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Qian B, Sheng B, Chen H, Wang X, Li T, Jin Y, Guan Z, Jiang Z, Wu Y, Wang J, Chen T, Guo Z, Chen X, Yang D, Hou J, Feng R, Xiao F, Li Y, El Habib Daho M, Lu L, Ding Y, Liu D, Yang B, Zhu W, Wang Y, Kim H, Nam H, Li H, Wu WC, Wu Q, Dai R, Li H, Ang M, Ting DSW, Cheung CY, Wang X, Cheng CY, Tan GSW, Ohno-Matsui K, Jonas JB, Zheng Y, Tham YC, Wong TY, Wang YX. A Competition for the Diagnosis of Myopic Maculopathy by Artificial Intelligence Algorithms. JAMA Ophthalmol 2024:2824092. [PMID: 39325442 PMCID: PMC11428027 DOI: 10.1001/jamaophthalmol.2024.3707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 07/11/2024] [Indexed: 09/27/2024]
Abstract
Importance Myopic maculopathy (MM) is a major cause of vision impairment globally. Artificial intelligence (AI) and deep learning (DL) algorithms for detecting MM from fundus images could potentially improve diagnosis and assist screening in a variety of health care settings. Objectives To evaluate DL algorithms for MM classification and segmentation and compare their performance with that of ophthalmologists. Design, Setting, and Participants The Myopic Maculopathy Analysis Challenge (MMAC) was an international competition to develop automated solutions for 3 tasks: (1) MM classification, (2) segmentation of MM plus lesions, and (3) spherical equivalent (SE) prediction. Participants were provided 3 subdatasets containing 2306, 294, and 2003 fundus images, respectively, with which to build algorithms. A group of 5 ophthalmologists evaluated the same test sets for tasks 1 and 2 to ascertain performance. Results from model ensembles, which combined outcomes from multiple algorithms submitted by MMAC participants, were compared with each individual submitted algorithm. This study was conducted from March 1, 2023, to March 30, 2024, and data were analyzed from January 15, 2024, to March 30, 2024. Exposure DL algorithms submitted as part of the MMAC competition or ophthalmologist interpretation. Main Outcomes and Measures MM classification was evaluated by quadratic-weighted κ (QWK), F1 score, sensitivity, and specificity. MM plus lesions segmentation was evaluated by dice similarity coefficient (DSC), and SE prediction was evaluated by R2 and mean absolute error (MAE). Results The 3 tasks were completed by 7, 4, and 4 teams, respectively. MM classification algorithms achieved a QWK range of 0.866 to 0.901, an F1 score range of 0.675 to 0.781, a sensitivity range of 0.667 to 0.778, and a specificity range of 0.931 to 0.945. MM plus lesions segmentation algorithms achieved a DSC range of 0.664 to 0.687 for lacquer cracks (LC), 0.579 to 0.673 for choroidal neovascularization, and 0.768 to 0.841 for Fuchs spot (FS). SE prediction algorithms achieved an R2 range of 0.791 to 0.874 and an MAE range of 0.708 to 0.943. Model ensemble results achieved the best performance compared to each submitted algorithms, and the model ensemble outperformed ophthalmologists at MM classification in sensitivity (0.801; 95% CI, 0.764-0.840 vs 0.727; 95% CI, 0.684-0.768; P = .006) and specificity (0.946; 95% CI, 0.939-0.954 vs 0.933; 95% CI, 0.925-0.941; P = .009), LC segmentation (DSC, 0.698; 95% CI, 0.649-0.745 vs DSC, 0.570; 95% CI, 0.515-0.625; P < .001), and FS segmentation (DSC, 0.863; 95% CI, 0.831-0.888 vs DSC, 0.790; 95% CI, 0.742-0.830; P < .001). Conclusions and Relevance In this diagnostic study, 15 AI models for MM classification and segmentation on a public dataset made available for the MMAC competition were validated and evaluated, with some models achieving better diagnostic performance than ophthalmologists.
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Affiliation(s)
- Bo Qian
- Shanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China
- Ministry of Education Key Laboratory of Artificial Intelligence, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Bin Sheng
- Shanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China
- Ministry of Education Key Laboratory of Artificial Intelligence, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Hao Chen
- Department of Computer Science and Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
- Department of Chemical and Biological Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Xiangning Wang
- Department of Ophthalmology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tingyao Li
- Shanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China
- Ministry of Education Key Laboratory of Artificial Intelligence, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yixiao Jin
- School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, China
- School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Zhouyu Guan
- Shanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China
| | - Zehua Jiang
- School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, China
- School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Yilan Wu
- School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, China
| | - Jinyuan Wang
- School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, China
- School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Tingli Chen
- Department of Ophthalmology, Shanghai Health and Medical Center, Wuxi, China
| | - Zhengrui Guo
- Department of Computer Science and Engineering, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Xiang Chen
- Shanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China
- Ministry of Education Key Laboratory of Artificial Intelligence, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Dawei Yang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Junlin Hou
- Shanghai Key Laboratory of Intelligent Information Processing, School of Computer Science, Fudan University, Shanghai, China
| | - Rui Feng
- Shanghai Key Laboratory of Intelligent Information Processing, School of Computer Science, Fudan University, Shanghai, China
- Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - Fan Xiao
- Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - Yihao Li
- Laboratoire de Traitement de l'Information Médicale UMR 1101, Inserm, Brest, France
- Université de Bretagne Occidentale, Brest, France
| | - Mostafa El Habib Daho
- Laboratoire de Traitement de l'Information Médicale UMR 1101, Inserm, Brest, France
- Université de Bretagne Occidentale, Brest, France
| | - Li Lu
- School of Computer Science and Technology, Dongguan University of Technology, Dongguan, China
| | - Ye Ding
- School of Computer Science and Technology, Dongguan University of Technology, Dongguan, China
| | - Di Liu
- AIFUTURE Laboratory, Beijing, China
- National Digital Health Center of China Top Think Tanks, Beijing Normal University, Beijing, China
- School of Journalism and Communication, Beijing Normal University, Beijing, China
| | - Bo Yang
- AIFUTURE Laboratory, Beijing, China
| | - Wenhui Zhu
- School of Computing and Augmented Intelligence, Arizona State University, Tempe
| | - Yalin Wang
- School of Computing and Augmented Intelligence, Arizona State University, Tempe
| | - Hyeonmin Kim
- Mediwhale, Seoul, South Korea
- Pohang University of Science and Technology, Pohang, South Korea
| | | | - Huayu Li
- Department of Electrical and Computer Engineering, University of Arizona, Tucson
| | - Wei-Chi Wu
- Department of Ophthalmology, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Qiang Wu
- Department of Ophthalmology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rongping Dai
- Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Huating Li
- Shanghai Belt and Road International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases, Department of Computer Science and Engineering, School of Electronic, Information, and Electrical Engineering, Shanghai Jiao Tong University, Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | | | - Carol Y. Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Xiaofei Wang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Gavin Siew Wei Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Jost B. Jonas
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Institut Français de Myopie, Rothschild Foundation Hospital, Paris, France
| | | | - Yih-Chung Tham
- Center for Innovation and Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Ophthalmology and Visual Science Academic Clinical Program, Duke–National University of Singapore Medical School, Singapore
| | - Tien Yin Wong
- School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, China
- School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Beijing, China
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Zhongshan Ophthalmic Center, Guangzhou, China
| | - Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Jiang F, Xiao O, Guo X, Yin Q, Luo L, He M, Li Z. Characteristics of myopic maculopathy in Chinese children and adolescents with high myopia. Br J Ophthalmol 2024:bjo-2023-324430. [PMID: 39060091 DOI: 10.1136/bjo-2023-324430] [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: 08/16/2023] [Accepted: 07/13/2024] [Indexed: 07/28/2024]
Abstract
AIMS To investigate the characteristics of myopic maculopathy among highly myopic Chinese children and adolescents and explore its associated risk factors. METHODS Children and adolescents aged 7-17 years with spherical equivalent (SE) ≤ -6.00 dioptres (D) were recruited. Myopic maculopathy was categorised based on the International Meta-Analysis of Pathological Myopia Classification. The extent of diffuse choroidal atrophy (DCA) was classified using Early Treatment Diabetic Retinopathy Study grid (ETDRS). The area of DCA was categorised into three classes relative to optic disk area (DA): A1 (≤1 DA), A2 (1 to ≤5 DA) and A3 (5 to ≤10 DA). Logistic regression was used to identify risk factors associated with myopic maculopathy. RESULTS Of the 425 participants aged 13.66±2.67 years, the proportions of tessellated fundus and DCA were 11.76% and 12.24%, and no more severe fundus lesions or 'plus' lesions. The proportion of DCA was 27.03% in children under 11, significantly higher than the 9.12% observed in those aged 11 and older (p<0.001). The percentages of DCA involving the outer, middle and central circles of the ETDRS grid were 42.31%, 55.77% and 1.92%. Myopic maculopathy was significantly associated with younger age (p<0.001), longer axial length (AL; p<0.001) and larger β-zone peripapillary atrophy (β-PPA; p=0.012). CONCLUSION In highly myopic children and adolescents, myopic maculopathy predominantly manifested as DCA (12.24%), with no cases of worse myopic maculopathy or 'plus' lesions. Younger age, longer AL and larger β-PPA were risk factors for myopic maculopathy.
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Affiliation(s)
- Feng Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Ou Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Xinxing Guo
- Wilmer Eye Institute, Johns Hopkins University, Maryland, Baltimore, USA
| | - Qiuxia Yin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Lixia Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Mingguang He
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, People's Republic of China
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong, People's Republic of China
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong, People's Republic of China
| | - Zhixi Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
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Zhang L, Yu X, Hong N, Xia Y, Zhang X, Wang L, Xie C, Dong F, Tong J, Shen Y. CircRNA expression profiles and regulatory networks in the vitreous humor of people with high myopia. Exp Eye Res 2024; 241:109827. [PMID: 38354945 DOI: 10.1016/j.exer.2024.109827] [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: 11/15/2023] [Revised: 01/18/2024] [Accepted: 02/11/2024] [Indexed: 02/16/2024]
Abstract
Myopia is a global health and economic issue. Circular RNAs (circRNAs) have been shown to play an important role in the pathogenesis of many ocular diseases. We first evaluated the circRNA profiles and possible roles in vitreous humor samples of individuals with high myopia by a competitive endogenous RNA (ceRNA) array. Vitreous humor samples were collected from 15 high myopic (5 for ceRNA array, and 10 for qPCR) and 15 control eyes (5 for ceRNA array, and 10 for qPCR) with idiopathic epiretinal membrane (ERM) and macular hole (MH). 486 circRNAs (339 upregulated and 147 downregulated) and 264 mRNAs (202 upregulated and 62 downregulated) were differentially expressed between the high myopia and control groups. The expression of hsa_circ_0033079 (hsa-circDicer1), hsa_circ_0029989 (hsa-circNbea), hsa_circ_0019072 (hsa-circPank1) and hsa_circ_0089716 (hsa-circEhmt1) were validated by qPCR. Pearson analysis and multivariate regression analysis showed positive and significant correlations for axial length with hsa-circNbea and hsa-circPank1. KEGG analysis showed that the target genes of circRNAs were enriched in the mTOR, insulin, cAMP, and VEGF signaling pathways. GO analysis indicated that circRNAs mainly targeted transcription, cytoplasm, and protein binding. CircRNA-associated ceRNA network analysis and PPI network analysis identified several critical genes for myopia. The expression of circNbea, circPank1, miR-145-5p, miR-204-5p, Nras, Itpr1 were validated by qPCR in the sclera of form-deprivation myopia (FDM) mice model. CircPank1/miR-145-5p/NRAS and circNbea/miR-204-5p/ITPR1 were identified and may be important in the progression of myopia. Our findings suggest that circRNAs may contribute to the pathogenesis of myopia and may serve as potential biomarkers.
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Affiliation(s)
- Liyue Zhang
- The Department of Ophthalmology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China
| | - Xin Yu
- The Department of Ophthalmology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China
| | - Nan Hong
- The Department of Ophthalmology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China
| | - Yutong Xia
- The Department of Ophthalmology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China
| | - Xuhong Zhang
- The Department of Ophthalmology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China
| | - Liyin Wang
- The Department of Ophthalmology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China
| | - Chen Xie
- The Department of Ophthalmology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China
| | - Feng Dong
- The Department of Ophthalmology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
| | - Jianping Tong
- The Department of Ophthalmology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
| | - Ye Shen
- The Department of Ophthalmology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
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Pan W, Lan W. The Current and Future Landscape of the Childhood Myopia Epidemic in China-A Review. Ophthalmol Ther 2024; 13:883-894. [PMID: 38300487 PMCID: PMC10912377 DOI: 10.1007/s40123-024-00887-1] [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: 10/15/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Abstract
Over the last two decades, the prevalence of myopia has gradually increased in China. Numerous epidemiological studies suggest that education and inadequate time spent outdoors are the major causes of the current myopia epidemic. China is one of the few countries that has begun to address the myopia epidemic with a national-level strategy, implementing nationwide education reform, cost-reduction measurements, and dissemination of information on myopia prevention and control. These "natural experiments" will provide insights into areas that may face similar or potential myopia problems.
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Affiliation(s)
- Wei Pan
- Aier School of Ophthalmology, Central South University, AIER Mansion, No. 188 South Furong Road, Changsha, 410000, Hunan Province, China
| | - Weizhong Lan
- Aier School of Ophthalmology, Central South University, AIER Mansion, No. 188 South Furong Road, Changsha, 410000, Hunan Province, China.
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, China.
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China.
- Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Xianning, China.
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Li J, Zeng S, Li Z, Xu J, Sun Z, Zhao J, Li M, Zou Z, Guan T, Zeng J, Liu Z, Xiao W, Wei R, Miao H, Ziyar I, Huang J, Gao Y, Zeng Y, Zhou XT, Zhang K. Accurate prediction of myopic progression and high myopia by machine learning. PRECISION CLINICAL MEDICINE 2024; 7:pbae005. [PMID: 38558949 PMCID: PMC10981449 DOI: 10.1093/pcmedi/pbae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 01/31/2024] [Indexed: 04/04/2024] Open
Abstract
Background Myopia is a leading cause of visual impairment in Asia and worldwide. However, accurately predicting the progression of myopia and the high risk of myopia remains a challenge. This study aims to develop a predictive model for the development of myopia. Methods We first retrospectively gathered 612 530 medical records from five independent cohorts, encompassing 227 543 patients ranging from infants to young adults. Subsequently, we developed a multivariate linear regression algorithm model to predict the progression of myopia and the risk of high myopia. Result The model to predict the progression of myopia achieved an R2 value of 0.964 vs a mean absolute error (MAE) of 0.119D [95% confidence interval (CI): 0.119, 1.146] in the internal validation set. It demonstrated strong generalizability, maintaining consistent performance across external validation sets: R2 = 0.950 vs MAE = 0.119D (95% CI: 0.119, 1.136) in validation study 1, R2 = 0.950 vs MAE = 0.121D (95% CI: 0.121, 1.144) in validation study 2, and R2 = 0.806 vs MAE = -0.066D (95% CI: -0.066, 0.569) in the Shanghai Children Myopia Study. In the Beijing Children Eye Study, the model achieved an R2 of 0.749 vs a MAE of 0.178D (95% CI: 0.178, 1.557). The model to predict the risk of high myopia achieved an area under the curve (AUC) of 0.99 in the internal validation set and consistently high area under the curve values of 0.99, 0.99, 0.96 and 0.99 in the respective external validation sets. Conclusion Our study demonstrates accurate prediction of myopia progression and risk of high myopia providing valuable insights for tailoring strategies to personalize and optimize the clinical management of myopia in children.
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Affiliation(s)
- Jiahui Li
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510120, China
- Guangzhou National Laboratory, Guangzhou 510000, China
| | - Simiao Zeng
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510120, China
- Guangzhou National Laboratory, Guangzhou 510000, China
| | - Zhihuan Li
- Zhuhai International Eye Center of the First Affiliated Hospital of Faculty of Medicine, Macau University of Science and Technology, Zhuhai 519000, China
| | - Jie Xu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100069, China
| | - Zhuo Sun
- Guangzhou National Laboratory, Guangzhou 510000, China
| | - Jing Zhao
- Key Laboratory of Myopia, Ministry of Health, Shanghai Key Laboratory of Visual Impairment and Restoration, Department of Ophthalmology, Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai 200031, China
| | - Meiyan Li
- Key Laboratory of Myopia, Ministry of Health, Shanghai Key Laboratory of Visual Impairment and Restoration, Department of Ophthalmology, Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai 200031, China
| | - Zixing Zou
- Guangzhou National Laboratory, Guangzhou 510000, China
| | - Taihua Guan
- Guangzhou National Laboratory, Guangzhou 510000, China
| | - Jin Zeng
- Guangzhou National Laboratory, Guangzhou 510000, China
| | - Zhuang Liu
- Zhuhai International Eye Center of the First Affiliated Hospital of Faculty of Medicine, Macau University of Science and Technology, Zhuhai 519000, China
| | - Wenchao Xiao
- Zhuhai International Eye Center of the First Affiliated Hospital of Faculty of Medicine, Macau University of Science and Technology, Zhuhai 519000, China
| | - Ran Wei
- Zhuhai International Eye Center of the First Affiliated Hospital of Faculty of Medicine, Macau University of Science and Technology, Zhuhai 519000, China
| | - Hanpei Miao
- Guangzhou National Laboratory, Guangzhou 510000, China
- DongguanPeople's Hospital, The First School of Clinical Medicinel, Southern Medical University, Dongguan 523059, China
| | - Ian Ziyar
- Zhuhai International Eye Center of the First Affiliated Hospital of Faculty of Medicine, Macau University of Science and Technology, Zhuhai 519000, China
| | - Junxiong Huang
- Zhuhai International Eye Center of the First Affiliated Hospital of Faculty of Medicine, Macau University of Science and Technology, Zhuhai 519000, China
| | - Yuanxu Gao
- Zhuhai International Eye Center of the First Affiliated Hospital of Faculty of Medicine, Macau University of Science and Technology, Zhuhai 519000, China
| | - Yangfa Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Xing-Tao Zhou
- Key Laboratory of Myopia, Ministry of Health, Shanghai Key Laboratory of Visual Impairment and Restoration, Department of Ophthalmology, Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai 200031, China
| | - Kang Zhang
- Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510120, China
- Guangzhou National Laboratory, Guangzhou 510000, China
- Zhuhai International Eye Center of the First Affiliated Hospital of Faculty of Medicine, Macau University of Science and Technology, Zhuhai 519000, China
- Wenzhou Eye Hospital and Institute for Advanced Study on Eye Health and Diseases, Wenzhou Medical University, Wenzhou 325000, China
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Jiang F, Wang D, Xiao O, Guo X, Yin Q, Luo L, He M, Li Z. Four-Year Progression of Myopic Maculopathy in Children and Adolescents With High Myopia. JAMA Ophthalmol 2024; 142:180-186. [PMID: 38270935 PMCID: PMC10811590 DOI: 10.1001/jamaophthalmol.2023.6319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/24/2023] [Indexed: 01/26/2024]
Abstract
Importance Individuals with high myopia younger than 18 years are at relatively high risk of progressively worsening myopic maculopathy. Additional studies are needed to investigate the progression of myopic maculopathy in this age group, as well as the risk factors associated with progression. Objective To investigate the 4-year progression of myopic maculopathy in children and adolescents with high myopia, and to explore potential risk factors. Design, Setting, and Participants This hospital-based observational study with 4-year follow-up included a total of 548 high myopic eyes (spherical power -6.00 or less diopters) of 274 participants aged 7 to 17 years. Participants underwent comprehensive ophthalmic examination at baseline and 4-year follow-up. Myopic maculopathy was accessed by the International Photographic Classification and Grading System. The data analysis was performed from August 1 to 15, 2023. Main Outcomes and Measures The progression of myopic maculopathy progression over 4 years and associated risk factors. Results The 4-year progression of myopic maculopathy was found in 67 of 548 eyes (12.2%) of 274 participants (138 girls [50.4%] at baseline and 4-year follow-up) with 88 lesion changes, including new signs of the tessellated fundus in 16 eyes (18.2%), diffuse atrophy in 12 eyes (13.6%), patchy atrophy in 2 eyes (2.3%), lacquer cracks in 9 eyes (10.2%), and enlargement of diffuse atrophy in 49 eyes (55.7%). By multivariable analysis, worse best-corrected visual acuity (odds ratio [OR], 6.68; 95% CI, 1.15-38.99; P = .04), longer axial length (AL) (OR, 1.73; 95% CI, 1.34-2.24; P < .001), faster AL elongation (OR, 302.83; 95% CI, 28.61-3205.64; P < .001), and more severe myopic maculopathy (diffuse atrophy; OR, 4.52; 95% CI, 1.98-10.30; P < .001 and patchy atrophy; OR, 3.82; 95% CI, 1.66-8.80; P = .002) were associated with myopic maculopathy progression. Conclusions and Relevance In this observational study, the progression of myopic maculopathy was observed in approximately 12% of pediatric high myopes for 4 years. The major type of progression was the enlargement of diffuse atrophy. Risk factors for myopic maculopathy progression were worse best-corrected visual acuity, longer AL, faster AL elongation, and more severe myopic maculopathy. These findings support consideration of follow-up in these individuals and trying to identify those at higher risk for progression.
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Affiliation(s)
- Feng Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Decai Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Ou Xiao
- 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
| | - Xinxing Guo
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
| | - Qiuxia Yin
- 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
| | - Lixia Luo
- 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
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- Experimental Ophthalmology, The Hong Kong Polytechnic University, Hong Kong, People’s Republic of China
| | - Zhixi Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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Zheng T, Jiang S, Fu W, Liu H, Ding S, Xv D, Zhang H, Zheng T, Yang X. Prevalence of and risk factors for myopia among urban and rural children in Northeast China: protocol for a school-based cross-sectional study. BMJ Open 2024; 14:e077735. [PMID: 38326264 PMCID: PMC10860113 DOI: 10.1136/bmjopen-2023-077735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024] Open
Abstract
INTRODUCTION The worldwide prevalence of myopia is high and continues to increase. In this study, a school screening programme for myopia will be implemented using the whole-process information method. The purpose of this study is to investigate the prevalence of myopia in urban and rural areas of Northeast China and to determine the factors related to myopia. METHODS AND ANALYSIS This is a school-based cross-sectional study. Our study population will include 6000 school-aged children from 2 urban and 2 rural schools in Jinzhou, China. The study will be conducted using our self-developed internet-based intelligent data collection, transmission, storage and analysis system. Examination parameters include uncorrected distance visual acuity, presenting distance visual acuity, non-cycloplegic autorefraction, height, weight, waist circumference, hip circumference, spinal curvature and dental caries. The examination report will be automatically sent to parents, who will complete the questionnaire, and appropriate statistical analysis will be performed. The main outcome is the prevalence of myopia, defined as an equivalent spherical degree ≤-0.5 D. ETHICS AND DISSEMINATION Ethical approval was obtained from the Third Affiliated Hospital of Jinzhou Medical University (number: JYDSY-KXYJ-IEC-2023-018). Findings will be published in a peer-reviewed journal. Subjects and their parents (or other authorised agents) give informed consent prior to study participation. TRIAL REGISTRATION NUMBER ChiCTR2300072893.
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Affiliation(s)
- Tianli Zheng
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, China
| | - Shuang Jiang
- Third Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Weiwei Fu
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, China
| | - Hua Liu
- Third Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Shangshang Ding
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, China
| | - Daoliang Xv
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, China
| | - Hetong Zhang
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, China
| | - Tianyou Zheng
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, China
| | - Xiaodong Yang
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, China
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Chen J, Tang Y, Lin Z, Tao Z, Deng H. Effect and safety posterior scleral reinforcement on controlling myopia in children: a meta-analysis. Int Ophthalmol 2024; 44:8. [PMID: 38319543 PMCID: PMC10847067 DOI: 10.1007/s10792-024-02929-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 12/17/2023] [Indexed: 02/07/2024]
Abstract
PURPOSE The aim of this meta-analysis was to assess the efficacy of posterior scleral reinforcement (PSR) on the control of pediatric myopia. Electronic databases were systematically searched. METHODS Standardized mean differences (SMDs) of outcomes were calculated. Eight studies with 357 patients with pediatric myopia were included. The SMD for the increase in mean axial length (AL) in the PSR and control group was - 1.19 (95% CI - 1.71, - 0.68). RESULTS The SMD for decrease of best-corrected visual acuity (BCVA) LogMAR in the PSR and control group was 0.85 (95% CI 0.28, 1.43). The SMD for change in intraocular pressure (IOP) at the time of surgery and at the end of the follow-up period in the PSR group was - 0.01 (95% CI - 0.48, 0.47). CONCLUSION This meta-analysis indicates that PSR surgery may be an effective therapeutic strategy to control the progression of myopia in childhood with acceptable adverse effects.
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Affiliation(s)
- Jing Chen
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Jinan University, No. 18 Zetian Road, Futian District, Shenzhen, 518040, Guangdong, China
| | - Yu Tang
- The Second Clinical Medical College, Jinan University, Shenzhen, China
| | - Zhihong Lin
- The Second Clinical Medical College, Jinan University, Shenzhen, China
| | - Zhengyang Tao
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Jinan University, No. 18 Zetian Road, Futian District, Shenzhen, 518040, Guangdong, China
| | - Hongwei Deng
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Jinan University, No. 18 Zetian Road, Futian District, Shenzhen, 518040, Guangdong, China.
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Wu YJ, Feng YL, Yang JS, Fan H, Li WS. Different approaches for treating myopic choroidal neovascularization: a network Meta-analysis. Int J Ophthalmol 2023; 16:2105-2116. [PMID: 38111927 PMCID: PMC10700081 DOI: 10.18240/ijo.2023.12.25] [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: 03/07/2023] [Accepted: 09/26/2023] [Indexed: 12/20/2023] Open
Abstract
AIM To evaluate the efficacy of intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF), photodynamic therapy (PDT), and laser treatment (LT) for anatomical and functional improvement in myopic choroidal neovascularization (mCNV) patients. METHODS Two researchers independently searched PubMed, Cochrane Library, Web of Science, and other databases to screen studies comparing best-corrected vision acuity (BCVA) and foveal center thickness (FCT) changes after mCNV treatment. Post-treatment chorioretinal atrophy (CRA) is a secondary outcome indicator. The retrieval time limit is from the database construction to January 30, 2023. RESULTS A total of 1072 eyes in 16 articles were included. In the RCTs, intravitreal bevacizumab (IVB) and intravitreal ranibizumab (IVR) were superior to PDT (MD=0.18, 95%CI: 0.02, 0.40, MD=0.18, 95%CI: 0.01, 0.42) in improving BCVA of mCNV patients (P<0.05). The relative effectiveness in improving BCVA, from high to low, appeared to be IVR, intravitreal aflibercept (IVA), IVB, LT, PDT, and sham first followed by IVA (Sham/IVA). While improving the FCT from high to low was IVA, IVR, IVB, PDT. In retrospective studies, the results of BCVA after long-term treatment showed that all the therapeutic effects from high to low was IVA, intravitreal conbercept (IVC), IVR, IVB, IVB/IVR, PDT with IVB/IVR, PDT. The effect of improving FCT was IVA, IVR, IVC, PDT, and IVB from high to low. And in the effects of improving CRA, the IVB appeared to be higher than IVR, while the PDT was the smallest, but none of the differences in the results were statistically significant. CONCLUSION Anti-VEGF has the best effect on long-term vision improvement in mCNV patients, using IVB or IVR alone to treat mCNV may be better than IVB or IVR combined with PDT. There is no significant difference in the improvement of visual acuity, macular edema, and CRA in mCNV patients treated with any different anti-VEGF drugs.
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Affiliation(s)
- Ya-Jun Wu
- Aier School of Ophthalmology, Central South University, Changsha 410000, Hunan Province, China
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai 200235, China
- Shanghai Aier Eye Institute, Shanghai 200235, China
| | - Yu-Liang Feng
- Aier School of Ophthalmology, Central South University, Changsha 410000, Hunan Province, China
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai 200235, China
- Shanghai Aier Eye Institute, Shanghai 200235, China
| | - Jia-Song Yang
- Aier School of Ophthalmology, Central South University, Changsha 410000, Hunan Province, China
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai 200235, China
- Shanghai Aier Eye Institute, Shanghai 200235, China
| | - Hua Fan
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai 200235, China
- Shanghai Aier Eye Institute, Shanghai 200235, China
| | - Wen-Sheng Li
- Aier School of Ophthalmology, Central South University, Changsha 410000, Hunan Province, China
- Department of Ophthalmology, Shanghai Aier Eye Hospital, Shanghai 200235, China
- Shanghai Aier Eye Institute, Shanghai 200235, China
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Yang L, Xu Y, Zhou P, Wan G. The SNTB1 and ZFHX1B gene have susceptibility in northern Han Chinese populations with high myopia. Exp Eye Res 2023; 237:109694. [PMID: 37890754 DOI: 10.1016/j.exer.2023.109694] [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: 08/12/2023] [Revised: 10/11/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
The aim of this study was to explore the association between SNTB1 and ZFHX1B polymorphisms and high myopia (HM) in a Northern Han Chinese population. This case-control study included 457 HM and 860 healthy subjects from the Northern Han Chinese population. Four single nucleotide polymorphisms (SNPs) (rs7839488, rs4395927, rs4455882, and rs6469937) in SNTB1 and one SNP in ZFHX1B (rs13382811)were selected based on two previous genome-wide association study (GWAS) studies. The allele and genotype distributions of SNPs in SNTB1 and ZFHX1B were compared between the two groups using the chi-square test. The allele results were adjusted for age and sex using Plink software (Plink 1.9). Pairwise linkage disequilibrium (LD) and haplotype analyses were performed using SHEsis software. For HM subjects, the mean age was 44.80 ± 17.11 years, and for the control subjects, it was 44.41 ± 14.26 years. For rs7839488 of the SNTB1 gene, the A allele is a risk allele and the G allele is a wild allele. The A allele had no statistical significance with the HM cases and controls (OR = 0.90, 95% CI = 0.74-1.09, aP = 0.273, Pc = NS). There was a LD in SNTB1 (rs7839488, rs4395927, rs4455882, and rs6469937). The G-C-A-G haplotype frequency was higher in HM subjects than that of the controls (OR = 1.31, 95% CI = 1.07-1.60, P = 0.008). Meanwhile, the A-T-G-A haplotype frequency was slightly lower in the HM group (OR = 0.81, 95% CI = 0.66-0.99, P = 0.048). In the ZFHX1B gene, the frequency of the minor T allele of rs13382811 was significant higher in the HM group than in the control group (OR = 1.34, 95% CI = 1.11-1.61, aP = 0.001, Pc = 0.009). Furthermore, compared to the CC genotype, there were significant differences in the CT genotype (OR = 1.57, 95% CI = 1.23-2.00, aP < 0.001, Pc = 0.002). In conclusion, G-C-A-G is a risk haplotype from the SNTB1 gene in high myopia patients. The minor T-allele of ZFHX1B rs13382811 is a risk factor for high myopia. SNTB1 and ZFHX1B are both risk genes associated with increased susceptibility to high myopia in the Northern Han Chinese population.
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Affiliation(s)
- Lin Yang
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Youmei Xu
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Pengyi Zhou
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Guangming Wan
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
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Li L, Yuan L, Yang K, Wu Y, Hua X, Wang Y, Yuan X. Comparative analysis of IOL power calculations in postoperative refractive surgery patients: a theoretical surgical model for FS-LASIK and SMILE procedures. BMC Ophthalmol 2023; 23:416. [PMID: 37845633 PMCID: PMC10578000 DOI: 10.1186/s12886-023-03164-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/04/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND As the two most prevalent refractive surgeries in China, there is a substantial number of patients who have undergone Femtosecond Laser-assisted In Situ Keratomileusis (FS-LASIK) and Small Incision Lenticule Extraction (SMILE) procedures. However, there is still limited knowledge regarding the selection of intraocular lens (IOL) power calculation formulas for these patients with a history of FS-LASIK or SMILE. METHODS A total of 100 eyes from 50 postoperative refractive surgery patients were included in this prospective cohort study, with 25 individuals (50 eyes) having undergone FS-LASIK and 25 individuals (50 eyes) having undergone SMILE. We utilized a theoretical surgical model to simulate the IOL implantation process in postoperative FS-LASIK and SMILE patients. Subsequently, we performed comprehensive biological measurements both before and after the surgeries, encompassing demographic information, corneal biometric parameters, and axial length. Various formulas, including the Barrett Universal II (BUII) formula, as a baseline, were employed to calculate IOL power for the patients. RESULTS The Barrett True K (BTK) formula, demonstrated an mean absolute error (AE) within 0.5 D for both FS-LASIK and SMILE groups (0.28 ± 0.25 D and 0.36 ± 0.24 D, respectively). Notably, the FS-LASIK group showed 82% of results differing by less than 0.25 D compared to preoperative BUII results. The Barrett True K No History (BTKNH) formula, which also incorporates measured posterior corneal curvature, performed similarly to BTK in both groups. Additionally, the Masket formula, relying on refractive changes based on empirical experience, displayed promising potential for IOL calculations in SMILE patients compared with BTK (p = 0.411). CONCLUSION The study reveals the accuracy and stability of the BTK and BTKNH formulas for IOL power calculations in myopic FS-LASIK/SMILE patients. Moreover, the Masket formula shows encouraging results in SMILE patients. These findings contribute to enhancing the predictability and success of IOL power calculations in patients with a history of refractive surgery, providing valuable insights for clinical practice. Further research and larger sample sizes are warranted to validate and optimize the identified formulas for better patient outcomes.
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Affiliation(s)
- Liangpin Li
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China
| | - Liyun Yuan
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Kun Yang
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China
| | - Yanan Wu
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China
| | - Xia Hua
- Tianjin Aier Eye Hospital, Tianjin University, Tianjin, 300190, China
| | - Yan Wang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China.
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China.
| | - Xiaoyong Yuan
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China.
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China.
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Huang S, Shen F, Zhou F, Gong Q, Liu K, Feng W, Cen D. Myopia in elementary school students in Eastern China during the COVID-19 pandemic. Front Public Health 2023; 11:1167379. [PMID: 37415713 PMCID: PMC10320216 DOI: 10.3389/fpubh.2023.1167379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/30/2023] [Indexed: 07/08/2023] Open
Abstract
Background Myopia is an increasingly serious public concern, particularly among primary school students. The prevalence of myopia and its influencing factors in primary school pupils in Eastern China during the COVID-19 pandemic had not been explored. Methods A randomly clustered sampling method was performed, and selected pupils from grade 1 to grade 3 in 15 primary schools in the Fenghua District of Zhejiang Province were included and given myopia screening and uniform questionnaire survey 1 year later. Results A total of 4,213 students completed the myopia screening and questionnaire survey. Myopia was diagnosed in 1,356 pupils, with a myopia incidence of 32.19%. The spherical equivalent (SE) refraction of the included pupils decreased on average by 0.50 ± 2.15 D 1 year later. The myopia rate was positively correlated with the increase of grade, in which the myopia rate among grade 3 students was the highest at 39.69%. The myopia rate among female students was higher than that among male students. Students residing in urban areas had a higher myopia rate than in rural areas. Maintaining an near work distance ≥33 cm was a significant protective factor (OR = 0.84, 95% CI: 0.74-0.96). Students with two myopic parents had a higher risk of myopia (OR = 1.61, 95% CI: 1.34-1.92). Conclusion During the COVID-19 pandemic, the myopia rate among early primary school students in Eastern China was high. More attention and implementation of interventions from health and education departments, such as training the development of good eye behavior, should be considered to strengthen the intervention of myopia in primary school students.
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Affiliation(s)
| | - Fanhan Shen
- Fenghua District Center for Disease Control and Prevention, Ningbo, China
| | - Fujun Zhou
- Fenghua District Center for Disease Control and Prevention, Ningbo, China
| | - Qinghai Gong
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Kui Liu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Wei Feng
- Fenghua District Center for Disease Control and Prevention, Ningbo, China
| | - Dong Cen
- Ningbo Yinzhou No.2 Hospital, Ningbo, China
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Xu Y, Li L, Shan J, Du L, Jin X, Zhou P. Extreme myopia is more susceptible to SOX2 gene than high myopia. Exp Eye Res 2023; 230:109435. [PMID: 36921835 DOI: 10.1016/j.exer.2023.109435] [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: 10/25/2022] [Revised: 01/10/2023] [Accepted: 03/06/2023] [Indexed: 03/16/2023]
Abstract
PURPOSE To explore the association between two single-nucleotide polymorphisms (SNPs) in the SOX2 gene and high and extreme myopia in the Han Chinese population. MATERIALS AND METHODS A genetic association study using a case-control method was performed with 139 high myopia, 318 extreme myopia, and 918 healthy participants from the Chinese Han population. Two SNPs (rs4459940 and rs4575941) near SOX2 gene were selected for genotyping. We compared the allelic frequencies and haplotypes of the SNPs to assess their association with high and extreme myopia. This study was adjusted for sex and age of participants in the groups. RESULT The mean ages of the extreme myopia and control subjects were 47.44 ± 15.59 and 44.15 ± 14.08 years, respectively. The rs4575941 SNP of the SOX2 gene and the GG and AG genotypes showed no significant association with the risk of high myopia as opposed to the AA genotype (GG, OR = 0.94, 95% CI = 0.55-1.60, P = 0.820, Pc = NS; AG, OR = 0.91, 95% CI = 0.54-1.52, P = 0.708, Pc = NS). However, the frequency of the risk G allele of rs4575941 was significantly higher in the extreme myopia group than in the control group (OR = 1.31, 95% CI = 1.08-1.59; P = 0.007; Pc = 0.014). Furthermore, there were significant differences in the GG genotype frequency between the extreme myopia and control groups (OR = 1.77, 95% CI = 1.45-2.74, P = 0.009, Pc = 0.036). The A-G haplotype frequency was higher in the extreme group (OR = 1.27, 95% CI = 1.05-1.55, P = 0.014), while there were no significant differences found in high myopia group (OR = 1.18, 95% CI = 0.77-1.31, P = 0.979). CONCLUSION The SOX2 rs4575941 polymorphism, in Chinese Han population, contributes to the susceptibility of extreme myopia. SOX2 may thus be implicated in extreme myopia rather than in high myopia.
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Affiliation(s)
- Youmei Xu
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China; The Academy of Medical Sciences, Zhengzhou University, Zhengzhou, PR China
| | - Lin Li
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Jiankang Shan
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China; The Academy of Medical Sciences, Zhengzhou University, Zhengzhou, PR China
| | - Liping Du
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Xuemin Jin
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
| | - Pengyi Zhou
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
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Wu L, Feng J, Zhang M. Implementing interventions to promote spectacle wearing among children with refractive errors: A systematic review and meta-analysis. Front Public Health 2023; 11:1053206. [PMID: 36969641 PMCID: PMC10036364 DOI: 10.3389/fpubh.2023.1053206] [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: 09/25/2022] [Accepted: 02/16/2023] [Indexed: 03/12/2023] Open
Abstract
Purpose To investigate the level of compliance of children with refractive errors who are provided free spectacles, and to identify the reasons for non-compliance. Methods We systematically searched the PubMed, EMBASE, CINAHL, Web of Science, and Cochrane Library databases from the time these databases were established to April 2022, including studies published in English. The search terms were "randomized controlled trial" [Publication Type] OR "randomized" [Title/Abstract], OR "placebo" [Title/Abstract]) AND (("Refractive Errors"[MeSH Terms] OR ("error refractive" [Title/Abstract] OR "errors refractive" [Title/Abstract] OR "refractive error" [Title/Abstract] OR "refractive disorders" [Title/Abstract] OR "disorder refractive" [Title/Abstract] OR "disorders refractive" [Title/Abstract] OR "refractive disorder" [Title/Abstract] OR "Ametropia" [Title/Abstract] OR "Ametropias" [Title/Abstract])) AND ("Eyeglasses" [MeSH Terms] OR ("Spectacles" [Title/Abstract] OR "Glasses"[Title/Abstract]) AND ("Adolescent" [MeSH Terms] OR ("Adolescents" [Title/Abstract] OR "Adolescence"[Title/Abstract]) OR "Child"[MeSH Terms] OR "Children"[Title/Abstract])). We only selected studies that were randomized controlled trials. Two researchers independently searched the databases, and 64 articles were retrieved after the initial screening. Two reviewers independently assessed the quality of the collected data. Results Fourteen articles were eligible for inclusion, and 11 studies were included in the meta-analysis. The overall compliance with spectacle use was 53.11%. There was a statistically significant effect of free spectacles on compliance among children (OR = 2.45; 95% CI = 1.39-4.30). In the subgroup analysis, longer follow-up time was associated with significantly lower reported ORs (6-12 vs. <6 months, OR = 2.30 vs. 3.18). Most studies concluded that sociomorphic factors, RE severity, and other factors contributed to children not wearing glasses at the end of the follow-up. Conclusion The combination of providing free spectacles along with educational interventions can lead to high levels of compliance among the study participants. Based on this study's findings, we recommend implementing policies that integrate the provision of free spectacles with educational interventions and other measures. In addition, a combination of additional health promotion strategies may be needed to improve the acceptability of refractive services and to encourage the consistent use of eyewear. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=338507, identifier: CRD42022338507.
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Affiliation(s)
- Linrong Wu
- Joint Shantou International Eye Center (JSIEC) of Shantou University & The Chinese University of Hong Kong, Shantou, China
- School of Public Health, Shantou University, Shantou, China
| | - Jiayi Feng
- Joint Shantou International Eye Center (JSIEC) of Shantou University & The Chinese University of Hong Kong, Shantou, China
- School of Public Health, Shantou University, Shantou, China
| | - Mingzhi Zhang
- Joint Shantou International Eye Center (JSIEC) of Shantou University & The Chinese University of Hong Kong, Shantou, China
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Wu Y, Luo X, Feng Y, Yang J, Fan H, Cen X, Li W. Comparison of the accuracy of axial length measurement by different imaging methods in Sprague Dawley rats. Front Neurosci 2023; 16:1106904. [PMID: 36685229 PMCID: PMC9854123 DOI: 10.3389/fnins.2022.1106904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 12/12/2022] [Indexed: 01/09/2023] Open
Abstract
Background Obtaining accurate axial length (AL) is very important for the establishment of animal models of myopia. The purpose of this study is to compare the accuracy of Quantel A-B scan, OD-1 A scan, and vernier caliper in measuring AL in Sprague Dawley (SD) rats. Methods In total, 60 5-week-old SD rats were divided into female rat group (n = 30) and male rat group (n = 30). Quantel A-B scan and OD-1 A scan were, respectively, used to measure the AL of both eyes of each living rat, and vernier caliper was used to measure the anterior-posterior diameter of each rat's eyeball. Besides, the correlation between refractive error (RE) and AL measured by different instruments was evaluated, and the accuracy of the three measurement methods was compared according to gender and left/right eyes. Results There were significant differences in AL and diopter of SD rats at the same age (p < 0.05). the AL of male rats was greater than that of female rats, while diopter (D) was the opposite; There was no significant difference in AL and D between left and right eyes in the same SD rats (p > 0.05); There were statistical differences among the three measurement methods (p < 0.05), AL measured by vernier caliper was the largest, followed by Quantel A-B scan, OD-1 A scan; Difference in AL between male and female was not statistically significant between the results obtained by Quantel A-B scan and vernier caliper (p > 0.05), but there were statistically significant differences between the other two measurement methods (p < 0.05). Conclusion Sex is the influencing factor of AL and RE. Imaging measurement can accurately measure the AL in living small rodents. Compared with OD-1 A scan, Quantel A-B scan may be more accurate.
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Affiliation(s)
- Yajun Wu
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China,Department of Ophthalmology, Shanghai Aier Eye Ophthalmology Hospital, Shanghai, China,Shanghai Aier Eye Institute, Shanghai, China
| | - Xiangdong Luo
- Department of Ophthalmology, Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Yuliang Feng
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China,Department of Ophthalmology, Shanghai Aier Eye Ophthalmology Hospital, Shanghai, China,Shanghai Aier Eye Institute, Shanghai, China
| | - Jiasong Yang
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China,Department of Ophthalmology, Shanghai Aier Eye Ophthalmology Hospital, Shanghai, China,Shanghai Aier Eye Institute, Shanghai, China
| | - Hua Fan
- Department of Ophthalmology, Shanghai Aier Eye Ophthalmology Hospital, Shanghai, China,Shanghai Aier Eye Institute, Shanghai, China
| | - Xiaobo Cen
- WestChina-Frontier PharmaTech Co., Ltd., Chengdu, Sichuan, China,Xiaobo Cen,
| | - Wensheng Li
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China,Department of Ophthalmology, Shanghai Aier Eye Ophthalmology Hospital, Shanghai, China,Shanghai Aier Eye Institute, Shanghai, China,*Correspondence: Wensheng Li,
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16
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Elhusseiny AM, Salim S. Cataract surgery in myopic eyes. Curr Opin Ophthalmol 2023; 34:64-70. [PMID: 36473016 DOI: 10.1097/icu.0000000000000914] [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]
Abstract
PURPOSE OF REVIEW We discuss the preoperative, intraoperative, and postoperative considerations for cataract surgery in eyes with high myopia. We also reviewed the recent literature on refractive outcomes and complications of cataract surgery in myopic eyes. RECENT FINDINGS Several novel intraocular lens (IOL) power calculation formulas have recently been developed to optimize refractive outcomes. Haigis formula is the most accurate among the third-generation IOL formulas. Novel formulas such as Barrett Universal II, Kane, and modified Wang-Koch adjustment for Holladay I formula provide a better refractive prediction compared with old formulas. Intraoperatively, the chopping technique is preferred to minimize pressure on weak zonules and reduce the incidence of posterior capsule rupture. Anterior capsular polishing is recommended to reduce the risk of postoperative capsular contraction syndrome (CCS). Postoperatively, complications such as refractive surprises, intraocular pressure spikes, and CCS remain higher in myopic eyes. Only 63% of myopic patients with axial length more than 26 mm achieve a visual acuity at least 20/40 after cataract surgery, mainly because of coexisting ocular comorbidities. SUMMARY There are multiple preoperative, intraoperative, and postoperative considerations when performing cataract surgery in myopic eyes. Further research is needed to optimize the refractive outcomes in these eyes and determine the best IOL formula. Surgeons should be adept and knowledgeable with different techniques to manage intraoperative complications.
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Affiliation(s)
- Abdelrahman M Elhusseiny
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas.,Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School
| | - Sarwat Salim
- Department of Ophthalmology, Tufts University School of Medicine, Boston, Massachusetts, USA
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17
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Agyekum S, Chan PP, Zhang Y, Huo Z, Yip BHK, Ip P, Tham CC, Chen LJ, Zhang XJ, Pang CP, Yam JC. Cost-effectiveness analysis of myopia management: A systematic review. Front Public Health 2023; 11:1093836. [PMID: 36923029 PMCID: PMC10008871 DOI: 10.3389/fpubh.2023.1093836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/10/2023] [Indexed: 03/03/2023] Open
Abstract
The rising prevalence of myopia is a major global public health concern. Economic evaluation of myopia interventions is critical for maximizing the benefits of treatment and the healthcare system. This systematic review aimed to evaluate the cost-effectiveness of interventions for treating myopia. Five databases were searched - Embase, Emcare, PubMed, Web of Science, and ProQuest - from inception to July 2022 and a total of 2,099 articles were identified. After careful assessments, 6 studies met the eligibility criteria. The primary outcomes of this systematic review were costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER). The secondary outcomes included utility values and net monetary benefits (NMB). One study determined the cost-effectiveness of photorefractive screening plus treatment with 0.01% atropine, 2 studies examined cost-effectiveness of corneal refractive surgery, and 3 studies evaluated cost-effectiveness of commonly used therapies for pathologic myopia. Corneal refractive surgeries included laser in situ keratomileusis (LASIK), femtosecond laser-assisted in situ keratomileusis (FS-LASIK), photorefractive keratectomy (PRK), and small-incision lenticule extraction (SMILE). Interventions for pathologic myopia included ranibizumab, conbercept, and photodynamic therapy (PDT). At an incremental cost of NZ$ 18 (95% CI 15, 20) (US$ 11) per person, photorefractive screening plus 0.01% atropine resulted in an ICER of NZ$ 1,590/QALY (US$ 1,001/QALY) (95% CI NZ$ 1,390, 1,791) for an incremental QALY of 0.0129 (95% CI 0.0127, 0.0131). The cost of refractive surgery in Europe ranged from €3,075 to €3,123 ([US$4,046 to $4,109 - adjusted to 2021 inflation). QALYs associated with these procedures were 23 (FS-LASIK) and 24 (SMILE and PRK) with utility values of 0.8 and ICERs ranging from approximately €14 (US$17)/QALY to €19 (US$23)/QALY. The ICER of LASIK was US$683/diopter gained (inflation-adjusted). The ICER of ranibizumab and PDT were £8,778 (US$12,032)/QALY and US$322,460/QALY respectively, with conbercept yielding a saving of 541,974 RMB (US$80,163)/QALY, respectively. The use of 0.01% atropine and corneal refractive surgery were cost-effective for treating myopia. Treating pathologic myopia with ranibizumab and conbercept were more cost-effective than PDT. Prevention of myopia progression is more cost-effective than treating pathologic myopia.
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Affiliation(s)
- Sylvia Agyekum
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Poemen P Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Hong Kong Eye Hospital, Kowloon, Hong Kong SAR, China.,Department of Ophthalmology and Visual Sciences, Lam Kin Chung, Jet King-Shing Ho Glaucoma Treatment and Research Centre, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Department of Ophthalmology and Visual Sciences, The Prince of Wales Hospital, Hong Kong, Hong Kong SAR, China
| | - Yuzhou Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Zhaohua Huo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Benjamin H K Yip
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Hong Kong Eye Hospital, Kowloon, Hong Kong SAR, China.,Department of Ophthalmology, Hong Kong Children Hospital, Kowloon, Hong Kong SAR, China.,Joint Shantou International Eye Centre of Shantou University and Chinese University of Hong Kong, Shantou, China
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Hong Kong Eye Hospital, Kowloon, Hong Kong SAR, China.,Department of Ophthalmology and Visual Sciences, The Prince of Wales Hospital, Hong Kong, Hong Kong SAR, China.,Joint Shantou International Eye Centre of Shantou University and Chinese University of Hong Kong, Shantou, China
| | - Xiu Juan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Hong Kong Eye Hospital, Kowloon, Hong Kong SAR, China.,Department of Ophthalmology, Hong Kong Children Hospital, Kowloon, Hong Kong SAR, China.,Joint Shantou International Eye Centre of Shantou University and Chinese University of Hong Kong, Shantou, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Department of Ophthalmology and Visual Sciences, Lam Kin Chung, Jet King-Shing Ho Glaucoma Treatment and Research Centre, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Joint Shantou International Eye Centre of Shantou University and Chinese University of Hong Kong, Shantou, China.,Hong Kong Hub of Pediatric Excellence, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Hong Kong Eye Hospital, Kowloon, Hong Kong SAR, China.,Department of Ophthalmology and Visual Sciences, Lam Kin Chung, Jet King-Shing Ho Glaucoma Treatment and Research Centre, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Department of Ophthalmology and Visual Sciences, The Prince of Wales Hospital, Hong Kong, Hong Kong SAR, China.,Department of Ophthalmology, Hong Kong Children Hospital, Kowloon, Hong Kong SAR, China.,Joint Shantou International Eye Centre of Shantou University and Chinese University of Hong Kong, Shantou, China.,Hong Kong Hub of Pediatric Excellence, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
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18
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Liu J, Lei Y, Diao Y, Lu Y, Teng X, Chen Q, Liu L, Zhong J. Altered whole-brain gray matter volume in form-deprivation myopia rats based on voxel-based morphometry: A pilot study. Front Neurosci 2023; 17:1113578. [PMID: 37144093 PMCID: PMC10151753 DOI: 10.3389/fnins.2023.1113578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/30/2023] [Indexed: 05/06/2023] Open
Abstract
Background Myopia is one of the major public health problems worldwide. However, the exact pathogenesis of myopia remains unclear. This study proposes using voxel-based morphometry (VBM) to investigate potential morphological alterations in gray matter volume (GMV) in form-deprivation myopia (FDM) rats. Methods A total of 14 rats with FDM (FDM group) and 15 normal controls (NC group) underwent high-resolution magnetic resonance imaging (MRI). Original T2 brain images were analyzed using VBM method to identify group differences in GMV. Following MRI examination, all rats were perfused with formalin, and immunohistochemical analysis of NeuN and c-fos levels was performed on the visual cortex. Results In the FDM group, compared to the NC group, significantly decreased GMVs were found in the left primary visual cortex, left secondary visual cortex, right subiculum, right cornu ammonis, right entorhinal cortex and bilateral molecular layer of the cerebellum. Additionally, significantly increased GMVs were found in the right dentate gyrus, parasubiculum, and olfactory bulb. Conclusions Our study revealed a positive correlation between mGMV and the expression of c-fos and NeuN in the visual cortex, suggesting a molecular relationship between cortical activity and macroscopic measurement of visual cortex structural plasticity. These findings may help elucidate the potential neural pathogenesis of FDM and its relationship to changes in specific brain regions.
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Affiliation(s)
- Jiayan Liu
- Department of Ophthalmology, First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
- Department of Ophthalmology, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People’s Hospital, Qingyuan, China
| | - Yahui Lei
- Department of Ophthalmology, First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
| | - Yuyao Diao
- Department of Ophthalmology, First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
| | - Yamei Lu
- Department of Ophthalmology, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People’s Hospital, Qingyuan, China
| | - Xingbo Teng
- Department of Ophthalmology, First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
| | - Qingting Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Lian Liu
- Department of Ophthalmology, First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
| | - Jingxiang Zhong
- Department of Ophthalmology, First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
- The Sixth Affiliated Hospital of Jinan University, Jinan University, Dongguan, China
- *Correspondence: Jingxiang Zhong,
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19
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Comparisons of objective and subjective refraction with and without cycloplegia using binocular wavefront optometer with autorefraction and retinoscopy in school-age children. Graefes Arch Clin Exp Ophthalmol 2022; 261:1465-1472. [PMID: 36527496 PMCID: PMC10148772 DOI: 10.1007/s00417-022-05936-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/16/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Abstract
Purpose
To compare school-age children’s objective and subjective refraction using a binocular wavefront optometer (BWFOM) with autorefraction and retinoscopy before and after cycloplegia.
Methods
Eighty-six eyes from 86 children (6–15 years old) were enrolled in this cross-sectional study. BWFOM objective and subjective refractions were compared with autorefraction and retinoscopy under cycloplegia. BWFOM refraction was evaluated before and after cycloplegia. Measurements were compared using a paired t-test; agreement was assessed using Bland–Altman plots.
Results
Under cycloplegia, the sphere, spherical equivalence, and J45 were significantly more negative on BWFOM objective refraction than autorefraction (− 1.39 ± 2.20 D vs. − 1.28 ± 2.23 D, P = 0.003; − 1.84 ± 2.38 D vs. − 1.72 ± 2.43 D, P = 0.001; − 0.02 ± 0.17 D vs. 0.03 ± 0.21 D, P = 0.004). The subjective sphere of BWFOM was less myopic, and the cylinder and the J45 were more negative than those with retinoscopy (− 1.17 ± 2.09 D vs. − 1.25 ± 2.20 D, P = 0.02; − 0.91 ± 0.92 D vs. − 0.76 ± 0.92 D, P < 0.001; − 0.01 ± 0.15 D vs. 0.03 ± 0.21 D, P = 0.028). For both BWFOM objective and subjective refraction, sphere and spherical equivalence with noncycloplegia were more myopic than those with cycloplegia (objective: − 1.76 ± 2.10 D vs. − 1.39 ± 2.20 D, − 2.21 ± 2.30 D vs. − 1.84 ± 2.38 D, P < 0.001; subjective: − 1.57 ± 1.92 D vs. − 1.17 ± 2.09 D, − 2.01 ± 2.13 D vs. − 1.62 ± 2.27 D, P < 0.001). Bland–Altman plots showed good agreement in spherical equivalence between BWFOM objective refraction and autorefraction (mean difference = 0.12 D, 95% confidence interval [CI] − 0.52 to 0.76), subjective refraction with retinoscopy (mean difference = − 0.01 D, 95% CI − 0.65 to 0.64), and BWFOM refractions with or without cycloplegia (objective: mean difference = − 0.37 D, 95% CI − 1.31 to 0.57; subjective: mean difference = − 0.39 D, 95% CI − 1.30 to 0.51). The time cost by BWFOM was significantly less than the total time of autorefraction and retinoscopy (264.88 ± 90.67 s vs. 315.89 ± 95.31 s, P < 0.001).
Conclusion
BWFOM is a new device that realizes both objective and subjective refraction. For children’s refractive errors, it is more convenient and quicker to obtain the proper prescription at a 0.05-D interval, and it is more accurate than autorefraction and retinoscopy under cycloplegia.
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