Optical treatment strategies to slow myopia progression: Effects of the visual extent of the optical treatment zone

Smith, Earl L.

doi:10.1016/j.exer.2012.11.019

Cited by 130 publications

(102 citation statements)

References 102 publications

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“…26 Wear of conventional spectacles does appear to contribute to this peripheral defocus, 27,28 which provided the impetus for the randomized trials of under-correction in preventing myopia progression as cited above. 14,15 The mechanism whereby spectacle wear (compared to nonwear) appears in fact to retard worsening of vision associated with progression of myopia is not well understood.…”

Section: Results From Itt Analysis In This Randomized Trialmentioning

confidence: 99%

Safety of Spectacles for Children's Vision: A Cluster-Randomized Controlled Trial

Ma¹,

Congdon²,

Yi³

et al. 2015

American Journal of Ophthalmology

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PURPOSE: To study safety of children's glasses in rural China, where fear that glasses harm vision is an important barrier for families and policy makers.DESIGN: Exploratory analysis from a clusterrandomized, investigator-masked, controlled trial.METHODS: Among primary schools (n [ 252) in western China, children were randomized by school to 1 of 3 interventions: free glasses provided in class, vouchers for free glasses at a local facility, or glasses prescriptions only (Control group). The main outcome of this analysis is uncorrected visual acuity after 8 months, adjusted for baseline acuity.RESULTS: Among 19 934 children randomly selected for screening, 5852 myopic (spherical equivalent refractive error £L0.5 diopters) eyes of 3001 children (14.7%, mean age 10.5 years) had VA £6/12 without glasses correctable to >6/12 with glasses, and were eligible. Among these, 1903 (32.5%), 1798 (30.7%), and 2151 (36.8%) were randomized to Control, Voucher, and Free Glasses, respectively. Intention-totreat analyses were performed on all 1831 (96.

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Section: Results From Itt Analysis In This Randomized Trialmentioning

confidence: 99%

Safety of Spectacles for Children's Vision: A Cluster-Randomized Controlled Trial

Ma¹,

Congdon²,

Yi³

et al. 2015

American Journal of Ophthalmology

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“…The emerging data from recent clinical trials show that optical strategies that take into account the peripheral retina and influence imagery over large part of the retina appear to produce larger reductions in myopia progression than those that do not. 59 More importantly these novel lens designs are producing clinically significant reductions in the progression of myopia in children.…”

Section: Discussionmentioning

confidence: 99%

“…54 Regardless, the pattern of results indicate that optical treatment strategies that take into account the optical state of the periphery are likely to be more successful than those that do not. 59 …”

Section: Peripheral Visual Signals Can Dominate Central Refractive Dementioning

confidence: 99%

Visual regulation of refractive development: insights from animal studies

Smith

Hung

Arumugam

2013

Eye

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Investigations employing animal models have demonstrated that ocular growth and refractive development are regulated by visual feedback. In particular, lens compensation experiments in which treatment lenses are used to manipulate the eye's effective refractive state have shown that emmetropization is actively regulated by signals produced by optical defocus. These observations in animals are significant because they indicate that it should be possible to use optical treatment strategies to influence refractive development in children, specifically to slow the rate of myopia progression. This review highlights some of the optical performance properties of the vision-dependent mechanisms that regulate refractive error development, especially those that are likely to influence the efficacy of optical treatment strategies for myopia. In this respect, the results from animal studies have been very consistent across species; however, to facilitate extrapolation to clinical settings, results are presented primarily for nonhuman primates. In agreement with preliminary clinical trials, the experimental data show that imposed myopic defocus can slow ocular growth and that treatment strategies that influence visual signals over a large area of the retina are likely to be most effective. Eye (2014) 28, 180-188; doi:10.1038/eye.2013.277; published online 13 December 2013Keywords: myopia; hyperopia; defocus; emmetropization Curtin 1 credits Kepler with being one of the first vision scientists to recognize the association between near work and myopia and for hypothesizing that myopia was an adaptation to near work. Although these seminal observations (circa 1610) have been replicated numerous times and much has been learnt about potential risk factors for the development of common forms of myopia, centuries of research on myopia in humans have failed to provide a clear indication of what it is about near work that promotes the development of myopia or to identify the physiological mechanisms that promote myopia in children as a result of chronic near work. However, beginning in the 1960s, research employing animal models was greatly expanded and began to provide new insights into the effects of visual experience on ocular growth and refractive development.The nature of the visual manipulations that have been employed to characterize refractive development in animals fall into three broad categories. The first category involved either natural or imposed restrictions in viewing distance and was largely motivated by the near work hypothesis. For example, comparisons of refractive errors between feral and domesticated or laboratory-reared animals supported the idea that environments that restrict viewing distance are myopiagenic. 2,3 However, these studies suffered from many of the same confounding issues associated with human studies. 4 A more controlled line of research was begun by Levinsohn 5 and continued most notably by Young, 6-9 who demonstrated that monkeys reared in environments with a maximum viewing distance o...

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“…The effect of undercorrection of myopia on myopia progression in school-aged children is still controversial [15]. Some studies [16][17][18][19][20] have reported that undercorrection retarded myopia progression compared to full correction, with differences of −0.05 D/year to −0.40 D/year.…”

Section: Introductionmentioning

confidence: 99%