Effects of Orthokeratology on Choroidal Thickness and Axial Length

Chen, Zhi; Xue, Feng; Zhou, Jiaqi; Qu, Xiaomei; Zhou, Xingtao

doi:10.1097/opx.0000000000000894

Cited by 95 publications

(88 citation statements)

References 41 publications

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“…No other studies have reported prolonged shortening of axial length over the course of treatment, although a shortening of axial length has commonly been observed at the initiation of ortho-k lens wear, attributed at least in part to central corneal thinning 9,11,12,17,18 and choroidal thickening. [31][32][33] Central corneal thinning reflects the redistribution of corneal tissue and this change usually stabilizes within a few weeks, once the optimal refractive correction has been achieved. [34][35] Compared to reports on the effect of ortho-k on corneal thickness, few studies have investigated changes in choroidal thickness.…”

Section: Discussionmentioning

confidence: 99%

“…However, choroidal thickening with ortho-k has been reported in two separate studies. 31,33 One was a short-term study, 33 lasting no more than 4 weeks, and the other was a longer term study, 31 investigating changes 1 to 9 months after lens wear. If the choroid is responding to the change in retinal defocus experienced initially with ortho-k, this adaptation would be expected to end when refractive status correction stabilized (i.e., no uncorrected myopia remains).…”

Section: Discussionmentioning

confidence: 99%

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Protective Role of Orthokeratology in Reducing Risk of Rapid Axial Elongation: A Reanalysis of Data From the ROMIO and TO-SEE Studies

Cho

Cheung

2017

Invest. Ophthalmol. Vis. Sci.

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Citation: Cho P, Cheung S-W. Protective role of orthokeratology in reducing risk of rapid axial elongation: a reanalysis of data from the ROMIO and TO-SEE studies. Invest Ophthalmol Vis Sci. 2017;58:141158: -141658: . DOI: 10.1167 PURPOSE. To determine the relative risk of rapid progression and number needed to treat (NNT) in younger and older children using combined data from the retardation of myopia in orthokeratology (ROMIO) and toric orthokeratology-slowing eye elongation (TO-SEE) studies.METHODS. Data from 136 subjects of two studies, ROMIO and TO-SEE, were retrieved (72 orthokeratology [ortho-k]: 37 ROMIO, 35 TO-SEE; 64 control: 41 ROMIO, 23 TO-SEE) and the myopia control effect on younger (6-8 years) and older (9-12 years) subjects evaluated. The rate of axial elongation was classified as not rapid (axial elongation ¼ <0.36 mm/year) or rapid (axial elongation >0.36 mm/year). RESULTS.Cumulative frequency curves showed that the younger subjects in the control group had the greatest and most rapid axial elongation at the end of 24 months. In the younger subjects, ortho-k lens wear significantly reduced the risk of rapid progression by 88.8% (P ¼ 0.002). The 2-year NNT for the younger ortho-k subgroup was 1.8, suggesting that treating just two younger subjects with ortho-k would prevent one subject from experiencing rapid progression over a 2-year period of treatment. The 2-year NNT for the older ortho-k subgroup was 11.8, which was statistically insignificant (P ¼ 0.197).CONCLUSIONS. Orthokeratology significantly reduced risk of rapid progression in younger subjects. Treating just two 6-to 8-year-old subjects with ortho-k instead of single-vision spectacles could prevent one subject from developing rapidly progressing axial elongation during this critical 2-year period.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Protective Role of Orthokeratology in Reducing Risk of Rapid Axial Elongation: A Reanalysis of Data From the ROMIO and TO-SEE Studies

Cho

Cheung

2017

Invest. Ophthalmol. Vis. Sci.

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“…Some studies have demonstrated a thickening of the choroid associated with Ortho‐k (Loertscher ; Chen et al. ), while others have reported no significant changes (Gardner et al. ).…”

Section: Introductionmentioning

confidence: 99%

Change in subfoveal choroidal thickness secondary to orthokeratology and its cessation: a predictor for the change in axial length

Cui

et al. 2018

Acta Ophthalmologica

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Purpose: To investigate changes in subfoveal choroidal thickness (SFChT) during orthokeratology (Ortho-K) lens wear and after its cessation and the association of short-term change in SFChT with the long-term eye elongation in Ortho-K subjects. Design: A prospective clinical trial. Methods: Fifty myopic children aged between 9 and 14 years were enrolled. Twenty-nine subjects continuously wore Ortho-K lens for 12 months and discontinued for 1 month. Twenty-one subjects wearing single vision distance spectacles for 12 months were included as the control group. SFChT was assessed using optical coherence tomography. Ocular parameters, including axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT) and apical corneal power (ACP), were also measured. Results: After 12 months of follow-up, AL elongation was larger and SFChT change was smaller in the control group compared to the Ortho-K group (both p < 0.001). In the Ortho-K group, SFChT increased by 16 lm from baseline at the 1-month visit (p < 0.001), and the magnitude of choroidal thickening remained unchanged at the 6-and 12-month visit (p = 0.289). One month after discontinuation of Ortho-K lens, SFChT and ocular parameters of the anterior segment, including ACP, CCT and ACD recovered to baseline level (All p > 0.05), and AL increased by 0.23 AE 0.18 mm compared to baseline (p = 0.018). SFChT change at 1-month was negatively associated with AL change at 13-month (standard b, À0.581, p = 0.001) after adjusting for other influencing factors, including baseline age and the ocular parameters. Conclusion: Subfoveal ChT (SFChT) significantly increased after short-term Ortho-K lens treatment and the increase maintained throughout the period of treatment. One month after Ortho-K lens cessation, SFChT, ACP, CCT and ACD returned to baseline. Short-term response in SFChT is associated with long-term change in AL in children undergoing Ortho-K lens and may be a predictor for the effectiveness of the treatment.

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“…Since choroidal thickness may vary with smoking, consumption of coffee and alcohol, only non‐smokers were included in this experiment and participants refrained from coffee or alcohol intake for at least four hours prior to the study visit. Subjects who were undergoing myopia control treatments such as orthokeratology, multifocal spectacle or contact lens, or atropine therapy were excluded due to possible effect of these treatments on choroidal thickness …”

Section: Methodsmentioning

confidence: 99%

Impact of image averaging on wide‐field choroidal thickness measurements using enhanced‐depth imaging optical coherence tomography

Hoseini-Yazdi

Vincent

Collins

et al. 2019

Clinical and Experimental Optometry

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Background: The aim of this study was to examine the influence of B-scan averaging on choroidal thickness using wide-field enhanced-depth imaging optical coherence tomography. Methods: Six high-resolution trans-foveal horizontal enhanced-depth imaging line scans (spanning a 60 field) were acquired consecutively from the right eye of 10 healthy adults (mean age 30 AE 5 years), with each line scan an average of 10, 20, 30, 40, 50 or 100 B-scans, using the automated real-time image averaging and follow-up features of a Spectralis device. The impact of B-scan averaging on regional measures of wide-field choroidal thickness (across macular and peripheral regions) and their accuracy was investigated, assuming that averaging 100 B-scans would provide the most accurate estimate of choroidal thickness. Results: Regional estimates of wide-field choroidal thickness did not vary across the different B-scan averaging conditions (all p > 0.05). The mean choroidal thickness averaged across the full wide-field area exhibited the closest agreement to measures obtained with 100 averaged B-scans, when frame averaging exceeded 30 B-scans (95 per cent limits of agreement +10 to −7, +7 to −7 and +6 to −3 μm for 30, 40 and 50 averaged B-scans, respectively), compared to 10 and 20 averaged B-scans (95 per cent limits of agreement +13 to −8 and +13 to −6 μm, respectively; p < 0.01 and p < 0.02 compared to the accuracy of 50 averaged B-scans). Conclusion: Averaging 30 B-scans for an individual enhanced-depth imaging optical coherence tomography line scan provided accurate measures of choroidal thickness across a wide-field (60 ) area in young healthy eyes. This information can assist in designing the volumetric scan protocols required for detailed examination of the macular and peripheral choroid.

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Effects of Orthokeratology on Choroidal Thickness and Axial Length

Abstract: Choroidal thickness increases after short-term ortho-k treatment. Regional choroidal thickening after ortho-k treatment may be attributable to the altered retinal defocus profile associated with ortho-k lens wear.

Cited by 95 publications

References 41 publications

Protective Role of Orthokeratology in Reducing Risk of Rapid Axial Elongation: A Reanalysis of Data From the ROMIO and TO-SEE Studies

Protective Role of Orthokeratology in Reducing Risk of Rapid Axial Elongation: A Reanalysis of Data From the ROMIO and TO-SEE Studies

Change in subfoveal choroidal thickness secondary to orthokeratology and its cessation: a predictor for the change in axial length

Impact of image averaging on wide‐field choroidal thickness measurements using enhanced‐depth imaging optical coherence tomography

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