AIM:To observe the effect of the plus power ring zone(PPRZ)area and distribution on myopia progression.METHODS:This retrospective study enrolled 137 pre-teens aged 8-12 at Taiyuan Aier Eye Hospital between 2019 and 20...AIM:To observe the effect of the plus power ring zone(PPRZ)area and distribution on myopia progression.METHODS:This retrospective study enrolled 137 pre-teens aged 8-12 at Taiyuan Aier Eye Hospital between 2019 and 2021.They were fitted with Ortho-K lenses for the first time due to refractive error,with a one-year follow-up period.To indicate the peripheral plus ring zone overlapping with the pupil zone(PPROPZ)accompanying PPRZ,participants were divided based on the PPROPZ to PPRZ ratio.The experimental group had 103 eyes with a PPROPZ to PPRZ ratio of≥0.2,and the control group had 103 eyes with a ratio of<0.2.Participants had a spherical diopter in the range of-6.00 D to-0.75 D,against-the-rule astigmatism less than 1.00 D,with-the-rule astigmatism less than 1.50 D,and corneal curvatures of 39.00 D to 46.00 D.They had a stable best corrected visual acuity of 0.10 LogMAR(20/25)or better when wearing orthokeratology(Ortho-K)lenses.PPRZ and PPROPZ were measured using ImageJ;corneal topography assessed corneal-related parameters,and an optical biometer measured the axial length of the eyes pre and post-one years of lens wear.RESULTS:Changes in axial length elongation were found to decrease when either the PPRZ(P<0.01)or PPROPZ(P<0.001)was increased significantly.The axial length growth was faster in the control group(0.37±0.2 mm)than in the experimental group(0.21±0.11 mm).Furthermore,we found that a larger horizontal visible iris diameter(HVID)corresponded to slower axial growth of the eye.In contrast,axial length growth showed no correlation with surface regularity index(SRI),surface asymmetry index(SAI),flat keratometry value(K_(f)),steep keratometry value(K_(s)).CONCLUSION:For orthokeratology,wearers with larger PPROPZ to PPRZ ratio usually experiences a reduction in axial length growth.The PPRZ and PPROPZ are negatively correlated with the axial length.Our findings provide a recommendation and methods for studying the myopia control mechanism through Ortho-K lenses.展开更多
Myopia has become a major visual disorder among school-aged children in East Asia due to its rising prevalence over the past few decades and will continue to be a leading health issue with an annual incidence as high ...Myopia has become a major visual disorder among school-aged children in East Asia due to its rising prevalence over the past few decades and will continue to be a leading health issue with an annual incidence as high as 20%-30%.Although various interventions have been proposed for myopia control,consensus in treatment strategies has yet to be fully developed.Atropine and orthokeratology stand out for their effectiveness in myopia progression control,but children with rapid progression of myopia require treatment with higher concentrations of atropine that are associated with increased rates of side effects,or with orthokeratology that carries risk of significant complication.Therefore,improved risk assessment for myopia onset and progression in children is critical in clinical decision-making.Besides traditional prediction models based on genetic effects and environmental exposures within populations,individualized prediction using machine learning and data based on age-specific refraction is promising.Although emerging treatments for myopia are promising and some have been incorporated into clinical practice,identifying populations who require and benefit from intervention remains the most important initial step for clinical practice.展开更多
AIM: To evaluate the effectiveness of peripheral defocus spectacle lenses(PDLs) in myopia control. METHODS: Literature retrieval on Pub Med, Cochrane Library, Embase, and Web of Science databases, and the search time ...AIM: To evaluate the effectiveness of peripheral defocus spectacle lenses(PDLs) in myopia control. METHODS: Literature retrieval on Pub Med, Cochrane Library, Embase, and Web of Science databases, and the search time limit was from the establishment of each database to December 29, 2021 were conducted. Change of spherical equivalent refraction(SER) and axial change(AL) were extracted from the literatures that met the inclusion criteria, and Rev Man5.3 software was used for Meta-analysis. RESULTS: A total of 4 randomized controlled trials(RCTs) were included in this Meta-analysis, involving 770 myopic children. The results showed that PDLs could delay the progression of myopia in children with myopia compared with single vision spectacle lenses(SVLs;WMD=0.21 D, 95%CI: 0.01, 0.41, P=0.04). However, there was no significant difference in controlling the growth of axial length(AL) in myopic children(WMD=-0.10 mm, 95%CI:-0.21, 0.01, P=0.07). The results of the effectiveness of myopia control between the two spectacle lenses showed that PDLs were more effective in controlling the progression of myopia(OR=5.73, 95%CI: 2.58, 12.70, P<0.001) and delaying the growth of AL(OR=44.25, 95%CI: 8.84, 221.58, P<0.001) than SVLs, and the differences were statistically significant. CONCLUSION: PDLs can control the progression of myopia compared with SVLs, but cannot delay the growth of AL, and the effectiveness of PDLs in myopia control better than SVLs.展开更多
Orthokeratology(OK)is a clinical technique that uses reverse geometry design rigid contact lenses to reshape the corneal profile and modify its refractive power during overnight lens wear in order to correct refractiv...Orthokeratology(OK)is a clinical technique that uses reverse geometry design rigid contact lenses to reshape the corneal profile and modify its refractive power during overnight lens wear in order to correct refractive error temporarily.OK achieves its reshaping effect through thinning of the central corneal epithelium.This raises concerns about the safety of this modality particularly in terms of microbial keratitis(MK).Since the mid 2000’s,with our increasing understanding of modifiable risk factors for MK in OK the prevalence of MK appears to have reduced significantly.It is now clear that the relative risk of MK in overnight OK is equivalent to other modalities of contact lens wear,provided that safe practice is followed in terms of lens fitting,wear and care.Although OK was originally used predominantly for correction of low to moderate myopic refractive error,its use for myopia control have become more common in recent years.This follows on from published clinical trials demonstrating an average of approximately 45%reduction in axial eye elongation when overnight OK is used in progressive myopic children.But there is significant individual variability in efficacy,and one of the current challenges for OK in myopia control is to identify those children who will benefit most from this particular intervention.Modifying OK lens parameters to customise corneal reshaping for enhanced myopia control efficacy also remains a significant challenge for the future of this modality.展开更多
The biological mechanisms of eye growth and refractive development are increasingly well characterised,a result of many careful studies that have been carried out over many years.As the outer coat of the eye,the scler...The biological mechanisms of eye growth and refractive development are increasingly well characterised,a result of many careful studies that have been carried out over many years.As the outer coat of the eye,the sclera has the ultimate impact on the restraint or facilitation of eye growth,thus any changes in its biochemistry,ultrastructure,gross morphology and/or biomechanical properties are critical in refractive error development and,in particular,the development of myopia.The current review briefly revisits our basic understanding of the structure and biomechanics of the sclera and how these are regulated and modified during eye growth and myopia development.The review then applies this knowledge in considering recent advances in our understanding of how the mechanisms of scleral remodelling may be manipulated or controlled,in order to constrain eye growth and limit the development of myopia,in particular the higher degrees of myopia that lead to vision loss and blindness.In doing so,the review specifically considers recent approaches to the strengthening of the sclera,through collagen cross-linking,scleral transplantation,implantation or injection of biomaterials,or the direct therapeutic targeting and manipulation of the biochemical mechanisms known to be involved in myopia development.These latest approaches to the control of scleral changes in myopia are,where possible,placed in the context of our understanding of scleral biology,in order to bring a more complete understanding of current and future therapeutic interventions in myopia,and their consequences.展开更多
Purpose: The purpose of this study was to evaluate the change in corneal wavefront aberrations in young adults who have been fit with multifocal soft contact lenses for myopia progression control. Findings have been a...Purpose: The purpose of this study was to evaluate the change in corneal wavefront aberrations in young adults who have been fit with multifocal soft contact lenses for myopia progression control. Findings have been analyzed for statistical significance and clinical relevance and compared to reportedly successful Orthokeratology outcomes. Methods: The dominant eye of 40 participants (27 women, 13 men;mean age 27.3 ± 3.2 years;range 23 to 39 years) was fit with Proclear Multifocal center distance lenses (Coopervision, Pleasanton, USA) having a variety of distance powers and reading additions. Refractive errors were limited to a range of –6.00 D up to +1.00 D of sphere, and no greater than –1.00 D of cylinder. Corneal wavefront measurements were performed over 6 mm diameters with a Zeiss Atlas 9000 corneal topographer (Zeiss Meditec, Dublin, USA) prior to, and following lens fitting. Data were converted into rectangular Fourier optics terms M, J0, J45 and RMS values for each reading addition were statistically analyzed. Following evaluation of statistical significance and clinical relevance, results were compared to published data from successful Orthokeratology treatments. Results: Statistically significant changes in higher order aberrations were detected for lenses of all reading additions. Lens groups with higher Add-powers demonstrated stronger changes with increased significance. Final RMS values relating to 2nd, 3rd and 4th Zernike Orders reached clinical significance with a wavefront error of 0.10 μm, the equivalent of 0.25D. Moreover, as Add-powers increased, 3rd and 4th order aberrations likewise showed an increase. Pre-fitting astigmatism values accounted for the highest recorded aberrations and remained predominantly unchanged. Conclusion: Proclear Multifocal center-distance contact lenses were found to increase higher order wavefront aberrations in a manner dependent on their Add-power. In comparison to successful Orthokeratology outcomes, the amounts of resulting aberrations are notably different.展开更多
AIM:To investigate the effects of binocular fusional C-optotypes(positive/negative)and 2D planar C-optotypes on the amplitude and stability of transient accommodation(TAC)in adults,and to provide a basis for non-conta...AIM:To investigate the effects of binocular fusional C-optotypes(positive/negative)and 2D planar C-optotypes on the amplitude and stability of transient accommodation(TAC)in adults,and to provide a basis for non-contact myopia intervention.METHODS:This was a self-controlled study.Using redblue 3D technology,four experimental stages were set up:Test A[fixating on the 1 m negative fusional C-optotypes,8△base-in(BI)],Test B(fixating on the 5 m planar C-optotypes),Test C(fixating on the 1 m planar C-optotypes),and Test D[fixating on the 1 m positive fusional C-optotypes,20△base-out(BO)].A WAM-5500 open-field autorefractor was used to measure TAC and accommodative microfluctuations[evaluated via interquartile range(IQR)and median-based coefficient of variation(CVmed)].Additionally,the convergence accommodation to convergence(CA/C)ratio was calculated,and a visual fatigue questionnaire was administered to assess participants’subjective visual comfort.RESULTS:A total of 21 subjects(7 males,14 females;aged 23-41y)with normal binocular visual function were enrolled.The results showed that the TAC increased gradually across the four stages,and these values were Test A(-0.35±0.26 D)<Test B(-0.46±0.24 D)<Test C(-0.77±0.32 D)<Test D(-1.38±0.31 D).There were significant overall differences(F=56.136,P<0.001).Compared with Test C,Test A reduced TAC by 0.42 D(P<0.05),while Test D increased it by 0.61 D(P<0.001).There was no significant intergroup difference in accommodative fluctuation amplitude(all P>0.05),but the fluctuation stability of Test D showed a significant difference between the first 20s and the second 20s(P=0.017).The CA/C ratio was significantly higher in Test D(0.05±0.02 D/△)than in Test A(0.03±0.02 D/△,P=0.007),indicating stronger accommodation-convergence linkage during positive fusional fixation.The visual fatigue scores of all stages were low(median 0-1),with Test D slightly higher than Test B and Test C(P<0.05).No linear correlation was found between TAC and age(all r<0.1,P>0.05).CONCLUSION:Negative fusional C-optotypes induce ciliary muscle relaxation to reduce TAC,while positive fusional C-optotypes enhance accommodation-convergence coordination to increase TAC.The red-blue 3D-based noncontact training mode exhibits good safety(median visual fatigue scores:0-1 across all tests)and provides a novel dual-directional(relaxation-activation)strategy for myopia prevention and control.展开更多
Background To investigate the control effect on the axial length elongation using corneal refractive therapy(CRT)with different optical zone diameters(BOZDs).We also sought to compare the difference in higher-order ab...Background To investigate the control effect on the axial length elongation using corneal refractive therapy(CRT)with different optical zone diameters(BOZDs).We also sought to compare the difference in higher-order aberrations(HOAs),treatment zone(TZ)size and Zernike defocus coefficient with different BOZDs and seek the optimal parameter for predicting axial elongation.Methods This prospective cohort study included 7-to 14-year-olds fitted with orthokeratology(ortho-K)lenses of 5-mm(5-mm group)or 6-mm BOZD(6-mm group).Axial length(AL),corneal topography,HOAs and Zernike defocus coefficient were obtained at baseline,and 1,3,6,9 and 12 months follow-up visits.Multivariate regression analyses were used to explore the association between AL change and ocular biometric parameters.Receiver operating characteristic(ROC)curve analysis was used to determine the best diagnostic value for AL change in ocular biometric parameters.Results In total,301 participants completed the one-year follow-up.The mean AL change in the 5-mm group(0.13±0.18 mm)was less than that in the 6-mm group(0.27±0.15 mm)at the 12 months visit.The TZ size and decentration were smaller,while the Zernike defocus coefficient and HOAs were higher in the 5-mm group(all P<0.05).Older age and smaller TZ size were protective factors against AL elongation in multiple regression.In predicting AL elongation,TZ diameter yielded an area under the ROC curve of 0.684 with a cut-off value of 3.82 mm.Conclusion The 5-mm group showed 0.14 mm(51.8%)less axial elongation than the 6-mm group.The 5-mm BOZD produced a smaller TZ size,higher Zernike defocus coefficient and higher HOA after reshaping of the cornea.TZ size was the best predictor of AL elongation.TZ diameter less than 3.82 mm may lead to AL elongation less than 0.2 mm in one year.展开更多
Objective:To investigate the lifestyle and myopia among primary school students in urban areas of Fujian with the context of myopia prevention and control measures,aiming to provide scientific evidence for identifying...Objective:To investigate the lifestyle and myopia among primary school students in urban areas of Fujian with the context of myopia prevention and control measures,aiming to provide scientific evidence for identifying high-risk myopia population and formulating effective intervention strategies.Methods:A cross-sectional study was conducted from October to November 2023,enrolling 811 fourth-grade students from three primary schools in three cities across Fujian.Personal information and lifestyle-related pattern were collected using customized questionnaire.Participants underwent comprehensive ophthalmic assessments including distance visual acuity tests and refractive examinations.Logistic regression analysis was used to assess the impact of lifestyle on the onset of myopia.Results:The prevalence of myopia among fourth-grade students in urban primary schools in Fujian was 46.4%.Only 25.8%students engaged in outdoor activities for more than 2 hours daily,while63.3%participated in outdoor activities during class breaks.Multivariate Logistic regression analysis revealed that outdoor activities during class breaks(OR=0.646(95%confidence interval(CI):0.473-0.881),P=0.006)and daily time spent outdoors(2-3 hours,OR=0.682(95%CI:0.466-0.993),P=0.047;more than 3 hours,OR=0.403(95%CI:0.192-0.796),P=0.01)were independent protective factors against myopia.Lifestyle significantly enhanced the predictive performance for myopia(P=0.01).Additionally,parental myopia(one parent with myopia,OR=2.247(95%CI:1.612-3.145),P<0.001;both parents with myopia,OR=4.824(95%CI:3.262-7.204),P<0.001)emerged as a key risk factor for myopia.Conclusions:There is considerable scope for improving the lifestyle of primary school students in urban areas of Fujian.Lifestyle is strongly associated with myopia onset,highlighting the need for schools and families to actively encourage students to engage in more outdoor activities and take breaks outdoors to prevent and control myopia.Students with parents,especially both parents,having myopia should be considered as a key target group for myopia prevention efforts.展开更多
Myopia poses a significant burden on the healthcare system,economy and quality of life.It is an emerging global public health challenge and requires interventions to delay or stop onset and progression.With changing t...Myopia poses a significant burden on the healthcare system,economy and quality of life.It is an emerging global public health challenge and requires interventions to delay or stop onset and progression.With changing times and evidence,the concepts of myopia are changing along with the treatment and control strategies.Behavioural modifications including increased outdoors time and reduced near work,optical and pharmaceutical management options are reviewed.This paper presents a current overview on the concepts of myopia,and is expected to summarize updates on myopia control methods.展开更多
AIM:To understand the current situation of parental perspectives,knowledge,and practices concerning myopia prevention and control for both pre-and school-aged children.METHODS:This study was a cross-sectional survey t...AIM:To understand the current situation of parental perspectives,knowledge,and practices concerning myopia prevention and control for both pre-and school-aged children.METHODS:This study was a cross-sectional survey that involved children aged 0 to 15y and their parents.Participants were required to respond to an online questionnaire by scanning a quick response(QR)code.The questionnaire consisted of 25 tick-box questions and was open to response from December 22,2022,to January 5,2023.The dioptric traits of the children,the visual status and educational background of the parents,the parental perspectives towards myopia and its risks,and the parents’knowledge and practices related to myopia prevention and control were recorded and measured.The Chi-square test and binomial logistic regression were used for statistics.RESULTS:Totally 350 parents responded to the questionnaire.The prevalence and severity of myopia among the surveyed children exhibited a positive correlation with advancing age(P<0.001 and P=0.004,respectively).Nearly half of parents with myopic children considered myopia did not pose any health threat and could be effectively corrected(P<0.001).Parents who held master’s or doctoral degree demonstrated a better understanding of children’s vision standards for each age group(P=0.001),and 31.63% of them could undergo initial vision screening for their children during the age of 0 to 3y while parents with bachelor’s degree(34.04%)and below(32.43%)mainly initiated the vision examination for their children at the age of 4 to 6y(P=0.05).Parents with master’s or doctoral degree also exhibited more rational practices concerning outdoor time(P=0.048)and sleep time(P=0.044).No other significant discrepancy among the different educational groups in additional conceptions of myopia,such as hyperopia reserve,axis length,and corneal curvature alterations.Most parents preferred to employ conventional interventions,such as enhancing indoor lighting condition(80.00%)and ensuring appropriate reading posture and distance(71.71%).CONCLUSION:The current status of parental knowledge and practices about myopia prevention and control remains outdated and deficient.The administrative department should implement efficacious and adaptable measures to enhance parental awareness and foster their commitment towards myopia prevention and control.展开更多
Currently, the number of myopic people in China has reached as high as 600 million, and it shows a trend of “early onset, high incidence, and a high degree of severity”. The issue of myopia among children and adoles...Currently, the number of myopic people in China has reached as high as 600 million, and it shows a trend of “early onset, high incidence, and a high degree of severity”. The issue of myopia among children and adolescents has attracted widespread attention from all sectors of society. Comprehensive myopia prevention and control efforts have been launched nationwide. Popular science education, vision screening, and improving visual environments are effective measures for preventing myopia. However, among the target audience for comprehensive myopia prevention and control, the preschool children group has been neglected, and the work of myopia prevention and control for this group has been significantly weakened and marginalized. Due to insufficient awareness of prevention and control, the hyperopia reserve in the preschool children group is being continuously depleted, leading to the early onset of myopia. In light of this situation, the focus of myopia prevention and control needs to shift forward, and it is worth exploring and pondering how college students with a background in optometry can develop entertaining and engaging popular science education materials and methods.展开更多
Objective: to analyze the effect of visual training in the prevention and control of juvenile myopia. Methods: 100 cases of juvenile myopia treated in our hospital from December 2017 to December 2018 were divided into...Objective: to analyze the effect of visual training in the prevention and control of juvenile myopia. Methods: 100 cases of juvenile myopia treated in our hospital from December 2017 to December 2018 were divided into reference group and experimental group by lot, with 50 cases in each group. The reference group received medical optometry according to the reference requirements, and the experimental group received visual training on the basis of the reference group. The changes of ocular axis length of the two groups after the intervention and the adjustment lag of the two groups before and after the intervention were compared. Results: the length of ocular axis in the experimental group was lower than that in the reference group, and the comparison between the groups had statistical value (P < 0.05);In the comparison of adjustment lag, there was no difference between the two groups before intervention (P > 0.05);After the intervention, the experimental group was lower than the reference group, and there was significant difference between the groups (P < 0.05). Conclusion: in order to reduce juvenile myopia, visual training can delay the growth of ocular axis length, reduce the amount of adjustment lag and myopia, which is conducive to the healthy growth of adolescents.展开更多
Objective: to analyze the role of orthokeratology lens (OK lens) in the prevention and control of myopia in adolescents. Methods: a total of 50 adolescent myopic patients who came to our hospital for myopic consultati...Objective: to analyze the role of orthokeratology lens (OK lens) in the prevention and control of myopia in adolescents. Methods: a total of 50 adolescent myopic patients who came to our hospital for myopic consultation and treatment from January 2018 to December 2020 were selected, and they were divided into two groups with 25 cases in each group according to their treatment intention and glasses wearing mode. The myopia patients in the frame group were treated with ordinary frame glasses, and the OK lens group was monitored by AL measurement. The visual acuity, intraocular pressure, AL monitoring and HHK were compared between the two groups before and after treatment. Results: there were no significant changes in visual acuity, intraocular pressure, AL monitoring and HHK between the two groups before treatment (P > 0.05), but there were no significant changes in visual acuity, intraocular pressure, AL monitoring and HHK between the two groups after treatment (P > 0.05). However, the visual acuity, intraocular pressure and HHK of OK mirror group were higher than those before treatment, P < 0.05. AL had no significant change, P > 0.05. Conclusion: AL measuring and monitoring OK lens has better effect on prevention and treatment of myopia than conventional glasses, which is worthy of recommendation for adolescent myopia patients who come to our hospital for consultation and treatment of myopia.展开更多
Various studies have suggested several environmental,pharmacological,medical,and optical interventions and some are in use but their efficacy in myopia control may be transient,and the cellular,molecular,and biochemic...Various studies have suggested several environmental,pharmacological,medical,and optical interventions and some are in use but their efficacy in myopia control may be transient,and the cellular,molecular,and biochemical mechanisms involved unclear.Daylight exposure is currently regarded as an effective and enduring strategy in the control of myopia development and progression.However,the mechanism behind the effect of outdoor exposure and its association with genetic predisposition and other relatively more significant environmental factors on myopia is still a conundrum.This review focuses on survey-based and intervention-based studies carried out to propose a mechanism that accounts for myopia development and important for its control.展开更多
文摘AIM:To observe the effect of the plus power ring zone(PPRZ)area and distribution on myopia progression.METHODS:This retrospective study enrolled 137 pre-teens aged 8-12 at Taiyuan Aier Eye Hospital between 2019 and 2021.They were fitted with Ortho-K lenses for the first time due to refractive error,with a one-year follow-up period.To indicate the peripheral plus ring zone overlapping with the pupil zone(PPROPZ)accompanying PPRZ,participants were divided based on the PPROPZ to PPRZ ratio.The experimental group had 103 eyes with a PPROPZ to PPRZ ratio of≥0.2,and the control group had 103 eyes with a ratio of<0.2.Participants had a spherical diopter in the range of-6.00 D to-0.75 D,against-the-rule astigmatism less than 1.00 D,with-the-rule astigmatism less than 1.50 D,and corneal curvatures of 39.00 D to 46.00 D.They had a stable best corrected visual acuity of 0.10 LogMAR(20/25)or better when wearing orthokeratology(Ortho-K)lenses.PPRZ and PPROPZ were measured using ImageJ;corneal topography assessed corneal-related parameters,and an optical biometer measured the axial length of the eyes pre and post-one years of lens wear.RESULTS:Changes in axial length elongation were found to decrease when either the PPRZ(P<0.01)or PPROPZ(P<0.001)was increased significantly.The axial length growth was faster in the control group(0.37±0.2 mm)than in the experimental group(0.21±0.11 mm).Furthermore,we found that a larger horizontal visible iris diameter(HVID)corresponded to slower axial growth of the eye.In contrast,axial length growth showed no correlation with surface regularity index(SRI),surface asymmetry index(SAI),flat keratometry value(K_(f)),steep keratometry value(K_(s)).CONCLUSION:For orthokeratology,wearers with larger PPROPZ to PPRZ ratio usually experiences a reduction in axial length growth.The PPRZ and PPROPZ are negatively correlated with the axial length.Our findings provide a recommendation and methods for studying the myopia control mechanism through Ortho-K lenses.
文摘Myopia has become a major visual disorder among school-aged children in East Asia due to its rising prevalence over the past few decades and will continue to be a leading health issue with an annual incidence as high as 20%-30%.Although various interventions have been proposed for myopia control,consensus in treatment strategies has yet to be fully developed.Atropine and orthokeratology stand out for their effectiveness in myopia progression control,but children with rapid progression of myopia require treatment with higher concentrations of atropine that are associated with increased rates of side effects,or with orthokeratology that carries risk of significant complication.Therefore,improved risk assessment for myopia onset and progression in children is critical in clinical decision-making.Besides traditional prediction models based on genetic effects and environmental exposures within populations,individualized prediction using machine learning and data based on age-specific refraction is promising.Although emerging treatments for myopia are promising and some have been incorporated into clinical practice,identifying populations who require and benefit from intervention remains the most important initial step for clinical practice.
基金Supported by National Natural Science Foundation of China(No.81960177)Jiangxi Provincial Science and Technology Grant(No.20192BAB205049)+2 种基金A research grant from Jiangxi Provincial Health Commission(No.202210723)Postgraduate Innovation Special Fund Project of Jiangxi Province(No.YC2021-S077)。
文摘AIM: To evaluate the effectiveness of peripheral defocus spectacle lenses(PDLs) in myopia control. METHODS: Literature retrieval on Pub Med, Cochrane Library, Embase, and Web of Science databases, and the search time limit was from the establishment of each database to December 29, 2021 were conducted. Change of spherical equivalent refraction(SER) and axial change(AL) were extracted from the literatures that met the inclusion criteria, and Rev Man5.3 software was used for Meta-analysis. RESULTS: A total of 4 randomized controlled trials(RCTs) were included in this Meta-analysis, involving 770 myopic children. The results showed that PDLs could delay the progression of myopia in children with myopia compared with single vision spectacle lenses(SVLs;WMD=0.21 D, 95%CI: 0.01, 0.41, P=0.04). However, there was no significant difference in controlling the growth of axial length(AL) in myopic children(WMD=-0.10 mm, 95%CI:-0.21, 0.01, P=0.07). The results of the effectiveness of myopia control between the two spectacle lenses showed that PDLs were more effective in controlling the progression of myopia(OR=5.73, 95%CI: 2.58, 12.70, P<0.001) and delaying the growth of AL(OR=44.25, 95%CI: 8.84, 221.58, P<0.001) than SVLs, and the differences were statistically significant. CONCLUSION: PDLs can control the progression of myopia compared with SVLs, but cannot delay the growth of AL, and the effectiveness of PDLs in myopia control better than SVLs.
文摘Orthokeratology(OK)is a clinical technique that uses reverse geometry design rigid contact lenses to reshape the corneal profile and modify its refractive power during overnight lens wear in order to correct refractive error temporarily.OK achieves its reshaping effect through thinning of the central corneal epithelium.This raises concerns about the safety of this modality particularly in terms of microbial keratitis(MK).Since the mid 2000’s,with our increasing understanding of modifiable risk factors for MK in OK the prevalence of MK appears to have reduced significantly.It is now clear that the relative risk of MK in overnight OK is equivalent to other modalities of contact lens wear,provided that safe practice is followed in terms of lens fitting,wear and care.Although OK was originally used predominantly for correction of low to moderate myopic refractive error,its use for myopia control have become more common in recent years.This follows on from published clinical trials demonstrating an average of approximately 45%reduction in axial eye elongation when overnight OK is used in progressive myopic children.But there is significant individual variability in efficacy,and one of the current challenges for OK in myopia control is to identify those children who will benefit most from this particular intervention.Modifying OK lens parameters to customise corneal reshaping for enhanced myopia control efficacy also remains a significant challenge for the future of this modality.
文摘The biological mechanisms of eye growth and refractive development are increasingly well characterised,a result of many careful studies that have been carried out over many years.As the outer coat of the eye,the sclera has the ultimate impact on the restraint or facilitation of eye growth,thus any changes in its biochemistry,ultrastructure,gross morphology and/or biomechanical properties are critical in refractive error development and,in particular,the development of myopia.The current review briefly revisits our basic understanding of the structure and biomechanics of the sclera and how these are regulated and modified during eye growth and myopia development.The review then applies this knowledge in considering recent advances in our understanding of how the mechanisms of scleral remodelling may be manipulated or controlled,in order to constrain eye growth and limit the development of myopia,in particular the higher degrees of myopia that lead to vision loss and blindness.In doing so,the review specifically considers recent approaches to the strengthening of the sclera,through collagen cross-linking,scleral transplantation,implantation or injection of biomaterials,or the direct therapeutic targeting and manipulation of the biochemical mechanisms known to be involved in myopia development.These latest approaches to the control of scleral changes in myopia are,where possible,placed in the context of our understanding of scleral biology,in order to bring a more complete understanding of current and future therapeutic interventions in myopia,and their consequences.
文摘Purpose: The purpose of this study was to evaluate the change in corneal wavefront aberrations in young adults who have been fit with multifocal soft contact lenses for myopia progression control. Findings have been analyzed for statistical significance and clinical relevance and compared to reportedly successful Orthokeratology outcomes. Methods: The dominant eye of 40 participants (27 women, 13 men;mean age 27.3 ± 3.2 years;range 23 to 39 years) was fit with Proclear Multifocal center distance lenses (Coopervision, Pleasanton, USA) having a variety of distance powers and reading additions. Refractive errors were limited to a range of –6.00 D up to +1.00 D of sphere, and no greater than –1.00 D of cylinder. Corneal wavefront measurements were performed over 6 mm diameters with a Zeiss Atlas 9000 corneal topographer (Zeiss Meditec, Dublin, USA) prior to, and following lens fitting. Data were converted into rectangular Fourier optics terms M, J0, J45 and RMS values for each reading addition were statistically analyzed. Following evaluation of statistical significance and clinical relevance, results were compared to published data from successful Orthokeratology treatments. Results: Statistically significant changes in higher order aberrations were detected for lenses of all reading additions. Lens groups with higher Add-powers demonstrated stronger changes with increased significance. Final RMS values relating to 2nd, 3rd and 4th Zernike Orders reached clinical significance with a wavefront error of 0.10 μm, the equivalent of 0.25D. Moreover, as Add-powers increased, 3rd and 4th order aberrations likewise showed an increase. Pre-fitting astigmatism values accounted for the highest recorded aberrations and remained predominantly unchanged. Conclusion: Proclear Multifocal center-distance contact lenses were found to increase higher order wavefront aberrations in a manner dependent on their Add-power. In comparison to successful Orthokeratology outcomes, the amounts of resulting aberrations are notably different.
文摘AIM:To investigate the effects of binocular fusional C-optotypes(positive/negative)and 2D planar C-optotypes on the amplitude and stability of transient accommodation(TAC)in adults,and to provide a basis for non-contact myopia intervention.METHODS:This was a self-controlled study.Using redblue 3D technology,four experimental stages were set up:Test A[fixating on the 1 m negative fusional C-optotypes,8△base-in(BI)],Test B(fixating on the 5 m planar C-optotypes),Test C(fixating on the 1 m planar C-optotypes),and Test D[fixating on the 1 m positive fusional C-optotypes,20△base-out(BO)].A WAM-5500 open-field autorefractor was used to measure TAC and accommodative microfluctuations[evaluated via interquartile range(IQR)and median-based coefficient of variation(CVmed)].Additionally,the convergence accommodation to convergence(CA/C)ratio was calculated,and a visual fatigue questionnaire was administered to assess participants’subjective visual comfort.RESULTS:A total of 21 subjects(7 males,14 females;aged 23-41y)with normal binocular visual function were enrolled.The results showed that the TAC increased gradually across the four stages,and these values were Test A(-0.35±0.26 D)<Test B(-0.46±0.24 D)<Test C(-0.77±0.32 D)<Test D(-1.38±0.31 D).There were significant overall differences(F=56.136,P<0.001).Compared with Test C,Test A reduced TAC by 0.42 D(P<0.05),while Test D increased it by 0.61 D(P<0.001).There was no significant intergroup difference in accommodative fluctuation amplitude(all P>0.05),but the fluctuation stability of Test D showed a significant difference between the first 20s and the second 20s(P=0.017).The CA/C ratio was significantly higher in Test D(0.05±0.02 D/△)than in Test A(0.03±0.02 D/△,P=0.007),indicating stronger accommodation-convergence linkage during positive fusional fixation.The visual fatigue scores of all stages were low(median 0-1),with Test D slightly higher than Test B and Test C(P<0.05).No linear correlation was found between TAC and age(all r<0.1,P>0.05).CONCLUSION:Negative fusional C-optotypes induce ciliary muscle relaxation to reduce TAC,while positive fusional C-optotypes enhance accommodation-convergence coordination to increase TAC.The red-blue 3D-based noncontact training mode exhibits good safety(median visual fatigue scores:0-1 across all tests)and provides a novel dual-directional(relaxation-activation)strategy for myopia prevention and control.
基金supported by Capital’s Funds for Health Improvement and Research(Grant No.2022-1G-4083)the National Natural Science Foundation of China(Grant No.82171092)the National Key R&D Program of China(Grant Nos.2021YFC2702100 and 2020YFC2008200).
文摘Background To investigate the control effect on the axial length elongation using corneal refractive therapy(CRT)with different optical zone diameters(BOZDs).We also sought to compare the difference in higher-order aberrations(HOAs),treatment zone(TZ)size and Zernike defocus coefficient with different BOZDs and seek the optimal parameter for predicting axial elongation.Methods This prospective cohort study included 7-to 14-year-olds fitted with orthokeratology(ortho-K)lenses of 5-mm(5-mm group)or 6-mm BOZD(6-mm group).Axial length(AL),corneal topography,HOAs and Zernike defocus coefficient were obtained at baseline,and 1,3,6,9 and 12 months follow-up visits.Multivariate regression analyses were used to explore the association between AL change and ocular biometric parameters.Receiver operating characteristic(ROC)curve analysis was used to determine the best diagnostic value for AL change in ocular biometric parameters.Results In total,301 participants completed the one-year follow-up.The mean AL change in the 5-mm group(0.13±0.18 mm)was less than that in the 6-mm group(0.27±0.15 mm)at the 12 months visit.The TZ size and decentration were smaller,while the Zernike defocus coefficient and HOAs were higher in the 5-mm group(all P<0.05).Older age and smaller TZ size were protective factors against AL elongation in multiple regression.In predicting AL elongation,TZ diameter yielded an area under the ROC curve of 0.684 with a cut-off value of 3.82 mm.Conclusion The 5-mm group showed 0.14 mm(51.8%)less axial elongation than the 6-mm group.The 5-mm BOZD produced a smaller TZ size,higher Zernike defocus coefficient and higher HOA after reshaping of the cornea.TZ size was the best predictor of AL elongation.TZ diameter less than 3.82 mm may lead to AL elongation less than 0.2 mm in one year.
基金supported by the Science and Technology Planning Project of Guangdong Province(2023A1111120011)the Natural Science Foundation of Guangdong Province(2024A1515010801).
文摘Objective:To investigate the lifestyle and myopia among primary school students in urban areas of Fujian with the context of myopia prevention and control measures,aiming to provide scientific evidence for identifying high-risk myopia population and formulating effective intervention strategies.Methods:A cross-sectional study was conducted from October to November 2023,enrolling 811 fourth-grade students from three primary schools in three cities across Fujian.Personal information and lifestyle-related pattern were collected using customized questionnaire.Participants underwent comprehensive ophthalmic assessments including distance visual acuity tests and refractive examinations.Logistic regression analysis was used to assess the impact of lifestyle on the onset of myopia.Results:The prevalence of myopia among fourth-grade students in urban primary schools in Fujian was 46.4%.Only 25.8%students engaged in outdoor activities for more than 2 hours daily,while63.3%participated in outdoor activities during class breaks.Multivariate Logistic regression analysis revealed that outdoor activities during class breaks(OR=0.646(95%confidence interval(CI):0.473-0.881),P=0.006)and daily time spent outdoors(2-3 hours,OR=0.682(95%CI:0.466-0.993),P=0.047;more than 3 hours,OR=0.403(95%CI:0.192-0.796),P=0.01)were independent protective factors against myopia.Lifestyle significantly enhanced the predictive performance for myopia(P=0.01).Additionally,parental myopia(one parent with myopia,OR=2.247(95%CI:1.612-3.145),P<0.001;both parents with myopia,OR=4.824(95%CI:3.262-7.204),P<0.001)emerged as a key risk factor for myopia.Conclusions:There is considerable scope for improving the lifestyle of primary school students in urban areas of Fujian.Lifestyle is strongly associated with myopia onset,highlighting the need for schools and families to actively encourage students to engage in more outdoor activities and take breaks outdoors to prevent and control myopia.Students with parents,especially both parents,having myopia should be considered as a key target group for myopia prevention efforts.
文摘Myopia poses a significant burden on the healthcare system,economy and quality of life.It is an emerging global public health challenge and requires interventions to delay or stop onset and progression.With changing times and evidence,the concepts of myopia are changing along with the treatment and control strategies.Behavioural modifications including increased outdoors time and reduced near work,optical and pharmaceutical management options are reviewed.This paper presents a current overview on the concepts of myopia,and is expected to summarize updates on myopia control methods.
基金Supported by the National Natural Science Foundation of China(No.82205196).
文摘AIM:To understand the current situation of parental perspectives,knowledge,and practices concerning myopia prevention and control for both pre-and school-aged children.METHODS:This study was a cross-sectional survey that involved children aged 0 to 15y and their parents.Participants were required to respond to an online questionnaire by scanning a quick response(QR)code.The questionnaire consisted of 25 tick-box questions and was open to response from December 22,2022,to January 5,2023.The dioptric traits of the children,the visual status and educational background of the parents,the parental perspectives towards myopia and its risks,and the parents’knowledge and practices related to myopia prevention and control were recorded and measured.The Chi-square test and binomial logistic regression were used for statistics.RESULTS:Totally 350 parents responded to the questionnaire.The prevalence and severity of myopia among the surveyed children exhibited a positive correlation with advancing age(P<0.001 and P=0.004,respectively).Nearly half of parents with myopic children considered myopia did not pose any health threat and could be effectively corrected(P<0.001).Parents who held master’s or doctoral degree demonstrated a better understanding of children’s vision standards for each age group(P=0.001),and 31.63% of them could undergo initial vision screening for their children during the age of 0 to 3y while parents with bachelor’s degree(34.04%)and below(32.43%)mainly initiated the vision examination for their children at the age of 4 to 6y(P=0.05).Parents with master’s or doctoral degree also exhibited more rational practices concerning outdoor time(P=0.048)and sleep time(P=0.044).No other significant discrepancy among the different educational groups in additional conceptions of myopia,such as hyperopia reserve,axis length,and corneal curvature alterations.Most parents preferred to employ conventional interventions,such as enhancing indoor lighting condition(80.00%)and ensuring appropriate reading posture and distance(71.71%).CONCLUSION:The current status of parental knowledge and practices about myopia prevention and control remains outdated and deficient.The administrative department should implement efficacious and adaptable measures to enhance parental awareness and foster their commitment towards myopia prevention and control.
文摘Currently, the number of myopic people in China has reached as high as 600 million, and it shows a trend of “early onset, high incidence, and a high degree of severity”. The issue of myopia among children and adolescents has attracted widespread attention from all sectors of society. Comprehensive myopia prevention and control efforts have been launched nationwide. Popular science education, vision screening, and improving visual environments are effective measures for preventing myopia. However, among the target audience for comprehensive myopia prevention and control, the preschool children group has been neglected, and the work of myopia prevention and control for this group has been significantly weakened and marginalized. Due to insufficient awareness of prevention and control, the hyperopia reserve in the preschool children group is being continuously depleted, leading to the early onset of myopia. In light of this situation, the focus of myopia prevention and control needs to shift forward, and it is worth exploring and pondering how college students with a background in optometry can develop entertaining and engaging popular science education materials and methods.
文摘Objective: to analyze the effect of visual training in the prevention and control of juvenile myopia. Methods: 100 cases of juvenile myopia treated in our hospital from December 2017 to December 2018 were divided into reference group and experimental group by lot, with 50 cases in each group. The reference group received medical optometry according to the reference requirements, and the experimental group received visual training on the basis of the reference group. The changes of ocular axis length of the two groups after the intervention and the adjustment lag of the two groups before and after the intervention were compared. Results: the length of ocular axis in the experimental group was lower than that in the reference group, and the comparison between the groups had statistical value (P < 0.05);In the comparison of adjustment lag, there was no difference between the two groups before intervention (P > 0.05);After the intervention, the experimental group was lower than the reference group, and there was significant difference between the groups (P < 0.05). Conclusion: in order to reduce juvenile myopia, visual training can delay the growth of ocular axis length, reduce the amount of adjustment lag and myopia, which is conducive to the healthy growth of adolescents.
文摘Objective: to analyze the role of orthokeratology lens (OK lens) in the prevention and control of myopia in adolescents. Methods: a total of 50 adolescent myopic patients who came to our hospital for myopic consultation and treatment from January 2018 to December 2020 were selected, and they were divided into two groups with 25 cases in each group according to their treatment intention and glasses wearing mode. The myopia patients in the frame group were treated with ordinary frame glasses, and the OK lens group was monitored by AL measurement. The visual acuity, intraocular pressure, AL monitoring and HHK were compared between the two groups before and after treatment. Results: there were no significant changes in visual acuity, intraocular pressure, AL monitoring and HHK between the two groups before treatment (P > 0.05), but there were no significant changes in visual acuity, intraocular pressure, AL monitoring and HHK between the two groups after treatment (P > 0.05). However, the visual acuity, intraocular pressure and HHK of OK mirror group were higher than those before treatment, P < 0.05. AL had no significant change, P > 0.05. Conclusion: AL measuring and monitoring OK lens has better effect on prevention and treatment of myopia than conventional glasses, which is worthy of recommendation for adolescent myopia patients who come to our hospital for consultation and treatment of myopia.
文摘Various studies have suggested several environmental,pharmacological,medical,and optical interventions and some are in use but their efficacy in myopia control may be transient,and the cellular,molecular,and biochemical mechanisms involved unclear.Daylight exposure is currently regarded as an effective and enduring strategy in the control of myopia development and progression.However,the mechanism behind the effect of outdoor exposure and its association with genetic predisposition and other relatively more significant environmental factors on myopia is still a conundrum.This review focuses on survey-based and intervention-based studies carried out to propose a mechanism that accounts for myopia development and important for its control.
