Introduction. The prevalence and progressive course of myopia is one of the most important medical and social problems worldwide. In recent years, in our country and abroad there is a tendency to increase the incidence of myopia, becoming in some countries an epidemic. In recent years, the most common method of effective control of myopia is the method of refractive therapy with orthokeratological lenses. Objective: To develop criteria for predicting the effectiveness of myopia control using orthokeratological lenses based on individual eye parameters. Object and methods of research. A total of 60 children (117 eyes) were included in the clinical study, who were selected by OKL of combined design, SkyOptix, licensed by KATT Design Group (Canada). The average age was 11 [10; 13], from 7 to 14 years, of which 37 were females (61.7%), 23 males (38.3%). Ophthalmological examination consisted of visometry without correction and with optical correction, autorefractometry on the narrow pupil and in the state of drug cycloplegia, biomicroscopy, biometry, ophthalmoscopy of the central and peripheral fundus, keratotopography of the horns, pupilometry. The results of the research: Among the studied people, the average refractive index at the beginning of the study was -2.25 [-3; -1.5] diopters. The initial diameter of the pupils was determined from 2.78 to 6.30 mm according to the pupilometry performed on the topograph. The average values of eccentricity (Ex) studied in the flat meridian averaged 0.51 [0.47; 0.58], in the steep - 0.53 [0.43; 0.59] at the beginning of the study. In our study, the keratometry of the cornea averaged 43.5 at the beginning of the study [42.7; 44.4]. As a result of probability analysis (increase in APS for two years), the method of construction of logistic regression models was used. We selected five factor features (X): Initial refraction, Pupil diameter (X2), Keratometry (X3), Peripheral corneal force on the reverse zone ring (X4 and X5), Corneal diameter, and Axial length of the eye (APS) at the time of treatment (initial). The equation of logistic regression of the model for predicting the probability of progression of myopia on the background of the use of OKL had the form: The classification ability of the model was determined according to the training sample and amounted to 79.5%. The probability of a true positive result (increase in APS less than 0.3) when using this model was 91.9%, and the probability of a true negative result - 38.5%. Evaluation of the quality of the model using ROC-analysis showed the following: the area under the ROC-curve (AUC) was equal to 0.86 (p <0.001), which characterizes the good quality of the classification of traits. The sensitivity of the model was 82.6%, specificity - 73.1%. As part of the research and mathematical calculations, an interactive WEB application was also developed, which can be accessed from various types of devices connected to the World Wide Web. Modern solutions and approaches used in IT (Information Technology) were used for development. Conclusions. It is determined that when examining a child with progressive myopia, it is important to pay attention to the diameter of the pupil in photographic conditions, because it can be a predictor of progression and influence the choice of correction individually. The smaller the value of keratometry before the appointment of refractive therapy, the greater the value of the size of the APS, so this factor can be indicated as prognostic. The differential topographic force of the cornea along the peripheral ring corresponding to the reverse zone of the lens is a prognostic practical factor. Taking into account the primary parameters of the eye allows you to customize the approach to each child with myopia, improving the individual design of orthokeratological lenses.
Background: Management of progressive myopia is a major issue in current optometry and ophthalmology in general. Refractive therapy with orthokeratology lenses (OKL) has become an increasingly popular technique for controlling the progression of myopia. Purpose: To assess the efficacy of orthokeratology lenses depending on the topography pupil size and lens optical zone (OZ) size. Material and Methods: Sixty children (117 eyes) with mild or moderate uncomplicated myopia were involved in this study. They underwent a comprehensive eye examination, corneal topography and pupillometry. Statistical analysis of correlations between the pupil diameter and axial elongation was performed. In order to conduct longitudinal surveillance of myopia, we compared two OKL designs, one with a conventional OZ diameter, and another with a smaller OZ diameter, for the efficacy of myopia control. Results: The pupil diameter was inversely correlated with the axial elongation both in mild myopes (r = -0.48, p < 0.001) and in moderate myopes (r = -0.7, p < 0.001). Patients showed slower axial length progression when treated with a 5.5-mm OZ lens design than with a conventional 6.0-mm OZ lens design. Conclusion: When examining a child with progressive myopia, it is important to pay attention to the photopic pupil size because the size may be a predictor of myopia progression and exert an influence on the choice of correction. Orthokeratology lenses with a smaller (5.5-mm) optical zone diameter are more effective for myopia control, which should be taken into consideration when selecting a lens design for children.
Progressive myopia is a leading problem in modern optometry and ophthalmology in general. In recent years, refractive therapy with orthokeratology lenses has gained popularity among methods to control myopia progression. The aim: To study peripheral refraction in children with myopia with the use of orthokeratology lenses (OKL) of combined design. Methods. We followed up 60 children (117 eyes) diagnosed with uncomplicated mild to moderate myopia. All children underwent a complete ophthalmological examination as well as corneal keratotopography and peripheral refraction determination. Statistical analysis of correlations between peripheral corneal refraction under the influence of OKL, peripheral defocus, and axial length growth gradient was performed. Results. An inverse correlation relationship of -0.2 (p=0.03) was obtained between corneal differential power in the return 6 mm zone and peripheral refraction in its corresponding peripheral refraction of 23° on the temporal side. A positive correlation with a correlation coefficient of 0.21 (p=0.026) was obtained between the defocus in the temporal part and the gradient of myopia progression over one year, while the same result was obtained in the nasal part with a correlation coefficient of 0.2 (p=0.036). Concluсions. Difference corneal power at the periphery may be prognostic in relation to the course of myopia in OКL users. With an aboveaverage pupil diameter, combined design orthokeratology lenses are more effective in controlling myopia due to the greater influence of the formed corneal refractive ring on peripheral refraction.
The progressive course of myopia is one of the most important medical and social problems worldwide. In Ukraine, the relative incidence of moderate myopia ranges from 8.9 to 30.8 % in schoolchildren and in final-year students, mild and moderate myopia is found, according to various data, in 30-68 % of individuals. Some researchers have tried to determine the shape of the cornea and its relationship to the eye size in myopia, but conflicting data have been obtained, so the issue needs further investigation. The aim. To analyze the effect of corneal eccentricity (Ex) in children with myopia on the increase of the axial length of the eye when using orthokeratology lenses (OKL). Methods. The study involved 60 children (117 eyes) aged 7 to 15 years with uncomplicated mild and moderate myopia from –0.75 to –5.0 diopters by spherical equivalent. Biometry was performed using an ultrasound scanner before the start of refractive therapy or prescription of glasses and then every 6 months of observation. Corneal topography was also performed with determination of keratometry and Ex in flat and steep meridians (Oculus Easygraph topographer, Germany). MoonLens OKL with combined design were selected for all the subjects. Results. In patients with mild myopia, there was direct strong correlation between the value of Ex, both in a flat and in a steep meridian, and the axial length at the beginning of the therapy which equaled to 0.28 (p = 0.011) There was also a strong direct relationship between the value of the initial Ex and the difference in refraction (ΔR) after 24 months of observation which equaled to 0.32 (p = 0.001). Assessment of the correlation between the initial value of keratometry and the axial length revealed negative correlation between –0.69 in the group with mild myopia (p<0.001) and –0.67 in children with moderate myopia (p<0.001). There was no correlation of the effect of Ex on the annual gradient of myopia progression in the study. Conclusions. There is no correlation between the baseline Ex and the annual gradient of myopia progression on the background of the use of OKL because the corneal profile changes and there are other factors influencing the pattern of the axial length change. A direct correlation between the baseline Ex and the annual changes in refraction (ΔR) was revealed.
Цель. Провести анализ роста аксиальной длины глаза у детей с прогрессирующей миопией на фоне использования ортокератологических линз (ОКЛ) комбинированного дизайна. Материалы и методы. В исследовании приняли участие 120 детей с миопией, I группа - 60 детей, которым назначались ортокератологические линзы, II группа - 60 детей, которым были назначены очки. Определялась рефракция до назначения коррекции и через 24 месяца после. Измерялась аксиальная длина глаза до начала коррекции и каждые 6 месяцев. Результаты. Дети, которые использовали ортокератологические линзы, имели прирост длины глазного яблока значительно меньше, чем дети в группе сравнения. В I группе прирост аксиальной длины может соответствовать прогрессированию миопии на 0,24 дптр/год, а в группе сравнения на 1,02 дптр/год. Выводы. Использование ОКЛ комбинированного дизайна является эффективным методом контроля прогрессирования миопии у детей. Purpose. To analyze the growth of the axial length of the eye in children with progressive myopia while using combined design orthokeratological lenses Materials and methods. 120 children with myopia took part, group I - 60 children who were prescribed orthokeratological lenses, group II - 60 children who were assigned glasses. Refraction was determined before correction was prescribed and 24 months later. The axial length of the eye was measured before the start of the correction and each 6 months later. Results. Children who used orthokeratological lenses had an increase in the length of the eyeball significantly less than children in the comparison group. In group I, the increase in axial size of the eyes can correspond to the progression of myopia by 0.24 diopters/year, and in the comparison group by 1.02 diopters/year. Conclusion. The use of a combined design OKL is an effective method for controlling the progression of myopia in children.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.