Abstract

Studies have found reduced myopia progression with multifocal contact lenses, albeit with an unclear mechanism behind their protective effect. It is hypothesized that the induced myopic defocus of the addition zones of the multifocal contact lenses leads to choroidal thickening and therefore inhibits eye growth. In the current study, the effect of the optical design of multifocal contact lenses on choroidal thickness was investigated. Eighteen myopic participants wore four different contact lenses ((1) single-vision lenses corrected for distance, (2) single-vision lenses with +2.50 D full-field defocus, (3) Multifocal center-distance design, (4) Multifocal center-near design, both with addition power +2.50 D) for 30 min each on their right eye. Automated analysis of the macular choroidal thickness and vitreous chamber depth were performed before and after the wear of each of the contact lenses. Peripheral refraction profiles in primary gaze were obtained using eccentric photorefraction prior to contact lens wear. Choroidal thickness and vitreous chamber depth showed no significant differences to baseline with any of the contact lenses (all p > 0.05). Choroidal thickness increased by +2.1 ± 11.1 μm with the Multifocal center-distance design, by +2.0 ± 11.1 μm with the full-field defocus lens, followed by the Multifocal center-near design with +1.6 ± 11.3 μm and the single-vision contact lens correcting for distance with +0.9 ± 11.2 μm. Multifocal contact lenses have no significant influence on choroidal thickness after short-term wear. Therefore, changes in choroidal thickness might not be the main contributor to the protective effect of multifocal contact lenses in myopia control.

Highlights

  • The worldwide prevalence of myopia constantly continues to increase, with predictions of half of the population being myopic by the year 2050 [1]

  • There was no difference between the choroidal thickness (ChT) of both eyes at any retinal region divided by the Early Treatment Diabetic Retinopathy Study (ETDRS) [24]

  • Each session of contact lens wear was set to only 30 min instead of the commonly used 60 min, since significant changes of choroidal thickness with myopic defocus were already reported after 20 min of exposure with a +2.0 D defocusing contact lens [15], which we could not observe

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Summary

Introduction

The worldwide prevalence of myopia constantly continues to increase, with predictions of half of the population being myopic by the year 2050 [1]. Myopia results in distance blur despite inactive accommodation as the light focuses in front of the retina, mainly due to an elongated ocular axial length [2, 3]. Due to the absence of scleral innervation, the choroid assumingly plays a major mediating role in the regulation of ocular growth, possibly as a reaction to defocus. The signal cascade from the retinal neurons must pass through the choroid on the way to the sclera [4].

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