Topographical Evaluation of the Decentration of Orthokeratology Lenses

Purpose: To evaluate the amount of lens decentration and various factors affecting decentration after orthokeratology lens wear and to observe the effect of decentration on the visual functions.Methods: Two kinds of orthokeratology lenses were fitted to 270 eyes of 135 patients [initial mean refractive error: (-3.98±1.51)D]. Humphery Instruments ATLAS 990 was used for the computer-assisted analysis of corneal topographical maps. The examination of corneal topography was performed on patients before and after 6 months of wearing orthokeratology lenses. The amount of decentration of orthokeratology lenses was measured by finding the distance between center of optic zone and the pupil center. The factors influencing the amount of decentration were analyzed, including the initial refraction error, astigmatism, keratometry values, corneal eccentricity, and the diameter of lens.Visual symptoms including monocular diplopia, glare around lights were recorded to evaluate the effects of decentration on visual functions.Results: The mean amount of decentration was (0.49±0.34) mm after one night's wear.The mean amount of decentration after 1 month, 3 months and 6 months was (0.57±0.41) mm, (0.55±0.48) mm and (0.59±0.39) mm, respectively. After one month, the amount of decentration was less than 0.50 mm in 51.1% eyes, 0.50～1.0 mm in 35.6% eyes and more than 1.00 mm in 13.3% eyes. The direction of decentration of more than 0.50 mm was mainly in the temporal quadrant (48.5%). Patients with greater initial astigmatism and smaller lenses showed greater decentration (P＜0.05). There was no statistically significant difference in decentration between the two groups with different corneal eccentricities and keratometry values (P＞0.05). The amount of decentration was greater in patients who complained of monocular diplopia and glare.Conclusions: The amount of decentration of orthokeratology depends on the initial refractive error, astigmatism and the design of orthokeratology lenses. Improvement in fitting technology and lens design can lead to reduced incidence of decentration and visual symptoms.

Intravitreal brimonidine inhibits formdeprivation myopia in guinea pigs

Background:The use of ocular hypotensive drugs has been reported to attenuate myopia progression.This study explores whether brimonidine can slow myopia progression in the guinea pig form-deprivation(FD)model.Methods:Three-week-old pigmented male guinea pigs(Cavia porcellus)underwent monocular FD and were treated with 3 different methods of brimonidine administration(eye drops,subconjunctival or intravitreal injections).Four different concentrations of brimonidine were tested for intravitreal injection(2μg/μL,4μg/μL,20μg/μL,40μg/μL).All treatments continued for a period of 21 days.Tonometry,retinoscopy,and A-scan ultrasonography were used to monitor intraocular pressure(IOP),refractive error and axial length(AL),respectively.On day 21,guinea pigs were sacrificed for RNA sequencing(RNA-seq)to screen for associated transcriptomic changes.Results:The myopia model was successfully established in FD animals(control eye vs.FD eye,respectively:refraction at day 20,0.97±0.18 D vs.−0.13±0.38 D,F=6.921,P=0.02;AL difference between day 0 and day 21,0.29±0.04mm vs.0.45±0.03 mm,F=11.655,P=0.004).Among the 3 different brimonidine administration methods,intravitreal injection was the most effective in slowing myopia progression,and 4μg/μL was the most effective among the four different concentrations of brimonidine intravitreal injection tested.The AL and the refraction of the brimonidine intravitreal injection group was significantly shorter or more hyperopic than those of other 2 groups.Fourμg/μL produced the smallest difference in AL and spherical equivalent difference values.FD treatment significantly increased the IOP.IOP was significantly lower at 1 day after intravitreal injections which was the lowest in FD eye of intravitreal injection of brimonidine.At day 21,gene expression analyses using RNA-seq showed upregulation of Col1a1 and Mmp2 expression levels by intravitreal brimonidine.Conclusions:Among the 3 different administration methods,intravitreal injection of brimonidine was the most effective in slowing myopia progression in the FD guinea pig model.Intravitreal brimonidine at 4μg/μL significantly reduced the development of FD myopia in guinea pigs.Expression levels of the Col1a1 and Mmp2 genes were significantly increased in the retinal tissues of the FD-Inj-Br group.

Intravitreal brimonidine inhibits formdeprivation myopia in guinea pigs

Background:The use of ocular hypotensive drugs has been reported to attenuate myopia progression.This study explores whether brimonidine can slow myopia progression in the guinea pig form-deprivation(FD)model.Methods:Three-week-old pigmented male guinea pigs(Cavia porcellus)underwent monocular FD and were treated with 3 different methods of brimonidine administration(eye drops,subconjunctival or intravitreal injections).Four different concentrations of brimonidine were tested for intravitreal injection(2μg/μL,4μg/μL,20μg/μL,40μg/μL).All treatments continued for a period of 21 days.Tonometry,retinoscopy,and A-scan ultrasonography were used to monitor intraocular pressure(IOP),refractive error and axial length(AL),respectively.On day 21,guinea pigs were sacrificed for RNA sequencing(RNA-seq)to screen for associated transcriptomic changes.Results:The myopia model was successfully established in FD animals(control eye vs.FD eye,respectively:refraction at day 20,0.97±0.18 D vs.−0.13±0.38 D,F=6.921,P=0.02;AL difference between day 0 and day 21,0.29±0.04mm vs.0.45±0.03 mm,F=11.655,P=0.004).Among the 3 different brimonidine administration methods,intravitreal injection was the most effective in slowing myopia progression,and 4μg/μL was the most effective among the four different concentrations of brimonidine intravitreal injection tested.The AL and the refraction of the brimonidine intravitreal injection group was significantly shorter or more hyperopic than those of other 2 groups.Fourμg/μL produced the smallest difference in AL and spherical equivalent difference values.FD treatment significantly increased the IOP.IOP was significantly lower at 1 day after intravitreal injections which was the lowest in FD eye of intravitreal injection of brimonidine.At day 21,gene expression analyses using RNA-seq showed upregulation of Col1a1 and Mmp2 expression levels by intravitreal brimonidine.Conclusions:Among the 3 different administration methods,intravitreal injection of brimonidine was the most effective in slowing myopia progression in the FD guinea pig model.Intravitreal brimonidine at 4μg/μL significantly reduced the development of FD myopia in guinea pigs.Expression levels of the Col1a1 and Mmp2 genes were significantly increased in the retinal tissues of the FD-Inj-Br group.