scholarly journals Multi-Factoral Mechanisms of Therapeutic Effect of Perifocal Spectacles (Perifocal-M) on Progressive Myopia in Children

2019 ◽  
Vol 15 (4) ◽  
pp. 433-438 ◽  
Author(s):  
R. A. Ibatulin ◽  
O. V. Proskurina ◽  
E. P. Tarutta
Keyword(s):  
Regulatory Control ◽  
Optical Methods ◽  
Myopia Progression ◽  
Detailed Review ◽  
Eye Growth ◽  
Progressive Myopia ◽  
Near Work ◽  
First Time ◽  
Complex Influence ◽  
Myopia Control

There is detailed review of multi-factoral mechanisms of spectacles with peripheral defocus influence in children with progressive myopia in this article. At present local retinal mechanisms of neuro-regulatory control of eye growth are most effective in prevention of myopia development and progression. Optical correction of relative peripheral hyperopia with following peripheral myopic defocus affects the biochemical cascade from retina to choroid and sclera, which constrains an eye growth. Optical methods of myopia control, including spectacles, widely used in native and foreign ophthalmology practice. Since 2011, in Russia Perifocal-M spectacles are using, said spectacles provides bigger functionality of influence on myopic eye comparing to foreign analogues. Construction features of said spectacle lens have a complex influence on different optic-physiological eye structures and each of said structures affects refractogenesis. Perifocal spectacles takes into account specific for myopic eye features of central and peripheral refraction along horizontal and vertical meridians. They have stronger refraction in horizontal, which allows to eliminate specific optical disbalance in myopic eye and to create optical balance in the eye. Perifocal-M lens construction with asymmetric horizontal progression allows to correct relative peripheral hyperopia, to create myopic defocus in horizontal and to affect relations between refraction of nasal and temporal halves of retina. The latter is due to the fact that optical influence starts earlier and has bigger effect on nasal half of retina relative to temporal. Perifocal spectacles are inducing positive spherical aberrations in the eye, increasing accommodation functions, supporting high binocular visual acuity, improving binocular interaction during near work, fighting against heteroforias. Thus, optical features of Perifocal-M spectacles for the first time creates conditions for versatile functional influence on main myopogenic factors simultaneously, it effectively stops myopia progression.

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 lenses and myopia control

The Eye ◽  
2019 ◽  
Vol 126 (2019-2) ◽  
pp. 13-20
Author(s):  
Pyotr Nagorsky ◽  
Nikolai Kikhtenko ◽  
Vera Milyukhina
Keyword(s):  
Axial Length ◽  
Growth Dynamics ◽  
Control Group ◽  
Myopia Progression ◽  
Eye Growth ◽  
Vision Correction ◽  
Uncorrected Visual Acuity ◽  
Progressive Myopia ◽  
Observation Period ◽  
Myopia Control

Purpose: To estimate the stabilizing effect of orthokeratology lenses (ortho-K, OK-lenses) on myopia progression by evaluating axial eye growth dynamics and clinical refraction. Material and methods. Ortho-K group consisted of 68 children (135 eyes) aged 7–17 years (mean age 12.2) with progressive myopia (initially -0.75–6.75 D). Observation period varied from 7 to 30 months (mean period 11.68±4.39). All patients used OK-lenses for overnight wear. The control group consisted of 90 patients (180 eyes) with myopia who were prescribed single vision spectacles for vision correction. Comparative analysis was performed for clinical refraction parameters as well as for axial length (AL). The data was obtained with the use of IOL-Master optical biometer (“Carl Zeiss”). Results. The parameters were stable in patients of ortho-K group: axial length, subjective and objective clinical refraction, the required power of corrective lenses. However, the parameters changed significantly in the control group during the observation period: uncorrected visual acuity (UCVA) decreased, the required power of corrective lenses increased, the indices of objective clinical refraction strengthened, annual gradient of progression (AGP) amounted to 0.26±0.19 and 0.16±0,39 mm in patients with low and moderate myopia, respectively. Conclusion. The use of OK-lenses ensures a significant deceleration of myopia progression in children. The results obtained suggest a wider use of ortho-K among pediatric ophthalmologists in their clinical practice as it is an effective preventive and therapeutic method for patients with progressive myopia.

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.

Myopiekontrolle: aktuelle Strategien

2021 ◽  
Vol 1 (5) ◽  
pp. 148-155
Keyword(s):  
Contact Lenses ◽  
Long Term Effects ◽  
Soft Contact ◽  
Myopia Progression ◽  
Soft Contact Lenses ◽  
Slowing Down ◽  
The Future ◽  
Progressive Myopia ◽  
The Individual ◽  
Myopia Control

Purpose. The prevalence of myopia is increasing worldwide and its long-term effects can have major impacts on eye health. Paediatric onset of myopia leads to a higher risk for developing high levels of myopia in adulthood. Slowing down or stopping myopia progression is an important task for the future. Material and Methods. Based on a literature review, the latest developments in the field of myopia control for children were summarized. The current study situation for orthokeratology, soft contact lenses, atropine therapy and spectacle lenses for the management of myopia is discussed in detail. Results. Results on the safety and effectiveness of orthokeratology and modified soft contact lenses are exceedingly consistent. Soft multifocal contact lenses, as well as newer spectacle lenses, recently received regulatory approval for myopia control. Studies on the administration of atropine recommend a dosage of 0.01 - 0.05 %. All methods slow down myopia progression and decrease axial length growth of the eye. Side effects, adverse events or discontinuation of treatment only occur in the rarest of cases. Orthokeratology and atropine continue to deliver the best results. Conclusion. From today’s perspective, carrying out myopia control can be recommended with great certainty. The choice of method depends on the individual requirements of each patient, with all methods offering success in reducing myopia progression. In the future, even more advanced contact lens geometries, more precise atropine dosages or improved optics of spectacle lenses will further increase the success of the treatment. Keywords. Progressive myopia, myopia control, children, contact lenses, atropine, spectacle lenses

scholarly journals Side effects of topical atropine 0.05% compared to 0.01% for myopia control in German school children: a pilot study

2021 ◽  
Author(s):  
Lutz Joachimsen ◽  
Navid Farassat ◽  
Tim Bleul ◽  
Daniel Böhringer ◽  
Wolf A. Lagrèze ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Side Effects ◽  
Reading Difficulties ◽  
Myopia Progression ◽  
Asian Children ◽  
German School ◽  
Atropine Treatment ◽  
Near Visual Acuity ◽  
Progressive Myopia ◽  
Myopia Control

Abstract Purpose Based on findings of the Asian low-concentration atropine for myopia progression study, a concentration of 0.05% has been proposed as a good compromise between safety and efficacy for myopia control. However, no data on side effects have been published so far in Caucasian children receiving this dose. Methods Prior to commencement of bilateral atropine treatment with 0.05% atropine, 19 myopic children aged 5 to 15 years were treated in only one eye at bedtime leaving the other eye as a control. Pupil size, accommodation amplitude and near visual acuity were measured at 10:00 a.m. the next day and compared to the untreated contralateral control eye. The results were then compared to a cohort of 18 children whose treatment with 0.01% atropine commenced in a similar fashion. Results Twelve children (63%) reported visual impairment or reading difficulties. Anisocoria was 2.9 ± 1.1 mm. In comparison, 0.01% atropine led to a significantly less anisocoria of 0.8 ± 0.7 mm (p < 0.0001). Accommodation was decreased by − 4.2 ± 3.8 D in 0.05% atropine treated eyes, whereas 0.01% atropine induced hypoaccommodation of − 0.05 ± 2.5 D (p < 0.01). Near visual acuity was not significantly reduced in eyes treated with 0.05% atropine compared to 0.01% atropine (p = 0.26). Conclusion Compared to 0.01%, our data indicate stronger more relevant side effects of 0.05% topical atropine in young Caucasian children with progressive myopia as recently reported in Asian children, potentially compromising acceptance and compliance.

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

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.

scholarly journals Additive effect of atropine eye drops and short-term retinal defocus on choroidal thickness in children with myopia

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Samuel T.-H. Chiang ◽  
Philip R. K. Turnbull ◽  
John R. Phillips
Keyword(s):  
Eye Drops ◽  
Additive Effects ◽  
Short Term ◽  
Myopia Progression ◽  
Eye Growth ◽  
Slow Progression ◽  
Before And After ◽  
Atropine Treatment ◽  
Optical Defocus ◽  
Myopia Control

Abstract Atropine eye drops and myopic retinal defocus each slow progression of myopia (short-sight). They also cause thickening of the choroid, and it has been suggested that the thickening is a precursor for reduced eye growth and slowed myopia progression. We investigated whether choroidal thickening due to optical defocus would add to thickening due to atropine when both were applied simultaneously. Addition would suggest that combining the two clinical treatments may improve efficacy of myopia control. We studied 20 children receiving 0.3% atropine daily for myopia control, over a period of 6 months. We imposed short periods of retinal defocus (1 h of myopic or hyperopic defocus (± 2.00D)) both before, and after 1 week and 3 and 6 months of atropine treatment. Prior to atropine, myopic or hyperopic defocus caused significantly thicker or thinner choroids respectively (± 12 µm, p < 0.001). After one week of atropine alone, thickness had increased (+ 21 µm; SD 17 µm; p < 0.001), and it increased further (by + 13 µm; SD 6 µm; p < 0.001) when exposed to myopic defocus. Atropine abolished choroidal thinning in response to hyperopic defocus. These effects remained the same after 3 and 6 months of atropine treatment. Our results show that additive effects of atropine and optical defocus are present at the level of the choroid, and suggest that combining optical and pharmaceutical treatments is likely to enhance efficacy of clinical myopia control.

Dietary ω-3 polyunsaturated fatty acids are protective for myopia

2021 ◽  
Vol 118 (43) ◽  
pp. e2104689118
Author(s):  
Miaozhen Pan ◽  
Fei Zhao ◽  
Bintao Xie ◽  
Hao Wu ◽  
Sen Zhang ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Polyunsaturated Fatty Acids ◽  
Guinea Pigs ◽  
Human Subjects ◽  
Blood Perfusion ◽  
Omega 3 ◽  
Myopia Progression ◽  
Control And Prevention ◽  
Near Work ◽  
Myopia Control

Myopia is a leading cause of visual impairment and blindness worldwide. However, a safe and accessible approach for myopia control and prevention is currently unavailable. Here, we investigated the therapeutic effect of dietary supplements of omega-3 polyunsaturated fatty acids (ω-3 PUFAs) on myopia progression in animal models and on decreases in choroidal blood perfusion (ChBP) caused by near work, a risk factor for myopia in young adults. We demonstrated that daily gavage of ω-3 PUFAs (300 mg docosahexaenoic acid [DHA] plus 60 mg eicosapentaenoic acid [EPA]) significantly attenuated the development of form deprivation myopia in guinea pigs and mice, as well as of lens-induced myopia in guinea pigs. Peribulbar injections of DHA also inhibited myopia progression in form-deprived guinea pigs. The suppression of myopia in guinea pigs was accompanied by inhibition of the “ChBP reduction–scleral hypoxia cascade.” Additionally, treatment with DHA or EPA antagonized hypoxia-induced myofibroblast transdifferentiation in cultured human scleral fibroblasts. In human subjects, oral administration of ω-3 PUFAs partially alleviated the near-work–induced decreases in ChBP. Therefore, evidence from these animal and human studies suggests ω-3 PUFAs are potential and readily available candidates for myopia control.

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.

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