Orthokeratology and Low-Intensity Laser Therapy for Slowing the Progression of Myopia in Children.

Fen Xiong,Xueyun Zhou,Rui Zhou,Hongfei Liao,Yunmin Yi,Xiaoqin Hu,Liang Huang,Tian Mao,Lei Shang,Nana Lin,Jinglin Yi,Li Yu,Pietro Emanuele Napoli

doi:10.1155/2021/8915867

Abstract

Orthokeratology (OK) is widely used to slow the progression of myopia. Low-level laser therapy (LLLT) provides sufficient low energy to change the cellular function. This research is aimed at verifying the hypothesis that LLLT treatment could control myopia progression and comparing the abilities of OK lenses and LLLT to control the refractive error of myopia. Eighty-one children (81 eyes) who wore OK lenses, 74 children (74 eyes) who underwent LLLT treatment, and 74 children (74 eyes) who wore single-vision distance spectacles for 6 months were included. Changes in axial length (AL) were 0.23 ± 0.06 mm for children wearing spectacles, 0.06 ± 0.15 mm for children wearing OK lens, and −0.06 ± 0.15 mm for children treated with LLLT for 6 months. Changes in subfoveal choroidal thickness (SFChT) observed at the 6-month examination were −16.84 ± 7.85 μm, 14.98 ± 22.50 μm, and 35.30 ± 31.75 μm for the control group, OK group, and LLLT group, respectively. Increases in AL at 1 month and 6 months were significantly associated with age at LLLT treatment. Changes in AL were significantly correlated with the baseline spherical equivalent refraction (SER) and baseline AL in the OK and LLLT groups. Increases in SFChT at 1 month and 6 months were positively associated with age at enrolment for children wearing OK lens. At 6 months, axial elongation had decelerated in OK lens-wearers and LLLT-treated children. Slightly better myopia control was observed with LLLT treatment than with overnight OK lens-wearing. Evaluations of age, SER, and AL can enhance screening for high-risk myopia, improve the myopia prognosis, and help determine suitable control methods yielding the most benefits.

Highlights

Myopia is a global epidemic, which is especially prevalent in East Asia [1]
At the time of our 6-month follow-up, the results of the single-vision spectacle lens group indicated an increase in axial length (AL) of 0:23 ± 0:06 mm, which is consistent with previous studies (0.18-0.24 mm) [23,24,25], and the level laser therapy (LLLT) group exhibited a decrease in AL of −0:06 ± 0:15 mm
We found that more myopic diopter and longer AL were significantly related to decreased AL changes after wearing OK lenses and LLLT treatment

Summary

Introduction

Especially in higher levels, results in an increased risk of complications such as retinal detachment, myopic macular degeneration, glaucoma, cataracts, and permanent vision loss [2]. The low levels of 5-MTHF in myopia patients may lead to the increase of homocysteine, which closely correlated with oxidative stress, inflammation, and cellular apoptosis [5]. Exogenous bFGF effectively ameliorates the excessive axial elongation in chronic form-deprivation myopia in chicks by suppressing retinal neuron apoptosis [3]. Finding a method to suppress the cell apoptosis may be an effective way to control the axial elongation. We first focused on low-level laser therapy (LLLT) as a new method that contributes to restricting the progression of myopia by preventing cell apoptosis, thereby minimizing inflammation and increasing cell turnover [7, 8]

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Discussion

Conclusion