Age-specific distribution of oculometric parameters and myopia in children aged 8-12y

AIM:To describe the distribution of ocular biometrics and to evaluate its associations with refractive error and to assess the contribution from ocular parameters to refractive error among Chinese myopic children.METHODS:This cross-sectional study evaluated subjects aged 8-12y.Keratometry,ocular biometry,and cycloplegic autorefraction were performed on each subject.Spherical equivalent refraction(SER)and ocular biometrics were assessed as a function of age and gender.The Pearson correlation analysis between SER and ocular biometrics was carried out.Multiple linear regression was performed to analyze the association between SER and ocular parameters.RESULTS:A total of 689 out of 735 participants(321 boys,48.1%)were analyzed,with a mean SER of-2.98±1.47 diopter(D).Axial length(AL),anterior chamber depth(ACD),corneal radius of curvature(CR),horizontal visible iris diameter(HVID),central corneal thickness(CCT)and lens power(LP)showed normal distribution.The AL,AL/CR ratio,ACD and CR increased from 8 to 12y of age,while SER and LP decreased,HVID and CCT remained stable.There was no difference in gender.SER decreased by 0.929 D for every 1 mm increase in AL and decreased by 1.144 D for every 0.1 increase in AL/CR ratio.The Pearson correlation coefficient between SER and AL was-0.538(P<0.01)and-0.747(P<0.01)between SER and AL/CR ratio.For the SER variance,AL explained 29.0%,AL/CR ratio explained 55.7%,while AL,CR,ACD and LP explained 99.3%after adjusting for age and gender.CONCLUSION:The AL,CR,ACD and LP are the most important determinants of myopic refractive error during myopia progression.

Choroidal thickness,myopia,and myopia control interventions in children:a Meta-analysis and systemic review

AIM:To investigate changes of choroidal thickness(ChT) in children with myopia and the effect of current myopia control interventions on ChT.METHODS:Major literature databases were searched for studies relevant to myopia in children.All studies used swept-source optical coherence tomography(SS-OCT) or enhanced depth imaging optical coherence tomography(EDI-OCT) to measure the ChT value.The weighted mean difference(WMD) and 95% confidence interval(CI) were pooled to evaluate ChT in myopia children.RESULTS:A total of 11 eligible articles,including 1693 myopic and 1132 non-myopic eyes,were included in the first Meta-analysis.The sub-foveal choroidal thickness(SFCT;WMD=-40.06,95%CI,-59.36 to-20.75,P<0.001) and ChT at other sectors were significantly thinner in myopic eyes compared with the non-myopic eyes.The Meta-analysis revealed that the ChT decreased horizontally from the temporal sector toward the nasal sector in the pediatric myopia population.Another 11 studies reporting the effect of myopia control interventions were included in the second Meta-analysis for the relationship between myopia control treatments and ChT.SFCT significantly increased after orthokeratology(OK) treatment and OK combined with 0.01% atropine(OKA) treatment(WMD=19.47,95%CI,15.96 to 22.98,P<0.001;WMD=21.81,95%CI,12.92 to 29.70,P<0.001,respectively).The forest plots showed that SFCT changed little in myopic children receiving 0.01% atropine(P=0.30).Furthermore,the Meta-analysis showed that OK treatment had a stronger effect on the value of SFCT in myopic children as compared with 0.01% atropine(WMD=9.86;95%CI,-0.21 to 19.93,P=0.05).There is no difference between the treatment with OK and OKA treatment in ChT in myopic children(P=0.37).CONCLUSION:The ChT in myopic eyes is thinner than that in non-myopic eyes in pediatric population.Myopia control interventions including OK and OKA lead to ChT thickening,but other treatments such as 0.01% atropine did not show an increase in ChT.

Recurrence after spontaneous separation of epiretinal membrane in a young woman:a case report

Dear Editor,We report a case of recurrence after spontaneous separation of epiretinal membrane (ERM) in a young woman with suspected retinal vasculitis.ERM is defined as the fibrocellular membrane that proliferates on the inner surface of neurosensory retina at the macular area.Idiopathic ERM(iERM) usually occurs without a clearly identifiable cause in patients of more than 50 years of age and a great discrepancy in its prevalence from 1.02%to 28.9%among different ethnic groups were noted in previous epidemiologic studies^([1-3]).

Ruthenium-106 plaque brachytherapy for the treatment of diffuse choroidal hemangioma in Sturge-Weber syndrome

AIM:To evaluate the efficacy of ruthenium-106 plaque brachytherapy for the treatment of diffuse choroidal hemangioma(DCH)in Sturge-Weber syndrome(SWS).METHODS:A total of 8 patients with DCH in SWS managed with plaque brachytherapy were retrospectively included.Patients were treated with ruthenium-106 plaque therapy(median apex dose:83 Gy)at the thickest tumor region.On follow-up,we recorded the tumor thickness,the best-corrected visual acuity(BCVA),subretinal fluid(SRF)status,and complications following treatment.RESULTS:At a median follow-up of 43 mo,tumor regression was observed in all cases,with a complete resolution of SRF and reduction in tumor-thickness.No radiation complications were recorded during the follow up time.CONCLUSION:Ruthenium-106 plaque therapy to the thickest portion of the tumor seems to be a useful treatment in patients with DCH in SWS.

A machine learning-based algorithm used to estimate the physiological elongation of ocular axial length in myopic children

Background:Axial myopia is the most common type of myopia.However,due to the high incidence of myopia in Chinese children,few studies estimating the physiological elongation of the ocular axial length(AL),which does not cause myopia progression and differs from the non-physiological elongation of AL,have been conducted.The purpose of our study was to construct a machine learning(ML)-based model for estimating the physiological elongation of AL in a sample of Chinese school-aged myopic children.Methods:In total,1011 myopic children aged 6 to 18 years participated in this study.Cross-sectional datasets were used to optimize the ML algorithms.The input variables included age,sex,central corneal thickness(CCT),spherical equivalent refractive error(SER),mean K reading(K-mean),and white-to-white corneal diameter(WTW).The output variable was AL.A 5-fold cross-validation scheme was used to randomly divide all data into 5 groups,including 4 groups used as training data and one group used as validation data.Six types of ML algorithms were implemented in our models.The best-performing algorithm was applied to predict AL,and estimates of the physiological elongation of AL were obtained as the partial derivatives of AL_(predicted)-age curves based on an unchanged SER value with increasing age.Results:Among the six algorithms,the robust linear regression model was the best model for predicting AL,with a R^(2) value of 0.87 and relatively minimal averaged errors between the predicted AL and true AL.Based on the partial derivatives of the AL_(predicted)-age curves,the estimated physiological AL elongation varied from 0.010 to 0.116 mm/year in male subjects and 0.003 to 0.110 mm/year in female subjects and was influenced by age,SER and K-mean.According to the model,the physiological elongation of AL linearly decreased with increasing age and was negatively correlated with the SER and the K-mean.Conclusions:The physiological elongation of the AL is rarely recorded in clinical data in China.In cases of unavailable clinical dat,an ML algorithm could provide practitioners a reasonable model that can be used to estimate the physiological elongation of AL,which is espedally useful when monitoring myopia progression in orthokeratology lens wearers.