Orthokeratology Group Research Articles

Effects of orthokeratology and spectacle lenses with highly aspherical lenslets on unilateral myopic anisometropia control.

To evaluate the 1-year effects of orthokeratology (OK) lenses and spectacle lenses with highly aspherical lenslets (HALs) on axial length (AL) elongation in children with unilateral myopic anisometropia. This ambispective cohort study recruited 81 children aged 8-14 years with unilateral myopic anisometropia. Of these, 42 participants (mean age 11.07 ± 1.54 years; 23 males) were treated with monocular OK lenses (OK group), and 39 (mean age 10.64 ± 1.72 years; 22 males) with binocular HALs (HAL group). Changes in AL and spherical equivalent refraction (SER) from baseline at 3, 6 and 12 months were compared between eyes and groups. Kaplan-Meier estimation and Cox proportional hazard regression were performed to analyse the risk of myopia onset in the initially non-myopic eyes. Mean axial elongation in the myopic and non-myopic eyes at the 12-month follow-up visit were 0.17 ± 0.20 and 0.41 ± 0.26 mm in the OK group (p < 0.001) and 0.10 ± 0.15 and 0.12 ± 0.12 mm in the HAL group (p = 0.32), respectively. Compared with the OK group, the non-myopic eyes in the HAL group had less axial elongation, lower cumulative myopia incidence and percentage of participants with rapid myopic shift at the 6- and 12 month follow-up (all p < 0.05). Cox regression analysis showed that a higher initial SER decreased the risk of myopia onset significantly in the initially non-myopic eyes (B = -2.06; 95% CI, 0.03-0.49; p = 0.003). Monocular OK lenses suppressed axial elongation in the myopic eye and minimised anisometropia; however, the non-treated contralateral eye may experience faster myopia onset and myopic shift. Binocular HALs can effectively reduce axial elongation in both eyes of children with unilateral myopic anisometropia.

Developmental characteristics and control effects of myopia and eye diseases in children and adolescents: a school-based retrospective cohort study in Southwest China

ObjectivesTo characterise the prevalence of myopia and eye diseases among school adolescents and children in Southwest China, and to evaluate the effectiveness of myopia control tools.DesignRetrospective cohort study.SettingAcross 95 basic...

Add-on effect of using 0.05% atropine in fast progressors of orthokeratology: A preliminary retrospective study

PurposeTo investigate the potential benefit of combining orthokeratology (OK) lenses with 0.05% atropine ophthalmic solution on the efficacy of myopia control in the fast progressors of OK. MethodsAverage axial length (AL) elongation of both eyes in 70 participants using OK lenses alone or OK lenses combined with 0.05 % atropine ophthalmic solution was retrospectively reviewed. During the observation period (phase 1), all participants exhibited an AL elongation that exceeded 0.15 mm over a 6-month period or 0.3 mm over a 12-month period. Subsequently, the participants were divided into two groups: one group received nightly 0.05 % atropine ophthalmic solution in addition to OK lenses for another 1 year (OKA), while the other group continued using OK lenses alone (phase 2). The changes in AL elongation over time and the differences in AL elongation between the two groups were then compared. ResultsThe baseline and phase 1 demographics and characteristics of the participants was similar between the two groups (all p > 0.05). when considering a one-year timeframe, the OKA group displayed a significantly less AL elongation compared to the OK group (0.14 ± 0.13 mm vs 0.27 ± 0.12 mm, p < 0.001). Within the OKA group, the AL elongation in the second half of the year was significantly faster than in the first half (0.12 ± 0.11 mm vs 0.02 ± 0.14 mm, p = 0.01). Conversely, there was no significant difference in AL elongation between the OK group in the first and second half of the year (0.12 ± 0.07 mm vs 0.15 ± 0.08 mm, p = 0.71). The combination of 0.05 % atropine ophthalmic solution had a significant effect on 1-year AL elongation (p < 0.001). ConclusionsThis study provided preliminary evidence that the combination of OK lenses and 0.05% atropine ophthalmic solution can significantly enhance the effectiveness of myopia control.

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.

Efficacy of the DRL orthokeratology lens in slowing axial elongation in French children.

This study aims to assess and compare the impact of Orthokeratology Double Reservoir Lens (DRL) versus Single Vision Lenses (SVL) on axial elongation and anterior chamber biometric parameters in myopic children over a 6- and 12-month treatment period in France. A retrospective study involving 48 patients aged 7 to 17 years, who underwent either orthokeratology treatment or single-vision spectacle correction, was conducted. Changes in refractive error, axial length, and anterior chamber depth were examined. Twenty-five patients comprised the Orthokeratology (OK) group, while twenty-three were in the control group (single-vision spectacle group). Significant increases in mean axial length were observed over time in both the control (0.12 ± 0.13 mm and 0.20 ± 0.17 mm after 6 and 12 months, respectively; F (2,28.9) = 27.68, p < 0.001) and OK groups (0.02 ± 0.07 mm and 0.06 ± 0.13 mm after 6 and 12 months, respectively; F (2,29.1) = 5.30, p = 0.023). No statistically significant differences in axial length were found between male and female children (p > 0.620). Age-specific analysis revealed no significant axial elongation after 12 months in the 14-17 years group in the OK group. Anterior biometric data analysis at 6 and 12 months showed statistical significance only for the DRL group. Orthokeratology resulted in an 86 and 70% reduction in axial elongation after 6 and 12 months of lens wear, respectively, compared to the single-vision spectacles group. Myopia progression was more pronounced in younger children, underscoring the importance of initiating myopia control strategies at early ages.

Axial Length Shortening after Combined Repeated Low-Level Red-Light Therapy in Poor Responders of Orthokeratology in Myopic Children.

To investigate the efficacy and safety of orthokeratology (ortho-k) and repeated low-level red-light (RLRL) therapy in treating poor responders of ortho-k in myopic children. Study participants were 100 myopic children who completed two years of ortho-k treatment in a retrospective study. In the first year of ortho-k treatment (phase one), they experienced axial elongation of 0.30 mm or greater (defined as poor responders to ortho-k). Children were divided into two groups: the orthokeratology group (OK, n = 45) continued to receive ortho-k monotherapy and the combination group (OK-RLRL, n = 55) received RLRL in addition to ortho-k for the next year (phase two). Axial elongation over time between the groups was compared. The mean age, male-to-female ratio, axial length (AL), and axial elongation in phase one were comparable between OK and OK-RLRL groups (all P > 0.05). During phase two, significant AL shortening was observed in the OK-RLRL group compared with children in the OK group (-0.10 ± 0.16 mm vs 0.30 ± 0.19 mm, P < 0.001). Among these 55 myopic children in the OK-RLRL group, 35 (63.6%), 25 (45.4%), 11 (20%), 6 (10.9%), and 3 (5.4%) of them had AL shortening over 0.05 mm/year, 0.10 mm/year, and 0.20 mm/year, 0.3 mm/year, and 0.4 mm/year, respectively. Older baseline age (β = -0.02), higher treatment compliance (β = -0.462), and AL change at 1 month (β = 1.263) were significantly associated with less AL elongation (all P < 0.05). For poor responders of orthokeratology, RLRL could slow axial elongation in addition to the ortho-k treatment effect. Those who respond poorly to ortho-k with elder age might benefit more from combined therapy.

The corneal biomechanical differences after wearing orthokeratology lenses and multifocal soft lenses in children: A self-control study

BackgroundTo compare the changes in corneal biomechanics after orthokeratology (OK) lens and Defocus Incorporated Soft Contact (DISC) lens treatment. MethodsOf 28 myopic children were recruited, with one eye wearing OK lens and the other eye wearing DISC lens for one year, and the data after discontinued for 4 weeks were also collected. Major outcomes were corneal biomechanics and axial length (AL) elongation. ResultsThroughout the follow-up period, the DISC group had longer the first applanation (A1) time, larger A1 deformation amplitude, A1 deflection length (A1 DLL), and A1 deflection amplitude than the OK group. AL elongation was less in the OK group at each visit (all P < 0.05) but faster in the OK group than in the DISC group after discontinuation (P = 0.006). Moreover, AL elongation was related to baseline A1 time, A1 velocity and whole eye movement max in the DISC group, and in the OK group, was related to the baseline the second applanation (A2) DLL, A2 delta arc length and stiffness parameter A1 (all P < 0.05). ConclusionsThe cornea was more deformable after wearing DISC lens than OK lens, and corneal biomechanical parameters were associated with AL elongation. Eyes showed less AL elongation during OK lens treatment while faster AL elongation after discontinuation than DISC lens. The baseline corneal biomechanics may help to predict AL elongation in myopic control strategies.

Relative corneal refractive power shift and inter-eye differential axial growth in children with myopic anisometropia treated with bilateral orthokeratology

PurposeTo investigate the relationship between relative corneal refractive power shift (RCRPS) and axial length growth (ALG) in bilateral myopic anisometropes treated with orthokeratology.MethodsA total of 102 children with myopic anisometropia in this prospective interventional study were randomly assigned to the spectacle group and orthokeratology group. Axial length (AL) and corneal topography was measured at baseline and the 12-month follow-up visit. ALG was defined as the difference between the two measurements, and RCRPS profiles were calculated from two axial maps obtained.ResultsIn the orthokeratology group, the ALG in the more myopic eye (0.06 ± 0.15 mm) was significantly smaller than that in the less myopic eye (0.15 ± 0.15 mm, p < 0.001), and the interocular difference in AL significantly decreased following 1-year treatment, from 0.47 ± 0.32 to 0.38 ± 0.28 mm (p < 0.001). However, in the spectacle group, the ALG was similar between the two eyes, and the interocular difference in AL did not change significantly over one year (all p > 0.05). The interocular difference in ALG in the orthokeratology group was significantly correlated with the interocular difference in RCRPS (dRCRPS, β=−0.003, p < 0.001) and the interocular difference in baseline AL (β=−0.1179, p < 0.001), with R2 being 0.6197.ConclusionOrthokeratology was effective in decreasing the magnitude of anisometropia. The interocular variation in RCRPS is an important factor accounting for the reduction of interocular ALG difference in anisomyopic children post-orthokeratology. These results provide insight into establishing eye-specific myopia control guidelines during orthokeratology treatment for myopic anisometropes.

Comparison of two different orthokeratology lenses and defocus incorporated soft contact (DISC) lens in controlling myopia progression

BackgroundTo compare axial elongation in 8–11-year-old myopes wearing orthokeratology (OK) lenses with different back optic zone diameters (BOZD), defocus incorporated soft contact (DISC) lenses, and single-vision soft contact lenses (SCLs).MethodsA total of 122 children (aged 8–11 years) with spherical equivalent refraction (SER) between − 1.00 D and − 4.00 D were enrolled in this prospective study and randomly assigned to four groups: 5.0 mm-BOZD OK, 6.2 mm-BOZD OK, DISC, and single-vision SCLs. Children in each group were further divided into subgroups stratified by the average baseline SER: low myopic eyes (SER: − 1.00 D to − 2.50 D) and moderate myopic eyes (SER: − 2.50 D and over). Axial length (AL) was measured at baseline and after one year.ResultsThe 5.0 mm-BOZD OK, 6.2 mm-BOZD OK, and DISC groups exhibited significantly slower AL elongation than the SCL group. The proportion of slow progressors (AL elongation ≤ 0.18 mm/year) in the first three groups was 42%, 23%, and 29%, respectively. Furthermore, one-year AL elongation was significantly smaller in the 5.0 mm-BOZD OK group compared with the 6.2 mm-BOZD OK group. Regardless of SER, children in the 5.0 mm-BOZD OK and DISC groups showed comparably slower AL elongation than those in the SCL group. However, fitting with 6.2 mm-BOZD OK lenses significantly retarded AL elongation in moderate myopic eyes, but not in low myopic eyes.ConclusionsOverall, 5.0 mm-BOZD OK lenses, 6.2 mm-BOZD OK lenses, and DISC lenses were effective in retarding AL elongation in 8–11-year-old myopes compared with single-vision SCLs, but for children with SER less than − 2.50 D, fitting with 5.0 mm-BOZD OK lenses and DISC lenses yielded better myopia control efficacy compared to wearing single-vision SCLs or 6.2 mm-BOZD OK lenses.

Changes of retinal vessel density in low to moderate myopic eyes with orthokeratology evaluated by optical coherence tomography angiography.

To explore the effect of orthokeratology (OK) fitting on retinal vessel density in low to moderate myopia adolescents by using optical coherence tomography angiography. Children aged 10 to 14y with a cycloplegic spherical equivalent refraction of -0.50 diopter (D) to -5.00 D and astigmatism with more than -1.50 D were recruited. The enrolled adolescents were divided into OK group and spectacle group. During regular follow-up, adolescents were measured respectively at pre-wear, 1, 3, and 6mo after treatment. The follow-up included uncorrected distance visual acuity (UDVA), axial length (AL), superficial capillary plexus density (SCPD), deep capillary plexus density (DCPD), central retinal thickness (CRT), foveal avascular zone area (FAZ-A), foveal avascular zone perimeter (FAZ-P) and foveal vessel density in a 300-µm-wide region around foveal avascular zone (FD-300). The collected data were analyzed using statistical methods. By one month, SCPD significantly increased in the fovea and superior retina, and DCPD significantly increased inferiorly in OK group compared to spectacle group (P<0.05). By three months, there were significant increases in SCPD in the fovea and inferior retina, and DCPD in the parafovea, superior, and inferior retina in OK group (P<0.05), while the increase in SCPD and DCPD in the fovea were observed by six months (P<0.05). The FD-300 significantly increased at every follow-up in OK group compared to spectacle group (P<0.05). No significant differences in the CRT, FAZ-A and FAZ-P and FD-300 were observed between two groups (P>0.05). OK group showed a significant improvement in UDVA after wearing OK, compared to spectacle group (P<0.01), while the AL did not show a significant difference between two groups (P>0.05). Short-term OK worn can increase local retinal vessel density in adolescents with low-to-moderate myopia.

The efficacy and safety of 0.01% atropine alone or combined with orthokeratology for children with myopia: A meta-analysis.

To evaluate the efficacy and safety of 0.01% atropine alone and in combination with orthokeratology for myopia control using a meta-analysis. PubMed, Cochrane Library, and EMBASE were searched. We included eligible randomized controlled trials (RCTs), non-RCTs, and retrospective cohort studies, published up to August 1, 2022. We calculated the weighted mean difference (WMD) and 95% confidence interval (CI) for all outcomes and plotted them in forest plots. Fourteen studies were included; 4 and 11 in the 0.01% atropine monotherapy and atropine-orthokeratology (AOK) groups, respectively. Compared with orthokeratology (OK) alone, 0.01% atropine alone had similar effects on slowing the axial elongation (WMD: -0.00 mm; 95% CI: -0.05-0.04, p<0.31), while AOK significantly lowered axial growth. Moreover, the baseline myopic degree and duration of treatment were influential for the change in axial elongation (WMD: -0.12 mm; 95% CI: -0.17--0.07, p = 0.00001 and WMD: -0.11 mm; 95% CI: -0.15--0.108, p<0.00001, respectively). Additionally, the AOK may reduce the change rate of the spherical equivalent refraction and the accommodation amplitude (WMD: -0.13 D; 95% CI: 0.07-0.19, p<0.001 and WMD: -1.08 mm; 95% CI: -1.73--0.43, p<0.0001, respectively), and cause a slight increase in the diameter of the pupil (WMD: 0.56 mm; 95% CI: 0.43-0.70, p = 0.007). No significant differences in the uncorrected distant visual acuity, best corrected visual acuity, intraocular pressure, tear film break-up time, lipid layer thickness, and corneal endothelial cell density were found between the OK and AOK groups. In slowing the axial elongation, 0.01% atropine alone and OK alone have similar effects, while AOK is more effective than OK alone in slowing down the axial elongation. Furthermore, the baseline degree of myopia and treatment duration may affect changes in axial elongation.

Add-On Effect of 0.01% Atropine in Orthokeratology Wearers for Myopia Control in Children: A 2-Year Retrospective Study.

Orthokeratology (OK) and low-concentration atropine are recommended approaches for controlling myopia. However, children with younger age and lower myopia are more likely to experience rapid axial progression during OK or atropine monotreatment. This study aimed to assess the efficacy of OK combined with low-concentration atropine for myopia control in childrenover 24months and to determine whether the effect was sustainable. In this retrospective study, we reviewed medical records of baseline and follow-up visits from children (7-14years) applying OK for myopia control. Sixty-eight children receiving monoorthokeratology treatment (OK group) and 68 children who received 0.01% atropine in combination with orthokeratology simultaneously (AOK group) were included. A series of ophthalmic tests at baseline were conducted, and axial length (AL) was measured every 6months. The comparison of AL change at different visits between the two groups was performed by repeated measures multivariate analyses of variance (RM-MANOVA). There were no significant differences in baseline characters between the two groups (p > 0.05). The AL significantly increased over time in both groups (all p < 0.05), and the 2-year change in AOK was 0.16mm (36%) lower than in OK (0.28 ± 0.22mm versus 0.44 ± 0.34mm, p = 0.001). Compared with OK group, the significant suppression of AL elongation in the AOK group was observed in 0-6, 6-12, and 12-18month periods (suppression rate: 62.5%, 33.3%, 38.5%, respectively, p < 0.05), while there was no significant difference in the 18-24month period (p = 0.105). The multiple regression analysis showed an interaction between age and treatment effect (interaction coefficient = 0.06, p = 0.040), indicating one year age decrease approximately associated with 0.06mm increased retardation in AL elongation in the AOK group. The add-on effect of 0.01% atropine in OK wearers only occurred within 1.5years, and younger children benefited more from the combination treatment.

The Effects of Spectacles or Orthokeratology on the Tear Film in Children and Adolescents.

Myopia prevalence among adolescents is increasing annually. While orthokeratology (OK) is effective for controlling myopia progression, it may also be detrimental. We investigated tear film parameters [including tear mucin 5AC (MUC5AC) concentration] in children and adolescents with myopia treated with spectacles or OK compared with those with emmetropia. This prospective case-control study enrolled children (aged 8-12years; 29 and 39 with myopia treated with OK and spectacles, respectively, and 25 with emmetropia) and adolescents (aged 13-18years; 38 and 30 with myopia treated with OK and spectacles, respectively, and 18 with emmetropia). We recorded the ocular surface disease index (OSDI), visual analog scale (VAS) score, tear meniscus height (TMH), noninvasive tear breakup time (NIBUT), meibomian gland score (meiboscore), ocular redness score, and tear MUC5AC concentration in the emmetropia, spectacle (after 12months of spectacle wearing), and OK (baseline, and after 1-, 3-, 6-, and 12-month use) groups. We observed changes from baseline to 12months in the OK group and compared parameters among the spectacle, 12-month OK, and emmetropia groups. The 12-month OK group differed significantly from the spectacle and emmetropia groups in most indicators among children and adolescents (P < 0.05). Differences were not noticeable between the spectacle and emmetropia groups (only PVAS < 0.05 among the children). In the OK group, the 12-month NIBUT was significantly decreased (P < 0.05) in both age groups; the upper meiboscore was increased at 6 and 12months (both P < 0.05) among children; ocular redness scores were higher at 12months than at baseline (P = 0.007), 1month (P < 0.001), and 3months (P = 0.007) among children; and the MUC5AC concentration was decreased at 6 and 12months among adolescents, but only at 12months among children (all P < 0.05). Long-term OK can negatively influence the tear film in children and adolescents. Moreover, changes are masked by spectacle wearing. This trial is registered with "ChiCTR2100049384."

Myopia Control Efficacy and Long-Term Safety of a Novel Orthokeratology Lens (MESOK Study)-A Randomized Controlled Clinical Trial Combining Clinical and Tear Proteomics Data.

Myopia control efficacy and long-term safety of the Breath-O-Correct orthokeratology (OK) lens was evaluated in a 2-year randomized, single vision (SV) spectacle lens-controlled, single-blind clinical trial combining clinical and tear proteomics data. A total of 71 children (43 OK, 9.8 ± 1.3 years; 28 SV, 9.5 ± 1.4 years) completed the 2-year study. Axial length (AL), cycloplegic refraction, clinical safety parameters (best-corrected visual acuity, central cornea thickness, corneal endothelial health, ocular surface disease index), and quantitative tear proteomics were evaluated by masked examiners. Mean 2-year-normalized AL elongations in the OK and SV groups differed significantly (p = 0.03) and were 0.37 ± 0.37 mm and 0.60 ± 0.41 mm, respectively. OK-mediated myopia control efficacy was 37.1%. No significant difference was found in clinical safety parameters of both groups (p > 0.10), except for a thinner central corneal thickness in the OK group (p = 0.01). Proteomics revealed modest OK lens-mediated effects on immune response proteins, including an increased abundance of haptoglobin at 6 and 12 months and a decreased abundance of two proteins (neutrophil defensin 3 and histone 4) at 6 months. The changes were further validated using a high-resolution multiple-reaction monitoring (MRMHR) mass spectrometry. In summary, the Breath-O-Correct OK lens significantly reduced AL elongation in schoolchildren without adverse clinical effects or subclinical inflammatory responses.

Health-related quality of life for children using orthokeratology (OK), peripheral lenslet designed (PLD) and single-vision (SV) spectacles: based on Child Health Utility 9 Dimensions (CHU9D)

PurposeThis study investigated the health-related quality of life (HRQoL) among children with myopia who used orthokeratology (OK), peripheral lenslet designed (PLD), and single-vision (SV) spectacles. MethodsThis cross-sectional study was conducted between February of 2021 and August of 2022. It involved 211, 231, and 206 respondents with OK, PLD, and SV spectacle lenses, respectively. The HRQoL was presented as utility values using a general preference-based Child Health Utility-nine Dimensions (CHU9D) questionnaire. Descriptive statistical analysis and nonparametric hypothesis testing were used to compare the HRQoL in the OK, PLD, and SV groups. ResultsOf the 648 respondents, the average utility scores was 0.936 (95 % confidence interval (CI): 0.929–0.943). Children who wore the PLD spectacles had a significantly higher utility scores (0.955, 95 % CI: 0.946–0.963) than those who wore the SV spectacles (0.926, 95 % CI: 0.913–0.939) and the OK lenses (0.925, 95 % CI: 0.913–0.937) (p < 0.01). The PLD spectacle wearers were less likely to be worried, sad, tired, or annoyed than those who wore OK and SV spectacles (P < 0.05). Self-reported improved eyesight and lessened eye pain and discomfort from myopia correction using PLD spectacles had higher utility values (P < 0.05). ConclusionsThe PLD spectacles had a significantly higher HRQoL than the OK and SV spectacles among children. Having better eyesight and less eye pain/discomfort from myopia correction could improve the HRQoL of children. This data indicates that PLD spectacles may be considered for myopia management in children and adolescents.

Comparison of Functional Vision and Eye-Related Quality of Life between Myopic Children Treated with Orthokeratology and Single-Vision Spectacles in Southern China.

To compare eye-related quality of life between Chinese children wearing orthokeratology (OK) contact lenses and single-vision spectacles (SVS) using the Pediatric Eye Questionnaire (PedEyeQ) and to evaluate the impact of different myopia correction methods on children and their parents. Children aged 12-17 years and their parents/legal guardians were recruited. The children's myopia ranged from -0.50 to -5.00 diopters (D), and their astigmatism was <1.50 D. They had all been wearing OK contact lenses or SVS for at least 12 months. The children completed the Child PedEyeQ. One of their parents (or a legal guardian) completed the Proxy PedEyeQ and the Parent PedEyeQ. Rasch-calibrated PedEyeQ scores were calculated for each domain and were converted to a scale from 0 to 100 for statistical analysis. A total of 50 children wearing OK contact lenses, 43 children wearing SVS, and their parents/legal guardians completed the questionnaires. The scores of all Child, Proxy, and Parent PedEyeQ domains in the OK contact lens group were higher than those in the SVS group (all P < 0.05). In the mild and moderate myopia subgroups, the Child, Proxy, and Parent PedEyeQ scores in the mild myopia OK contact lens subgroup were higher than those in the mild myopia SVS group (all P < 0.05) except functional vision and bothered by eyes/vision domains for the proxy PedEyeQ. Similarly, the Child, Proxy, and Parent PedEyeQ scores in the moderate myopia OK contact lens subgroup were higher than those in the moderate myopia SVS subgroup (all P < 0.05) except impact on parent and family domain for the parent PedEyeQ. In the subgroup analysis of glasses type, no significant score difference of any Child, Proxy, and Parent PedEyeQ domain was detected between mild and moderate myopia in either the OK contact lens group or the SVS group (all P > 0.05). Compared with children wearing SVS, children wearing OK contact lenses have better functional vision and eye-related quality of life. Moreover, OK contact lens has a better correction effect, higher acceptance rates, and less impact on parents and families than SVS.

Repeatability and agreement of swept-source optical coherence tomography and partial coherence interferometry biometers in myopes

ABSTRACT Clinical relevance Biometric measurements in the context of myopia are fundamental to detect eyes at risk of developing myopia and during the follow-up of patients with myopia control treatment. Thus, the accuracy of biometers has high clinical relevance. Background The Myopia Master is a new biometer based on partial coherence interferometry especially dedicated to the follow-up of myopic patients. This study aims to assess the repeatability of the Myopia Master and evaluate its agreement with a swept-source optical coherence interferometry biometer (IOL Master 700). Methods This cross-sectional prospective study assessed the biometric parameters of two groups of myopes (age range: 8–16 years old), spectacle corrected (n = 60) and orthokeratology contact lens wearers (n = 60). One senior optometrist performed two consecutive measurements per instrument, which included axial length, mean keratometry and horizontal visible iris diameter (HVID). The repeatability of each device and the agreement between devices were assessed by the dispersion of the measurement differences, for AL, mean keratometry, corneal astigmatism and HVID. Results The two biometers measured approximately the same value in both measurements. Test–retest repeatability tended to be lower than clinical significant thresholds, in particular, for AL and mean keratometry. Corneal-related parameters tended to have lower repeatability in the orthokeratology group, especially mean keratometry. The agreement between instruments revealed statistically significant differences between devices with the SS-OCT measuring longer eyes, steeper corneas and larger HVID. Conclusions In a paediatric population, the Myopia Master showed clinically acceptable repeatability levels, but the IOL Master 700 demonstrated superior repeatability. Eyes treated with orthokeratology may compromise the repeatability of the corneal-related parameters. The Myopia Master and the IOL Master 700 are repeatable devices appropriate for monitoring myopia progression, but the differences observed do not allow their use interchangeably.

Application of orthokeratology on myopia control and its effect on ocular surface and meibomian gland function in Chinese myopic adolescents.

This study aimed to investigate the influence of orthokeratology (OK) on myopia control and ocular surface and meibomian gland function in myopic adolescents. A prospective study was conducted over a 12-month period. The subjects were classified into two groups, namely, the OK lens group and the frame glasses control group. Axial length, corneal curvature, ocular surface, and meibomian gland parameters were measured at baseline, 1, 3, 6, and 12 months after wearing OK lenses. The axial length growth rate in the OK group was significantly slower than in the control group (P < 0.01). The naked eye vision and the ocular surface disease index (OSDI) scores recorded 1, 3, 6, and 12 months after wearing OK lenses were significantly higher than the scores recorded before wearing OK lenses. There was no significant difference in other ocular parameters at each follow-up time point compared with pre-wearing (P > 0.05). After using the OK lens for 6 months, the OSDI score and corneal fluorescein staining (CFS) score increased significantly (P < 0.001), but there were no significant differences in other parameters among the groups. No infectious keratitis occurred during the study. These results provide evidence that the use of OK lenses can control the axial growth and progress rate of myopia compared with frame glasses. During the 12-month follow-up, although wearing OK lenses may have aggravated dry eye symptoms, each patient's ocular surface and meibomian gland function did not change significantly, indicating that the use of OK lenses is a relatively safe modality for the control of myopia in adolescents.

Comparisons of Three Methods for Myopia Control in Adolescents.

Objective A rising trend in electronic use has increased the prevalence of myopia in adolescents, but the optimal approach to controlling myopia remains undetermined. Here, we explored the effects of common single vision (SV) spectacle lenses combined with 0.01% atropine eye drops (SV + A), orthokeratology (OK) lenses, and peripheral defocus (PD) spectacle lenses on myopia control in adolescents. Methods Totally 150 myopic adolescent patients (300 eyes) receiving treatment at The First People's Hospital of Chenzhou City were enrolled. According to doctors' advice and guardians' wishes, the patients were divided into SV + A group, OK group, and PD group, with each group consisting of 50 cases (100 eyes). The spherical equivalent, axial length, accommodative response index (accommodative sensitivity and accommodative lag), and intraocular pressure were compared before and after 12 months of wearing lenses, and the complications were recorded. Results Before wearing lenses, there was no statistical significance in baseline characteristics such as age, gender, and spherical equivalent among the three groups (P > 0.05). After wearing lenses, the increase in spherical equivalent and axial length in the SV + A and OK groups were lower than in the PD group (P < 0.05), and the SV + A group had the lowest axial length growth. Compared with the SV + A group, accommodative sensitivity was much higher and accommodative lag was significantly lower in the OK and PD groups (P < 0.01). In addition, there was no significant difference in intraocular pressure before and after wearing lenses among the three groups (P > 0.05). Though the OK group patients had more complications, the difference was not statistically significant (P > 0.05). Conclusion SV + A, OK, and PD lenses can effectively control the progression of myopia in adolescents, but SV + A and OK lenses exhibited more significant effects.

Investigation of retinal microvasculature and choriocapillaris in adolescent myopic patients with astigmatism undergoing orthokeratology

BackgroundTo observe alterations of fundus microcirculation and retinal thickness in adolescent myopic patients with astigmatism after toric and spherical orthokeratology using optical coherence tomography angiography (OCTA), to explore the effects of orthokeratology on the retinal thickness and choroidal blood flow.MethodsA total of 48 patients were enrolled and divided into two group (toric orthokeratology (T) group and spherical orthokeratology (S) group) according to the type of lens design. OCTA was used to measure the superficial and deep retinal vessel densities at the macular region, radial peripapillary capillary (RPC) density, foveal avascular zone (FAZ) area, and choriocapillaris (ChC) perfusion area before and after orthokeratology for 3 months. The data were statistically analyzed by SPSS 19.0 software.ResultsCompared with before orthokeratology, the superficial vessel density in the fovea and parafovea in the T group significantly increased, and the deep vessel density in the whole area and fovea were significantly elevated after 3 months (P < 0.05). The superficial vessel density was significantly higher only in the parafovea in the S group after 3 months than that before orthokeratology (P < 0.05), deep vessel density in the whole area and parafovea after 3 months was significantly higher than that before orthokeratology (P < 0.05). RPC density in the two groups increased after 3 months of orthokeratology in the whole area and inside the disc area (P < 0.05).Three months after toric orthokeratology, FAZ area in the T group was significantly reduced by 0.05 (− 0.41 to + 0.08) mm2, while ChC perfusion area was enlarged by 0.06 ± 0.12 mm2. FAZ area in the S group significantly decreased by 0.01 (− 0.19 to + 0.01) mm2, whereas ChC perfusion area increased by 0.06 (− 0.07 to + 0.50) mm2. Retinal thickness in the two groups increased after 3 months of orthokeratology in the whole area and parafoveal area (P < 0.05).ConclusionOrthokeratology improved retinal blood flow in macular area and RPC while controlling myopia. The changes in FAZ and ChC perfusion areas did not significantly differ between toric and spherical orthokeratology.