Rate Of Myopia Progression Research Articles

Development of Refractive Error in Individual Children With Regressed Retinopathy of Prematurity

We investigated longitudinally the refraction development in children with regressed retinopathy of prematurity (ROP), including those with and those without a history of peripheral retinal laser photocoagulation. Longitudinal (0-7 years) cycloplegic refraction data were collected prospectively for two groups of preterm children: severe ROP group included those with regressed ROP following bilateral panretinal laser photocoagulation (n = 37; median gestational age [GA] = 25.2; range, 22.7-27.9 weeks) and mild/no ROP group included those with spontaneously regressed ROP or no ROP (n = 27; median GA = 27.1; range, 23.1-32.0 weeks). Analyses were based on spherical equivalent (SEQ), anisometropia, astigmatism, and age (corrected for gestation). The prevalence, magnitude, and rate of myopic progression all were significantly higher in the severe ROP group than in the mild/no ROP group. Longitudinal SEQ in the severe ROP group were best fit with a bilinear model. Before 1.3 years old, the rate of myopic shift was -4.7 diopters (D)/y; after 1.3 years, the rate slowed to -0.15 D/y. Longitudinal SEQ in the mild/no ROP group was best fit with a linear model, with a rate of -0.004 D/y. Anisometropia in the severe ROP group increased approximately three times faster than in the mild/no ROP group. In the severe ROP group, with-the-rule astigmatism increased significantly with age. The severe ROP group progressed rapidly toward myopia, particularly during the first 1.3 years; anisometropia and astigmatism also increased with age. The mild/no ROP group showed little change in refraction. Infants treated with laser photocoagulation for severe ROP should be monitored with periodic cycloplegic refractions and provided with early optical correction.

Late results of sclera reconstructive surgery aimed at preventing the progression of myopic macular dystrophies

AbstractPurpose To assess the long‐term efficiency of scleroplasty performed using a simplified technique of buckling the posterior pole in patients with congenital myopia complicated by macular dystrophy and posterior staphyloma of the scleraMethods The surgery was performed according to Snyder–Thompson technique in which the buckle made of a biologically active synthetic graft was sutured using a simplified technique of its localization at the posterior pole. 42 surgeries were administered to 34 patients aged 13–43 with myopia of –11.5 to –31.0 D. The shape and stage of staphyloma was determined by ultrasound scanning or with an ophthalmoscope. The follow‐up period reached 3‐8 yrs (4.2±1.3 yrs).Results Next day after surgery, flattening of the staphyloma can be seen on B‐scan. The axial length becomes 1.0‐2.0 mm shorter, the acoustic density of the posterior pole of the sclera increases by 5.3 dB, visual acuity shows a 0.1‐0.3 growth, while the refraction is 1.5‐2.5 D lower. The late follow‐up results (6‐8 years) demonstrated myopia stabilization in 90.2% of cases. Myopia progression rate turned out to be half as slow as prior to the surgery, and B‐scan showed a sustainable flattening of the staphyloma. Over the whole observation period, no new pathological processes emerged in the macular area, while no existing pathological processes showed progressionConclusion Scleroplastic surgery combined with posterior pole bucking with a biologically active synthetic graft should be recommended for the treatment of high complicated myopia, the prevention of staphyloma progression, myopic macular dystrophies and vitreomacular traction syndrome.

The Effect of Multifocal Soft Contact Lenses on Peripheral Refraction

To compare changes in peripheral refraction with single-vision (SV) and multifocal (MF) correction of distance central refraction with commercially available SV and MF soft contact lenses (SCLs) in young myopic adults. Thirty-four myopic adult subjects were fitted with Proclear Sphere and Proclear Multifocal SCLs to correct their manifest central refractive error. Central and peripheral refraction were measured with no lens wear and subsequently with the two different types of SCL correction. At baseline, refraction was myopic at all locations along the horizontal meridian. Peripheral refraction was relatively hyperopic compared with center at 30 and 35 degrees in the temporal visual field (VF) in low myopes, and at 30 and 35 degrees in the temporal VF, and 10, 30, and 35 degrees in the nasal VF in moderate myopes. Single-vision and MF distance correction with Proclear Sphere and Proclear Multifocal SCLs, respectively, caused a hyperopic shift in refraction at all locations in the horizontal VF. Compared with SV correction, MF SCL correction caused a significant relative myopic shift at all locations in the nasal VF in both low and moderate myopes and also at 35 degrees in the temporal VF in moderate myopes. Correction of central refractive error with SV and MF SCLs caused a hyperopic shift in both central and peripheral refraction at all positions in the horizontal meridian. Single-vision SCL correction caused the peripheral retina, which initially experienced absolute myopic defocus at baseline with no correction to experience an absolute hyperopic defocus. Multifocal SCL correction resulted in a relative myopic shift in peripheral refraction compared with SV SCL correction. This myopic shift may explain recent reports of reduced myopia progression rates with MF SCL correction.

Relationship between higher-order aberrations and myopia progression in schoolchildren: a retrospective study.

To investigate the relationship between higher-order aberration (HOA) and myopic progression in school children. Between April 23, 2011 and August 29, 2011 in the children's myopia outpatient clinic of the West China Hospital of Sichuan University, 148 eyes of 74 schoolchildren were reviewed. HOAs for a 6-mm pupil were measured with an aberrometer. Myopic progression rate was defined according to the change in spherical equivalent refraction (SER) divided by the time span (years). Subjects with myopic progression rate of ≥0.50 diopters (D) were classified as the 'fast' group and the subjects with myopic progression rate of <0.50D were classified as the 'slow' group. A retrospective study was conducted to compare HOA between the two groups, using root mean square (RMS) values and Zernike coefficients. The RMS values of HOA (t=2.316, P=0.02), HOA without Z4 (0) (t=2.224, P=0.03), third-order aberrations (t'=2.62, P=0.01), and coma (t'=2.49, P=0.01) were significantly higher in the fast group than those in the slow group. The individual Zernike coefficients of Z3 (-1) (t=-2.072, P=0.04) and Z5 (1) (Z =-2.627, P=0.01) displayed statistically significant differences between the two groups. Significant correlations were found between the RMS values of HOA (r=0.193, P=0.019), RMS values of HOA without Z4 (0) (r=0.23, P =0.005), RMS values of coma (r=0.235, P=0.004), RMS values of third-order aberrations (r=0.243, P =0.003), and the progression rate. Our results provide evidence of a relationship between HOA and myopic progression. In a future prospective longitudinal study, we aim to verify whether HOA is a risk factor for myopic progression.

Full correction and Undercorrection of Myopia Evaluation Trial: design and baseline data of a randomized, controlled, double‐blind trial

To determine the difference in the rate of myopic progression between children wearing single vision lenses with undercorrection of +0.50 D and children whose myopia is fully corrected, and to explore the factors that may influence the process. Randomized, controlled, double-blind trial. Two hundred children aged 7-15 years with low-to-moderate myopia (-1.5 D to -6.0 D), astigmatism <-1.5 D and anisometropia <1.0 D. The children were randomly allocated to wear single vision lenses with full correction or undercorrection by +0.50 D. Ocular examinations and questionnaire surveys for myopia-related factors will be performed every 6 months. Cycloplegic autorefraction and axial length. Of 200 children, 100 (50%) were girls, 41 (21%) esophoric and 82 (42%) exophoric at near. The characteristics of gender, age, age of myopia onset, phoria, eye dominance, parental myopia, refractive error, axial length, corneal curvature, mean time spent in near work and outdoor activities between the two groups were not significantly different. The accommodative responses at 33 cm, the accommodative demands and lags at infinity were significantly different in the two groups as they were measured with full correction in one group and undercorrection in the other. Full correction and Undercorrection of Myopia Evaluation Trial is a clinical trial designed to determine the effectiveness of undercorrection of myopia by +0.5 D on myopic progression in a population of school-aged children known to be susceptible to myopia and to identify the factors influencing the process.

Time Outdoors, Visual Activity, and Myopia Progression in Juvenile-Onset Myopes

To investigate the association between myopia progression and time spent outdoors and in various visual activities. Subjects were 835 myopes (both principal meridians -0.75 diopters [D] or more myopia by cycloplegic autorefraction) in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study with both progression data and at least one measure of activity associated with a progression interval. Activity data were collected by parental survey. Average activity level (mean of the activity at the beginning and the end of a 1-year progression interval) was the primary predictor in a repeated-measures mixed model. The model controlled for age, sex, ethnicity, refractive error at the beginning of the progression interval, clinic site, and type of autorefractor used. Effects were scaled based on performing an additional 10 hours per week of an activity. In the multivariate model, the number of hours of reading for pleasure per week was not significantly associated with annual myopia progression at an a priori level of P ≤ 0.01, nor were the other near activities, the near-work composite variable diopter-hours, or outdoor/sports activity. The magnitude of effects was clinically small. For example, the largest multivariate effect was that each additional 10 hours of reading for pleasure per week at the end of a progression interval was associated with an increase in average annual progression by -0.08 D. Despite protective associations previously reported for time outdoors reducing the risk of myopia onset, outdoor/sports activity was not associated with less myopia progression following onset. Near work also had little meaningful effect on the rate of myopia progression.

Atropine use in childhood myopia treatment

AbstractPurpose To discuss the role of atropine use in childhood myopia treatment.Methods The analysis of the literature and studies of the subject.Results The prevelance of myopia the population in the United States, Europe and Australia is about 30‐40%, whreaes in some southern Asian countries is up to 80‐90%. Moreover, it was shown that this prevalence has been increasing in the recent 20 years. Although the pathogenesis of myopia is unknown, it is argued that, at least in the case of school myopia, environmental factors are of major imprtance, whrease genetic factors play secondary role. The role of atropine in the lowering the rate of myopia progression was analysed in recent 10 years in many studies, differing with the atropine concentration, studied group characteristics, the time of treatment and the the time of observation, etc. The lowering effect of atropine was proved, however, its effectiveness decreased with the time of drug use, and after the drug discontuinuation the effect was partially reversed. On the other hand, it is well‐known that atropine use is related to significant side‐effects, including mydriasis, cycloplegia, increased exposure to UV light. Moreover, some argue that results of the therapy, i.e. lowering of the magnitude of school myopia, cannot be be balanced by the problems and unknown longterm effects related to the therapy.Conclusion The atropine use in childhood myopia treatment remains controversial and possible benefits and weaknesses of the therapy should be carefully analysed.

Correction method may influence myopia progression rate

Correction method may influence myopia progression rate

The Prevalence and Impact of High Myopia

Myopia has gained increasing interest in recent years, particularly because of its increase in prevalence across populations worldwide. The onset of myopia has shifted to a younger age, and the number of high myopes with prescriptions of more than -5.00 D has increased over the last few decades. High myopia is strongly associated with a greater incidence of pathologic complications, has shown to impact vision-related quality of life in children and adults and is further associated with certain contact lens complications. Different pharmaceutical and optical treatment options are currently under investigation with a common goal to slow down the rate of myopia progression.

Myopia Progression Rates in Urban Children Wearing Single-Vision Spectacles

To conduct a meta-analysis on the rates of myopia progression in urban children of Asian and predominately European ethnicities who are corrected with traditional single-vision spectacles. A search of the National Library of Medicine's PubMed literature database for articles on myopia progression was conducted using the terms "myopi*progression" and MeSH terms "myopia" and "disease progression," and limited to publications from January 1990 and only for articles reporting data for humans <16 years of age. Studies were excluded if they were non-randomized, did not use cycloplegic autorefraction, had a sample size <30 individuals, examined high myopia (worse than -6.0 D) or special subject groups, presented myopia as part of a syndrome or condition, were retrospective, or used controls wearing optical corrections other than spectacles. Of 175 articles identified, 20 remained after applying the exclusion criteria. The estimated myopia progression at a mean age of 9.3 years after 1 year of follow-up was -0.55 D [95% confidence interval (CI), -0.39 to -0.72 D] for populations of predominantly European extraction and -0.82 D (95% CI, -0.71 to -0.93 D) for Asians. The estimated progression rates were dependent on baseline age, with decreasing progression as age increased. The rates also varied with gender. For an average baseline age of 8.8 years, estimated annual progression (combined ethnicities) was -0.80 D/yr for females (95% CI, -0.51 to -1.10), and a significantly slower (p < 0.01) -0.71 D/yr for males (95% CI, -0.42 to -1.00). In children wearing single-vision spectacles, higher myopia progression rates were found in urban Asians compared with urban populations of predominantly European descent. Younger children and females demonstrated greater annual rates of progression of myopia.

Decrease in Rate of Myopia Progression with a Contact Lens Designed to Reduce Relative Peripheral Hyperopia: One-Year Results

To determine whether a novel optical treatment using contact lenses to reduce relative peripheral hyperopia can slow the rate of progress of myopia. Chinese children, aged 7 to 14 years, with baseline myopia from sphere -0.75 to -3.50 D and cylinder ≤1.00 D, were fitted with novel contact lenses (n = 45) and followed up for 12 months, and their progress was compared with that of a group (n = 40) matched for age, sex, refractive error, axial length, and parental myopia wearing normal, single-vision, spherocylindrical spectacles. On adjusting for parental myopia, sex, age, baseline spherical equivalent (SphE) values, and compliance, the estimated progression in SphE at 12 months was 34% less, at -0.57 D, with the novel contact lenses (95% confidence interval [CI], -0.45 -0.69 D) than at -0.86 D, with spectacle lenses (95% CI, -0.74 to -0.99 D). For an average baseline age of 11.2 years, baseline SphE of -2.10 D, a baseline axial length of 24.6 mm, and 320 days of compliant lens wear, the estimated increase in axial length (AL) was 33% less at 0.27 mm (95% CI, 0.22-0.32 mm) than at 0.40 mm (95% CI, 0.35-0.45 mm) for the contact lens and spectacle lens groups, respectively. The 12-month data support the hypothesis that reducing peripheral hyperopia can alter central refractive development and reduce the rate of progress of myopia. (chictr.org number, chiCTR-TRC-00000029 or chiCTR-TRC-00000032.).

Atropine in Ameliorating the Progression of Myopia in Children with Mild to Moderate Myopia: A Meta-Analysis of Controlled Clinical Trials

Myopia is the most common ocular disorder associated with increasing risk for chorioretinal degeneration, retinal detachment, and other vision-threatening abnormalities worldwide. Recently, atropine has been becoming a focus of attention due to its role in ameliorating the myopia progression in children. This meta-analysis was conducted to address the efficacy and safety of atropine on myopia in children and the dose-response relationship between atropine and annual rate of myopia progression. Controlled clinical trials were retrospectively analyzed to compare atropine and placebo for the treatment of myopia. The primary outcome measure was annual rate of myopia progression after daily atropine application over 1 year. Data were extracted from 6 randomized clinical trials and analyzed using standard meta-analysis and meta-regression methods. Comparing with placebo, the effect size of atropine for retarding myopia progression was 0.773 diopters (D)/year [95% confidence interval (CI): 0.699-0.848]. Regression model, -0.728+1.281log (dose+1), revealed the dose-response relationship between atropine and myopia progression. The estimate of effect for 0.05%, 0.1%, and 0.25% atropine was -0.665 (95% CI: -1.070 to -0.260), -0.606 (95% CI: -0.967 to -0.245), and -0.442 (95% CI: -0.701 to -0.183) D/year respectively, whereas that for 0.5% and 1% was -0.208 (95% CI: -0.435-0.018) and 0.160 (95% CI: -0.293-0.613), respectively, suggesting that myopia might deteriorate at low dose of atropine but not at 0.5% atropine and 1% atropine within the duration of 6-24 months. No serious adverse event was reported during the period of treatment. The major adverse reactions associated with 0.5% and 1% atropine were photophobia, glare, and recurrent allergic blepharitis. Photochromatic lenses or sunglasses with ultraviolet protection could be used to minimize the glare and photophobia. In summary, 0.5% and 1% atropine was demonstrated to be effective and safe to ameliorate myopia progression in childhood with low-to-moderate myopia.

Analysis of head position used by myopes and emmetropes when performing a near-vision reading task

The aim of the study was to compare head posture in young, adult emmetropes and corrected myopes during a reading task. Thirty-two (32) myopes (mean spherical equivalent: −3.46 ± 2.35 D) and 22 emmetropes (mean spherical equivalent: −0.03 ± 0.36 D) participated in the study. Of the myopes, 16 were progressing (rate of progression ⩾−0.5 D over the previous 2 years), 12 were stable (changes of −0.25 D or less over 2 years) and four could not be classified. Seated subjects were asked to read a text binocularly in their habitual posture. To measure head posture, two simultaneous images were recorded from different directions. In a separate study with the same subjects and conditions, a motion monitor was used to track head posture for 1 min. The habitual reading distance was measured in both studies, together with the stereoscopic acuity and fixation disparity for each subject. The results of the photographic study showed no significant differences in head posture or reading distance between the myopic and emmetropic groups ( p > 0.05) but there was some evidence that downward pitch angles were greater in progressing myopes than in non-progressing myopes ( p = 0.03). No correlations were observed between the binocular parameters and head posture. Reading distances were systematically shorter with the helmet-mounted eye tracker and it was concluded that posture was affected by the weight of the equipment. With this reservation, it appeared that the rate of change of downward pitch angle over the 1-min recording session increased with the subject’s rate of myopia progression (correlation between myopia progression and slope of pitch: r 2 = −0.69, p = 0.001), implying a greater reliance on head movements when reading down a page. Overall, while no differences in mean head posture were found between myopes and emmetropes, there was some evidence that head posture and movement during reading may differ in progressing myopes.

Relative Peripheral Refractive Error and the Risk of Onset and Progression of Myopia in Children

To investigate whether relative peripheral hyperopia is a risk factor for either the onset of myopia in children or the rate of myopic progression. The risk of myopia onset was assessed in 2043 nonmyopic third-grade children (mean age ± SD = 8.8 ± 0.52 years) participating in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study between 1995 and 2007, 324 of whom became myopic by the eighth grade. Progression analyses used data from 774 myopic children in grades 1 to 8. Foveal and relative peripheral refractive error 30° in the nasal visual field was measured annually by using cycloplegic autorefraction. Axial length was measured by A-scan ultrasonography. The association between more hyperopic relative peripheral refractive error in the third grade and the risk of the onset of myopia by the eighth grade varied by ethnic group (Asian children odds ratio [OR] = 1.56, 95% confidence interval [CI] = 1.06-2.30; African-American children OR = 0.75, 95% CI = 0.58-0.96; Hispanics, Native Americans, and whites showed no significant association). Myopia progression was greater per diopter of more hyperopic relative peripheral refractive error, but only by a small amount (-0.024 D per year; P = 0.02). Axial elongation was unrelated to the average relative peripheral refractive error (P = 0.77), regardless of ethnicity. Relative peripheral hyperopia appears to exert little consistent influence on the risk of the onset of myopic refractive error, on the rate of myopia progression, or on axial elongation.

Myopia: its prevalence, origins and control

Myopia: its prevalence, origins and control

Comparing myopic progression of urban and rural Taiwanese schoolchildren

To compare myopic progression rates in Taiwanese schoolchildren between urban and rural areas. Several longitudinal studies of myopic progression were performed in urban and rural areas. Five primary schools, four junior high schools, and two senior high schools were selected from both urban and rural areas. Ages ranged from 7 to 18 years. The refractive state of each student was measured with an autorefractometer under cycloplegia. Mean myopic progression in primary school children (ages 7 to 12) in the urban areas was around 0.20 D/year for boys and 0.27 D/year for girls. The mean myopic progression rate in urban children from primary to junior high school age (ages 10 to 15) was 0.43 D/year for boys and 0.50 D/year for girls, faster than that in rural children (0.24 and 0.31 D/year, respectively). The average progression rate was fastest in children in junior high school (ages 13 to 15), around 0.45 D/year in urban areas and 0.28 D/year in rural areas. In senior high schools (ages 16 to 18), myopic progression slowed to 0.17 D/ year in boys and 0.33 D/year in girls. Myopic progression in all groups was faster in myopic eyes than in emmetropic or hyperopic eyes. The average myopic progression in urban areas was greater than that in rural areas. Environmental factors such as urban development and academic grade level may be important contributing factors to myopic progression.

Has Near Work's Star Fallen?

Has Near Work's Star Fallen?

Atropine for the Treatment of Childhood Myopia: Effect on Myopia Progression after Cessation of Atropine

The aim of this study was to assess the effect on myopia progression after cessation of topical atropine treatment. Parallel-group, placebo-controlled, randomized, double-masked study. Four hundred children aged 6 to 12 years with refractive error of spherical equivalent -1.00 to -6.00 diopters (D) and astigmatism of -1.50 D or less. No intervention was administered. Subjects were followed up for 12 months after stopping treatment, which consisted of either 1% atropine or vehicle eyedrops once nightly for 2 years. Only 1 eye of each subject was chosen through randomization for treatment. The main efficacy outcome measures were change in spherical equivalent refraction as measured by cycloplegic autorefraction and change in ocular axial length as measured by ultrasonography. After cessation of atropine drops, the mean progression in the atropine-treated group was -1.14+/-0.80 D over 1 year, whereas the progression in placebo-treated eyes was -0.38+/-0.39 D (P<0.0001). However, after 3 years of participation in the trial (with 2 years on atropine treatment), eyes randomized to atropine have less severe myopia than other eyes. Spherical equivalent was -4.29+/-1.67 D in the atropine-treated eyes compared with -5.22+/-1.38 D in the placebo-treated eyes (P<0.0001). Spherical equivalents in atropine-untreated and placebo-untreated eyes were -5.00+/-1.62 D and -5.28+/-1.43 D, respectively. Over the 3 years, the increase in axial length of the atropine-treated eyes was 0.29+/-0.37 mm compared with 0.52+/-0.45 mm in the placebo-treated eyes (P<0.0001). After cessation of atropine, the amplitude of accommodation and near visual acuity returned to pretreatment levels. After stopping treatment, eyes treated with atropine demonstrated higher rates of myopia progression compared with eyes treated with placebo. However, the absolute myopia progression after 3 years was significantly lower in the atropine group compared with placebo.

Features of the Multifocal Electroretinogram May Predict the Rate of Myopia Progression in Children

Features of the Multifocal Electroretinogram May Predict the Rate of Myopia Progression in Children

Features of the Multifocal Electroretinogram May Predict the Rate of Myopia Progression in Children

To investigate the multifocal electroretinogram (mfERG) in myopic children in relation to the rate of myopia progression. Observational study. Eighty-one school children with myopia. Cycloplegic refraction, ocular biometry, and mfERG recordings were performed in myopic children aged 9 to 11 years in 2002. The refraction and ocular biometry assessments were repeated 2 years later in 2004. The 2-year myopia progression rate was calculated for a randomly selected eye of each individual. The mfERG parameters recorded at the initial visit in 2002 were compared with subsequent progression rates. First-order kernel mfERG responses. Of the 81 eyes, 12 eyes had a high progression rate (defined as a progression rate of >1 diopter [D]/2 years), 44 eyes had a moderate progression rate (progression rate of >0.25 D but < or =1 D/2 years), and 25 eyes showed no progression or a low progression rate (progression rate of < or =0.25 D/2 years). The P1 amplitude of the mfERG in the high progression group was significantly smaller than that in the moderate (P = 0.023) and non/low-progression groups (P = 0.030) but only within the central 5 degrees (ring 1). None of the other mfERG parameters of the central ring were significantly different among the groups. The mfERG parameters of the outer rings were similar in all groups. Decreased foveal function as determined by the mfERG is associated with a high rate of myopia progression. Electrophysiologic examination of central retinal function may predict the progression and severity of myopia in school children.