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The incidence of myopia among Chinese adolescents is progressively rising, indicating a distinct trend toward younger age onset.This paper aims to comprehensively review the impact of various visual performance on myopia and its progression, with a specific emphasis on accommodative function, convergence function, and ocular position. A meticulous exploration of accommodation function, encompassing accommodative amplitude, accommodative facility, accommodative response, positive relative accommodation, and negative relative accommodation, has been undertaken to elucidate its contributory role in myopia progression. Concurrently, an exhaustive analysis of convergence function has been conducted including esotropia and exotropia, convergence insufficiency and convergence excess, fusional function vergence, divergence insufficiency, and excess, providing a nuanced understanding of convergence's implications for myopia advancement. Furthermore, the influence of ocular position on myopia progression, along with other factors affecting perceptual ocular position and intermittent exotropia, is discussed. The primary objective of this article is to unveil the multifaceted visual performance influencing myopia and its progression, elucidating the paramount significance of accommodative function, convergence function, and ocular position in this context.
ABSTRACT
La miopía constituye un problema de salud pública a nivel mundial, y se espera que afecte a un número cada vez mayor de personas en las próximas décadas. El control de la progresión de este defecto refractivo se ha convertido en una parte importante de la práctica clínica, ante la ausencia de un tratamiento protocolizado con el objetivo de disminuirla, se han valorado varias opciones terapéuticas. El objetivo del estudio fue proporcionar información actualizada sobre el tratamiento óptico en niños miopes. Para su realización se revisaron publicaciones, en idioma español e inglés, disponibles en bases de datos como PubMed, Ebsco, Google Académico, SciELO entre otras(AU)
Myopia constitutes a worldwide public health problem, and is expected to affect an increasing number of people in the coming decades. The control of the progression of this refractive defect has become an important part of clinical practice, and in the absence of a protocolized treatment with the aim of reducing it, several therapeutic options have been evaluated. The aim of the study was to provide updated information on optical treatment in myopic children. For its realization, publications were reviewed, in Spanish and English, available in databases such as PubMed, Ebsco, Google Scholar, SciELO, among others(AU)
Subject(s)
Humans , Child , Evidence-Based Practice/methods , Myopia , Review Literature as Topic , Databases, BibliographicABSTRACT
Purpose: To investigate the knowledge of myopia and its natural history including complications and clinical approaches for management adopted by optometrists across India. Methods: An online survey was distributed to Indian optometrists. A pre?validated questionnaire was adopted from previous literature. Respondents provided information about their demographics (gender, age, practice location, and modality), myopia knowledge, self?reported practice behaviors relating to childhood myopia, the information and evidence base used to guide their practice, and perceived extent of adult caregiver engagement in making management decisions for myopic children. Results: A total of 302 responses were collected from different regions of the country. Most respondents demonstrated knowledge of the association between high myopia and retinal breaks, retinal detachment and primary open?angle glaucoma. Optometrists used a range of techniques to diagnose childhood myopia, with a preference for non?cycloplegic refractive measures. The most common approaches to management were single?vision distance despite most optometrists identifying orthokeratology and low?dose (0.01%) topical atropine as two potentially more effective therapeutic interventions for controlling childhood myopia progression. Almost 90% of respondents considered increasing the time spent outdoors to be beneficial for reducing the rate of myopia progression. The main sources of information used to guide clinical practice were continuing education conferences, seminars, research articles, and workshops. Conclusion: Indian optometrists appear to be aware of emerging evidence and practices, but are not routinely adopting measures. Clinical guidelines, regulatory approval, and sufficient consultation time may be of value for assisting practitioners in making clinical decisions based on the current available research evidence
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Purpose: Low?concentration atropine is an emerging therapy for myopia progression, but its efficacy remains uncertain among high myopic children. This study aimed to evaluate the efficacy and safety of low?concentration atropine eye drop (0.01%) in high myopic children. Methods: A non?randomized, parallel?group, longitudinal interventional cohort study. Myopic children were divided into two groups: (1) the intervention arm of children who received one drop of topical 0.01% atropine once a day at bedtime and (2) the control arm, in which enrolled children who were on observation only. Repeated measurements of spherical equivalent refractive errors (SERs) were performed at baseline and 1 and 2 years after treatment. Results: A total of 37 eyes were enrolled in the intervention arm (allocated to 0.01% atropine at year 1 follow?up) and 23 eyes in the control arm. After 1 year of 0.01% atropine therapy, the myopia progression was 0.15 ± 0.9 D in the intervention group versus 1.1 ± 1 D in the control group (P = 0.001). Similarly, after 2 years of treatment, the myopia progression was 0.3 ± 1.1 D in the intervention group versus 1.4 ± 1.1 D in the control group (P ? 0.001). Conclusion: Compared to no treatment, 0.01% atropine treatment had shown better effect on myopia progression in high myopic children
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Purpose: This study was performed to compare the rate of progression of myopia before and during the COVID?19 pandemic and to assess the risk factors of hastened progression. Methods: All children with myopia of spherical equivalence ? ?0.5 D with at least two prior documented refractions 6 months and 1 year before were included. The annual progression rate before COVID?19 and during COVID?19 was calculated. Annual myopia progression was categorized as no progression (0), slow progression (<1 D), and fast progression (?1 D). Results: A total of 133 children (266 eyes) aged 6–18 years were included in the study. Mean annual myopia progression was found to be statistically significant during COVID?19 as compared with pre?COVID?19 (0.90 vs 0.25 D, P < 0.00001). A total of 45.9% of children showed an annual progression of ?1 D during the pandemic as compared with 10.5% before the COVID?19 (p < 0.00001). In multivariate analysis, history of rapid progression in pre?COVID?19 era (P = 0.002) and sun exposure <1 h/ day (P < 0.00001) were found to be independent risk factors for rapid myopia progression. Conclusion: Parents should consider risk of rapid myopia progression in children during current pandemic and children should be provided with socially distant outdoor activities to increase their sun exposure and diminish the rate of myopia progression
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Purpose: To develop a consensus statement for use of dilute atropine in control of myopia progression in children based on review of existing literature, opinions and suggestions of the members of the Group of Paediatric Ophthalmologist and Strabismologists, Mumbai (GPOS). Methods: Literature review, group discussions, questionnaire study and consensus building by supermajority voting. Results: About 65% of paediatric ophthalmologists in Mumbai have started prescribing atropine sulphate 0.01% as routine in their patients showing myopia progression. Majority of the respondents who have used it for >1 year in their patient population are extremely happy with the results. About 47% respondents expressed concerns regarding some yet unknown side effects of long-term use in our patient population. Majority of the respondents agree that it is safe and have rarely encountered side effects with its use. Conclusion: Atropine sulphate 0.01% is a safe and effective treatment for myopia control. Most trained paediatric ophthalmologists recommend its use in children with progressive simple myopia.
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PURPOSE: To investigate the change of refractive error between the full-correction and under-correction treatment groups of myopic anisometropic patients. METHODS: This study included 36 patients who had no amblyopia with myopic anisometropia > 3.00 diopters (D) and less than 6.00 D using the cycloplegic refraction test. The patients were divided into two groups involving the full-correction of both eyes (group 1) or full-correction on the less myopic eye and under-correction with −0.50 D of the more myopic eye (group 2). We monitored refractive changes every 6 months for 24 months. RESULTS: At the first visit, the mean refractive error of the less myopic eye was −0.68 ± 0.54 D and that of the more myopic eye was −4.22 ± 0.77 D in group 1. The mean refractive error of the less myopic eye was −0.75 ± 0.58 D and that of the more myopic eye was −4.36 ± 0.73 D in group 2. There was no significant difference between the groups (p = 0.713 and p = 0.585, respectively). At 24 months, the mean refractive errors of group 1 were −1.27 ± 0.54 D and −4.88 ± 0.81 D, respectively, and that of group 2 were 1.38 ± 0.54 D and −5.59 ± 1.01 D, respectively. The mean refractive error of the less myopic eyes showed no significant difference between both groups (p = 0.555), but that of the more myopic eyes was significantly different (p = 0.027). Between both groups, the degree of anisometropia at 24 months was 3.61 ± 0.60 in group 1 and 4.20 ± 0.86 in group 2. Group 2 showed a significant difference and more severe anisometropic changes (p = 0.022). CONCLUSIONS: Full correction of myopic anisometropia without amblyopia is a better method for reducing the progression of anisometropia.
Subject(s)
Humans , Amblyopia , Anisometropia , Methods , Myopia , Refractive ErrorsABSTRACT
PURPOSE: To compare myopia progression in patients with astigmatism over 3.0 dipoters and in patients with astigmatism with less than 1.0 diopter. METHODS: Between March 2001 and March 2006, regular refraction was performed in patients without amblyopia or strabismus. Patients with astigmatism over 3.0 diopter were classified into subject group, and patients with astigmatism less than 1.0 diopter were classified into control group. We performed cycloplegic refraction at the first visit, and manifest refraction at follow-up examination. Minimal follow-up period was 12 months. Data analysis was performed with T-test and ANOVA. RESULTS: There was no difference in myopia progression in patients with astigmatism over 3.0 dipoters and in patients with astigmatism with less than 1.0 diopter. Age, sex, type of astigmatism, spherical equivalent, age to start wearing glasses, and time to watch television and computer didn't show significant influence on myopic progression in subject group and control group. Patients with astigmatism over 3.0 diopters in one eye and astigmatism less than 3.0 diopters in the other eye were evaluated and there was no difference in myopia progression between both eyes. Eyes with non-progressive astigmatism over 3.0 diopters showed similar myopia progression with eyes with progressive astigmatism over 3.0 diopters. CONCLUSIONS: There was no difference in myopia progression between patients with astigmatism over 3.0 dipoters and patients with astigmatism with less than 1.0 diopter.