Novel application of multispectral refraction topography in the observation of myopic control effect by orthokeratology lens in adolescents

BACKGROUND Myopia,as one of the common ocular diseases,often occurs in adolescence.In addition to the harm from itself,it may also lead to serious complications.Thus,prevention and control of myopia are attracting more and more attention.Previous research revealed that single-focal glasses and orthokeratology lenses(OK lenses)played an important part in slowing down myopia and preventing high myopia.AIM To compare the clinical effects of OK lenses and frame glasses against the increase of diopter in adolescent myopia and further explore the mechanism of the OK lens.METHODS Changes in diopter and axial length were collected among 70 adolescent myopia patients(124 eyes)wearing OK lenses for 1 year(group A)and 59 adolescent myopia patients(113 eyes)wearing frame glasses(group B).Refractive states of their retina were inspected through multispectral refraction topography.The obtained hyperopic defocus was analyzed for the mechanism of OK lenses on slowing down the increase of myopic diopter by delaying the increase of ocular axis length and reducing the near hyperopia defocus.RESULTS Teenagers in groups A and B were divided into low myopia(0 D--3.00 D)and moderate myopia(-3.25 D--6.00 D),without statistical differences among gender and age.After 1-year treatment,the increase of diopter and axis length and changes of retinal hyperopic defocus amount of group A were significantly less than those of group B.According to the multiple linear analysis,the retinal defocus in the upper,lower,nasal,and temporal directions had almost the same effect on the total defocus.The amount of peripheral retinal defocus(15°-53°)in group A was significantly lower than that in group B.CONCLUSION Multispectral refraction topography is progressive and instructive in clinical prevention and control of myopia.

Relative peripheral refraction in school children with different refractive errors using a novel multispectral refraction topographer

AIM:To compare relative peripheral refraction(RPR)in Chinese school children with different refractive errors using multispectral refraction topography(MRT).METHODS:A total of 713 eyes of primary school children[172 emmetropia(E),429 low myopia(LM),80 moderate myopia(MM),and 32 low hypermetropia(LH)]aged 10 to 13y were analyzed.RPRs were measured using MRT without mydriasis.MRT results showed RPR at 0-15°(RPR 0-15),15°-30°(RPR 15-30),and 30°-45°(RPR 30-45)annular in the inferior(RPR-I),superior(RPR-S),nasal(RPR-N),and temporal(RPR-T)quadrants.Spherical equivalent(SE)was detected and calculated using an autorefractor.RESULTS:There were significant differences of RPR 15-30 between groups MM[0.02(-0.12;0.18)]and LH[-0.13(-0.36;0.12)](P<0.05),MM and E[-0.06(-0.20;0.10)](P<0.05),and LM[-0.02(-0.15;0.15)]and E(P<0.05).There were also significant differences of RPR 30-45 between groups MM[0.45(0.18;0.74)]and E[0.29(-0.09;0.67)](P<0.05),and LM[0.44(0.14;0.76)]and E(P<0.001).RPR values increased from the hyperopic to medium myopic group in each annular.There were significant differences of RPR-S between groups MM[-0.02(-0.60;0.30)]and E[-0.44(-0.89;-0.04)](P<0.001),and LM[-0.28(-0.71;0.12)]and E(P<0.05).There were also significant differences of RPR-T between groups MM[0.37(0.21;0.78)]and LH[0.14(-0.52;0.50)](P<0.05),LM[0.41(0.06;0.84)]and LH(P<0.05),and LM and E[0.29(-0.10;0.68),P<0.05].A Spearman’s correlation analysis showed a negative correlation between RPR and SE in the 15°-30°(P=0.005),30°-45°(P<0.05)annular(P=0.002),superior(P<0.001),and temporal(P=0.001)quadrants.CONCLUSION:Without pupil dilation,values for RPR 15-30,30-45,RPR-S,and T shows significant differences between myopic eyes and emmetropia,and the differences are negatively correlated with SE.

One-year results for myopia control of orthokeratology with different back optic zone diameters: a randomized trial using a novel multispectral-based topographer

AIM:To present the 1-year results of a prospective cohort study investigating the efficacy,potential mechanism,and safety of orthokeratology(ortho-k)with different back optic zone diameters(BOZD)for myopia control in children.METHODS:This randomized clinical study was performed between Dec.2020 and Dec.2021.Participants were randomly assigned to three groups wearing ortho-k:5 mm BOZD(5-MM group),5.5 mm BOZD(5.5-MM group),and 6 mm BOZD(6-MM group).The 1-year data were recorded,including axial length,relative peripheral refraction(RPR,measured by multispectral refractive topography,MRT),and visual quality.The contrast sensitivity(CS)was evaluated by CSV-1000 instrument with spatial frequencies of 3,6,12,and 18 cycles/degree(c/d);the corneal higher-order aberrations(HOAs)were measured by iTrace aberration analyzer.The one-way ANOVA was performed to assess the differences between the three groups.The correlation between the change in AL and RPR was calculated by Pearson’s correlation coefficient.RESULTS:The 1-year results of 20,21,and 21 subjects in the 5-MM,5.5-MM,and 6-MM groups,respectively,were presented.There were no statistical differences in baseline age,sex,or ocular parameters between the three groups(all P>0.05).At the 1-year visit,the 5-MM group had lower axial elongation than the 6-MM group(0.07±0.09 vs 0.18±0.11 mm,P=0.001).The 5-MM group had more myopic total RPR(TRPR,P=0.014),with RPR in the 15°–30°(RPR 15–30,P=0.015),30°–45°(RPR 30–45,P=0.011),temporal(RPR-T,P=0.008),and nasal area(RPR-N,P<0.001)than the 6-MM group.RPR 15–30 in the 5.5-MM group was more myopic than that in the 6-MM group(P=0.002),and RPR-N in the 5-MM group was more myopic than that in the 5.5-MM group(P<0.001).There were positive correlations between the axial elongation and the change in TRPR(r=0.756,P<0.001),RPR 15–30(r=0.364,P=0.004),RPR 30–45(r=0.306,P=0.016),and RPR-N(r=0.253,P=0.047).The CS decreased at 3 c/d(P<0.001),and the corneal HOAs increased in the 5-MM group(P=0.030).CONCLUSION:Ortho-k with 5 mm BOZD can control myopia progression more effectively.The mechanism may be associated with greater myopic shifts in RPR.

Refraction difference value variations in children and adolescents with different refractive errors

AIM:To evaluate the refraction difference value(RDV)variations in children and adolescents with different refractive errors and analyze its correlation with refractive development.METHODS:Participants aged 4-16y with different refractive statuses(hyperopia,emmetropia,myopia)underwent comprehensive eye examinations,including spherical equivalent(SE)refraction,axial length(AL),total RDV(TRDV),and RDVs at various eccentricities(0°-15°,15°-30°,30°-45°)and quadrants(inferior,superior,nasal,temporal).Statistical analysis involved one-way ANOVA for group comparisons and Pearson correlation for examining relationships between SE/AL and RDVs.Paired t-tests compared quadrant-specific RDVs within groups.RESULTS:Significant difference was found in TRDV(P<0.001),RDV15°-30°(P=0.033),RDV30°-45°(P<0.001),RDV-inferior(RDV-I,P<0.001)and RDV-temporal(RDV-T,P<0.001)among hyperopia,emmetropia and myopia group.Pearson correlation analysis revealed a negative correlation of SE with TRDV(P=0.001),RDV30°-45°(P=0.004),RDV-I(P=0.047),and RDV-T(P<0.001).The differences between RDV-superior(RDV-S)and RDV-I were statistically significant in all groups(P<0.001 for all)and between RDV-T and RDV-nasal(RDV-N)were statistically significant in hyperopia group(P<0.001).Within the premyopic group,the analysis revealed a negative correlation of SE with RDV-I(P=0.009).Pearson correlation analysis revealed a positive correlation of AL with TRDV(P=0.036),RDV15°-30°(P=0.004),RDV30°-45°(P<0.001),RDV-S(P=0.003),RDV-I(P<0.001),RDV-T(P<0.001),RDV-N(P=0.022),while revealed a negative correlation of AL with RDV0-15°(P=0.018).CONCLUSION:Our study indicates TRDV,RDV30°-45°,RDV-I,RDV-T may relate to refractive development,and a negative correlation between SE and RDV-I in pre-myopic children.

Observation of peripheral refraction in myopic anisometropia in young adults

AIM:To investigate the differences in retinal refraction difference values(RDVs)of adult patients with myopic anisometropia compared with those without myopic anisometropia,and to investigate the relationship between ocular biometric measurements and relative peripheral refraction.METHODS:This clinical observation study included 130 patients with myopia(-0.25 to-10.00 D)between October 2022 and January 2023 aged between 18 and 40y.The patients were divided into anisometropia(n=63;difference in binocular anisometropia≥1.00 D)and non-anisometropia(n=67;difference in binocular anisometropia<1.00 D)groups accordingly.Ocular biometric measurements were performed by optical biometrics and corneal topography to assess the steep keratometry(Ks),flap keratometry(Kf),axial length(AL),corneal astigmatism(CYL;Ks-Kf),surface regularity index(SRI),surface asymmetry index(SAI),and central corneal thickness(CCT).The RDV was measured at five retinal areas from the fovea to 53 degrees(RDV-0-10,RDV-10-20,RDV-20-30,RDV-30-40,and RDV-40-53),the total RDV(TRDV)of 53 degrees,and four regions,including RDV-superior,RDV-inferior,RDV-temporal,and RDV-nasal.An analysis of Spearman correlation was carried out to examine the correlation between RDV and the spherical equivalent(SE)and ocular biological parameters.RESULTS:Within RDV-20-53,both groups showed relative hyperopic defocus,and the increase in RDV corresponds to the increase in eccentricity.In the myopic anisometropia group,the TRDV,RDV-20-53,RDV-superior,and more myopic eyes had significantly higher RDVtemporal values than less myopic eyes.(P<0.05).In the non-anisometropia group,there was no significant difference in the RDV between the more and less myopic eyes at different eccentricities(P>0.05).There was a negative correlation between SE and TRDV(r=-0.205,P=0.001),RDV-20-53(r=-0.281,-0.183,-0.176,P<0.05),RDV-superior(r=-0.251,P<0.001),and RDV-temporal(r=-0.230,P<0.001),a negative correlation between CYL and RDV-10-30(r=-0.147,-0.180,P<0.05),and a negative correlation between SRI and RDV-0-20(r=-0.190,-0.170,P<0.05).AL had a positive correlation with RDV-20-30(r=0.164,P=0.008)and RDV-temporal(r=0.160,P=0.010).CONCLUSION:More myopic eyes in patients with myopic anisometropia show more peripheral hyperopic defocus.Diopter and corneal morphology may affect peripheral retinal defocus.