Effect of spectacle lenses with aspherical lenslets on choroidal thickness in myopic children: a 2-year randomised clinical trial

Abstract

ObjectiveSpectacle lenses with highly aspherical lenslets (HAL) and slightly aspherical lenslets (SAL) showed effective myopia control. This study was to investigate their effects on macular choroidal thickness (ChT) in myopic children.MethodsExploratory analysis from a 2-year, double-masked, randomised trial. 170 children aged 8–13 years with myopia between −0.75D and −4.75D, astigmatism of 1.50D or less, and anisometropia of 1.00D or less were recruited. Participants were randomly assigned in a 1:1:1 ratio to receive HAL, SAL or single vision spectacle lenses (SVL). The subfoveal, parafoveal and perifoveal ChT were evaluated every 6 months.Results154 participants completed all examinations. The ChT showed significant changes over time in all three groups in all regions (all p<0.05). The ChTs continuously decreased in the SVL group (ranging from −20.75 (SD 22.34) μm to −12.18 (22.57) μm after 2 years in different regions). Compared with the SVL group, ChT in the SAL group decreased less (ranging from −16.49 (21.27) μm to −5.29 (18.15) μm). In the HAL group, ChT increased in the first year and then decreased in the second year (ranging from −0.30 (27.54) μm to 8.92 (23.97) μm after two years). The perifoveal ChT decreased less than the parafoveal ChT, and the superior region decreased the least.ConclusionsThe ChT of the macula decreased after 2 years of myopia progression with SVL. Wearing spectacle lenses with aspherical lenslets reduced or abolished the ChT thinning and HAL had a more pronounced effect.Trial registration numberChiCTR1800017683.

Short‐term effects of cyclopentolate and tropicamide eye drops on macular choroidal thickness in myopic children

“…This is important because the magnitude of the observed changes, particularly with two drops of cyclopentolate, was comparable to the ChT changes seen during myopia management. 7,11 Choroidal thinning following the instillation of cyclopentolate was similar in the atropine and placebo treatment groups, suggesting that the short-term effects of cyclopentolate were independent of long-term myopia management. To the contrary, 1% tropicamide did not produce any significant changes in ChT following cycloplegia, relative to the testretest ChT changes.…”

“…Therapies such as orthokeratology, management spectacles and atropine eye drops all produce effects on ChT. [7][8][9]11 Although the site action for atropine in myopia control remains unresolved, 32 recent evidence suggests that atropine's myopia control effect may be correlated with changes in ChT. 11 Consequently, ChT has been proposed as a useful biomarker in gauging long-term myopia control treatment.…”

“…Furthermore, treatments to slow myopia progression have been noted to alter ChT. [7][8][9] For example, myopia control spectacles, orthokeratology and atropine eye drops have all been reported to increase ChT or slow choroidal thinning during myopia treatment. 7,10,11 Therefore, analysis of the ChT response to myopia control intervention might provide a useful additional biomarker of treatment efficacy on the basis that the optimal treatment for myopia would positively impact both axial elongation and ChT in progressive myopes.…”

Multiple segment spectacle lenses for myopia control. Part 2: Impact on myopia progression

“…It appears that when their effects are integrated over time, the MS spectacles are successful in reducing the rate of myopia progression. The finding by Zhang et al 26 that the pattern of peripheral refraction in children who have worn MiyoSmart lenses differed from that of children wearing a SV correction emphasises the importance of the periphery in this process, although Huang et al 27 also found central changes in choroidal thickness after 2 years of Stellest wear.…”

IMI—The Dynamic Choroid: New Insights, Challenges, and Potential Significance for Human Myopia

“… 235 – 237 Measurements of choroidal thickness up to a month (1–4 weeks) following the initiation of optical myopia control treatments in myopic children have captured significant increases in choroidal thickness associated with a number of optical, myopia control treatments compared to children in traditional single-vision myopia correction, 237 – 241 with evidence of sustained effects (i.e., thicker choroid) over 12 to 24 months of treatment in some cases. 235 , 239 , 240 Furthermore, in the case of orthokeratology, the change in choroidal thickness after 1 month of lens wear was found to be associated with the degree of axial elongation observed over 12 months, suggesting that the shorter-term 1-month choroidal responses may be predictive of myopia control efficacy. 239 Both increased light exposure (i.e., outdoor time) and red light therapy have also been associated with long-term increases in choroidal thickness, 228 although the initial short-term response (1–2 hours) appears to be choroidal thinning.…”