The Experts below are selected from a list of 2766 Experts worldwide ranked by ideXlab platform
Jeffrey J. Walline - One of the best experts on this subject based on the ideXlab platform.
-
peripheral refraction and eye lengths in myopic children in the bifocal lenses in nearsighted kids blink study
Translational Vision Science & Technology, 2019Co-Authors: Donald O. Mutti, Loraine T Sinnott, Lisa A Jonesjordan, Kathleen Reuter, Maria K Walker, David A Berntsen, Jeffrey J. WallineAbstract:Purpose Provide a detailed assessment of peripheral refractive error and peripheral eye length in myopic children. Methods Subjects were 294 children aged 7 to 11 years with -0.75 to -5.00 diopter (D) of Myopia by cycloplegic autorefraction. Peripheral refraction and eye length were measured at ±20° and ±30° horizontally and vertically, with peripheral refraction also measured at ±40° horizontally. Results Relative peripheral refraction became more hyperopic in the horizontal meridian and more myopic in the vertical meridian with increasing field angle. Peripheral eye length became shorter in both meridians with increasing field angle, more so horizontally than vertically with correlations between refraction and eye length ranging from -0.40 to -0.57 (all P < 0.001). Greater foveal Myopia was related to more peripheral hyperopia (or less peripheral Myopia), shorter peripheral eye lengths, and a consistent average asymmetry between meridians. Conclusions Peripheral refractive errors in children do not appear to exert strong local control of peripheral eye length given that their correlation is consistently negative and the degree of meridional asymmetry is similar across the range of refractive errors. The BLINK study will provide longitudinal data to determine whether peripheral Myopia and additional peripheral myopic defocus from multifocal contact lenses affect the Progression of Myopia in children. Translational Relevance Local retinal control of ocular growth has been demonstrated numerous times in animal experimental Myopia models but has not been explored in detail in human Myopia development. These BLINK baseline results suggest that children's native peripheral optical signals may not be a strong stimulus for local growth responses.
-
imi interventions Myopia institute interventions for controlling Myopia onset and Progression report
Investigative Ophthalmology & Visual Science, 2019Co-Authors: Christine F Wildsoet, Seang-mei Saw, Audrey Chia, Padmaja Sankaridurg, Pauline Cho, Jeremy A Guggenheim, Jan Roelof Polling, Scott A Read, Klaus Trier, Jeffrey J. WallineAbstract:Myopia has been predicted to affect approximately 50% of the world’s population based on trending Myopia prevalence figures. Critical to minimizing the associated adverse visual consequences of complicating ocular pathologies are interventions to prevent or delay the onset of Myopia, slow its Progression, and to address the problem of mechanical instability of highly myopic eyes. Although treatment approaches are growing in number, evidence of treatment efficacy is variable. This article reviews research behind such interventions under four categories: optical, pharmacological, environmental (behavioral), and surgical. In summarizing the evidence of efficacy, results from randomized controlled trials have been given most weight, although such data are very limited for some treatments. The overall conclusion of this review is that there are multiple avenues for intervention worthy of exploration in all categories, although in the case of optical, pharmacological, and behavioral interventions for preventing or slowing Progression of Myopia, treatment efficacy at an individual level appears quite variable, with no one treatment being 100% effective in all patients. Further research is critical to understanding the factors underlying such variability and underlying mechanisms, to guide recommendations for combined treatments. There is also room for research into novel treatment options.
-
food and drug administration american academy of ophthalmology american academy of optometry american association for pediatric ophthalmology and strabismus american optometric association american society of cataract and refractive surgery and conta
Eye & Contact Lens-science and Clinical Practice, 2018Co-Authors: Jeffrey J. Walline, Michael X. Repka, Marc W. Robboy, Gene Hilmantel, Michelle E. Tarver, Natalie A. Afshari, Deepinder K. Dhaliwal, Christie L. Morse, Christopher J. Quinn, Malvina B. EydelmanAbstract:Abstract:The prevalence of Myopia is high and increasing. Approximately 5 billion people around the world are expected to be myopic by the year 2050. Methods to slow the Progression of Myopia and therefore potentially decrease the associated sight-threatening complications have been the subject of a
-
Food and Drug Administration, American Academy of Ophthalmology, American Academy of Optometry, American Association for Pediatric Ophthalmology and Strabismus, American Optometric Association, American Society of Cataract and Refractive Surgery, and
Eye & contact lens, 2018Co-Authors: Jeffrey J. Walline, Michael X. Repka, Marc W. Robboy, Gene Hilmantel, Michelle E. Tarver, Natalie A. Afshari, Deepinder K. Dhaliwal, Christie L. Morse, Christopher J. Quinn, Malvina B. EydelmanAbstract:The prevalence of Myopia is high and increasing. Approximately 5 billion people around the world are expected to be myopic by the year 2050. Methods to slow the Progression of Myopia and therefore potentially decrease the associated sight-threatening complications have been the subject of a number of investigations. A workshop, sponsored by the United States Food and Drug Administration (FDA) Center for Devices and Radiological Health, American Academy of Ophthalmology, American Academy of Optometry, American Association for Pediatric Ophthalmology and Strabismus, American Optometric Association, American Society of Cataract and Refractive Surgery, and Contact Lens Association of Ophthalmologists, Inc, convened Myopia experts from around the world to discuss principles to consider in the design of clinical trials investigating the effectiveness and safety of Myopia control devices. Experts discussed parameters such as study endpoints, duration, enrollment criteria, patient-reported outcomes, recruitment, and retention. The discussions among the experts, FDA, and audience members should help to facilitate the development and evaluation of reasonably safe and effective Myopia control devices.
-
Multifocal contact lens Myopia control
Optometry and Vision Science, 2013Co-Authors: Jeffrey J. Walline, Katie L. Greiner, M. Elizabeth Mcvey, Lisa A. Jones-jordanAbstract:PURPOSE: Previous studies on soft multifocal contact lens Myopia control published in the peer-reviewed literature reported findings of noncommercial contact lenses worn for 1 year or less. This study sought to determine the Progression of Myopia and axial elongation of children fitted with commercially available distance center soft multifocal contact lenses for 2 years. METHODS: Eight- to eleven-year-old children with -1.00 D to -6.00 D spherical component and less than 1.00 D astigmatism were fitted with soft multifocal contact lenses with a +2.00 D add (Proclear Multifocal "D"; CooperVision, Fairport, NY). They were age- and gender-matched to participants from a previous study who were fitted with single-vision contact lenses (1 Day Acuvue; Vistakon, Jacksonville, FL). A-scan ultrasound and cycloplegic autorefraction were performed at baseline, after 1 year, and after 2 years. Multilevel modeling was used to compare the rate of change of Myopia and axial length between single-vision and soft multifocal contact lens wearers. RESULTS: Forty participants were fitted with soft multifocal contact lenses, and 13 did not contribute complete data (5 contributed 1 year of data). The adjusted mean ± standard error spherical equivalent Progression of Myopia at 2 years was -1.03 ± 0.06 D for the single-vision contact lens wearers and -0.51 ± 0.06 for the soft multifocal contact lens wearers (p < 0.0001). The adjusted mean axial elongation was 0.41 ± 0.03 and 0.29 ± 0.03 for the single-vision and soft multifocal contact lens wearers, respectively (p < 0.0016). CONCLUSIONS: Soft multifocal contact lens wear resulted in a 50% reduction in the Progression of Myopia and a 29% reduction in axial elongation during the 2-year treatment period compared to a historical control group. Results from this and other investigations indicate a need for a long-term randomized clinical trial to investigate the potential for soft multifocal contact lens Myopia control.
Donald T H Tan - One of the best experts on this subject based on the ideXlab platform.
-
age of onset of Myopia predicts risk of high Myopia in later childhood in myopic singapore children
Ophthalmic and Physiological Optics, 2016Co-Authors: Sharon Chua, Tien Yin Wong, Audrey Chia, Chingyu Cheng, Charumathi Sabanayagam, Yin Bun Cheung, Robert K Valenzuela, Donald T H Tan, Seang-mei SawAbstract:Purpose To investigate the effect of age of Myopia onset on the severity of Myopia later in life among myopic children. Methods In this prospective study, school children aged 7–9 years from the Singapore Cohort of the Risk factors for Myopia (SCORM) were followed up till 11 years (n = 928). Age of Myopia onset was defined either through questionnaire at baseline (age 7–9 years) or subsequent annual follow-up visits. Age of onset of Myopia was a surrogate indicator of duration of Myopia Progression till age 11 years. Cycloplegic refraction and axial length were measured at every annual eye examination. High Myopia was defined as spherical equivalent of ≤−5.0 D. A questionnaire determined the other risk factors. Results In multivariable regression models, younger age of Myopia onset (per year decrease) or longer duration of Myopia Progression was associated with high Myopia (odds ratio (OR) = 2.86; 95% CI: 2.39 to 3.43), more myopic spherical equivalent (regression coefficient (β) = −0.86 D; 95% CI: −0.93 to −0.80) and longer axial length (β = 0.28 mm; 95% CI: 0.24 to 0.32) at aged 11 years, after adjusting for gender, race, school, books per week and parental Myopia. In Receiver Operating Curve (ROC) analyses, age of Myopia onset alone predicted high Myopia by 85% (area under the curve = 0.85), while the addition of other factors including gender, race, school, books per week and parental Myopia only marginally improved this prediction (area under the curve = 0.87). Conclusions Age of Myopia onset or duration of Myopia Progression was the most important predictor of high Myopia in later childhood in myopic children. Future trials to retard the Progression of Myopia to high Myopia could focus on children with younger age of Myopia onset or with longer duration of Myopia Progression.
-
atropine for the treatment of childhood Myopia
Ophthalmology, 2006Co-Authors: Wei Han Chua, Louis Tong, V Balakrishnan, Yionghuak Chan, Yvonne Ling, Boonlong Quah, Donald T H TanAbstract:Purpose To evaluate the efficacy and safety of topical atropine, a nonselective muscarinic antagonist, in slowing the Progression of Myopia and ocular axial elongation in Asian children. Design Parallel-group, placebo-controlled, randomized, double-masked study. Participants Four hundred children aged 6 to 12 years with refractive error of spherical equivalent −1.00 to −6.00 diopters (D) and astigmatism of −1.50 D or less. Intervention Participants were assigned with equal probability to receive either 1% atropine or vehicle eye drops once nightly for 2 years. Only 1 eye of each subject was chosen through randomization for treatment. Main Outcome Measures The main efficacy outcome measures were change in spherical equivalent refraction as measured by cycloplegic autorefraction and change in ocular axial length as measured by ultrasonography. The primary safety outcome measure was the occurrence of adverse events. Results Three hundred forty-six (86.5%) children completed the 2-year study. After 2 years, the mean Progression of Myopia and of axial elongation in the placebo-treated control eyes was −1.20±0.69 D and 0.38±0.38 mm, respectively. In the atropine-treated eyes, Myopia Progression was only −0.28±0.92 D, whereas the axial length remained essentially unchanged compared with baseline (−0.02±0.35 mm). The differences in Myopia Progression and axial elongation between the 2 groups were −0.92 D (95% confidence interval, −1.10 to −0.77 D; P P Conclusions Topical atropine was well tolerated and effective in slowing the Progression of low and moderate Myopia and ocular axial elongation in Asian children.
-
incidence and Progression of Myopia in singaporean school children
Investigative Ophthalmology & Visual Science, 2005Co-Authors: Seang-mei Saw, Donald T H Tan, Louis Tong, Wei Han Chua, Kee Seng Chia, David Koh, Joanne KatzAbstract:Purpose To determine the incidence and Progression rates of Myopia in young Singaporean children. Methods A prospective cohort study, the Singapore Cohort Study of the Risk Factors for Myopia (SCORM), was conducted in two schools in Singapore (1999-2002). Children aged 7 to 9 years (n=981) were followed up over a 3-year period. Cycloplegic autorefraction and biometry parameter measures were performed annually, according to the same protocol. Results The 3-year cumulative incidence rates were 47.7% (95% confidence interval [CI]: 42.2-53.3), 38.4% (95% CI: 31.4-45.4), and 32.4% (95% CI: 21.8-43.1) for 7-, 8-, and 9-year-old children, respectively. The 3-year cumulative incidence rates were higher in Chinese (49.5% vs. 27.2%) and in 7-year-old compared with 9-year-old children at baseline (47.7% vs. 32.4%), though the latter relationship was of borderline significance after adjustment for race, gender, amount of reading (books/week), and parental Myopia (P=0.057). Premyopic children with greater axial lengths, vitreous chamber depths, and thinner lenses were more prone to the development of Myopia, after controlling for age, gender, race, reading, and parental Myopia. The 3-year mean cumulative Myopia Progression rates were -2.40 D (95% CI: -2.57 to -2.22) in 7-year-old myopic children, -1.97 (95% CI: -2.16 to -1.78) in 8-year-olds, and -1.71 (95% CI: -1.98 to -1.44) in 9-year-olds. Conclusions Both the incidence and Progression rates of Myopia are high in Singaporean children.
-
one year multicenter double masked placebo controlled parallel safety and efficacy study of 2 pirenzepine ophthalmic gel in children with Myopia
Ophthalmology, 2004Co-Authors: Donald T H Tan, Dennis S C Lam, Wei Han Chua, Dorothy Fan Shuping, Stephens R CrockettAbstract:Objective To evaluate the safety and efficacy of the relatively selective M 1 -antagonist, pirenzepine ophthalmic gel (gel), in slowing the Progression of Myopia in school-aged children. Design Parallel-group, placebo-controlled, randomized, double-masked study. Participants Three hundred fifty-three healthy children, 6 to 12 years old, with a spherical equivalent (SE) of −0.75 to −4.00 diopters (D) and astigmatism of ≤1.00 D. Subjects underwent a baseline complete eye examination, and regular examinations over a 1-year period. The study was conducted at 7 academic centers and clinical practices in Asia. Intervention Subjects received 2% gel twice daily (gel/gel), 2% gel daily (evening, placebo/gel), or vehicle twice daily (placebo/placebo) in a 2:2:1 ratio, respectively, for 1 year. Main outcome measure Spherical equivalent under cycloplegic refraction. Results At study entry, mean SE refraction was −2.4±0.9 D. At 12 months, there was a mean increase in Myopia of 0.47 D, 0.70 D, and 0.84 D in the gel/gel, placebo/gel, and placebo/placebo groups, respectively ( P Conclusions Gel (2% twice daily) was effective and relatively safe in slowing the Progression of Myopia over a 1-year treatment period.
Karla Zadnik - One of the best experts on this subject based on the ideXlab platform.
-
Myopia Progression as a function of sex age and ethnicity
Investigative Ophthalmology & Visual Science, 2021Co-Authors: Lisa A Jonesjordan, Donald O. Mutti, Susan A Cotter, Robert N Kleinstein, Ruth E Manny, Daniel J Twelker, Loraine T Sinnott, Raymond H Chu, Karla ZadnikAbstract:Purpose To model juvenile-onset Myopia Progression as a function of race/ethnicity, age, sex, parental history of Myopia, and time spent reading or in outdoor/sports activity. Methods Subjects were 594 children in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study with at least three study visits: one visit with a spherical equivalent (SPHEQ) less myopic/more hyperopic than -0.75 diopter (D), the first visit with a SPHEQ of -0.75 D or more Myopia (onset visit), and another after Myopia onset. Myopia Progression from the time of onset was modeled using cubic models as a function of age, race/ethnicity, and other covariates. Results Younger children had faster Progression of Myopia; for example, the model-estimated 3-year Progression in an Asian American child was -1.93 D when onset was at age 7 years compared with -1.43 D when onset was at age 10 years. Annual Progression for girls was 0.093 D faster than for boys. Asian American children experienced statistically significantly faster Myopia Progression compared with Hispanic (estimated 3-year difference of -0.46 D), Black children (-0.88 D), and Native American children (-0.48 D), but with similar Progression compared with White children (-0.19 D). Parental history of Myopia, time spent reading, and time spent in outdoor/sports activity were not statistically significant factors in multivariate models. Conclusions Younger age, female sex, and racial/ethnic group were the factors associated with faster myopic Progression. This multivariate model can facilitate the planning of clinical trials for Myopia control interventions by informing the prediction of Myopia Progression rates.
-
relative peripheral refractive error and the risk of onset and Progression of Myopia in children
Investigative Ophthalmology & Visual Science, 2011Co-Authors: Loraine T Sinnott, Susan A Cotter, Lynn G Mitchell, Melvin L Moeschberger, Robert N Kleinstein, Ruth E Manny, Daniel J Twelker, Lisa A Jonesjordan, Karla ZadnikAbstract:Numerous experiments show that chronic exposure to lenses simulating hyperopic refractive error accelerates axial growth in a predictable manner in various species, suggesting that defocus at the fovea influences eye growth.1–5 Greater amounts of accommodative lag from a deficient accommodative response is the putative analogous source of hyperopic defocus during near work in children.6–8 Several studies have shown that myopic children or those undergoing more rapid myopic Progression spend more time in near work than nonmyopes or more slowly progressing myopes,9–13 yet the association between refractive error and near work is not always statistically significant.14–17 In addition, the potency of accommodative lag in stimulating human ocular growth is not clear. Hyperopic defocus is less related to the rate of emmetropization in infancy than is the level of accommodative effort expended by hyperopic infants.18 In children, many attempts to reduce accommodative lag through plus lens corrections at near have had only modest results in slowing myopic Progression.12,19–23 However, other studies and subsamples of myopic children—for example, esophores at near with high accommodative lag—have shown a larger treatment effect of plus at near.24–26 Whether a high accommodative lag increases the risk of onset of Myopia in nonmyopic children is also unclear. One study found increased accommodative lag 2 years before the onset of Myopia and in the year of onset.7 Our own larger investigation showed no increase in accommodative lag before Myopia onset in children who became myopic compared with children who were emmetropic.8 Recent investigations of the effects of hyperopic defocus on ocular growth have shifted their attention away from measures at the fovea and moved toward the retinal periphery. Ablation and occlusion experiments in primates have shown that manipulation of the more extensive peripheral visual environment can guide not only peripheral ocular growth, but also axial growth, suggesting that perhaps peripheral hyperopic defocus can act as a guide for foveal refractive error.27,28 Myopes have relative peripheral hyperopia more often than other refractive error groups, at least in the lateral visual field, because of their relatively less oblate ocular shape.29–35 This exposure to peripheral hyperopic defocus appears about 2 years before Myopia onset, on average.36 The degree of risk for Myopia onset from peripheral hyperopia has not yet been quantified, nor has it been adjusted for foveal refractive error or ethnicity. The purpose of this analysis was to use longitudinal data from the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study to evaluate the following hypotheses: (1) nonmyopic children with more relative peripheral hyperopia are at higher risk for becoming myopic, and (2) myopic children with more relative peripheral hyperopia have a faster rate of myopic Progression.
-
two year multicenter randomized double masked placebo controlled parallel safety and efficacy study of 2 pirenzepine ophthalmic gel in children with Myopia
Journal of Aapos, 2008Co-Authors: Michael R Siatkowski, Susan A Cotter, R S Crockett, Joseph M Miller, Gary D Novack, Karla ZadnikAbstract:Purpose To evaluate if the safety and efficacy of the relatively selective M1-antagonist, pirenzepine, in slowing the Progression of Myopia in children is sustained over a 2-year period. Methods This was a multicenter, parallel-group, placebo-controlled, double-masked, randomized clinical trial. Enrolled were children aged 8 to 12 years, with entry spherical equivalent refractive error of −0.75 to −4.00 D and astigmatism ≤1.00 D. Patients were randomized in a 2:1 ratio to receive 2% pirenzepine ophthalmic gel or a placebo control (vehicle), twice daily to each eye. The main outcome measure was spherical equivalent refractive error via cycloplegic autorefraction. Results At study entry, spherical equivalent was −2.10 ± 0.90 D (mean ± SD) for the pirenzepine group (n = 117) and −1.93 ± 0.83 D for the placebo group (n = 57; p = 0.22). At 1 year, there was a mean increase in Myopia of 0.26 D in the pirenzepine group versus 0.53 D in the placebo group ( p p = 0.008). Thirteen (11%) pirenzepine patients dropped out due to adverse effects in the first year, and 1 did so in the second year. Conclusions Pirenzepine ophthalmic gel 2% was effective compared with placebo in slowing the Progression of Myopia over a 2-year treatment period and demonstrated a clinically acceptable safety profile.
Sek-jin Chew - One of the best experts on this subject based on the ideXlab platform.
-
prevalence incidence and Progression of Myopia of school children in hong kong
Investigative Ophthalmology & Visual Science, 2004Co-Authors: Dorothy S P Fan, Dennis S C Lam, Robert F Lam, Joseph Lau, King Chong, Eva Y Y Cheung, Ricky Y K Lai, Sek-jin ChewAbstract:PURPOSE: To determine the prevalence, incidence, and Progression of Myopia of Chinese children in Hong Kong. METHODS: A cross-sectional survey was initially conducted. A longitudinal follow-up study was then conducted 12 months later. RESULTS: A total of 7560 children of mean age 9.33 (95% confidence interval [CI] = 9.11-9.45; range, 5-16) participated in the study. Mean spherical equivalent refraction (SER) was -0.33 D (SD = 11.56; range, -13.13 to +14.25 D). Myopia (SER
-
A randomized trial of rigid gas permeable contact lenses to reduce Progression of children's Myopia.
American journal of ophthalmology, 2003Co-Authors: Joanne Katz, Seang-mei Saw, Brian Levy, Oliver D. Schein, Tom Cruiscullo, Rajan U, Tat Keong Chan, Chong Yew Khoo, Sek-jin ChewAbstract:Abstract Purpose To test whether rigid gas permeable (RGP) contact lens wear can reduced the rate of Myopia Progression in school age children. Design Randomized clinical trial. Methods Setting: Single clinical center. Study Population: Both eyes of 428 Singaporean children. Inclusion Criteria: 6 through 12 years of age with Myopia between −1 and −4 diopters, astigmatism ≤ 2 diopters, no prior contact lens wear, no other ocular pathologies.Intervention: Spectacle or RGP lens correction for Myopia. After a 3-month adaptation period, 383 children were followed, and 298 (78%) remained after 24 months.Outcome measures: Cycloplegic subjective refraction, keratometry, and axial length measured at 12 and 24 months. Results Children who adapted to contact lenses wore them for a median of 7 hours per day, but no more than 40% wore them at least 8 hours per day, 7 days per week. Spectacles were worn for a median of 15 hours per day at the time of the 24-month follow-up. There was an increase in the spherical equivalent of −1.33 and −1.28 diopters ( P = .64), and axial length increased by 0.84 and 0.79 mm ( P = .38) over 2 years among children randomized to contact lenses and spectacles, respectively. Adjustment for baseline differences between the groups and for hours per day of contact lens wear did not alter these findings. Conclusions Rigid gas permeable lenses did not slow the rate of Myopia Progression, even among children who used them regularly and consistently. It is unlikely that this intervention holds promise as a method by which to slow the rate of Progression of Myopia in children.
-
factors related to the Progression of Myopia in singaporean children
Optometry and Vision Science, 2000Co-Authors: Seang-mei Saw, Brian Levy, Joanne Katz, Oliver D. Schein, Javier F Nieto, Sek-jin ChewAbstract:Purpose: To examine the possible factors related to the Progression of Myopia in Singapore children. Methods: One hundred fifty-three Singapore children aged 6 to 12 years were recruited to participate in a concurrent cohort study of the risk factors for the Progression of Myopia. Socioeconomic status, outdoor activity, and near-work activity were documented in a face-to-face clinic interview. The changes in cycloplegic subjective refraction and autorefraction were ascertained with the use of a Nidek ARK 900 over a 2-year period. Results: The average rate of Progression of Myopia as measured by subjective refraction was 20.59 D per year (95% confidence interval 20.52, 20.66). Younger children and children who were more myopic at the beginning (refractive error worse than 22.0 D) of the study had higher Myopia Progression rates. Conclusions: Myopia Progression was faster for younger children and for children who had more severe Myopia at baseline. Socioeconomic status and near-work activity were not related to Myopia Progression. (Optom Vis Sci 2000;77:549-554)
-
epidemiology of Myopia
Epidemiologic Reviews, 1996Co-Authors: Seang-mei Saw, Joanne Katz, Oliver D. Schein, Sek-jin Chew, Tat Keong ChanAbstract:Myopia is a major health problem throughout the world due to its increasingly high prevalence in the past few decades. Myopia, in particular high Myopia, is directly or indirectly associated with a number of ocular complications such as glaucoma and cataract that are potentially blinding. Myopic retinopathy, a major cause of visual impairment and blindness, affects 1–3 % of the general populations in some countries. Increased amount of near-work activities and decreased time spent outdoors are the two most important modifiable risk factors related to Myopia onset and Progression, though the exact role of how these two risk factors impact on Myopia remains to be determined. Efforts should be made to discover treatments to slow or stop Progression of Myopia to prevent further Progression to high Myopia and pathologic Myopia. Further research on the understanding of the natural history of pathologic Myopia and more effective treatment for pathologic Myopia is of also of public health importance.
Seang-mei Saw - One of the best experts on this subject based on the ideXlab platform.
-
imi interventions Myopia institute interventions for controlling Myopia onset and Progression report
Investigative Ophthalmology & Visual Science, 2019Co-Authors: Christine F Wildsoet, Seang-mei Saw, Audrey Chia, Padmaja Sankaridurg, Pauline Cho, Jeremy A Guggenheim, Jan Roelof Polling, Scott A Read, Klaus Trier, Jeffrey J. WallineAbstract:Myopia has been predicted to affect approximately 50% of the world’s population based on trending Myopia prevalence figures. Critical to minimizing the associated adverse visual consequences of complicating ocular pathologies are interventions to prevent or delay the onset of Myopia, slow its Progression, and to address the problem of mechanical instability of highly myopic eyes. Although treatment approaches are growing in number, evidence of treatment efficacy is variable. This article reviews research behind such interventions under four categories: optical, pharmacological, environmental (behavioral), and surgical. In summarizing the evidence of efficacy, results from randomized controlled trials have been given most weight, although such data are very limited for some treatments. The overall conclusion of this review is that there are multiple avenues for intervention worthy of exploration in all categories, although in the case of optical, pharmacological, and behavioral interventions for preventing or slowing Progression of Myopia, treatment efficacy at an individual level appears quite variable, with no one treatment being 100% effective in all patients. Further research is critical to understanding the factors underlying such variability and underlying mechanisms, to guide recommendations for combined treatments. There is also room for research into novel treatment options.
-
age of onset of Myopia predicts risk of high Myopia in later childhood in myopic singapore children
Ophthalmic and Physiological Optics, 2016Co-Authors: Sharon Chua, Tien Yin Wong, Audrey Chia, Chingyu Cheng, Charumathi Sabanayagam, Yin Bun Cheung, Robert K Valenzuela, Donald T H Tan, Seang-mei SawAbstract:Purpose To investigate the effect of age of Myopia onset on the severity of Myopia later in life among myopic children. Methods In this prospective study, school children aged 7–9 years from the Singapore Cohort of the Risk factors for Myopia (SCORM) were followed up till 11 years (n = 928). Age of Myopia onset was defined either through questionnaire at baseline (age 7–9 years) or subsequent annual follow-up visits. Age of onset of Myopia was a surrogate indicator of duration of Myopia Progression till age 11 years. Cycloplegic refraction and axial length were measured at every annual eye examination. High Myopia was defined as spherical equivalent of ≤−5.0 D. A questionnaire determined the other risk factors. Results In multivariable regression models, younger age of Myopia onset (per year decrease) or longer duration of Myopia Progression was associated with high Myopia (odds ratio (OR) = 2.86; 95% CI: 2.39 to 3.43), more myopic spherical equivalent (regression coefficient (β) = −0.86 D; 95% CI: −0.93 to −0.80) and longer axial length (β = 0.28 mm; 95% CI: 0.24 to 0.32) at aged 11 years, after adjusting for gender, race, school, books per week and parental Myopia. In Receiver Operating Curve (ROC) analyses, age of Myopia onset alone predicted high Myopia by 85% (area under the curve = 0.85), while the addition of other factors including gender, race, school, books per week and parental Myopia only marginally improved this prediction (area under the curve = 0.87). Conclusions Age of Myopia onset or duration of Myopia Progression was the most important predictor of high Myopia in later childhood in myopic children. Future trials to retard the Progression of Myopia to high Myopia could focus on children with younger age of Myopia onset or with longer duration of Myopia Progression.
-
Efficacy comparison of 16 interventions for Myopia control in children: A network meta-analysis
Ophthalmology, 2016Co-Authors: Jinhai Huang, Daizong Wen, Haisi Chen, Fangjun Bao, Seang-mei Saw, Colm Mcalinden, Ian Flitcroft, Qinmei Wang, Hao Chen, Yune ZhaoAbstract:Purpose To determine the effectiveness of different interventions to slow down the Progression of Myopia in children. Methods We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov from inception to August 2014. We selected randomized controlled trials (RCTs) involving interventions for controlling the Progression of Myopia in children with a treatment duration of at least 1 year for analysis. Main Outcome Measures The primary outcomes were mean annual change in refraction (diopters/year) and mean annual change in axial length (millimeters/year). Results Thirty RCTs (involving 5422 eyes) were identified. Network meta-analysis showed that in comparison with placebo or single vision spectacle lenses, high-dose atropine (refraction change: 0.68 [0.52-0.84]; axial length change: -0.21 [-0.28 to -0.16]), moderate-dose atropine (refraction change: 0.53 [0.28-0.77]; axial length change: -0.21 [-0.32 to -0.12]), and low-dose atropine (refraction change: 0.53 [0.21-0.85]; axial length change: -0.15 [-0.25 to -0.05]) markedly slowed Myopia Progression. Pirenzepine (refraction change: 0.29 [0.05-0.52]; axial length change: -0.09 [-0.17 to -0.01]), orthokeratology (axial length change: -0.15 [-0.22 to -0.08]), and peripheral defocus modifying contact lenses (axial length change: -0.11 [-0.20 to -0.03]) showed moderate effects. Progressive addition spectacle lenses (refraction change: 0.14 [0.02-0.26]; axial length change: -0.04 [-0.09 to -0.01]) showed slight effects. Conclusions This network analysis indicates that a range of interventions can significantly reduce Myopia Progression when compared with single vision spectacle lenses or placebo. In terms of refraction, atropine, pirenzepine, and progressive addition spectacle lenses were effective. In terms of axial length, atropine, orthokeratology, peripheral defocus modifying contact lenses, pirenzepine, and progressive addition spectacle lenses were effective. The most effective interventions were pharmacologic, that is, muscarinic antagonists such as atropine and pirenzepine. Certain specially designed contact lenses, including orthokeratology and peripheral defocus modifying contact lenses, had moderate effects, whereas specially designed spectacle lenses showed minimal effect.
-
incidence and Progression of Myopia in singaporean school children
Investigative Ophthalmology & Visual Science, 2005Co-Authors: Seang-mei Saw, Donald T H Tan, Louis Tong, Wei Han Chua, Kee Seng Chia, David Koh, Joanne KatzAbstract:Purpose To determine the incidence and Progression rates of Myopia in young Singaporean children. Methods A prospective cohort study, the Singapore Cohort Study of the Risk Factors for Myopia (SCORM), was conducted in two schools in Singapore (1999-2002). Children aged 7 to 9 years (n=981) were followed up over a 3-year period. Cycloplegic autorefraction and biometry parameter measures were performed annually, according to the same protocol. Results The 3-year cumulative incidence rates were 47.7% (95% confidence interval [CI]: 42.2-53.3), 38.4% (95% CI: 31.4-45.4), and 32.4% (95% CI: 21.8-43.1) for 7-, 8-, and 9-year-old children, respectively. The 3-year cumulative incidence rates were higher in Chinese (49.5% vs. 27.2%) and in 7-year-old compared with 9-year-old children at baseline (47.7% vs. 32.4%), though the latter relationship was of borderline significance after adjustment for race, gender, amount of reading (books/week), and parental Myopia (P=0.057). Premyopic children with greater axial lengths, vitreous chamber depths, and thinner lenses were more prone to the development of Myopia, after controlling for age, gender, race, reading, and parental Myopia. The 3-year mean cumulative Myopia Progression rates were -2.40 D (95% CI: -2.57 to -2.22) in 7-year-old myopic children, -1.97 (95% CI: -2.16 to -1.78) in 8-year-olds, and -1.71 (95% CI: -1.98 to -1.44) in 9-year-olds. Conclusions Both the incidence and Progression rates of Myopia are high in Singaporean children.
-
A randomized trial of rigid gas permeable contact lenses to reduce Progression of children's Myopia.
American journal of ophthalmology, 2003Co-Authors: Joanne Katz, Seang-mei Saw, Brian Levy, Oliver D. Schein, Tom Cruiscullo, Rajan U, Tat Keong Chan, Chong Yew Khoo, Sek-jin ChewAbstract:Abstract Purpose To test whether rigid gas permeable (RGP) contact lens wear can reduced the rate of Myopia Progression in school age children. Design Randomized clinical trial. Methods Setting: Single clinical center. Study Population: Both eyes of 428 Singaporean children. Inclusion Criteria: 6 through 12 years of age with Myopia between −1 and −4 diopters, astigmatism ≤ 2 diopters, no prior contact lens wear, no other ocular pathologies.Intervention: Spectacle or RGP lens correction for Myopia. After a 3-month adaptation period, 383 children were followed, and 298 (78%) remained after 24 months.Outcome measures: Cycloplegic subjective refraction, keratometry, and axial length measured at 12 and 24 months. Results Children who adapted to contact lenses wore them for a median of 7 hours per day, but no more than 40% wore them at least 8 hours per day, 7 days per week. Spectacles were worn for a median of 15 hours per day at the time of the 24-month follow-up. There was an increase in the spherical equivalent of −1.33 and −1.28 diopters ( P = .64), and axial length increased by 0.84 and 0.79 mm ( P = .38) over 2 years among children randomized to contact lenses and spectacles, respectively. Adjustment for baseline differences between the groups and for hours per day of contact lens wear did not alter these findings. Conclusions Rigid gas permeable lenses did not slow the rate of Myopia Progression, even among children who used them regularly and consistently. It is unlikely that this intervention holds promise as a method by which to slow the rate of Progression of Myopia in children.
