Moderate Myopia Research Articles

Different efficacy in myopia control: Comparison between orthokeratology and defocus-incorporated multiple segment lenses

PurposeTo compare the efficiency of orthokeratology (OK) and defocus-incorporated multiple segment (DIMS) lenses in myopia control in children. MethodsThis prospective study involved 540 subjects (7–14 years) categorized into three groups: DIMS lenses (180 cases), OK lenses (180 cases), or single-vision spectacles (SVS) (180 cases). After a one-year follow-up, changes in axial length (AL) and differences among the groups were analyzed. The subjects were further divided into a low myopia degree subgroup (LM, −1.50 D ≤ SE ≤ −0.50 D), a moderate myopia degree subgroup (MM, −3.00 D ≤ SE ＜ −1.50 D), and a high myopia degree subgroup (HM, −5.00 D ≤ SE ＜ −3.00 D). A one-way ANOVA and multiple linear regression analysis were used to compare AL elongation and the factors influencing the different groups. ResultsA total of 496 (92 %) subjects completed the study. The mean AL change in the OK lenses, DIMS lenses, and SVS were 0.20±0.18 mm, 0.30±0.22 mm, and 0.38±0.19 mm, respectively (P < 0.001). In the LM subgroup, the OK and DIMS groups showed similar AL changes, but both exhibited slower changes than the SVS group (P = 0.001). In the MM and HM subgroups, the OK lens performed the shortest AL elongation compared with the DIMS lenses and SVS (P < 0.001). Multiple regression analysis showed that the AL change was associated with age (β = −0.038 and P = 0.005), initial AL (β = −0.010 and P = 0.011), initial SE (β = 0.028 and P = 0.007), and interventions using OK lenses (β = −0.172 and P = 0.020) and DIMS lenses (β = −0.089 and P = 0.020). ConclusionOver a one-year treatment period, OK and DIMS lenses can significantly retard AL elongation compared with SVS. In addition, the OK lenses were more effective than the DIMS lenses in controlling AL in patients with higher degrees of myopia.

Влияние ортокератологических контактных линз на анатомо-функциональное состояние роговицы

Aim: To analyze the potential impact of orthokeratological lenses when correcting myopia on the anatomical and functional state of the cornea. 160 eyes (80 patients) were examined – 60 eyes (30 patients) with mild myopia, 100 eyes (50 patients) with moderate myopia, average age 12.0 ± 0.38 years. Control group – 40 eyes (20 patients), with emmetropia, average age – 13.0 ± 0.45 years. All patients used reverse geometry orthokeratological lenses «Moonlens» from «Sky Optix» in night mode. Research methods. Special research methods were carried out: keratotopography, OCT of the anterior segment of the eye, autorefractometry, ophthalmometry, biometry, skiascopy against the background of cycloplegia, ultrasound of the eye, biomicroscopy, ophthalmoscopy. Results. After the use of orthokeratological lenses, flattening of the cornea from the center to the periphery was revealed with the formation of a negative value of the asphericity index «Q» – exactly (-) 0.57±0.054 (p &lt;0.01); an increase in refraction in the middle and peripheral zones of the cornea with an increase in the asymmetry index «l-S» is 3.0±0.12D (p &lt;0.01). According to the SimK1 and SimK2 meridians, the degree of weakening of refraction in the center of the cornea was revealed (-) 2.32±0.19D and the degree of enhancement of refraction of the cornea in the middle and peripheral zones – (+) 61±0.53D and (+) 0.97 0, 11D. Conclusion. Thus, the identified changes in the anatomical and functional state of the cornea during the treatment of myopia with orthokeratological lenses in the night mode indicate a transformation of the induced myopic defocus.

Clinical management of a nonoptimal vault and unexpected postoperative refraction in a patient implanted with a phakic intraocular lens

Introduction: This case reports the management of a bilateral toric implantable collamer lens (ICL) surgery with low vaulting and unilateral reduction in visual acuity (VA) associated with a combined effect of surgically induced astigmatism (SIA) and toric-ICL rotation. This case expands the common management of toric-ICL rotation, by adding surgically induced corneal changes. Patient and Clinical Findings: The patient presented with moderate myopia and high astigmatism and was implanted with a toric-ICL, resulting in bilateral low vault &lt;150 μm and unilateral VA reduction (20/40) because of postoperative oblique astigmatism, observed at the 4-week follow-up. Diagnosis, Intervention and Outcomes: The low ICL vaulting was associated with a high crystalline lens rise and underestimation of the sulcus-to-sulcus distance. The VA reduction resulted from a combined effect of ∼1.0 diopter SIA and 8-degree ICL rotation. The authors associate the high SIA to abnormal corneal biomechanics indexes and the toric-ICL rotation to a lack of stability resultant from a small ICL size. The left eye toric-ICL has exchanged with one with larger size and the power recalculated using vectorial analysis. The toric-ICL exchange increased the vault 75 μm and improved VA. Conclusions: Detailed anterior chamber morphometry and corneal biomechanics may assist in improving the refractive outcome in toric-ICL surgery.

Characteristic features of patients with myopia depending on the expressiveness of anxiety/depression.

Aim: To determine the peculiarities of character traits of patients with myopia at different levels of anxiety and depression. Materials and Methods: 30 patients with moderate myopia and mild myopic astigmatism in both eyes were examined. The "Kettel Test" was used to study the characteristics of the patient's character, and the Hospital Anxiety and Depression Scale was used to assess the levels of anxiety and depression. All examined patients were divided into 3 groups: the 1st group with a normal level of anxiety, the 2nd group with subclinical anxiety/depression, the 3rd grоup with clinically pronounced anxiety/depression. Mathematical processing of the research results was carried out using the methods of mathematical statistics. Results: Characteristic features of patients with myopia include conservatism, restraint, subordination, anxiety, developed imagination and high self-control. In half of people with myopia, anxiety/depression is subclinically determined, and in a third - clinically expressed anxiety/depression is observed. In the absence of anxiety in patients with myopia, the main character traits were conservatism, restraint, subordination, sufficient normative behavior, high self-control, and self-confidence; in the presence of subclinical anxiety - sufficient self-control and normative behavior, sociability, developed imagination, conservatism; with clinically expressed anxiety and depression - developed imagination, anxiety, significant normative behavior, conservatism, restraint, subordination. Conclusions: Studying the characteristic features of patients with myopia is necessary to clarify the peculiarities of the formation of the internal picture of the disease, the etiopathogenesis of the formation of nosogenies due to this pathology, and the development of individual psycho-corrective programs for such patients.

A comparative analysis of the effectiveness of laser correction with a mechanical and laser microkeratome for myopia.

Myopia, or nearsightedness, is one of the most common eye conditions worldwide. However, a comparison of the effectiveness of different laser-assisted interventions is lacking. Thus, we aimed to compare the efficacy and safety of LASIK and IntraLASIK in addressing myopia. The study was conducted in two ophthalmology clinics in Beijing, China, in 2022. A total of 84 patients (152 eyes) with different degrees of myopia were examined and underwent LASIK (n=46, 80 eyes) or IntraLASIK (n=38, 72 eyes). Keratometry, corneal topography, pachymetry, visual acuity evaluation, and corneal biomechanical analysis were performed before and after the intervention. IntraLASIK produced more precise flaps than LASIK, with deviations of <8 mm and 0.1 mm from the intended thickness and diameter, respectively. LASIK resulted in nonuniform flaps, with thickness deviations of 5-86 mm. IntraLASIK demonstrated a superior efficacy for patients with severe myopia and thin corneas, with a mean spherical equivalent of 0.9 D at 6 months compared to the 1.4 D for LASIK. Approximately 91% and 83% of the patients with mild to moderate and severe myopia, respectively, achieved results within ± 0.49 D from the refractive target with IntraLASIK. Corneal hysteresis and corneal resistance factor decreased with an increase in laser intensity, and they decreased faster with thinner corneas. Thus, IntraLASIK is more useful than LASIK in patients with thin corneas and severe myopia.

Characteristics of Peripheral Retinal Refraction and Its Role in Children with Different Refractive States.

Peripheral retinal refraction plays a crucial role in myopia, but the specific mechanism is not clear. We refined the retinal partitions to explore the characteristics of peripheral retinal refraction and its role in emmetropic, low, and moderate myopic children aged 6 to 12 years. A total of 814 subjects (814 eyes) were enrolled in the study. The participants were divided into three groups according to the central spherical equivalent refraction (SER), which were emmetropia group (E), low myopia group (LM) and moderate myopia group (MM). Multispectral refractive topography (MRT) was used to measure the retinal absolute and relative refractive difference value (RDV) in different regions. The range was divided into superior, inferior, temporal, and nasal RDV (SRDV, IRDV, TRDV, and NRDV) on the basis of several concentric circles extending outward from the macular fovea (RDV15, RDV30, RDV45, RDV30-15, RDV45-30, and RDV-45). Kruskal-Wallis test was used to analyze the differences of peripheral refraction for all the regions among the three groups. Spearman rank correlation was performed to explore correlations between SER and RDV, axial length (AL) and RDV. The absolute value of RDV decreased with increasing degree of myopia in all regions (P < 0.01). Subjects with different refractive degrees had different relative value of RDV. In nasal position within 45° and temporal position within 30°, the peripheral retina exhibited significantly different relative hyperopic refractive status among Group E, Group LM, and Group MM (P < 0.05). SER was negatively correlated with NRDV within 30° (especially in the range of NRDV30-15) (r = -0.141, P < 0.01), positively correlated with TRDV within 15° (r = 0.080, P = 0.023), and not significantly correlated with SRDV and IRDV when the retina was divided into four parts. AL was positively correlated with NRDV within 30° (especially in the range of NRDV30-15) (r = 0.109, P = 0.002), negatively correlated with TRDV within 15° (r = -0.095, P = 0.007). The peripheral defocus has significant implications for the genesis of myopia. The peripheral defocus of the horizontal direction, especially within the range of NRDV30, has greater effect on the development of myopia in children. Higher NRDV30 is associated with lower SER and longer AL.

Relationship between central corneal thickness and ganglion cell complex thickness in mild to moderate myopia

Relationship between central corneal thickness and ganglion cell complex thickness in mild to moderate myopia

Exploration of Myopia Trends among Medical Students in Saudi Arabia: A One-year Cohort Study

Introduction: Myopia is a prevalent refractive condition associated with higher occupational groups and education. Contributing data from a region like Saudi Arabia adds to the global understanding of myopia progression, potentially uncovering patterns or risk factors that may differ from those observed in other parts of the world. Aim: To estimate myopia progression among junior medical students. Materials and Methods: This was a one-year longitudinal cohort study conducted on 85 students at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Demographics, detailed ocular history, use of electronic devices, and other related risk factors were collected at the start of the study. Students underwent a comprehensive eye examination including visual acuity, autorefraction, ocular biometry, and Spectral Domain-Optical Coherence Tomography (SD-OCT) of the macula and optic nerve at the start and end of the study. Progression of myopia over one year and its associations were assessed using pairedsamples t-test for a single group, while ≥two-group comparison was tested with Independent t-tests and one-way Analysis of Variance (ANOVA), respectively. Results: This cohort study involved 85 medical students (41 men and 44 women) aged between 19 and 23 years. Myopia prevalence was 76.5% (65/85) on the first visit. One participant progressed from hyperopia to myopia, five from initial emmetropia to myopia, four from mild to moderate myopia, and one from moderate to high myopia. A significant myopic shift was observed in the second visit in both eyes {Right Eye (RE): -0.3D, p-value=0.001; Left Eye (LE): -0.2 D, p-value=0.015}. The myopic shift in male participants from a mean±SD of -1.1±1.6 D (RE) and -1.0±1.5 D (LE) to -1.5±1.7 D (RE) and -1.4±1.7 D (LE) in the one year follow-up was statistically significant (RE: p-value=0.006; LE: p-value=0.004). Myopia prevalence was significantly related to the hours spent reading for learning/ studying and hours spent watching TV at the first visit (p-value=0.023, p-value=0.046, respectively) and total weekly average screen time at the second visit (p-value=0.002). Conclusion: The medical students had a significant myopic shift over one year, which was associated with longer hours spent reading. The factors associated with the rapid refraction change should be identified to reduce myopic shift among medical students.

Corneal biomechanical changes following small incision lenticule extraction (SMILE) with variable cap thickness in management of mild to moderate myopia

Corneal biomechanical changes following small incision lenticule extraction (SMILE) with variable cap thickness in management of mild to moderate myopia

Relationship between nutritional status and myopia degree in adolescents at Prof. CPL USU Hospital

Myopia is currently a major global public health problem causing significant vision loss and is a risk factor for more serious ocular conditions. Weight gain in adolescents has increased significantly in recent years due to lack of physical activity, increased caloric intake, and comfort in indoor environments. Weight gain is also the most common cause of dyslipidemia in adolescents. This is an observational analytic study with a cross sectional design. The study was conducted at Prof. CPL Universitas Sumatera Utara General Hospital from March 2023 until July 2023. Data analysis was carried out analytically and presented in the form of data tabulations. This study was attempted by 50 subjects with myopia who visited the Eye Polyclinic. Most of the subjects in this study were female, totaling 26 people (52%). The mean age of the subjects was 20.92 years with the youngest was 13 years old and the oldest was 24 years old. The mean height and weight measurements respectively were 1.63+0.1 m and 68.74+19.87 kg. Based on body mass index, most of the subjects were in normal cathegories accounted for 20 subjects (40%). Based on cholesterol levels, subjects with mild myopia showed a mean value of 206.84 mg/dL, those with moderate myopia had a mean of 190.94 mg/dL and severe myopia had a mean of 207.36 mg/d. Nutritional status have no significant correlation to the degree of myopia in adolescents at Prof. CPL Universitas Sumatera Utara General Hospital.

Prospective cross-sectional study on visual health assessment in the pediatric population

Background Aim: This study investigates the prevalence and severity of myopia among 841 pediatric individuals aged 3.5 to 16 years in Bangalore. The global rise in myopia, particularly among children, underscores the urgency for preventive measures. To assess the occurrence and severity of myopia in the pediatric population, providing insights into the growing public health concern and advocating for holistic interventions. Methods: Conducted as a prospective cross-sectional study, the research utilized visual acuity assessments with the Snellen chart. A total of 840 participants were included, and data analysis employed descriptive statistics through Microsoft Excel. Results: Out of the participants, 26.79% experienced visual impairment, with 22.50% having mild myopia, 2.62% moderate myopia, and 0.71% severe myopia. Astigmatism and squint eyes were observed in 0.36% and 0.60% of cases, respectively. Conclusion: The study contributes valuable insights into pediatric myopia, emphasizing the need for a holistic approach through education and awareness. With 26.79% of participants affected, evidence-based interventions are crucial to safeguard the eye health of the younger population globally.

The Role of Corneal Aberrations in the Development and Progression of Pseudophakic Myopia after Congenital Cataract Extraction in Infancy

Relevance. Many studies have shown a relationship between higher order aberrations and refractive errors in children without comorbidities, but these studies have not been conducted in children with pseudophakia. Purpose. Evaluation of corneal aberrations after congenital cataract (CC) extraction with intraocular lens (IOL) implantation in infancy, and their impact on the dynamics of eye growth and myopia progression. Materials. Thirty-two children (the median age 9.35 ± 3.31 years; range 4–15 years) with pseudophakia were divided to: group 1, planned refraction (17 children, 23 eyes) and group 2, pseudophakic myopia (15 children, 23 eyes). Twelve children (24 eyes; the median age 11.67 ± 2.43 years) with moderate and high myopia without ophthalmic pathology were examined as a comparison group. Keratometry and aberrometry were performed on a Scheimpflug Galilei G2. Results. Total corneal aberrations root mean square (RMS) and higher order aberrations (HOA) were higher in pseudophakic children (2.77 and 1.13 µm in group 1, 2.48 and 1.15 µm in group 2) when compared with children with acquired myopia (1.58 and 0.44 µm; p &lt; 0.05). Oblique astigmatism and negative oblique trefoil were the highest in pseudophakic myopia (0.63 and (-)0.48 µm). There were positive correlations between eye growth in 4 years and HOA (r = 0,699; p &lt; 0,01), eye growth during the total follow-up time and oblique astigmatism (r = 0,393; p &lt; 0,01), and negative correlation between eye growth during the total follow-up time and oblique trefoil (r = -0,322; p &lt; 0,05). Conclusion. Corneal incision with forced corneal suture during surgery in infants leads to an increase in HOA, especially oblique astigmatism, and oblique trefoil. Correlations between corneal aberrations and the dynamics of globe axial length growth indicate the effect of monochromatic aberrations on eye growth already in the early postoperative period.

OUTCOME COMPARISON OF LASER-ASSISTED IN SITU KERATOMILEUSIS IN VARIOUS DEGREE OF MYOPIA

Introduction: The femtosecond Laser-Assisted in Situ Keratomileusis (fs-LASIK) procedure is commonly used for myopia correction because of good efficacy, safety, and predictability. The aim of this study was to compare the outcome of the fs-LASIK procedure among myopia groups in Cicendo Eye Hospital from January to December 2021. Methods: This retrospective study included 212 patients (399 eyes) and the data were obtained from medical records from January 2021 to December 2021 using ICD-10 coding for LASIK (S0800), consisting of fs-LASIK procedures. The outcome variables were safety index, and efficacy index. Results: The median of safety index was not statistically significant different between groups, 1,00(0,50-1,67) in low myopia, 1,00(0,20-1,43) in moderate myopia, and 1,00(0,30-3,33) in high myopia. The median of efficacy index was statistically significant different between groups, 1,00(0,40-1,67) in low myopia, 1,00(0,20-1,43) in moderate myopia, and 1,00(0,30-3,33) in high myopia. The proportion of eye with UCVA &gt; 6/12 on the first month after the procedure was higher in the mild myopia group (223;99,2%) than in moderate myopia (87;98,8%) and high myopia (77;88,5%) with p=0,0001. The proportion of eye with BCVA &gt; 6/12 on the first month after the procedure was also higher in the mild myopia group (224;100%) than in moderate myopia (87;98,8%) and high myopia (82;94,3%) with p=0,0001. Conclusion: There was no statistically significant difference of the safety index between groups. The efficacy index was statistically significant different between groups.

Evaluation of Indicators of the Optical System and Hydrodynamics of Eyes With Myopia in the Treatment of Orthokeratological Lenses

Purpose. To study the features of changes in the parameters of the optical system and hydrodynamics of eyes with myopia during treatment with orthokeratological lenses. 80 patients (160 eyes) with mild myopia were examined — 30 patients (60 eyes) and 50 patients (100 eyes) with moderate myopia before and after treatment with orthokeratological lenses. Research methods. Visometry, autorefractometry, ophthalmometry, biometry, keratotopography, determination of accommodation indicators (AOA, ZOA) and hydrodynamics of the eyes. Results: It was revealed after the use of orthokeratological lenses in the night mode, a significant decrease in the true vg d (Po) and an increase in the coefficient of ease of outflow (C) with the activation of accommodation indicators — AOA and ZOA, contributing to a decrease in the degree of myopia and an increase in uncorrected visual acuity. Conclusion: One of the factors of the effectiveness of the treatment of myopia with orthokeratological lenses are the indicators of the hydrodynamics of the eyes and the strengthening of the functions of the accommodation apparatus — an increase in AOA and ZOA.

Evaluation of changes in corneal biomechanics after orthokeratology using Corvis ST

PurposeTo investigate the alterations in corneal biomechanical metrics induced by orthokeratology (ortho-k) using Corvis ST and to determine the factors influencing these changes. MethodA prospective observational study was conducted to analyze various Corvis ST parameters in 32 children with low to moderate myopia who successfully underwent ortho-k lens fitting. Corneal biomechanical measurements via Corvis ST were acquired at six distinct time points: baseline (pre) and 2 h (pos2h), 6 h (pos6h), and 10 h (pos10h) following the removal of the first overnight wear ortho-k, one week (pos1w) and one month (pos1m) subsequent to the initiation of ortho-k. ResultSignificant differences were observed in Corvis ST Biomechanical parameters DAR2, IIR, CBI, and cCBI post ortho-k intervention. The integration of covariates (CCT, SimK, and bIOP) mitigated the differences in DAR2, IIR, and cCBI, but not in CBI. Initially, the stiffness parameter at first applanation, SP-A1, did not demonstrate significant variations, but after adjusting for covariates, noticeable differences over time were observed. The Stress-Strain Indeces, SSIv1 and SSIv2, did not manifest considerable changes over time, irrespective of the adjustment for covariates. No significant disparities were identified among different ortho-k lens brands. ConclusionCorneal biomechanics remained consistent throughout the one-month period of ortho-k lens wear. The observed changes in Corvis ST parameters subsequent ortho-k are primarily attributable to alterations in corneal pachymetry and morphology, rather than actual alterations in corneal biomechanics. The stability of corneal biomechanics post ortho-k treatment suggests the safety of this approach for adolescents from a corneal biomechanics perspective.

Morphology and thickness of corneal endothelial cells in young Sudanese individuals with myopia.

Deviations in corneal endothelium morphology and thickness may indicate corneal abnormalities and could be associated with myopia development. This study aimed to evaluate corneal endothelial cell morphology and central corneal thickness in young individuals with myopia. A prospective study was conducted at Al-Neelain University Eye Hospital between January 2019 and January 2020, including 160 patients with myopia (320 eyes). Data was gathered through clinical assessment of visual acuity, refractive error, and corneal endothelial cells. Results showed that 60% of participants with myopia were female, with a mean age of 21.99±2.8 years and a mean equivalent sphere of -3.19±2.67D. There was a significant difference in endothelial cell degeneration between myopia groups (P<0.001). Corneal guttata occurred in 9.1% of eyes with low myopia and 68.2% with moderate myopia, whereas polymegathism and polymorphism were more prevalent in high myopia. The mean central corneal thickness was 500.50±38.94 µm in low myopia, 497.02±36.23 µm in moderate myopia, and 477.87±43.625 µm in high myopia (P=0.007). The mean endothelial cell number in low myopia was 107.86±21.12, 106.0±24.03 in moderate myopia, and 101.23±18.49 in high myopia (P<0.05). The mean difference in endothelial cell density, coefficient of variation, and hexagonality in low, moderate, and high myopia was not significant (P>0.05). However, Pearson's correlation revealed a significant negative correlation between the degree of myopia and central corneal thickness (r= -0.174, P=0.002) as well as endothelial cell number (r= -0.124, P=0.026). The study concluded that central corneal thickness and endothelial cell number significantly decreased with an increase in the degree of myopia. Corneal guttata was the most common form of endothelial cell degeneration observed in cases of high myopia.

Temporal effects of an original myopia song on school children’s myopia and awareness: a 3-year prospective study

ABSTRACT Clinical Relevance Raising children’s myopia prevention awareness and behaviour tends to exhibits a protective effect against myopia among schoolchildren. Background To investigate the effect of an original myopia song in raising school children’s awareness of healthier eye use behaviour and on myopia prevention. Methods In this prospective randomised control study, two groups of students from one primary schools in Jiangxi, China, were enrolled and monitored from grade 3 to grade 6 (2016–2019). The primary outcome was the change in axial length (AL) after the intervention. Secondary outcomes included changes in spherical equivalent refraction (SER), near work and outdoor time, corrected near and distant visual acuity, visual discomfort score (VDS) and accommodative lag. Results Four hundred students (193 females, 48.25%) aged 9.3 (range 8–10) years with emmetropia to moderate myopia were enrolled. Children in the myopia song group had a significantly shorter AL and less myopic refractive change than those in the control group (p = 0.04 and 0.02, respectively). Compared with the control group, children in the myopia song group spent less time on near work and more time outdoors (p = 0.04 and 0.04, respectively). At the final follow-up, the proportion of children with myopia was significantly lower in the myopia song group (30.5%) than in the control group (41%) (p = 0.03). No significant differences were found for the secondary outcomes, including corrected near and distant visual acuity, VDS and accommodative lag. Conclusions An original myopia song performed twice daily in primary schools appeared to have a modest effect on myopia control among school-aged children by changing their lifestyles in the long term.

Kaleidos-based binocular vision analyzer for the estimation of refractive errors and horizontal ocular deviation in children

ABSTRACT Clinical relevance Knowing the agreement and interobserver variability of the 2WIN-S photorefractometer with cycloplegic retinoscopy and prism cover test is important for judging the clinical usefulness of the device. Background This study aims to determine an agreement and interobserver reliability between 2WIN-S photorefractometer and cycloplegic retinoscopy for estimating refractive errors and between 2WIN-S and prism cover test for measuring horizontal ocular deviation in children. Methods Two groups of 129 and 64 participants (range, 5 to 16 years) were recruited for the agreement and interobserver reliability studies, respectively. Non-cycloplegic 2WIN-S refraction was compared with cycloplegic retinoscopy for low and moderate myopia and hyperopia. Similarly, corneal reflex-function (CR-function) of 2WIN-S was compared with prism cover test for horizontal ocular deviation. Bland-Altman plots were used to depict agreement, and the intraclass correlation coefficient (ICC) was used for determining interobserver reliability of repeated measures. Results The mean differences in spherical equivalent, J0 (Cartesian astigmatism) and J45 (oblique Jackson cross-cylinder) between cycloplegic retinoscopy and 2WIN-S were 1.10 (95% CI = 0.97 to 1.21, p < 0.001), −0.06 (95% CI = −0.09 to −0.03, p < 0.001) and 0.009 (95% CI = −0.01 to 0.03, p = 0.35), respectively. The overall median difference in the horizontal ocular deviation between prism cover test and 2WIN-S was −4.5 (Interquartile range = −12.0 to 4.0). For constant strabismus, this difference was insignificant (median= −2.0, interquartile range = −11.0 to 6.7, p = 0.19) between prism cover test and 2WIN-S. The ICC was high for the spherical equivalent (0.997; p < 0.001), J0 (0.932; p < 0.001) and J45 (0.901; p < 0.001), whereas it was low-to-moderate for horizontal ocular deviation (0.50; p < 0.001). Conclusion 2WIN-S refraction was in agreement with cycloplegic retinoscopy for low and moderate myopia and hyperopia, and requires an adjustment for the consistent differences between cycloplegic retinoscopy and 2WIN-S refraction. The measurement of constant strabismus with 2WIN-S is comparable to that of prism cover test.

The Impact of Parental Myopia and High Myopia on the Hyperopia Reserve of Preschool Children

Introduction: The aim of this study was to explore the association between parental myopia and high myopia with children’s refraction and ocular biometry in large-scale Chinese preschool children from the Beijing Hyperopia Reserve Study. Subjects/Methods: This cross-sectional kindergarten-based study enrolled children aged 3–6 years. Cycloplegic refraction, axial length (AL), and corneal radius (CR) were measured for all children. Parents were asked to complete a questionnaire about refractive status (no myopia, mild myopia <−3 D, moderate myopia ≥−3 D and ≤−6, and high myopia >−6 D). Results: The study enrolled 2,053 children (1,069 boys and 984 girls), with a mean age of 4.26 ± 0.96 years and mean spherical equivalent refraction (SER) of 1.11 ± 0.97 diopter. Of the children, 90.7% had at least one myopic parent, and 511 children (24.9%) had at least one highly myopic parent. SER decreased significantly with increasing severity of parental myopia (p < 0.001). Preschool children’s myopia was independently associated with parental myopia (OR, 10.4 and 11.5 for one and two highly myopic parent[s]). Age (OR = 1.1), gender (OR = 1.7; girls as references), near work time (OR = 1.2), and both maternal (OR, 1.4 and 2.0 for moderate and high myopia) and paternal myopia (OR, 1.6 and 1.9 for moderate and high myopia) were independent risk factors for lacking hyperopia reserve. Conclusion: Severe parental myopia was associated with a lower SER, longer AL, and higher AL/CR ratio in preschool children. Parental myopia and near work may predispose children to faster elimination of hyperopia reserves before exposure to higher educational stress.

Quantitative analysis of optic disc changes in school-age children with ametropia based on artificial intelligence.

To explore changes in the optic disc and peripapillary atrophy (PPA) in school-age children with ametropia using color fundus photography combined with artificial intelligence (AI) technology. Based on the retrospective case-controlled study, 226 eyes of 113 children aged aged 6-12y were enrolled from October 2021 to May 2022. According to the results of spherical equivalent (SE), the children were divided into four groups: low myopia group (66 eyes), moderate myopia group (60 eyes), high myopia group (50 eyes) and emmetropia control group (50 eyes). All subjects underwent un-aided visual acuity, dilated pupil optometry, best-corrected visual acuity (BCVA), intraocular pressure, ocular axis measurement and color fundus photography. The width of PPA, horizontal diameter ratio of PPA to the optic disc and area ratio of PPA to the optic disc were significantly different among the four groups (P<0.05). The width of the nasal and temporal neuroretinal rim, the roundness of the optic disc, the height of PPA, the vertical diameter ratio of PPA to the optic disc, and the average density of PPA in the high myopia group were significantly different compared with the other three groups (P<0.05). There were strong negative correlations between SE and area ratio of PPA to the optic disc (r=-0.812, P<0.001) and strong positive correlation between axial length (AL) and area ratio of PPA to the optic disc (r=0.736, P<0.001). In school-age children with high myopia, the nasal and temporal neuroretinal rims are narrowed and even lost, which have high sensitivity. The area ratio of the PPA to the optic disc could be used as an early predictor of myopia progression, which is of great significance for the development prevention and management of myopia.