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OBJECTIVE: To investigate the effects of orthokeratology lenses (OK lenses) on corneal biomechanics in subjects of different ages. METHODS: Fifty subjects with mild to moderate myopia were categorized into three groups (Group I-III) based on their age. Corvis ST was used to collect dynamic corneal response parameters (DCRs) at different follow-up time points. Repeated measures analysis of variance combined with simple effect analysis was used to analyze the changes in DCRs in different groups during the follow-up period. Multiple linear regression analysis was used to analyze the correlations between axial length growth (ALG) at 6 months (ALG-6M) or 12 months (ALG-12M) and sex, baseline spherical equivalent refraction (SER), and DCRs. RESULTS: The DCRs changed in all three groups after wearing OK lenses. Most DCRs showed significant differences between baseline and 6 months after wearing OK lenses, while the differences between DCRs at 6 months and 12 months were not statistically significant. No significant differences in DCRs were observed among the three groups at the same follow-up time point. Additionally, at 6 months post-OK lens wear, ALG-6M was significantly correlated with velocity of the corneal apex at the first applanation (A1V-6M) (P = 0.002), Corvis biomechanical index (CBI-6M) (P = 0.004), the maximum amount of corneal movement (DAM-6M) (P = 0.010), deformation amplitude ratio of 2 mm (DAR2-6M) (P = 0.010), and stress-strain index (SSI-6M) (P = 0.038) in Group I. Furthermore, ALG-12M showed significant correlations with SSI-6M (P = 0.031), peak distance at the DAM (PD)-6M (P = 0.037), baseline Ambrósio Relational Thickness to the horizontal profile (P = 0.013) in Group I. CONCLUSIONS: The majority of DCRs displayed significant changes within the initial 6 months of OK lens wear. Minimal variation in DCRs was observed across different age groups at the same follow-up time point. Certain DCR parameters exhibited correlations with ALG, suggesting their potential in predicting ALG in myopic children undergoing OK lenses correction.
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Myopia , Orthokeratologic Procedures , Child , Humans , Corneal Topography , Cornea , Myopia/therapy , Refraction, Ocular , China , Axial Length, EyeABSTRACT
The global prevalence of myopia is increasing year by year, leading to many ocular health issues and social problems. In recent years, it has been confirmed that peripheral defocus is closely related to the occurrence and development of myopia. Alteration of the state of peripheral defocus can significantly influence the progression of myopia and emmetropization, but the exact mechanisms are still unclear. At present, there is no method that can completely control myopia. Nowadays, the main controlling methods, including orthokeratology lens, peripheral defocus lens and multi-focal soft lens, have been confirmed to be closely related to peripheral defocus. In this paper, we will review and summarize the development and effect of these peripheral defocus relating control methods. In addition, the researches on the related mechanisms of peripheral retinal defocus and myopia prevention and control at home and abroad are reviewed, as well as the potential mechanisms of peripheral defocus, with a view to further improving the controlling effects of existing methods, developing new prevention and control methods and reducing the incidence and progression of myopia.
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INTRODUCTIONS: This study aimed to analyze the correlation between refractive status and ocular biological parameters in preschool-age children (3-6 years old), establish a regression curve, guide the clinical judgment of children's refractive status, and improve the accuracy of refractive screening for this age group. METHODS: A total of 508 children, aged 3-6 years, were admitted to the hospital, exhibiting symptoms of ametropia and a need for dilation optometry. Among these, 326 children were included in the statistics group, having been examined between August 2021 and October 2022, and 182 children were included in the validation group, having been examined between November 2022 and March 2023. Using IOL Master700, ocular biometry parameters were measured for all participants, including axial length (AL), keratometry readings (K1 and K2), anterior chamber depth (ACD), lens thickness (LT), and central corneal thickness (CCT). One percent atropine sulfate eye gel was administered, and then the spherical equivalent (SE) was calculated by Bennett's formula. The correlation between SE and other ocular biometrics was analyzed, followed by the establishment of an SE prediction equation. The SE prediction equation was used to calculate the spherical equivalent (SE#) using ocular biometry data from the validation group, and the consistency between SE and SE# was evaluated. RESULTS: SE showed a negative correlation with AL/CR (r = -0.936), AL (r = -0.811), ACD (r = -0.500), age (r = -0.396), and Km (r = -0.213) (p < 0.001), and positive correlation with LT (r = 0.301), LP (r = 0.176) (p < 0.001). A multiple linear regression equation was established for SE using the stepwise selection method, SE = 49.232 - 23.583 × AL/CR + 1.703 × ACD + 0.589 × Km - 0.609 × LP + 1.103 × LT (R2 = 0.997). Based on the regression equation, the predicted SE# highly correlated with SE after cycloplegia in the validation group (r = 0.998, p < 0.001). CONCLUSION: The main ocular biological factors of ocular diopter in children aged 3-6 years are AL/CR, ACD, Km, LP, and LT, which are jointly influenced by multiple factors. Ocular biometry is a reliable predictor of real refraction among children aged 3-6.
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Myopia , Refractive Errors , Humans , Child, Preschool , Child , Myopia/diagnosis , Refraction, Ocular , Vision Tests , Refractive Errors/diagnosis , Cornea , BiometryABSTRACT
Worldwide, the incidence rate of myopia is maintained in a high level. Especially, the morbidity is rising continuously among children and adolescents. The progression of myopia affects visual acuity, vision related quality of life and productivity. Moreover, high myopia and its related ocular complications also aggravate the family and social burden. Therefore, the mechanism of myopia, related complications and methods of myopia prevention and control need further exploration. International Myopia Institute(IMI)published the second-edition white papers in April 2021. These white papers included reflections on the implications for clinical practice, the impact of myopia, the risk factors of myopia, the relationship among accommodation and binocular vision with myopia, pathologic myopia, prevention of myopia and digest. Comparing to the first edition, more than thousands of articles and conference abstracts were considered in white papers II, highlighting the latest research and progress related to myopia prevention and control. This article briefly summarizes and interprets the contents of the above white papers, including overview of myopia, impact of myopia, risk factors in myopia, ocular changes in the progress of myopia, and myopia prevention and control, hoping to provide advice for the clinical and scientific research work relating to myopia prevention and control.
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AIM: To analyse the prevalence and risk factors of dry eye among children aged 7-14 years in myopia prevention and control clinic.METHODS:A total of 222 children aged 7-14 years in myopia prevention and control clinic from December 2021 to February 2022 were included. General data of included children were collected, assessing the prevalence of dry eye by the ocular surface disease index(OSDI)scale and Keratograph 5M, and analyzing risk factors for dry eye occurrence by Logistic regression model.RESULTS:The prevalence of dry eye in children in myopia prevention and control clinic was 27.9%. Logistic Regression analysis showed that, allergic conjunctivitis(OR=2.31, 95%CI=1.12-4.78, P=0.02), refractive error(OR=5.57, 95%CI=2.40-12.94, P&#x003C;0.01), use time of electronic &#x003E;2h per day(OR=2.74, 95%CI=1.11-6.78, P=0.03), time of playing games &#x003E;2h per day(OR=2.33, 95%CI=1.12-4.84, P=0.02), outdoor activity time ≤2h per day(OR=4.28, 95%CI=2.02-9.07, P&#x003C;0.01)and sleep duration &#x003C;8h per day(OR=3.23, 95%CI=1.44-7.27, P=0.01)were risk factors for dry eye among the children.CONCLUSIONS:The prevalence of dry eye among children in myopia prevention and control clinic should be paid high attention. Therefore, improving behavior habits and controlling the use time of visual display terminal products to prevent and slow down the occurrence of dry eye in children.
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The incidence of myopia is gradually on the rise worldwide, which seriously affects the eye health of teenagers and children, causing enormous loss of socioeconomic benefits. As a result, the prevention and control of myopia is crucial and urgent. In recent years, orthokeratology lens have gradually demonstrated its superiority in the field of myopia prevention and control. At present, the principle of controlling the development of myopia by orthokeratology lens is mainly based on the theory of retinal hyperopia optical defocus, which promotes the shift of hyperopic defocus to myopic defocus in myopic patients to curb the growth of the axial length. The effect of controlling the development of myopia is related to various factors, including the total amount of defocusing, pupil diameter, optical zone design, and lens decentration. The widespread use of orthokeratology lenses will effectively reduce the incidence of myopia in teenagers and children. This paper discusses the principle of controlling the development of myopia by the defocus technique of orthokeratology lenses, and the relationship between the amount of defocusing and the position of the defocusing circle and the effect of myopia prevention and control. A specific review was conducted to clarify the research progress on defocus technique of orthokeratology lens in the prevention and control of myopia.
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Myopia is one of the main causes of visual impairment. In recent years, the incidence of myopia has been increasing. Effective prevention and control of myopia is essential for maintaining patients' visual function and quality of life. With the continuous development of computer technology and big data acquisition, artificial intelligence(AI)is developing rapidly in the field of medical and health care. Machine learning and deep learning are gradually emerging in the field of myopia prevention and control. Through the AI model formed by training the diopter, axial length, color fundus photography, optical coherence tomography and other myopia-related data, with the help of remote medical platform, AI has played a positive role in the occurrence, progress prediction and monitoring of myopia, early warning of pathological myopia, prevention and treatment of myopia and ophthalmological telemedicine. This paper mainly reviews the research progress of AI in the field of myopia prevention and control, aiming to provide a new direction for the prevention and control of myopia in the future.
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The high prevalence of myopia is a global public health concern, and the risk of associated complications is becoming increasingly apprent.The International Myopia Institute (IMI) was established in 2015 to promote scientific research and clinical practice in myopia control, and IMI published the White Paper on Myopia Prevention and Control on the diagnosis, treatment, and management of myopia.In 2023, the IMI released the series three of the White Paper on Myopia Prevention and Control, which delves deeper into key issues in myopia research and management.The white paper focuses on non-pathological changes observed in axial myopia, and the role of the choroid in eye growth and myopia management.It also reviews the evidence for myopia incidence, progression and management in atypical populations, such as infants, pre-school children, and young adults.It provides recommendations and strategies for clinical practice in myopia management and summarizes important new findings in myopia research since 2019, which are summarized into the IMI 2023 Digest.This article aims to interpret the key contents of the series three of the White Paper on Myopia Prevention and Control, to help professionals involved in myopia control to stay informed about the latest evidence from international research, to optimize strategies for preventing and treating myopia-related diseases, and ultimately to promote the development of myopia research and management in China.
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@#Myopia refers to the refraction state in front of macular fovea when the external parallel light falls through the refractive system of the eye. Myopia has seriously affected the healthy growth of teenagers,so that prevention and control of myopia have become a hot issue of social concern. Studies generally agreed that myopia has a close relationship with choroid changes, and the choroid thickness shows a gradual thinning trend with the increase of diopter and ocular axis. Evidence-based medical studies have proved that effective methods for myopia prevention and control(orthokeratology, defocus lens, atropine eye drops, illumination, posterior scleral reinforcement, <i>etc</i>.)showed choroid thickening effect, suggesting that choroid thickening is a protective factor for myopia control. In order to provide a reference for the change of choroid thickness as an evaluation index of myopia prevention and control efficacy, this paper reviews the effect of current effective methods of myopia prevention and control on choroid thickness.
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Based on the literature on myopia epidemiology, experiments of basic science, and clinical research, we have identified a number of major characteristics of the myopia problem. It was concluded that the student population of grades 1-12 showed high incidence of myopia and the problem was becoming increasingly more serious. Etiological investigations revealed the aggressive role played by environmental factors. Mature clinical correction methods were available, but there were still a multitude of uncertainties hampering the effort to slow the progression of myopia. Student myopia has become an issue of top concern in China's effort to prevent and control myopia. In order to approach the issue by dealing with problems in the educational environment and to explore for specific measures to prevent and control the onset and development of student myopia, it is important that we gain better understanding of the multiple effects on the onset and development of student myopia caused by the growing demand for education induced by high social development and the rapid changes in the educational environment caused by technological advancement. Approaching the problem from the perspective of the features of the eye and vision in the developmental stages of students of grades 1-12, and the study workload at each stage, this paper retrospectively reviewed the historical literature from the last 90 years and the data from cohort studies done before and after the outbreak of COVID-19. Identifying the education environment as the primary factor causing the onset and progression of student myopia, the paper fully recognizes the scientific rationality of and the specific role served by education-medicine synergy in student myopia prevention and control.
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COVID-19 , Myopia , Humans , Myopia/epidemiology , Myopia/etiology , Retrospective Studies , SARS-CoV-2 , StudentsABSTRACT
BACKGROUND: Myopia is the most common visual impairment in children and adolescents worldwide. This study described an economical and effective population-based screening pipeline and performed the project of a million scale children and adolescents myopia survey (CAMS), which will shed light on the further study of myopia from the level of epidemiology and precision medicine. METHODS: We developed a novel population-based screening pattern, an intelligent screening process and internet-based information transmission and analysis system to carry out the survey consisting of school children in Wenzhou, China. The examination items include unaided distance visual acuity, presenting distance visual acuity, and non-cycloplegic autorefraction. Myopia and high myopia were defined as spherical equivalent (SE) ≤ - 1.00 diopters (D) and SE ≤ - 6.00 D, respectively. Next, the reports of the vision checking were automatically sent to parents and the related departments. The CAMS project will be done two to four times annually with the support of the government. An online eyesight status information management system (OESIMS) was developed to construct comprehensive and efficient electronic vision health records (EVHRs) for myopia information inquiry, risk pre-warning, and further study. RESULTS: The CAMS completed the first-round of screening within 30 days for 99.41% of Wenzhou students from districts and counties, in June 2019. A total of 1,060,925 participants were eligible for CAMS and 1,054,251 (99.37% participation rate) were selected through data quality control, which comprised 1305 schools, and 580,609, 251,050 and 170,967 elementary, middle, and high school students. The mean age of participants was 12.21 ± 3.32 years (6-20 years), the female-to-male ratio was 0.82. The prevalence of myopia in elementary, middle, and high school students was 38.16%, 77.52%, and 84.00%, respectively, and the high myopia incidence was 0.95%, 6.90%, and 12.98%. CONCLUSIONS: The CAMS standardized myopia screening model involves automating large-scale information collection, data transmission, data analysis and early warning, thereby supporting myopia prevention and control. The entire survey reduced 90% of staff, cost, and time consumption compared with previous surveys. This will provide new insights for decision support for public health intervention.
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BACKGROUND: Nowadays, because of the increasing incidence, the prevention and control of myopia has become an urgent issue. In China, auricular acupressure has been commonly used in the clinical treatment of myopia in children, but the exact effectiveness remains unproven. The purpose of this trial is to observe the efficacy of auricular acupressure in myopia prevention and control, as well as its effect on the choroidal and retinal thickness. METHOD/DESIGN: A total of 480 subjects at 8-9 years old will be randomized in a 1:1 ratio to an intervention group versus a control group. The intervention group will receive auricular acupressure for 12 months, while the control group will be taken as a blank control. The primary and secondary outcomes will be measured at baseline, and again at 3, 6, 9, and 12 months after recruitment. The myopia incidence (spherical equivalent ≤ - 0.50 D) and the mean change of spherical equivalent will be taken as the primary variables; the secondary outcome measures include axial length, uncorrected visual acuity, and choroidal and retinal thickness. DISCUSSION: This trial aims to evaluate the effectiveness of auricular acupressure for myopia prevention and control with objective evidence and to preliminarily explore the plausible mechanism and provide reference for adopting this approach to retard the onset and control the progression of myopia. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2000038456 . Registered on September 23, 2020.
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Acupressure , Myopia , Child , China , Choroid , Humans , Myopia/diagnosis , Myopia/prevention & control , Randomized Controlled Trials as Topic , RetinaABSTRACT
Along with the increasing global prevalence of myopia, severer myopia brings concerns about a higher risk of potentially blinding complications.Myopia is becoming one of the major causes of vision impairment and blindness in the world, and the myopia prevention and control has been a focus of the whole society.Management of myopia includes more outdoor activities, medications, orthokeratology, peripheral defocus soft contact lens, progressive addition lenses and bifocal lenses, etc.These methods have raised ethical disputes among regulatory bodies, manufacturers, academics and clinicians, who share an ethical responsibility to ensure that the products used for myopia control are safe and efficacious and that patients understand the benefits and potential risks of such products.The IMI- Industry Guidelines and Ethical Considerations for Myopia Control Report published in 2019 highlights the ethical challenges and provides stakeholders with recommendations and guidelines in decision-making, production development, spreading of research progress, prescribing, financial support and advertising of such treatments.Some common problems in combination with the latest clinical studies and relevant evidence-based guidelines were reviewed and reasonable solutions were recommended in this article.
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@#Myopia is one of the most common eye diseases in the world. MicroRNAs(miRNAs)are small, non-protein-coded single-stranded RNAs with a length of about 20-25 nucleotides,which are widely involved in the process of post-transcriptional regulation of many physiological and pathological processes of organisms. It has attracted extensive attention for the regulation role of miRNAs in the process of induction and development of myopia in recent years. This article reviews the regulatory role and related signal pathways of miRNAs in the development of myopia. It will provide highlights for the understanding of molecular mechanism of myopia and benefit for potential molecular diagnosis of myopia in the future.
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@#AIM: To study the effects between low concentration atropine and orthokeratology on myopia prevention and control.<p>METHODS: Totally 150 cases of juvenile outpatients with myopia were chosen in our hospital. They were divided into 3 groups randomly. Group A(50 cases)were treated with low concentration atropine. Group B(50 cases)were treated with orthokeratology. Group C(50 cases)were treated with spectacles. Refractive degree and ocular axial length had no statistically significant differences between three groups before treatment. After 1a follow-up, refractive degree and ocular axial length of three groups were statistically analyzed. <p>RESULTS: After 1a, the refractive degree changes of each group before and after treatment were statistically significant(<i>P</i><0.01). The results of refractive degree changes among the groups were as follows: there was no significant differences between low concentration atropine group and orthokeratology group(<i>P</i>>0.05); compared with orthokeratology and low concentration atropine group, that of spectacles group was significantly different(<i>P</i>>0.05). After 1a follow up, the ocular axial length changes of each group before and after treatment were statistically significant(<i>P</i><0.01). The results of ocular axial length changes among the groups were as follows: there was no significant differences between low concentration atropine group and orthokeratology group(<i>P</i>>0.05); compared with orthokeratology and low concentration atropine group, that of spectacles group was significantly different(<i>P</i><0.05). <p>CONCLUSION: The effects of low concentration atropine and orthokeratology on controlling juvenile myopia and ocular axial length have no significant difference. They are superior to spectacles on controlling juvenile myopia.
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Dopamine is one of neurotransmitters of the central nervous system,and it can activate or inhibit cAMP by binding the corresponding membrane receptor and further regulate calcium signals.Dopamine is also primary neurotransmitter and modulator in retina,and it plays very important roles over the entire visual pathway including retina,lateral geniculate body and visual cortex.Recent study showed that dopamine participates in the pathogenesis of amblyopia and myopia.In addition,it is also involved in the regulation of intraocular pressure (IOP).These studies offered some new clues for the treatment and prevention of amblyopia and myopia as well as the regulation of IOP.Hence,this paper describes the new progress of retinal dopamine in the form deprivation myopia,myopic defocus,the regulation of IOP,the eye growth and the treatment of amblyopia.
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The current prevalence of myopia has been as high as 27.65%～53.80%among adolescents in Chinese schools.The major reasons are too much near-work activity and lack of outdoor activity for a long time.In order to reduce the prevalence of myopia in Chinese adolescents,we suggest that Chinese students should have 3.5 hours outdoor activity everyday,including 30 minutes travel between home and school,1 hour outdoor activity between classes,1 hour outdoor sport class at school,and 1 hour outdoor activity after school.
