Abstract
PurposeTo investigate the factors affecting axial length (AXL) growth and myopia progression in orthokeratology.MethodsThis prospective, observational study enrolled 28 new orthokeratology lens wearers from a contact lens clinic between March 2016 and March 2017. Among them, 32 eyes of 17 wearers who completed one year of follow-up were finally analyzed. All participants underwent central (C) and peripheral (nasal 30° [N30] and temporal 30° [T30]) AXL measurements as well as central and peripheral refraction, ocular aberrations, and corneal topography at baseline and every posttreatment visit. A generalized estimating equation (GEE) was used to assess the associations between AXL change and all independent variables in both eyes.ResultsThe mean central AXL was 24.21 ± 0.60 mm and the mean baseline central spherical equivalent refractive error (SER) was −2.43 ± 0.97 diopters (D). Among all parameters that were significantly associated with AXL change in univariable GEE analyses, the baseline difference in AXL between C and N30 (β = −0.213, p < 0.001), baseline SER (β = −0.040, p < 0.033), posttreatment coma (β = −0.291, p < 0.031), third-order higher-order aberrations (HOAs) (β = −0.482, p < 0.001), and changes in second-order aberrations (β = 0.025, p = 0.027) at one year of follow-up were identified as significant factors in multivariable GEE analysis.ConclusionsThe inhibition of AXL elongation and myopia progression in orthokeratology lens wear is significantly associated with the peripheral myopization and asymmetric optical changes mostly induced by third-order HOAs.
Highlights
Myopia is one of the most common ocular diseases that can present during childhood
Among all parameters that were significantly associated with axial length (AXL) change in univariable generalized estimating equation (GEE) analyses, the baseline difference in AXL between C and N30 (β = −0.213, p < 0.001), baseline spherical equivalent refractive error (SER) (β = −0.040, p < 0.033), posttreatment coma (β = −0.291, p < 0.031), third-order higher-order aberrations (HOAs) (β = −0.482, p < 0.001), and changes in second-order aberrations (β = 0.025, p = 0.027) at one year of follow-up were identified as significant factors in multivariable GEE analysis
The inhibition of AXL elongation and myopia progression in orthokeratology lens wear is significantly associated with the peripheral myopization and asymmetric optical changes mostly induced by third-order HOAs
Summary
Myopia is one of the most common ocular diseases that can present during childhood. The prevalence of myopia has increased over the last few decades [1], especially in East Asians [2]. Additional factors including changes in higher-order aberrations (HOAs) were suggested as possible mechanisms [20, 21]. In accordance with this concept, recent reports indicated that the amounts of HOAs are negatively associated with myopia progression during the natural course of axial eye growth in childhood [22, 23]. Considering individual variability in the effects of orthokeratology on myopia progression and controversies regarding the precise underlying mechanism, in the present study, we sought to elucidate the factors affecting AXL growth and myopia progression in orthokeratology
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