Baseline Spherical Equivalent Refraction Research Articles

Microcirculatory parameters as risk factors for predicting progression of posterior staphyloma in highly myopic eyes: a case–control study

BackgroundTo assess the rate of macular blood flow decreasing in adults with and without posterior staphyloma (PS) using optical coherence tomography angiography (OCTA) and to identify risk factors associated with PS progression.MethodsThis longitudinal case-control study enrolled 122 eyes of 122 patients—64 patients with PS (PS group) and 58 patients without PS (NPS group). Participants underwent OCTA and clinical examinations at least twice, and those followed for at least one year were included in the analysis. Logistic regression analysis and machine learning were applied to explore the risk factors for PS and its progression.ResultsPatients in the PS group exhibited faster growth rates of spherical equivalent refraction (SER), axial length (AL), curvature index (CI), and posterior scleral height (PSH) as well as higher loss rates of choriocapillaris perfusion area (CCPA), choroid perfusion area (CPA) and choroidal vascularity index (CVI) compared to the NPS group (all P < 0.05). The baseline SER (B = − 1.291, OR = 0.275, P = 0.008), baseline subfoveal scleral thickness (B = − 1.621, OR = 0.198, P = 0.046), baseline PSH (B = 2.959, OR = 19.282, P = 0.001) and foveal CVI changes per year (B = − 2.776, OR = 0.062, P < 0.001) were the risk factors for PS. Baseline AL (B = 0.561, OR = 1.752, P = 0.033), parafoveal choroidal thickness changes per year (B = − 0.094, OR = 0.910, P = 0.032), foveal retinal vascular density changes per year (B = 0.104, OR = 1.110, P = 0.013) and foveal CCPA changes per year (B = − 0.214, OR = 0.807, P = 0.038) were the risk factors for the PS progression.ConclusionsDuring the progression of myopia in adults, changes in the morphology of the eye's posterior pole are not limited to axial lengthening alone; there also will be a phase of compensatory lateral expansion. Baseline AL and changes in the microcirculation can be utilized to predict the progression of PS.

Clinical Investigation of Short-Term Axial Elongation Control After Orthokeratology Lens Correction: Exploring Its Predictive Role in Long-Term Therapeutic Efficacy.

This study was developed with the goal of exploring the efficacy of orthokeratology (OK) as an approach to controlling axial length (AL) growth and identifying factors predictive of the long-term efficacy of this approach. This was a retrospective study that enrolled 157 myopic children 7 to 15 years of age undergoing OK correction for over 3 years. The short- and long-term effectiveness of this approach at 1 and 3 years post-OK correction, respectively, was assessed. All participants were classified into two groups based on whether they exhibited good or poor long-term efficacy outcomes. Measurements of changes in AL were made at baseline and at 1 and 3 years post-OK. Univariate analyses and binary logistic regression approaches were used to evaluate baseline age, baseline spherical equivalent refraction, baseline keratometry (K) values of flat and steep meridians, and short-term effectiveness with the goal of identifying predictors of long-term efficacy. Univariate analyses led to the identification of significant differences in baseline age, baseline spherical equivalent refraction, baseline AL, and short-term efficacy between these two groups ( P <0.05), whereas gender, baseline flat K, and baseline steep K did not differ significantly ( P >0.05). In binary logistic regression analyses, baseline AL ( P =0.017) and short-term efficacy ( P <0.001) were both found to significantly influence long-term efficacy. Receiver operating characteristic curves demonstrated that short-term efficacy offered an area under the curve value >0.8, consistent with its highly accurate performance as a predictor of long-term efficacy. These results suggest that short-term efficacy outcomes can feasibly be used to predict the long-term effectiveness of OK correction in children. In patients exhibiting poor short-term efficacy, timely replacement or the incorporation of additional treatment modalities may aid efforts to better control the progression of myopia.

Effect of 0.01% atropine combined with orthokeratology lens on axial elongation: a 2-year randomized, double-masked, placebo-controlled, cross-over trial.

To evaluate the effect of 0.01% atropine combined with orthokeratology (OK) lens on axial elongation in schoolchildren with myopia. Sixty children aged 8-12 years with spherical equivalent refraction (SER) from -1.00D to -4.00D in both eyes were enrolled in this randomized, double-masked, placebo-controlled, cross-over trial. Children who had been wearing OK lenses for 2 months were randomly assigned into combination group (combination of OK lens and 0.01% atropine) for 1 year followed by control group (combination of OK lens and placebo) for another 1 year or vice versa. This trial was registered in the Chinese Clinical Trial Registry (Number: ChiCTR2000033904, 16/06/2020). The primary outcome was changes in axial length (AL). Data of right eyes were analyzed. There were statistically significant differences in the changes in AL between combination and control groups after generalized estimating equation model adjusting for age and baseline SER (p = 0.001). The mean axial elongation difference between combination and control groups was 0.10 mm in the first year (0.10 ± 0.13 mm vs. 0.20 ±0.15 mm; p = 0.01), and 0.09 mm in the second year (0.22 ± 0.10 mm vs. 0.13 ± 0.14 mm; p = 0.01), respectively. The mean axial elongation difference of two groups in the first year was similar to that in the second year during the cross-over treatment. In central Mainland China in myopic children, the treatment of combination therapy is more effective than single OK lens in controlling axial elongation.

Role of lens in early refractive development: evidence from a large cohort of Chinese children

AimsTo document longitudinal changes in spherical equivalent refraction (SER) and related biometric factors during early refractive development.MethodsThis was a prospective cohort study of Chinese children, starting in 2018 with annual...

Atropine 0.01% Eye Drops for Myopia Control in a tertiary care center of Pakistan: An interventional case series

Purpose: To evaluate the real time results of once-dailyAtropine 0.01% eye drops in controlling myopia. Study Design: Interventional case series. Place and Duration of Study: The Eye Centre, South City Hospital, Karachi from September 2020 to August 2021. Methods: One hundred(both) eyes of 50 children were included in the study using non-probability consecutive sampling technique. Baseline spherical equivalent refraction(SER) was recorded at the initiation of treatment.The endpoint was measuring the rate of progression in SER at one year after treatment. Responders weredefined as the ones with either no progression of myopia or worsening of myopia of ≤ -0.50 SER and non-responders were defined as ones with a progression rate of myopia of greater than0.50 SER. Results: The baseline means SER for 100 eyes was 3.25±1.37 D. On follow-up after 12 months of treatment with Atropine 0.01% eye drops, the mean SER was -3.74 ± 1.34 D. The rate of SER progression was significantly lower at one year follow-up (p-value&lt;0.001). The percentage of responders was84%. Conclusion: Significant reduction in myopia progression occurred after treatment with Atropine 0.01% eye drops in a greater percentage of children. This has led us to be confident in providing Atropine 0.01% eye drops along with simple spectacles as an effective treatment strategy to control myopia progression.

Epidemiological characteristics of myopia among school-age children before, during, and after the COVID-19 pandemic: a cohort study in Shenzhen, China.

To evaluate the epidemiological characteristics of myopia among school-aged children before, during, and after the coronavirus disease (COVID-19) pandemic. A total of 848,697 students aged 6-15 years from 786 primary and secondary schools in Shenzhen, China, were randomly selected as research subjects. We conducted annual myopia screenings from 2019 to 2022. 2019 was considered before the COVID-19 pandemic, 2020 as during the pandemic, and 2021 and 2022 as after the pandemic. Demographic characteristics, visual acuity, and spherical equivalent refraction (SE) were collected. During the 4-year follow-up period, the uncorrected visual acuity (UCVA) of the study subjects progressed following a trend of -0.18 ± 0.30D (-0.17 ± 0.29D for boys, -0.21 ± 0.32Dfor girls) (p < 0.001). Those students who were in grade 4 aged 9-10 years at the baseline examination showed the greatest decline in visual acuity (0.23). The SE of the study subjects progressed following a trend of -1.00 ± 1.27D (-0.96 ± 1.25D for boys, -1.05 ± 1.31D for girls) (p < 0.001). The students who were in grade 5 aged 10-11 years at the baseline examination showed the greatest decline in SE (1.15D ± 1.22, p < 0.001). The prevalence of myopia (UCVA<5.0 and SE < -0.50D of any eye) increased by 28.2% (27.0% for boys and 29.8% for girls). Those students who were in grade 2 aged 7-8 years at the baseline examination showed the greatest increase in myopia prevalence (37.6%, p < 0.001). During the COVID-19 pandemic, the subjects' visual acuity and SE measurements decreased by -0.05 ± 0.19 (p < 0.001) and - 0.36 ± 0.89D (p < 0.001) respectively, and the prevalence of myopia increased by 11.3% (10.6% for boys and 12.2% for girls) (p < 0.001). The 3-year cumulative incidence of myopia for non-myopic grade 1 aged 6-7 years students with baseline SE of ≥1.00D, ≥ 0.50D and < 1.00D, ≥0D and < 0.50D, and ≥ -0.50D and < 0D were 6.8, 24.8, 39.0, and 48.1%, respectively. During the COVID-19 pandemic, the SE of school-aged children showed myopic drift and decreased visual acuity. Myopia progressed faster among girls than among boys in the same grades. The risk of myopia among school-aged children persisted even after the home quarantine of the COVID-19 pandemic was lifted.

Effects of 0.01% Atropine Eye Drops on Controlling Myopia Progression in School Age Children in Ophthalmology Department of a Tertiary Care Hospital

Purpose: To determine the effects of 0.01% atropine eye drops in controlling myopia progression in school age children presenting to Ophthalmology Department of a Tertiary Care Hospital. Study Design: Quasi experimental study. Place &amp; Duration of Study: Department of ophthalmology Jinnah postgraduate Medical Center, JPMC Karachi and Advance Eye Clinic Karachi, Pakistan from July 2018 to July 2020. Methods: One hundred myopic patients (myopia of 0.5D to 13.0D) with age range of 6 – 14 years were recruited. Patients with astigmatism &lt;-2.0D, other ocular or medical disease and history of laser or ocular surgery were excluded. Atropine group was instructed to instill Atropine 0.01% once at night time. Control group did not receive any treatment. Refraction was performed at all examinations with and without Cycloplegia along with fundoscopy and axial length measurements. The follow up frequency was at 3 monthly intervals. Data was analyzed using SPSS 22. To compare quantitative data between groups, t-test was used while for qualitative data Chi-square test was used. Results: Mean age was 9.21 ± 2.45 years. Out of 100, 57 were males. There was no statistical difference between atropine group vs control group in terms of baseline SER (spherical equivalent refraction), (p = 0.407) and baseline axial length (p = 0.892). Mean difference in SER from baseline to after completion of study two groups was statistically significant (p &lt; 0.001). Mean difference in AL from baseline to end of study between two groups was also statistically significant (p &lt; 0.001). Conclusion: Low concentration atropine 0.01% can be helpful in halting myopia progression.

Comparison of two different orthokeratology lenses and defocus incorporated soft contact (DISC) lens in controlling myopia progression

BackgroundTo compare axial elongation in 8–11-year-old myopes wearing orthokeratology (OK) lenses with different back optic zone diameters (BOZD), defocus incorporated soft contact (DISC) lenses, and single-vision soft contact lenses (SCLs).MethodsA total of 122 children (aged 8–11 years) with spherical equivalent refraction (SER) between − 1.00 D and − 4.00 D were enrolled in this prospective study and randomly assigned to four groups: 5.0 mm-BOZD OK, 6.2 mm-BOZD OK, DISC, and single-vision SCLs. Children in each group were further divided into subgroups stratified by the average baseline SER: low myopic eyes (SER: − 1.00 D to − 2.50 D) and moderate myopic eyes (SER: − 2.50 D and over). Axial length (AL) was measured at baseline and after one year.ResultsThe 5.0 mm-BOZD OK, 6.2 mm-BOZD OK, and DISC groups exhibited significantly slower AL elongation than the SCL group. The proportion of slow progressors (AL elongation ≤ 0.18 mm/year) in the first three groups was 42%, 23%, and 29%, respectively. Furthermore, one-year AL elongation was significantly smaller in the 5.0 mm-BOZD OK group compared with the 6.2 mm-BOZD OK group. Regardless of SER, children in the 5.0 mm-BOZD OK and DISC groups showed comparably slower AL elongation than those in the SCL group. However, fitting with 6.2 mm-BOZD OK lenses significantly retarded AL elongation in moderate myopic eyes, but not in low myopic eyes.ConclusionsOverall, 5.0 mm-BOZD OK lenses, 6.2 mm-BOZD OK lenses, and DISC lenses were effective in retarding AL elongation in 8–11-year-old myopes compared with single-vision SCLs, but for children with SER less than − 2.50 D, fitting with 5.0 mm-BOZD OK lenses and DISC lenses yielded better myopia control efficacy compared to wearing single-vision SCLs or 6.2 mm-BOZD OK lenses.

A systematic review and meta-analysis of the efficacy of different optical interventions on the control of myopia in children.

To compare the treatment efficacy of childhood myopia control optical interventions [spectacles, soft contact lenses (SCLs) and orthokeratology (OK) lenses], explore the consistency of treatment efficacies during the treatment period and evaluate the impact of baseline spherical equivalent refraction (SER), axial length (AL) and age on the treatment effect. A literature search of EMBASE, PubMed and Google Scholar databases identified 220 articles published between January 2000 and April 2022, which reported the treatment efficacy by differences in the SER and AL change between intervention and control groups. Thirty-five articles were included in the analysis. Treatment effect sizes (ESs) were calculated, where more positive and negative directions indicated greater treatment efficacy for SER and AL respectively. For SER, the ESs with peripheral add design spectacles (0.66) and SCLs (0.53) were large but not significantly different between treatment types (p = 0.69). For AL, ESs with peripheral add design spectacles (-0.37), SCLs (-0.55) and OK lenses (-0.93) were large, but OK lenses had a significantly greater effect than peripheral add design spectacles (p ≤ 0.001). ESs were large during the first 12 months of treatment for all interventions [peripheral add design SCLs and OK (F ≥ 5.39, p ≤ 0.01), peripheral add design spectacles (F = 0.47, p = 0.63)] but reduced towards the end of 24-36 months of treatment. Baseline SER had an impact on the treatment effect with peripheral add design spectacles only. Optical interventions are efficacious in controlling childhood myopia progression. However, treatment effects were largest only during the first 12 months of treatment and reduced over time.

Investigation of corneal epithelial thickness and irregularity by optical coherence tomography after transepithelial photorefractive keratectomy

ABSTRACT Clinical relevance Corneal epithelial healing after refractive surgery is a clinically significant issue, especially for surface ablation procedures, and this can be monitored using optical coherence tomography (OCT). Background The aim of this work is to investigate the corneal epithelial thickness and irregularity by OCT after transepithelial photorefractive keratectomy (t-PRK) and analyse its correlation with visual and refractive outcomes. Methods Patients aged ≥18 years with myopia, with or without astigmatism, who underwent t-PRK between May 2020 and August 2021 were included. All participants were subjected to complete ophthalmic examinations and OCT pachymetry at every follow-up visit. Patients were followed up at 1 week and 1, 3, and 6 months postoperatively. Results A total of 67 patients (126 eyes) were enrolled in this study. One month postoperatively, spherical equivalent refraction and visual acuity achieved preliminary stability. However, central corneal epithelial thickness (CCET) and standard deviation of the corneal epithelial thickness (SDcet) took 3–6 months to progressive recovery. Patients with higher baseline spherical equivalent refraction were associated with slower epithelial recovery. At every follow-up time point, a significant superior-inferior difference in the minimum corneal epithelial thickness area was observed. Higher stromal haze was correlated with higher spherical equivalent refraction (both baseline and residual) but had no relation with visual outcomes. There was a significant correlation between higher CCET with a better uncorrected distance visual acuity and lower corneal epithelial thickness irregularity. Conclusions CCET and SDcet measured by OCT seem to be a good auxiliary indicator for reflecting the status of corneal wound recovery after t-PRK surgery. However, a well-designed randomised control study is needed to confirm the study results.

Nasal-temporal asymmetric changes in retinal peripheral refractive error in myopic adolescents induced by overnight orthokeratology lenses.

To observe the changes in peripheral refraction in myopic adolescents after overnight orthokeratology and its influencing factors. This was a prospective study among young myopic adolescents aged 8-14 years (n = 21). The peripheral refraction of the subjects was measured at 5, 10, 15, 20, 25, and 30° from the nasal and temporal side to the central fixation by WAM-5500 Open-field refractometer. The axial length, baseline spherical equivalent refraction, and other parameters were measured. The data were measured at baseline and 1, 3, and 12 months after wearing orthokeratology lenses. The relative peripheral refraction at the nasal and temporal side from central to 30° eccentricity revealed relative hyperopic defocus in all subjects at baseline measurement. One month after wearing the orthokeratology lenses, the relative peripheral refraction changed to myopic defocus, the nasal-temporal relative peripheral refraction was asymmetric, and the observed difference was statistically significant. Positive correlations were found between the change amount of nasal relative peripheral refraction and baseline spherical equivalent refraction, the baseline nasal relative peripheral refraction was higher than that on the temporal side, and after orthokeratology, the value of nasal relative peripheral refraction was lower than that on the temporal side. The changes at 30° on both sides were correlated to the axial elongation (rNasal = 0.565, rTemporal = 0.526, p < 0.05). This study demonstrated that after orthokeratology, relative peripheral hyperopia in the myopic patients turned into relative peripheral myopia, and the nasal-temporal asymmetry changed significantly after orthokeratology, which was correlated with the baseline refractive state.

Epidemiological Characteristics and Influencing Factors of Myopia Among Primary School Students in Southern China: A Longitudinal Study.

Objectives: To study the epidemiological characteristics and influencing factors of myopia to provide a scientific basis for the prevention and control of myopia. Methods: 7,597 students studying in grades 1-3 were followed up. Eye examinations and questionnaire surveys were conducted annually from 2019 to 2021. The influencing factors of myopia were analyzed by logistic regression model. Results: The prevalence of myopia among students in grades 1-3 in 2019 was 23.4%, which increased to 41.9% and 51.9% after the 1-and 2-year follow-up, respectively. The incidence of myopia and change in the spherical equivalent refraction (SER) were higher in 2020 than in 2021. The 2-year cumulative incidences of myopia were 2.5%, 10.1%, 15.5%, 36.3%, and 54.1% in students with a baseline SER >+1.50D, +1.00D to +1.50D, +0.50D to +1.00D, 0.00D to +0.50D, and -0.50D to 0.00D, respectively. Outdoor activities, sex, age, baseline SER, parental myopia, sleep time, and digital device exposure were associated with myopia. Conclusion: The prevalence of myopia demonstrated a rapid increase; thus, healthy habits and outdoor activities should be promoted for the prevention and control of myopia.

Assessing the efficacy of myopia control in monocular orthokeratology treated unilateral myopic children

PurposeTo investigate the efficacy of myopia control by comparing the orthokeratology (Ortho-K) treated eyes and the emmetropic contralateral eyes in unilateral myopic children, and to identify the inter-individual influence factors.MethodIn this retrospective study, 1566 medical records of children wearing Ortho-K lens were reviewed, and 62 children who received monocular Ortho-K lens for more than 1 year were analyzed. The change in axial length (AL) of the Ortho-K eyes and the emmetropic contralateral eyes was recorded. To evaluate the absolute and relative efficacy of myopia control, the intra-bilateral absolute reduction in AL growth (ibARAL) and the intra-bilateral relative reduction in AL growth (ibRRAL) were calculated as main outcomes. Association of the AL elongation, ibARAL and ibRRAL with age, sex and ocular parameters was analyzed by correlation analysis and generalized estimating equation (GEE) analysis.ResultThe average initial wearing age was 10.76 ± 1.45 (ranged 8.5 to 15.8). The average baseline SER was − 2.15 ± 1.03 (ranged − 5.25 to -1.00) D in the Ortho-K eyes and − 0.01 ± 0.40 (ranged − 0.75 to 0.75) D in the contralateral eyes. At the 1-year follow-up, the average increased AL was significantly less in the Ortho-K eyes (0.07 ± 0.18 mm) than in the fellow eyes (0.48 ± 0.24 mm) (p < 0.001). The mean ibARAL was 0.41 ± 0.30 mm, and the mean ibRRAL was 83.4%±56.3%. In the GEE model, the AL change in Ortho-K eyes (β = 0.051, p = 0.009, 95%CI: 0.012 to 0.090), the ibARAL (β= -0.153, p = 0.000, 95%CI: -0.228 to -0.078) and the ibRRAL (β= -0.196, p = 0.020, 95%CI: -0.361 to -0.030) were independently associated with the spherical equivalent refraction (SER) of the Ortho-K eyes, after adjusting for age, sex, and keratometry.ConclusionIn our study, the Ortho-K treatment was efficacious in controlling axial length growth in the monocular orthokeratology treated unilateral myopic eyes. The efficacy increased when the myopia was more severe. In the children from 8 to 16 years old, the effectiveness was independent of age and sex.

The effect of back optic zone diameter on relative corneal refractive power distribution and corneal higher-order aberrations in orthokeratology

To compare axial elongation, relative corneal refractive power (RCRP) distribution within the pupillary diameter, and corneal higher-order aberrations (HOAs) in myopic children wearing orthokeratology (ortho-k) lenses with different back optic zone diameters (BOZD). Children aged 8-11 years were fitted with 5.0 or 6.2 mm-BOZD ortho-k lenses (groups A and B, respectively). Axial length (AL) and corneal topography were measured at baseline and during the annual visit. RCRP and corneal HOAs were compared between the two groups after one-year treatment. Multivariate linear regression analysis was performed to determine the association between AL elongation and RCRP parameters, corneal HOAs, and other variables between the groups. After one-year treatment, axial elongation was slower in group A than in group B, with a difference of 0.15 mm. Children in group A showed smaller treatment zone size, smaller 3/4X value (describing the distance from the apex RCRP profile rising to its three-quarter-peak level), greater RCRP sum value within the pupillary area, and higher increases in corneal total HOAs and horizontal coma (Z31). AL elongation was significantly correlated with baseline age, baseline spherical equivalent refraction (SER), treatment zone size, and 3/4X value. Ortho-k lenses designed with smaller BOZD increased myopia control efficacy, induced a steeper distribution of the RCRP profile within the pupillary diameter, and induced greater increases in corneal total HOAs and horizontal coma (Z31). Lens-induced RCRP profile within pupillary diameter, rising to its three-quarter-peak level at a smaller distance, may show a better myopia control effect.

Factors determining the myopia control effect of an orthokeratology lens: A two-year multi-level model.

A multi-level model was used to analyse factors, including environmental factors, affecting the controlling effect of orthokeratology on myopia progression. A 2-year prospective study was conducted in the West China Hospital, Sichuan University. Age, sex, height, baseline spherical equivalent refraction, choroidal thickness, axial length and other biometric ocular parameters were collected. Additionally, data on the following environmental factors were obtained: near-work distance and time, sleep time and time spent outdoors. After the baseline measurements, participants were followed up every 3months for 2years of lens wear. The primary outcome measure was axial length elongation over 2years of orthokeratology. All variables were included in a univariate, three-level analysis model with inclusion in the final multivariate multi-level model if statistically significant. Thirty-three participants (average age 9.73±1.55years) were included in this study. During the 2-year period of lens wearing, binocular changes in axial length increased significantly from the ninth month and continued until the end of the follow-up. Changes in axial length after 2years of lens wearing were 0.44±0.30mm and 0.37±0.26mm in the right and left eyes, respectively (both p<0.001). Based on the 2-year multi-level model, age, sex, baseline spherical equivalent refraction, flatter keratometry meridian and near-work time influence the effect of orthokeratology. This is the first study to use a multi-level model to analyse factors, including environmental factors, that affect myopia control using orthokeratology. These results showed that younger age, being female, having lower myopia at baseline, a steeper flattest keratometry meridian and no more than 5h of near work per day were associated with better myopia control effect using orthokeratology over a 2-year treatment period.

Annual Incidences and Progressions of Myopia and High Myopia in Chinese Schoolchildren Based on a 5-Year Cohort Study.

PurposeTo determine the annual incidences and rates of progression of myopia and high myopia in Chinese schoolchildren from grade 1 to grade 6 and explore the possible cause-specific risk factors for myopia.MethodsFrom 11 randomly selected primary schools in Anyang city, central China, 2835 grade 1 students were examined with annual follow ups for 5 years. Students were invited to undergo a comprehensive examination, including cycloplegic autorefraction, ocular biometry, and standardized questionnaires.ResultsThe mean spherical equivalent refraction decreased substantially from +0.94 ± 1.03 diopter (D) in grade 1 to −1.37 ± 2.08 D in grade 6, with rapid annual myopic shifts, especially for students in grades 3 through 6 (−0.51 to −0.59 D). The prevalence of myopia increased substantially, with the yearly incidence of myopia increasing from 7.8% in grade 1 and 2 to 25.3% in grades 5 and 6, and the incidence of high myopia increased from 0.1% to 1.0%. The 5-year incidence of myopia was lowest among children who has a baseline spherical equivalent refraction of greater than +2.00 D (4.4%), and increased to nearly 92.0% among children whose baseline spherical equivalent refraction was 0.00 to −0.50 D. The incidence of myopia was higher in children who had less hyperopic baseline refraction, two myopic parents, longer axial length, deeper anterior chamber, higher axial length–corneal radius of curvature ratio, and thinner lenses.ConclusionsBoth the annual incidence and progression rates of myopia and high myopia were high in Chinese schoolchildren, especially after grade 3. Hyperopic refraction of children should be monitored before primary school as hyperopia reserve to prevent the onset of myopia and high myopia.

Adjunctive effects of orthokeratology and atropine 0.01% eye drops on slowing the progression of myopia

ABSTRACT Clinical relevance All eye health care practitioners should know how to control myopia. Background Investigating the adjunctive effects of orthokeratology and 0.01% atropine eye drops on controlling the progression of myopia in Chinese children. Methods The prospective study included Chinese children aged 8 to 13 years having a spherical equivalent refractive error ranging from −2.00 to −5.00 D. Participants were categorised into two groups: combination group (orthokeratology and 0.01% atropine) or atropine group (0.01% atropine). The axial length and spherical equivalent refraction were measured at baseline and every three months post-treatment and compared over two years. Results The combinaion and atropine groups comprised 20 and 22 participants. Following two years of treatment, the average spherical equivalent refraction change was 0.88 ± 0.31 D and 1.14 ± 0.63 D in the combination group and atropine group, respectively (P = 0.026), with an average increment in axial length of 0.50 ± 0.17 mm and 0.61 ± 0.21 mm, respectively (P = 0.091). In the atropine group, increased axial length was positively correlated with baseline spherical equivalent refraction (P = 0.018) and negatively correlated with baseline age (P = 0.003). However, these correlations were not observed in the combination group. In the subgroup of subjects aged 8-10 years and another subgroup of subjects with shorter initial axial length (22.00 to 24.50 mm), the changes in axial length over two years were significantly smaller in the combination group than the atropine group. Conclusion Orthokeratology and 0.01% atropine eye drops combination therapy were found to be more effective in reducing progression of myopia, as measured through spherical equivalent refraction changes, than atropine monotherapy in children over two years. Combinatorial therapy was more effective in controlling the elongation of axial length in children with younger baseline age or shorter baseline axial length.

Eyes grow towards mild hyperopia rather than emmetropia in Chinese preschool children.

PurposeTo document one‐year changes in refraction and refractive components in preschool children.MethodsChildren, 3–5 years old, in the Jiading District, Shanghai, were followed for one year. At each visit, axial length (AL), refraction under cycloplegia (1% cyclopentolate), spherical dioptres (DS), cylinder dioptres (DC), spherical equivalent refraction (SER) and corneal curvature radius (CR) were measured.ResultsThe study included 458 right eyes of 458 children. The mean changes in DS, DC and SER were 0.02 ± 0.35 D, −0.02 ± 0.33 D and 0.01 ± 0.37 D, while the mean changes in AL, CR and lens power (LP) were 0.27 ± 0.10 mm, 0.00 ± 0.04 mm and − 0.93 ± 0.49 D. The change in the SER was linearly correlated with the baseline SER (coefficient = −0.147, p < 0.001). When the baseline SER was at 1.05 D (95% CI = 0.21 to 2.16), the change in SER was 0 D. The baseline SER was also linearly associated with the change in LP (coefficient = 0.104, p = 0.013), but not with the change in AL (p = 0.957) or with the change in CR (p = 0.263).ConclusionIn eyes with a baseline SER less than +1.00 D, LP loss was higher compared to axial elongation, leading to hyperopic shifts in refraction, whereas for those with baseline SER over this range, loss of LP compared to axial elongation was reduced, leading to myopic shifts. This model indicated the homeostasis of human refraction and explained how refractive development leads to a preferred state of mild hyperopia.

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

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.

Association between Time Spent on Smart Devices and Change in Refractive Error: A 1-Year Prospective Observational Study among Hong Kong Children and Adolescents.

This study examined the association between smart device usage and the 1-year change in refractive error among a representative sample of Hong Kong children and adolescents aged 8–14 years. A total of 1597 participants (49.9% male, mean age 10.9, SD 2.0) who completed both baseline (2017–2018) and 1-year follow-up (2018–2019) eye examinations were included in the present study. The non-cycloplegic auto-refractive error was measured and the average spherical equivalent refraction (SER) was analyzed. The participants also self-reported their smart device usage at baseline. Multivariate regression adjusted for age, sex, baseline SER, parents’ short-sightedness, BMI, time spent on moderate-to-vigorous physical activity (MVPA), and caregiver-reported socio-economic status showed that, compared with the reference group (<2 h per day on both smartphone and tablet usages), those who spent ≥2 h per day using a smartphone and <2 h per day using a tablet had a significantly negative shift in refractive error (1-year change in SER −0.25 vs. −0.09 D, p = 0.01) for the right eye, while the level of significance was marginal (1-year change −0.28 vs. −0.15 D, p = 0.055) for the left eye. To conclude, our data suggested spending at most 2 h per day on both smartphones and tablets.