Relationship between Reduced Accommodative Lag and Myopia Progression

Koomson, Nana Yaa; Amedo, Angela Ofeibea; Opoku-Baah, Collins; Ampeh, Percy Boateng; Ankamah, Emmanuel; Bonsu, Kwaku

doi:10.1097/opx.0000000000000867

Cited by 52 publications

(45 citation statements)

References 45 publications

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“…There appears to be no relationship between the lag of accommodation and myopia progression. 14,26 It is not clear why under-correction would accelerate myopic progression, but study findings suggest that any malfunction of the sign detection mechanism in emmetropisation can cause eye growth. 12 Progressing myopes have large accommodative lags, micro-fluctuations and an increased depth of focus, compared to non-myopes, but similar blur detection thresholds.…”

Section: Discussionmentioning

confidence: 88%

“…Koomson et al conducted a two‐year single masked randomised controlled trial on 150 Ghanaian myopic children aged 10 to 15 years, with mean baseline myopia of −1.98 to −0.50 D. The children were randomly assigned to wear either full‐correction (n = 75) or +0.50 D under‐correction (n = 75) single vision spectacle lenses. An open‐field autorefractor was used to obtain refraction data and ocular biometry results were determined using A‐Scan ultrasonography.…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, controlled studies showing under‐correction reduces accommodative effort and accommodative lag are of limited relevance in the natural world environment. There appears to be no relationship between the lag of accommodation and myopia progression …”

Section: Discussionmentioning

confidence: 99%

“…Koomson et al 14 lenses. An open-field autorefractor was used to obtain refraction data and ocular biometry results were determined using A-Scan ultrasonography.…”

Section: Under-correction Of Myopiamentioning

confidence: 98%

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Role of un‐correction, under‐correction and over‐correction of myopia as a strategy for slowing myopic progression

Logan

Wolffsohn

2020

Clinical and Experimental Optometry

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This systematic review investigates the association between un‐, under‐ and over‐correction of myopic refractive error and myopia progression in children and adolescents (up to 18 years of age). The literature search included three databases (PubMed, Web of Science, and Cochrane Central Register of Controlled Trials [CENTRAL]), and reference lists of retrieved studies in any language. Eight prospective cohort studies and one retrospective analysis of clinical data provided comparison data on un‐ and under‐correction of myopia versus full‐correction of myopia; however, the quality of studies and length of follow‐up times varied. A forest plot showed no beneficial effect of under‐correction with some studies finding an increase in myopia progression. While one study suggested that myopia progression is slower in an un‐corrected cohort compared to those who are fully corrected, another study suggests the opposite. One study utilised anisomyopes to allow comparison of under‐correction of one eye with full‐correction of the fellow eye indicating that under‐correction in one eye appears to slow the rate of myopia progression in that eye. Another study on full‐correction only in one eye found that progression was faster in the un‐corrected eye. No benefits of over‐correction of myopia was found. The overall findings are equivocal with under‐correction causing a faster rate of myopia progression. There is no strong evidence of benefits from un‐correction, monovision or over‐correction. Hence, current clinical advice advocates for the full‐correction of myopia. Further studies are warranted to determine the level of myopia that can be left uncorrected without impacting on myopia progression and how this changes with time.

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Section: Discussionmentioning

confidence: 88%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Koomson et al 14 lenses. An open-field autorefractor was used to obtain refraction data and ocular biometry results were determined using A-Scan ultrasonography.…”

Section: Under-correction Of Myopiamentioning

confidence: 98%

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Role of un‐correction, under‐correction and over‐correction of myopia as a strategy for slowing myopic progression

Logan

Wolffsohn

2020

Clinical and Experimental Optometry

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“…Li et al 5 found the mean myopic progressions in the full-correction group and under-correction group were −0.68 AE 0.46 D and −0.64 AE 0.44 D, respectively, at one-year follow-up. In the results of Koomson et al, 6 the mean myopic progressions in the fullcorrection and under-correction groups were −0.54 AE 0.26 D and −0.50 AE 0.22 D, respectively, at the end of 24 months.…”

mentioning

confidence: 86%

Re: Role of un‐correction, under‐correction and over‐correction of myopia as a strategy for slowing myopic progression

Wang

2020

Clinical and Experimental Optometry

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EDITOR: A review titled 'Role of un-correction, under-correction and over-correction of myopia as a strategy for slowing myopic progression' 1 published recently in Clinical and Experimental Optometry was an excellent, systematic and comprehensive article. However, we are concerned that the section 'Under-correction of myopia' made no mention of the notion that it is very difficult to maintain full-correction of myopia during the entire test period.In the section 'Under-correction of myopia', seven studies were listed, all of which revealed that the degree of myopia had increased in every full-correction or under-correction group. The first article mentionedby Tokoro and Kabe 2 in Japanesewas published 55 years ago. Logan and Wolffsohn 1 reported that the myopic progressions of the fullcorrection group and under-correction group were −0.75 AE 0.27 D and −0.54 AE 0.39 D, respectively. In the study of Adler and Millodot, 3 the mean progressions in the fullcorrection group and under-correction group were −0.82 AE 0.11 D and −0.99 AE 0.1 D, respectively, at the end of the 18-month period. In the research by Chung et al., 4 the mean progressions in the full-correction and under-correction groups were −0.77 D and −1.00 D, respectively, at the end of the 24-month period. Li et al. 5 found the mean myopic progressions in the full-correction group and under-correction group were −0.68 AE 0.46 D and −0.64 AE 0.44 D, respectively, at one-year follow-up. In the results of Koomson et al., 6 the mean myopic progressions in the fullcorrection and under-correction groups were −0.54 AE 0.26 D and −0.50 AE 0.22 D, respectively, at the end of 24 months.In the study of Chen, 7 myopia values at three time points were adopted to conduct the comparison between full-correction and undercorrection; that is, at the beginning of the test (−3.96 AE 0.59 D versus −4.11 AE 0.74 D), six months (−4.16 AE 0.69 D versus −4.32 AE 0.72 D) and 12 months (−4.48 AE 0.62 D versus −4.71 AE 0.48 D) after wearing glasses. Vasudevan et al. 8 found a significant positive correlation between under-correction of refractive error and myopic progression after one-year follow-up.

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Refractive Error Change and Overminus Lens Therapy for Childhood Intermittent Exotropia

Alexander,

Allen,

Alluri

et al. 2024

JAMA Ophthalmol

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ImportanceIncreased myopic shift was found to be associated with 1 year of overminus spectacle treatment for children with intermittent exotropia (IXT). Persistence of myopic shift after discontinuing overminus spectacles is unknown.ObjectiveTo compare refractive error change over 3 years in children with IXT originally treated with overminus vs nonoverminus spectacles.Design, Setting, and ParticipantsThis study was an 18-month extension of the Trial of Overminus Spectacle Therapy for Intermittent Exotropia cohort, which previously randomized children aged 3 to 10 years with IXT and baseline spherical equivalent refractive error (SER) between −6.00 diopters (D) and 1.00 D to overminus spectacles (−2.50 D for 12 months, −1.25 D for 3 months, and nonoverminus for 3 months) or nonoverminus spectacles. Children were recruited from 56 sites from July 2010 to February 2022. Data were analyzed from February 2022 to January 2024.InterventionsAfter trial completion at 18 months, participants were followed up at 24 and 36 months. Treatment was at investigator discretion from 18 to 36 months.Main Outcomes and MeasuresChange in SER (cycloplegic retinoscopy) from baseline to 36 months.ResultsOf 386 children in the Trial of Overminus Spectacle Therapy for Intermittent Exotropia, 223 (57.8%) consented to 18 months of additional follow-up, including 124 of 196 (63.3%) in the overminus treatment group and 99 of 190 (52.1%) in the nonoverminus treatment group. Of 205 children who completed 36-month follow-up, 116 (56.6%) were female, and the mean (SD) age at randomization was 6.2 (2.1) years. Mean (SD) SER change from baseline to 36 months was greater in the overminus group (−0.74 [1.00] D) compared with the nonoverminus group (−0.44 [0.85] D; adjusted difference, −0.36 D; 95% CI, −0.59 to −0.12; P = .003), with 30 of 112 (26.8%) in the overminus group having more than 1 D of myopic shift compared with 14 of 91 (15%) in the nonoverminus group (risk ratio, 1.8; 95% CI, 1.0-3.0). From 12 to 36 months, mean (SD) myopic shift was −0.34 (0.67) D and −0.36 (0.66) D in the overminus and nonoverminus groups, respectively (adjusted difference, −0.001 D; 95% CI, −0.18 to 0.18; P = .99).Conclusions and RelevanceThe greater myopic shift observed after 1 year of −2.50-D overminus lens treatment remained at 3 years. Both groups had similar myopic shift during the 2-year period after treatment weaning and cessation. The risk of myopic shift should be discussed with parents when considering overminus lens treatment.Trial RegistrationClinicalTrials.gov Identifier: NCT02807350

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Relationship between Reduced Accommodative Lag and Myopia Progression

Abstract: This study showed no relationship between lag of accommodation and rate of myopia progression in children with progressing myopia. Different ethnic groups may respond differently to the same size of hyperopic blur.

Cited by 52 publications

References 45 publications

Role of un‐correction, under‐correction and over‐correction of myopia as a strategy for slowing myopic progression

Role of un‐correction, under‐correction and over‐correction of myopia as a strategy for slowing myopic progression

Re: Role of un‐correction, under‐correction and over‐correction of myopia as a strategy for slowing myopic progression

Refractive Error Change and Overminus Lens Therapy for Childhood Intermittent Exotropia

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