Alterations in peripheral refraction with spectacles, soft contact lenses and orthokeratology during near viewing: implications for myopia control

Damani, Jyoti M; Annasagaram, Madhuri; Kumar, Preetam; Verkicharla, Pavan K.

doi:10.1080/08164622.2021.1970480

Cited by 8 publications

(11 citation statements)

References 65 publications

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“…A rapidly growing research revealed that the onset and progression of myopia should be a complex and multifactorial process. One of the current hypotheses is peripheral defocus theory [36][37][38] , which have been shown in animal studies that peripheral myopic defocus could modulate not only peripheral ocular growth, but also axial growth [39] . However, recent investigations in humans have failed to find the correlation between peripheral refraction and myopia progression [40] .…”

Section: Resultsmentioning

confidence: 99%

Photopic pupil size change in myopic orthokeratology and its influence on axial length elongation

Zhu¹,

Du²,

He³

et al. 2022

Int J Ophthalmol

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AIM: To explore the photopic pupil size behavior in myopic children undergoing overnight orthokeratology (ortho-k) over 1-year period and its effects on the axial elongation. METHODS: A total of 202 Chinese myopic children were enrolled in this prospective clinical trial. Ninety-five subjects in ortho-k group and eighty-eight subjects in spectacle group completed the 1-year study. Axial length (AL) was measured before enrollment and every 6mo after the start of ortho-k. The photopic pupil diameter (PPD) was determined using the Pentacam AXL and measured in an examination room with lighting of 300-310 Lx. Stepwise multiple linear regression analysis was used to identify variables contribution to axial elongation. RESULTS: Compared with spectacle group, the average 1-year axial elongation was significantly slower in the ortho-k group (0.25±0.27 vs 0.44±0.23 mm, P<0.0001). In ortho-k group, PPDs significantly decreased from 4.21±0.62 mm to 3.94±0.53 mm after 1mo of lens wear (P=0.001, Bonferroni correction) and the change lasts for 3-month visit. No significantly change during the other follow-up visits was found (P>0.05, Bonferroni correction). The 4.81 mm PPD may be a possible cutoff point in the ortho-k group. Subjects with PPD below or equal to 4.81 mm tended to have smaller axial elongation compared to subjects with PPD above 4.81 mm after 1-year period (t=-3.09, P=0.003). In ortho-k group, univariate analyses indicated that those with older age, greater degree of myopia, longer AL, smaller baseline PPD (PPDbaseline) experienced a smaller change in AL. In multivariate analyses, older age, greater AL and smaller PPDbaseline were associated with smaller increases in AL. In spectacle group, PPD tended to be stable (P>0.05, Bonferroni correction) and did not affect axial growth. CONCLUSION: PPDs experience significantly decreases at 1-month and 3-month ortho-k treatment. Children with smaller PPD tend to experience slower axial elongation and may benefit more from ortho-k.

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Section: Resultsmentioning

confidence: 99%

Photopic pupil size change in myopic orthokeratology and its influence on axial length elongation

Zhu¹,

Du²,

He³

et al. 2022

Int J Ophthalmol

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“…These findings were consistent with another recent study by our group in Indian eyes that investigated how the magnitude of peripheral refraction varied during distance and near viewing with different modalities of optical correction. 32 Therefore, the relative change in peripheral refraction with respect to the fovea was similar at 3 m and 0.33 m. Likewise, the pattern of pre-cycloplegic absolute mfERG N1, P1 and N2 amplitude densities was also similar to the post-cycloplegic absolute mfERG amplitude densities. Individual absolute peripheral refraction profiles and mfERG amplitudes for each participant (n = 5) are provided in Figures S1 and S2.…”

Section: Multifocal Electroretinogram Testmentioning

confidence: 52%

“…The central refraction was measured first followed by the peripheral refraction measurements in 5° steps up to ±30° horizontally and ±15° vertically. Measurements were recorded using the previously used standard protocol, 5,[30][31][32] where participants fixated on the high-contrast Maltese crosses placed as central and peripheral targets at the aforementioned eccentricities along the horizontal and vertical meridians in the participant's visual field at eye…”

Section: Measurement Of Axial Length Central and Peripheral Refractionmentioning

confidence: 99%

Association between relative peripheral refraction and corresponding electro‐retinal signals

Gupta

Chakraborty

Verkicharla

2023

Ophthalmic Physiologic Optic

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Considering the potential role of the peripheral retina in refractive development and given that peripheral refraction varies significantly with increasing eccentricity from the fovea, we investigated the association between relative peripheral refraction (RPR) and corresponding relative peripheral multifocal electroretinogram (mfERG) responses (electro-retinal signals) from the central to the peripheral retina in young adults. Methods: Central and peripheral refraction using an open-field autorefractor and mfERG responses using an electrophysiology stimulator were recorded from the right eyes of 17 non-myopes and 24 myopes aged 20-27 years. The relative mfERG N1, P1 and N2 components (amplitude density and implicit time) of a mfERG waveform were compared with the corresponding RPR measurements at the best-matched eccentricities along the principal meridians, that is at the fovea (0°), horizontal (±5°, ±10° and ± 25°) and vertical meridians (±10° and ± 15°). Results:The mean absolute mfERG N1, P1 and N2 amplitude densities (nV/deg 2 ) were maximum at the fovea in both non-myopes (N1: 57.29 ± 14.70 nV/deg 2 , P1: 106.29 ± 24.46 nV/deg 2 , N2: 116.41 ± 27.96 nV/deg 2 ) and myopes (N1: 56.25 ± 15.79 nV/ deg 2 , P1: 100.79 ± 30.81 nV/deg 2 , N2: 105.75 ± 37.91 nV/deg 2 ), which significantly reduced with increasing retinal eccentricity (p < 0.01). No significant association was reported between the RPR and corresponding relative mfERG amplitudes at each retinal eccentricity (overall Pearson's correlation, r = −0.25 to 0.26, p ≥ 0.09). In addition, the presence of relative peripheral myopia or hyperopia at extreme peripheral retinal eccentricities did not differentially influence the corresponding relative peripheral mfERG amplitudes (p ≥ 0.24). Conclusions: Relative peripheral mfERG signals are not associated with corresponding RPR in young adults. It is plausible that the electro-retinal signals may respond to the presence of absolute hyperopia (and not relative peripheral hyperopia), which requires further investigation.

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“…This peripheral myopia defocus is hypothesized to stabilize eye growth and reduce myopia progression. 8 , 10 After more than 30 years of clinical application, the effectiveness for myopia control of the OK lens has been confirmed. 11 Because the lenses are worn at night and preserve good vision during the day, OK therapy has been recognized by many patients and their families.…”

mentioning

confidence: 96%

“…For the prevention and control of myopia in adolescents, orthokeratology (OK) therapy has attracted increasing attention from ophthalmologists and myopia patients because of its good corrective effects and ability to control the progression of myopia. 7 , 8 Orthokeratology lenses have a much flatter central base curve than the secondary curve, thus creating positive pressure that pushes against the central cornea and negative pressure that pulls against the midperipheral cornea, flattening the central cornea by thinning the epithelial layer to change the refractive power and correct myopic ametropia. 9 Meanwhile, light would be refracted simultaneously onto the midperipheral retina and macula through plateau-shaped cornea, leaving the peripheral retina with relative myopic defocus.…”

mentioning

confidence: 99%

Analysis of the Reasons for the Discontinuation of Orthokeratology Lens Use: A 4-Year Retrospective Study

Wang

et al. 2022

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Purpose:Although orthokeratology has a positive effect on myopia control, some patients discontinue orthokeratology lens use. This study analyzed the data of all patients who had been fitted with an orthokeratology lens in the past 4 years and the reasons for discontinued lens use, with the aim of improving the prevention and control of myopia.Methods:This retrospective study analyzed the data of patients, aged 8 to 18 years, fitted with orthokeratology lenses from 2017 to 2020. The ametropic spherical lens powers ranged from −6.00 D to −0.75 D, and the cylindrical lens powers were all more than −1.50 D. The reasons for discontinuation of lens wear were analyzed and compared. The period of lens wear (median [range]) was 24 (13.5–34.5) months.Results:A total of 2,499 patients' files were retrieved. The duration of lens wear was 24 (13.5–34.5) months. A total of 50 patients discontinued lens use, including 25 patients (50.0%) who could not adhere to lens use for various reasons, nine patients (18.0%) with a short sleep time, eight patients (16.0%) with economic difficulties, and five patients (10.0%) who experienced a poor effect after wearing the lenses. Corneal infiltrates affected lens use in three patients (6.0%). In addition, 30 patients underwent surgical correction when they reached adulthood.Conclusion:Although orthokeratology lenses are effective and safe, there are still a small number of patients who discontinued lens use for various reasons. Adherence and precautions should be emphasized during the process.

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Alterations in peripheral refraction with spectacles, soft contact lenses and orthokeratology during near viewing: implications for myopia control

Cited by 8 publications

References 65 publications

Photopic pupil size change in myopic orthokeratology and its influence on axial length elongation

Photopic pupil size change in myopic orthokeratology and its influence on axial length elongation

Association between relative peripheral refraction and corresponding electro‐retinal signals

Analysis of the Reasons for the Discontinuation of Orthokeratology Lens Use: A 4-Year Retrospective Study

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