Changes In Axial Length Research Articles

The human axial length and choroidal thickness responses to continuous and alternating episodes of myopic and hyperopic blur

PurposeTo investigate the change in axial length (AxL) and choroidal thickness (ChT) in response to continuous and alternating episodes of monocular myopic and hyperopic defocus.MethodsThe right eye of sixteen young adults was exposed to 60 minute episodes of either continuous or alternating myopic and hyperopic defocus (+3 DS & -3 DS) over six separate days, with the left eye optimally corrected for distance. During alternating defocus conditions, the eye was exposed to either 30 or 15 minute cycles of myopic and hyperopic defocus, with the order of defocus reversed in separate sessions. The AxL and ChT of the right eye were measured before, during and after each defocus condition.ResultsSignificant changes in AxL were observed over time, dependent upon the defocus condition (p < 0.0001). In general, AxL exhibited a greater magnitude of change during continuous than alternating defocus conditions. The maximum AxL elongation was +7 ± 7 μm (p = 0.010) in response to continuous hyperopic defocus and the maximum AxL reduction was -8 ± 10 μm of (p = 0.046) in response to continuous myopic defocus. During both 30 and 15 minute cycles of alternating myopic and hyperopic defocus of equal duration, the effect of opposing blur sessions cancelled each other and the AxL was near baseline levels following the final defocus session (mean change from baseline across all alternating defocus conditions was +2 ± 10 μm, p > 0.05). Similar, but smaller magnitude, changes were observed for ChT.ConclusionsThe human eye appears capable of temporal averaging of visual cues from alternating myopic and hyperopic defocus. In the short term, this integration appears to be a cancellation of the effects of the preceding defocus condition of opposite sign.

Topical atropine in retarding myopia progression and axial length growth in children with myopia

This study was conducted to observe the effect of atropine in retarding myopia progression and axial length growth in 36 myopic children (atropine group, 24; control, 12). The initial spherical equivalent of the atropine group and control group was -3.0 ± 1.6 dioptre and -3.5 ± 1.6 dioptre respectively. At the 12th month in atropine group, it was -2.9 ± 2.6 dioptre and -4.6 ± 1.9 dioptre in the control group. The power of the atropine group reduced but rose in the control group after 12 months. There was a statistically significant difference in final refractive errors between the two groups (p&lt;0.05). The initial axial length of the atropine group and control group was 24.3± 1.0 mm and 24.6 ± 1.1 mm respectively. In 12th month, the changes in axial length in the two groups was insignificant. However, the mean axial length progression at 12 months of the atropine group was -0.1 ± 0.1 mm and it was lower than the control group which was -0.2 ± 0.2 mm, and this was statistically significant (p&lt;0.05). In conclusion, topical atropine (0.01%) retarded myopia progre-ssion and axial length growth in myopic children.

Increased Choroidal Blood Perfusion Can Inhibit Form Deprivation Myopia in Guinea Pigs.

PurposeIn guinea pigs, choroidal thickness (ChT) and choroidal blood perfusion (ChBP) simultaneously decrease in experimental myopia, and both increase during recovery. However, the causal relationship between ChBP and myopia requires further investigation. In this study, we examined the changes of ChBP with three different antimyopia treatments. We also actively increased ChBP to examine the direct effect on myopia development in guinea pigs.MethodsExperiment 1: Guinea pigs wore occluders on the right eye for two weeks to induce form-deprivation myopia (FDM). Simultaneously they received daily antimyopia treatments: peribulbar injections of atropine or apomorphine or exposure to intense light. Experiment 2: The vasodilator prazosin was injected daily into the form-deprivation eyes to increase ChBP during the two-week induction of FDM. Other FDM animals received appropriate control treatments. Changes in refraction, axial length, ChBP, ChT, and hypoxia-labeled pimonidazole adducts in the sclera were measured.ResultsThe antimyopia treatments atropine, apomorphine, and intense light all significantly inhibited myopia development and the decrease in ChBP. The treatments also reduced scleral hypoxia, as indicated by the decrease in hypoxic signals. Furthermore, actively increasing ChBP with prazosin inhibited the progression of myopia, as well as the increase in axial length and scleral hypoxia.ConclusionsOur data strongly indicate that increased ChBP attenuates scleral hypoxia, and thereby inhibits the development of myopia. Thus ChBP may be a promising target for myopia retardation. As such, it can serve as an immediate predictor of myopia development as well as a long-term marker of it.

Comparison of postoperative anterior segment changes associated with pars plana vitrectomy with and without vitreous base shaving.

To compare changes in anterior segment topography and axial length (AL) evaluated with Pentacam and IOL Master after pars plana vitrectomy (PPV) performed with and without vitreous base shaving. This prospective study included patients who underwent PPV or phacoemulsification+PPV (Phaco+PPV) for various indications. Patients who underwent total posterior hyaloid detachment and excessive vitreous base shaving with scleral indentation were referred to as complete PPV (c-PPV). The patients whom posterior hyaloid was separated as far as the posterior arcades and vitreous base shaving with scleral depression was not performed were classified as the partial PPV (p-PPV) group. All patients underwent detailed ophthalmologic examinations preoperatively and 1wk, 1, and 3mo postoperatively. Changes in the anterior chamber depth (ACD), anterior chamber volume (ACV), iridocorneal angle (ICA), central corneal thickness (CCT), and keratometric measurements (K1 and K2) were evaluated with Pentacam HR. Changes in the AL measurements were analyzed with IOL Master. A significant increase in ACD was observed in c-PPV cases (P=0.02), but this increase was not significant in the p-PPV group (P=0.053). In contrast, ICA increased significantly in the c-PPV group (P=0.02) but decreased in the p-PPV group (P=0.09). BCVA was significantly improved in the c-PPV group from week 1 (P<0.001) while the increase in the p-PPV group reached significance at 3mo (P=0.035). CCT increased in the first week and later returned to baseline in both groups. No significant differences in the other parameters were observed between the groups, and there were no significant changes in intraocular pressure, ACV, AL, K1 or K2 values (P>0.05 for all). Incomplete posterior hyaloid excision and not removing the vitreous base in PPV surgeries may create a more stable anterior chamber, thus preventing the downward movement of the lens-iris diaphragm, and may cause ciliary body retraction, thereby reducing ICA. Awareness of these effects can provide some amount of guidance to physicians in selecting the appropriate PPV procedure and preempting surgical complications.

Age-Related Change of Axial Length, Spherical Equivalent, and Prevalence of Myopia and High Myopia in School-Age Children in Shanghai: 2014–2018

Purpose. To investigate the age-related change of axial length (AL), spherical equivalent (SE), and prevalence of myopia and high myopia in children at 7–18-year-olds in Shanghai in 2014 and 2018, respectively. Methods. This was an observational study in Shanghai. The same 3 schools were selected in 2014 and 2018, respectively. AL, SE, prevalence of myopia and high myopia, height, and weight were measured. A questionnaire regarding the lifestyles was completed. Results. Mean age was smaller in 2018 than in 2014 (P&lt;0.001), and mean AL was shorter in 2018 than in 2014 (P=0.003), whereas mean SE was greater in 2018 than in 2014 (P&lt;0.001). The prevalence of myopia and high myopia was lower in 2018 than in 2014 (P&lt;0.001andP=0.013, respectively). Mean AL increased with age from 7-year-olds to 18-year-olds in 2014 and 2018 (bothP&lt;0.001), respectively. Mean SE decreased with age in 2014 and 2018 (bothP&lt;0.001), respectively. The prevalence of myopia and high myopia increased with age in 2014 and 2018 (allP&lt;0.001), respectively. Less mean time outdoors and more mean time of study of all children were observed in 2018 than in 2014 (P=0.018andP&lt;0.001, respectively). Conclusion. This study shows normative growth values for AL and SE in Shanghai children at the age of 7–18-year-olds, as well as the age-specific prevalence of myopia and high myopia.

The Effect of Hemodialysis on Axial Length, Ocular Surface, and Intraocular Pressure in Patients with End-Stage Renal Failure.

PurposeTo evaluate the changes in intraocular pressure (IOP), central corneal thickness (CCT), axial length, and ocular surface in patients with end-stage renal failure after single-session hemodialysis treatment and to examine the correlation of these findings with systemic hemodynamic parameters.Patients and MethodsA total of 112 eyes of 112 patients enrolled in a hemodialysis treatment program for three times a week (approximately four hours per session) for at least three months in our hospital between December 2019 and March 2020 were included in the study. Approximately 30 minutes before and after hemodialysis, the best-corrected visual acuity measurement, slit-lamp examination, IOP measurement, and dilated fundus examination with the Goldmann applanation tonometer were performed in all patients. The axial length measurement was undertaken by ultrasonic biometry, and the CCT measurement by ultrasonic pachymetry. The ocular surface evaluation was performed based on the tear breakup time (BUT), basal secretion time (BST) and keratoepitheliopathy score. Blood pressure, serum osmolarity, and body weight were measured before and after hemodialysis.ResultsThe mean IOP decreased from 12.2 ± 3.5 to 10.8 ± 2.2 mmHg, and the mean decrease was 1.4 ± 2 mmHg, indicating statistical significance (p<0.001). The mean CCT dropped from 502 ± 41.2 to 494.1 ± 35.4 μm, and the mean decrease was 8.1 ± 7.7 μm, which also indicated a statistically significant change (p<0.001). The mean axial length was reduced from 23.1 ± 0.8 to 22.9 ± 0.8 mm. The reduction in the axial length was significant with an average value of 0.26 ± 0.15 mm (p<0.001). When the ocular surface changes were examined, BUT decreased from 7.4 ± 3.1 to 6.3 ± 2.5 s, BST from 8.6 ± 1.7 to 6.6 ± 1.3 mm, and the keratoepitheliopathy score increased from 0.36 ± 0.61 to 1.59 ± 0.93, and all these changes were statistically significant (p<0.001). There was a significant correlation between the axial length change and the IOP change (r=0.202, p=0.03). A significant correlation was also observed between BST and plasma colloid osmotic pressure (r=−0.268, p=0.004). In addition, there was a strong correlation between serum osmolarity and the keratoepitheliopathy score (r=−0.437, p<0.001).ConclusionHemodialysis causes significant changes in IOP, CCT, axial length, and ocular surface. These changes should be considered in the ophthalmological examination of patients after the hemodialysis session.

Long-term longitudinal changes in axial length in the Caucasian myopic and hyperopic population with a phakic intraocular lens.

PurposeTo determine the long‐term longitudinal axial length changes in myopic and hyperopic adults with an iris‐fixated phakic intraocular lens (pIOL).MethodsThe medical records of patients aged ≥18 years with myopia or hyperopia who were treated with pIOL implantation between 1996 and 2011 for refractive correction with a minimum follow‐up of 5 years after pIOL implantation were analyzed. The main outcome measure was change in ocular axial length over time.Results149 eyes of 149 myopic patients and 27 hyperopic eyes of 27 patients were included in this study. Mean patient age was 37.1 ± 10.4 years (35% male) in the myopic group and 39.4 ± 9.4 years (4% male) in the hyperopic group. The eyes of the myopic patients showed a significant mean increase in axial length of 0.45 ± 0.61 mm after a mean follow‐up time of 144 ± 38 months (p < 0.001). In 26 eyes (17%), the axial length had increased by ≥1 mm. The mean annual axial length increase was 0.04 ± 0.06 mm. Axial elongation was associated with a higher degree of myopia (p < 0.001) and younger age (p = 0.02). The eyes of the hyperopic patients showed no change in axial length over time.ConclusionsMyopic eyes corrected with an iris‐fixated pIOL show continuous increase in axial length at an adult age. Although this study is limited to subjects with a pIOL, this is the first time myopization in Caucasian adults has been reported in a large long‐term longitudinal study.

Two-Year Reproducibility of Axial Length Measurements after Combined Phacovitrectomy for Epiretinal Membrane, and Refractive Outcomes.

Purpose: To determine the long-term reproducibility of axial length measurements and mean postoperative prediction errors after combined phacovitrectomy in patients with idiopathic epiretinal membranes. Design: Retrospective cohort study. Methods: The study included 43 patients who underwent combined phacovitrectomy and 30 patients who underwent only phacoemulsification. To determine the effect of vitrectomy, we compared patients treated with phacoemulsification only versus those treated with combined phacovitrectomy. Axial lengths were measured three times with a one-year interval, and the intraclass correlation coefficient (ICC), coefficient of variation (CV), and test–retest standard deviation (TRTSD) were assessed. Results: There was no significant change in axial length, and axial length measurements showed high reproducibility in all groups. ICC, CV, and TRTSD values were 0.997, 0.24%, and 0.056, respectively, for the vitrectomized eyes. The mean postoperative prediction error was −0.37 diopters(D) in vitrectomized eyes (p < 0.001), while it was +0.11 D in patients with phacoemulsification (p = 0.531). The myopic shift was more obvious in eyes with a shallower anterior chamber (p = 0.008) and a thicker lens (p = 0.025). Conclusions: Axial length measurements showed excellent long-term reproducibility at 2 years after combined phacovitrectomy. Myopic shifts were observed after combined phacovitrectomy, which was probably due to changes in the effective lens position after combined phacovitrectomy, rather than to changes in the axial length.

The relationship between axial length, age and intraocular pressure in children with primary congenital glaucoma

Whilst axial length (AxL) from ultrasound examination is a useful clinical parameter for monitoring progression in younger children with glaucoma, distinguishing AxL changes due to raised intraocular pressure (IOP) from age is often challenging. Existing normograms have included a limited number of children with glaucoma. The aim of this study was to evaluate the relationship between AxL with age and IOP in children with primary congenital glaucoma (PCG) and develop a model for expected AxL increase with age. All children (n = 208; 397 eyes) with PCG who attended our tertiary eye care facility from June 2014 and July 2018 and had AxL and IOP measurements were included. The relationship of AxL with age and IOP was studied by applying a LOWESS fit and then mixed effects models. In the final model, age was the most significant factor influencing the growth of AxL (coefficient age 3.14[95% CI 2.91–3.35, p < 0.001], coefficient age2 − 0.53[95% CI, − 0.59 to − 0.47, p < 0.001]), and this association was influenced by the interaction of IOP with sex (p = 0.098 for girls relative to boys), the number of antiglaucoma medications (AGM [p < 0.001 for ≥ 3 AGM]) and glaucoma surgery (p = 0.015). This model enabled us to derive predicted values for clinical use in children with PCG to predict those with progressive glaucoma.

Effect of isotretinoin on myopia and axial length: a pilot study

Purpose To investigate the effect of oral isotretinoin use on refractive error, axial length, and anteroposterior segment parameters. Materials and methods In this prospective study, 50 eyes of 50 patients using isotretinoin with a diagnosis of acne vulgaris and 50 eyes of 50 healthy control subjects were included. After detailed biomicroscopy, measurements were taken of axial length, lens thickness, central corneal thickness, anterior chamber depth, central retinal thickness, and subfoveal choroidal thickness. The pupils of both eyes were dilated with one drop of cycloplegic drops after refraction measurement. Visual acuity examination was performed with a Snellen chart the next day. The same procedure was repeated at the end of the third and sixth month of drug treatment. Results Forty-seven patients with acne vulgaris and 45 healthy controls met the inclusion criteria and were included in the analysis. The mean ages of the patients and the controls were 21.7 ± 2.5 years (range, 18–28 years) and 22.6 ± 2.7 years (range, 19–27 years), respectively. No significant changes were observed in any parameters in the third and sixth month in the control group (p > 0.05). The most important result was significant increases in myopia and axial length in the sixth month of isotretinoin use (p = 0.01, p = 0.04, respectively). There were no significant relationships between increases in myopia and axial length and patients’ age, sex, drug dose, and initial refraction (p > 0.05). The changes in spherical equivalent and axial length differed significantly between the drug group and the control group (p = 0.001, p = 0.001, respectively). Conclusions Isotretinoin is one of the important molecules in the aetiology of myopia. Oral isotretinoin treatment may increase myopia and axial length, although not to a clinically significant degree. However, as this was a pilot study, there is a need for further studies with more patients and longer follow-up periods.

Can the progression of myopia be restrained by monolateral excimer laser correction?

The purpose of this study was a comparative assessment of the refraction and the axial length (AL) changes occurring in the operated and unoperated eyes of patients with anisometropic myopia who underwent unilateral excimer laser correction. Material and methods . We observed 13 patients (8 women and 5 men) aged 21 to 53 years (34.2 ± 8.6) with anisometropic myopia (averagely, with spherical equivalent of refraction -3.87 ± 1.77 D in one eye and 0.71 ± 0.71 D in the other), who underwent unilateral LASIK. The observation period was 3-5 years (averagely 3.5 ± 1.1 years). The observation included autorefractometry on a Nidek ARK-530A apparatus, ultrasound biometry on a Nidek US-1800 Echos с an (Japan), and pachymetry on a GALILEI G6 (Ziemer, Switzerland). Results. No significant changes in refraction or axial length were observed either in operated or fellow eyes. Changes in the axial length were controversial: 7 operated and 7 fellow eyes showed an increasing tendency while another 6 operated and 6 fellow eyes showed a decreasing tendency (p &gt; 0.05). Conclusion. The data obtained fail to support the assumption that excimer laser reshaping of the cornea produces an inhibitory effect on the development of myopia.

Age-related axial length changes in adults: a review.

To investigate the origins of age-related decreases in axial length in the literature. A literature review was performed, including all articles regarding axial length changes with age. These data were combined with mean body length and education level for the countries of each study to assess their influence in a multivariate analysis. Furthermore, analyses were performed of how optical path length, used by optical biometers to measure axial length, is affected by the known age-related changes in the crystalline lens. The influence of other factors mentioned in the literature was also investigated. Seventeen cross-sectional studies were found that met the search criteria. The decrease in axial length over time was consistent across most of these studies. However, when plotted as a function of year of birth, mean body length and number of years in school, the data indicated an increase in length. Multivariate analysis confirmed the influence of body length (P=0.005) and birth year (P=0.017), but not age (P=0.50). Meanwhile, the lenticular changes due to aging and cataract formation cause a minor bias in the form of increased axial length measurements. Finally, a gradual thinning of the choroidal arteries was reported to cause an increase in axial length. The age-related decrease in axial length is mainly associated with gradual changes in increased body length and education level, while attenuated by minor biases in measurement procedure and thinning of the choroidal arteries.

Effects of Narrowband Light on Choroidal Thickness and the Pupil.

PurposeTo determine the effects of narrowband light exposure on choroidal thickness and the pupil response in humans.MethodsTwenty subjects, ages 21 to 43 years, underwent 1 hour of exposure to broadband, short wavelength “blue,” or long wavelength “red” light, or darkness. Choroidal thickness, imaged with spectral domain optical coherence tomography, axial length, determined from biometry, and rod/cone- and intrinsically photosensitive retinal ganglion cell-driven pupil responses were measured before and after exposure. Pupil stimuli were six 1 second alternating red (651 nm) and blue (456 nm) stimuli, 60 seconds apart. Pupil metrics included maximum constriction and the 6 second post-illumination pupil response (PIPR).ResultsCompared with before exposure, the choroid significantly thinned after broadband light, red light, and dark exposure (all P < 0.05), but not after blue light exposure (P = 0.39). The maximum constriction to 1 second red stimuli significantly decreased after all light exposures (all P < 0.001), but increased after dark exposure (P = 0.02), compared with before exposure. Maximum constriction and 6-second PIPR to 1 second blue stimuli significantly decreased after all light exposures compared with before exposure (all P < 0.005), with no change after dark exposure (P > 0.05). There were no differences in axial length change or 6-second PIPR to red stimuli between exposures.ConclusionsNarrowband blue and red light exposure induced differential changes in choroidal thickness. Maximum constriction, a function of rod/cone activity, and the intrinsically photosensitive retinal ganglion cell-mediated PIPR were attenuated after all light exposures. Findings demonstrate differing effects of short-term narrowband light and dark exposure on the choroid, rod/cone activity, and intrinsically photosensitive retinal ganglion cells.

3-D assessment of gaze-induced eye shape deformations and downgaze-induced vitreous chamber volume increase in highly myopic eyes with staphyloma

PurposeTo determine if the stress of normal eye movements results in gaze-induced globe deformations, vitreous chamber axial length and vitreous chamber axial volume (VCAV) change in highly myopic eyes.MethodsA prospective...

Effect of 0.01% atropine eye drops on choroidal thickness in myopic children

To examine the effects of low-dose atropine on the choroidal thickness (CT) of young children in Shanghai, China, as well as the ocular biometrics of myopic patients. A total of 59 eyes of 35 myopic children had subfoveal CT and ocular biometry measurements taken before and after 2weeks, 4weeks, and 8weeks of treatment with 0.01% atropine. All eyes were measured using swept-source optical coherence tomography. CT and changes in it were also recorded. The choroid exhibited significant and continuous thickening under the fovea after patients were treated with 0.01% atropine. The magnitude of change in CT varied with the location and with the duration of treatment. The greatest change was observed in the fovea. There was no significant relationship between changes in subfoveal CT and axial length. Using 0.01% atropine eye drops significantly increased CT in eyes of young myopic children, by variable magnitude depending upon location.

Erratum to: Change in optical axial length after cataract surgery: segmental method vs composite method

Erratum to: Change in optical axial length after cataract surgery: segmental method vs composite method

In vivo Structural Assessments of Ocular Disease in Rodent Models using Optical Coherence Tomography.

Spectral-domain optical coherence tomography (SD-OCT) is useful for visualizing retinal and ocular structures in vivo. In research, SD-OCT is a valuable tool to evaluate and characterize changes in a variety of retinal and ocular disease and injury models. In light induced retinal degeneration models, SD-OCT can be used to track thinning of the photoreceptor layer over time. In glaucoma models, SD-OCT can be used to monitor decreased retinal nerve fiber layer and total retinal thickness and to observe optic nerve cupping after inducing ocular hypertension. In diabetic rodents, SD-OCT has helped researchers observe decreased total retinal thickness as well as decreased thickness of specific retinal layers, particularly the retinal nerve fiber layer with disease progression. In mouse models of myopia, SD-OCT can be used to evaluate axial parameters, such as axial length changes. Advantages of SD-OCT include in vivo imaging of ocular structures, the ability to quantitatively track changes in ocular dimensions over time, and its rapid scanning speed and high resolution. Here, we detail the methods of SD-OCT and show examples of its use in our laboratory in models of retinal degeneration, glaucoma, diabetic retinopathy, and myopia. Methods include anesthesia, SD-OCT imaging, and processing of the images for thickness measurements.

In vivo Structural Assessments of Ocular Disease in Rodent Models using Optical Coherence Tomography

Spectral-domain optical coherence tomography (SD-OCT) is useful for visualizing retinal and ocular structures in vivo. In research, SD-OCT is a valuable tool to evaluate and characterize changes in a variety of retinal and ocular disease and injury models. In light induced retinal degeneration models, SD-OCT can be used to track thinning of the photoreceptor layer over time. In glaucoma models, SD-OCT can be used to monitor decreased retinal nerve fiber layer and total retinal thickness and to observe optic nerve cupping after inducing ocular hypertension. In diabetic rodents, SD-OCT has helped researchers observe decreased total retinal thickness as well as decreased thickness of specific retinal layers, particularly the retinal nerve fiber layer with disease progression. In mouse models of myopia, SD-OCT can be used to evaluate axial parameters, such as axial length changes. Advantages of SD-OCT include in vivo imaging of ocular structures, the ability to quantitatively track changes in ocular dimensions over time, and its rapid scanning speed and high resolution. Here, we detail the methods of SD-OCT and show examples of its use in our laboratory in models of retinal degeneration, glaucoma, diabetic retinopathy, and myopia. Methods include anesthesia, SD-OCT imaging, and processing of the images for thickness measurements.

Refractive, biometric and corneal topographic parameter changes during 12-months of orthokeratology

BackgroundThe aim of this study was to monitor refractive, topographic and biometric changes in Singaporean myopic children fitted with orthokeratology over a period of 12-months.MethodsData from 62 myopic eyes from an Asian population corrected with orthokeratology were retrospectively collected from an optometric clinic in Singapore. Anterior segment parameters were analysed with a Pentacam. Axial length was measured using the IOLMaster and refraction was assessed by subjective examination before the treatment and after one night, one week, and one, three, six and 12-months. A logistic regression model was built to evaluate the probability of slower (< 0.10-mm/year) or faster eye growth (≥ 0.10-mm/year).ResultsSubjects had a mean age of 12.2 ± 3.9-years (range 5–19-years), and 71 per cent were female. Baseline myopia was −3.95 ± 1.59-D (range −1.50 and −8.75 D). Statistically significant differences were found after 12-months of treatment for refractive error, parameters of the central anterior corneal surface (curvature and elevation) and central corneal thickness. Topographic and thickness changes stabilised after one week of treatment. During 12-months of orthokeratology treatment there was a significant increase of axial length (difference = 0.11 ± 0.18-mm, p < 0.001) while refraction remained stable. Changes in axial length of subjects above 11-years were not statistically significantly independent of the baseline myopia, and in subjects with baseline myopia greater than 4.00 D. Logistic regression showed that each additional year of age and each additional dioptre of baseline myopia decreased the probability of faster axial elongation (odds ratio [OR] = 1.23, 2.19 95% CI; OR = 1.08, 3.47 95% CI, respectively).ConclusionCorneal parameters in orthokeratology treatment were stable after one week, particularly for myopes under 4.00 D. Axial length did not change significantly in children older than 11-years of age or in subjects with myopia above 4.00 D undergoing orthokeratology treatment.

From Conventional Angle Surgery to 360-Degree Trabeculotomy in Pediatric Glaucoma

To describe the transition from conventional angle surgery (CAS), trabeculotomy with rigid probe or goniotomy, to 360-degree trabeculotomy assisted with microcatheter (MCT). Retrospective comparative interventional case series. Review of consecutive children with glaucoma undergoing angle surgery, including cases with previous surgery, from January 2012 until March 2018 at Moorfields Eye Hospital. Main outcome measure was success rate, defined as intraocular pressure (IOP) ≤21mm Hg with a minimum of 20% of IOP reduction and no further glaucoma surgery (complete success: without the need of glaucoma drops; qualified success: drops were needed to keep the IOP under control). Among the 106 eyes (77 patients) included were 54 MCT and 52 CAS eyes. At last visit, after a single surgery, qualified success was 85% (46 eyes) in MCT and 37% (19 eyes) in CAS. Complete success was 69% (37 cases) in MCT and 23% (12 cases) in CAS. The mean (95% confidence interval) change in axial length after surgery was-0.03mm (-0.34 to 0.40) for MCT and+1.35mm (-0.64 to 1.62) for CAS (P < .001). The percentage of IOP reduction was 52.1% in MCT and 45.5% in CAS (P= .1616). Further glaucoma surgery was required in 5.5% (3) in MCT and 63.4% (33) in CAS. At 1 year, 94.3% of MCT cases achieved qualified success compared to 34.6% of CAS (P < .0001). No significant complications were found on either group. MCT achieved better results with significantly lower reoperation rates. The transition from CAS to MCT can be easily achieved, even in difficult cases or those previously operated.