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 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
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
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
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.
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.
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.
