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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<0.001).The negative growth rate of AL after 6 mo of treatment was significantly higher than that of the control group(P<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<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.
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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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@#Myopia is a common ocular disorder. In recent years, the incidence of myopia presents an increasing trend year by year. Patients with high myopia are at an increased risk for severe visual impairment. The economic and societal impacts of complication associated with myopia are enormous. Therefore, it is essential and imminent for implementing effective myopia control strategies. The results of the current study suggest that uncontrolled axial elongation produced by periphral hyperopic defocus could be one of the possible mechanisms for myopia development, multiple strategies especially optical defocus technology based on this are increasingly becoming part of the mainstream clinical practice in myopia management. This article reviews the principle of optical defocus on myopia control, experimental research on defocus myopia animals, and the latest clinical applications of different optical defocus technologies on myopia control, summarizes the clinical research results of myopia control using progressive addition spectacle lenses, peripheral defocus spectacle lenses, defocus incorporated multiple segments spectacle lenses, orthokeratology contact lenses and multifocal soft contact lenses. It is proposed to provide a new option for the treatment plan to delay the progression of myopia.
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@#As the prevalence of myopia continues to increase, our society shows increasing interest in the visual impairment associated with myopia and methods for myopia control. Current methods for myopia control include atropine, orthokeratology, dual-focus contact lenses, multifocal contact lenses, and functional frame glasses, <i>etc</i>. Low-concentration atropine(0.01%, 0.05%)became the first-line medication which has been administrated and shown to be effective in controlling the occurrence and progression of myopia. Meanwhile, low-concentration atropine shows longer-lasting effects, less frequent adverse effects and higher patients' acceptance than high-concentration atropine. This article reviews the efficacy, safety, time-to-treatment, and effects when combined with other treatments to provide evidence for the clinical application of low-concentration atropine on myopia control.
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@#AIM: To observe the control effects of low concentration atropines, orthokeratology, and spectacles on children with myopia in Baotou, and to analyze change rules of myopia-related regulatory parameters for providing bases for myopia preventions and controls.<p>METHODS: We selected 120 children with myopia aged 8-14 years old(240 eyes), treated in Ophthalmology Clinic of the First Affiliated Hospital of Baotou Medical College from June 2018 to December 2018. They were divided into three groups as follows: low concentration atropine group, orthokeratology group, and spectacles group. The accommodative lag, positive relative accommodation, negative relative accommodation, and diopter were followed up at 1, 3, 6, 12mo.<p>RESULTS:During the follow ups of 3, 6, and 12mo. We observed a statistically significant difference in the accommodative lag between the orthokeratology group and low concentration atropine group spectacles group(<i>P</i><0.05). At the 6, 12mo follow up, there was a statistical difference in the accommodative lag between the orthokeratology group and the spectacles group(<i>P</i><0.05). During the follow ups of 3, 6, and 12mo, there was a statistically significant difference in negative relative accommodations among the low concentration atropine group, orthokeratology group, and spectacles group(<i>P</i><0.05). The difference in positive relative accommodations was statistically significant among the orthokeratology group, low concentration atropine group, and spectacles group at each time point during the follow ups(<i>P</i><0.05). During the follow ups of 6, 12mo,the difference of equivalent spherical lens was statistically significant among the low concentration atropine group and spectacles group(<i>P</i><0.05). At the follow up 12mo, the difference between the equivalent spherical lens of the orthokeratology group and the spectacles group was statistically significant(<i>P</i><0.05).<p>CONCLUSION: The effects of three commonly used methods of controlling myopia on the accommodation parameters of myopic children are as follows: orthokeratology can not only solve the problem of hyperopia defocus by reducing accommodation lags but also improve positive relative accommodations, while it should be worn for a prolonged period. Low concentration atropine can improve the negative relative accommodations. However, there may be other ways to control myopia development. Compared to other groups, the spectacles group exerted fewer effects on each adjustment index, and did not demonstrate a significant effect on myopia control.
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@#AIM: To observe the changes of binocular eye accommodation function in correcting anisometropia by monocular orthokeratology in anisometropic children, and to explore the mechanism of regulation in the progression of myopia control by orthokeratology.<p>METHODS: It was a prospective self-control study. A total of 22 anisometropic children(44 eyes), aged 8-13 years, who wore an orthokeratology lens in only one eye were enrolled in the outpatient clinic of Hainan Provincial Eye Hospital from September 2016 to September 2018. The eyes with an orthokeratology lens had a mean spherical equivalent refraction of -2.751±1.16 diopter(D), and fellow eyes without a lens had a refraction of -0.10±0.32D. The eyes wearing orthokeratology lens were used as the lens wearing group, and the fellow eyes without a lens were used as non-wearing lens group. During the follow-up period,we measured changes of diopter difference, monocular accommodative amplitude(MAA), monocular accommodative facility(MAF)and accommodative response(AR)before wearing the lens and wearing the lens for 12mo.<p>RESULTS: The monocular accommodative amplitude and monocular accommodative facility of the wearing group before wearing the lens were lower than those of the non-wear group(<i>P</i><0.01), and the accommodative lag were higher than that of the non-wear group(<i>P</i><0.05). The monocular accommodative amplitude 15.63±1.66D after wearing the lens for 12mo was higher than that before wearing the lens 11.25±3.15D(<i>t</i>=3.63, <i>P</i><0.01), and the difference was not statistically significant(<i>t</i>=0.75, <i>P</i>=0.46)compared with the non-wearing group. The monocular accommodative facility 14.63±1.58 cyc/min after wearing the lens for 12mo was higher than that before wearing the lens 9.25±3.38cyc/min(<i>t</i>=2.83, <i>P</i>=0.01), and the difference was not statistically significant(<i>t</i>=0.38, <i>P</i>=0.71)compared with the non-wearing group. The accommodative lag 0.62±0.29D of the wearing group after 12mo was reduced compared with that before wearing the lens 1.35±0.26D(<i>t</i>=2.57, <i>P</i>=0.02),and compared with the non-wearing group, the difference was not statistical significance(<i>t</i>=0.61, <i>P</i>=0.55). The mean equivalent diopter of the non-lens group was -0.75±0.35D after 12mo, and the number of diopter group increased by -0.65±0.39D(<i>t</i>=4.24, <i>P</i><0.01). The diopter of the wearing group increased by -0.15±0.22D(<i>t</i>=2.90, <i>P</i><0.001), there was a statistically significant difference in the change of diopter between the two groups(<i>t</i>=5.30, <i>P</i><0.01). There was no statistically significant difference in the change of the accommodation before and after 12mo in the non-wear group(<i>P</i>>0.05).<p>CONCLUSION: The accommodation function of anisometropic children in correcting anisometropia by monocular orthokeratology was significantly improved compared with that before wearing the lens and was consistent with the contralateral eyes without lens group. The refractive state of the group wearing orthokeratology lens was more stable, and the contralateral eyes without lens gradually showed mild myopia refractive state, but the accommodation did not change significantly.
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@#AIM: To observe the changes of binocular eye accommodation function in correcting anisometropia by monocular orthokeratology in anisometropic children, and to explore the mechanism of regulation in the progression of myopia control by orthokeratology.<p>METHODS: It was a prospective self-control study. A total of 22 anisometropic children(44 eyes), aged 8-13 years, who wore an orthokeratology lens in only one eye were enrolled in the outpatient clinic of Hainan Provincial Eye Hospital from September 2016 to September 2018. The eyes with an orthokeratology lens had a mean spherical equivalent refraction of -2.751±1.16 diopter(D), and fellow eyes without a lens had a refraction of -0.10±0.32D. The eyes wearing orthokeratology lens were used as the lens wearing group, and the fellow eyes without a lens were used as non-wearing lens group. During the follow-up period,we measured changes of diopter difference, monocular accommodative amplitude(MAA), monocular accommodative facility(MAF)and accommodative response(AR)before wearing the lens and wearing the lens for 12mo.<p>RESULTS: The monocular accommodative amplitude and monocular accommodative facility of the wearing group before wearing the lens were lower than those of the non-wear group(<i>P</i><0.01), and the accommodative lag were higher than that of the non-wear group(<i>P</i><0.05). The monocular accommodative amplitude 15.63±1.66D after wearing the lens for 12mo was higher than that before wearing the lens 11.25±3.15D(<i>t</i>=3.63, <i>P</i><0.01), and the difference was not statistically significant(<i>t</i>=0.75, <i>P</i>=0.46)compared with the non-wearing group. The monocular accommodative facility 14.63±1.58 cyc/min after wearing the lens for 12mo was higher than that before wearing the lens 9.25±3.38cyc/min(<i>t</i>=2.83, <i>P</i>=0.01), and the difference was not statistically significant(<i>t</i>=0.38, <i>P</i>=0.71)compared with the non-wearing group. The accommodative lag 0.62±0.29D of the wearing group after 12mo was reduced compared with that before wearing the lens 1.35±0.26D(<i>t</i>=2.57, <i>P</i>=0.02),and compared with the non-wearing group, the difference was not statistical significance(<i>t</i>=0.61, <i>P</i>=0.55). The mean equivalent diopter of the non-lens group was -0.75±0.35D after 12mo, and the number of diopter group increased by -0.65±0.39D(<i>t</i>=4.24, <i>P</i><0.01). The diopter of the wearing group increased by -0.15±0.22D(<i>t</i>=2.90, <i>P</i><0.001), there was a statistically significant difference in the change of diopter between the two groups(<i>t</i>=5.30, <i>P</i><0.01). There was no statistically significant difference in the change of the accommodation before and after 12mo in the non-wear group(<i>P</i>>0.05).<p>CONCLUSION: The accommodation function of anisometropic children in correcting anisometropia by monocular orthokeratology was significantly improved compared with that before wearing the lens and was consistent with the contralateral eyes without lens group. The refractive state of the group wearing orthokeratology lens was more stable, and the contralateral eyes without lens gradually showed mild myopia refractive state, but the accommodation did not change significantly.
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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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@#AIM: To investigate the related factors of orthokeraology(ortho-K)decentration.<p>METHODS: Within a prospective study, 88 eyes of 88 patients who visited to our center between July 2014 and December 2016 were enrolled. To verify the possible role of the spherical equivalent(SE), the corneal astigmatism(CA), e value, steep K, flat K, front curvature asymmetry index(SIf)and age in the ortho-K location prediction.<p>RESULTS: This study included 24 eyes of grade Ⅰ decentration, 26 eyes with grade Ⅱ, 25 eyes with grade Ⅲ, and 13 eyes with grade Ⅳ, by which based on the decentration system that published by our team. One-way ANOVA showed that there was statically significant difference of SE, Ks and Kf in different grading groups(<i>P</i><0.05). Multiple linear regression analysis showed SE was negatively correlated with the decentration(<i>P</i><0.01). The others factors such as the CA, e, Ks, Kf, SIf, age has weak correlation with the ortho-K decentration.<p>CONCLUSION: The SE might be the main factor which lead to the ortho-K decentration.
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AlM:To evaluate the long-term efficiency and safety of overnight orthokeratology in myopia correction and control in adolescents.METHODS: Sixty-five myopia adolescents treated in our hospital from August 2011 to February 2012 were retrospectively analyzed and followed up to 2a. Among them, 35 cases ( 67 eyes ) wearing overnight orthokeatology were included as trial group, and 30 cases ( 60 eyes ) wearing spectacles were included as control group. The trial group were divided into 2 subgroup according the myopic grading in the initial visit:subgroup A(35 eyes,≤-3. 00D), B subgroup (32 eyes,>-3. 00D and ≤-6. 00D). ln the trial group, slit lamp, visual acuity, refraction, intraocular pressure, corneal tomography were collected before wearing overnight orthokeratology, 1d, 1wk, 1month, 3mo, and every 6mo after wearing overnight orthokeratology , with axial length, corneal thickness, anterior chamber depth, corneal endothelial cell count, abjective refraction and tear film were also collected before and 2a after wearing overnight orthokeratology. ln the control group, slit lamp, visual acuity, refraction and intraocular pressure were collected before wearing and 2a after wearing spectacles. Paired t test were used to compare the intragroup difference. One-way analysis of variance ( ANOVA) was used to compare the differences among the groups. P<0. 05 was considered statistically significant.RESULTS: The uncorrected visual acuity of the trial group was improved obviously after wearing Orthokeratology Lens 1d, the visual acuity of a group patients improved more significantly. The corneal curvature ( including vertical curvature and horizontal curvature ) of the trial group became more flat after wearing Orthokeratology Lens 2a and stopped 2 wk; The length of ocular axis was also increased, the growth rate of B group (0.33±0.31)mm was lower than that of group A (0. 43±0. 25)mm; Subjective refraction of myopia was increased 0.68±0.49D than wearing Orthokeratology Lens before, but compared with the growth (2. 08 ± 0. 57) D of the control, the effect of myopia control was more obviously. Grade of dry eye was more severely than that of wearing Orthokeratology Lens before, but there was no significant difference between groups A and B. Compared with wearing Orthokeratology Lens before, corneal thickness, anterior chamber depth, corneal endothelial cell number and the intraocular pressure were all no significant differences between the trial and control group.CONCLUSlON: Orthokeratology is a safe and effective method for the correction of myopia, and long-term use of Orthokeratology Lens can effectively control the development of myopia. Controlling of moderate myopia is more effective than that of low myopia.
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Abstract? AlM: To observe the effect of combining partial reduction orthokeratology ( Ortho-K ) and spectacles on slowing myopic progressionin high myopic adolescent.? METHODS: Sixty - nine eyes of 36 high myopic adolescent ( aged 9 ~15 years ) with spherical equivalent refraction ≧-6. 00 diopters ( D) ( spherical component≧-5. 50D) were fitted with custom-made four-zone/five-curve Ortho-K lenses. The target of reduction was to achieve -5. 00D for both eyes. The residual refractive errors after at least one month of Ortho-K wear were corrected with single-vision spectacles for clear vision in the daytime. The unaided visual acuity ( UVA) , refractive error ( RE ) , axial length ( AL ) , and ocular health were assessed before the Ortho-K lens wear, and followed up for 2a after Ortho-K.?RESULTS: ( 1 ) Changes in UVA: The mean UVA was 0. 09±0. 05 at baseline before Ortho-K;the mean UVA was 0. 27 ± 0. 14, 0. 54 ± 0. 18, 0. 78 ± 0. 24, and 0. 81 ± 0. 19, respectively after Ortho-K wear for l night, 1wk, 1, and 3mo. The differences of UVA were significant with baseline (P0. 05 compared to baseline). The mean RE was-7. 11±0. 81D after Ortho-K wear for 2a, and the amount of myopia increased -0. 29 ± 0. 37D compared to baseline (P0. 05) from the AL after Ortho-K wear for 6mo (26. 19±0. 54mm) and for 1a (26. 21± 0. 47mm). The AL was 26. 37±0. 59mm after Ortho-K wear for 2a, and the mean increase was 0. 19 ± 0. 28mm compared to baseline (P<0. 05). (4) Grade 1 corneal staining was observed in some subjects at each visit. However, the staining was improved after lens cleaning, discontinuing lens wear, or applying artificial tears. No other adverse events were reported in all subjects during the 2a study.?CONCLUSlON:Combining partial reduction Ortho-K and spectacles completely slowed myopic progression in high myopic adolescent after receiving the treatment for 1a, and partially reduced myopia progression after 2a of treatment. No severe ocular complications were found throughout the treatment. The combination treatment appeared to be effective and safe, but its long-term effect needs to be further assessed.