The clinical significance of a controlled visual exercise regimen for the progression of school myopia

Purpose. Analysis of the dynamics of the progression of myopia with observance and non-observance of the rules of visual work in primary school students. Material and methods. There were 40 children under supervision. The age at initial treatment was 8-10 years. All children were diagnosed with acquired myopia of mild degree from 1.0 to 3.0 D upon treatment. The children were observed for three years. At the first visit, the child's parents were explained in detail the mechanisms of the onset of school myopia, in particular, they focused on two reasons – bowed head syndrome and infinity of visual work, taking into account the use of gadgets. Results. For the analysis, 2 observation groups were formed. 1st group – 20 children (40 eyes), who strictly adhered to the rules of visual work at close range. The 2 nd group of children (20 people, 40 eyes) continued, despite the doctor's recommendations, to adhere to their usual way of life. When analyzing the results of the examination in the 1 st group of children, it was found that over 3 years of observation, all children showed a tendency towards a slow progression of myopia. This was expressed in the annual increase in the length of the anteroposterior axis (APA) of the eye by an average of 0.2 mm, which corresponded to an increase in refraction by no more than 1.0 D. In patients of the 2 nd group, over 3 years of follow-up, there was a significant progression of myopia with an annual increase in the length of the APA of the eye by an average of 0.5 mm, which corresponded to an increase in refraction by 3.5 D. Conclusion. This analysis showed that there are simple, affordable, inexpensive, non-surgical, but effective ways to prevent the progression of myopia, which makes it possible to reduce the likelihood of a rapid progression of myopia by 2.5 times. Key words: progression of myopia, anteroposterior axis of the eye, refraction, school myopia, visual stress regime.

Assessment of the Influence of Undifferentiated Connective Tissue Dysplasia on the Course of Myopia in School Age Children

Purpose. To study the effect of undifferentiated connective tissue dysplasia (UCTD) on the clinical features of the course of school myopia. Material and methods. The object of study – 120 children (240 eyes) aged 12–15 years with moderate axial myopia. In addition to standard examination methods, computer accommodography and measure of convergence were carried out. Two observation groups were formed: the main – 80 people (160 eyes) with clinical manifestations of UCTD, the control – 40 people (80 eyes) without clinical manifestations of UCTD. According to the severity of clinical manifestations of UCTD in the main group, 3 subgroups were distinguished: 1–A – 25 children (50 eyes) with a weak degree of UCTD, 1–B – 38 children (76 eyes) with a moderate degree of UCTD, 1–C – 17 children (34 eyes) with a pronounced degree of UCTD. Results. Locomotor syndrome prevails in the structure of UCTD in children of the main group. A comparative analysis of the frequency of peripheral retinal degeneration revealed that most often they are detected in children with myopia associated with UCTD. In children of the main observation group, weakness of accommodation prevails in the structure of accommodation disorders (p<0,05). In the general population of examined in 39 children (32,5%), the presence of esophoria of varying degrees of compensation was diagnosed. A statistically significant difference was revealed between the control group and the subgroup of children with myopia associated with a pronounced degree of UCTD. Conclusion. Phenotypic signs of locomotor syndrome prevails in the structure of UCTD. School myopia in children with UCTD is characterized by: an increase in the frequency of peripheral retinal degeneration in 2,9 times; an increase in the proportion of children with a weakness of accommodation – in 1,7 times and violations between accommodation and convergence – in 2,2 times, compared with children with myopia without UCTD.

Relevance of the Problem of Myopia in School-age Children with Signs of Undifferentiated Connective Tissue Dysplasia

Purpose:to study the frequency and structure of undifferentiated connective tissue dysplasia (UCTD) in school-age children with myopia, their relationship to choroidal thickness and course of myopia.Patients and methods. The object of study was 120 children (240 eyes) aged 11–13 years with school axial myopia (axial length (AL) from 24.5 to 26.0 mm). Special ophthalmological examination included optical coherent tomography of macular zone (“RTVue 100” Optovue, USA) and “Cross Line” scan for measuring choroidal thickness in foveal area and 1000 μm from it in nasal and temporal regions.Results.According to studies, the phenotypic signs of UCTD were diagnosed in 56 children (46.7%) with school myopia, the largest group included phenotypic signs of locomotor syndrome; 14 children (25%) had a weak degree of UCTD, 34 children (60.7%) — moderate degree and 8 children (14.3%) — pronounced degree. Comparative characteristic of changes in choroidal thickness detected a high degree of interrelation between the severity of clinical manifestations of UCTD and the level of decrease in blood-flow in the choroid. In children of the main group with signs of UCTD, the annual growth of AL exceeded the same parameters in children of the control group by more than 2.5 times (p < 0.05); due of accumulation of phenotypic signs of UCTD, a more noticeable tendency to decrease of choroidal thickness and the increase of AL was observed (p < 0.05). The statistical analysis confirmed the presence of significant negative correlation between the decrease in average thickness index in segment of the macular map and the degree of increase of AL (p < 0.05).Conclusions. According to results of diagnostic screening, in 46.7% children with school myopia, we detected phenotypic signs of UCTD. The method of optical coherence tomography showed that with increasing severity of UCTD, indexes of choroidal thickness in the macular zone are significant decreased. In the catamnesis (duration 1 year), it was found that in children with myopia with moderate and pronounced degrees of UCTD, increase of AL is associated with degree of thinning choroidal thickness, which indicates violations of biomechanical status of sclera.