Effectivity and safety of trifocal intraocular lenses and capsular tension rings implantation for cataract patients with axial high myopia

●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical trial was conducted.Totally 98 eyes(74 patients)who underwent femtosecond laser-assisted cataract surgery(FLACS)with trifocal IOLs were enrolled in the study and followed up for 2y after surgery:46 eyes(33 patients)with capsular tension ring implantation in the long axial lengths(AL)group(26<AL<29 mm)and 52 eyes(41 patients)in the normal AL group(22<AL<24.5 mm).Postoperative outcomes about effectivity and safety,including the subjective and objective visual quality,and postoperative complications were assessed.●RESULTS:Uncorrected distance visual acuity at 5 m and uncorrected intermediate visual acuity at 60 and 80 cm in the long AL group were significantly worse than those in the normal AL group at 3mo postoperatively(P<0.05).The differences in reading speed,spectacle independence and potential visual complaints between the two groups were not statistically significant(P>0.05).The dysfunctional lens index and total modulation transfer function(MTF)average height were similar between the two groups.The postoperative internal coma aberrations in the axial high myopia eyes were significantly higher than that in the normal AL group(P<0.05).The total satisfaction score in the long AL group(91.32±2.76)was slightly higher than that in the normal AL group(90.36±3.47),but there was no difference(P=0.136).A statistically negative correlation was found between corrected distance visual acuity(CDVA)and dysfunctional lens index(r=-0.382,P=0.009),and between CDVA and the total MTF average height(r=-0.374,P=0.01).But there was no significant correlation between CDVA and total satisfaction score(r=0.059,P=0.696).Postoperative complications mainly presented as posterior capsular opacity(PCO),retinal detachment and cystoid macular edema.There was no difference in the incidence of fundus disease(6.5%vs 3.8%,P=0.663)or PCO(17.4%vs 7.7%,P=0.217)between the two groups at two years.●CONCLUSION:The utilization of trifocal IOL and capsular tension ring implantation is beneficial for cataract patients with axial high myopia undergoing FLACS.This approach not only ensures excellent subjective feelings and objective visual quality,but also does not increase the incidence of postoperative complications.

Early changes in corneal densitometry after FS-LASIK combined with accelerated corneal cross-linking for correction of high myopia

AIM:To observe the effects of femtosecond laserassisted excimer laser in situ keratomileusis combined with accelerated corneal cross-linking(FS-LASIK Xtra)on corneal densitometry after correcting for high myopia.METHODS:In this prospectively study,130 patients underwent FS-LASIK or FS-LASIK Xtra for high myopia.Their right eyes were selected for inclusion in the study,of which 65 cases of 65 eyes in the FS-LASIK group,65 patients with 65 eyes in the FS-LASIK Xtra group.Patients were evaluated for corneal densitometry at 1,3,and 6mo postoperatively using Pentacam Scheimpflug imaging.RESULTS:Preoperative differences in corneal densitometry between the FS-LASIK and FS-LASIK Xtra groups in different ranges were not statistically significant(P>0.05).Layer-by-layer analysis revealed statistically significant differences in the anterior(120μm),central,and total layer corneal densitometry between the FS-LASIK and FS-LASIK Xtra groups at 1 and 3mo postoperatively(all P<0.05),the FS-LASIK Xtra group is higher than that of the FS-LASIK group.Analysis of different diameter ranges showed statistically significant differences between the FS-LASIK group and the FS-LASIK Xtra group at 1mo postoperatively in the ranges of 0–2,2–6,and 6–10 mm(both P<0.05);At 3mo postoperatively,the FS-LASIK Xtra group is higher than that of the FS-LASIK group in the ranges of 0–2 and 2–6 mm(P<0.05).At 6mo postoperatively,there were no statistically significant differences in corneal densitometry between the FS-LASIK group and the FS-LASIK Xtra group in different diameter ranges(all P>0.05).CONCLUSION:There is an increase in internal corneal densitometry during the early postoperative period after FS-LASIK Xtra for correction of high myopia.However,the densitometry values decreased to the level of conventional FS-LASIK at 6mo after surgery,with the most significant changes observed in the superficial central zone.

Clinical Effect Analysis of Posterior Chamber Intraocular Lens Implantation for Correcting High Myopia and Astigmatism

Objective:To explore the corrective effect of posterior chamber intraocular lens implantation with phakic eyes in the treatment of high myopia and astigmatism.Methods:From May 2023,the hospital began to collect the case data of diagnosis and treatment of high myopia and astigmatism.By May 2024,310 cases were included,all of which were treated with posterior chamber intraocular lens implantation.The visual acuity,astigmatism and axial position of the intraocular lens were observed before and after treatment.Results:At different time points after the operation,the patient’s vision was significantly improved compared with that before the operation(P<0.05),and the vision level was equal to or greater than the best-corrected vision before the operation.At different time points after the operation,the average rotation of the intraocular lens was less than 5 degrees.Astigmatism was significantly lower than that before the operation(P<0.05).After the operation,the intraocular pressure increased in 11 cases,accounting for 3.55%,with no adverse complications such as lens turbidity,glare and obvious halo occurring.Conclusion:The posterior chamber intraocular lens implantation with phakic eyes has an ideal correction effect in the treatment of high myopia and astigmatism,which can effectively improve the vision level of patients and reduce the degree of astigmatism,and has high effectiveness and safety.

Time trends in myopia and high myopia prevalence in young university adults in China

AIM:To investigate time trends in myopia and high myopia prevalence over 6y among young university adults in China.METHODS:This is a 6-year series cross-sectional study from 2016 to 2021.Totally 4910 freshmen were enrolled and completed a questionnaire concerning age,gender,and disease history.Students with eye diseases were excluded after a detailed eye examination.The refractive status was measured by non-cycloplegic objective refraction and ocular parameters were measured by Lenstar 900.The examination followed the same protocol each year.Trends over time in myopia and high myopia prevalence,as well as ocular biometry parameters,were analyzed.RESULTS:From 2016 to 2021,the axial length(AL)and corneal radius(CR)increased significantly(P=0.002 for AL;P=0.04 for CR).However,the spherical equivalent(SE)and the ratio of axial length to the corneal radius(AL/CR)did not change significantly(P=0.59 for SE;P=0.24 for AL/CR).The frequency of AL≥26.0 mm increased from 26.6%in 2016 to 29.3%in 2021(P=0.05 for trend).The prevalence of myopia and high myopia did not change significantly in our study(P≥0.18).Compared to a similar cross-sectional study conducted 10 years ago,the prevalence of myopia decreased significantly(94.9%vs 91.8%,P<0.001).Whereas the prevalence of high myopia increased largely(18.12%vs 27.6%,P<0.001).CONCLUSION:The prevalence of high myopia increases in young university adults during 10y period.Myopia control should begin earlier in childhood.However,these interventions are still needed for high myopia even in young adulthood.

Effects of endogenous dopamine induced by low concentration atropine eye drops on choroidal neovascularization in high myopia mice

AIM:To evaluate effects of endogenous dopamine induced by low concentration atropine eye drops on choroidal neovascularization(CNV)in high myopia mice.METHODS:The C57BL/6J mice were deprived of the right eye for 4wk,and the high myopia was diagnosed by optometry,the diopter was less than-6.00 D,and CNV was induced by 532 nm laser.The changes of dopamine D1 receptor(DRD1),dopamine D2 receptor(DRD2),and vascular endothelial growth factor A(VEGFA)were detected by Western blot technology at 0.5,1,2h,and 7d after 0.01%,0.05%,and 0.1%atropine eye drops,respectively,the area of CNV was measured.RESULTS:Significant increases were observed on the expression of DRD2 in mouse high myopia model at 0.5,1,2h,7d with 0.05%and 0.1%atropine eye drops(P<0.05).Significant decreases were observed on the expression of DRD1 and VEGFA in mouse high myopia model at 0.5,1,2h,7d with 0.05%and 0.1%atropine eye drops(P<0.05).The area of CNV induced by laser in the drug-treated group was significantly smaller than that in the control group,and the higher the concentration,the more significant the inhibitory effect(P<0.05).CONCLUSION:The 0.01%,0.05%,0.1%atropine eye drops can decrease the level of VEGFA and inhibit high myopia CNV indirectly by up-regulating the level of DRD2 and down-regulating the level of DRD1,and the effect of 0.05%and 0.1%atropine eye drops is more significant.

Changes of optic nerve head microcirculation in high myopia

AIM:To analyze the correlation of age,spherical equivalent(SE),and axial length(AL)with the microcirculation of optic nerve head(ONH)in high myopia(HM).METHODS:In this cross-sectional clinical study,164 right eyes were included.Optical coherence tomography angiography(OCTA)was used to detect ONH vessel density.Eyes were classified based on age,SE,and AL.Groups of Age1,Age2,and Age3 were denoted for age classification(Age1<20y,20y≤Age2<30y,Age3≥30y);Groups SE1,SE2,and SE3 for the SE classification(-9≤SE1<-6 D,-12≤SE2<-9 D,SE3<-12 D);Groups AL1,AL2,AL3,and AL4 for the AL classification(AL1<26 mm,26≤AL2<27 mm,27≤AL3<28 mm,AL4≥28 mm).RESULTS:No significant difference was observed in vessel density among the Age1,Age2,and Age3 groups(all P>0.05)and the SE1,SE2,and SE3 groups(all P>0.05).No significant difference was observed in the intrapapillary vascular density(IVD)among AL1,AL2,AL3,and AL4 groups(P>0.05).However,a significant decrease was found in the peripapillary vascular density(PVD)in the AL1,AL2,AL3,and AL4 groups(F=3.605,P=0.015),especially in the inferotemporal(IT;F=6.25,P<0.001),temporoinferior(TI;F=2.865,P=0.038),and temporosuperior(TS;F=6.812,P<0.001)sectors.The IVD was correlated with age(r=-0.190,P<0.05)but not with SE or AL(P>0.05).The PVD was correlated with AL(r=-0.236,P<0.01)but not with age or SE(P>0.05).CONCLUSION:With the increase of AL,the IVD remains stable while the PVD decreases,especially in the three directions of temporal(IT,TI,and TS).The main cause of microcirculation reduction may be related to AL elongation rather than an increase in age or SE.

Quality of life and depression among patients with high myopia in Nigeria:a cross sectional study

AIM:To evaluate the quality of life(QOL)and level of depression among participants with high myopia in Nigeria and the demographic factors associated with these outcomes.METHODS:This cross-sectional study was conducted on 100 adult participants with high myopia(defined as refractive error≤-5.00 D or worse,and uncorrected visual acuity worse than 6/18 in the better seeing eye)attending ophthalmology centres in Nigeria from 2 October 2021 to 30 August 2022.The means and standard deviations were calculated for each of the four domains of World Health Organization Quality of life scale(WHOQOL-BREF)using the transformed scores.The Beck Depression Inventory(BDI)scale was used to assess the level of depression.RESULTS:The highest and the lowest mean scores of WHOQOL-BREF domains were found for the psychological and physical health domains(mean percentage scores were 67.0[95% confidence intervals(CI)64.1-68.9]and 55.3(95%CI 51.8-58.8,P<0.001),respectively.One-way analysis of variance(ANOVA)revealed significant differences in physical health with educational status(higher among those with tertiary education:mean difference 0.9,95%CI-0.2-2.1;P=0.049),differences in psychological health with working status(higher among those who were working 1.2,95%CI 0.3-2.1;P=0.012).Also,the result showed a statistically significant association between environmental health and marital status(higher among non-married:1.7,95%CI-0.9-2.3;P=0.012)while overall health was associated with place of residence(higher in urban areas:2.3,95%CI 1.2-3.5;P=0.024).For depression,one in every nine participants reported major depressive symptom,mostly younger people(aged 16-29 vs 30-49y:17.0%vs 0,P=0.019),and slightly more women than men(14.3%vs 0,P=0.064).There were significant negative correlations between the depression scores and psychological health(r=-0.48,P<0.001),physical health(r=-0.29,P=0.002),social and relationship(r=-0.49,P<0.001),environmental(r=-0.48,P<0.001)and overall health(r=-0.49,P<0.001)CONCLUSION:People with high myopia have a relatively moderate QOL,but poor physical health,particularly the younger age group,and women who are more likely to experience clinically relevant depression.Eye care professionals should consider possible referrals for counselling for people with high myopia.

Value of optical coherence tomography measurement of macular thickness and optic disc parameters for glaucoma screening in patients with high myopia

BACKGROUND The basic method of glaucoma diagnosis is visual field examination,however,in patients with high myopia,the diagnosis of glaucoma is difficult.AIM To explore the value of optical coherence tomography(OCT)for measuring optic disc parameters and macular thickness as a screening tool for glaucoma in patients with high myopia.METHODS Visual values(contrast sensitivity,color vision,and best-corrected visual acuity)in three groups,patients with high myopia in Group A,patients with high myopia and glaucoma in Group B,and patients with high myopia suspicious for glaucoma in Group C,were compared.Optic disc parameters,retinal nerve fiber layer(RNFL)thickness,and ganglion cell layer(GCC)thickness were measured using OCT technology and used to compare the peri-optic disc vascular density of the patients and generate receiver operator characteristic(ROC)test performance curves of the RNFL and GCC for high myopia and glaucoma.RESULTS Of a total of 98 patients admitted to our hospital from May 2018 to March 2022,totaling 196 eyes in the study,30 patients with 60 eyes were included in Group A,33 patients with 66 eyes were included in Group B,and 35 patients with 70 eyes were included in Group C.Data were processed for Groups A and B to analyze the efficacy of RNFL and GCC measures in distinguishing high myopia from high myopia with glaucoma.The area under the ROC curve was greater than 0.7,indicating an acceptable diagnostic value.CONCLUSION The value of OCT measurement of RNFL and GCC thickness in diagnosing glaucoma in patients with high myopia and suspected glaucoma is worthy of development for clinical use.

Evolution and trends of high myopia research from 2002 to 2021: a scientometric analysis

Background:Research on high myopia has gradually formed a complex network of knowledge,but a panorama of evolutionary trends is lacking.By conducting a scientometric analysis,we can gain a deeper understanding of the development and evolution of this field.Methods:The global literature on high myopia published from 2002 to 2021 was extracted from the Science Citation Index Expanded in the Web of Science Core Collection.Microsoft Excel,VOSviewer,and CiteSpace were used to analyse and visualize the bibliometric data.Publication-related information,including countries,journals,authors,citations,subject categories,and its’time trends,was analysed.Results:A total of 4,226 included publications showed an annually increasing trend during the past 20 years.The high myopia research hotspots were refractive error correction,epidemiology,ocular biometry,drug and laser treatment of myopic fundus lesions,and surgical treatment of myopic fundus lesions.Cocitation analysis showed that high myopia genetics and myopic fundus lesion research were the research frontiers.A total of 116 disciplines were involved in high myopia research.Ophthalmology(n=3,338)was the most dominant subject category.Engineering(betweenness centrality=0.65)was the discipline with the most obvious bridge role.Science&technology—other topics(burst years:2015–2021;strength=14.88)had the greatest strength as of 2021,which was the hottest subject category.Conclusions:High myopia genetics and myopic fundus lesion research showed a potential for breakthroughs.Medical-engineering cross-innovation is a cutting-edge technology trend.

Trends in research related to high myopia from 2010 to 2019:a bibliometric and knowledge mapping analysis

AIM:To evaluate the global trends in and explore hotspots of high myopia(HM)research.METHODS:This bibliometric analysis was used to reveal the publication trends in HM research field based on the Web of Science Core Collection(WoSCC).VOSviewer version 1.6.13 software was used to analyze the data and construct a knowledge map including the yearly publication number,journals,countries,international collaborations,authors,research hotspots,and intellectual base in HM.RESULTS:The search engine found 3544 peer-reviewed publications on HM between 2010 and 2019,and the yearly research output substantially elevated over the past decade.China is the top publishing country,and Sun Yatsen University was the most active academic institution.Jonas JB is the top publishing scientist,and Investigative Ophthalmology and Visual Science(IOVS)was the most productive journal.The highest cited references mainly focused on epidemiology and management.The keywords formed 6 clusters:1)refractive surgery;2)etiology and clinical characteristics;3)the mechanism of eye growth;4)management for myopic maculopathy;5)vitrectomy surgical treatment;6)myopia-associated glaucoma-like optic neuropathy.CONCLUSION:The evaluation of development trends based on the data extracted from WoSCC can provide valuable information and guidance for ophthalmologists and public health researchers to improve management procedures in HM field.

Single-step transepithelial photorefractive keratectomy in high myopia：qualitative and quantitative visual functions

AIM：To investigate quantitative and qualitative optical outcomes of single-step transepithelial photorefractive keratectomy（Trans PRK）in high myopia.METHODS：In a prospective interventional case-series,30 eyes with high myopia（-6.00 to-8.75 D）with（up to-3.00 D）or without astigmatism were enrolled from Bina Eye Hospital,Tehran,Iran. One-step Trans PRK was performed with aberration-free aspherical optimized profile and SCHWIND AMARIS 500 laser. One-year follow-up results for refraction,visual acuities,vector analysis,ocular wavefront（OWF）and corneal wave-front（CWF）higher order aberrations（HOA）,contrast sensitivity（CS）,and postoperative haze were assessed.RESULTS：After the surgery,both photopic and mesopic CSs significantly improved（both P〈0.001）. We detected significant induction of OWF coma and trefoil（P〈0.001 for both）HOAs; CWF coma（P=0.002）,spherical（P〈0.001）,and tetrafoil（P=0.003）HOAs in 6 mm analysis diameter; and CWF trefoil（P=0.04）HOA in 4 mm analysis diameter. The range of mean induction observed for various HOAs was0.005-0.11 μm. The 86.7% of eyes reached an uncorrected distance visual acuity of 20/20 or better; 96.7% of eyes were within ±0.5 D of targeted spherical refraction. In vector analysis,mean correction index value was 1.03 and mean index of success was 0.22. By 12mo after the operation,no eye lost any number of corrected distancevisual acuity lines. We detected no corneal haze greater than 1~＋ throughout the follow-up.CONCLUSION：Our findings show promising effects of single-step Trans PRK on quality of vision in high myopic eyes. It also improves refraction and visual acuity.

Diagnostic capability of peripapillary retinal nerve fiber layer parameters in time-domain versus spectral-domain optical coherence tomography for assessing glaucoma in high myopia

AIM： To evaluate and compare the diagnostic capabilities of peripapillary retinal nerve fiber layer（p-RNFL） parameters of Spectralis optical coherence tomography（OCT） versus Stratus OCT to detect glaucoma in patients with high myopia. METHODS： This is a retrospective, cross-sectional study. Sixty highly myopic eyes of 60 patients were enrolled, with 30 eyes in the glaucoma group and 30 eyes in the control group. All eyes received peripapillary imaging of the optic disc using Stratus and Spectralis OCT. Areas under the receiver operating characteristic curve（AUROC） and the sensitivity at specificity of 〉80% and 〉95% for p-RNFL parameters obtained using the two devices to diagnose glaucoma were analysed and compared. RESULTS： In Spectralis OCT, p-RNFL thickness parameters with the largest AUROC were the temporal-inferior sector（0.974） and the inferior quadrant（0.951）, whereas in Stratus OCT, the best parameters were the 7-o＇clock sector（0.918） and the inferior quadrant（0.918）. Compared to the Stratus OCT parameters, the Spectralis OCT parameters demonstrated generally higher AUROC; however, the difference was not statistically significant. CONCLUSION： The best p-RNFL parameters for diagnosing glaucoma in patients with high myopia were the temporal-inferior sector on Spectralis OCT and the 7-o＇clock sector on Stratus OCT. There were no significant differences between the AUROCs for Spectralis OCT and Stratus OCT, which suggest that the glaucoma diagnostic capabilities of these two devices in patients with high myopia are similar.

Association of COL1A1 polymorphism with high myopia: a Meta-analysis

AIM： To investigate the association between collagen type I alpha 1（COL1A1） gene and high myopia.· METHODS： In this Meta-analysis, we examined 5published case-control studies that involved 1942 high myopia cases and 2929 healthy controls to assess the association between the COL1A1 rs2075555 polymorphism and high myopia risk. We calculated the pooled odds ratios（ORs） of COL1A1 rs2075555 polymorphism in high myopia cases vs healthy controls to evaluate the strength of the association.·RESULTS： Overall, there was no significant difference both in the genotype and allele distributions of COL1A1rs2075555 polymorphism between high myopia cases and healthy controls： CC vs AA OR =1.10, 95% confidence interval（CI）=0.76-1.58; AC vs AA OR=0.98, 95%CI 0.80-1.20; CC/AC vs AA/OR=1.01, 95%CI 0.84-1.22; CC vs AC/AA OR =1.06, 95% CI =0.93-1.20; C vs A OR =1.06, 95% CI0.91-1.23）. In addition, in the stratified analyses by ethnicity, no significant associations were found in any genetic model both in European and Asia cohorts.·CONCLUSION： Our results indicate that the COL1A1rs2075555 polymorphism may not affect susceptibility to high myopia.

CHARACTERISTICS OF MULTIFOCAL ELECTRORETINOGRAM IN THE FELLOW EYES OF PATIENTS WITH HIGH MYOPIA WITH RETINAL DETACHMENT

Objective To observe the changes on multifocal electroretinography （MfERG） in the fellow eyes of patients with high myopia without fundus lesions and rhegmatogenous retinal detachment （RRD）. Methods MfERG was performed in 66 patients （ 66 eyes） which were grouped into ： emmetropes （ n = 22 ） as the control eye ; high myopes without fundus lesions （ corrected visual acuity ≥ 1. 0, n = 15 ） ; and fellow eyes of high myopics with RRD （n = 29 ）. The first-order kernels N1, P1, N2 response density and latency were analyzed. Results When compared with the emmetropes group, the high myopes group had significantly reduced N1 , PI , and N2 wave response densities in rings 1 to 6 （ P 〈 0. 05 ）, delayed N1 wave latency in rings 3 to 6, and P1 wave latency in rings 3 to 5 （ P 〈 0. 05 ）. The fellow eyes group had significantly reduced N1, P1, and N2 wave response densities in rings 1 to 6 and significantly delayed N1 and P1 wave latencies in rings 3 to 6 （ P 〈0. 05） compared with the emmetropes group. Compared with the high myopes group, P1 wave response densities in rings 1 to 6, N1 wave response densities in rings 1,3, 4, and 6, and N2 wave response density in ring 1 were significantly decreased in the fellow eyes group （ P 〈 0. 05 ） ; whereas there were no significant differences in latencies between the two groups （P 〉0.05）. Conclusion MfERG can sensitively assess the early changes in visual function in fellow eyes in patients with RRD.

Long-term vision-threatening complications of phakic intraocular lens implantation for high myopia

AIMTo report the long-term vision-threatening complications in patients who underwent phakic intraocular lens (pIOLs) implantation for high myopia.

Comparison of OA-2000 and IOL Master 500 using in cataract patients with high myopia

This study was designed to compare optical biometry measurements and predicted refraction in cataract patients with high myopia [axial length(AL) ≥26 mm] using OA-2000 and IOL Master 500. Ocular biometry measurements were performed using both biometers before surgery. Uneventful cataract surgery was performed in all patients. Postoperative manifest refraction was obtained 3 wk after surgery or later. A total of 67 eyes were examined. The AL, keratometry(K), and anterior chamber depth(ACD) of the two biometers showed excellent agreement. Predicted errors were similar and a strong positive correlation was observed(r=0.909). Out of 21 eyes(31.34%) with unsuccessful AL readings using the IOL Master 500, 20 eyes of them could be measured using OA-2000. Therefore, the biometric parameters measured by the two biometers showed good agreement. However, OA-2000 had a lower AL measurement failure rate.

Diagnostic ability of ganglion cell complex thickness to detect glaucoma in high myopia eyes by Fourier domain optical coherence tomography

AIM：To evaluate the ability of macular ganglion cell complex（GCC） thickness using Fourier domain optical coherence tomography（FD-OCT） to detect glaucoma in highly myopic eyes.METHODS：Cross-sectional study.A total of 114 participants,consecutively were enrolled.Macular GCC thickness and peripapillary retinal nerve fiber layer（RNFL） thickness were obtained with RTVue FD-OCT.Receiver operating characteristics curves were constructed for each measurement parameter,and areas under the curves（AUCs） were compared.RESULTS：Both the average GCC and average RNFL thickness showed negative correlations with axial length（rGCC=-0.404,P=0.001;rRNFL=-0.561,P〈0.001）.The largest AUCs from GCC,and RNFL parameters were 0.968 [global loss volume（GLV）],and 0.855（average RNFL）,respectively.GLV was significantly better for detecting high myopic glaucoma than average RNFL（P〈0.001）.CONCLUSION：Macular GCC thickness has higher diagnostic power than peripapillary RNFL thickness to discriminate glaucoma patients from non-glaucoma subjects in high myopia.

Comparison axial length measurements from three biometric instruments in high myopia

AIM： To compare the axial lengths （ALs） measured with Lenstar, IOLMaster and A-scan contact ultrasound （Ultrasound） in normal and high myopia （HM）. METHODS： Eighty-four normal eyes and 49 HM eyes were included. Three consecutive measurements were performed on each eye in the following order： Lenstar, IOLMaster, and Ultrasound. The repeatabilities of the AL measurements for each instrument were assessed by calculating the pooled coefficients of variation （CVs） of 18 eyes in each group. Comparisons between the HM and normal groups were made with independent sample t-tests. The inter-device agreements were evaluated with Bland-Altman analyses and paired two-tailed t-tests. RESULTS： For normal group, the CVs of the AL measurements taken with the Lenstar, IOLMaster and Ultrasound were 0.001%, 0.01% and 0.14%, respectively. The corresponding CVs for the HM group were 0.005%, 0.02% and 0.15%, respectively. There was significant difference between the Lenstar and the IOLMaster in normal group （P=0.031） but not in HM group （n=0.100）. In the two groups, the Lenstar and the IOLMaster produced higher values than did the Ultrasound （all P〈 0.001）. All three instruments exhibited good agreement in terms of AL values. For the intraocular lens （IOL） power calculation using SRK II formula, the Lenstar and the IOLMaster showed 0.5 D higher than Ultrasound in both groups （all P〈0.001）. No significant difference existed between the Lenstar and the IOLMaster for the IOL power calculation in both normal （n=0.474） and HM group （P= 0.103）. CONCLUSION： The three devices exhibited excellent intra-visit repeatabilities in the AL measurements. The AL and IOL power difference between partial coherence interferometry and ultrasound instruments should be noticed.

The association of lumican polymorphisms and high myopia in a Southern Chinese population

AIM：To investigate the correlation between lumican（LUM）gene and high myopia in a Southern Chinese population.METHODS：The study comprised of 95 high myopia patients with a spherical equivalent≤-6.5 diopters（D）.The control group recruited 95 individuals with a spherical equivalent ranging from-0.5 D to＋0.5 D.Direct sequencing was used to detect the single nucleotide polymorphisms（SNPs）of LUM gene in coding region.Genotype distributions were tested for Hardy-Weinberg disequilibrium.Genotypic and allelic frequencies were analyzed through Chi-square test or Fisher’s exact test.RESULTS：We identified 3 SNPs of the LUM gene：LUM c.32（rs577456426）,LUM c.507（rs17853500）and LUM c.849（rs181915277）.Among the three SNPs,the genotype and allele frequencies of rs17853500 showed a significant difference between patients and control subjects（P〈0.05）.However,there were no significant differences in rs181915277and rs577456426 between the two groups（P〉0.05）.CONCLUSION：LUM c.507 polymorphism may be a risk factor for the pathogenesis of high myopia in the Southern Chinese population.

Association between lumican gene-1554 T/C polymorphism and high myopia in Asian population:a meta-analysis

AIMTo investigate the association between lumican gene -1554 T/C polymorphism and high myopia susceptibility.