Juvenile Myopia Research Articles

Correlation of Myopia with Physical Exercise and Sleep Habits among Suburban Adolescents.

Purpose To analyse the correlation of myopia with physical exercise and sleep habits to explore the possible risk or protective factors of juvenile myopia. Methods This study was a retrospective cross-sectional study. A total of 1831 students aged 11–18 years from five schools in Qingpu completed questionnaires from 2018 to 2019; the students were divided into the nonmyopia group and the myopia group, with students in the myopia group having myopia in at least one eye. Based on the chi-square test, the variables with statistical significance were selected for the logistic regression analysis. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were determined. Results Myopia was positively associated with older age (OR = 2.216, 95% CI: 1.720–2.855), having a parent with myopia (father: OR = 2.463, 95% CI: 1.900–3.193; mother: OR = 2.853, 95% CI: 2.232–3.646), and a late bedtime during holidays (before 10 pm: p = 0.002; 10 pm-11 pm: OR = 1.516, 95% CI: 1.095–2.100; 11 pm-12 am: OR = 1.966, 95% CI: 1.383–2.795), but negatively correlated with male gender (OR = 0.693, 95% CI: 0.549–0.876), a late daily wake time (OR = 0.782, 95% CI: 0.621–0.985), and having more days per week of outdoor activities during the semester (OR = 0.764, 95% CI: 0.597–0.978). After adjustment for demographic characteristics, myopia was positively associated with a late bedtime during holidays (before 10 pm: p = 0.003; 10 pm-11 pm: OR = 1.570, 95% CI: 1.076–2.289; 11 pm-12 am: OR = 2.173, 95% CI: 1.451–3.253; after 12 am: OR = 1.786, 95% CI: 1.093–2.919), but negatively correlated with a late daily wake time during the semester (OR = 0.761, 95% CI: 0.581–0.997). Conclusion The association of outdoor exercise with myopia among Chinese suburban adolescents does not seem to be as strong as that of sleep habits. Future research could seek to provide consistent evidence for a potential association between myopia and sleep habits.

Visual quality of juvenile myopes wearing multifocal soft contact lenses

BackgroundIt is unclear whether multifocal soft contact lenses (MFSCLs) affect visual quality when they are used for myopia control in juvenile myopes. The aim of this study was, therefore, to investigate the effect of MFSCLs on visual quality among juvenile myopia subjects.MethodsIn a prospective, intervention study, thirty-three juvenile myopes were enrolled. Visual perception was assessed by a quality of vision (QoV) questionnaire with spectacles at baseline and after 1 month of MFSCL wear. At the one-month visit, the high (96%) contrast distance visual acuity (distance HCVA) and low (10%) contrast distance visual acuity (distance LCVA) were measured with single vision spectacle lenses, single vision soft contact lenses (SVSCLs) and MFSCLs in a random order. Wavefront aberrations were measured with SVSCLs, with MFSCLs, and without any correction.ResultsNeither distance HCVA (p > 0.05) nor distance LCVA (p > 0.05) revealed any significant difference between MFSCLs, SVSCLs and single vision spectacle lenses. The overall score (the sum of ten symptoms) of the QoV questionnaire did not show a statistically significant difference between spectacles at baseline and after 1 month of MFSCL wear (p = 0.357). The results showed that the frequency (p < 0.001), severity (p = 0.001) and bothersome degree (p = 0.016) of halos were significantly worse when wearing MFSCLs than when wearing single vision spectacle lenses. In contrast, the bothersome degree caused by focusing difficulty (p = 0.046) and the frequency of difficulty in judging distance or depth perception (p = 0.046) were better when wearing MFSCLs than when wearing single vision spectacle lenses. Compared with the naked eye, MFSCLs increased the total aberrations (p < 0.001), higher-order aberrations (p < 0.001), trefoil (p = 0.023), coma aberrations (p < 0.001) and spherical aberrations (SA) (p < 0.001). Compared with the SVSCLs, MFSCLs increased the total aberrations (p < 0.001), higher-order aberrations (p < 0.001), coma aberrations (p < 0.001) and SA (p < 0.001). The direction of SA was more positive (p < 0.001) with the MFSCLs and more negative (p = 0.001) with the SVSCLs compared with the naked eye.ConclusionsWearing MFSCLs can provide satisfactory corrected visual acuity (both distance HCVA and distance LCVA). Although the lenses increased the aberrations, such as total aberrations and higher-order aberrations, there were few adverse effects on the distance HCVA, distance LCVA and visual perception after 1 month of MFSCL use.Trial registrationChinese Clinical Trial Registry: ChiCTR-OOC-17012103. Registered 23 July 2017, http://www.chictr.org.cn/usercenter.aspx

Redistribution of the corneal epithelium after overnight wear of orthokeratology contact lenses for myopia reduction

BackgroundTo investigate changes in the corneal thickness profile in juvenile myopia after overnight wear of orthokeratology lenses (OK). MethodsA total of 53 juveniles (53 right eyes) successfully wore OK between January 2016 and July 2017 and they were reviewed one day, one week and one month after first wearing it. Epithelial and corneal data were obtained by optical coherence tomography (OCT). Changes in uncorrected visual acuity, refractive error, corneal refractive power, and epithelial and corneal thickness were analyzed before and after wear of OK. ResultsThe corneal epithelium was reshaped after 1 day of OK; the myopia degree was reduced, and uncorrected visual acuity reached 0 logMAR at 1 week. The central (2 mm) average epithelial thickness was 52.04 ± 2.35 μm, 49.25 ± 2.67 μm, 45.91 ± 2.80 μm, and 47.53 ± 3.44 μm before and after 1 day, 1 week, and 1 month of OK, respectively (t = 4.497, 9.741, and 7.340, respectively, P<0.001). The central epithelium was thinnest at 1 week, when the average thinning of 6.13 ± 1.67 μm accounted for approximately 11.78 % ± 3.21 % of the total epithelium thickness at baseline. The epithelial thickness of the reverse curve zone was 51.83 ± 2.49 μm, 57.62 ± 3.01 μm, 59.43 ± 3.19 μm, and 60.22 ± 2.75 μm before and after 1 day, 1 week, and 1 month of OK, respectively, showing a significant increase over time (t=-4.752, -6.208, and -6.848, respectively, P < 0.001). ConclusionIn the early stage of OK, the corneal epithelium was redistributed very quickly. The central epithelium became thin, while the epithelium of the reverse curve zone correspondingly thickened. Effectively reduced the refractive power of the cornea equivalent to the effect of adding a concave spectacle lens, which ensures uncorrected vision after removal of the lenses.

基于肝肾–脑目理论应用推拿治疗青少年近视疗效观察

基于肝肾–脑目理论应用推拿治疗青少年近视疗效观察

聊城市青少年近视流行病学调查及近视防控

聊城市青少年近视流行病学调查及近视防控

Physical, chemical, and microbiological stability study of diluted atropine eye drops

BackgroundAtropine eye drops are indicated for juvenile myopia progression, cycloplegia, amblyopia, and strabismus. According to the package insert, 10 mg/mL atropine eye drops must be diluted for pediatric patients to prevent systemic adverse effects. Compounding units in hospital pharmaceutical departments or community pharmacies are compelled to prepare this essential medication; however, validated atropine stability data is limited and the shelf life after preparation is extremely short. As it is a long-term treatment, a longer shelf life is necessary to improve patient care. This study aimed to demonstrate the physical, chemical, and microbiological stability of diluted atropine eye drops over a period of six months.MethodsPreparation consists of dilution of a 10 mg/mL atropine solution (Nitten Atropine Ophthalmic Solution 1%; Nitten Pharmaceutical Co., Ltd.) in 0.9% NaCl to concentrations of 0.1, 1.0, 2.5, and 5.0 mg/mL, followed by a sterilizing filtration procedure and then an aseptic filling process of 5 mL in 5 mL polyethylene eyedropper bottles. The entire process is carried out in an overpressure isolator. All concentration products were kept for six months at 25 °C or 5 °C. Visual inspection was conducted and pH, osmolality, and atropine concentration were measured at day 0, day 14, day 28, and every month until six months. Atropine concentration was measured using liquid chromatography tandem mass spectrometry. The sterility was monitored using a method adapted from the Japanese Pharmacopoeia sterility assay.ResultsAtropine remained within ±5% of the target value in the six batches. Osmolality (285 mOsm/kg) as well as pH (5.88) were kept constant. No variations in solution characteristics (crystallization, discoloration) were noted. Sterility was maintained.ConclusionsThis study validated the physical, chemical, and microbiological stability of 0.1, 1.0, 2.5, and 5.0 mg/mL atropine sulfate eye drops conserved inside polyethylene eyedroppers for six months at 25 °C or 5 °C.

Establishment and practice on collaborative education model of "medicine, teaching, research and prevention" in Optometry

In order to satisfy the social and medical demands for optometric talents, the education model combining medicine, teaching, research and was established, fully integrated with various resources like talents, facilities, equipment from the affiliated eye hospital, institute of ophthalmology and prevention and treatment center for juvenile myopia. Cultivation of high-quality applicative talents which integrated knowledge, skills and accomplishment were taken as the main line, Cultivation goal was established in accordance with requirement of talent. The curriculum system was optimized on the basis of competence. The teaching mode was reformed to 2+2 mode, double-position teachers became the requirement for the teaching staff and professional education comprehensive practice platform of one entity, two wings was constructed, with good effectiveness being achieved. Key words: Optometry; Collaborative education; Talent cultivation

The changes in corneal transparency after orthokeratology with juvenile myopia

Objective: To evaluate the changes of corneal transparency undergoing overnight orthokeratology treatment. Methods: Prospective cohort study. Right eyes of juvenile myopic patients fitted with Ortho-K CL at Qingdao Eye Hospital were enrolled. Corneal optical density values were measured by the Pentacam Scheimpflug system before orthokeratology and at 1 day, 1 week, and 1, 3, 6, and 12 months after wearing. Four concentric radial zones centered on the apex of the cornea (≤2 mm, >2 mm and ≤6 mm, >6 mm and ≤10 mm, and>10 mm and ≤12 mm diameter) were applied. Anterior layer (anterior 120 μm), central layer, and posterior layer (posterior 60 μm) were defined according to corneal depth. The data analysis were used One-Way Repeated Measures ANOVA and LSD test. Results: Forty patients (40 eyes) with myopia (24 male and 16 female, age 10.76±1.74 years) were in enrolled. Corneal optical density value was 13.18±0.23 before orthokeratology, then showed a decreasing trend at the early stage, but there was no statistical difference (within 3months: t=-1.594, -1.472, 0.064, 1.971; P>0.05). The value increased significantly and reached the peak (15.31±0.23, t=7.613, P<0.01) at 6-month, and was still maintained in a high value at 1-year (15.15±0.24, t=7.227, P<0.01). Anterior, central, and posterior layer of corneal optical density values had a downward trend at early stage, and increased significantly in 6-and 12-month (anterior layer t=7.143, 6.177, central layer t=7.508, 6.563, posterior layer t=6.722, 8.533;P<0.01). Only the values decreased significantly in posterior layer at 1-week (baseline 10.21±0.14 vs. 1-week 9.91±0.14, t=-2.348, P=0.024). The corneal optical density value of ≤2 mm diameter began to increase significantly at 1-month (baseline 12.88±0.14 vs. 1-month 13.31±0.19, t=2.158, P=0.037),>2 mm and ≤6 mm diameter at 3-month (baseline 11.71±0.13 vs. 3-month 12.50±0.19, t=3.213, P=0.003), and>6 mm and ≤10 mm diameter at 6-month (baseline 11.40±0.30 vs. 6-month 13.70±0.33, t=7.635, P=0.000). The high values lasted for 1 year at this three areas. However, >10 mm and ≤12 mm diameter had no obvious change in optical density (F=1.668, P>0.05). In addition, the significant reduction of optical density values at early stage were mainly concentrated in the posterior layer of the cornea and the>6 mm and ≤10 mm diameter. Conclusions: Orthokeratology transiently increases corneal transparency of the posterior layer and the>6 mm and ≤10 mm diameter at early stage. However, long-term wearing can cause a decrease of transparency within a 10 mm diameter range. The corneal transparency changes first at the center of the optical zone, then gradually expanding to the periphery, and the anterior, central and posterior layers of cornea are all affected. We speculate orthokeratology affect the corneal oxygen supply and compress cornea mechanically, that leads to corneal stromal remodeling. (Chin J Ophthalmol, 2019, 55:435-441).

One-year effect of wearing orthokeratology lenses on the visual quality of juvenile myopia: a retrospective study.

ObjectiveTo study the one-year effect of wearing orthokeratology (OK) lenses on the visual quality of juvenile myopia.MethodsThe right eyes of 36 juvenile myopias were retrospectively studied in this work. Q-value, e-value, corneal curvature, strehl ratio (SR), modulation transfer function (MTF) and wavefront aberration (WA) were compared before and at 1, 3 and 12 months after wearing OK lenses. The SR, MTF and WA of cornea, internal optic and ocular were analyzed separately. The spherical and cylinder diopter, vision acuity, compensating factor (CF) and compensative rate (CF%) were compared before and at 12 months after wearing OK lenses.Results(1) The vision of LogMAR increased and the corneal curvature decreased significantly after wearing OK lenses. There was no significant difference for the e-value before and after wearing OK lenses. The Q-value increased at 1 month but decreased at 3 and 12 months remarkably. (2) The ocular and internal optic SR and MTF increased significantly at 1 month and then remained stable. The MTF in different spacial frequencies increased after wearing OK lenses. There was no significant difference for the corneal SR before and after wearing OK lenses, and the corneal MTF decreased significantly after wearing OK lenses. (3) For the ocular, the total higher order aberration (HOA), spherical, coma and trefoil aberrations increased, and the total aberration, total lower order aberration (LOA) and defocus aberration decreased obviously except astigmatism. The corneal aberrations increased significantly after wearing OK lenses except astigmatism. For the internal optic, the total aberration, total LOA and defocus aberration decreased, and the total HOA, coma and trefoil aberration increased significantly except the astigmatism and spherical aberrations. (4) The CF and CF% of total aberration, total LOA, total HOA and coma aberrations increased, and those of astigmatism and spherical decreased at 12 months.ConclusionsOrthokeratology is effective in correcting the refractive error and improving the vision quality of juvenile myopia over the one-year follow-up period.

Virtual reality: A possible approach to myopia prevention and control?

In East Asian countries including China, myopia has become a public hygiene issue that threatens the health of vast populations. In response to the huge market demand, a variety of products purportedly capable of treating myopia have been launched onto the market. Some manufacturers claim that juvenile myopia can be effectively controlled, or even cured, using their VR devices and software. Can VR devices be used for the prevention and control of juvenile myopia under existing technical conditions? In order to answer this question, the authors of this article analyzed the pathogenesis of myopia and the technical features of VR.

Relationship between retinal thickness and refractive error in juvenile myopia patients

Relationship between retinal thickness and refractive error in juvenile myopia patients

Observation on the long-term effectiveness and safety of juvenile myopia patients wearing orthokeratology

Observation on the long-term effectiveness and safety of juvenile myopia patients wearing orthokeratology

Clinical observation of Zheng's stunt needling technique in the treatment of juvenile myopia

To compare the differences in the clinical therapeutic effects on juvenile myopia between Zheng's stunt needling technique and traditional even needling technique. A total of 166 cases of mild juvenile myopia (diopter <-3.00D) were randomized into an observation group (Zheng's stunt needling technique) and a control group (traditional even needling technique), 83 cases in each one (166 affected eyes). Taiyang (EX-HN 5), Fengchi (GB 20), Cuanzhu (BL 2), Hegu (LI 4) and Guangming (GB 37) were used in the two groups. In the observation group, the erlongxizhu needling technique was adopted at Taiyang (EX-HN 5), the guoyanre needling technique at Fengchi (GB 20) and xiquedengmei needling technique at Cuanzhu (BL 2). The traditional needling technique was used at Hegu (LI 4) and Guangming (GB 37). In the control group, traditional even needling technique was applied at all the acupoints. The treatment was given once every day, continuously for 6 times as one course. There was 1 day at interval. After treatment for 4 courses, the changes in visual acuity, diopter and axial length were observed before and after treatment. The therapeutic effects were evaluated. After treatment, the visual acuity of the naked eyes, and diopter were remarkably improved in the patients of the two groups (all P <0.05). The improvements in the observation group were better than those in the control group (both P <0.05). The axial length did not change in the two groups (both P>0.05). The total effective rate was 78.3% (130/166) in the observation group, which was better than 57.8% (96/166) in the control group (P <0.05). . Zheng's stunt needling technique effectively improves the vision, rectifies the refractive error and delays the progression of myopia. The therapeutic effects of it are better than traditional even needling technique.

Subclinical Decrease in Central Inner Retinal Activity Is Associated With Myopia Development in Children.

To investigate the characteristics of retinal electrophysiological activity in relation to early myopia development in children. Fifty-six children aged 6 to 9 years with emmetropic refractive error (defined as ≥ -0.5 diopter [D] and ≤ +0.5 D) were recruited. Cycloplegic refraction, axial length, and global flash multifocal electroretinogram (MOFO mfERG) at 49% and 96% contrast levels were recorded in all children at their first visit. The refraction and axial length measurements were repeated after 1 year. The amplitudes and implicit times of the direct component (DC) and the induced component (IC) of the MOFO mfERG obtained at the initial visit were analyzed. Correlations between the MOFO mfERG parameters and changes in refractive error and axial length were investigated. The mean spherical equivalent refractive error and axial length of the eyes of the children at the first visit were +0.19 ± 0.33 D and 23.14 ± 0.6 mm, respectively. After 1 year, the mean refractive error increased by -0.55 ± 0.53 D, whereas axial length increased by 0.37 ± 0.22 mm. The changes in refractive error and axial length were significantly correlated with the central IC amplitudes at 49% contrast level measured at the initial visit (ρ = 0.46, P < 0.001 and ρ = -0.34, P = 0.01, respectively). The prospective changes we have shown are believed to derive from central inner retina. These changes appear to precede myopia and could be a potential reference for juvenile myopia development.

Effect of orthokeratology on progression of juvenile myopia and the relative influencing factors

Effect of orthokeratology on progression of juvenile myopia and the relative influencing factors

Bio-environmental factors associated with myopia: An updated review

Experimental studies in animals, as well as observational and intervention studies in humans, seem to support the premise that the development of juvenile myopia is promoted by a combination of the effect of genetic and environmental factors, with a complex interaction between them. The very rapid increase in myopia rates in some parts of the world, such as Southeast Asia, supports a significant environmental effect. Several lines of evidence suggest that humans might respond to various external factors, such as increased activity in near vision, increased educational pressure, decreased exposure to sunlight outdoors, dietary changes (including increased intake of carbohydrates), as well as low light levels indoors. All these factors could be associated with a higher prevalence of myopia.

Los factores bioambientales asociados a la miopía: una revisión actualizada

Experimental studies in animals, as well as observational and intervention studies in humans, seem to support the premise that the development of juvenile myopia is promoted by a combination of the effect of genetic and environmental factors, with a complex interaction between them. The very rapid increase in myopia rates in some parts of the world, such as Southeast Asia, supports a significant environmental effect. Several lines of evidence suggest that humans might respond to various external factors, such as increased activity in near vision, increased educational pressure, decreased exposure to sunlight outdoors, dietary changes (including increased intake of carbohydrates), as well as low light levels indoors. All these factors could be associated with a higher prevalence of myopia.

Clinical study of orthokeratology lens for correction effects of adolescent myopia

Objective To investigate the correction effect and influence of orthokeratology lens and aspheric spectacles on adolescent myopia. Methods A total of 124 cases of juvenile myopia in our hospital from January 2012 to January 2013 was divided into experimental and control groups according to the principle of random. Patients in both groups were followed for a period of 2 years, patient's vision, binocular refraction, and eye axis length were recorded. Results Unaided visual acuity of patients in the experimental group was increased significantly, the trend was clear with statistical significance (P 0.05). In the experiment group, for patients wearing glasses, their axis lengths were (24.7±0.19)mm after six months. After 1 year, their axis lengths were (24.5±0.16)mm, and after 2 years, their axis lengths were (24.3±0.20)mm. Compared to non-wearing glasses before, which was (24.3±0.21)mm, the difference was not statistically significant (P>0.05). In the control group, for patients wearing glasses, their axis lengths were (24.8±0.20)mm after six months. After 1 year, their axis lengths were (24.9±0.17)mm, and after 2 years, their axis lengths were (25.7±0.15)mm. Compared to non-wearing glasses before, which was (24.5±0.18)mm, the difference was statistically significant (P<0.05). Conclusions Orthokeratology lenses can reduce myopia in adolescent patients, reduce the degree of anisometropia, and prevent the increase of the axial length. It can achieve the purpose of myopia control. Key words: Eyeglasses; Myopia/TH

Theoretical and experimental investigation of design for multioptical-axis freeform progressive addition lenses

A freeform progressive addition lens (PAL) provides a good solution to correct presbyopia and prevent juvenile myopia by distributing pupils’ optical powers of distance zone, near zone, and intermediate zone and is more widely adopted in the present optometric study. However, there is still a lack of a single-optical-axis system for the design of a PAL. This paper focuses on the research for an approach for designing a freeform PAL. A multioptical-axis system based on real viewing conditions using the eyes is employed for the representation of the freeform surface. We filled small pupils in the intermediate zone as a progressive corridor and the distance- and near-vision portions were defined as the standard spherical surfaces delimited by quadratic curves. Three freeform PALs with a spherical surface as the front side and a freeform surface as the backside were designed. We demonstrate the fabrication and measurement technologies for the PAL surface using computer numerical control machine tools from Schneider Smart and a Visionix VM-2000 Lens Power Mapper. Surface power and astigmatic values were obtained. Preliminary results showed that the approach for the design and fabrication is helpful to advance the design procedure optimization and mass production of PALs in optometry.

Who Says There's Nothing New under the Sun?

The time since our first publication in 2007 describing time spent outdoors as protective for juvenile myopia onset to clinical trials incorporating outdoor light interventions has been short. The time outdoors/myopia example highlights the incorporation of clinical or epidemiologic evidence to translational research that may eventually change clinical practice and/or behavior.