The 12-month data support the hypothesis that reducing peripheral hyperopia can alter central refractive development and reduce the rate of progress of myopia. (chictr.org number, chiCTR-TRC-00000029 or chiCTR-TRC-00000032.).
Purpose To report the results of 12-month wear of three novel spectacle lens designs intended to reduce peripheral hyperopic defocus and one standard design control lens and their effect on the progression of myopia in Chinese children aged 6 to 16 years. Methods Chinese children (n = 210) with myopia (−0.75 D to −3.50 D sphere, cylinder ≤−1.50 D) were randomized to one of four groups wearing either one of three novel spectacle lens designs (types I, II, or III) or conventional, single-vision spectacle lenses. Data were collected at 6 and 12 months. Primary and secondary outcome measures were the changes in central cycloplegic auto-refraction and eye axial length, respectively. Peripheral refraction along the horizontal meridian (nasal and temporal) was taken at baseline with and without spectacle lenses. Multivariate linear regression was used to adjust analyses for important covariates. Results Progression in eyes wearing control spectacle lenses at 6 and 12 months was −0.55 D ± 0.35 D and −0.78 ± 0.50 D, respectively. For the entire group, no statistically significant differences were observed in the rates of progression with the novel designs in comparison to control spectacle lenses. However, in younger children (6 to 12 years) with parental history of myopia (n = 100), there was significantly less progression (−0.68 D ± 0.47 D vs. −0.97 D ± 0.48 D) with lens type III compared with control spectacles (mean difference, 0.29 D, std error, 0.11, p = 0.038). Conclusions There were no statistically significant differences in the rate of progression of myopia between the control and novel lens wearing eyes for the age group 6 to 16 years. The finding of reduced progression of myopia with type III lens design in younger children with parental myopia needs to be validated in a more targeted study.
Purpose To conduct a meta-analysis on the rates of myopia progression in urban children of Asian and predominately European ethnicities who are corrected with traditional single-vision spectacles. Methods A search of the National Library of Medicine’s PubMed literature database for articles on myopia progression was conducted using the terms ‘myopi*progression’ and MeSH terms ‘myopia’ and ‘disease progression’, and limited to publications from January 1990 and only for papers reporting data for humans < 16 years of age. Studies were excluded if they were non-randomized, did not use cycloplegic autorefraction, had a sample size less than 30 individuals, examined high myopia (worse than −6.0D) or special subject groups, presented myopia as part of a syndrome or condition, were retrospective, or used controls wearing optical corrections other than spectacles. Results Of 175 articles identified, 20 remained after applying the exclusion criteria. The estimated myopia progression at a mean age of 9.3 years after one year of follow-up was −0.55 D (95% C.I. −0.39 to −0.72 D) for populations of predominantly European extraction and −0.82 D (95% C.I. −0.71 to −0.93 D) for Asians. The estimated progression rates were dependent on baseline age, with decreasing progression as age increased. The rates also varied with gender. For an average baseline age of 8.8 years, estimated annual progression (combined ethnicities) was −0.80 D/year for females (95% CI: −0.51 to −1.10), and a significantly slower (p<0.01) −0.71 D/year for males (95% CI: −0.42 to −1.00). Conclusions In children wearing single-vision spectacles, higher myopia progression rates were found in urban Asians compared to urban populations of predominantly European descent. Younger children and females demonstrated greater annual rates of progression of myopia.
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