Peripheral Defocus and Myopia Progression in Myopic Children Randomly Assigned to Wear Single Vision and Progressive Addition Lenses

BACKGROUND Hyperopia occurs due to insufficient ocular growth and a failure to emmetropize in childhood. In anisohyperopia, it is unclear why one eye may remain hyperopic while the fellow eye grows toward an emmetropic state. Animal studies have shown that manipulating peripheral defocus through optical means while simultaneously providing correct axial focus can either discourage or encourage axial eye growth to effectively treat myopia or hyperopia, respectively. Myopia progression and axial eye growth can be significantly reduced in children and adolescents through the use of multifocal contact lenses. These contact lenses correct distance central myopia while simultaneously imposing relative peripheral myopic defocus. The effect of correcting distance central hyperopia while simultaneously imposing relative peripheral hyperopic defocus is yet to be elucidated in humans. OBJECTIVE The objective of our study is to understand the natural progression of axial eye growth and refractive error in hyperopes and anisohyperopes and to establish whether axial eye growth and refractive error can be modified using multifocal contact lenses in hyperopes and anisohyperopes. METHODS There are 3 elements to the program of research. First, the natural progression of axial eye growth and refractive error will be measured in spectacle-wearing hyperopic and anisohyperopic subjects aged between 5 and <20 years. In other words, the natural growth of the eye will be followed without any intervention. Second, as a paired-eye control study, anisohyperopes aged between 8 and <16 years will be fitted with a center-near multifocal design contact lens in their more hyperopic eye and a single-vision contact lens in the fellow eye if required. The progression of axial eye growth and refractive error will be measured and compared. Third, subjects aged between 8 and <16 years with similar levels of hyperopia in each eye will be fitted with center-near multifocal design contact lenses in each eye; the progression of axial eye growth and refractive error in these subjects will be measured and compared with those of subjects in the natural progression study. RESULTS Recruitment commenced on 6 June 2016 and was completed on 8 April 2017. We estimate the data collection to be completed by April 2020. CONCLUSIONS This trial will establish whether axial eye growth can be accelerated in children with hyperopia by imposing relative peripheral hyperopic defocus using center-near multifocal contact lenses. CLINICALTRIAL ClinicalTrials.gov NCT02686879; https://clinicaltrials.gov/ct2/show/NCT02686879 (Archived by Webcite at http://www.webcitation.org/71o5p3fD2) REGISTERED REPORT IDENTIFIER RR1-10.2196/9320

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One-year myopia control efficacy of spectacle lenses with aspherical lenslets

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-318367 ◽

2021 ◽

pp. bjophthalmol-2020-318367

Author(s):

Jinhua Bao ◽

Adeline Yang ◽

Yingying Huang ◽

Xue Li ◽

Yiguo Pan ◽

...

Keyword(s):

Control Efficacy ◽

Myopia Progression ◽

Corrected Visual Acuity ◽

Single Vision ◽

Spherical Equivalent Refraction ◽

Registration Number ◽

The Mean ◽

One Year ◽

To Receive ◽

Myopia Control

AimsTo evaluate the 1-year efficacy of two new myopia control spectacle lenses with lenslets of different asphericity.MethodsOne hundred seventy schoolchildren aged 8–13 years with myopia of −0.75 D to −4.75 D were randomised to receive spectacle lenses with highly aspherical lenslets (HAL), spectacle lenses with slightly aspherical lenslets (SAL), or single-vision spectacle lenses (SVL). Cycloplegic autorefraction (spherical equivalent refraction (SER)), axial length (AL) and best-corrected visual acuity (BCVA) were measured at baseline and 6-month intervals. Adaptation and compliance questionnaires were administered during all visits.ResultsAfter 1 year, the mean changes in the SER (±SE) and AL (±SE) in the SVL group were −0.81±0.06 D and 0.36±0.02 mm. Compared with SVL, the myopia control efficacy measured using SER was 67% (difference of 0.53 D) for HAL and 41% (difference of 0.33 D) for SAL, and the efficacy measured using AL was 64% (difference of 0.23 mm) for HAL and 31% (difference of 0.11 mm) for SAL (all p<0.01). HAL resulted in significantly greater myopia control than SAL for SER (difference of 0.21 D, p<0.001) and AL (difference of 0.12 mm, p<0.001). The mean BCVA (−0.01±0.1 logMAR, p=0.22) and mean daily wearing time (13.2±2.6 hours, p=0.26) were similar among the three groups. All groups adapted to their lenses with no reported adverse events, complaints or discomfort.ConclusionsSpectacle lenses with aspherical lenslets effectively slow myopia progression and axial elongation compared with SVL. Myopia control efficacy increased with lenslet asphericity.Trial registration numberChiCTR1800017683.

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To Correct or Not Correct? Actual Evidence, Controversy and the Questions That Remain Open

Journal of Clinical Medicine ◽

10.3390/jcm9061975 ◽

2020 ◽

Vol 9 (6) ◽

pp. 1975

Author(s):

Miguel García García ◽

Katharina Breher ◽

Arne Ohlendorf ◽

Siegfried Wahl

Keyword(s):

Basic Research ◽

Control Group ◽

Myopia Progression ◽

Ethical Implications ◽

Eye Growth ◽

Single Vision ◽

Full Correction ◽

New Guidelines ◽

Lens Wear ◽

Myopia Control

Clinical studies and basic research have attempted to establish a relationship between myopia progression and single vision spectacle wear, albeit with unclear results. Single vision spectacle lenses are continuously used as the control group in myopia control trials. Hence, it is a matter of high relevance to investigate further whether they yield any shift on the refractive state, which could have been masked by being used as a control. In this review, eye development in relation to eyes fully corrected versus those under-corrected is discussed, and new guidelines are provided for the analysis of structural eye changes due to optical treatments. These guidelines are tested and optimised, while ethical implications are revisited. This newly described methodology can be translated to larger clinical trials, finally exerting the real effect of full correction via single vision spectacle lens wear on eye growth and myopia progression.

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Progressive-Addition Lenses versus Single-Vision Lenses for Slowing Progression of Myopia in Children with High Accommodative Lag and Near Esophoria

Investigative Ophthalmology & Visual Science ◽

10.1167/iovs.10-6631 ◽

2011 ◽

Vol 52 (5) ◽

pp. 2749-2757 ◽

Cited By ~ 75

Author(s):

Keyword(s):

Single Vision ◽

Progressive Addition Lenses ◽

Accommodative Lag

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Quality of Life in Presbyopes with Low and High Myopia Using Single-Vision and Progressive-Lens Correction

Journal of Clinical Medicine ◽

10.3390/jcm10081589 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1589

Author(s):

Adeline Yang ◽

Si Ying Lim ◽

Yee Ling Wong ◽

Anna Yeo ◽

Narayanan Rajeev ◽

...

Keyword(s):

Quality Of Life ◽

High Myopia ◽

Rasch Analysis ◽

Single Vision ◽

Refractive Status ◽

Related Quality ◽

Progressive Addition Lenses ◽

The Impact ◽

Visual Correction

This study evaluates the impact of the severity of myopia and the type of visual correction in presbyopia on vision-related quality of life (QOL), using the refractive status and vision profile (RSVP) questionnaire. A total of 149 subjects aged 41–75 years with myopic presbyopia were recruited: 108 had low myopia and 41 had high myopia. The RSVP questionnaire was administered. Rasch analysis was performed on five subscales: perception, expectation, functionality, symptoms, and problems with glasses. Highly myopic subjects had a significantly lower mean QOL score (51.65), compared to low myopes (65.24) (p < 0.001). They also had a significantly lower functionality score with glasses (49.38), compared to low myopes (57.00) (p = 0.018), and they had a worse functionality score without glasses (29.12), compared to low myopes (36.24) (p = 0.045). Those who wore progressive addition lenses (PAL) in the high-myope group (n = 25) scored significantly better, compared to those who wore single-vision distance (SVD) lenses (n = 14), with perception scores of 61.19 and 46.94, respectively (p = 0.029). Highly myopic presbyopes had worse overall QOL and functionality, both with and without glasses, compared to presbyopes with low myopia. High-myopic PAL users had a better perception outcome than SVD lens wearers. Low-myopic PAL wearers had a better QOL than SVD wearers.

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