Myopia Progression In Children Research Articles

Suitability of multifunction devices Myah and Myopia Master for monitoring myopia progression in children and adults.

To assess the feasibility of using multifunction instruments to measure axial length for monitoring myopia progression in children and adults. Axial length was measured in 60 children (aged 6-18 years) and 60 adults (aged 19-50 years) with multifunction instruments (Myah and Myopia Master) and stand-alone biometers (Lenstar LS900 and IOLMaster 700). Repeatability (measurements by the same examiner) and reproducibility (measurements by different examiners) were computed as the within-subject standard deviation (Sw) and 95% limits of agreement (LoA). Inter-instrument agreement was computed as intraclass correlation coefficients. The threshold for detecting myopic progression was taken as 0.1 mm. Measures were repeated only in children following the administration of 1% tropicamide to determine the impact of cycloplegia on axial length. Overall, the IOLMaster 700 had the best repeatability in children (0.014 mm) and adults (0.009 mm). Repeatability Sw values for all devices ranged from 0.005 to 0.021 mm (children) and 0.003 to 0.016 mm (adults). In children, reproducibility fell within 0.1 mm 95% of the time for the Myah, Myopia Master and IOLMaster 700. Agreement among all devices was classified as excellent (ICC 0.999; 95% CI 0.998-0.999), but the 95% LoA among the Myah, Myopia Master and Lenstar LS900 was ≥0.1 mm. Cycloplegia had no statistically significant effect on axial length (all p > 0.13). The Myah and Myopia Master multifunction instruments demonstrated good repeatability and reproducibility, and their accuracy was comparable to stand-alone biometers. Axial length measurements using different instruments can be considered interchangeable but should be compared with some caution. Accurate axial length measurements can be obtained without cycloplegia. The multifunction instruments Myah and Myopia Master are as well suited for monitoring myopia progression in children asthe stand-alone biometers IOLMaster 700 and Lenstar LS900.

Evidence for the use of atropine to control myopia in children

To describe the effectiveness of using atropine as a method of controlling the progression of myopia in children. This is a systematic review study of literature, which search strategies in the Biblioteca Virtual em Saúde (BVS) and PubMed, through different combinations of the descriptors “Myopia”, “Control”, “Children” and “Atropine ” in the 2020-2023 timeframe. After selecting the inclusion and exclusion criteria, 30 articles compose the sample corpus. Atropine concentration is directly related to efficacy, with higher doses being more effective, however, also is associated with the appearance of adverse effects, especially photophobia. The most used dose is 0.01%, which presents positive results in control and fewer side effects; most of these studies involve the Asian population. There is a variation in results between populations, due to the different level of pigment in the iris, in addition to sociocultural differences between ethnicities. The lack of intervention can result in complications, with an increased risk related to the degree among children, and is not reduced with optical correction alone. The use of atropine is promising for controlling myopia in children, however it must be tested in association with other control methods and in different populations, so that the treatment is individualized and carried out in a way that presents results, in addition to reducing complications related to refractive disorder.

Insights Into Myopia from Mouse Models.

Animal models are critical for understanding the initiation and progression of myopia, a refractive condition that causes blurred distance vision. The prevalence of myopia is rapidly increasing worldwide, and myopia increases the risk of developing potentially blinding diseases. Current pharmacological, optical, and environmental interventions attenuate myopia progression in children, but it is still unclear how this occurs or how these interventions can be improved to increase their protective effects. To optimize myopia interventions, directed mechanistic studies are needed. The mouse model is well-suited to these studies because of its well-characterized visual system and the genetic experimental tools available, which can be combined with pharmacological and environmental manipulations for powerful investigations of causation. This review describes aspects of the mouse visual system that support its use as a myopia model and presents genetic, pharmacological, and environmental studies that significantly contribute to our understanding of the mechanisms that underlie myopigenesis.

Effectiveness of repeated low-level red light in myopia prevention and myopia control.

To compare the effects of repeated low-level red light (RLRL) treatment on axial length growth and refractive error changes in myopic and premyopic children. Subjects were assigned randomly to four subgroups: myopia-RLRL group (M-RL), myopia-control group (M-C), premyopia-RLRL group (PM-RL) and premyopia-control group (PM-C). Subjects in the RLRL group completed a 12-month treatment composed of a 3 min RLRL treatment session twice daily, with an interval of at least 4 hours, for 7 days per week. Visits were scheduled before and at 1-month, 3-month, 6-month, 9-month and 12-month follow-up after the treatment. Repeated-measures analysis of variance was used to compare the spherical equivalent refractive errors (SE) and axial length (AL) changes between the groups across the treatment period. After 12 months of treatment, in the myopia group, SE and AL changes were -0.078±0.375 D and 0.033±0.123 mm for M-RL and -0.861±0.556 D and 0.415±0.171 mm for M-C; in the premyopia group, the progression of SE and AL was -0.181±0.417 D and 0.145±0.175 mm for PM-RL and -0.521±0.436 D and 0.292±0.128 mm for PM-C. PM-RL indicated a lower myopia incidence than PM-C (2.5% vs 19.4%). Additionally, the percentage of AL shortening in the M-RL was higher than that in the PM-RL before the 9-month follow-up. RLRL effectively delayed myopia progression in children with myopia and reduced the incidence of myopia in premyopic children. Moreover, RLRL exhibited a stronger impact on myopic children compared with premyopic individuals.

Randomised clinical trial of extended depth of focus lenses for controlling myopia progression: Outcomes from SEED LVPEI Indian Myopia Study.

To determine the efficacy of extended depth of focus (EDOF) contact lenses for controlling myopia progression in children through a 1-year randomised clinical trial. A total of 104 children aged 7-15 years, with spherical equivalent refraction ≤-0.50 D, were randomly assigned to wear SEED 1 dayPure EDOF Mid contact lenses (n=48) or single vision spectacle lenses (n=56). Cycloplegic refraction with Shin-Nippon open field autorefractor and axial length with Lenstar LS 900 was determined at the baseline and 12-month visits. The compliance, visual discomfort and dryness questionnaires were administered during the final visit. Sixty-nine children (control: n=38; treatment: 31) completed the 12-month follow-up visit, with no difference in baseline characteristics between the groups. Mean (SEM) myopia progression in the 12th month was -0.48±0.07D in the control group and -0.20±0.08D in the treatment group. Mean axial elongation was 0.22±0.03 mm and 0.11±0.03 mm in the control and treatment groups, respectively. SEED 1 dayPure EDOF Mid contact lenses slowed myopia progression by 59% (-0.28D; p=0.01) based on spherical equivalent refraction and controlled axial length by 49% (0.11 mm; p=0.007) in comparison to single vision spectacle lenses. None of the participants reported any adverse effects. While most of the participants (82%) were comfortable with the contact lenses, 11% reported occasional dryness and 14% experienced mild fluctuations in visual acuity after immediate lens wear. Daily wear of SEED 1 dayPure EDOF Mid contact lenses in Indian children showed a significant effect in controlling myopia progression and axial elongation.

Naked-Eye 3-Dimensional Vision Training for Myopia Control

Early onset of myopia increases the risk of high myopia, which can lead to irreversible retinal damage and even loss of central vision. To investigate the efficacy and safety of naked-eye 3-dimensional vision training (NVT) in preventing the progression of myopia in children. This randomized clinical trial was conducted in 3 hospitals from May 25, 2022, to February 24, 2023. Participants were children (aged 6-18 years) who had a diagnosis of myopia with a spherical equivalent refraction of -0.75 to -6.00 diopters (D). Children in the intervention group received 20 minutes of NVT treatment every day, whereas children in the control group lived as usual without vision training. The primary outcome was the change in axial length at 6 months. Spherical equivalent refraction (SER) was included as a secondary outcome. Among 263 participants, 125 (47.5%) were male and 138 (52.5%) were female; the mean (SD) age was 10.3 (1.9) years (range, 6.1-15.6 years). A total of 227 patients (86.3%) completed the 6-month follow-up, including 102 in the intervention group and 125 in the control group. In the intervention group, the changes in axial length and SER at 6 months were 0.18 mm (95% CI, 0.16 to 0.20 mm) and -0.25 D (95% CI, -0.31 to -0.19 D), respectively. In the control group, the changes in axial length and SER at 6 months were 0.23 mm (95% CI, 0.21 to 0.25 mm) and -0.35 D (95% CI, -0.41 to -0.30 D), respectively. The differences in AL and SER between the 2 groups were significant (AL difference: -0.06 mm; 95% CI, -0.09 to -0.03; P < .001; SER difference: 0.10 D; 95% CI, 0.02 to 0.19; P = .02). No study-related adverse reactions were reported during follow-up. NVT is a safe and promising means to control myopia progression in children with good adherence. ClinicalTrials.gov Identifier: NCT05468775.

One-year efficacy of myopia control by the defocus distributed multipoint lens: a multicentric randomised controlled trial

AimsTo report the 1-year results of the efficacy of a defocus distributed multipoint (DDM) lens in controlling myopia progression in a multicentre, randomised controlled trial.MethodsOverall, 168 children aged 6–13 years...

The Impact of Vergence Dysfunction on Myopia Control in Children Wearing Defocus Spectacle Lenses.

To investigate the impact of vergence dysfunction on myopia progression in children with Defocus incorporated multiple segments (DIMS) spectacle lenses. We retrospectively enrolled children prescribed DIMS spectacle lenses to slow myopic progression. Baseline vergence dysfunction was determined according to phoria at distance and near. Axial length (AL) measurement and cycloplegic subjective refraction were performed before fitting the lenses and at six-month and one-year follow-ups. The six-month and one-year AL and spherical equivalent (SE) change from baseline were calculated and compared in subgroups stratified with the type of vergence dysfunction. Two hundred and ninety-two myopic children were included. Significant AL elongation and SE progression were observed at six months and one year (P < 0.05 for all comparisons). Multiple regression demonstrated that AL elongation at six months (P < 0.001) and one year (P < 0.001) was negatively correlated with age, and SE progression at six months was associated with age (P = 0.002). The AL elongation at six months in children with convergence excess was significantly greater than in normal myopic subjects (P = 0.011) and subjects with convergence insufficiency (P = 0.008), divergence excess (P = 0.007), divergence insufficiency (P = 0.024) and basic esophoria (P = 0.048) at six months. The present research demonstrated that vergence dysfunction influences myopia progression for myopic children with DIMS, and the children with convergence excess suffer from the greatest myopia progression among different types of vergence dysfunction.

Effect of defocus incorporated multiple segments lenses on halting myopia progression not responding to low-concentration atropine (0.01%) eye drops.

To assess the effect of defocus incorporated multiple segments (DIMS) (Miyosmart) lenses on myopic progression in children not responding to low-concentration atropine (LCA) (0.01%) eye drops. A total of 10 children not responding to LCA (0.01%) eye drops were advised to start using the DIMS lens to halt the progression of myopia. The children were followed for a period of 1 year. Eight out of 10 children showed a reduction in the progression of myopia. Pre DIMS, the progression was -0.68 D ± 0.3 D sph, which reduced to -0.24 ± 0.2 diopter progression post DIMS lens in the eight children. The remaining two children still progressed by -0.57 ± 0.4 D sph over a year. The axial length growth reduced from 0.28 ± 0.3 mm to 0.16 ± 0.2 mm after using the DIMS lens in these non-responders. The DIMS lens shows initial promise in reducing the progression of myopia even in children not responding to LCA 0.01% eye drops.

Vitamin D and myopia: a review.

Myopia is a worldwide public health problem of vision disorder caused by multiple factors, which has posed a huge socioeconomic burden, raising concerns about sight-threatening ocular complications. Vitamin D, as a kind of fat-soluble vitamin, related to time-spent-outdoors, has been considered by extensive studies to have potential relationship with myopia. We reviewed studies published in a decade which estimated the association of blood vitamin D status with myopia and summarized the universality and individuality of all research articles. Several research articles suggested the known environmental risk factors of myopia, including age, gender, ethnicity, education level, parental and school conditions, time-spent-outdoors, and sunlight exposure, and recent epidemiological studies demonstrate that increased vitamin D levels, by virtue of the extended outdoor time, may be an important modifiable factor and a protective effect that delay the progression of myopia in children and adolescents rather than in adults. The genetic studies have been conducted to get access to the evidence of gene polymorphism for explaining the association of serum vitamin D status and myopia, but the precise genetic interpretation of vitamin D and myopia remains unclear so far; on the other hand, the possible mechanisms are various like copolymerization mechanism, calcium homeostasis and imbalance of ciliary muscle function regulation, but nearly all of the investigators are inclined to remain skeptical. This article reviews the age-related epidemiological proofs, existent genetics correlations, possible underlying biological mechanisms and further values for the protective association between vitamin D and myopia, providing the possibility of prevention or postponement for myopia.

Effectiveness of a Spectacle Lens with a Specific Asymmetric Myopic Peripheral Defocus: 12-Month Results in a Spanish Population.

Different designs of ophthalmic lenses have been studied to control the progression of myopia in children. This study aims to evaluate the short-term efficacy of a new design of ophthalmic lens with asymmetric myopic peripheral defocus (MPDL) on myopia progression in children compared to a control group wearing a single-vision lens (SVL). Children aged 5 to 12 with myopia up to -0.50 D, astigmatism and anisometropia under 1.50 D, and corrected visual acuity over 20/20 were randomized to either the study group (MPDL) or control group (SVL). The myopia progression was evaluated by measuring axial length (AL) growth (IOL Master; Zeiss) over a period of one year. Ninety-two subjects were recruited. Forty-six children were randomly assigned to the control group, and 46 to the study group. In total, 83 children completed the clinical trial, with a mean age of 10.81 [9.53-11.92] years, among which 59.04% were female. After one year of treatment, there was less AL elongation in the study group compared to the control group (0.16 ± 0.16 mm vs. 0.24 ± 0.16 mm, p = 0.034). The MPDL significantly reduced the absolute growth of AL by 39% (p = 0.014) and relative growth of AL by 37.3% (p = 0.012) after 12 months in comparison to the control group in a Spanish population.

Treatment of Rapid Progression of Myopia: Topical Atropine 0.05% and MF60 Contact Lenses.

This retrospective study evaluates the effectiveness of combining 0.05% atropine with MF60 contact lenses in managing rapid myopia progression in children over one year. The study involved three groups: the treatment group (TG) with 15 children (53% male, average age 12.9 ± 1.04), the MF group (MF) with 12 children (50% male, average age 12.8 ± 0.8) using only MF60 lenses, and the control group (CG) with 14 children (43% male, average age 12.1 ± 0.76). Baseline myopia and axial length (AL) were similar across groups, with the TG, MF, and CG showing -4.02 ± 0.70 D, -4.18 ± 0.89 D, -3.86 ± 0.99 D, and 24.72 ± 0.73 mm, 24.98 ± 0.70 mm, 24.59 ± 1.02 mm, respectively. Prior to the study, all groups exhibited significant myopia and AL progression, with no previous myopia control management. The treatment involved daily 0.05% atropine instillation, the use of MF60 lenses and increased outdoor activity. Biannual cycloplegic refraction and slit lamp evaluations confirmed no adverse reactions. After one year, the TG showed a significant reduction in myopia and AL progression (-0.43 ± 0.46 D, p < 0.01; 0.22 ± 0.23 mm, p < 0.01), whereas the CG showed minimal change (-1.30 ± 0.43 D, p = 0.36; 0.65 ± 0.35 mm, p = 0.533). The MF group also exhibited a notable decrease (-0.74 ± 0.45 D, p < 0.01; 0.36 ± 0.23 mm). Increased outdoor activity during the treatment year did not significantly impact myopia control, suggesting its limited additional effect in this cohort. The study concludes that the combination of 0.05% atropine and peripheral defocus soft contact lenses effectively controls myopia progression in children.

Аnnual results of the use of spectacle lenses with embedded rings of high-spherical microlenses Stellest™ for the control of myopia

AIM: To evaluate the effect of continuous wearing of Stellest™ spectacle lenses on refractive dynamics, accommodation, and binocular interaction after 6 months and 1 year.&#x0D; MATERIAL AND METHODS: Children aged 8–13 years who had mild-to-moderate myopia were included. Stellest™ spectacle lenses were prescribed to 35 children with myopia (3.15±0.19 D on average). The control group consisted of 32 children with myopia (2.68±0.18 D on average) using single-vision correction. Refraction, axial length of the eye, accommodation, and binocular interaction were evaluated.&#x0D; RESULTS: After 1 year, the average increase in refraction in the Stellest™ group was 0.19±0.07 D. A decrease in the annual progression gradient (APG) was observed in 82.4% of cases and averaged 0.72±0.1 D. The axial length of the eye increased by an average of 0.08±0.02 mm. In the control group, after 1 year of observation, the average increase in refraction was 0.6±0.07 D. A decrease in APG was observed in 51.6% of the cases and averaged 0.26±0.12 D. The axial length of the eye increased by an average of 0.26±0.03 mm. After 1 year, the increase in refraction and growth of the axial length of the eye in the Stellest ™ group was less than that in the control group by 68.3% and 69.2%, respectively. In the Stellest™ group, positive relative accommodation (PRA) increased after 1 year by 1.06±0.14 D and that in the control group by 0.6±0.16 D. The difference was significant (p 0.02). No differences were found between the groups in terms of objective indicators of accommodation. The stabilization effect in Stellest™ spectacle lenses was the least pronounced with esophoria.&#x0D; CONCLUSION: The use of Stellest™ spectacle lenses slows down the progression of myopia in children and reduces APG by more than two times. A significant increase in PRA was found in children using Stellest™ spectacle lenses for 1 year compared with children using single-vision correction.

A meta-analysis of randomized controlled trials evaluating the effectiveness and safety of the repeated low-level red light therapy in slowing the progression of myopia in children and adolescents.

The aim of this study was to evaluate the effectiveness and safety of repeated low-level red light (RLRL) therapy in controlling myopia progression in children through a meta-analysis. We searched several databases including PubMed, Embase, The Cochrane Library, Web of Science, CNKI, WANFANG, CBM, and VIP with languages restricted to both Chinese and English. The search was conducted from the establishment of the databases to March 23, 2023. We collected randomized controlled trials and controlled experiments to evaluate changes in axial length (AL) and spherical equivalent (SE) before and after RLRL intervention. Two researchers performed literature screening and data extraction, and RevMan software (Ver 5.3) and StataMP 17.0 were used for meta-analysis. A total of 141 articles were retrieved, and finally, six randomized controlled trials met the inclusion and exclusion criteria, including 820 eyes (RLRL group: 411 eyes, control group: 409 eyes). The meta-analysis results showed that the RLRL group was significantly better than the control group in controlling AL, and the difference between the two groups was statistically significant (mean difference [MD] = -0.22, 95% confidence interval [CI] [ - 0.28, -0.16]; P < 0.001). The RLRL group was also better than the control group in terms of SE, and the difference between the two groups was statistically significant (MD = 0.46, 95% CI [0.32, 0.6]; P < 0.001). Five studies reported adverse reactions in the RLRL group, and two cases stopped treatment due to the feeling of too bright light, while the others had no significant side effects in the short term. RLRL therapy is a safe and effective method for controlling myopia, which can inhibit the growth of AL and slow down the progression of myopia. However, further research and validation are needed to determine its treatment efficacy and course.

Myopia progression patterns among paediatric patients in a clinical setting.

This retrospective analysis of electronic medical record (EMR) data investigated the natural history of myopic progression in children from optometric practices in Ireland. The analysis was of myopic patients aged 7-17 with multiple visits and not prescribed myopia control treatment. Sex- and age-specific population centiles for annual myopic progression were derived by fitting a weighted cubic spline to empirical quantiles. These were compared to progression rates derived from control group data obtained from 17 randomised clinical trials (RCTs) for myopia. Linear mixed models (LMMs) were used to allow comparison of myopia progression rates against outputs from a predictive online calculator. Survival analysis was performed to determine the intervals at which a significant level of myopic progression was predicted to occur. Myopia progression was highest in children aged 7 years (median: -0.67 D/year) and progressively slowed with increasing age (median: -0.18 D/year at age 17). Female sex (p < 0.001), a more myopic SER at baseline (p < 0.001) and younger age (p < 0.001) were all found to be predictive of faster myopic progression. Every RCT exhibited a mean progression higher than the median centile observed in the EMR data, while clinic-based studies more closely matched the median progression rates. The LMM predicted faster myopia progression for patients with higher baseline myopia levels, in keeping with previous studies, which was in contrast to an online calculator that predicted slower myopia progression for patients with higher baseline myopia. Survival analysis indicated that at a recall period of 12 months, myopia will have progressed in between 10% and 70% of children, depending upon age. This study produced progression centiles of untreated myopic children, helping to define the natural history of untreated myopia. This will enable clinicians to better predict both refractive outcomes without treatment and monitor treatment efficacy, particularly in the absence of axial length data.

Myopia: An alarming situation in near future

Madam, I am writing to draw attention to an issue that I believe is of great concern for our society: the alarming increase in cases of myopia due to excessive near work. Myopia, or nearsightedness, when the eye has difficulty focusing on distant objects. The prevalence of myopia has been increasing rapidly worldwide, particularly in Asia, where it is estimated that up to 80% of young adults are affected. In the United States, the prevalence of myopia has doubled in the past 30 years.[1] One major factor contributing to this increase is the growing amount of time people spend near work, such as reading, using computers, and playing video games. This kind of work requires the eyes to focus on close objects for extended periods, which can cause the eye to elongate and result in myopia. The consequences of myopia are not only visual but also have significant impacts on quality of life. Myopia increases the risk of eye diseases such as glaucoma, cataracts, and retinal detachment, which can lead to blindness. It can also have a negative impact on academic and career opportunities, as well as physical and social activities. [2] Get regular eye exams: Regular eye exams are crucial for detecting myopia early and monitoring its progression. It is recommended that infants have their first eye exam at six months, and then again at the ages of three and five, and every two years after that. Adults should have an eye exam at least once every two years, or more frequently if advised by their eye doctor. Practice good visual habits: Good visual habits can help prevent myopia from worsening. This includes taking frequent breaks when reading or using electronic devices, maintaining a comfortable distance from the screen, and practicing good posture. You can also try doing eye exercises to strengthen your eye muscles. Spend time outdoors: Studies have shown that spending time outdoors, especially in natural light, can help prevent the onset and progression of myopia in children. Aim for at least 2 hours of outdoor time per day. A study by David A Wilson et al. showed that by 2050 there will be 1 billion people with myopia.[3] Nowadays, our young generation is executively using smartphones and digital screens. All ophthalmologist and optometrist are advised to know all the clints regarding close work to rest in between your work. ---Continue

Cost-Effectiveness Analysis of Myopia Progression Interventions in Children

Several interventions exist for treating myopia progression in children. While these interventions' efficacy has been studied, their cost-effectiveness remains unknown and has not been compared. To determine cost-effective options for controlling myopia progression in children. In this cost-effectiveness analysis, a Markov model was designed to compare the cost-effectiveness of interventions for controlling myopia progression over 5 years from a societal perspective in a simulated hypothetical cohort of patients aged 10 years with myopia. Myopia interventions considered included atropine eye drops, 0.05% and 0.01%, defocus incorporated multiple segment spectacles, outdoor activity, soft contact lenses (daily disposable and multifocal), rigid gas-permeable contact lenses, progressive addition lenses, bifocal spectacle lenses, orthokeratology, highly aspherical lenslets (HALs), and red light therapy; all interventions were compared with single-vision lenses. Deterministic and probabilistic sensitivity analysis determined the association of model uncertainties with the cost-effectiveness. Costs were obtained from the charges of the Hospital Authority of Hong Kong and The Chinese University of Hong Kong Eye Center. The mean costs (in US dollars) per child included the cost of hospital visits, medications, and optical lenses. The outcomes of effectiveness were the annual spherical equivalent refraction (SER) and axial length (AL) reductions. Incremental cost-effectiveness ratios (ICERs) were calculated for each strategy relative to single-vision lenses over a time horizon of 5 years. Outdoor activity, atropine (0.05%), red light therapy, HALs, and orthokeratology were cost-effective. The ICER of atropine, 0.05%, was US $220/SER reduction; red light therapy, US $846/SER reduction; and HALs, US $448/SER reduction. Outdoor activity yielded a savings of US $5/SER reduction and US $8/AL reduction. Orthokeratology resulted in an ICER of US $2376/AL reduction. These findings suggest that atropine eye drops, 0.05%, and outdoor activity are cost-effective for controlling myopia progression in children. Though more expensive, red light therapy, HALs, and orthokeratology may also be cost-effective. The use of these interventions may help to control myopia in a cost-effective way.

Orthokeratology in controlling myopia of children: a meta-analysis of randomized controlled trials

BackgroundDelaying the development and lowering the progression of myopia in children is the focus of current ophthalmology researches. We aimed to evaluate the role of orthokeratology in controlling myopia of children, to provide insights to the clinical treatment and care of children with myopia.MethodsTwo investigators searched the The Cochrane Library, Embase, Pubmed, China national knowledge infrastructure, China biomedical literature database, WanFang and Weipu databases for randomized controlled trials(RCTs) on the role of orthokeratology in controlling myopia of children up to November 5, 2022. Two researchers independently searched, screened and extracted the studies according to the inclusion and exclusion standards. RevMan5.3 software was used for statistical analysis.ResultsA total of 14 RCTs involving 2058 children were included in this meta-analysis. Synthesized outcomes indicated that orthokeratology improved the uncorrected visual acuity(MD = 0.40, 95%CI: 0.05 ~ 0.74), reduced the diopter change(MD=-3.19, 95%CI: -4.42~-1.95), changes of corneal curvature(MD=-3.21, 95%CI: -3.64~-2.79), the length of ocular axis (MD=-0.66, 95%CI: -1.27~-0.06) and amount of ocular axis change(MD=-0.42, 95%CI: -0.64~-0.21) after 1 year of wearing orthokeratology(all P < 0.05). Besides, orthokeratology reduced the diopter change (MD=-3.22, 95%CI: -4.86~-1.58), the length of ocular axis (MD=-1.15, 95%CI: -2.25~-0.06) and the amount of ocular axis change after 2 year of wearing orthokeratology (MD=-0.53, 95%CI: -0.96~-0.11) after 2 year of wearing orthokeratology (all P < 0.05). No publication biases were found amongst the synthesized outcomes (all P > 0.05).ConclusionsOrthokeratology delays the progression of myopia in children, the long-term effects of orthokeratology need further investigations in future studies.

Age-related results over 2 years of the multicenter Spanish study of atropine 0.01% in childhood myopia progression

To evaluate the age-related efficacy and safety of atropine 0.01% eye drops over 2 years for myopia control in a multicentric pediatric Spanish cohort. A non-controlled, interventional, prospective multicenter study was conducted as an extension of the Spanish Group of Atropine Treatment for Myopia Control Study (GTAM 1). Children aged 6–14 years with myopia from − 2.00 to − 6.00 D, astigmatism < 1.50 D and documented annual myopic progression of at least − 0.50 D under cycloplegic examination were recruited. From the original cohort of 105 participants, 92 children who had been receiving atropine 0.01% eye drops once nightly in each eye for 1 year continued their participation in this extended study (GTAM 2). All the patients underwent a standardized quarterly follow-up protocol, which included measurements of best-corrected visual acuity (BCVA), cycloplegic autorefraction, axial length (AL), anterior chamber depth (ACD), and pupil diameter. The study sample was divided into three age groups: 6–8, 9–11, and 12–14 years old. The mean change in cycloplegic spherical equivalent (SE) and axial length (AL) during the 24 months of follow-up was analyzed. Correlations between SE and AL, as well as the distribution of annual progression, were evaluated. Adverse effects were recorded using a specific questionnaire. Finally, 81 children completed the follow-up and were included in the analysis. Over the 2-year period, the mean changes in SE and AL were − 0.88 ± 0.60 D and 0.49 ± 0.25 mm, respectively. Additionally, 51 patients (63%) experienced SE annual progression lower than − 0.50 D. The correlation between the progression of SE and AL during the total period of treatment was mild (r = − 0.36; p < 0.001). There were no differences between the first and the second year of treatment in the progression of SE (− 0.42 ± 0.41 D versus − 0.45 ± 0.39 D; p = 0.69) or AL (0.25 ± 0.16 mm versus 0.23 ± 0.14 mm; p = 0.43). Older patients (12–14 years old) showed less AL progression than younger children (6–8 years old): 0.36 ± 0.18 mm versus 0.59 ± 0.30 mm; p = 0.01. Adverse effects were mild, infrequent, and decreased over time. On average, the myopia progression in control groups from other published biannual studies exceeded that observed in our study. Over 2 years, atropine 0.01% demonstrated a safe treatment for controlling myopia progression in a multicentric cohort of Spanish children. The effect remained stable during this period. Older patients exhibited a more favorable response in terms of AL enlargement. However, further studies are needed to investigate the age-related effect of low-dose atropine in the Caucasian population.

Development of the University of Houston near work, environment, activity, and refraction (UH NEAR) survey for myopia.

There is a need to better elucidate demographic and behavioural factors that are contributing to the rising prevalence of myopia. Doing so will aid in developing evidence-based recommendations for behavioural modifications to prevent onset and slow progression of myopia in children. The contributions of environmental and behavioural factors in myopia remain unclear. The goal of this work was to provide a standardised survey to better understand risk factors for myopia. Development of the survey was carried out in 4 phases. In phase 1, three methods (direct, lay terms, and indirect) of parental reporting for the presence of myopia in their child were investigated through a questionnaire (N = 109) to determine sensitivity and specificity. The best method determined from phase 1 was used in phase 2, where questions regarding demographics, ocular history, and visual behaviour were compiled and refined. In phase 3, the survey was administered to focus groups of parents (N = 9). In phase 4, a scoring system was developed. The highest sensitivity for parental reporting for myopia of their child was the indirect method (0.84), and the lowest sensitivity was the direct method (0.41). The highest specificity was the direct method (0.86), once excluding the 'do not know' responses, and the lowest specificity was the indirect method (0.53). The direct method yielded a 53.2% 'do not know' response rate, 50.5% for the lay method, and 1.8% for the indirect method. Time to complete the survey was 10:09 ± 2:45 minutes. This study provides a comprehensive and up-to-date myopia risk factor survey that can be utilised by researchers and clinicians. Parents found the survey to be easy to understand and relatively quick to answer, and the scoring system allows quantification of behaviours across different categories using provided equations.