Therapeutic effects of orthokeratology lens combined with 0.01% atropine eye drops on juvenile myopia / Efeitos terapêuticos da lente de ortoceratologia combinados com colírio atropina 0,01% em miopia juvenil

ABSTRACT Purpose: To explore the therapeutic effects of orthokeratology lens combined with 0.01% atropine eye drops on juvenile myopia. Methods: A total of 340 patients with juvenile myopia (340 eyes) treated from 2018 to December 2020 were divided into the control group (170 cases with 170 eyes, orthokeratology lens) and observation group (170 cases with 170 eyes, orthokeratology lens combined with 0.01% atropine eye drops). The best-corrected distance visual acuity, best-corrected near visual acuity, diopter, axial length, amplitude of accommodation, bright pupil diameter, dark pupil diameter, tear-film lipid layer thickness, and tear break-up time were measured before treatment and after 1 year of treatment. The incidence of adverse reactions was observed. Results: Compared with the values before treatment, the spherical equivalent degree was significantly improved by 0.22 (0.06, 0.55) D and 0.40 (0.15, 0.72) D in the observation and control groups after the treatment, respectively (p<0.01). After the treatment, the axial length was significantly increased by (0.15 ± 0.12) mm and (0.24 ± 0.11) mm in the observation and control groups, respectively, (p<0.01). After the treatment, the amplitude of accommodation significantly declined in the observation group and was lower than that in the control group, whereas both bright and dark pupil diameters significantly increase and were larger than those in the control group (p<0.01). After the treatment, the tear-film lipid layer thickness and tear break-up time significantly declined in the two groups (p<0.01). Conclusions: Orthokeratology lens combined with 0.01% atropine eye drops can synergistically enhance the control effect on juvenile myopia with high safety.

RESUMO Objetivo: Explorar os efeitos terapêuticos das lentes de ortoceratologia combinados com colírio atropina 0,01% em miopia juvenil. Métodos: Um total de 340 pacientes com miopia juvenil (340 olhos) tratados entre 2018 e Dezembro de 2020 foram divididos em Grupo Controle (170 casos com 170 olhos, lentes de ortoceratologia) e Grupo Observação (170 casos com 170 olhos, lentes de ortoceratologia combinadas com colírio atropina 0,01%). A acuidade visual melhor corrigida para longe, acuidade visual melhor corrigida para perto, dioptria, comprimento axial, amplitude de acomodação, diâmetro da pupila brilhante, diâmetro da pupila escura, espessura da camada lipídica da película lacrimal e tempo de ruptura do rasgo foram medidos antes do tratamento e 1 ano depois. A incidência de reações adversas foi observada. Resultados: Antes do tratamento, o grau esférico equivalente foi significativamente melhorado em 0,22 (0,06, 0,55) D e 0,40 (0,15, 0,72) D respectivamente no Grupo Observação e no Grupo Controle após o tratamento (p<0,01). Após tratamento, o comprimento axial foi significativamente aumentado em (0,15 ± 0,12) mm e (0,24 ± 0,11) mm respectivamente nos Grupos Observação e controle (p<0,01), enquanto, no grupo de observação, a amplitude de acomodação diminuiu significativamente e foi inferior a do Grupo Controle, e o diâmetro da pupila brilhante e o diâmetro da pupila escura aumentaram significativamente e foram maiores do que os do Grupo Controle (p<0,01). A espessura da camada lipídica da película lacrimal e o tempo de ruptura do rasgo diminuíram significativamente nos dois grupos (p<0,01) após o tratamento. Conclusões: As lentes de ortoceratologia combinadas com colírio atropina 0,01% podem melhorar significativamente o efeito controle em miopia juvenil com elevada segurança.

Accuracy of the ratio of axial length to corneal radius in the assessment of myopia in children and adolescents / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the accuracy of the ratio of axial length(AL)to the average corneal radius(CR)(AL/CR value, i.e., axial ratio)in assessing myopia in children and adolescents.METHOD:Cross-sectional study. A total of 340 cases(680 eyes)of children and adolescents aged 4-16 years old were collected from the ophthalmology clinic of Shangyu People's Hospital of Shaoxing between January 2022 and October 2022. All patients were subjected to optometry after cycloplegia to obtain spherical equivalent(SE), check and record the patient's AL, average CR, and calculate the AL/CR value.RESULTS:All subjects in this study underwent optometry after cycloplegia, and a total of 609 eyes(89.6%)were found to have myopia(SE≤-0.50 D), 58 eyes(8.5%)with hyperopia(SE≥+0.50 D)and 13 eyes(1.9%)with emmetropia(-0.50 D&#x0026;#x003E;SE&#x0026;#x003E;+0.50 D). There was a statistically significant difference in SE, AL and AL/CR values among different refractive states(P&#x0026;#x003C;0.01), but there was no difference in CR(P&#x0026;#x003E;0.05). All subjects have refractive parameters: SE +8.75--8.75(average -2.25±2.38)D; AL 19.91-27.54(average 24.41±1.22)mm; CR 7.17-8.71(average 7.83±0.27); AL/CR values range from 2.50-3.50(average 3.12±0.14), correlation analysis showed a relative strong negative correlation between SE and AL/CR and AL(r=-0.891, P&#x0026;#x003C;0.01; r=-0.758, P&#x0026;#x003C;0.01), but no significant correlation between SE and CR(r=0.067, P&#x0026;#x003E;0.05), there was a positive correlation between AL and CR(r=0.483, P&#x0026;#x003C;0.01). The linear relationships between SE and AL/CR, AL were SE=45.026-15.162×AL/CR, R2=0.794, SE=33.741-1.474×AL, R2=0.574, respectively. The gold standard was based on the optometric results of cycloplegia, the sensitivity, specificity, misdiagnosis rate and missed diagnosis rate of AL/CR value for myopia were 0.962, 0.839, 0.169, 0.038, respectively, and the accuracy was 94.85%, the Kappa coefficient was 0.742, and the area under the ROC curve was 0.972.CONCLUSION:With high qualitative diagnostic value for myopia and a certain clinical significance for myopia monitoring, AL/CR value can be used to guide myopia prevention and control and other related ophthalmic clinical work.

Control effect of high aspherical lenticule in children and adolescents with low myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To explore the effect of high aspherical lenticule on controlling low myopia.METHODS: Prospective study. A total of 100 patients aged 7 to 12 years old with low myopia who visited our hospital from May 1 to 31, 2022 were collected. They were divided into two groups with 50 cases in each group according to the wishes of patients. The control group was given single vision glasses after optometry, while the study group was given high aspherical lenticule. The myopia progression(absolute value), axial length(AL)growth, transition rate to moderate myopia, and AL negative growth rate over 6 mo and 1 a were compared between the two groups.RESULTS: The myopia progression and the AL growth of study group was lower than that of the control group after 6 mo and 1 a(all P&#x0026;#x003C;0.001).The negative growth rate of AL after 6 mo of treatment was significantly higher than that of the control group(P&#x0026;#x003C;0.001). The transition rate to moderate myopia between the two groups was not statistically significant(P=0.62); while the transition rate to moderate myopia in the study group was significantly lower than that in the control group after wearing lens for 1 a(P&#x0026;#x003C;0.001), and there was no statistically significant difference in AL negative growth rate between the two groups(P=0.12). Compare with single vision glasses, high aspherical lenticule achieved an 88.2% control rate for low myopia progression over 6mo and a 90.0% control rate of AL growth. The control rate for low myopia to moderate myopia was 66.7%; while the control rate of myopia progression growth was 75.6% after wearing lens for 1a, the control rate of AL growth was 69.2%, and the control rate of the transition rate to moderate myopia was 88.9%.CONCLUSION: For children and adolescents aged 7 to 12 with low myopia, high aspherical lenticule was more effective than single vision glasses in controlling myopia, making it one of the optimal choices for myopia control.

Research progress on the stress-strain index of Corvis ST / 国际眼科杂志(Guoji Yanke Zazhi)

Corneal visualization Scheimpflug technology(Corvis ST)is currently the most commonly used clinical device for assessing in vivo corneal biomechanics. The new parameter stress-strain index(SSI)has been a hot topic of clinical research in recent years, which not only directly reflect corneal biomaterial stiffness, but also closely correlates with the progression of certain diseases. SSI was generated based on the predictions of corneal behavior using finite element(FE)numerical modeling to simulate the effects of intraocular pressure and Corvis ST jets. The SSI algorithm does not change with central corneal thickness(CCT), intraocular pressure, or biomechanically corrected intraocular pressure(BIOP), but it is clearly associated with altered collagen fibres in the corneosclera. The principles of SSI, the relationship between age and SSI, the relationship between axial length and SSI, the relationship between myopia and SSI, and the application of SSI are summarized and concluded.

Role of spherical aberration and coma in orthokeratology for myopia control / 国际眼科杂志(Guoji Yanke Zazhi)

As a highly prevalent global condition, myopia significantly impacts the ocular health of young individuals in China. Orthokeratology lens, as a rigid corneal contact lens, has demonstrated effective control over the progression of myopia; however, its mechanism of action remains incompletely elucidated. As one of the factors influencing visual acuity, higher-order aberrations will undergo marked changes after orthokeratology, with particular emphasis on the alterations in spherical aberrations and coma. The changes in corneal morphology induced by orthokeratology lead to significant positive increase in both spherical aberration and coma. Furthermore, the elevation of spherical aberration and coma demonstrates a negative correlation with the rate of axial length growth following orthokeratology. The interplay among spherical aberration, coma, defocus, accommodation, astigmatism, and pseudo-accommodation may constitute the underlying mechanism governing the control of myopia through orthokeratology.

Modificaciones biométricas en paciente miopes con implante de la lente fáquica ACRIOL 128

Objetivo: Determinar las modificaciones biométricas en pacientes miopes con implante de la lente fáquica ACRIOL 128. Métodos: Se realizó un estudio transversal con 31 ojos (17 pacientes) con alta miopía tratados con implante de lente fáquica ACRIOL 128, entre septiembre 2016 y febrero 2019, los cuales tenían mediciones biométricas preoperatorias con el sistema IOL Master 3.0.2 y estabilidad refractiva posoperatoria (≤ 0,5 dioptrías) después de los tres meses del implante. Se les efectuaron las mediciones posoperatorias con el propio IOL Master 3.0.2 en modo lente fáquica y con el sistema Scheimpflug Pentacam AXL para compararlas, mediante la prueba t para datos pareados, con una significación del 95 %. Resultados: La edad promedio fue de 29,82 ± 5,99 años, el 82,4 % del sexo femenino. El equivalente esférico preoperatorio medio fue de -12,00 ± 4,10 dioptrías. La diferencia de longitud axial y profundidad de la cámara anterior en milímetros entre el pre- y posoperatorio fue significativa con IOL Master 3.0.2 (0,13 ± 0,33 y -0,08 ± 0,17) y Pentacam AXL (0,12 ± 0,32 y -0,10 ± 0,24), respectivamente. Sin embargo, las posoperatorias entre ambos equipos no fueron significativas (p>0,05) para estas variables, pero sí para las queratometrías. Conclusiones: El implante de la lente fáquica ACRIOL 128 modifica la medición de la longitud axial y la profundidad de la cámara anterior. El IOL Master 3.0.2 y el Pentacam AXL ofrecen mediciones de longitud axial y profundidad de cámara anterior posoperatorias similares, no así para las queratometrías.

Objective: To determine the biometric modifications in myopic patients with ACRIOL 128 phakic lens implantation. Methods: A cross-sectional study was performed on 31 eyes (17 patients) with high myopia treated with ACRIOL 128 phakic lens implant, between September 2016 and February 2019, which had preoperative biometric measurements with the IOL Master 3.0.2 system and postoperative refractive stability (≤ 0.5 diopters) after three months of implantation. Postoperative measurements were performed with the IOL Master 3.0.2 in phakic lens mode and with the Scheimpflug Pentacam AXL system for comparison, using the t-test for paired data, with 95% significance. Results: The average age was 29.82 ± 5.99 years, 82.4% female. The mean preoperative spherical equivalent was -12.00 ± 4.10 diopters. The difference in axial length and anterior chamber depth in millimeters between pre- and postoperative was significant with IOL Master 3.0.2 (0.13 ± 0,33 and -0.08 ± 0.17) and Pentacam AXL (0.12 ± 0.32 and -0.10 ± 0.24), respectively. However, postoperative between the two teams were not significant (p > 0.05) for these variables but significant for keratometries. Conclusions: Implantation of the ACRIOL 128 phakic lens modifies the measurement of axial length and anterior chamber depth. The IOL Master 3.0.2 and Pentacam AXL provide similar postoperative axial length and anterior chamber depth measurements, but not for keratometries.

Comparison between ocular biometry parameters in patients with unilateral congenital glaucoma

Purpose: To compare the axial length (AL) and corneal diameter between glaucomatous eye (GE) and fellow normal eye (NE) in patients with unilateral congenital glaucoma and to obtain a normative database for ocular growth among Indian children below 3 years of age. Methods: Retrospective longitudinal study. Patients who had a follow?up of 3 years from diagnosis with ocular biometry parameters being recorded at least thrice (once a year) and fellow eye being normal were included. Data collected were age, gender, intraocular pressure (IOP), AL, corneal diameter, optic disc findings, diagnosis, and surgery details. Results: Eleven patients were analyzed. All GE underwent combined trabeculotomy with trabeculectomy. Mean (SD) baseline IOP, AL, and corneal diameter were 17.1 (6.7) mmHg, 18.9 (1.1) mm and 12 (0.91) mm in GE, and 11.1 (3.8) mmHg, 17.8 (0.44) mm, and 10.5 (0.58) mm in NE, respectively. Increase in AL was 3.1 mm in the first year followed by 0.6 mm in second year and 0.4 mm in third year in GE compared to 2.6, 0.6, and 0.5 mm in NE, respectively. Corneal diameter increased by 1.1 mm in GE in the first year and remained stable thereafter compared to 0.7 mm in first year followed by 0.3 mm in second year and stable thereafter in NE. The percentage of success was 73% at 3 years. Conclusion: Axial length and corneal diameter were higher in GE than NE at all?time points. With prompt intervention, the growth curve of the GE was made parallel to that of NE.

Simplifying biometry in oil-filled eyes: A novel formula for axial length calculation in eyes with 1000 cSt silicone oil

Purpose: To derive a formula for accurate axial length (AL) assessment using routine ultrasound in silicone oil?filled eyes, where optical biometry is unavailable or not possible. Methods: This was a prospective, consecutive, nonrandomized study of 50 eyes of 50 patients conducted in a tertiary care hospital in North India. AL measurements were taken using both manual A?scan and IOL master, both in silicone oil?filled status and 3 weeks after silicone oil removal. A correction factor of 0.7 was used for AL adjustment in oil?filled eyes. The corrected AL (cAL) was compared with IOL master values in oil?filled eyes. Agreement analysis was carried out using Bland Altman plot. Linear regression analysis was done using uncorrected manual AL to find a new equation. Data was analyzed using Stata 14. A P value <0.05 was taken as significant. Results: The study included 40 males and 10 females, with an age range of 6–83 years (mean 41.9 years). The mean AL of the oil?filled eye as measured by manual A?scan was 31.76 mm ± 3.09 and by IOL master was 24.7 mm ± 1.74. Linear regression analysis was performed in randomly selected 35 eyes of the observed data to obtain a new equation: predicted AL (PAL) = 14 + 0.3 × manual AL. The mean difference between PAL and optically measured AL with silicone oil in situ was 0.98 ± 1.67. Conclusion: We propose a new formula for better prediction of the correct AL in silicone oil?filled eyes using ultrasound?based AL measurement.

Prediction of spherical equivalent refraction and axial length in children based on machine learning

Purpose: Recently, the proportion of patients with high myopia has shown a continuous growing trend, more toward the younger age groups. This study aimed to predict the changes in spherical equivalent refraction (SER) and axial length (AL) in children using machine learning methods. Methods: This study is a retrospective study. The cooperative ophthalmology hospital of this study collected data on 179 sets of childhood myopia examinations. The data collected included AL and SER from grades 1 to 6. This study used the six machine learning models to predict AL and SER based on the data. Six evaluation indicators were used to evaluate the prediction results of the models. Results: For predicting SER in grade 6, grade 5, grade 4, grade 3, and grade 2, the best results were obtained through the multilayer perceptron (MLP) algorithm, MLP algorithm, orthogonal matching pursuit (OMP) algorithm, OMP algorithm, and OMP algorithm, respectively. The R2 of the five models were 0.8997, 0.7839, 0.7177, 0.5118, and 0.1758, respectively. For predicting AL in grade 6, grade 5, grade 4, grade 3, and grade 2, the best results were obtained through the Extra Tree (ET) algorithm, MLP algorithm, kernel ridge (KR) algorithm, KR algorithm, and MLP algorithm, respectively. The R2 of the five models were 0.7546, 0.5456, 0.8755, 0.9072, and 0.8534, respectively. Conclusion: Therefore, in predicting SER, the OMP model performed better than the other models in most experiments. In predicting AL, the KR and MLP models were better than the other models in most experiments.

Effectiveness of 0.01% atropine in anisomyopic children

Purpose: To investigate the change in ocular parameters of anisomyopic children treated with 0.01% atropine. Methods: This retrospective study analyzed the data of anisomyopic children who underwent comprehensive examination at a tertiary eye center in India. Anisomyopic subjects (difference of ?1.00 D) of age 6–12 years who were treated with 0.01% atropine or prescribed regular single vision spectacle and had follow?ups of more than 1 year were included. Results: Data from 52 subjects were included. No difference was observed in the mean rate of change of spherical equivalent (SE) of more myopic eyes between 0.01% atropine (?0.56 D; 95% confidence interval [CI]: ?0.82, ?0.30) and single vision lens wearers (?0.59 D; 95% CI: ?0.80, ?0.37; P = 0.88). Similarly, insignificant change in the mean SE of less myopic eyes was noted between the groups (0.01% atropine group, ?0.62 D; 95% CI: ?0.88, ?0.36 vs. single vision spectacle wearer group, ?0.76 D; 95% CI: ?1.00, ?0.52; P = 0.43). None of the ocular biometric parameters showed any difference between the two groups. Though anisomyopic cohort treated with 0.01% atropine revealed a significant correlation between the rate of change of mean SE and axial length in both eyes (more myopic eyes, r = ?0.58; P = 0.001 and less myopic eyes, r = ?0.82; P < 0.001) compared to single vision spectacle wearer group, the change was not significant. Conclusion: Administration of 0.01% atropine had minimal effect on reducing the rate of myopia progression in anisomyopic eyes.

Relatively anterior lens position in primary angle-closure glaucoma eyes with long axial length

Purpose: To evaluate the refractive status and ocular biometric parameters in primary angle?closure glaucoma (PACG) eyes with different axial lengths (ALs). Methods: In total, 742 Chinese PACG subjects with complete ophthalmic examinations were enrolled. The refractive status was categorized as myopia (spherical equivalent [SE] ??0.5 D), emmetropia (?0.5 D < SE < +0.5 D), and hyperopia (SE ?+0.5 D), whereas the AL was divided into short (AL <22.5 mm), regular (22.5 ? AL <23.5 mm), and long (AL ?23.5 mm). The refractive status and ocular biometric parameters were compared among different AL groups. Results: The mean AL of the PACG eyes was 22.53 ± 0.84 mm (range: 19.68–25.57 mm). The refractive status was significantly different among different AL groups (P < 0.001). Also, 92.6% of hyperopic PACG eyes showed AL <23.5 mm, and 19.0% of myopic PACG eyes showed AL ?23.5 mm. The SE showed significant differences among different AL groups only in the hyperopic subjects (P = 0.012). The AL was significantly longer in myopic eyes (P < 0.001). The PACG eyes with longer AL exhibited lower keratometry, longer central anterior chamber depth and corneal diameter, and lens position and relative lens position closer to the anterior (P < 0.001). Conclusion: Axial hyperopia was common in PACG eyes, and axial myopia was not uncommon. Relatively anterior lens position could explain the occurrence of PACG in the eyes with long AL.

Myopia, axial length, and optic coherence tomography characteristics of the macula in Indian children

Background: Myopia is a common condition affecting a significant proportion of the pediatric population in Asian countries. Aim and Objectives: This study was undertaken to investigate the associations of optical coherence tomography measurements of macular volume and macular thickness with refractive error and axial length in Indian children. Materials and Methods: The prospective observational study was carried out at MRA Medical College, Ambedkar Nagar, Uttar Pradesh. We enrolled 300 consecutive cases (190 cases and 110 controls) of pediatric age group (6–18 years) between January 2015 and December 2018. Pearson’s correlation was performed with refractive errors, axial length, macular thickness, and volume. Results: Children with myopia (SE ?0.5–?4.57 D) tended to have smaller total macular volume and thinner macular thickness as, compared to control. The correlation of macular thickness and macular volume was analyzed with spherical equivalent (SE) and axial length. Macular thickness had negative correlation with SE and positive with axial length, correlation coefficients being observed as (r = ?0.886 and 0.880, P ? 0.001). Total macular volume correlated negatively with SE, (r= ?0.771, P ?0.001) and positively with axial length (r = 0.764, P ?0.001). Conclusion: Increasing axial myopia was associated with increased macular volume and thickness. It establishes the importance of the fact that refractive error should be considered in the interpretation of macular thickness.

Agreement between corneal diameter measurements obtained with an optical biometer and a Placido-based topographer / Acordo de medições do diâmetro da córnea obtidas por um biômetro óptico e um topógrafo com base em Plácido

ABSTRACT Purpose: The purpose of this study was to compare the white-to-white distance measurements of two devices (IOL Master 500 and Atlas corneal topographer) commonly used in clinical practice to determine if they were interchangeable. Providing information on instrument interchangeability could eliminate several unnecessary tests and consequently reduce the economic burden for the patient and society. Methods: In this prospective, comparative case series, the white-to-white distance was measured by independent examiners using the Atlas topographer (Carl Zeiss Meditec) and the IOL Master 500 (Carl Zeiss Meditec). One eye each of 184 patients was tested. Statistical analyses were performed using a paired t-test, Pearson correlation analysis, and Bland-Altman analysis to compare the measurement methods. Results: The mean white-to-white distance measurements with the Atlas topographer and the IOL Master 500 were 12.20 ± 0.44 mm and 12.12 ± 0.41 mm, respectively (p<0.001). The mean white-to-white difference between the two devices was 0.07 mm (95% confidence interval of mean difference: 0.04-0.11 mm). The Pearson correlation coefficient between the two devices was 0.85 (p<0.0001). The 95% limits of agreement between the two devices were -0.38 mm to 0.53 mm. Conclusions: The Atlas topographer and IOL Master 500 can be used interchangeably with respect to white-to-white distance measurements, as the range of differences is unlikely to affect clinical practice and decision making.

RESUMO Objetivo: O objetivo deste estudo é comparar as medições de diâmetro corneano de dois dispositivos normalmente utilizados na prática clínica (IOL Master 500 e Atlas topógrafo corneal) para ver se são permutáveis. O fornecimento de informações sobre a permutabilidade de instrumentos poderia eliminar vários testes desnecessários e, consequentemente, reduzir a carga econômica para o paciente e para a sociedade. Métodos: Nesta série de casos prospectivos e comparativos, a distância do diâmetro corneano foi medida por examinadores independentes utilizando o Topógrafo Atlas (Carl Zeiss Meditec) e o IOL Master 500 (Carl Zeiss Meditec), em um olho de 184 pacientes. A análise estatística foi realizada utilizando o teste t pareado, a correlação Pearson e a análise Bland-Altman para comparar os métodos de medição. Resultados: As medições médias da distância do diâmetro corneano com o topógrafo Atlas e o IOL Master 500 foram de 12,20 ± 0,44 mm e 12,12 ± 0,41 mm, respectivamente (p<0,001). A diferença média de WTW entre os dois dispositivos foi de 0,07 mm (intervalo de confiança de 95% da diferença média: 0,04 - 0,11 mm). O coeficiente de correlação Pearson entre os dois dispositivos foi de 0,85, p<0,0001. Os limites de concordância de 95% entre os dois dispositivos foram de -0,38 mm a 0,53 mm. Conclusões: O Atlas topographer e o IOL Master 500 podem ser utilizados permutavelmente em relação à medição do diâmetro corneano, uma vez que a gama de diferenças encontradas é pouco susceptível de afetar a prática clínica e a tomada de decisões.

Association between axial length and level of education in elderly patients with cataracts unexposed to electronic devices in the first two decades of life / Associação entre diâmetro axial e nível educacional em pacientes idosos com catarata não expostos a dispositivos eletrônicos nas duas primeiras décadas de vida

ABSTRACT Purpose: To determine whether the axial length is associated with the education level in elderly patients with cataracts who were not exposed to electronic devices in the first two decades of life. Methods: This cross-sectional study was conducted in elderly patients with cataracts in Campinas, Brazil. Patients were divided into 2 groups: Group 1 included those who completed, at most, elementary school (including the illiterate and those who partially or totally attended elementary school), which corresponded to 12 years of schooling; Group 2 included, at least, high school graduates (including those who completed high school and those who partially or fully attended university). The sample was selected randomly with stratification for sex and age. The main outcome was the axial length. Results: The sample consisted of 472 elderly patients (236 per group) who underwent cataract surgery. There were 272 (57.6%) men and 200 (42.4%) women; the distribution was symmetrical between the two groups. The median age (IQR; range) was 66 (12; 50-89) years. The median axial length (IQR; range) was 22.82 (1.51; 20.34-28.71) mm in Group 1 and 23.32 (1.45; 20.51-31.34) mm in Group 2 (p<0.001). Conclusion: A greater axial length was associated with a higher level of education in elderly patients with cataracts, suggesting that myopization is related to an increase in activities requiring near-vision even before exposure to electronic devices.

RESUMO Objetivo: Determinar se o diâmetro axial está asso­ciado ao nível educacional em pacientes idosos com catarata que não foram expostos a dispositivos eletrônicos nas duas primeiras décadas de vida. Métodos: Este estudo transversal foi conduzido em pacientes idosos com catarata na cidade de Campinas, Brasil. Os Pacientes foram divididos em 2 grupos: no Grupo 1 foram incluídos aqueles que completaram, pelo menos, o ensino fundamental (incluindo analfabetos e aqueles com ensino fundamental completo ou incompleto), o que corresponde a 12 anos de escolaridade; no Grupo 2 foram incluídos indivíduos que, pelo menos, estudaram até o ensino médio (incluindo indivíduos com ensino médio completo e superior completo ou superior incompleto). A amostra foi selecionada aleatoriamente com estratificação por sexo e idade. O desfecho principal foi a medida do diâmetro axial. Resultados: A amostra foi constituída por 472 indivíduos que foram submetidos a cirurgia de catarata. Duzentos e trinta e seis indivíduos (50%) foram alocados no Grupo 1 e duzentos e trinta e seis indivíduos (50%) no Grupo 2. A mediana da idade (IIQ; intervalo) foi 66 (12; 50-89) anos. Duzentos e setenta e dois (57,6%) eram homens e duzentos (42,4%) mulheres, com distribuição simétrica entre os dois grupos. A mediana do diâmetro axial (IIQ; intervalo) foi 22,82 (1,51; 20,34-28,71) mm no Grupo 1 e 23,32 (1,45; 20,51-31,34) mm no Grupo 2 (p<0,001). Conclusão: Maiores medidas de diâmetro axial foram asso­ciadas a níveis educacionais mais elevados em pacientes idosos submetidos a cirurgia de catarata. Tal achado sugere que a miopização relacionada ao aumento de atividades que utilizam a visão de perto é fenômeno que ocorre antes mesmo da exposição a dispositivos eletrônicos.

The influencing factors of surgically induced astigmatism in phacoemulsification / 西安交通大学学报(医学版)

【Objective】 To investigate the influencing factors of surgically induced astigmatism (SIA) in phacoemulsification. 【Methods】 Cataract phacoemulsification was performed in 69 patients with regular corneal astigmatism from December 2021 to March 2022. SIA of the anterior corneal surface, posterior corneal surface and simulated keratometry (SimK) in the diameter range of 3 mm, 5 mm and 7 mm centered at the apex of the cornea was observed. Pearson correlation analysis was used to analyze SIA with age, axial length (AL), anterior chamber depth (ACD), white-to-white (WTW), and central corneal thickness (CCT). Multiple linear regression was used to analyze the influencing factors of SIA. 【Results】 The mean age of the 69 patients was (63.25±14.74) years old, and 28 (40.58%) were male. The analysis found that the |SIA| of SimK was negatively correlated with WTW (r=-0.265, P=0.028), the |SIA| of 3 mm, 5 mm, 7 mm anterior surface was negatively correlated with WTW (r=-0.320, P=0.007; r=-0.337, P=0.005; r=-0.287, P=0.017), and the |SIA| of 3 mm, 5 mm, 7 mm posterior surface was negatively correlated with AL (r=-0.390, P=0.001; r=-0.352, P=0.003; r=-0.317, P=0.008). Multiple regression analysis showed that WTW was negatively correlated with |SIA| of SimK, 3 mm, 5 mm, 7 mm anterior surface and 3 mm posterior surface (B=-0.261, P=0.047; B=-0.387, P=0.016; B=-0.323, P=0.009; B=-0.297, P=0.041; B=-0.085, P=0.049). WTW was positively correlated with XSIA of 3 mm anterior surface, YSIA of 5 mm, and 7 mm anterior surface (B=0.347, P=0.040; B=0.318, P=0.034; B=0.403, P=0.010). AL was negatively correlated with |SIA| on the posterior surface of 3 mm and 5 mm (B=-0.023, P=0.021; B=-0.034, P=0.030). 【Conclusion】 During cataract surgery, the effect of ocular biological parameters such as axial length and corneal diameter on SIA should be considered.

Analysis of the correlation between the axial length and diabetic retinopathy in patients with type 2 diabetes mellitus / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the correlation between axial length and diabetic retinopathy(DR)in patients with type 2 diabetes mellitus.METHODS:This study is a cross-sectional study. A total of 53 cases(104 eyes)of type 2 diabetes patients who admitted to the ophthalmology department of the Jining No.1 People's Hospital between January and May 2023 were included. Among these cases, 51 patients had both eyes included, while 2 patients had only one eye included. The patients were divided into two groups based on the presence or absence of fundus lesions. The non-diabetic retinopathy(NDR)group consisted of 32 eyes, and the DR group consisted of 72 eyes. Within the DR group, the patients were further categorized based on the severity of fundus lesions. The non-proliferative diabetic retinopathy(NPDR)group comprised of 27 eyes, and the proliferative diabetic retinopathy(PDR)group consisted of 45 eyes. The axial lengths of eyes in the DR group were divided into four groups using quartiles: 19 eyes in the 20.00～22.09 mm group, 17 eyes in the 22.10～22.70 mm group, 18 eyes in the 22.71～23.12 mm group, and 18 eyes in the 23.13～24.48 mm group. Binary Logistic regression analysis was employed to investigate the factors influencing the occurrence of DR and PDR.RESULTS:Binary Logistic regression analysis showed that both axial length and age significantly influenced the development of DR and PDR.(Axial length: OR=0.296, 95%CI:0.130～0.672, P&#x0026;#x003C;0.05; OR=0.237, 95%CI:0.076～0.736, P&#x0026;#x003C;0.05; age: OR=0.949, 95%CI:0.907～0.994, P&#x0026;#x003C;0.05; OR=0.879, 95%CI: 0.820～0.942, P&#x0026;#x003C;0.05). The risk of PDR in the group with axial length of 23.13～24.48 mm was reduced compared to the group with axial length of 20.00～22.09 mm(OR=0.057; 95%CI: 0.006～0.515, P=0.011).CONCLUSION:The findings indicate that longer axial length in patients with type 2 diabetes are associated with a decreased risk of developing DR, as well as a reduced likelihood of DR progressing to PDR. Therefore, a long axial length can be considered a protective factor against DR.

Comparison of the effects among orthokeratology lens, defocus incorporated multiple segments and single-vision spectacles for the control of myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the control effectiveness among orthokeratology(OK), defocus incorporated multiple segments(DIMS)and single-vision spectacles(SVS)in adolescent myopia.METHODS: Retrospective study. A total of 111 myopic patients(221 eyes)in Ningbo Aier Guangming Eye Hospital from April 2020 to March 2021 were selected, and they were grouped into OK group(42 cases, 83 eyes), DIMS group(30 cases, 60 eyes)and SVS group(39 cases, 78 eyes)according to the method in myopia correction. All patients were followed up for 24mo, and the changes of axial length and spherical equivalent before and after treatment were recorded and analyzed.RESULTS: After 6, 12, 18 and 24mo of treatment, the axial length grew in three groups of patients, and the growth of axial length in SVS group was higher than that in OK group and DIMS group(P&#x0026;#x003C;0.01). After 24mo of treatment, the control effect of axial length with OK and DIMS was 59.7% and 41.7% respectively. After 12, 18 and 24mo of treatment, the spherical equivalent increased in both DIMS and SVS groups, and the increase of spherical equivalent in SVS group was higher than that in DIMS group(P&#x0026;#x003C;0.01). After 24mo of treatment, the control effect of myopia with DIMS was 58.6%.CONCLUSION: Both OK and DIMS showed good clinical effectiveness in the control of adolescent myopia, and the effectiveness of OK is better than that of DIMS.

Comparison of the myopia control effects of orthokeratology lens and peripheral defocus spectacles / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the effect of peripheral defocus spectacles and orthokeratology lenses on the control of axial length in children and adolescents with myopia.METHODS: Prospective study. A total of 71 cases(134 eyes)of children and adolescents with myopia who visited the Second Hospital of Longyan from June 2019 to June 2021 were selected. They were fitted with peripheral defocus spectacles for 12mo and then switched to orthokeratology lenses. The growth of axial length was observed at 3, 6, and 12mo after wearing peripheral defocus spectacles and orthokeratology lenses.RESULTS: The median axial length growth after wearing peripheral defocus spectacles and orthokeratology lenses for 12mo was 0.35 and 0.14mm, respectively. The axial growth at 3, 6, and 12mo after wearing orthokeratology lenses was lower than those after wearing peripheral defocus spectacles(P&#x0026;#x003C;0.001), and the growth rate of axial length was significantly reduced. The patients were divided into a rapid progression group(axial growth ≥0.4 mm, 29 cases, 54 eyes)and a non-rapid progression group(axial growth &#x0026;#x003C;0.4mm, 42 cases, 80 eyes)according to the axial growth of peripheral defocus spectacles for 12mo. The median axial growth after wearing peripheral defocus spectacles for 12mo in the two groups was 0.70 and 0.24mm, respectively, while the median axial growth after wearing orthokeratology lenses was 0.31 and 0.09mm, respectively. The growth rate was reduced by 56% and 63% respectively in the two groups after wearing orthokeratology lens. The axial growth of cases wearing orthokeratology lenses for 12mo in the non-rapid progression group was lower than that in the rapid progression group, and it did not change with age or diopter. There was no significant difference among different ages and different diopters in the rapid progression group(P&#x0026;#x003E;0.05). In the non-rapid progression group, axial growth of cases aged 7-12 years was higher than those aged 13-16 years(P&#x0026;#x003C;0.05), but there was no significant difference among different diopters(P&#x0026;#x003E;0.05).CONCLUSION: Orthokeratology lens is more effective than peripheral defocus spectacles in controlling axial growth in children and adolescents with myopia, and the control effect of orthokeratology lens on rapid-progressing myopia is remarkable.

Clinical observation of acupuncture treatment for children with accommodative myopia / 针灸推拿医学（英文版）

Objective:To observe the effect of acupuncture in the treatment of accommodative myopia in children.Methods:A total of 76 children with accommodative myopia who met the inclusion criteria were divided into a control group or a test group according to the random number table method,with 38 cases in each group.The control group was given education on eye hygiene,and the test group was treated with acupuncture twice a week for 2 months in addition to the intervention used in the control group.The patient's uncorrected visual acuity(UCVA),refraction,and axial length(AL)were measured before treatment and 1 month and 2 months after treatment.Results:After 1 month of treatment,there was no significant difference in the UCVA between the two groups(P＞0.05);after 2 months of treatment,the UCVA of the test group was better than that of the control group(P＜0.05).After 1 and 2 months of treatment,the refraction of the two groups was significantly different from that before treatment(P＜0.01),but there was no significant difference between the two groups(P＞0.05).After 1 and 2 months of treatment,the AL in the control group was increased compared with that before treatment(P＜0.05),while there was no significant change in the test group(P＞0.05),and there was no significant difference between the two groups(P＞0.05).Conclusion:Acupuncture treatment can improve UCVA in children with accommodative myopia.

Research status and progress on the influence of high myopia on ocular structure and visual function / 中华眼底病杂志

High myopia has a high genetic tendency, it not only shows in the excessive elongation of the axial length, but also lends to the formation and progression of various eye lesions, such as peripheral retinopathy, optic disc changes, posterior staphyloma, and myopic maculopathy, due to the mechanical stretching of the axial length to the ocular structure. In addition, high myopia increases the risk of several complications, such as glaucoma, cataract, and corneal disease. All these pathological changes will affect visual function and lead to irreversible vision impairment and blindness in the future. Therefore, it is important to pay attention to screening for optic disc abnormalities and posterior staphyloma, and regular monitor the changes of fundus, intraocular pressure, and lens. At the same time, high myopia has an impact on personal life such as study, psychology, sport, and work, and can reduce the quality of life as well as increase the cost of health care. The clinic should pay more attention to high myopia, prevent and control the development of high myopia from an early stage, in order to minimize its impact on ocular structure and visual function as well as its hazard to personal life and society.