of myopia was significantly lower with baseline HAT ≥0.5 D, compared to children <0.5 D. For 54 (3.75%) children who were myopic at baseline, SE was significant positively associated with myopic progression in univariable (P = 0.03) and multivariable general mixed linear regression analysis (P = 0.03). CONCLUSIONS Baseline SE was an independent influencing factor for the incidence of myopia and its progression. The incidence of myopia was significantly higher with lower baseline HAT among hyperopic children, indicating that lower HAT was potentially associated with myopic development.
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Affiliation(s)
- Fei Luo
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, China
| | - Jie Hao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, China
| | - Lei Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, China
| | - Jiawen Liu
- Industrial Engineering and Operations Research, University of California, Berkeley, California, United States
| | - Weiwei Chen
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, China
| | - Jing Fu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, China
| | - Nathan Congdon
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, United Kingdom
- Orbis International, New York, New York, United States
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22
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Zieliński G, Matysik-Woźniak A, Pająk B, Ginszt M, Rejdak R, Gawda P. Study protocol: Accommodative effects on the musculoskeletal system. PLoS One 2023; 18:e0289347. [PMID: 37506164 PMCID: PMC10381037 DOI: 10.1371/journal.pone.0289347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Accommodation is a phenomenon of the eyeball, which consists of adapting to view objects at different distances. The main aim of this study is to evaluate the effect of accommodations on the musculoskeletal system in myopic and emmetropic subjects. To date, the effect of accommodative paralysis on the musculoskeletal system has not been studied. The research hypothesis based on the current research reports is that accommodation affects the musculoskeletal system in myopic and emmetropic subjects. A smaller aim of the study is to evaluate the effect of unilateral accommodative palsy on the musculoskeletal system in myopic and emmetropic subjects. According to the authors of the previous reports, unilateral accommodative palsy will affect increased musculoskeletal asymmetry in myopic and emmetropic subjects. The surface electromyography (sEMG) of the musculoskeletal system will be performed by using the Noraxon Ultium DTS 8-K MR 3 myo Muscle Master Edition. Cycloftyal (10 mg/ml, eye drops, solution) will be used to paralyze accommodation. After the paralysis of unilateral accommodation, the test will be repeated. Both-sided accommodation will be paralyzed next, and the test will be repeated. The study may provide insight into the effects of accommodation on the musculoskeletal system, and it may also help in understanding the connections between these systems.
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Affiliation(s)
- Grzegorz Zieliński
- Department of Sports Medicine, Medical University of Lublin, Lublin, Poland
| | - Anna Matysik-Woźniak
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
| | - Beata Pająk
- Interdisciplinary Scientific Group of Sports Medicine, Department of Sports Medicine, Medical University of Lublin, Lublin, Poland
| | - Michał Ginszt
- Department of Rehabilitation and Physiotherapy, Medical University of Lublin, Lublin, Poland
| | - Robert Rejdak
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
| | - Piotr Gawda
- Department of Sports Medicine, Medical University of Lublin, Lublin, Poland
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23
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Meng Q, Wang L, Zhao M, Wu X, Guo L. Comparing myopic error in patients with basic and convergence insufficiency intermittent exotropia in China. BMC Ophthalmol 2023; 23:290. [PMID: 37365512 DOI: 10.1186/s12886-023-03043-8] [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: 01/05/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023] Open
Abstract
PURPOSE To compare the degree of myopia between the dominant and non-dominant eyes in teenagers with intermittent exotropia (IXT) in China. METHODS A total of 199 IXT patients with myopia were included in this retrospective study and were divided into two groups according to the difference between near and distance exodeviation: basic IXT and convergence insufficiency (CI) IXT. Refractive errors were analyzed by spherical equivalent (SE) values. Patients were further stratified into anisometropia group and non-anisometropia group based on binocular SE values difference greater than 1.0D or not. RESULTS There were 127 patients in the CI IXT group, with a near deviation of 46.94 ± 20.53 prism diopters (PD) and a distance deviation of 28.36 ± 14.34 PD, and there were 72 (36.2%) patients in the basic IXT group, with a near deviation of 37.68 ± 22.21 PD and a distance deviation angle of 33.21 ± 23.96 PD. The near exodeviation was significantly larger in the CI group than in the basic IXT group(P < 0.001). In the CI IXT group, the mean SE was - 2.09 ± 1.45 diopters (D) in the dominant eye and - 2.53 ± 1.44D in the non-dominant eye, while in the basic IXT group, the mean SE was - 2.46 ± 1.56D in the dominant eye and - 2.89 ± 1.37D in the non-dominant eye. The anisometropia group included 43 patients, while non-anisometropia group included 156 patients. The near and distance exodeviation in the anisometropia group were 45.26 ± 24.41 PD and 33.53 ± 23.31 PD, respectively, and those in the non-anisometropia group were 43.42 ± 20.69 PD and 29.07 ± 16.84 PD, respectively. There were no significant differences in near and distance deviation (P = 0.78 and P = 0.73 respectively) between the two groups. The SE of the dominant eye was less myopic than of the non-dominant eyes in both the CI and anisometropia groups (P = 0.002 and P < 0.001, respectively). CONCLUSIONS Our study revealed that convergence insufficiency IXT is more common than the basic type in pediatric myopic population and is characterized by higher inter-eye differences of myopia. The dominant eye was found to be less myopic in IXT patients, particularly in those with convergence insufficiency and anisometropia.
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Affiliation(s)
- Qingyu Meng
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
| | - Lejin Wang
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
| | - Mingwei Zhao
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
| | - Xi Wu
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
| | - Lili Guo
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China.
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China.
- Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China.
- College of Optometry, Peking University Health Science Center, Beijing, China.
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Manoharan MK, Thakur S, Dhakal R, Gupta SK, Priscilla JJ, Bhandary SK, Srivastava A, Marmamula S, Poigal N, Verkicharla PK. Myopia progression risk assessment score (MPRAS): a promising new tool for risk stratification. Sci Rep 2023; 13:8858. [PMID: 37258536 DOI: 10.1038/s41598-023-35696-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/22/2023] [Indexed: 06/02/2023] Open
Abstract
Timely identification of individuals "at-risk" for myopia progression is the leading requisite for myopia practice as it aids in the decision of appropriate management. This study aimed to develop 'myopia progression risk assessment score' (MPRAS) based on multiple risk factors (10) to determine whether a myope is "at-risk" or "low-risk" for myopia progression. Two risk-score models (model-1: non-weightage, model-2: weightage) were developed. Ability of MPRAS to diagnose individual "at-risk" for myopia progression was compared against decision of five clinicians in 149 myopes, aged 6-29 years. Using model-1 (no-weightage), further 7 sub-models were created with varying number of risk factors in decreasing step-wise manner (1a: 10 factors to 1g: 4 factors). In random eye analysis for model-1, the highest Youden's J-index (0.63-0.65) led to the MPRAS cut-off score of 41.50-43.50 for 5 clinicians with a sensitivity ranging from 78 to 85% and specificity ranging from 79 to 87%. For this cut-off score, the mean area under the curve (AUC) between clinicians and the MPRAS model ranged from 0.89 to 0.90. Model-2 (weighted for few risk-factors) provided similar sensitivity, specificity, and AUC. Sub-model analysis revealed greater AUC with high sensitivity (89%) and specificity (94%) in model-1g that has 4 risk factors compared to other sub-models (1a-1f). All the MPRAS models showed good agreement with the clinician's decision in identifying individuals "at-risk" for myopia progression.
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Affiliation(s)
- Manoj K Manoharan
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
- Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Swapnil Thakur
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
| | - Rohit Dhakal
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
- Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Satish K Gupta
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
| | - Jacinth J Priscilla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
| | - Shashank K Bhandary
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
| | - Alok Srivastava
- L V Prasad Eye Institute, Hyderabad, Telangana, India
- Sri Innovation and Research Foundation, Ghaziabad, Uttar Pradesh, India
| | - Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Nitish Poigal
- L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Pavan K Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India.
- Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India.
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Zhu J, Guo D, Jin L, Zhou T, Shan S, Zhu H, Zhang L, Tong J, Shen Y. Comparison of higher-order aberrations between implantable collamer lens V4c implantation and simulated spectacle correction in patients with high myopia. J Fr Ophtalmol 2023:S0181-5512(23)00145-6. [PMID: 37149460 DOI: 10.1016/j.jfo.2022.11.024] [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: 09/10/2022] [Revised: 11/13/2022] [Accepted: 11/21/2022] [Indexed: 05/08/2023]
Abstract
PURPOSE To investigate the differences in higher-order aberrations between non-toric or toric implantable collamer lens (ICL or TICL) V4c implantation and simulated spectacle correction. METHODS Patients with high myopia who underwent ICL/TICL V4c implantation were enrolled. The "total no defocus" pattern of iTrace aberrometry to simulate the condition of spectacle correction was measured before ICL/TICL implantation, and higher-order aberrations in this condition were compared to those 3 months after surgery. Related factors with changes in coma were comprehensively analyzed. RESULTS A total of 89 right eyes of 89 patients were included. Compared to simulated spectacle correction, total-eye coma (P<0.0001 ICL, P<0.0001 TICL) and internal coma (P<0.0001 ICL, P<0.001 TICL) decreased in the ICL- and TICL-treated groups after surgery. Total-eye secondary astigmatism (P<0.0001 ICL, P=0.007 TICL) and internal secondary astigmatism (P<0.0001 ICL, P=0.009 TICL) were also decreased in both groups postoperatively. Spherical error showed positive correlations with variation in total-eye coma (r=0.37, P=0.004 ICL; r=0.56, P=0.001 TICL) and internal coma (r=0.30, P=0.02 ICL and r=0.45, P=0.01 TICL). Axial length revealed negative correlations with changes in total-eye coma (r=-0.45, P<0.001 ICL; r=-0.39, P=0.03 TICL) and internal coma (r=-0.28, P=0.03 ICL and r=-0.42, P=0.02 TICL). CONCLUSIONS Both ICL- and TICL-treated groups demonstrated a decrease in coma and secondary astigmatism after 3 months, postoperatively. ICL/TICL may confer a compensatory effect on coma aberration and secondary astigmatism. Patients with a higher myopia achieved a greater improvement in coma and may benefit more from ICL/TICL implantation than from spectacle correction implantation than from spectacle correction.
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Affiliation(s)
- J Zhu
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - D Guo
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - L Jin
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - T Zhou
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - S Shan
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - H Zhu
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - L Zhang
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - J Tong
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China.
| | - Y Shen
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China.
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26
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Han JY, Han J, Han SH. Correlation between bilateral lateral rectus muscle recession and myopic progression in children with intermittent exotropia. Sci Rep 2023; 13:7200. [PMID: 37137972 PMCID: PMC10156685 DOI: 10.1038/s41598-023-34441-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/30/2023] [Indexed: 05/05/2023] Open
Abstract
Although several studies have reported about the relationship between the surgical correction of intermittent exotropia and myopic progression, it remains unclear, unlike the relationship between esotropia and hyperopia. Thus, this retrospective case control study evaluated the impact of bilateral lateral rectus recession in intermittent exotropia on myopic progression. This study included 388 patients with intermittent exotropia. The refractive errors and degree of exodeviation at each follow up period were analyzed. The rate of myopic progression was -0.46 ± 0.62 diopter (D)/year in patients who underwent surgery and -0.58 ± 0.78 D/year in patients who did not, with no significant difference between them (p = 0.254). Patients who had recurrences of more than 10 prism diopters were compared with patients who did not have. The rate of myopic progression was -0.57 ± 0.72 D/year in the recurrent group and -0.44 ± 0.61 D/year in the non-recurrent group, with no significant difference between them (p = 0.237). Patients with fast myopic progression had more recurrence than patients with slow progression (p = 0.042). Moreover, recurrence had a positive correlation with fast myopic progression (OR = 2.537, p = 0.021). Conclusively, the surgical correction of intermittent exotropia did not influence myopic progression.
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Affiliation(s)
- Jae Yong Han
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonseiro, Seodaemun-gu, Seoul, Republic of Korea
| | - Jinu Han
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonseiro, Seodaemun-gu, Seoul, Republic of Korea
| | - Sueng-Han Han
- Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonseiro, Seodaemun-gu, Seoul, Republic of Korea.
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Yii FSL. Letter to the Editor: 20-20-20 Rule: Are These Numbers Justified? Optom Vis Sci 2023; 100:346-347. [PMID: 36951847 DOI: 10.1097/opx.0000000000002016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Affiliation(s)
- Fabian S L Yii
- Curle Ophthalmology Laboratory, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
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Tahhan N, Wolffsohn JS, Sankaridurg P, Jonas JB, Bullimore MA, Flitcroft I, Ostrin LA, Wildsoet C, Resnikoff S. Editorial: International Myopia Institute White Paper Series 2023. Invest Ophthalmol Vis Sci 2023; 64:1. [PMID: 37126361 PMCID: PMC10153580 DOI: 10.1167/iovs.64.6.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Affiliation(s)
- Nina Tahhan
- Brien Holden Vision Institute, Sydney Australia
- School of Optometry and Vision Science, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - James S Wolffsohn
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute, Sydney Australia
- School of Optometry and Vision Science, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
| | - Mark A Bullimore
- University of Houston, College of Optometry, Houston, Texas, United States
| | - Ian Flitcroft
- Centre for Eye Research Ireland, School of Physics and Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland
- Department of Ophthalmology, Children's Health Ireland at Temple Street Hospital, Dublin, Ireland
| | - Lisa A Ostrin
- University of Houston, College of Optometry, Houston, Texas, United States
| | - Christine Wildsoet
- UC Berkeley Wertheim School Optometry & Vision Science, Berkeley, California, United States
| | - Serge Resnikoff
- Brien Holden Vision Institute, Sydney Australia
- School of Optometry and Vision Science, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Bullimore MA, Lee SSY, Schmid KL, Rozema JJ, Leveziel N, Mallen EAH, Jacobsen N, Iribarren R, Verkicharla PK, Polling JR, Chamberlain P. IMI-Onset and Progression of Myopia in Young Adults. Invest Ophthalmol Vis Sci 2023; 64:2. [PMID: 37126362 PMCID: PMC10153577 DOI: 10.1167/iovs.64.6.2] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
Myopia typically starts and progresses during childhood, but onset and progression can occur during adulthood. The goals of this review are to summarize published data on myopia onset and progression in young adults, aged 18 to 40 years, to characterize myopia in this age group, to assess what is currently known, and to highlight the gaps in the current understanding. Specifically, the peer-reviewed literature was reviewed to: characterize the timeline and age of stabilization of juvenile-onset myopia; estimate the frequency of adult-onset myopia; evaluate the rate of myopia progression in adults, regardless of age of onset, both during the college years and later; describe the rate of axial elongation in myopic adults; identify risk factors for adult onset and progression; report myopia progression and axial elongation in adults who have undergone refractive surgery; and discuss myopia management and research study design. Adult-onset myopia is common, representing a third or more of all myopia in western populations, but less in East Asia, where onset during childhood is high. Clinically meaningful myopia progression continues in early adulthood and may average 1.00 diopters (D) between 20 and 30 years. Higher levels of myopia are associated with greater absolute risk of myopia-related ocular disease and visual impairment, and thus myopia in this age group requires ongoing management. Modalities established for myopia control in children would be options for adults, but it is difficult to predict their efficacy. The feasibility of studies of myopia control in adults is limited by the long duration required.
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Affiliation(s)
- Mark A Bullimore
- University of Houston, College of Optometry, Houston, Texas, United States
| | - Samantha Sze-Yee Lee
- Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Katrina L Schmid
- School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Jos J Rozema
- Visual Optics Lab Antwerp (VOLANTIS), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium
| | - Nicolas Leveziel
- Department of Ophthalmology, Centre Hospitalier Universitaire de Poitiers, Poitiers, Cedex, France
| | - Edward A H Mallen
- School of Optometry and Vision Science, University of Bradford, Bradford, United Kingdom
| | | | | | - Pavan K Verkicharla
- Myopia Research Lab and Infor Myopia Centre, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Jan Roelof Polling
- Ophthalmology, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands Rotterdam, The Netherlands
- Orthopics & Optometry, University of Applied Science, Utrecht, The Netherlands
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30
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Ma LU, Yu X, Gong L, Wei L, Peng Z, Wang K, Li Y, Zhou J, Zhao M. Evaluating the optimised font size and viewing time of online learning in young children: a multicentre cross-sectional study. BMJ Paediatr Open 2023; 7:10.1136/bmjpo-2022-001835. [PMID: 37185652 PMCID: PMC10151978 DOI: 10.1136/bmjpo-2022-001835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/14/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVES Near viewing distance (VD) and longer viewing times are associated with myopia. This study aimed to identify the font size and viewing time that guarantee the appropriate VD and pixels per degree (PPD) for children's online learning. DESIGN This cross-sectional study comprised two experiments. In experiment A, participants read text in five font sizes on three backlit displays (a personal computer, a smartphone and a tablet), an E-ink display and paper for 5 min per font size. In experiment B, participants watched videos for 30 min on three backlit displays. SETTING The Peking University People's Hospital in Beijing (China) and the School of Ophthalmology and Optometry, Wenzhou Medical University (Zhejiang Province, China). PARTICIPANTS Thirty-five participants completed experiment A. Ten of them participated in experiment B. PRIMARY AND SECONDARY OUTCOME MEASURES VDs were measured by Clouclip. The corresponding PPD was calculated. RESULTS In experiment A, font size and display type significantly affected VD (F(4840)=149.44, p<0.001, ES (Effect size)=0.77; F(4840), p<0.001, ES=0.37). VDs were >33 cm for all five font sizes on the PC, the tablet and paper and for 18-pt on the smartphone and 16-pt on E-ink. PPD for 16-pt on the PC, 14-pt on the tablet and all five font sizes on the phone were >60. In experiment B, VD increased over the four previous 5 min periods but decreased slightly on tablets and PCs in the fifth 5 min period. PPD was >60. CONCLUSION Children demonstrated different VDs and PPDs based on font size and display type. To ensure a 33 cm VD and 60 PPD, the minimum font size for online reading should be 18-pt on smartphones, 16-pt on PCs and E-ink, 10.5-pt on tablets and 9-pt on paper. More attention should be given to children's VD with continuous video viewing of more than 25 min. TRIAL REGISTRATION NUMBER ChiCTR2100049584.
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Affiliation(s)
- L U Ma
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- Institute of Medical Technology, Peking University Health Science Centre, Beijing, China
| | - Xi Yu
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ling Gong
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lili Wei
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zisu Peng
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- Institute of Medical Technology, Peking University Health Science Centre, Beijing, China
| | - Kai Wang
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- Institute of Medical Technology, Peking University Health Science Centre, Beijing, China
| | - Yan Li
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Jiawei Zhou
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Mingwei Zhao
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- Institute of Medical Technology, Peking University Health Science Centre, Beijing, China
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31
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Effect of Myopic Undercorrection on Habitual Reading Distance in Schoolchildren: The Hong Kong Children Eye Study. Ophthalmol Ther 2023; 12:925-938. [PMID: 36574139 PMCID: PMC10011230 DOI: 10.1007/s40123-022-00628-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/28/2022] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION This study aimed to evaluate the habitual reading distance among non-myopic children and also myopic children with undercorrection and with full correction. METHODS This was a population-based cross-sectional study with a total of 2363 children aged 6-8 years who were recruited from the Hong Kong Children Eye Study. Cycloplegic autorefraction, subjective refraction, habitual visual acuity, and best corrected visual acuity were measured. The entire reading process (9 min) was recorded using a hidden video camera placed 5 m away from the reading desk. Reading distances were taken at 6, 7, 8, and 9 min after the child began reading and were measured using a customized computer program developed in MATLAB. The main outcome was the association of habitual reading distances with refraction status. Habitual reading distances of children were documented via video camera footage. RESULTS The habitual reading distances of undercorrected myopic children (23.37 ± 4.31 cm) were the shortest when compared to non-myopic children (24.20 ± 4.73 cm, P = 0.002) and fully corrected myopic children (24.81 ± 5.21 cm, P < 0.001), while there was no significant difference between the last two children groups (P = 0.17). A shorter reading distance was associated with myopia (OR 1.67; 95% CI 1.11-2.51; P = 0.013) after adjusting for age, sex, height, near work time, outdoor time, and parental myopia. The association of reading distance with myopia did not hold after undercorrected myopic children were excluded (OR 0.97, 95% CI 0.55-1.73; P = 0.92). A shorter reading distance correlated with poorer vision under habitual correction (β = - 0.003, P < 0.001). CONCLUSION A shorter reading distance was present among undercorrected myopic children. Myopia undercorrection is not recommended as a strategy for slowing myopic progression.
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Kim YJ, Kim TG. Analysis of 2-year spherical equivalent progression in emmetropic children with non-cycloplegic refraction: a retrospective chart review. BMC Ophthalmol 2023; 23:131. [PMID: 36997895 PMCID: PMC10064540 DOI: 10.1186/s12886-023-02869-6] [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: 10/10/2022] [Accepted: 03/20/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND We aimed to investigate children with an emmetropic non-cycloplegic refraction (NCR) to compare the difference in progression of NC spherical equivalent (SE) over 2 years between the children with emmetropic and hyperopic cycloplegic refraction (CR) values. METHODS Through a retrospective medical record review, 59 children aged under 10 years were evaluated. Refractive error was calculated as the average of the SE values of both eyes. According to the CR results, children with emmetropia (-0.50 to 1.00 diopter [D]) were assigned to group 1 (n = 29), and those with hyperopia (≥ 1.00 D) were assigned to group 2 (n = 30). The prevalence of myopia and SE progression were compared over 2 years. Correlations between final SE progression and baseline age and refractive error were analyzed and multiple regression analysis was conducted. Receiver operating characteristic curves that achieved the best cutoff points to distinguish between the groups were calculated. RESULTS Group 1 showed significantly myopic SE changes compared to baseline at the 1-year follow-up, and group 1 was significantly myopic compared with group 2 at the 2-year follow-up. Myopia prevalence was 51.7% in group 1 and 6.7% in group 2 after 1 year, and 61.1% and 16.7% after 2 years, respectively. In the correlation analysis, baseline age, baseline CR, and difference between CR and NCR showed significant correlations with the 2-year SE progression (r = -0.359, p = 0.005; r = 0.450, p < 0.001; r = -0.562, p < 0.001, respectively). However, NCR refractive error showed no significant correlation (r = -0.097, p = 0.468). In multiple regression analysis, baseline age (β= -0.082), and CR-NCR difference (β= -0.214) showed a significant effect on SE progression for 2 years. When an NCR value of 0.20 D was set as the cut-off value to distinguish between the groups, a sensitivity of 70% and specificity of 92% were obtained. CONCLUSION Even if NCR showed emmetropia, children with baseline CR values of emmetropia showed greater SE progression compared with those with hyperopia. Cycloplegia is essential to confirm the correct refractive status in children. It may be useful for predicting prognosis of SE progression.
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Affiliation(s)
- Yoo Jin Kim
- Department of Ophthalmology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Tae Gi Kim
- Department of Ophthalmology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seoul, Korea.
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Zhu J, Zhou T, Yang Q, Tong J, Shen Y. Visual Outcomes Early after Implantable Collamer Lens V4c Implantation in Different Preoperative Spectacle Correction: Full Correction vs. Under Correction. Curr Eye Res 2023; 48:576-583. [PMID: 36803084 DOI: 10.1080/02713683.2023.2183481] [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: 02/22/2023]
Abstract
PURPOSE To investigate visual outcomes early after implantable collamer lens (ICL) V4c implantation between patients with fully corrected and under-corrected spectacles preoperatively. METHODS Patients who implanted ICL V4c were divided into the full correction (46 eyes/23 patients) and under-correction groups (48 eyes/24 patients) based on preoperative differences between the spherical diopter of the spectacles and the actual spherical diopter. Refractive outcomes, scotopic pupil size, higher-order aberrations, and subjective visual outcomes as assessed using a validated questionnaire were compared between the two groups 3 months postoperatively. Moreover, the relationships between the severity of haloes and postoperative ocular or ICL parameters were analyzed. RESULTS At the 3-month follow-up, the efficacy indices in the full correction and under-correction groups were 0.99 ± 0.12 and 1.00 ± 0.10, respectively; the safety indices were 1.15 ± 0.16 and 1.15 ± 0.15, respectively. Total-eye spherical aberration (p < 0.0001) and internal spherical aberration (p = 0.0005) were significantly different pre- and post-operatively in the under-correction group, while no differences were found in the full correction group. Total-eye spherical aberration (p = 0.002) and the severity of haloes (p = 0.03) were postoperatively different between the two groups. The severity of haloes was associated with postoperative spherical aberration (total-eye spherical aberration: r = -0.32, p = 0.002; internal spherical aberration: r = -0.24, p = 0.02). CONCLUSION Good efficacy, safety, predictability, and stability were obtained early after surgery regardless of preoperative spectacle correction. Patients in the under-correction group possessed a shift to negative spherical aberration and reported greater severity of haloes at the 3-month follow-up. Haloes were the most common visual symptoms after ICL V4c implantation and the severity of them was correlated with postoperative spherical aberration.
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Affiliation(s)
- Jiru Zhu
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Tianan Zhou
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Qianjie Yang
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jianping Tong
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ye Shen
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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Wang J, Han Y, Musch DC, Li Y, Wei N, Qi X, Ding G, Li X, Li J, Song L, Zhang Y, Ning Y, Zeng X, Li Y, Sun L, Hua N, Li S, Jardines S, Qian X. Evaluation and Follow-up of Myopia Prevalence Among School-Aged Children Subsequent to the COVID-19 Home Confinement in Feicheng, China. JAMA Ophthalmol 2023; 141:333-340. [PMID: 36821130 PMCID: PMC9951104 DOI: 10.1001/jamaophthalmol.2022.6506] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Importance Progression of myopia in a school-aged population due to home confinement (January to May 2021) during the COVID-19 pandemic has been previously reported. A key remaining question was whether the myopia spike in children aged 6 to 8 years persisted. Objective To investigate the changes in refractive status and prevalence of myopia in school-aged children 1 year after home confinement ended in China. Design, Setting, and Participants This cross-sectional study with a cohort substudy prospectively evaluated data from school-based photoscreening in Feicheng, China. Children aged 6 to 13 years participated in 8 screenings from 2015 to 2021. Exposures Noncycloplegic photorefraction was conducted using the Spot Vision photoscreener. Main Outcomes and Measures The main outcomes were the differences in spherical equivalent refraction (SER) and prevalence of myopia between 2020 (during home confinement) and 2021 (after home confinement). The SER was recorded for each child, and the prevalence of myopia was calculated annually for each age group. Results A total of 325 443 children participated in the study (51.4% boys, 48.6% girls; age range, 6 to 13 years). Compared with 2020, the mean SER of children in 2021 increased significantly for those aged 6 (0.42 diopters [D]), 7 (0.41 D), and 8 (0.33 D) years. The prevalence of myopia in 2021 was similar to in 2019 for each age group (aged 6 years: 7.9% vs 5.7%; aged 7 years: 13.9% vs 13.6%; aged 8 years: 29.5% vs 26.2%). Both the prevalence of myopia and mean SER for these children returned to their prepandemic levels. Conclusions and Relevance Compared with 2020, the prevalence of myopia among children aged 6 to 8 years in the 2021 screenings decreased, and the mean SER returned to prepandemic level. The refractive development in children aged 6 to 8 years may be most susceptible to environmental changes. These findings support the premise that age 6 to 8 years is a critical period for myopia development and suggest a need to focus preventive interventions for myopia control on children in this age range.
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Affiliation(s)
- Jiaxing Wang
- Department of Ophthalmology, Emory University, Atlanta, Georgia
| | - Yujie Han
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of the National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - David C. Musch
- Departments of Ophthalmology and Visual Sciences and Epidemiology, University of Michigan, Ann Arbor, Michigan
| | - Ying Li
- Department of Ophthalmology, Emory University, Atlanta, Georgia
| | - Nan Wei
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xiaoli Qi
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Gang Ding
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xue Li
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Jing Li
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Linlin Song
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Ying Zhang
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yuxian Ning
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xiaoyu Zeng
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yaoling Li
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Ling Sun
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of the National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Ning Hua
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Shuo Li
- Department of Respiratory and Critical Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Sandra Jardines
- Department of Ophthalmology, Emory University, Atlanta, Georgia
| | - Xuehan Qian
- Department of Strabismus and Pediatric Ophthalmology, Tianjin Medical University Eye Hospital, Tianjin, China
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Chen H, Wang W, Liao Y, Zhou W, Li Q, Wang J, Tang J, Pei Y, Wang X. Low-intensity red-light therapy in slowing myopic progression and the rebound effect after its cessation in Chinese children: a randomized controlled trial. Graefes Arch Clin Exp Ophthalmol 2023; 261:575-584. [PMID: 35976467 DOI: 10.1007/s00417-022-05794-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/18/2022] [Accepted: 07/29/2022] [Indexed: 01/17/2023] Open
Abstract
PURPOSE To investigate the effect of low-intensity red-light (LRL) therapy on myopic control and the response after its cessation. METHODS A prospective clinical trial. One hundred two children aged 6 to 13 with myopia were included in the LRL group (n = 51) and the single-focus spectacles (SFS) group (n = 51). In LRL group, subjects wore SFS and received LRL therapy provided by a laser device that emitted red-light of 635 nm and power of 0.35 ± 0.02 mW. One year after the control trial, LRL therapy was stopped for 3 months. The outcomes mainly included axial length (AL), spherical equivalent refraction (SER), subfoveal choroidal thickness (SFCT), and accommodative function. RESULTS After 12 months of therapy, 46 children in the LRL group and 40 children in the SFS group completed the trial. AL elongation and myopic progression were 0.01 mm (95%CI: - 0.05 to 0.07 mm) and 0.05 D (95%CI: - 0 .08 to 0.19 D) in the LRL group, which were less than 0.39 mm (95%CI: 0.33 to 0.45 mm) and - 0.64 D (95%CI: - 0.78 to - 0.51 D) in the SFS group (p < 0.05). The change of SFCT in the LRL group was greater than that in the SFS group (p < 0.05). Accommodative response and positive relative accommodation in the LRL group were more negative than those in the SFS group (p < 0.05). Forty-two subjects completed the observation of LRL cessation, AL and SER increased by 0.16 mm (95%CI: 0.11 to 0.22 mm) and - 0.20 D (95%CI: - 0.26 to - 0.14 D) during the cessation (p < 0.05), and SFCT returned to baseline (p > 0.05). CONCLUSIONS LRL is an effective measure for preventing and controlling myopia, and it may also have the ability to improve the accommodative function. There may be a slight myopic rebound after its cessation. The effect of long-term LRL therapy needs to be further explored. TRIAL REGISTRATION Chinese Clinical Trial Registry: Chinese Clinical Trails registry: ChiCTR2100045250. Registered 9 April 2021; retrospectively registered. http://www.chictr.org.cn/showproj.aspx?proj=124250.
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Affiliation(s)
- Hongyan Chen
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.,Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Wei Wang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Ya Liao
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.,Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Wen Zhou
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.,Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Qin Li
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Jingjing Wang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Jie Tang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yifei Pei
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xiaojuan Wang
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China. .,Xuzhou Medical University, Xuzhou, Jiangsu, China.
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Effects of Morning or Evening Narrow-band Blue Light on the Compensation to Lens-induced Hyperopic Defocus in Chicks. Optom Vis Sci 2023; 100:33-42. [PMID: 36473083 DOI: 10.1097/opx.0000000000001967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
SIGNIFICANCE Exposure to blue light before bedtime is purported to be deleterious to various aspects of human health. In chicks, blue evening light stimulated ocular growth, suggesting a role in myopia development. To further investigate this hypothesis, we asked if brief blue light altered the compensatory responses to hyperopic defocus. PURPOSE Previous work showed that several hours' evening exposure to blue light stimulated ocular growth in chicks, but morning exposure was only effective at a lower illuminance. By contrast, rearing in blue light has inhibited ocular growth in untreated eyes and eyes exposed to form deprivation or defocus. We studied the effects of brief exposures to blue light on the compensation to hyperopic defocus. METHODS Chicks wore monocular negative lenses (-10 D) starting at age 10 days. They were subsequently exposed to blue light (460 nm) for 4 hours in the morning or evening for 8 to 9 days ("dim," 200 lux[morning, n = 9; evening, n = 11]; "bright," 600 lux[morning, n = 8; evening, n = 20]); controls wore lenses in white light (n = 14). Ultrasonography was done on days 1, 5, 8, and 9 for "evening" groups and days 1, 6, and 8 for "morning." All data are reported as interocular differences (experimental minus fellow eyes). Refractions were measured on the last day. RESULTS For evening exposure, dim blue light enhanced the axial compensation at all times (change in axial length: day 6: 465 vs. 329 μm/9 days, analysis of variance P < .001, P = .03; day 9: 603 vs. 416 μm/9 days, analysis of variance P < .001; P < .05). Bright blue light had a transient inhibitory effect (day 5: 160 vs. 329 μm; P < .005). Refractive errors were consistent with axial growth, with dim causing more myopia than bright (-9.4 vs. -4.7 D; P < .05). Morning blue light had no significant effect. CONCLUSIONS We speculate that these findings reflect a complex interaction between illuminance, defocus, and time of day.
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Ramamurthy D, Radhakrishnan H, Pardhan S. Associations between Accommodative Facility, Age, and Refractive Errors in Early, Older Adolescent Myopes and Emmetropes. Br Ir Orthopt J 2023; 19:15-25. [PMID: 37008825 PMCID: PMC10064887 DOI: 10.22599/bioj.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 02/01/2023] [Indexed: 04/03/2023] Open
Abstract
Background: Accommodative functions are known to differ between myopes and emmetropes. It is not known whether accommodative facility differs at near between younger adolescent and older adolescent myopes and emmetropes. Aim: To examine whether accommodative facility differs at near between younger and older adolescent myopes and emmetropes. Methods: 119 participants aged between 11–21 years were recruited. Refractive error was measured using cycloplegic retinoscopy. Near monocular accommodative facility was measured for 60 seconds, using a +2.00D/–2.00D handheld flipper and N6 print at 40 cm. Participants were classified into two age groups: (i) younger adolescents (range: 11–14 years) and (ii) older adolescents (range: 15–21 years). The criterion applied to define myopia was spherical equivalent refraction: ≥–0.50D) and spherical equivalent refraction: –0.25D to +0.75D) for emmetropia. Univariate Analysis of Variance was carried out to analyze the interaction of age groups and refractive groups on near accommodative facility. Results: Near monocular accommodative facility was significantly lower (p = 0.003) in younger adolescents (5.87 ± 3.72 cpm) compared to older adolescents (8.11 ± 4.11 cpm), indicating age as a significant main effect (F1,115 = 13.44; p = 0.0001). Younger adolescent emmetropes (4.77 ± 2.05 cpm, p = 0.005) and younger adolescent myopes (6.48 ± 4.12 cpm, p = 0.022) had significantly lower monocular near accommodative facility compared to older adolescent emmetropes (9.52 ± 3.27 cpm), but did not show any difference when compared to older adolescent myopes (p > 0.05). This indicates a significant association linking age and refractive error to near accommodative facility (F1,115 = 4.60; p = 0.03). Conclusion: Younger adolescent myopes and younger adolescent emmetropes had reduced monocular near accommodative facility than older adolescent emmetropes, but not when compared to older adolescent myopes.
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Affiliation(s)
- Dharani Ramamurthy
- SRM Medical College Hospital & Research Centre, SRM Institute of Science and Technology, IN
| | - Hema Radhakrishnan
- Faculty of Biology, Medicine and Health, The University of Manchester, GB
| | - Shahina Pardhan
- Vision and Eye Research Institute, School of Medicine, Anglia Ruskin University, GB
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Long Y, Li X, Zhou T, Ye B, Guo D, Shen Y. Short-term Evaluation of Visual Quality, Amplitude of Accommodation, and Stereoacuity Between Patients With Moderate-to-High Myopia Who Underwent ICLV4c Implantation and SMILE. J Refract Surg 2022; 38:632-640. [DOI: 10.3928/1081597x-20220919-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Kaphle D, Varnas SR, Schmid KL, Suheimat M, Leube A, Atchison DA. Accommodation lags are higher in myopia than in emmetropia: Measurement methods and metrics matter. Ophthalmic Physiol Opt 2022; 42:1103-1114. [PMID: 35775299 PMCID: PMC9544228 DOI: 10.1111/opo.13021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 12/29/2022]
Abstract
Purpose To determine whether accommodative errors in emmetropes and myopes are systematically different, and the effect of using different instruments and metrics. Methods Seventy‐six adults aged 18–27 years comprising 24 emmetropes (spherical equivalent refraction of the dominant eye +0.04 ± 0.03 D) and 52 myopes (−2.73 ± 0.22 D) were included. Accommodation responses were measured with a Grand Seiko WAM‐5500 and a Hartmann–Shack Complete Ophthalmic Analysis System aberrometer, using pupil plane (Zernike and Seidel refraction) and retinal image plane (neural sharpness—NS; and visual Strehl ratio for modulation transfer function—VSMTF) metrics at 40, 33 and 25 cm. Accommodation stimuli were presented to the corrected dominant eye, and responses, referenced to the corneal plane, were determined in the fellow eye. Linear mixed‐effects models were used to determine influence of the refractive group, the measurement method, accommodation stimulus, age, race, parental myopia, gender and binocular measures of heterophoria, accommodative convergence/accommodation and convergence accommodation/convergence ratios. Results Lags of accommodation were affected significantly by the measurement method (p < 0.001), the refractive group (p = 0.003), near heterophoria (p = 0.002) and accommodative stimulus (p < 0.05), with significant interactions between some of these variables. Overall, emmetropes had smaller lags of accommodation than myopes with respective means ± standard errors of 0.31 ± 0.08 D and 0.61 ± 0.06 D (p = 0.003). Lags were largest for the Grand Seiko and Zernike defocus, intermediate for NS and VSMTF, and least for Seidel defocus. Conclusions The mean lag of accommodation in emmetropes is approximately equal to the previously reported depth of focus. Myopes had larger (double) lags than emmetropes. Differences between methods and instruments could be as great as 0.50 D, and this must be considered when comparing studies and outcomes. Accommodative lag increased with the accommodation stimulus, but only for methods using a fixed small pupil diameter.
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Affiliation(s)
- Dinesh Kaphle
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia.,Discipline of Optometry, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Saulius R Varnas
- Carl Zeiss Vision Australia Holdings Limited, Adelaide, South Australia, Australia
| | - Katrina L Schmid
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Marwan Suheimat
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - David A Atchison
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
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40
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Kaphle D, Schmid KL, Davies LN, Suheimat M, Atchison DA. Ciliary Muscle Dimension Changes With Accommodation Vary in Myopia and Emmetropia. Invest Ophthalmol Vis Sci 2022; 63:24. [PMID: 35749128 PMCID: PMC9234357 DOI: 10.1167/iovs.63.6.24] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Purpose The purpose of this study was to determine whether accommodation-induced changes in ciliary muscle dimensions vary between emmetropes and myopes, and the effect of the image analysis method. Methods Seventy adults aged 18 to 27 years consisted of 25 people with emmetropia (spherical equivalent refraction [SER] +0.21 ± 0.36 diopters [D]) and 45 people with myopia (−2.84 ± 1.72 D). There were 23 people with low myopia (>−3 D) and 22 people with moderate myopia (−3 to −6 D). Right eye ciliary muscles were imaged (Visante OCT; Carl Zeiss Meditec) at 0 D and 6 D demands. Measures included ciliary muscle length (CML), ciliary muscle curved length (CMLarc), maximum ciliary muscle thickness (CMTmax), CMT1, CMT2, and CMT3 (fixed distances 1–3 mm from the scleral spur), CM25, CM50, and CM75 (proportional distances 25%–75%). Linear mixed model analysis determined effects of refractive groups, race, and demand on dimensions. Significance was set at P < 0.05. Results Myopic eyes had greater CML and CMLarc nasally than emmetropic eyes. Myopic eyes had thicker muscles than emmetropic eyes at nasal positions, except CM25 and CMT3, and at CM75 temporally. During accommodation and only nasally, CML reduced in emmetropic and myopic eyes, and CMLarc reduced in myopic eyes only. During accommodation, both nasally and temporally, muscles thickened anteriorly (CMT1 and CM25) and thinned posteriorly (CMT3 and CM75) except for temporal CM75. Moderate myopic eyes had greater temporal CMLarc than low myopic eyes, and the moderate myopes had thicker muscles both nasally and temporally using fixed and proportional distances. Conclusions People with myopia had longer and thicker ciliary muscles than people with emmetropia. During accommodation, the anterior muscle thickened and the curved nasal muscle length shortened, more in myopic than in emmetropic eyes. The fixed distance method is recommended for repeat measures in the same individual. The proportional distance method is recommended for comparisons between refractive groups.
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Affiliation(s)
- Dinesh Kaphle
- Centre for Vision and Eye Research, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Discipline of Optometry, Faculty of Health, University of Canberra, Bruce ACT 2617, Australia
| | - Katrina L Schmid
- Centre for Vision and Eye Research, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Leon N Davies
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, United Kingdom
| | - Marwan Suheimat
- Centre for Vision and Eye Research, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - David A Atchison
- Centre for Vision and Eye Research, Queensland University of Technology, Kelvin Grove, Queensland, Australia
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Chen X, Xiong Y, Liu F, Wang J, Yang B, Liu L. Factors determining the myopia control effect of an orthokeratology lens: A two‐year multi‐level model. Ophthalmic Physiol Opt 2022; 42:786-796. [PMID: 35499112 DOI: 10.1111/opo.12990] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 03/28/2022] [Indexed: 02/05/2023]
Affiliation(s)
- Xiaohang Chen
- Department of Optometry and Visual Science, West China School of Medicine Sichuan University Chengdu China
- Laboratory of Optometry and Vision Sciences, West China Hospital Sichuan University Chengdu China
- Department of Ophthalmology, West China Hospital Sichuan University Chengdu China
| | - Yan Xiong
- Department of Pediatrics Affiliated Hospital of North Sichuan Medical University Nanchong China
| | - Fengyang Liu
- Department of Optometry Guizhou Provincial People's Hospital Guiyang China
| | - Jianglan Wang
- Department of Optometry and Visual Science, West China School of Medicine Sichuan University Chengdu China
- Laboratory of Optometry and Vision Sciences, West China Hospital Sichuan University Chengdu China
- Department of Ophthalmology, West China Hospital Sichuan University Chengdu China
| | - Bi Yang
- Department of Optometry and Visual Science, West China School of Medicine Sichuan University Chengdu China
- Laboratory of Optometry and Vision Sciences, West China Hospital Sichuan University Chengdu China
- Department of Ophthalmology, West China Hospital Sichuan University Chengdu China
| | - Longqian Liu
- Department of Optometry and Visual Science, West China School of Medicine Sichuan University Chengdu China
- Laboratory of Optometry and Vision Sciences, West China Hospital Sichuan University Chengdu China
- Department of Ophthalmology, West China Hospital Sichuan University Chengdu China
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42
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Zhang H, Lam CSY, Tang WC, Leung M, Qi H, Lee PH, To CH. Myopia Control Effect Is Influenced by Baseline Relative Peripheral Refraction in Children Wearing Defocus Incorporated Multiple Segments (DIMS) Spectacle Lenses. J Clin Med 2022; 11:jcm11092294. [PMID: 35566423 PMCID: PMC9099701 DOI: 10.3390/jcm11092294] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/12/2022] [Accepted: 04/16/2022] [Indexed: 02/01/2023] Open
Abstract
The aim of this study is to investigate if baseline relative peripheral refraction (RPR) influences the myopia control effects in Chinese myopic children wearing Defocus Incorporated Multiple Segments (DIMS) lenses. Peripheral refraction at 10°, 20°, and 30° nasal (10 N, 20 N, 30 N) and temporal (10 T, 20 T, 30 T) retina were measured at six-month intervals for children who participated in a 2-year randomized controlled trial. The relationship between the baseline peripheral refractions and myopia progression and axial length changes were analysed. A total of 79 children and 81 children in the DIMS and single vision (SV) group were investigated, respectively. In the DIMS group, more baseline myopic RPR spherical equivalent (SE) was associated with more myopic progression (10 N: r = 0.36, p = 0.001; 20 N: r = 0.35, p = 0.001) and greater axial elongation (10 N: r = −0.34, p = 0.001; 20 N: r = −0.29, p = 0.006) after adjusting for co-factors. In the SV group, baseline RPR had association with only myopia progression (10 N: r = 0.37, p = 0.001; 20 N: r = 0.36, p = 0.001; 30 N: r = 0.35, p = 0.002) but not with axial elongation after Bonferroni correction (p > 0.008). No statistically significant relationship was found between temporal retina and myopia progression or axial elongation in both groups. Children with baseline myopic RPR had statistically significant more myopia progression (mean difference around −0.40 D) and more axial elongation (mean difference 0.15 mm) when compared with the children having baseline hyperopic RPR in the DIMS group but not in the SV group. In conclusion, the baseline RPR profile may not influence future myopia progression or axial elongation for the SV lens wearers. However, DIMS lenses slowed down myopia progression and was better in myopia control for the children with baseline hyperopic RPR than the children with myopic RPR. This may partially explain why myopia control effects vary among myopic children. Customised myopic defocus for individuals may optimise myopia control effects, and further research to determine the optimal dosage, with consideration of peripheral retinal profile, is warranted.
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Affiliation(s)
- Hanyu Zhang
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China; (H.Z.); (W.-C.T.); (C.-H.T.)
- Centre for Eye and Vision Research (CEVR), Hong Kong SAR, China
| | - Carly S. Y. Lam
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China; (H.Z.); (W.-C.T.); (C.-H.T.)
- Centre for Eye and Vision Research (CEVR), Hong Kong SAR, China
- Correspondence:
| | - Wing-Chun Tang
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China; (H.Z.); (W.-C.T.); (C.-H.T.)
| | - Myra Leung
- Discipline of Optometry and Vision Science, Faculty of Health, University of Canberra, Canberra 2617, Australia;
| | - Hua Qi
- Hoya Corporation, Tokyo 1608347, Japan;
| | - Paul H. Lee
- Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK;
| | - Chi-Ho To
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China; (H.Z.); (W.-C.T.); (C.-H.T.)
- Centre for Eye and Vision Research (CEVR), Hong Kong SAR, China
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Huang Y, Li M, Shen Y, Liu F, Fang Y, Xu H, Zhou X. Study of the Immediate Effects of Autostereoscopic 3D Visual Training on the Accommodative Functions of Myopes. Invest Ophthalmol Vis Sci 2022; 63:9. [PMID: 35113140 PMCID: PMC8819359 DOI: 10.1167/iovs.63.2.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose Stereoscopic viewing has an impact on ocular dynamics, but its effects on accommodative functions are not fully understood, especially for autostereoscopic viewing. This study aimed to investigate the changes in dynamic accommodative response, accommodative amplitude, and accommodative facility of myopes after autostereoscopic visual training. Methods We enrolled 46 adults (men = 22 and women = 24; age = 21.5 ± 2.5 [range = 18–25] years, spherical equivalent: −4.52 ± 1.89 [−8.88 to −1.75] diopters [D]) who visited the Eye & ENT Hospital of Fudan University. The study population was randomly divided into three-dimensional (3D) and two-dimensional (2D) viewing groups to watch an 11-minute training video displayed in 3D or 2D mode. Dynamic accommodative response, accommodative facility, and accommodative amplitude were measured before, during, and immediately after the training. Accommodative lag and the variability of accommodation were also analyzed. Visual fatigue was evaluated subjectively using a questionnaire. Results Accommodative lag decreased from 0.54 ± 0.29 D to 0.42 ± 0.32 D (P = 0.004), whereas accommodative facility increased from 10.83 ± 4.55 cycles per minute (cpm) to 13.15 ± 5.25 cpm (P < 0.001) in the 3D group. In the 2D group, there was no significant change in the accommodative lag (P = 0.163) or facility (P = 0.975), but a decrease in accommodative amplitude was observed (from 13.88 ± 3.17 D to 12.71 ± 2.23 D, P = 0.013). In the 3D group, the accommodative response changed with the simulated target distance. Visual fatigue was relatively mild in both groups. Conclusions The immediate impact of autostereoscopic training included a decrease in the accommodative lag and an increase in the accommodative facility. However, the long-term effects of autostereoscopic training require further exploration.
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Affiliation(s)
- Yangyi Huang
- 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, China
| | - Meiyan Li
- 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, China
| | - Yang Shen
- 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, China
| | - Fang Liu
- 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, China
| | - Yong Fang
- Shanghai EVIS Technology Co. Ltd., Shanghai, China
| | - Haipeng Xu
- 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, 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, China
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Queirós A, Cerviño A, González-Méijome JM. Peripheral refraction of myopic eyes with spectacle lenses correction and lens free emmetropes during accommodation. EYE AND VISION (LONDON, ENGLAND) 2021; 8:45. [PMID: 34847960 PMCID: PMC8638353 DOI: 10.1186/s40662-021-00267-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 10/25/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE To measure axial and off-axis refraction patterns in myopic eyes with spectacle lenses correction and lens free emmetropes in young healthy subjects at different target distances from 2.00 m (0.50 D) to 0.20 m (5.00 D) in terms of sphere, astigmatism, and spherical equivalent refraction. METHODS Refraction was measured at the center, 20 and 40 degrees from the line of sight both nasally and temporally in 15 emmetropic and 25 myopic young healthy subjects with an open field, binocular, infrared autorefractor (Grand Seiko WAM-5500, Hiroshima, Japan). Fixation target was a Maltese cross set at 2.00, 0.50, 0.33 and 0.20 m from the corneal plane. Changes in off-axis refraction with accommodation level were normalized with respect to distance axial values and compared between myopic eyes with spectacle lenses correction and lens free emmetropes. RESULTS Off-axis refraction in myopic eyes with spectacle lenses correction was significantly more myopic in the temporal retina compared to lens free emmetropes except for the closest target distance. Relative off-axis refractive error changed significantly with accommodation when compared to axial refraction particularly in the myopic group. This change in the negative direction was due to changes in the spherical component of refraction that became more myopic relative to the center at the 0.20 m distance as the J0 component of astigmatism was significantly reduced in both emmetropes and myopes for the closest target. CONCLUSION Accommodation to very near targets (up to 0.20 m) makes the off-axis refraction of myopes wearing their spectacle correction similar to that of lens free emmetropes. A significant reduction in off-axis astigmatism was also observed for the 0.20 m distance.
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Affiliation(s)
- António Queirós
- Clinical & Experimental Optometry Research Lab (CEORLab), Center of Physics (Optometry), University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal.
| | - Alejandro Cerviño
- Optometry Research Group, Department of Optics and Optometry and Vision Sciences, University of Valencia, Valencia, Spain
| | - José Manuel González-Méijome
- Clinical & Experimental Optometry Research Lab (CEORLab), Center of Physics (Optometry), University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
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Reduction in Accommodative Response of Schoolchildren by a Double-Mirror System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18199951. [PMID: 34639251 PMCID: PMC8508213 DOI: 10.3390/ijerph18199951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/13/2021] [Accepted: 09/21/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE This study first proposed the application of a double-mirror system (DMS) to extend viewing distance and investigate the accommodative response of schoolchildren under a DMS. METHOD Fifty-seven subjects aged between 7 and 12 years old were recruited in this study, and the experiment was divided into two stages. The first stage consisted of a case history inquiry, a refraction state, and a visual function examination. In the second stage, the subjects gazed at an object at distances of 0.4 m, 2.285 m, and through a DMS, respectively, and their accommodative responses were measured using an open-field autorefractor. RESULTS There was no significant difference in the schoolchildren's accommodative response between subjects gazing at an object at 2.285 m (0.14 ± 0.35 D, p > 0.05) and those gazing at it through a DMS (0.20 ± 0.35 D). However, their accommodative response showed a significant difference between subjects gazing at an object at 0.4 m and 2.285 m and those gazing at it at 0.4 m and through a DMS. CONCLUSION In this experiment, the results of the children's accommodative response measured at 2.285 m or through a DMS are very similar. The viewing distance can be extended by a DMS, resulting in accommodative relaxation. This result may have potential applications in myopia control.
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Wolffsohn JS, Jong M, Smith EL, Resnikoff SR, Jonas JB, Logan NS, Morgan I, Sankaridurg P, Ohno-Matsui K. IMI 2021 Reports and Digest - Reflections on the Implications for Clinical Practice. Invest Ophthalmol Vis Sci 2021; 62:1. [PMID: 33909037 PMCID: PMC8083124 DOI: 10.1167/iovs.62.5.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The International Myopia Institute's (IMI) mission is to advance research, education, and management of myopia to decrease future vision impairment and blindness associated with increasing myopia. Its approach is to bring together scientists, clinicians, policymakers, government members, and educators into the field of myopia to stimulate collaboration and sharing of knowledge. The latest reports are on pathologic myopia, the impact of myopia, risk factors for myopia, accommodation and binocular vision in myopia development and progression, and the prevention of myopia and its progression. Together with the digest updating the 2019 International Myopia Institute white papers using the research published in the last 18 months, these evidence-based consensus white papers help to clarify the imperative for myopia control and the role of environmental modification initiatives, informing an evidence-based clinical approach. This guidance includes who to treat and when to start or stop treatment, and the advantages and limitations of different management approaches.
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Affiliation(s)
| | - Monica Jong
- Brien Holden Vision Institute, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.,Discipline of Optometry and Vision Science, University of Canberra, Canberra, Australia
| | - Earl L Smith
- Brien Holden Vision Institute, Sydney, Australia.,College of Optometry, University of Houston, Houston, Texas, United States
| | - Serge R Resnikoff
- Brien Holden Vision Institute, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Nicola S Logan
- School of Optometry, Aston University, Birmingham, United Kingdom
| | - Ian Morgan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yatsen University, Guangzhou, China.,Research School of Biology, College of Medicine, Biology and Environment, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
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