Effect of undercorrection on myopia progression in 12-year-old children

Li, Si Yuan; Li, Shiming; Zhou, Yue; Liu, Luo Ru; He, Lin; Kang, Meng Tian; Zhan, Si Yan; Wang, Ke; Millodot, Michel

doi:10.1007/s00417-015-3053-8

Cited by 55 publications

(47 citation statements)

References 27 publications

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“…This result is contradicted by a later study [8]. The difference in myopia progression between the groups with full correction and under-corrected by 0.5 D is less than 0.25D.…”

mentioning

confidence: 63%

“…The age Bcorrection^may be questionable given the large variation in progression rate and the reduced number of subjects. The natural variation in myopia progression is much larger than the effect of undercorrection.A recent study of two groups of under-corrected and fully corrected children [8] failed to show any difference in myopia progression. However, the regression analysis showed that…”

mentioning

confidence: 88%

“…A recent study of two groups of under-corrected and fully corrected children [8] failed to show any difference in myopia progression. However, the regression analysis showed that myopia progression significantly decreased with increasing amount of under-correction.…”

mentioning

confidence: 88%

“…Reports [3][4][5][6]8] discussed in the paragraphs below confirm the small and conflicting effect and exemplify the difficulty.…”

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confidence: 89%

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Detecting the effect of under-correcting myopia

Medina

2015

Graefes Arch Clin Exp Ophthalmol

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The Letter to the Editor BRefractive correction and myopia progression^[1] (Bthe Letter^) makes some good points about the article BThe progression of corrected myopia^ [2] that the article had already addressed in part.Medina's feedback model for emmetropization predicts that correction of myopes aggravates their condition, and that delaying correction will result in less progression rate and probably a reduced myopic final level. The model also predicts that under-correcting myopia would have a small effect in reducing the progression rate.The Letter advises that there is controversy on the issue of whether under-correction of myopia will have any beneficial effect, citing four published reports [3][4][5][6] involving distance under-correction. Medina [2] cites those reports, and others, noting the conflict and suggesting experimental problems. The Letter overlooks several reports that show that undercorrection for near vision with bifocals reduces myopia progression, e.g. [7] and those cited in [2].In response to the Letter, the effect of distance undercorrection would be difficult to detect experimentally due to the small effect and the difficult experiment. Reports [3][4][5][6]8] discussed in the paragraphs below confirm the small and conflicting effect and exemplify the difficulty.Chung and Mohidin [3] showed a small (0.23 D) but significant greater rate of progression in a group of 47 children under-corrected by about 0.75 D as compared to another group of 47 children fully corrected for a period of 2 years. They paired the data in an attempt to avoid the problem of intersubject variation. However, the myopia progression rate is very variable, even for paired subjects of the same age and initial refractive error. Adler and Millodot [4] show no significant myopia progression difference between two groups of 23 fully corrected myopes and 25 myopes under-corrected by 0.50 D for a period of 18 months.Vasudevan et al.[5] found a significant positive correlation between the degree of under-correction of refractive error and the rate of myopic progression. This result is contradicted by a later study [8]. The difference in myopia progression between the groups with full correction and under-corrected by 0.5 D is less than 0.25D. See its Figure 1 (as amended [9]).Ong et al.[6] in a longitudinal study concluded that, over a period of at least 3 years, refractive shifts were not significantly different among a group of full-time wearers (n = 8) of spectacle correction and a group of non-wearers (n = 5), when the data were corrected for age effects. The non-wearers, however, developed less myopia than the fulltime lens wearers, and the difference was borderline significant when there was no Bcorrection^for age effects. The age Bcorrection^may be questionable given the large variation in progression rate and the reduced number of subjects. The natural variation in myopia progression is much larger than the effect of undercorrection.A recent study of two groups of under-corrected and fully corrected children [8] fail...

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“…This result is contradicted by a later study [8]. The difference in myopia progression between the groups with full correction and under-corrected by 0.5 D is less than 0.25D.…”

mentioning

confidence: 63%

mentioning

confidence: 88%

mentioning

confidence: 88%

“…Reports [3][4][5][6]8] discussed in the paragraphs below confirm the small and conflicting effect and exemplify the difficulty.…”

mentioning

confidence: 89%

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Detecting the effect of under-correcting myopia

Medina

2015

Graefes Arch Clin Exp Ophthalmol

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“…In myopic defocus with positive lenses, ocular growth was inhibited and myopia was decreased [34]. Based on those results, other studies have revealed that the under-correction of myopia slows the progression of myopia in children [35–37], although other studies had shown conflicting results [38,39]. The exact mechanism by which hyperopia under-correction induces emmetropization in childhood is unclear.…”

Section: Discussionmentioning

confidence: 99%

Refractive error change and vision improvement in moderate to severe hyperopic amblyopia after spectacle correction: Restarting the emmetropization process?

Chang

2017

PLoS ONE

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PurposeThe aims of the study were to develop guidelines for prescribing spectacles for patients with moderate to severe hyperopic amblyopia and to demonstrate how emmetropization progresses.MethodsChildren with hyperopic amblyopia who had a spherical equivalent of ≥ +4.0 diopters (D) or more were included, while those who had astigmatism of > 2.0 D or anisometropia of > 2.0 D were excluded. The patients were divided into a full correction group and an under-correction group according to the amount of hyperopia correction applied. The under-correction group was further subdivided into a fixed under-correction group and a post-cycloplegic refraction (PCR) under-correction group. The duration of amblyopia treatment and changes in initial hyperopia were compared between the groups.ResultsIn total, 76 eyes of 38 patients were analyzed in this study. The full correction group and under-correction group were subjected to 5.5 months and 5.9 months of amblyopia treatment, respectively (P = 0.570). However, the PCR under-correction group showed more rapid improvement (2.9 months; P = 0.001). In the under-correction group, initial hyperopia was decreased by -0.28 D and -0.49 D at 6 months and 12 months, respectively, after initial cycloplegic refraction. Moreover, the amount of hyperopia under-correction was correlated with the amount of hyperopia reduction (P = 0.010).ConclusionThe under-correction of moderate to severe hyperopic amblyopia has beneficial effects for treating amblyopia and activating emmetropization. PCR under-correction can more rapidly improve visual acuity, while both fixed under-correction and PCR under-correction can induce emmetropization and effectively reduce initial hyperopia.

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