Factors determining the myopia control effect of an orthokeratology lens: A two‐year multi‐level model

Abstract

A multi-level model was used to analyse factors, including environmental factors, affecting the controlling effect of orthokeratology on myopia progression. Methods:A 2-year prospective study was conducted in the West China Hospital, Sichuan University. Age, sex, height, baseline spherical equivalent refraction, choroidal thickness, axial length and other biometric ocular parameters were collected.Additionally, data on the following environmental factors were obtained: near-work distance and time, sleep time and time spent outdoors. After the baseline measurements, participants were followed up every 3 months for 2 years of lens wear. The primary outcome measure was axial length elongation over 2 years of orthokeratology. All variables were included in a univariate, three-level analysis model with inclusion in the final multivariate multi-level model if statistically significant.Results: Thirty-three participants (average age 9.73 ± 1.55 years) were included in this study. During the 2-year period of lens wearing, binocular changes in axial length increased significantly from the ninth month and continued until the end of the follow-up. Changes in axial length after 2 years of lens wearing were 0.44 ± 0.30 mm and 0.37 ± 0.26 mm in the right and left eyes, respectively (both p < 0.001). Based on the 2-year multi-level model, age, sex, baseline spherical equivalent refraction, flatter keratometry meridian and near-work time influence the effect of orthokeratology.Conclusions: This is the first study to use a multi-level model to analyse factors, including environmental factors, that affect myopia control using orthokeratology. These results showed that younger age, being female, having lower myopia at baseline, a steeper flattest keratometry meridian and no more than 5 h of near work per day were associated with better myopia control effect using orthokeratology over a 2-year treatment period.

Association Between Myopia and Pupil Diameter in Preschoolers: Evidence from a Machine Learning Approach Based on a Real-World Large-Scale Dataset

“…This study indicated a reduced pupil sizes in preschoolers with myopia than preschoolers with emmetropia. Although our previous study has suggested a suppressive effect of large pupil diameter on myopia progression [ 18 ], and similar findings have been reported in other literature [ 41 , 42 ]. Some scholars believed that higher concentrations of atropine, which result in a greater increase in pupil diameter, lead to more light entering the eye, thereby resulting in superior therapeutic effects [ 17 , 43 ].…”

The rate of orthokeratology lens use and associated factors in 33,280 children and adolescents with myopia: a cross-sectional study from Shanghai

“…Previous studies have rarely involved the influence of sleep time on the effect of ortho-k lens. Chen et al studied the factors influencing the effect of ortho-k lens on the control of myopia progression and did not find significant correlation, but all children participants in the study had a sleeping time ≥8 h [ 41 ]. Previous studies have shown that daytime vision can reach 0.0 after ortho-k lens use and remain stable for longer than 6 months [ 34 , 42 – 44 ].…”

Sleep Quality is Associated with Axial Length Elongation in Myopic Children Receiving Orthokeratology: A Retrospective Study

“…However, a prospective study by Chen et al revealed that daily near-work of ≤5 h was associated with better control of myopia during a 2-year ortho-k treatment period. 23 Numerous studies have focused on the role of outdoor activity in myopia prevention and control. A cluster randomized trial of primary school students in Guangzhou, China, showed that 40 min of outdoor activity time at school decreased myopia incidence in the following 3 years.…”