scholarly journals Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute

2021 ◽  
pp. 112067212199896
Author(s):  
János Németh ◽  
Beáta Tapasztó ◽  
Wagih A Aclimandos ◽  
Philippe Kestelyn ◽  
Jost B Jonas ◽  
...  
Keyword(s):  
European Society ◽  
High Myopia ◽  
Treatment Options ◽  
Vision Impairment ◽  
Pathological Myopia ◽  
Myopia Progression ◽  
Preventive Actions ◽  
Prevalence Estimates ◽  
Number Of Individuals ◽  
Myopia Control

The prevalence of myopia is increasing extensively worldwide. The number of people with myopia in 2020 is predicted to be 2.6 billion globally, which is expected to rise up to 4.9 billion by 2050, unless preventive actions and interventions are taken. The number of individuals with high myopia is also increasing substantially and pathological myopia is predicted to become the most common cause of irreversible vision impairment and blindness worldwide and also in Europe. These prevalence estimates indicate the importance of reducing the burden of myopia by means of myopia control interventions to prevent myopia onset and to slow down myopia progression. Due to the urgency of the situation, the European Society of Ophthalmology decided to publish this update of the current information and guidance on management of myopia. The pathogenesis and genetics of myopia are also summarized and epidemiology, risk factors, preventive and treatment options are discussed in details.

scholarly journals Efficacy of myopia control by combination of orthokeratology and instillation of low-concentration atropine

The Eye ◽  
2019 ◽  
Vol 126 (2019-2) ◽  
pp. 22-30
Author(s):  
Elena Tarutta ◽  
Tatiana Verzhanskaya
Keyword(s):  
High Myopia ◽  
Inhibitory Effect ◽  
Myopia Progression ◽  
Noticeable Effect ◽  
Low Concentration ◽  
Biomechanical Changes ◽  
Positive Effect ◽  
Myopia Control ◽  
Ampli Tude

Majority of reports regarding methods of myopia control are devoted to the use of orthokeratology lens¬es (OKL) or atropine. The purpose of the study was to estimate the efficacy and safety of using OKL in com¬bination with instillation of 0.01% atropine drops for myopia control in children. Material and methods. Prospective cohort study in¬cluded 34 patients (68 eyes) aged 8 to 14 years old with acquired myopia. Groups with low (17 patients, 34 eyes), moderate (12 patients, 24 eyes) and high (5 patients, 10 eyes) myopia were identified and examined prior to and 6, 12 and 18 months after adding 0.01% atropine instillations to OKL wearing. To assess the degree of pro¬gression of myopia in dynamics the following parameters were evaluated: refraction (by Huvitz MRK 3100P, axial length (AL) by IOL-Master, “Carl Zeiss”, (Germany), ampli¬tude of accommodation (AA) by Grand Seiko WRK-5100K, positive-relative accommodation (PRA), pseudoaccom¬modation (PA) and annual gradient of progression (AGP). Results. The most noticeable effect was observed in patients with low myopia. In patients with low myopia, the rate of annual progression gradient decreased by 3.4 times by 18th month of atropine use; therefore a condition close to stabilization of myopia progression occurred. The data is statistically significant. In patients with moderate myopia, despite the de¬crease of the AGP within 6-month period of atropine use by 3.7 times, the increase of APG was observed by 12th month of atropine use, which continued until 18th month of observation. In spite of this, in comparison with baseline indices, the decrease in the rate of myo¬pia progression was obtained. The data is statistically significant. In patients with high myopia, change in the AGP was not ob¬served within the 6-month period of atropine use; afterwards, a gradual decrease in the rate of myopia progression was noted: AGP decreased by 1.2 times by 12th month. By 18th month of atropine use, AGP decreased by 1.5 times compared to its initial level. The data is statistically significant. Evidently, the inhibitory effect of OKL, which is de¬termined by optical factors such as peripheral myopic defocus, even in combination with atropine, is not suf¬ficient to halt the progression of high myopia, because of structural and biomechanical changes of the sclera. Conclusion. Based on the preliminary results ob¬tained, 100% efficacy of a long-term instillation of low-concentration atropine cannot be claimed, howev¬er, the positive effect does exist and therefore the study continues.

CONTROLLING MYOPIA PROGRESSION IN CHILDREN

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Neelam Verma
Keyword(s):  
Systematic Review ◽  
Contact Lenses ◽  
Treatment Options ◽  
East Asian ◽  
Asian Countries ◽  
Myopia Progression ◽  
The Us ◽  
Progressive Myopia ◽  
Pharmaceutical Agents ◽  
Myopia Control

Main aim of this article was a systematic review on causes and management of Myopia progression in children. Myopia is a general disorder, affecting just about one-third of the US popula­tion and over 90% of the population in some East Asian countries. Elevated amounts of myopia are connected with a bigger risk of sight-threatening troubles, such as retinal detachment, choroidal degeneration, cataracts and glaucoma. Slowing the progression of myopia could potentially advantage millions of children in the India. Few approaches used for myopia organize have proven to be useful. Treatment options such as undercorrection of myopia, gas permeable contact lenses, and bifocal or multifocal spectacles have all been proven to be inef­fective for myopia control, although one recent randomized clinical trial using executive top bifocal spectacles on children with progressive myopia has shown to decrease the progression to nearly half of the control subjects. The most effective methods are the use of orthokeratology contact lenses, soft bifocal contact lenses, and pharmaceutical agents such as atropine, timolol or pirenzepine. Keyword: Myopia progression, pharmaceutical agents, lenses, treatment.

scholarly journals Myopia control effect of defocus incorporated multiple segments (DIMS) spectacle lens in Chinese children: results of a 3-year follow-up study

2021 ◽  
pp. bjophthalmol-2020-317664
Author(s):  
Carly SY Lam ◽  
Wing Chun Tang ◽  
Paul H Lee ◽  
Han Yu Zhang ◽  
Hua Qi ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Mean Difference ◽  
Historical Control ◽  
Control Group ◽  
Control Effect ◽  
Myopia Progression ◽  
The Third ◽  
Spherical Equivalent Refraction ◽  
Mean Differences ◽  
Myopia Control

AimsTo determine myopia progression in children who continued to wear the defocus incorporated multiple segments (DIMS) lenses or switched from single vision (SV) to DIMS lenses for a 1-year period following a 2-year myopia control trial.Methods128 children participated in this study. The children who had worn DIMS lenses continued to wear DIMS lenses (DIMS group), and children who had worn SV lenses switched to wear DIMS lenses (Control-to-DIMS group). Cycloplegic spherical equivalent refraction (SER) and axial length (AL) were measured at 6-month interval. Historical controls were age matched to the DIMS group at 24 months and used for comparing the third-year changes.ResultsOver 3 years, SER and AL changes in the DIMS group (n=65) were −0.52±0.69D and 0.31±0.26 mm; these changes were not statistically significant over time (repeated measures analysis of variance, p>0.05).SER (−0.04±0. 38D) and AL (0.08±0.12 mm) changes in the Control-to-DIMS group (n=55) in the third year were less compared with the first (mean difference=0.45 ± 0.30D, 0.21±0.11 mm, p<0.001) and second (0.34±0.30D, 0.12±0.10 mm, p<0.001) years.Changes in SER and AL in both groups over that period were significantly less than in the historical control group (DIMS vs historical control: mean difference=−0.18±0.42D, p=0.012; 0.08±0.15 mm, p=0.001; Control-to-DIMS versus historical control: adjusted mean differences=−0.30±0.42D, p<0.001; 0.12±0.16 mm, p<0.001).ConclusionsMyopia control effect was sustained in the third year in children who had used the DIMS spectacles in the previous 2 years and was also shown in the children switching from SV to DIMS lenses.

scholarly journals Myopia Control with Combination Low-Dose Atropine and Peripheral Defocus Soft Contact Lenses: A Case Series

2021 ◽  
pp. 548-554
Author(s):  
Nir Erdinest ◽  
Naomi London ◽  
Nadav Levinger ◽  
Yair Morad
Keyword(s):  
Low Dose ◽  
Contact Lenses ◽  
Case Series ◽  
Concentric Circle ◽  
Retrospective Case ◽  
Soft Contact ◽  
Myopia Progression ◽  
Soft Contact Lenses ◽  
Center Distance ◽  
Myopia Control

The goal of this retrospective case series is to demonstrate the effectivity of combination low-dose atropine therapy with peripheral defocus, double concentric circle design with a center distance soft contact lenses at controlling myopia progression over 1 year of treatment. Included in this series are 3 female children aged 8–10 years with progressing myopia averaging −4.37 ± 0.88 D at the beginning of treatment. Their average annual myopic progression during the 3 years prior to therapy was 1.12 ± 0.75 D. They had not attempted any myopia control treatments prior to this therapy. The children were treated with a combination of 0.01% atropine therapy with spherical peripheral defocus daily replacement soft lenses MiSight<sup>®</sup> 1 day (Cooper Vision, Phoenix, AZ, USA). They underwent cycloplegic refraction, and a slit-lamp evaluation every 6 months which confirmed no adverse reactions or staining was present. Each of the 3 children exhibited an average of 0.25 ± 0.25 D of myopia progression at the end of 1 year of treatment. To the best of the authors’ knowledge, this is the first published study exhibiting that combining low-dose atropine and peripheral defocus soft contact lenses is effective at controlling children’s moderate to severe myopia progression during 1 year of therapy.

scholarly journals Myopia progression from wearing first glasses to adult age: the DREAM Study

2021 ◽  
pp. bjophthalmol-2020-316234
Author(s):  
Jan Roelof Polling ◽  
Caroline Klaver ◽  
Jan Willem Tideman
Keyword(s):  
Retrospective Study ◽  
The Netherlands ◽  
Refractive Error ◽  
High Myopia ◽  
Prognostic Indicator ◽  
Treatment Intensity ◽  
Spherical Equivalent ◽  
Inclusion Criteria ◽  
Myopia Progression ◽  
Adult Age

PurposeData on myopia progression during its entire course are scarce. The aim of this study is to investigate myopia progression in Europeans as a function of age and degree of myopia from first prescription to final refractive error.MethodsThe Drentse Refractive Error and Myopia Study assessed data from a branch of opticians in the Netherlands from 1985 onwards in a retrospective study. First pair of glasses prescribed was defined as a spherical equivalent of refraction (SER) ≤−0.5 D to ≥−3.0 D. Subjects with prescriptions at an interval of at least 1 year were included in the analysis.ResultsA total of 2555 persons (57.3% female) met the inclusion criteria. Those with first prescription before the age of 10 years showed the strongest progression (−0.50 D; IQR: −0.75 to −0.19) and a significantly (p<0.001) more negative median final SER (−4.48 D; IQR: −5.37 to −3.42). All children who developed SER ≤−3 D at 10 years were highly myopic (SER ≤−6D) as adults, children who had SER between −1.5 D and −3 D at 10 years had 46.0% risk of high myopia, and children with SER between −0.5 D and −1.5 D had 32.6% risk of high myopia. Myopia progression diminished with age; all refractive categories stabilised after age 15 years except for SER ≤−5 D who progressed up to −0.25 D annually until age 21 years.ConclusionOur trajectories of the natural course of myopia progression may serve as a guide for myopia management in European children. SER at 10 years is an important prognostic indicator and will help determine treatment intensity.

scholarly journals Endothelin-1 Serum Concentration is Lower in Children and Adolescents with High Myopia, a Preliminary Study

2020 ◽  
Vol 9 (5) ◽  
pp. 1327
Author(s):  
Katarzyna Powierza ◽  
Beata Żelazowska-Rutkowska ◽  
Jolanta Sawicka-Powierza ◽  
Bożena Mikołuć ◽  
Beata Urban ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Axial Length ◽  
High Myopia ◽  
Cross Sectional Study ◽  
Enzyme Linked Immunosorbent Assay ◽  
Serum Concentrations ◽  
Myopia Progression ◽  
Cross Sectional ◽  
Weak Negative Correlation ◽  
Preliminary Study

The aim of this study is to evaluate the levels of enothelin-1 (ET-1) in children and adolescents with high myopia and its association with the axial length of the eye and the presence of myopic retinal degeneration. The cross-sectional study was carried out in 57 patients with high myopia and 29 control subjects. Serum concentrations of ET-1 were measured using enzyme-linked immunosorbent assay (ELISA) kit. A significantly lower concentration of ET-1 in highly myopic patients compared to controls was found (1.47 (0.91; 1.87) vs. 1.94 (1.1; 2.69) pg/mL, p = 0.005). In patients with high myopia, a weak negative correlation between ET-1 concentration and the longest axial length out of the two eyes was found (r = −0.255, p = 0.0558). Further analysis revealed statistically significant differences in ET-1 concentration between patients with the axial length of the eye > 26 and ≤ 26 mm (p < 0.041) and patients with the axial length of the eye > 26 mm and controls (p < 0.001). ET-1 expression is disturbed in highly myopic children and adolescents. Lower ET-1 concentration in patients with the axial length of the eye > 26 mm may co-occur with high myopia and should be considered a risk factor in the pathophysiology of high myopia progression.

scholarly journals Pharmacological Myopia Control Influence on Quality of Life and Psyche among Adolescents

2020 ◽  
Vol 9 (12) ◽  
pp. 3920
Author(s):  
Andrzej Michalski ◽  
Małgorzata Rogaczewska ◽  
Magdalena Maleszka-Kurpiel ◽  
Marcin Stopa
Keyword(s):  
Quality Of Life ◽  
Low Dose ◽  
Self Esteem ◽  
Progression Rate ◽  
Myopia Progression ◽  
Significant Difference ◽  
High Level ◽  
Near Work ◽  
Myopia Control

Myopia is a global problem affecting all aspects of patients’ lives. Objectives: The aim of the study was to evaluate the influence of low dose atropine (LDA) myopia control on the quality of life in patients with myopia. Material and Methods: A self-constructed questionnaire, including eight questions, was distributed among 40 patients. The questionnaire was divided into two subsections: (1) influence of LDA on visual functions and (2) influence of LDA on self-esteem. Answers were collected separately for boys (18 patients) and girls (22 patients) and compared considering spherical equivalent (SE) and myopia progression rate. Results: Girls reported more issues with near activities and pupil size. Boys and girls complained similarly, regarding the sun glare. We found a high level of certainty about the efficacy of LDA therapy among both examined groups and a little improvement in self-esteem. Girls recommended LDA therapy more often than boys, especially when the progression rate was low. There was no statistically significant difference in answer scores between groups with different myopia progression rates for boys. Girls with lower progression rates reported more issues with near work and sun glare and less trust in LDA therapy’s effectiveness than girls with a higher progression rate. There was no statistically significant correlation between SE and the total answer score for both genders. Conclusions: Findings concerning childrens’ and adolescents’ psyche are a new aspect of myopia control. We prove that patients during pharmacological myopia control did not report significant problems caused by LDA therapy and they were convinced about its efficacy, had greater self-esteem, and recommended it to peers.

scholarly journals Modern optical methods of peripheral defocus correction

2019 ◽  
Vol 12 (4) ◽  
pp. 92-98 ◽  
Author(s):  
S. V. Milash ◽  
M. V. Epishina ◽  
R. R. Toloraya
Keyword(s):  
Experimental Animal ◽  
Animal Studies ◽  
Optical Methods ◽  
Myopia Progression ◽  
Eye Growth ◽  
Retinal Periphery ◽  
Speed Up ◽  
Spectacle Correction ◽  
Myopia Control

Experimental animal studies proved that by manipulating with the defocus one can slow down or speed up the eye growth. The leading mechanism among modern optical strategies of myopia progression treatment is to induce myopic defocus to retinal periphery or decrease the hyperopic defocus. This review sums up the data on peripheral refraction in orthokeratological, multifocal contact, and multifocal spectacle correction. The effectiveness of these methods in myopia control in children and teenagers is shown.

scholarly journals Orthokeratology and Low-Intensity Laser Therapy for Slowing the Progression of Myopia in Children

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Fen Xiong ◽  
Tian Mao ◽  
Hongfei Liao ◽  
Xiaoqin Hu ◽  
Lei Shang ◽  
...  
Keyword(s):  
Laser Therapy ◽  
Low Level Laser Therapy ◽  
Control Group ◽  
Myopia Progression ◽  
Level Laser ◽  
Spherical Equivalent Refraction ◽  
Treatment Changes ◽  
Low Intensity Laser Therapy ◽  
Intensity Laser ◽  
Myopia Control

Orthokeratology (OK) is widely used to slow the progression of myopia. Low-level laser therapy (LLLT) provides sufficient low energy to change the cellular function. This research is aimed at verifying the hypothesis that LLLT treatment could control myopia progression and comparing the abilities of OK lenses and LLLT to control the refractive error of myopia. Eighty-one children (81 eyes) who wore OK lenses, 74 children (74 eyes) who underwent LLLT treatment, and 74 children (74 eyes) who wore single-vision distance spectacles for 6 months were included. Changes in axial length (AL) were 0.23 ± 0.06   mm for children wearing spectacles, 0.06 ± 0.15   mm for children wearing OK lens, and − 0.06 ± 0.15   mm for children treated with LLLT for 6 months. Changes in subfoveal choroidal thickness (SFChT) observed at the 6-month examination were − 16.84 ± 7.85   μ m , 14.98 ± 22.50   μ m , and 35.30 ± 31.75   μ m for the control group, OK group, and LLLT group, respectively. Increases in AL at 1 month and 6 months were significantly associated with age at LLLT treatment. Changes in AL were significantly correlated with the baseline spherical equivalent refraction (SER) and baseline AL in the OK and LLLT groups. Increases in SFChT at 1 month and 6 months were positively associated with age at enrolment for children wearing OK lens. At 6 months, axial elongation had decelerated in OK lens-wearers and LLLT-treated children. Slightly better myopia control was observed with LLLT treatment than with overnight OK lens-wearing. Evaluations of age, SER, and AL can enhance screening for high-risk myopia, improve the myopia prognosis, and help determine suitable control methods yielding the most benefits.

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