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The relationship between myopia progression and axial elongation in children wearing orthokeratology contact lenses

  • Author Footnotes
    1 contributed equally to the study and should be considered co-first authors
    Zhi Chen
    Footnotes
    1 contributed equally to the study and should be considered co-first authors
    Affiliations
    Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China

    NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China

    Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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  • Author Footnotes
    1 contributed equally to the study and should be considered co-first authors
    Zhe Zhang
    Footnotes
    1 contributed equally to the study and should be considered co-first authors
    Affiliations
    Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China

    NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China

    Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
    Search for articles by this author
  • Author Footnotes
    1 contributed equally to the study and should be considered co-first authors
    Feng Xue
    Footnotes
    1 contributed equally to the study and should be considered co-first authors
    Affiliations
    Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China

    NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China

    Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
    Search for articles by this author
  • Jiaqi Zhou
    Affiliations
    Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China

    NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China

    Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
    Search for articles by this author
  • Li Zeng
    Affiliations
    Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China

    NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China

    Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
    Search for articles by this author
  • Xiaomei Qu
    Affiliations
    Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China

    NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China

    Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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  • Xingtao Zhou
    Correspondence
    Corresponding author at: 19 Baoqing Road, Xuhui District, Shanghai, China.
    Affiliations
    Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China

    NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China

    Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
    Search for articles by this author
  • Author Footnotes
    1 contributed equally to the study and should be considered co-first authors
Published:October 05, 2021DOI:https://doi.org/10.1016/j.clae.2021.101517

      Abstract

      Purpose

      To investigate the relationship between myopia progression and axial length (AL) elongation in orthokeratology (ortho-k) patients.

      Methods

      This study investigated 184 patients (baseline age 9.0 ± 1.6 years), who underwent overnight ortho-k treatment for 12 to 72 months, and stopped lens wear for 1 to 2 months. Refractive sphere and cylinder after cycloplegia, corneal curvatures along both meridians, and AL were compared before the commencement and after discontinuation of ortho-k treatment. The effects of AL change, baseline AL, corneal curvature change, baseline age, and duration of ortho-k treatment on the change in spherical equivalent refractive error (SER) were analysed.

      Results

      Myopia significantly progressed and AL increased following 32.8 ± 13.0 months of ortho-k lens wear and 1 to 2 months washout period, as compared to baseline (all P < 0.001). Corneal curvature along the flat meridian (FK) became significantly flatter (P < 0.001) and corneal curvature along the steep meridian (SK) became steeper (P = 0.036). In the first stepwise multiple linear regression model (R2 = 0.696), the change in SER over time (ΔSER) is significantly correlated to the change in AL (ΔAL, P < 0.001), baseline AL (P < 0.001), baseline age (P = 0.028), change in SK (P = 0.002), and the duration of ortho-k lens treatment before discontinuation (P = 0.010). In a more simplified model (R2 = 0.628), the regression equation using ΔAL to predict ΔSER is: ΔSER = -0.094–1.608*ΔAL.

      Conclusions

      The change in SER was significantly correlated to the change in AL, change in SK, baseline AL, baseline age, and the duration of treatment among children undergoing ortho-k therapy. The ratio of axial elongation to myopia progression was approximately 1:1.6 between the ages of 6 to 14 years. A simplified equation was derived for clinical use to estimate myopia progression from repeated AL measurement in ortho-k patients.

      Keywords

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      References

        • Morgan I.G.
        • French A.N.
        • Ashby R.S.
        • Guo X.
        • Ding X.
        • He M.
        • et al.
        The epidemics of myopia: Aetiology and prevention.
        Prog Retin Eye Res. 2018; 62: 134-149
        • Saw S.-M.
        • Tong L.
        • Chua W.-H.
        • Chia K.-S.
        • Koh D.
        • Tan D.T.H.
        • et al.
        Incidence and progression of myopia in Singaporean school children.
        Invest Ophthalmol Vis Sci. 2005; 46: 51https://doi.org/10.1167/iovs.04-0565
        • Saw S.-M.
        • Gazzard G.
        • Shih-Yen E.C.
        • Chua W.-H.
        Myopia and associated pathological complications.
        Ophthalmic Physiol Opt. 2005; 25: 381-391
        • Bullimore M.A.
        • Brennan N.A.
        Myopia control: Why each diopter matters.
        Optom Vis Sci. 2019; 96: 463-465
        • Huang J.
        • Wen D.
        • Wang Q.
        • McAlinden C.
        • Flitcroft I.
        • Chen H.
        • et al.
        Efficacy Comparison of 16 Interventions for Myopia Control in Children: A Network Meta-analysis.
        Ophthalmology. 2016; 123: 697-708
        • Xie P.
        • Guo X.
        Chinese Experiences on Orthokeratology.
        Eye Contact Lens. 2016; 42: 43-47
        • Cho P.
        • Cheung S.-W.
        Retardation of myopia in Orthokeratology (ROMIO) study: a 2-year randomized clinical trial.
        Invest Ophthalmol Vis Sci. 2012; 53: 7077https://doi.org/10.1167/iovs.12-10565
        • Cho P.
        • Cheung S.W.
        • Edwards M.
        The longitudinal orthokeratology research in children (LORIC) in Hong Kong: a pilot study on refractive changes and myopic control.
        Curr Eye Res. 2005; 30: 71-80
        • Hiraoka T.
        • Kakita T.
        • Okamoto F.
        • Takahashi H.
        • Oshika T.
        Long-term effect of overnight orthokeratology on axial length elongation in childhood myopia: a 5-year follow-up study.
        Invest Ophthalmol Vis Sci. 2012; 53: 3913https://doi.org/10.1167/iovs.11-8453
        • Walline J.J.
        • Jones L.A.
        • Sinnott L.T.
        Corneal reshaping and myopia progression.
        Brit. J. Ophthalmol. 2009; 93: 1181-1185
        • Vincent S.J.
        • Cho P.
        • Chan K.Y.
        • Fadel D.
        • Ghorbani-Mojarrad N.
        • González-Méijome J.M.
        • et al.
        CLEAR - Orthokeratology.
        Cont Lens Anterior Eye. 2021; 44: 240-269
        • Cheung S.-W.
        • Cho P.
        Validity of axial length measurements for monitoring myopic progression in orthokeratology.
        Invest Ophthalmol Vis Sci. 2013; 54: 1613https://doi.org/10.1167/iovs.12-10434
        • Jones L.A.
        • Mitchell G.L.
        • Mutti D.O.
        • Hayes J.R.
        • Moeschberger M.L.
        • Zadnik K.
        Comparison of ocular component growth curves among refractive error groups in children.
        Invest Ophthalmol Vis Sci. 2005; 46: 2317https://doi.org/10.1167/iovs.04-0945
        • Mutti D.O.
        • Hayes J.R.
        • Mitchell G.L.
        • Jones L.A.
        • Moeschberger M.L.
        • Cotter S.A.
        • et al.
        Refractive error, axial length, and relative peripheral refractive error before and after the onset of myopia.
        Invest Ophthalmol Vis Sci. 2007; 48: 2510https://doi.org/10.1167/iovs.06-0562
        • Wong H.-B.
        • Machin D.
        • Tan S.-B.
        • Wong T.-Y.
        • Saw S.-M.
        Ocular component growth curves among Singaporean children with different refractive error status.
        Invest Ophthalmol Vis Sci. 2010; 51: 1341https://doi.org/10.1167/iovs.09-3431
      1. Tang T, Yu Z, Xu Q, et al. A machine learning-based algorithm used to estimate the physiological elongation of ocular axial length in myopic children. Eye Vis (Lond) 2020;7:doi.org/10.1186/s40662-40020-00214-40662.

        • Cho P.
        • Cheung S.W.
        • Boost M.V.
        • Virgili G.
        Categorisation of myopia progression by change in refractive error and axial elongation and their impact on benefit of myopia control using orthokeratology.
        PLoS ONE. 2020; 15: e0243416
        • Walline J.J.
        • Walker M.K.
        • Mutti D.O.
        • Jones-Jordan L.A.
        • Sinnott L.T.
        • Giannoni A.G.
        • et al.
        Effect of high add power, medium add power, or single-vision contact lenses on myopia progression in children: the BLINK randomized clinical trial.
        JAMA. 2020; 324: 571https://doi.org/10.1001/jama.2020.10834
        • Chamberlain P.
        • Peixoto-de-Matos S.C.
        • Logan N.S.
        • Ngo C.
        • Jones D.
        • Young G.
        A 3-year randomized clinical trial of MiSight lenses for myopia control.
        Opt. Vision Sci. Off. Publ. Am. Acad. Opt. 2019; 96: 556-567
        • Chen Z.
        • Zhou J.
        • Xue F.
        • Zhou X.
        • Qu X.
        Increased corneal toricity after long-term orthokeratology lens wear.
        Journal of ophthalmology. 2018; 2018: 1-6
        • Mutti D.O.
        • Mitchell G.L.
        • Jones L.A.
        • Friedman N.E.
        • Frane S.L.
        • Lin W.K.
        • et al.
        Axial growth and changes in lenticular and corneal power during emmetropization in infants.
        Invest Ophthalmol Vis Sci. 2005; 46: 3074https://doi.org/10.1167/iovs.04-1040