High Myopia Research Articles

In vivo assessment of cone loss and macular perfusion in children with myopia

This study evaluated cone density (CD) in the macular region and assess macular perfusion in children with varying degrees of myopia. This was a prospective, cross-sectional, observational study. Children underwent confocal scanning laser ophthalmoscopy (cSLO), optical coherence tomography (OCT), and OCT angiography (OCTA) imaging. A built-in software was used to measure mean CD (cells/mm2), retinal vessel density, choriocapillaris perfusion area, and choroidal thickness (CT). The study included 140 eyes from children categorized into four groups: emmetropia (31 eyes), low myopia (44 eyes), moderate myopia (31 eyes), and high myopia (34 eyes). The high myopia group exhibited significantly lower macular CD than the emmetropia group (P < 0.05). Additionally, the high myopia group showed thinner CT and higher choriocapillaris perfusion area in the macular region than the emmetropia group (all P < 0.01). Macular CD was significantly correlated with age, spherical equivalent, axial length, and CT (all P < 0.05). Generalized linear models revealed CT as the independent factor associated with macular CD (Wald χ2 = 9.265, P = 0.002). Children with high myopia demonstrate reduced CD in the macular region, accompanied by reduced CT. These findings may have important implications for future myopia prevention and management strategies.

Comparison of bilateral implantation of monofocal intraocular lenses with enhanced intermediate function targeting with − 2.00 D and emmetropia in moderate to high myopic Asian patients

BackgroundTo investigate the outcomes of bilateral implantation of enhanced monofocal intraocular lenses (IOLs, ICB00) with a − 2.00 diopter (D) target in patients with moderate to high myopia and to compare the clinical outcomes of a − 2.00 D binocular target with an emmetropia target in patients who underwent cataract surgery.MethodsIn this retrospective study, we reviewed the medical records of patients who underwent uncomplicated phacoemulsification with ICB00 IOL implantation. Emmetropia (Group 1) and − 2.00 D (Group 2) were targeted in 60 and 20 eyes of 30 and 10 patients, respectively. Three months after surgery, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), and uncorrected near visual acuity (UNVA) were measured. Defocus curves were measured under the photopic condition by intervals of 0.50 D from + 0.50 D to − 4.00 D.ResultsThe postoperative binocular logMAR UDVA, UIVA, and UNVA were 0.01 ± 0.03, 0.08 ± 0.11, and 0.33 ± 0.15 in Group 1 and 0.31 ± 0.13, 0.04 ± 0.05, and 0.11 ± 0.07 in Group 2, respectively. Group 2 showed a significantly superior postoperative binocular UNVA (P = 0.027) and inferior binocular UDVA (P = 0.003) than Group 1. Binocular UIVA and CDVA did not significantly differ between the groups although UIVA was better in Group 2 than in Group 1. Near glasses were needed by 66% of Group 1 and 0% of Group 2.ConclusionsBilateral implantation of ICB00 IOL with − 2.00 D of residual myopia is suitable for patients with moderate to high myopia to improve UDVA, UIVA, and UNVA.

Orthokeratology for high myopia

Purpose. With an increasing proportion of children with myopia especially in Asia, efforts have been made to reduce chances of preventable sight loss related to high myopia in the future. Orthokeratology lens has been used as one of the modalities not just to correct myopia, but also to slow down myopic progression and axial elongation. This case report reviews a patient with clinically significantly high myopia, whose refractive errors was partially corrected with orthokeratology lens and spectacle lenses. Material and Methods. A now 14-year-old patient with a history of fast progressing myopia, was prescribed and commended orthokeratology to manage myopia, while regularly monitoring her refractive errors, axial length, binocular vision status, corneal topography, and anterior eye health was monitored regularly at the author’s practice. Results. Over a two year follow up period, a partial correction of high myopia with orthokeratology lenses and residual refractive errors with additional spectacle lenses was effective in managing this patient’s myopia, as well as slowing of axial elongation. An updated pair of orthokeratology lens with a steeper back optic zone radii were prescribed to reduce superficial corneal staining and to maintain corneal health. Conclusion. Patient commitment and adherence to close monitoring of eyes in terms refractive errors, axial length, and anterior eye health, are vital in achieving a successful orthokeratology lens wear for high myopia. A dual fitting strategy consisting of orthokeratology lens and spectacle wear can be a safe management strategy that is acceptable for patients with high myopia. It would be helpful for practitioners to be able to rely on robust evidence-based guidance when determining whether lens wear can be ceased, i.e. when further axial elongation and myopic progression are no longer likely.

Association of Peripapillary Arterial Circle of Zinn-Haller with Glaucoma in Highly Myopic Eyes.

The visualization of circle of Zinn-Haller (CZH) on optical coherence tomography angiography (OCTA) or its pattern does not have a clear effect on glaucoma, while the location of CZH is associated with axial length in highly myopic eyes. To investigate the association between the CZH and the presence of glaucoma using swept-source optical coherence tomography angiography (SS-OCTA) images of the optic nerve of patients with high myopia (HM). This retrospective case series included 227 eyes with HM, comprising 134 and 93 eyes with and without glaucoma, respectively. The characteristics of CZH, including visualization, pattern, and location, were assessed using SS-OCTA. Vascular parameters, such as vessel density and microvascular dropout (MvD), were quantified. The factors affecting the presence of glaucoma and the correlations between the CZH distance and axial length (AXL) were identified using logistic regression analysis and Pearson correlation analysis, respectively. CZH was detected more frequently in HM patients with glaucoma (71.6%) than in patients without glaucoma (51.6%) (P<0.002). However, the visualization of CZH was not related to the presence of glaucoma in multivariate regression analysis (odds ratio [OR], 0.688; 95% confidence interval [CI], 0.328-1.444; P=0.322). Moreover, compared to the annular pattern used as a reference, triangular and irregular patterns were not associated with the presence of glaucoma (OR: 1.043, 95% CI: 0.101-10.763, P=0.971; OR: 0.527, 95% CI: 0.255-1.092, P=0.085, respectively). MvD was significantly higher in patients with glaucoma (61.2%) than that in patients without glaucoma (2.2%) (P<0.001) and was identified as a significant factor affecting the presence of glaucoma (OR, 42.120; 95% CI, 9.416-188.413; P<0.001). AXL showed a significant correlation with CZH distance in all patients (R=0.399; P<0.001). CZH was more commonly detected in HM patients with glaucoma. However, no clear associations of glaucoma with the visualization, pattern, or location of CZH were observed in the present study. The correlation between AXL and CZH distance in eyes with HM warrants further investigation. These results may offer insights into the pathogenesis of glaucoma in eyes with HM as OCTA technology advances.

Nonlinear pathological trajectory of a high-myopia C57/BL6J mouse model induced by form deprivation

IntroductionTo establish a high myopia model in C57BL/6J mice with monocular form deprivation myopia (FDM) and investigate its ocular structure pathological trajectory.MethodsHealthy 3-week-old C57BL/6J mice were divided into an FDM group (n = 36) and a control group (n = 24). The left eyes of the FDM group were patched, while the right eyes served as controls. Biometric parameters and fundus morphology were assessed at baseline and after 4, 8, and 12 weeks of form deprivation.ResultsSignificant differences were observed in the deprived eyes, including longer axial length, higher refractive power, deeper vitreous chambers, thinner retina, choroid, and sclera, and smaller scleral fibers’ diameters under a transmission electron microscope. Retinal vascular area proportion in covered eyes decreased significantly (P &amp;lt; 0.05), with a decline rate of 11% from weeks 4 to 8 and a faster decline of 19% from weeks 8 to 12, while this proportion increased significantly in control eyes.DiscussionThis study successfully induced a high myopia model in mice with long-term form deprivation. The axial length grew dramatically in FDM in the first 8 weeks, while the pathological progress of the fundus accelerated from weeks 8 to 12.

Automated Posterior Scleral Topography Assessment for Enhanced Staphyloma Visualization and Quantification With Improved Maculopathy Correlation.

To quantitatively characterize the posterior morphology of high myopia eyes with posterior staphyloma. Surface points of the eyeball were automatically extracted from magnetic resonance imaging scans using deep learning. Subsequently, the topography of posterior staphylomas was constructed to facilitate accurate visualization and quantification of their location and severity. In the three-dimensional Cartesian coordinate system established with surface points, measurements of distances (D) from each point to the hypothetical pre-elongation eye center within the eyeball and local curvatures (C) at each point on the posterior sclera were computed. Using this data, specific parameters were formulated. The concordance of these parameters with traditional staphyloma classification methods and their association with myopic traction maculopathy (MTM) grades based on the ATN classifications were investigated. The study included 102 eyes from 52 participants. The measured parameters, particularly the variance of distance (Dvar) and the maximum value of the curvature and distance product (C · Dmax), demonstrated efficacy in differentiating various types of posterior staphyloma and exhibited strong correlations with the grades of MTM. The automated generation of the posterior scleral topography facilitated visualization and quantification of staphyloma location and severity. Simple geometric parameters can quantify staphyloma shape and correlate well with retinal complications. Future works on expanding these measures to more imaging modalities could improve their clinical use and deepen insights into the link between posterior staphyloma and related retinal diseases. This work has the potential to be translated into clinical practice, allowing for the accurate assessment of staphyloma severity and ultimately improving disease management.

Prevalence of symptomatic dry eye and influencing factors among Chinese adolescents: A cross-sectional study.

Comprehensive research on the impact of various types of refractive errors (RE) and anisometropia on dry eye disease is still lacking. This study aimed to estimate the prevalence rates and potential lifestyle factors related to symptomatic dry eye (SDE) among adolescents in eastern China. A cross-sectional study was performed in 2023, and a stratified cluster sampling technique was used among adolescents in Nantong, China. Demographic information, including sex, age and BMI, were collected. All participants underwent optometric tests, while Ocular Surface Disease Index (OSDI) and self-designed questionnaires were administered. Both univariate and multivariate logistic regression analyses were used to assess associations between SDE and related parameters, and various types of RE and anisometropia were also included in the study. A total of 1,518 participants were enrolled in the study, and the overall prevalence of SDE was 20.3% among adolescents in Nantong, China. Multiple logistic regression analyses showed that high myopia (aOR = 3.42, 95% CI = 1.60-3.36, p = 0.025), frequent use of eye drops (aOR = 2.31, 95% CI = 1.60-3.36, p<0.001), a history of allergic conjunctivitis (aOR = 1.93, 95% CI = 1.09-3.34, p = 0.025), and frequent blinking (aOR = 3.23, 95% CI = 2.31-4.53, p<0.001) were identified as risk factors for SDE. Conversely, male gender (aOR: 0.76, 95% CI: 0.58-0.99, p = 0.043), increased sleep time (6-7 h: aOR = 0.64, 95% CI = 0.46-0.89, p = 0.009; 7-8 h: aOR = 0.64, 95% CI = 0.43-0.95, p = 0.026; >8 h: aOR = 0.43, 95% CI = 0.23-0.82, p = 0.010), and timely intervention when vision decline occurred were protective factors against SDE (aOR = 0.61, 95% CI = 0.43-0.85, p = 0.004). High myopia was found to be independently associated with an increased risk of SDE., while hyperopia, astigmatism, and anisometropia were not independent risk factors for SDE. The identified risk and protective factors may help provide valuable insights for future research and interventions aimed at improving ocular health in adolescents.

Observations on relative peripheral refraction in Chinese adults with myopia based on a novel application of multispectral refraction topography

In this population-based observational cross-sectional study, we investigated retinal peripheral refraction in Chinese adults with myopia. We categorized 1511 Chinese adults with myopia (18 − 55 years) into low (LM), moderate (MM), and high myopia (HM) groups. Axial length, central corneal thickness, steep keratometry, flat keratometry, and intraocular pressure were measured. Refractive difference values (RDVs) for different eccentricities (RDV0–53) and the superior (RDV-S), inferior (RDV-I), temporal (RDV-T), and nasal (RDV-N) retinal regions were measured using multispectral refractive topography. The hyperopic defocus was higher for the MM group than for the LM group in RDV20–53, RDV-S, and RDV-T and HM group in RDV20–53, RDV-S, RDV-T and RDV-N. The hyperopic defocus was higher for the HM group than for the LM group in RDV20-53, RDV-S and RDV-T but lower for the LM group in RDV-N. RDV-N decreased with age (R2 = 0.0191, slope = − 0.01, p < 0.0001), whereas RDV-S (R2 = 0.0112, slope = 0.01,p < 0.0001) and RDV-T increased (R2 = 0.0038, slope = 0.01, p = 0.0160). RDV correlated with central spherical equivalent and axial length. Flat keratometry explained the most RDV variation (RDV20–30: β = 0.0714, p < 0.0001; RDV-N: β = 0.1801, p < 0.0001; RDV-S: β = 0.1426, p < 0.0001; RDV-T: β = 0.1239, p < 0.0001). Reference values for peripheral retinal defocus are provided for Chinese adults with different myopia ranges.

Association between weekend catch-up outdoor duration and prevalence of myopia: evidence from a cross-sectional, multi-center study in China

BackgroundThis study aimed at investigating the relationship between the weekend catch-up outdoor duration (WCOD) and prevalence of myopia among students in China.MethodsThis cross-sectional study recruited participants in 107 schools (six cities, 30 districts) from China from May to June 2021. Demographic characteristics (age, grade, sex, ethnicity, BMI, resident, and parents’ myopia), optically habits (bad writing habits, working/studying time per day, continuous working/studying time per day, and screen time per day) and outdoor duration (weekday and weekend) were obtained from questionnaire. WCOD was defined as outdoor time 1 h longer on weekends than on weekdays. Spherical equivalent (SE) of refractive error were measured with non-cycloplegic refraction. Adjusted multivariate logistic regression analysis was performed to evaluate the relationship between WCOD and prevalence of myopia.ResultsStudents with myopia had shorter WCOD compared with those without myopia (P < 0.001). Adjusted multivariate logistic regression analyses showed negative associations between WCOD and prevalence of myopia in Chinese students, especially in students with WCOD of 2–3 h (OR = 0.577, P < 0.001) and 3–4 h (OR = 0.571, P = 0.004) when the weekday outdoor duration was 0.5–1 h, as well as students with WCOD of 2–3 h (OR = 0.614, P = 0.003) when the weekday outdoor duration was 1–2 h. Similar results were observed in students with high myopia. Students with high myopia had shorter WCOD compared with those without high myopia (P = 0.001). Negative associations between WCOD and prevalence of high myopia were significant in students with WCOD of 1–2 h when the weekday outdoor duration was < 0.5 h (OR = 0.585, P = 0.007) and 0.5–1 h (OR = 0.537, P = 0.018).ConclusionOur study, for the first time, reported that a WCOD have a potential to reduce the prevalence of myopia and high myopia in Chinese students.

Distribution and associated factors of choroidal thickness in highly myopic eyes-a real-world study based on a Chinese population.

To measure the subfoveal choroidal thickness (SFCT) in highly myopic eyes at different locations using enhanced depth imaging spectral-domain optical coherence tomography (EDI SD-OCT). To identify the ocular and systemic risk factors associated with choroidal thinning in high myopia. Based on the Beijing Eye Study, a detailed ophthalmic examination was performed including EDI SD-OCT for the measurement of SFCT. OCT images were obtained from 103 highly myopic eyes (≥ -6.00 dioptres) and 227 normal eyes randomly selected from the baseline population, matched for age and sex. The mean SFCT was 110.6 ± 85.2 μm in highly myopic eyes (range, 3-395 μm). Mean regional choroidal thickness was lowest on the nasal and inferior sides of the macula, and slightly higher on the temporal and superior sides than at the fovea. On multivariate analysis, SFCT was associated with age (b = -0.48; P < 0.001), axial length (b = -0.44; P < 0.001), gender (b = -0.31; P < 0.05) and staphyloma (b = -0.26; P = 0.05). In highly myopic eyes, SFCT decreased by 5.1 μm/year of age, by 9.2 µm/D of myopia, and by 22.6 µm/mm of axial length. The SFCT decreases with age and increased axial length in highly myopic eyes. The formation of a posterior staphyloma has been identified as a major contributor to choroidal thinning and is therefore a reliable indicator for risk management. The involvement of choroidal abnormalities may be a significant factor in the development of myopic degeneration.

Prevalence and risk factors of myopia among children and adolescents in Hangzhou.

To analyze the prevalence and influencing factors of myopia among children and adolescents in Hangzhou city, and provide ideas for the formulation of myopia prevention and control measures. A cross-sectional school-based study using stratified cluster random sampling method was used to select 31,880 students from 113 schools in Hangzhou city. Myopia screening and questionnaires on the influencing factors of poor visual acuity were carried out. Univariate and multivariate logistic regression were used to screen possible risk factors of myopia. The overall prevalence of myopia was found to be 55.3% (17,630/31,880), with the myopia rates observed among students in kindergarten, primary school, junior high school, and senior high school, at 5.8%, 34.9%, 74.2%, and 85.0%, respectively. As the academic year progresses, there has been an observable increase in the prevalence of myopia (χ2 = 8676.748, P<0.001), low myopia (χ2 = 5444.040, P<0.001) and high myopia (χ2 = 2171.073, P<0.001) among students, with the difference between the three groups being statistically significant. The myopia prevalence in girls is higher than that in boys (χ2 = 119.917, P<0.001); the prevalence of myopia in urban students is higher than that in suburban students (χ2 = 4.603, P = 0.032). The time spent on homework after school, the correctness of reading and writing postures, the duration of exposure to electronic screens, and the use of lighting in an appropriate manner all have an impact on the development of myopia (all P<0.05). The overall prevalence of myopia and high myopia in schools in eastern China, is notably high. The prevalence of myopia and high myopia increases with grade or age. Myopia is associated with increased age, parental myopia, extended periods of homework after school, poor reading and writing posture, prolonged exposure to electronic screens and inappropriate lighting. In light of the findings of the present survey, it is recommended that a comprehensive prevention and control intervention model for myopia in children and adolescents based on society-hospital-school-family-individual students with a view to preventing and controlling myopia.

Frontiers of myopia research in the 21st century: A bibliometric analysis of the top 100 most influential articles in the field.

Myopia is the most common refractive error worldwide, contributing not only to visual impairment but also serving as a potential risk factor for various severe ocular diseases. Its impact on patients' quality of life and health is significant and imposes substantial socioeconomic burdens. In this study, we analyzed the top 100 most cited articles related to myopia published in the Web of Science Core Collection database from January 2000 to February 2024. Using data visualization tools CiteSpace, VOSviewer, and Scimago Graphica, we identified the most influential research papers and academic journals in the field of myopia. The top 100 most influential articles were published in 25 renowned journals across 30 countries, with Investigative Ophthalmology & Visual Science being the most prolific. Ophthalmology had the highest total citation frequency, while The Lancet had the highest average citation frequency. The United States and the National University of Singapore were the top countries and institutions with the most published papers. The 3 major research directions are Ophthalmology, Medicine, General & Internal, and Genetics & Heredity. The top 5 co-occurring keywords were refractive error, risk factors, prevalence, eye growth, and form-deprivation myopia. Cluster analysis results highlighted focal points such as retinal detachment, high myopia, and contrast sensitivity, indicating potential future research trends. Prospective research directions include investigating the pathogenesis of myopia, updating diagnostic technologies, and identifying risk genes for myopia and its complications.

Automatic fovea detection and choroid segmentation for choroidal thickness assessment in optical coherence tomography.

To develop an automated model for subfoveal choroidal thickness (SFCT) detection in optical coherence tomography (OCT) images, addressing manual fovea location and choroidal contour challenges. Two procedures were proposed: defining the fovea and segmenting the choroid. Fovea localization from B-scan OCT image sequence with three-dimensional reconstruction (LocBscan-3D) predicted fovea location using central foveal depression features, and fovea localization from two-dimensional en-face OCT (LocEN-2D) used a mask region-based convolutional neural network (Mask R-CNN) model for optic disc detection, and determined the fovea location based on optic disc relative position. Choroid segmentation also employed Mask R-CNN. For 53 eyes in 28 healthy subjects, LocBscan-3D's mean difference between manual and predicted fovea locations was 170.0 µm, LocEN-2D yielded 675.9 µm. LocEN-2D performed better in non-high myopia group (P=0.02). SFCT measurements from Mask R-CNN aligned with manual values. Our models accurately predict SFCT in OCT images. LocBscan-3D excels in precise fovea localization even with high myopia. LocEN-2D shows high detection rates but lower accuracy especially in the high myopia group. Combining both models offers a robust SFCT assessment approach, promising efficiency and accuracy for large-scale studies and clinical use.

Efficacy of Posterior Scleral Reinforcement in Treating Anisometropic Amblyopia Associated With Unilateral High Myopia in Children.

The aim of this study is to examine the effectiveness and safety of posterior scleral reinforcement (PSR) for treating anisometropic amblyopia and myopia associated with high myopia in children. Children with unilateral high myopia (uHM) and anisometropic amblyopia who underwent PSR in their highly myopic eyes were included in this study. The treated eye was designated as the PSR group, whereas the healthier eye served as the control, and paired comparisons were made. Thirteen patients (13 eyes in each group) were included, with an average age of 5.85±2.08 years. Cross-sectional comparisons between the groups showed that within 2 to 3 years after surgery, the PSR group had a significantly greater increase in best-corrected visual acuity per month compared with the control group (P=0.03), a significantly lower increase in axial length per month (P=0.007), and a significantly smaller absolute value of the increase in SE per month (P=0.002). Temporal longitudinal comparisons within the PSR group indicated that the increase in axial length per month 2 to 3 years after surgery was significantly slower than 1 year before surgery (P=0.045). The increase in best-corrected visual acuity per month was higher than 1 year before surgery, although not significantly (P=0.859). PSR is a safe and effective treatment for refractory anisometropic amblyopia caused by uHM, and for controlling axial length and the degree of myopia.

Punctate inner choroiditis and choroidal neovascular membrane formation following vitreoretinal surgery: A case report.

To report a case of punctate inner choroiditis (PIC) and subsequent choroidal neovascular membrane (CNVM) development in a young, high myope following vitreoretinal surgery for rhegmatogenous retinal detachment. A 44-year-old male with high myopia underwent pars plana vitrectomy for subtotal retinal detachment in the left eye, followed by cataract extraction and silicone oil removal. Three years postoperatively, he presented with blurred vision, and fundus examination revealed PIC lesions at the posterior pole. Spectral-domain optical coherence tomography (SD-OCT) showed characteristic features of PIC, including hyperreflective nodule-like elevations, disrupted ellipsoid and interdigitation zones, retinal pigment epithelium (RPE) elevations and increased choroidal hyper transmission signals. Initially, no treatment was initiated, and the patient was monitored. Three years later, the patient experienced further vision loss, and fundus examination showed progression of PIC lesions and new CNVM formation in the left eye. The patient was treated with systemic corticosteroids and an intravitreal anti-VEGF injection (Razumab® 0.5 mg/0.05 ml). Three weeks after the intervention, SD-OCT showed regression of the CNVM, and the patient's visual symptoms improved. This case underscores the importance of long-term follow-up and timely intervention in managing PIC, especially in high myopes post-retinal surgery. Early identification and treatment with systemic corticosteroids and anti-VEGF therapy are crucial to preserving visual function and preventing severe complications like CNVM.

Cone dysfunction in ARR3-mutation-associated early-onset high myopia: an electrophysiological study

BackgroundMyopia-26, a Mendelian form of early-onset high-myopia (eoHM) caused by mutations in the X-chromosomal ARR3 gene and predominantly affecting females, curiously, may provide an alternative route of investigation to unveil retinal mechanisms underlying pathological eye growth. We conducted a case-control cross-sectional prospective electrophysiological study in genetically characterized Myopia-26 patients (ARR3 heterozygous symptomatic females) compared with high myopes harboring intact ARR3 alleles and one carrier hemizygous male.ResultsParticipants were 26 volunteers: 10 healthy control females (E-CTRL, mean age = 31.5 ± 8.8 years), one healthy control male, one carrier male of the mutant ARR3 allele and 14 female eoHM patients (mean age = 27.0 ± 13.1 years) divided in two groups: seven without (M-CTRL) and seven with (MYP-26) genetic alteration in the ARR3 gene. The clinical evaluation included complete eye screening and full-field electroretinograms (ERGs) recorded from both eyes under mydriasis. Spherical equivalent was comparable (mean=-9.55 ± 2.46 and − 10.25 ± 3.22 for M-CTRL and MYP-26, respectively) and best corrected visual acuity (BCVA) was significantly different between M-CTRL and MYP-26 (1.0 vs. 0.406 ± 0.253, respectively). E-CTRL and M-CTRL showed similar light-adapted flash and flicker ERG amplitudes; however, the prior values were reduced by ~ 35% (a- and b-waves alike), the latter by ~ 55% in the MYP-26 group (F(2, 45) > 21.821, p < 0.00001). Dark-adapted a-wave amplitudes were slightly reduced (by ~ 20%) in all myopic patients compared to E-CTRL, irrespective of the ARR3 genotype (E-CTRL vs. eoHM, p = 0.038).ConclusionsThe cone dysfunction observed in Myopia-26 patients is specifically linked to the mutation of ARR3, and is not the consequence of eoHM, i.e. elongation of the eye. It may play a role in myopic refractive error development through a yet unconfirmed pathomechanism.

Comparison of intraocular lens power formulas for negative-diopter intraocular lens implantation for high myopia.

To compare the accuracy of intraocular lens (IOL) power calculation formulas for myopic eyes requiring negative diopter powered IOLs. Retrospective case series. K… hospital and Y… Hospital, …, …. Sixty-one eyes that underwent phacoemulsification with implantation of a negative power IOL were investigated. The trueness, precision and accuracy of IOL power calculation were assessed for the Barrett Universal II (BUII), EVO 2.0, Haigis, Hoffer QST, Holladay 1 and SRK/T formulas using the Eyetemis online tool. The analysis was performed using 1) the ULIB IOL constants and 2) after constant optimization. With ULIB constants, the Haigis, Holladay 1 and SRK/T resulted in a hyperopic mean prediction error (PE) >1.00 diopter (D), which was significantly different from zero (adjusted p <0.05). The mean PE of the remaining formulas was closer to zero. The absolute PE was significantly higher with the Holladay 1 and SRK/T (adjusted p <0.05) with respect to the remaining formulas. After constant optimization, the outcomes of traditional formulas improved and no statistically significant differences were found among any of the formulas in terms of trueness, precision and accuracy. The percentage of eyes with an absolute PE within 0.50 D was low (<50%) even after constant optimization. With ULIB constants, the BUII, EVO 2.0 and Hoffer QST were more accurate than traditional formulas in eyes with negative-diopter IOLs. The results of IOL power calculation in these eyes remain poor even after constant optimization.

Variability in Optic Nerve Head Morphology in High Axial Myopia and Its Association with Glaucoma

Purpose: To investigate optic disc morphology in high axial myopia and its associations with the deep-layer structure of the optic disc using optical coherence tomography and glaucoma.Methods: We retrospectively reviewed the medical records of 69 eyes (33 normal and 36 glaucomatous eyes) with an axial length of 26-27 mm. The eyes were categorized into two groups based on the optic disc tilt ratio (≥ 1.3 or &lt; 1.3). Characteristics of optic disc morphology, including lamina cribrosa depth, peripapillary atrophy width, and Bruch’s membrane opening area, were compared between the two groups. Furthermore, factors related to mean deviation and global retinal nerve fiber layer (RNFL) thickness were analyzed.Results: The mean optic disc tilt ratio was 1.31 ± 0.23. Eyes with a tilt ratio ≥ 1.3 (30 eyes) had a higher likelihood of glaucoma (&lt;i&gt;p&lt;/i&gt; = 0.035) and severe visual field (VF) defects (&lt;i&gt;p&lt;/i&gt; &lt; 0.001), a thinner global RNFL thickness (&lt;i&gt;p&lt;/i&gt; = 0.046), and larger gamma peripapillary atrophy width (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) compared to eyes with a tilt ratio &lt; 1.3 (39 eyes). Linear regression analysis revealed that the optic disc tilt ratio was significantly associated with VF loss (&lt;i&gt;p&lt;/i&gt; = 0.018) but not with global RNFL thinning (&lt;i&gt;p&lt;/i&gt; = 0.203).Conclusions: Variations in optic disc morphology are observed in eyes with similar axial lengths, and a higher optic disc tilt ratio is associated with more severe VF defects. These findings suggest the potential influence of optic disc morphological changes due to axial elongation on the severity of glaucomatous damage.

Retinal detachment in Type IX collagen recessive Stickler syndrome.

Stickler Syndrome (SS) is associated with eye, joint and orofacial abnormalities. Most cases are dominantly inherited through COL2A1/COL11A1 variants encoding type-II/XI collagen, with patients having up to 78% retinal detachment (RD) risk. Rarer cases of recessive SS have also been identified, associated with pathogenic variants of genes including COL9A1, COL9A2 & COL9A3 encoding type-IX collagen, but there is limited published data on patients' phenotype or RD risk. Our study aimed to investigate RD risk in type-IX recessive SS, determining whether patients would benefit from prophylactic retinopexy. A secondary objective was to explore patient phenotypes, identifying key features which clinicians should identify, leading to earlier diagnosis. We report 13 cases from 11 families with Type-IX recessive SS, identified from the cohort attending the NHS England Highly Specialised Stickler Syndrome Service (1/1/15-31/12/22). Patients underwent multidisciplinary assessment by ophthalmology, rheumatology and audiology. 6/11 families exhibited previously undescribed genetic variants, and 7 had consanguineous parents. Clinical findings included abnormal vitreous architecture and high myopia. 15.4% of patients developed RD secondary to horseshoe retinal tears, with no cases of bilateral RD or giant retinal tears (GRTs). No patients had cleft palate, and 30.8% had midfacial hypoplasia. Hearing loss was more prevalent (91.7%) than in dominant SS. Arthropathy was uncommon but variable in manifestation. Ours results do not point to high RD nor GRT incidence in recessive SS, although given the rarity, our numbers are small. Prophylactic retinopexy should only be offered case-by-case for fellow eyes of patients presenting with GRT detachments in their first eye.

Association of polymorphisms in the HTRA1 gene with myopia

PurposeTo evaluate the associations of single-nucleotide polymorphisms (SNPs) in the high-temperature requirement protease A 1 (HTRA1) gene with myopia.Methods25 SNPs in HTRA1 were selected, including 23 haplotype-tagging SNPs, SNP rs2142308...