Efficacy of myopia control by combination of orthokeratology and instillation of low-concentration atropine

Тарутта, Е. П.; Verzhanskaya, T Yu

doi:10.33791/2222-4408-2019-2-22-30

The Eye

2019

DOI: 10.33791/2222-4408-2019-2-22-30

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Efficacy of myopia control by combination of orthokeratology and instillation of low-concentration atropine

Е. П. Тарутта

T Yu Verzhanskaya²

Abstract: Majority of reports regarding methods of myopia control are devoted to the use of orthokeratology lens¬es (OKL) or atropine. The purpose of the study was to estimate the efficacy and safety of using OKL in com¬bination with instillation of 0.01% atropine drops for myopia control in children. Material and methods. Prospective cohort study in¬cluded 34 patients (68 eyes) aged 8 to 14 years old with acquired myopia. Groups with low (17 patients, 34 eyes), moderate (12 patients, 24 eyes) and high (5 patients, 10 e… Show more

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The issue of juvenile myopia from the parents’ point of view

Pokrebysheva¹,

Myagkov²

2022

Rossijskij oftalʹmologičeskij žurnal

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The success of preventing the development and progression of myopia in children depends on establishing compliance between the doctor and the patient (parents).Purpose: to study the attitude of parents of myopic children towards the issue of myopia and methods of its control.Materials and methods. 106 doctors from 53 regions of Russia and 2931 parents of myopic children took part in a prospective multicenter epidemiological observational study in the form of a questionnaire.Results. As preferable interventions to control myopia, parents mention single vision glasses (67.9 %), glasses with perifocal lenses (16.3 %), bifocal or progressive glasses (3.4 %), other types of glasses (1.6 %), soft contact lenses (11.5 %), orthokeratology lenses (5.8 %), while 13.8 % of myopic children do not use any of those. The average time that children spend on visual work amounts to 10 hours a day, while their light-time daily outdoor activities last for 2.12 ± 1.39 hours. Only 27.1 % of the parents surveyed follow all recommendations of the eye doctor. The reasons for not following are lack of time (45.1 %), complexity of implementation (7.3 %), high cost of treatment (8.5 %), other reasons (39.1 %). Parents consider that the most effective interventions to control myopia are eye drops instillation courses (53.4 %), device-assisted therapy (59.6 %), home visual gymnastics (52.4 %), orthokeratology lenses (13.7 %), bifocal soft contact lenses (4.6 %), specialty glasses (22.7 %), vitamins intake (44.4 %), while 10.6 % believe opinion that no effective myopia control methods exist.Conclusion. Parents choose single vision glasses as the main optical interventi on method. Near visual work significantly reduces physical activity in the children’s daily routine. Parents’ failure to comply with the medical advice is mostly due to lack of time. The most effective methods of myopia control are considered to be pharmacological treatment, device-assisted therapy and home visual gymnastics.

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The issue of juvenile myopia from the parents’ point of view

Pokrebysheva¹,

Myagkov²

2022

Rossijskij oftalʹmologičeskij žurnal

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Long-term results of orthokeratology correction combined with 0.01 % atropine instilliations in children and adolescents with progressive myopia of various degrees

Verzhanskaya¹

2023

Rossijskij oftalʹmologičeskij žurnal

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Purpose. To evaluate the effectiveness of control of myopia of various degrees in children and adolescents with the combined use of orthokeratology (OK) correction and ultralow-dose atropine instillations (0.01 %) over a long-term follow-up period (up to 3 years). Material and methods. Children and adolescents aged 11.0–13.5 with continuing progression of acquired myopia who wore nocturnal OK lens (OKL) were divided into three groups according to the duration of 0.01 % atropine application: group 1 comprised 58 children (116 eyes) who received the treatment for 6 months, group 2, 34 children (68 eyes), 8 months, group 3, 145 children (290 eyes), 36 months. The patients were examined before their OK-correction was supplemented by 0.01 % atropine instillations and every 6 months after it. The examination included visometry, refractometry, determination of reserves of relative accommodation reserve (RAR), objective accommodation response, pseudo accommodation (PA), measurement of axial length by optical biometry, anterior biomicroscopy, assessment of lens conditions; ophthalmoscopy under maximum mydriasis using binocular ophthalmoscope. Results. With atropine instillations, the yearly progression rate of myopia (YPR) in group 1 significantly decreased (by 1.6 times). the best effect showing in mild and moderate myopia. In group 2, after 18 months’ follow-up, YPR had significantly decreased (by 2.2 times). In group 3, after a 36 months’ observation, the maximum, 2.8-fold decrease in YPR was observed. The most marked and significant, 3.5-fold decrease in progression rate was observed in low myopia. In moderate myopia, the inhibitory effect of the combination of OKL/atropine combination showed a significant increase as the treatment duration became longer. In high myopia, progression rate fell insignificantly in the first 6 months, but over the whole period of observation, YPR showed a statistically significant, 1.6-fold decrease as compared to the initial level. RAR and PA remained at the levels they were before atropine instillations. Conclusion. OK correction combined with 0.01% atropine instillations produces a pronounced inhibitory effect in children with the most unfavourable course of myopia – progression continuing with night-time orthokeratology. The most pronounced effect was obtained in mild to moderate myopia. The longer the treatment period, the greater the effect of myopia stabilization. Over the 36 months’ period, 0.01% atropine showed no negative effect on the quality of visual functions of subjects wearing OK lenses.

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Optical methods for the management of progressive myopia

Myagkov¹,

Myagkov²

2023

jour

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Introduction. Myopia is the main cause of preventable blindness and is widespread around the world at an alarming rate, especially in Asian countries. The age of the onset of myopia is getting younger. The prevalence of myopia and high myopia is sharply increasing, which requires clinicians to use new and safe methods of its stabilization. The main methods of correction are optical. This group is based on the hypothesis of induced peripheral myopic defocus.Aim: to study the domestic and international experience with the use of the optical methods in treatment of progressive myopia according to the literature and factors, as well as factors affecting their effectiveness.Materials and methods. More than 200 publications on PubMed, eLibrary, and Crossref Metadata over the past 10 years were analyzed. Our analysis includes a review of 60 publications.Results. Over the past years, there has been a strong interest of researchers in the problem of progressive myopia. This is reflected by a more than four-fold increase in the number of publications devoted to the causes and methods of treatment in patients with progressive myopia. Publications demonstrate the importance of using the modern optical methods, such as spectacle lenses, multifocal and bifocal soft contact lenses and orthokeratology in the routine practice of ophthalmologists and optometrists in order to stabilize the progression of myopia in children and adolescents. On the one hand, the results of analysis show their high efficiency. On the other hand, we need an individual approach in choosing the method for myopia control in each specific case. The factors influencing the result are identified: the diameter of the optical zone, the force of addition that creates the peripheral myopic defocus and the time of use myopia correction during the day.Conclusion. No method of treating progressive myopia demonstrates clear superiority. Orthokeratology, multifocal and bifocal soft contact lenses, special glasses and low doses atropine instillation demonstrates the similar effect with some clauses. When choosing optical methods for myopia control, the factors affecting their effectiveness should be taken into account.

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Efficacy of myopia control by combination of orthokeratology and instillation of low-concentration atropine

Cited by 3 publications

References 2 publications

The issue of juvenile myopia from the parents’ point of view

The issue of juvenile myopia from the parents’ point of view

Long-term results of orthokeratology correction combined with 0.01 % atropine instilliations in children and adolescents with progressive myopia of various degrees

Optical methods for the management of progressive myopia

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