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Chamarty S, Kamalon S, Madishetti N, Verkicharla PK. Link between parental myopia and early-onset high myopia: Insights from a clinical retrospective analysis. Ophthalmic Physiol Opt 2024; 44:1270-1278. [PMID: 38803137 DOI: 10.1111/opo.13341] [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: 12/11/2023] [Revised: 05/06/2024] [Accepted: 05/11/2024] [Indexed: 05/29/2024]
Abstract
INTRODUCTION Genetic aetiology is suspected in the development of early-onset high myopia (spherical equivalent refractive error [SER] ≤-6.00 D at ≤6 years of age), considering that the role of environmental factors in inducing high myopia is improbable at an early age. Therefore, we aimed to understand if early-onset high myopia is associated with parental myopia in a clinical setting. METHODS A retrospective study was conducted in which information about demographics, age of apparent onset of myopia, refractive error, axial length, number of myopic parents, time spent outdoors and time spent on near-work was obtained from electronic medical records (EMR). It included 195 myopic individuals categorised into (1) Early-onset high myopes (EOHM): SER ≤ -6.00 D with age of presentation ≤6 years, (2) Early-onset low myopes (EOLM): SER > -6.00 D with age of apparent onset ≤6 years, (3) Late-onset high myopes (LOHM): SER ≤ -6.00 D with age of presentation and age of apparent onset >6 years and (4) Late-onset low myopes (LOLM): SER > -6.00 D with age of apparent onset >6 years. RESULTS Overall, 63% of individuals were found to have parental myopia. The proportion of individuals with EOHM, EOLM, LOHM and LOLM with parental myopia was 57%, 74%, 53% and 64%, respectively. After adjustment for age, gender and environmental factors, the odds of development of EOHM (Odds ratio: 0.78, 95% confidence interval: 0.25-2.48), EOLM (1.54, 0.65-3.67) or LOHM (0.70, 0.30-1.65) were similar in the presence of myopic parents, when compared with LOLM. The SER and axial length did not differ based on the number of myopic parents in any of these categories. CONCLUSION This retrospective analysis reveals that the presence of parental myopia, which was self-reported, did not induce additional risk for early-onset high myopia.
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Affiliation(s)
- Sruthi Chamarty
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Sreena Kamalon
- Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
| | - Naveen Madishetti
- Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
| | - Pavan K Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
- Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, India
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Chow AHY, Mungalsingh MA, Thai D, Selimos Z, Yan SK, Xu H, Jones DA. Suitability of multifunction devices Myah and Myopia Master for monitoring myopia progression in children and adults. Ophthalmic Physiol Opt 2024; 44:1017-1030. [PMID: 38760986 DOI: 10.1111/opo.13332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/22/2024] [Accepted: 04/28/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE To assess the feasibility of using multifunction instruments to measure axial length for monitoring myopia progression in children and adults. METHODS Axial length was measured in 60 children (aged 6-18 years) and 60 adults (aged 19-50 years) with multifunction instruments (Myah and Myopia Master) and stand-alone biometers (Lenstar LS900 and IOLMaster 700). Repeatability (measurements by the same examiner) and reproducibility (measurements by different examiners) were computed as the within-subject standard deviation (Sw) and 95% limits of agreement (LoA). Inter-instrument agreement was computed as intraclass correlation coefficients. The threshold for detecting myopic progression was taken as 0.1 mm. Measures were repeated only in children following the administration of 1% tropicamide to determine the impact of cycloplegia on axial length. RESULTS Overall, the IOLMaster 700 had the best repeatability in children (0.014 mm) and adults (0.009 mm). Repeatability Sw values for all devices ranged from 0.005 to 0.021 mm (children) and 0.003 to 0.016 mm (adults). In children, reproducibility fell within 0.1 mm 95% of the time for the Myah, Myopia Master and IOLMaster 700. Agreement among all devices was classified as excellent (ICC 0.999; 95% CI 0.998-0.999), but the 95% LoA among the Myah, Myopia Master and Lenstar LS900 was ≥0.1 mm. Cycloplegia had no statistically significant effect on axial length (all p > 0.13). CONCLUSIONS The Myah and Myopia Master multifunction instruments demonstrated good repeatability and reproducibility, and their accuracy was comparable to stand-alone biometers. Axial length measurements using different instruments can be considered interchangeable but should be compared with some caution. Accurate axial length measurements can be obtained without cycloplegia. The multifunction instruments Myah and Myopia Master are as well suited for monitoring myopia progression in children as the stand-alone biometers IOLMaster 700 and Lenstar LS900.
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Affiliation(s)
- Amy H Y Chow
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
- Centre for Eye and Vision Research, Hong Kong, SAR China
| | - Melanie A Mungalsingh
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Danny Thai
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Zoe Selimos
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Sarah Kathryn Yan
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Hellen Xu
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Deborah A Jones
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
- Centre for Eye and Vision Research, Hong Kong, SAR China
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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 2024; 34:952-966. [PMID: 38087768 PMCID: PMC11295429 DOI: 10.1177/11206721231219532] [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: 08/29/2023] [Accepted: 11/23/2023] [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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Farassat N. Topical Atropine for Myopia Control: A Review. Klin Monbl Augenheilkd 2024. [PMID: 38802078 DOI: 10.1055/a-2307-0363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Over the past decade, atropine has emerged as an effective intervention for preventing myopia in children. Multiple randomized controlled trials, mainly from Asia, have demonstrated the safety and efficacy of topical atropine for myopia control. Both efficacy and side effects exhibit a positive dose-response relationship. This review focuses on new data from studies with predominantly white populations, ethnicity-dependent differences in efficacy and side effects, and primary prevention of incident myopia with atropine.
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Affiliation(s)
- Navid Farassat
- Medical Center, Eye Center, University Freiburg, Germany
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5
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Wang YH, Xin C, Li XX, Yang K, Liu SM, Qiao LY. Posterior scleral reinforcement surgery effectively slows the rate of high myopic progression in children. J Fr Ophtalmol 2024; 47:104213. [PMID: 38788251 DOI: 10.1016/j.jfo.2024.104213] [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: 05/10/2023] [Revised: 01/25/2024] [Accepted: 02/17/2024] [Indexed: 05/26/2024]
Abstract
PURPOSE To investigate the rate of axial length elongation and high myopia progression in operated eyes before and after posterior scleral reinforcement (PSR) surgery. METHODS This was a retrospective study. Children with pathological myopia treated with PSR at Beijing Tongren Hospital between May 2013 and May 2020 were recruited into the PSR surgery group. Children matched for age and myopia were recruited into the control group. All children underwent comprehensive ophthalmologic examinations. The presurgical and postsurgical rates of axial length elongation and myopic (spherical equivalent) progression were calculated. RESULTS A total of 35 PSR patients were included in the study. The mean age was 6.5±3.0 years (range 2 to 14 years). Mean follow-up was 544 days (range 216 to 1657 days). The rate of axial length elongation was significantly less after posterior scleral reinforcement surgery (0.505±0.048mm per year prior to surgery; 0.382±0.045mm per year after surgery, P<0.001). The rate of myopic progression decreased after posterior scleral reinforcement surgery (1.162±0.118 D per year prior to surgery; 0.153±0.437 D per year after surgery, P=0.0239). There was no statistically significant difference in axial length elongation or myopic progression between pre-inclusion and post-inclusion in the control group. Moreover, the children's best-corrected visual acuity was significantly improved after posterior scleral reinforcement surgery (P<0.001). CONCLUSION Posterior scleral reinforcement surgery effectively decreased the rate of high myopic progression and axial length elongation in children.
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Affiliation(s)
- Yu-Han Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, 100730 Beijing, China
| | - Chen Xin
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, 100730 Beijing, China
| | - Xiao-Xia Li
- Department of Ophthalmology, Beijing Shijitan Hospital, Capital Medical University, 100038 Beijing, China
| | - Ke Yang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, 100730 Beijing, China
| | - Su-Meng Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, 100730 Beijing, China
| | - Li-Ya Qiao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, 100730 Beijing, China.
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Müller J, Chen X, Ohlendorf A, Li L, Wahl S. Method comparison and overview of refractive measurements in children: implications for myopia management. BMJ Open Ophthalmol 2024; 9:e001322. [PMID: 38429067 PMCID: PMC10910427 DOI: 10.1136/bmjophth-2023-001322] [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: 04/18/2023] [Accepted: 01/28/2024] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVE This study investigated the agreement between objective wavefront-based refraction and subjective refraction in myopic children. It also assessed the impact of cyclopentolate and refraction levels on the agreement. METHODS A total of 84 eyes of myopic children aged 6-13 years were included in the analysis. Non-cycloplegic and cycloplegic objective wavefront-based refraction were determined and cycloplegic subjective refraction was performed for each participant. The data were converted into spherical equivalent, J0 and J45, and Bland-Altman plots were used to analyse the agreement between methods. RESULTS Linear functions were used to determine the dependency between the central myopic refractive error and the difference between the method of refraction (=bias). The influence of central myopia was not clinically relevant when analysing the agreement between wavefront results with and without cyclopentolate (comparison 1). The bias for wavefront-based minus subjective spherical equivalent refraction (comparison 2) was ≤-0.50 D (95% limits of agreement -0.010 D to -1.00 D) for myopia of -4.55 D and higher when cycloplegia was used (p<0.05). When no cyclopentolate was used for the wavefront-based refraction (comparison 3), the bias of -0.50 D (95% limits of agreement -0.020 D to -0.97 D) was already reached at a myopic error of -2.97 D. Both astigmatic components showed no clinically relevant bias. CONCLUSION The spherical equivalent, measured without cycloplegic agents, led to more myopic measurements when wavefront-based refraction was used. The observed bias increased with the amount of myopic refractive error for comparisons 2 and 3, which needs to be considered when interpreting wavefront-refraction data. TRIAL REGISTRATION NUMBER NCT05288335.
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Affiliation(s)
- Jonas Müller
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Xiaoqin Chen
- Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, China
| | - Arne Ohlendorf
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Germany
- Carl Zeiss Vision International GmbH, Aalen, Germany
| | - Lihua Li
- Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, China
| | - Siegfried Wahl
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Germany
- Carl Zeiss Vision International GmbH, Aalen, Germany
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Chen C, An G, Yu X, Wang S, Lin P, Yuan J, Zhuang Y, Lu X, Bai Y, Zhang G, Su J, Qu J, Xu L, Wang H. Screening Mutations of the Monogenic Syndromic High Myopia by Whole Exome Sequencing From MAGIC Project. Invest Ophthalmol Vis Sci 2024; 65:9. [PMID: 38315492 PMCID: PMC10851780 DOI: 10.1167/iovs.65.2.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/17/2024] [Indexed: 02/07/2024] Open
Abstract
Purpose This observational study aimed to identify mutations in monogenic syndromic high myopia (msHM) using data from reported samples (n = 9370) of the Myopia Associated Genetics and Intervention Consortium (MAGIC) project. Methods The targeted panel containing 298 msHM-related genes was constructed and screening of clinically actionable variants was performed based on whole exome sequencing. Capillary sequencing was used to verify the identified gene mutations in the probands and perform segregation analysis with their relatives. Results A total of 381 candidate variants in 84 genes and 85 eye diseases were found to contribute to msHM in 3.6% (335/9370) of patients with HM. Among them, the 22 genes with the most variations accounted for 62.7% of the diagnostic cases. In the genotype-phenotype association analysis, 60% (201/335) of suspected msHM cases were recalled and 25 patients (12.4%) received a definitive genetic diagnosis. Pathogenic variants were distributed in 18 msHM-related diseases, mainly involving retinal dystrophy genes (e.g. TRPM1, CACNA1F, and FZD4), connective tissue disease genes (e.g. FBN1 and COL2A1), corneal or lens development genes (HSF4, GJA8, and MIP), and other genes (TEK). The msHM gene mutation types were allocated to four categories: nonsense mutations (36%), missense mutations (36%), frameshift mutations (20%), and splice site mutations (8%). Conclusions This study highlights the importance of thorough molecular subtyping of msHM to provide appropriate genetic counselling and multispecialty care for children and adolescents with HM.
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Affiliation(s)
- Chong Chen
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Center of Optometry International Innovation of Wenzhou, Eye Valley, Wenzhou, China
| | - Gang An
- Institute of PSI Genomics Co., Ltd., Wenzhou, China
| | - Xiaoguang Yu
- Institute of PSI Genomics Co., Ltd., Wenzhou, China
| | - Siyu Wang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Peng Lin
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jian Yuan
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Youyuan Zhuang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xiaoyan Lu
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yu Bai
- Center of Optometry International Innovation of Wenzhou, Eye Valley, Wenzhou, China
| | - Guosi Zhang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jianzhong Su
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jia Qu
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Center of Optometry International Innovation of Wenzhou, Eye Valley, Wenzhou, China
| | - Liangde Xu
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Center of Optometry International Innovation of Wenzhou, Eye Valley, Wenzhou, China
| | - Hong Wang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Center of Optometry International Innovation of Wenzhou, Eye Valley, Wenzhou, China
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Logan NS, Bullimore MA. Optical interventions for myopia control. Eye (Lond) 2024; 38:455-463. [PMID: 37740053 PMCID: PMC10858277 DOI: 10.1038/s41433-023-02723-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 07/26/2023] [Accepted: 08/25/2023] [Indexed: 09/24/2023] Open
Abstract
A range of optical interventions have been developed to slow the progression of myopia. This review summarizes key studies and their outcomes. Peer-reviewed, randomized controlled clinical trials of at least 18 months duration were identified. Randomized clinical trials were identified and summarised: 13 for spectacles, 5 for overnight orthokeratology, 5 for soft contact lenses, and 3 for orthokeratology combined with low concentration atropine. Overnight orthokeratology trials were the most consistent with 2-year slowing of axial elongation between 0.24 and 0.32 mm. Other modalities were more variable due to the wide range of optical designs. Among spectacle interventions, progressive addition lenses were the least effective, slowing axial elongation and myopia progression by no more than 0.11 mm and 0.31 D, respectively. In contrast, novel designs with peripheral lenslets slow 2-year elongation and progression by up to 0.35 mm and 0.80 D. Among soft contact lens interventions, medium add concentric bifocals slow 3-year elongation and progression by only 0.07 mm and 0.16 D, while a dual-focus design slows 3-year elongation and progression by 0.28 mm and 0.67 D. In summary, all three optical interventions have the potential to significantly slow myopia progression. Quality of vision is largely unaffected, and safety is satisfactory. Areas of uncertainty include the potential for post-treatment acceleration of progression and the benefit of adding atropine to optical interventions.
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Bullimore MA, Brennan NA. Juvenile-onset myopia-who to treat and how to evaluate success. Eye (Lond) 2024; 38:450-454. [PMID: 37709925 PMCID: PMC10858167 DOI: 10.1038/s41433-023-02722-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 07/26/2023] [Accepted: 08/25/2023] [Indexed: 09/16/2023] Open
Abstract
The risk of eye diseases such as myopic macular degeneration increases with the level of myopia, but there is no safe level of myopia and the burden of lower degrees of myopia remains considerable. Effective treatments are available that slow progression and thus limit the final degree of myopia. In this review, the rationale for slowing progression is summarized, and a case made for treating all myopic children. Measurement of refractive error and axial length is reviewed, stressing the precision of optical biometry, but also the need for cycloplegic autorefraction. The factors influencing progression are considered and the available tools for interpretation of progression rate are discussed. Finally, the need to set attainable treatment goals is emphasized.
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