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Purpose: The study analyzed the changes in corneal surface shape after replacing orthokeratology lenses carrying a small base curve (BC) diameter. Methods: In this retrospective study, we included ~54 right eyes belonging to 54 myopic children who insisted on wearing an orthokeratology (ortho-k BC 6.0 mm) lens for more than 12 months and then replaced the second ortho-k (BC 6.0 mm or BC 5.0 mm) lens ~12 months. The children were categorized into two groups based on the design of the BC of the replaced ortho-k lens 6.0/5.0 and 6.0/6.0. Results: The ratio of axial length (AL) elongation in the 6.0/5.0 group was significantly less than in the 6.0/6.0 group (−0.015 ± 0.014 mm/M vs. −0.005 ± 0.012 mm/M, t = −2.672, P = 0.010). After replacing the BC 5.0 ortho-k lens, the optical zone (8.19 ± 2.60 mm2 vs. 9.64 ± 1.57 mm2, t = −2.345, p = 0.023), reverse zone (31.64 ± 5.80 mm2 vs. 34.86 ± 4.61 mm2, t = −2.169, p = 0.035), and treatment zone (17.16 ± 3.94 mm2 vs. 22.96 ± 2.59 mm2, t = −6.049, p < 0.001) were all smaller than those in the 6.0/6.0 group. In the 6.0/5.0 group, the optical zone (wearing more than 1 month as first: 11.16 ± 2.12 mm2, the last inspection before replacing lens as before: 10.87 ± 1.90 mm2), reverse curve zone (first: 22.03 ± 3.11 mm2, before: 26.24 ± 5.06 mm2), and treatment zone (first: 35.97 ± 5.54 mm2, before: 37.11 ± 6.04 mm2) were all greater than these after replacing ortho-k lens (all P < 0.001). Conclusion: Replacing an ortho-k lens with a smaller BC resulted in a larger decrease in the mean central corneal zone and a substantial increase in the paracentral corneal zone. In addition, the ortho-k lens with a smaller BC does not increase the decentration distance and contributes to effective myopia control. [ABSTRACT FROM AUTHOR]

Orthokeratology (OK) lenses are designed to reshape the cornea overnight, allowing users to see clearly during the day without glasses. However, prolonged wear increases the risk of microbial contamination and eye infections. Even with cleaning techniques, the surface of OK lenses can become contaminated due to residual bacterial debris. Therefore, developing self-cleaning antibacterial technology for OK lens surfaces is an urgent clinical challenge. Herein, we integrated the temperature responsiveness of PNIPAM molecular chains with the surface contact-killing mechanism of AMP into the surface of OK lenses for the first time, constructing an intelligent OK lens with synergistic antibacterial and self-cleaning properties. The modified OK lenses can achieve over 95% bacterial efficiency against Staphylococcus aureus and Pseudomonas aeruginosa. More importantly, in both worn and removed states, the modified OK lenses can achieve a surface bacterial debris self-cleaning efficiency of 50–75%. These research findings provide important references and insights for the future development of more efficient self-cleaning lens materials. [ABSTRACT FROM AUTHOR]

Clinical relevance: There are many methods to control the progression of myopia. However, it is currently unknown which method could better control myopia progression: 0.02% atropine eye drops, peripheral myopic defocus design spectacle lenses (PMDSL), or orthokeratology (OK). Background: To compare the efficacy of 0.02% atropine, PMDSL, and OK to control axial length (AL) elongation in children with myopia. Methods: This study was analysed based on a previous cohort study (0.02% atropine group) and retrospective data (PMDSL and OK group). Overall, 387 children aged 6–14 years with myopia − 1.00D to − 6.00D in the three groups were divided into four subgroups according to age and spherical equivalent refraction (SER). The primary outcome was changed in AL over 1-year. Results: The mean axial elongation was 0.30 ± 0.21 mm, 0.23 ± 0.16 mm, and 0.17 ± 0.19 mm in the 0.02% atropine, PMDSL, and OK groups, respectively. Multivariate linear regression analyses showed significant differences in axial elongation among the three groups, especially in children aged 6–10, but not in children aged 10.1–14; the corresponding axial elongation was 0.35 ± 0.21 mm, 0.23 ± 0.17 mm, and 0.21 ± 0.20 mm (P < 0.05 between any two groups, except between PMDSL and OK groups at P > 0.05) and 0.22 ± 0.20 mm, 0.21 ± 0.13 mm, and 0.13 ± 0.18 mm (P < 0.05 between any two groups, except between 0.02% atropine and PMDSL groups at P > 0.05) in children with SER from − 1.00D to − 3.00D and from − 3.01D to − 6.00D, respectively. Conclusions: Within the limits of this study design and using only the current brand of PMDSL, OK appeared to be the best method, followed by PMDSL and then 0.02% atropine, for controlling AL elongation over one year. However, different effects were found in the various age and SER subgroups. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the 1‐year effects of orthokeratology (OK) lenses and spectacle lenses with highly aspherical lenslets (HALs) on axial length (AL) elongation in children with unilateral myopic anisometropia. Methods: This ambispective cohort study recruited 81 children aged 8–14 years with unilateral myopic anisometropia. Of these, 42 participants (mean age 11.07 ± 1.54 years; 23 males) were treated with monocular OK lenses (OK group), and 39 (mean age 10.64 ± 1.72 years; 22 males) with binocular HALs (HAL group). Changes in AL and spherical equivalent refraction (SER) from baseline at 3, 6 and 12 months were compared between eyes and groups. Kaplan–Meier estimation and Cox proportional hazard regression were performed to analyse the risk of myopia onset in the initially non‐myopic eyes. Results: Mean axial elongation in the myopic and non‐myopic eyes at the 12‐month follow‐up visit were 0.17 ± 0.20 and 0.41 ± 0.26 mm in the OK group (p < 0.001) and 0.10 ± 0.15 and 0.12 ± 0.12 mm in the HAL group (p = 0.32), respectively. Compared with the OK group, the non‐myopic eyes in the HAL group had less axial elongation, lower cumulative myopia incidence and percentage of participants with rapid myopic shift at the 6‐ and 12 month follow‐up (all p < 0.05). Cox regression analysis showed that a higher initial SER decreased the risk of myopia onset significantly in the initially non‐myopic eyes (B = −2.06; 95% CI, 0.03–0.49; p = 0.003). Conclusions: Monocular OK lenses suppressed axial elongation in the myopic eye and minimised anisometropia; however, the non‐treated contralateral eye may experience faster myopia onset and myopic shift. Binocular HALs can effectively reduce axial elongation in both eyes of children with unilateral myopic anisometropia. [ABSTRACT FROM AUTHOR]

To investigate the efficacy and safety of repeated low-level red-light (RLRL) therapy combined with orthokeratology among children who, despite undergoing orthokeratology, exhibited an axial elongation of at least 0.50 mm over 1 year. Multicenter, randomized, parallel-group, single-blind clinical trial (ClinicaTrials.gov identifier, NCT04722874). Eligible children were 8–13 years of age with a cycloplegic spherical equivalent refraction of –1.00 to –5.00 diopters at the initial orthokeratology fitting examination and had annual axial length (AL) elongation of ≥0.50 mm despite undergoing orthokeratology. Forty-eight children were enrolled from March 2021 through January 2022, and the final follow-up was completed in March 2023. Children were assigned randomly to the RLRL therapy combined with orthokeratology (RCO) group or to the orthokeratology group in a 2:1 ratio. The orthokeratology group wore orthokeratology lenses for at least 8 hours per night, whereas the RCO group received daily RLRL therapy twice daily for 3 minutes in addition to orthokeratology. The primary outcome was AL change measured at 12 months relative to baseline. The primary analysis was conducted in children who received the assigned intervention and completed at least 1 follow-up after randomization using the modified intention-to-treat principle. Forty-seven children (97.9%) were included in the analysis (30 in the RCO group and 17 in the orthokeratology group). The mean axial elongation rate before the trial was 0.60 mm/year and 0.61 mm/year in the RCO and orthokeratology groups, respectively. After 12 months, the adjusted mean AL changes were –0.02 mm (95% confidence interval [CI], –0.08 to +0.03 mm) in the RCO group and 0.27 mm (95% CI, 0.19–0.34 mm) in the orthokeratology group. The adjusted mean difference in AL change was –0.29 mm (95% CI, –0.44 to –0.14 mm) between the groups. The percentage of children achieving an uncorrected visual acuity of more than 20/25 was similar in the RCO (64.3%) and orthokeratology (65.5%) groups (P = 0.937). Combining RLRL therapy with orthokeratology may offer a promising approach to optimize axial elongation control among children with myopia. This approach also potentially allows children to achieve satisfactory visual acuity, reducing daytime dependence on corrective eyewear. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusion The purpose of this study is to investigate 3‐year efficacy of orthokeratology lenses (OKL) in controlling axial length progression in myopic Scandinavian children. Through a cross‐over design of the control group to compare the treatment efficacy in younger versus older children, with the latter having higher cycloplegic spherical refractive error (cSEQ) at treatment initiation. Further, the study aimed to evaluate the safety of the treatment.This was a continuation of the randomized controlled study Clinical study Of Near‐sightedness; TReatment with Orthokeratology Lenses (CONTROL study) in which the follow‐up period of the original intervention group, that received OKL, was extended from 18 months to 36 months. Meanwhile, the original control group was crossed‐over to OKL after the 18‐month follow‐up visit and treated for 18 months. Biometry was measured using Lenstar LS900, and contact lens complications were graded according to Efron Grading Scale for Contact Lens Complications (Efron score). Mixed models were used for statistical analysis.Nineteen subjects in the OKL group and 28 in the control group completed the CONTROL study. Hereof, 17 and 24 subjects from the OKL group and control group, respectively, agreed to participate in the CONTROL2 study. In the OKL continue group, the treatment efficacy did not decline during the 3‐year study period (p‐values for follow‐up visits were all ≥0.82). There was no statistically significant difference between treatment efficacy when OKL treatment was initiated in younger versus older children (p‐value ≥0.14 for all follow‐up visits). Low‐grade corneal staining was seen in several subjects at some point during the study, but here were no treatment‐requiring or sight‐threatening adverse events during the study period.The efficacy of myopia control by OKL was stable during 3 years of treatment. Similar treatment efficacies were found regardless of the age at treatment initiation. No severe adverse events occurred during the study period. [ABSTRACT FROM AUTHOR]

Background: Approximately, 10% of people report a penicillin allergy; however, more than 90% can safely undergo delabeling after a detailed history, oral challenge, or other investigations such as penicillin skin testing (PST). Although PST is the gold standard, the results can be heterogeneous, and awaiting specialist assessment may take an inordinate amount of time. Therefore, oral provocation challenge has become acceptable for individuals with low-risk penicillin allergy histories. There also appears to be an association with increased prevalence of adverse drug reaction reporting in female individuals, which may translate to penicillin allergy prevalence; however, the evidence has not been assessed through a sex and gender lens. This systematic review will identify and synthesize the findings from studies that report measures of effectiveness and safety of interventions aimed at delabeling penicillin allergies in low-risk individuals. Information related to sex and gender will be extracted, where available, to understand potential differences in allergy reporting and patient outcomes. Methods: The Cochrane Handbook for Systematic Reviews of Interventions and the Centre for Review and Dissemination's Guidance for Undertaking Reviews in Health Care will be used as frameworks for conducting this systematic review. The literature search will be conducted by a medical librarian (B. M. M.) and will consist of a search strategy to identify and retrieve published studies that meet our inclusion criteria. Studies that require penicillin skin testing (PST) as a step prior to other interventions will be excluded. Integrated knowledge translation involving co-design was carried out for this systematic review protocol creation. Data extraction will be conducted at four levels: (1) study level, (2) patient level, (3) intervention level, and (4) outcome level. A narrative descriptive synthesis of results and risk of bias of all included studies will be provided, and, if relevant, a meta-analysis will be performed. Discussion: The dissemination of findings from this knowledge synthesis to various stakeholders is intended to inform on options for evidence-based interventions to aid in delabeling penicillin allergies in individuals with a low risk of experiencing a hypersensitivity reaction. Detailed reporting on the characteristics of delabeling interventions as well as the effectiveness of similar interventions will benefit policy makers considering the implementation of a penicillin allergy delabeling protocol. Additionally, findings from this systematic review will report on the current evidence regarding the role of sex and gender in both the prevalence and outcomes associated with the presence of penicillin allergies. Systematic review registration: PROSPERO CRD42022336457. [ABSTRACT FROM AUTHOR]

AIM: To elucidate whether differences exist in the impact on retarding the elongation of axial length (AL) among children with myopia when utilizing orthokeratology (ortho-k) lenses employing the corneal refractive therapy (CRT) design versus those employing the vision shaping treatment (VST) design. METHODS: This retrospective clinical trial aimed to collect and analyze AL data from individuals who wore ortho-k lenses for three years. A total of 654 subjects were enrolled and prescribed one of the three specific brands of ortho-k lenses: CRT, Euclid, and Mouldway. The study's primary focus was to compare the rates of AL elongation and myopic progression across these three brands of ortho-k lenses. RESULTS: In the 3-year follow-up, the AL elongation exhibited variations of 0.73±0.36 mm in the CRT lens group, 0.59±0.37 mm in the Euclid lens group, and 0.63±0.38 mm in the Mouldway lens group. A noteworthy disparity emerged between the CRT and Mouldway groups (P

AIM: To observe the effect of orthokeratology combined with vision therapy and Clouclip(OCVTC)on myopic children with dysfunctional accommodation.METHODS: A prospective, non-randomized control study was conducted on 99 myopic children(99 eyes)with dysfunctional accommodation at the optometry center were of Langfang Aier Eye Hospital from April 2022 to January 2023. and they selected and divided into three groups: 39 children in OCVTC group, 30 in orthokeratology(Ortho-k)group, and 30 in single vision spectacle lens(SVL)group. The OCVTC group received office-based accommodative therapy for 3 mo and home reinforcement for 3 mo, and Clouclip was used in the first 3 wk to monitor and remind children of eye habits; the accommodative amplitudes and facility were measured at baseline, 3, 6, and 12 mo after treatment.RESULTS: The OCVTC group showed significantly better improvement in accommodative amplitude compared with both the Ortho-k group and the SVL group(all P

AIM:To explore the effect of the peripheral defocus spectacle lenses and orthokeratology(OK)on the control of myopia progression and the impact on vision related quality of life in children and adolescents.METHODS:Prospective study. A total of 237 children initially diagnosed with myopia in the ophthalmology department of Huzhou Central Hospital from January 2021 to January 2022 were selected and divided into two groups according to different correction methods: peripheral defocus spectacle lenses group(105 cases, 105 eyes)and OK lens group(132 cases, 132 eyes). The Vision Related Quality of Life Questionnaire for Primary and Secondary School Students was used to follow up the both groups of myopic children, and the best corrected visual acuity(BCVA), spherical equivalent(SE), and axial length(AL)were recorded at the first visit and 1 a of follow-up.RESULTS:After wearing lenses for 1 a, both the peripheral defocus spectacle lenses group and OK lens group showed an increase in SE and AL, but there was no statistical difference between two groups(P>0.05). The changes in SE and AL in the peripheral defocus spectacle lenses group were greater than those in the OK lens group(all P=0.001). After 1 a of follow-up, in the emotional dimension scores, the peripheral defocus spectacle lenses group of children's vision-related quality of life scales scored higher than in the OK lens group(P

AIM: To compare the progression of myopia in children wearing orthokeratology lenses combined with low-concentration atropine before and after drug withdrawal, to determine the rebound effect of drug withdrawal in orthokeratology lens wearers, and to analyze its causes based on changes in pupil diameter.METHODS:A prospective case-control study was conducted to collect 80 children with myopia who were treated with orthokeratology lenses combined with 0.01% atropine ophthalmic gel at the Xi'an No.1 Hospital from January to June 2022. One year later, they were divided into a drug withdrawal group(Group A, 40 cases)and a continuous medication group(Group B, 40 cases)based on whether they stopped taking the medication. The progression of myopia before and after drug withdrawal was observed by analyzing changes in axial length(AL)and spherical equivalent(SE)in the group A within 1 a before and after drug withdrawal. The changes in AL, pupil diameter(PD), and SE were compared between the group A and group B within 2 a, and the correlation between PD and AL growth was analyzed.RESULTS:In the group A, the AL increased by 0.17±0.23 and 0.29±0.18 mm at 0.5 and 1 a after drug withdrawal, respectively, which were both greater than before drug withdrawal(t=5.318, 2.983, both P0.05). There were no statistically significant differences in AL and PD between the group A and group B at baseline, 0.5 and 1 a during combined medication(all P>0.05). At 1.5 a, the AL growth of the group A was greater than that of the group B(0.32±0.27 mm vs 0.26±0.20 mm, t=7.363, P

Purpose: To discuss the characteristics of anterior corneal elevation asymmetry in myopic eyes and clarify which kind of asymmetry most influenced lens position. Methods: In this retrospective study of 199 consecutive myopic participants, corneal topography was used to analyse asymmetry in anterior corneal elevation. Amongst them, 65 participants (65 eyes) who underwent orthokeratology (31 and 34 with spherical and toric lenses, respectively) were re‐evaluated. Stepwise multiple linear regression analysis was used to identify the contributing factors that influenced lens decentration. Receiver operating characteristic curve (ROC) analysis was employed to assess how the corneal asymmetry vector could predict decentration. Results: There were no significant differences in treatment zone decentration (TZDec) between participants wearing toric and spherical lenses (p = 0.60 and 0.64 for 1 week and 1 month of wear, respectively). Amongst the underlying factors, the magnitude of TZDec was only correlated with the amount of corneal asymmetry vector (standardised β = 0.44, 0.48, p < 0.001 for all) after 1 week and 1 month of wear, and the direction of TZDec after 1 month of lens wear was associated with the angle of the asymmetry vector (r = 0.25, p = 0.04). ROC analysis showed that the magnitude of corneal asymmetry vector produced accurate discrimination between non‐severe and severe decentration for 1 week and 1 month of wear (area under the curve was 0.93 ± 0.04 and 0.89 ± 0.05, respectively, p < 0.001). Amongst participants whose corneal asymmetry vector exceeded 41.06 μm and was oriented inferiorly, 35.29% showed severe decentration after 1 month of lens wear. Conclusions: In myopic participants, corneal asymmetry existed in the 8.0 mm chord diameter. If the asymmetry vector >41.06 μm and the direction was oriented inferiorly, then practitioners must be vigilant about severe decentration which would not be alleviated by a toric design. [ABSTRACT FROM AUTHOR]

Orthokeratology (OK) is widely used for effective myopia correction and control. However, the incomplete understanding of its biomechanical mechanisms makes OK lens fitting rely heavily on clinician judgment, complicating accurate predictions of treatment outcomes. In this paper, we performed clinical experiments and numerical analysis to study corneal deformation modes and long-term changes in central corneal thickness. Clinical experiments were conducted on 194 Chinese myopic patients under OK treatment for 3 months. Based on the experimental data, a patient-specific computational biomechanical model for OK was established and validated. Specifically, the anisotropic mechanical properties of the cornea were incorporated into the model to describe the significant difference between its shear modulus (29.5 kPa) and tensile modulus (768.4 kPa). Additionally, a visco-hyperelastic material model with a prolonged corneal relaxation time of 5.6 h was developed to capture the long-term deformation response. The results show that corneal thickness reduction in OK is primarily due to out-of-plane shear deformation, influenced by the cornea’s low shear resistance. Modeling the extended corneal relaxation time is crucial for predicting long-term biomechanical responses. The computational model effectively captures long-term changes in central corneal thickness, potentially improving OK lens fitting accuracy. [ABSTRACT FROM AUTHOR]

Orthokeratology(OK lens)is considered to be one of the most effective optical treatments for myopia control. Its safety and efficiency in controlling myopia progression have been rigorously verified by numerous studies. As the materials and technology of lens have evolved, orthokeratology has demonstrated remarkable results in myopia control, particularly among children with moderate myopia. Not only does orthokeratology effectively decelerate axial length growth, but it also positively impacts regulatory function. However, it is crucial to acknowledge that there may be some compromise in visual quality. Therefore, the perfect balance between lens design and patient adaptability must be considered to maintain visual clarity and optimize myopia control. While orthokeratology has made significant strides in myopia control, there are still lingering questions about its long-term stability, the precise impact of visual quality, and the others. Furthermore, combining orthokeratology with other strategies offers better effects. Nevertheless, further clinical data is needed to estimate the rebound effects of withdrawal. This review summarizes the technology, safety, efficacy and combination therapy of orthokeratology on myopia control.

AIM: To assess the gap between the peak of the base curve to the surface of the cornea, as well as examines the correlation between the thickness of the tear film and the fitting of the orthokeratology lens through optical coherence tomography(OCT), providing an intuitive and quantitative clinical evaluation method for the fitting of the orthokeratology lens.METHODS: Myopia patients who fitted orthokeratology at our hospital from January to December 2023 were included. Examinations, including naked vision, slit lamp, non-contact intraocular pressure, ocular fundus, eye position, corneal diameter, corneal topography, tear film rupture time, optometry, etc., were performed on all patients before fitting. The trial lens parameter was selected according to the examination results, and fluorescein staining was performed to evaluate lens fitting state after patients adapted to wearing glasses. According to the performance of fluorescein staining, the inspected eyes are divided into three groups: lens loose group, lens fitting group, and lens tight group. In addition, the tear film thickness of three groups of subjects was measured by OCT, and the differences between the three groups of data were evaluated.RESULTS: A total of 49 myopic patients(77 eyes)were included. The average sphere degree was -3.10±1.25 D, the average cylinder degree was -0.43(-0.75, 0)D, the average horizontal keratometry(HK)was 42.48±0.81 D, and vertical keratometry(VK)was 42.98(42.25, 43.50)D. There were 21 cases(34 eyes)in the lens fitting group, with 13 cases of bilateral eyes, 8 cases of one eye, 14 cases(22 eyes)in the lens loose group, with 8 cases of bilateral eyes, 6 cases of one eye, and 14 cases(21 eyes)in the lens tight group, with 7 cases of bilateral eyes, 7 cases of one eye. There was no statistical difference in the main basic data of the subjects in the three groups(all P>0.05). OCT showed that the tear film thickness of the lens fitting group, the lens loose group, and the lens tight group was 231.18(219.0, 243.0), 220.41(214.0, 224.3), and 249.00(241.5, 258.0)μm, respectively, and there was statistical significance in the thickness among the three groups(P

AIM: To compare the clinical effectiveness of using multifocal defocus spectacle lenses, orthokeratology lenses, and single-vision spectacle lenses in patients with myopia and small-angle intermittent exotropia.METHODS: This retrospective study included 150 patients aged 8-15 years with basic intermittent exotropia, strabismus of -10△ to -20△ prism diopters(D)(block lenses), and spherical equivalents of -1.00 to -5.50 D, who visited our hospital from June 2021 to September 2022. They were selected and divided into three groups on a voluntary basis: the HAL group(50 patients with multifocal myopia defocus spectacle lenses), the OK lens group(50 patients with nighttime orthokeratology lenses), and the SVL group(50 patients with regular single-vision spectacle lenses). After wearing the lenses consistently, changes in axial length, prism diopters with the naked eye and lenses(prism at 33 cm), positive fusional vergence of blurred points, and near stereopsis were observed and compared among groups before intervention and after 1 a. The Newcastle control score(NCS)was used to evaluate the eye position control ability of the patients in the three groups.RESULTS: Before the intervention, the axial lengths of the HAL, OK lens, and SVL groups were 24.83±0.91, 24.93±0.97, and 24.98±0.68 mm, respectively(P>0.05). After 1 a, the axial lengths of the three groups were 25.02±0.90, 25.18±0.97, and 25.45±0.65, respectively(P0.05). After 1 year, near stereopsis in the groups were 76.00″±20.40″, 81.20″±18.91″, and 100.60″±51.41″, respectively(P0.05), and it was 17.10±2.02, 13.12±1.41, and 13.26±2.45, respectively, after 1 a(P

Purpose: To optimise the precision and efficacy of orthokeratology, this investigation evaluated a deep neural network (DNN) model for lens fitting. The objective was to refine the standardisation of fitting procedures and curtail subjective evaluations, thereby augmenting patient safety in the context of increasing global myopia. Methods: A retrospective study of successful orthokeratology treatment was conducted on 266 patients, with 449 eyes being analysed. A DNN model with an 80%–20% training‐validation split predicted lens parameters (curvature, power and diameter) using corneal topography and refractive indices. The model featured two hidden layers for precision. Results: The DNN model achieved mean absolute errors of 0.21 D for alignment curvature (AC), 0.19 D for target power (TP) and 0.02 mm for lens diameter (LD), with R2 values of 0.97, 0.95 and 0.91, respectively. Accuracy decreased for myopia of less than 1.00 D, astigmatism exceeding 2.00 D and corneal curvatures >45.00 D. Approximately, 2% of cases with unique physiological characteristics showed notable prediction variances. Conclusion: While exhibiting high accuracy, the DNN model's limitations in specifying myopia, cylinder power and corneal curvature cases highlight the need for algorithmic refinement and clinical validation in orthokeratology practice. [ABSTRACT FROM AUTHOR]

Purpose: To investigate axial elongation (AE) and changes in relative peripheral refraction (RPR) in anisomyopic children undergoing orthokeratology (ortho‐k). Methods: Bilateral anisomyopic children, 7–12 years of age, were treated with ortho‐k. Axial length (AL) and RPR, from 30° nasal (N30°) to 30° temporal (T30°), were measured at baseline and every 6 months over the study period. AE, changes in RPR and changes in the interocular AL difference were determined over time. Results: Twenty‐six of the 33 subjects completed the 2‐year study. The AE of the higher myopic (HM) eyes (at least 1.50 D more myopia than the other eye) (0.26 ± 0.29 mm) was significantly smaller than for the less myopic (LM) eyes (0.50 ± 0.27 mm; p = 0.003), leading to a reduction in the interocular difference in AL (p = 0.001). Baseline RPR measurements in the HM eyes were relatively more hyperopic at T30°, N20° and N30° (p ≤ 0.02) and greater myopic shifts were observed at T20° (p < 0.001), T30° (p < 0.001), N20° (p = 0.02) and N30° (p = 0.01) after lens wear. After 2 years of ortho‐k lens wear, temporal–nasal asymmetry increased significantly, being more myopic at the temporal locations in both eyes (p < 0.001), while AE was associated with the change in RPR at N20° (β = 0.134, p = 0.01). The interocular difference in AE was also positively associated with the interocular difference in RPR change at N30° (β = 0.111, p = 0.02). Conclusions: Ortho‐k slowed AE in bilateral anisomyopia, with slower growth in the HM eyes leading to a reduction in interocular AL differences. After ortho‐k, RPR changed from hyperopia to myopia, with greater changes induced in the HM eyes, and slower AE was associated with a more myopic shift in RPR, especially in the nasal field of both eyes. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to determine whether orthokeratology (OK) lenses with a smaller back optic zone diameter (BOZD) could exhibit stronger myopia control effects. Method: A meta‐analysis was registered in PROSPERO (CRD42023408184). A comprehensive systematic database search was conducted, encompassing PubMed, Cochrane Library, EMBASE, MEDLINE, Web of Science, Ovid, CNKI and CBM, to identify relevant studies up to 25 March 2023. The primary inclusion criteria for this meta‐analysis were studies that investigated the myopia control effect of OK lenses with a small optical treatment area (≤5 mm). To assess the quality of the retrieved articles, two researchers evaluated them using the Cochrane bias risk assessment criteria. The primary outcome measures were the changes in axial length (AL) and refractive error, using the weighted mean differences (WMD) and 95% confidence intervals (CI) to assess differences between small and traditional back optical treatment zone groups in terms of these outcomes. Results: The analysis encompassed five eligible studies, with a 1 year duration. The average difference in AL between the groups was 0.12 mm (WMD = −0.12, 95% CI [−0.16, −0.09], p < 0.00001). Likewise, the average difference in refractive error between the two groups was 0.44 D (WMD = 0.44, 95% CI [0.30, 0.57], p < 0.00001). None of the studies reported severe adverse events. Conclusions: Current evidence suggests that OK lenses with smaller back optical treatment zone are more effective in preventing myopia progression than traditional lenses. However, a longer‐term evaluation is warranted. [ABSTRACT FROM AUTHOR]

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Copyright of Anatolian Clinic Journal of Medical Sciences is the property of Hayat Saglik ve Sosyal Hizmetler Vakfi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To observe the effectiveness and safety of long-term wearing of orthokeratology lens in adolescent myopia patients. Methods: From June 2019 to April 2023, 30 myopic adolescents (60 eyes) who had been fitted with orthokeratology lens in the ophthalmology department of Xuanwu hospital and had worn them for a long time (≥ 3 years) were reviewed. They were reexamined 1 day, 7 days, 1 month and 3 month after wearing the glasses. The changes of the axial length and the parameters of corneal endothelioscopy were compared before and after wearing the glasses for 6 months, 1 year, 2 years and 3 years. Result: A total of 30 cases (60 eyes) were observed in this study, including 13 males and 17 females, aged 7-14 years old, with an average age of 9.77 ± 1.89 years old. The equivalent spherical scope was -5.00-0.75D, with an average of -1.98± 0.97 D. Among them, 5 cases (8 eyes, 13.3%) developed grade 1 corneal staining, but no grade 2-3 staining was observed. 2 cases (4 eyes, 6.7%) developed allergic conjunctivitis, which was cured after stopping wearing and receiving corresponding treatment. The axial lengths of 6 mon, 1 a, 2 a, and 3 a before and after wearing glasses were 24.57± 0.74 mm, 24.67± 0.85 mm, 24.78± 0.96 mm, 24.91± 0.97 mm, and 25.06± 0.85 mm, respectively, showing an overall increasing trend (F=21.904, P<0.001). There were statistically significant differences in axial lengths between pre and post wearing glasses at various time points, with P values of 0.027, 0.001, 0.000, and 0.000, respectively. There was a statistically significant difference between 6 mon after wearing glasses and 1 a, 2 a, and 3 a after wearing glasses. The P-values were 0.005, 0.000, and 0.008, respectively. There was a statistically significant difference (P<0.001) between 1 year after wearing the mirror and 2 years after wearing the mirror, while there was no statistically significant difference (P>0.05) between other time points. The coefficient of variation of cell area at 6 mon, 1 a, 2 a, and 3 a before and after wearing glasses were 25± 2.9%, 26± 3.7%, 27± 4.1%, 27± 4.6%, and 27± 4.1%, respectively. Overall, F=5.490, P=0.001. Comparing the two groups, it was found that there was a statistically significant difference between the two groups, with P values of 0.012 and 0.008, respectively (P<0.05). The difference between the two groups was statistically significant (P=0. 007), There was no statistically significant difference between other time points (P>0.05). There was no statistically significant difference in corneal thickness, endothelial cell density, average area, and hexagonal cell ratio at each time point (P>0.05).Conclusion: Adolescent myopia patients can effectively control the rapid growth of their eye axis by wearing corneal reshaping lenses for a long time. However, comprehensive examination and evaluation must be conducted, qualified and appropriately sized lenses must be worn, standardized operations must be carried out, and follow-up visits must be made on time. If allergies or corneal injuries occur, timely cessation of wearing and corresponding treatment can ensure the safety of long-term wearing. Morphological examination of corneal cells revealed that long-term wearing of glasses showed an increasing trend in the variation of corneal endothelial cell area. [ABSTRACT FROM AUTHOR]

Background: A pro-oxidant enzyme, NADPH oxidase 4 (Nox4) has been reported to be a critical downstream effector of TGFβ-induced myofibroblast transformation during fibrosis. While there are a small number of studies suggesting an oncogenic role of Nox4 derived from activated fibroblasts, direct evidence linking this pro-oxidant to the tumor-supporting CAF phenotype and the mechanisms involved are lacking, particularly in breast cancer. Methods: We targeted Nox4 in breast patient-derived CAFs via siRNA-mediated knockdown or administration of a pharmaceutical inhibitor (GKT137831). We also determine primary tumor growth and metastasis of implanted tumor cells using a stable Nox4-/- syngeneic mouse model. Autophagic flux of CAFs was assessed using a tandem fluorescent-tagged ptfl-LC3 plasmid via confocal microscopy analysis and determination of the expression level of autophagy markers (beclin-1 and LC3B). Nox4 overexpressing CAFs depend on the Nrf2 (nuclear factor-erythroid factor 2-related factor 2) pathway for survival. We then determined the dependency of Nox4-overexpressing CAFs on the Nrf2-mediated adaptive stress response pathway for survival. Furthermore, we investigated the involvement of Birc5 on CAF phenotype (viability and collagen contraction activity) as well as the expression level of CAF markers, FAP and αSMA. Conclusions: We found that deletion of stroma Nox4 and pharmaceutically targeting its activity with GKT137831 significantly inhibited orthotopic tumor growth and metastasis of implanted E0771 and 4T1 murine mammary carcinoma cell lines in mice. More importantly, we found a significant upregulation of Nox4 expression in CAFs isolated from human breast tumors versus normal mammary fibroblasts (RMFs). Our in situ RNA hybridization analysis for Nox4 transcription on a human breast tumor microarray further support a role of this pro-oxidant in the stroma of breast carcinomas. In addition, we found that Nox4 promotes autophagy in CAFs. Moreover, we found that Nox4 promoted survival of CAFs via activation of Nrf2, a master regulator of oxidative stress response. We have further shown Birc5 is involved as a downstream modulator of Nrf2-mediated pro-survival phenotype. Together these studies indicate a role of redox signaling via the Nox4-Nrf2 pathway in tumorigenesis and metastasis of breast cancer cells by promoting autophagy and survival of CAFs. [ABSTRACT FROM AUTHOR]

This study aimed to synthesize the variations in subfoveal choroidal thickness (SFCT) observed at different follow-up intervals in myopic children undergoing orthokeratology treatment. Relevant articles were systematically retrieved from databases such as PubMed, EMBASE, Web of Science, and Cochrane Library. The retrieval period extended from the inception of these databases to November 2023. Means and standard deviations (SD) of baseline and post-treatment SFCT were selected as the results for analysis and calculation. A total of eight articles involving 478 eyes fulfilled the inclusion criteria. At 1 month, 3 months, and 6 months intervals, the SFCT demonstrated significant increases by 16.74 μm (95% CI: 8.66, 24.82; p < 0.0001), 13.41 μm (95% CI: 4.36, 22.45; p = 0.004), and 17.57 μm (95% CI: 8.41, 26.73; p = 0.0002), respectively. Besides, children treated with orthokeratology exhibited a notably thicker change of SFCT in comparison with children with single-vision spectacles (SVL) (WMD = 13.50, 95% CI: 11.69, 15.13; p < 0.0001). Myopic children undergoing orthokeratology treatment experience a discernible increase in SFCT at 1 month, 3 months, and 6 months. Furthermore, compared to children utilizing SVL, those undergoing orthokeratology manifest a more pronounced thickening of SFCT. [ABSTRACT FROM AUTHOR]

PurposeThe study analyzed the changes in corneal surface shape after replacing orthokeratology lenses carrying a small base curve (BC) diameter.MethodsIn this retrospective study, we included ~54 right eyes belonging to 54 myopic children who insisted on wearing an orthokeratology (ortho-k BC 6.0 mm) lens for more than 12 months and then replaced the second ortho-k (BC 6.0 mm or BC 5.0 mm) lens ~12 months. The children were categorized into two groups based on the design of the BC of the replaced ortho-k lens 6.0/5.0 and 6.0/6.0.ResultsThe ratio of axial length (AL) elongation in the 6.0/5.0 group was significantly less than in the 6.0/6.0 group (−0.015 ± 0.014 mm/M vs. −0.005 ± 0.012 mm/M, t = −2.672, P = 0.010). After replacing the BC 5.0 ortho-k lens, the optical zone (8.19 ± 2.60 mm2 vs. 9.64 ± 1.57 mm2, t = −2.345, p = 0.023), reverse zone (31.64 ± 5.80 mm2 vs. 34.86 ± 4.61 mm2, t = −2.169, p = 0.035), and treatment zone (17.16 ± 3.94 mm2 vs. 22.96 ± 2.59 mm2, t = −6.049, p < 0.001) were all smaller than those in the 6.0/6.0 group. In the 6.0/5.0 group, the optical zone (wearing more than 1 month as first: 11.16 ± 2.12 mm2, the last inspection before replacing lens as before: 10.87 ± 1.90 mm2), reverse curve zone (first: 22.03 ± 3.11 mm2, before: 26.24 ± 5.06 mm2), and treatment zone (first: 35.97 ± 5.54 mm2, before: 37.11 ± 6.04 mm2) were all greater than these after replacing ortho-k lens (all P < 0.001).ConclusionReplacing an ortho-k lens with a smaller BC resulted in a larger decrease in the mean central corneal zone and a substantial increase in the paracentral corneal zone. In addition, the ortho-k lens with a smaller BC does not increase the decentration distance and contributes to effective myopia control.

PurposeTo develop a predictive model for orthokeratology (Ortho-K) lens decentration 1 month after wear.MethodsThis study included myopic children who were fitted with Ortho-K lenses at Fujian Provincial Hospital between December 2022 and May 2024. Corneal topography parameters and other relevant metrics were collected pre- and post-treatment. Feature selection was conducted using univariate logistic regression and Lasso regression analysis. A machine learning approach was used to develop multiple predictive models, including Decision Tree, Logistic Regression, Multilayer Perceptron, Random Forest, and Support Vector Machine. Model performance was evaluated using accuracy, sensitivity, specificity, ROC curves, DCA curves, and calibration curves. SHAP values were employed to interpret the models.ResultsThe Logistic Regression model demonstrated the best predictive performance, with an AUC of 0.82 (95% CI: 0.69–0.95), accuracy of 77.59%, sensitivity of 85%, and specificity of 61.11%. The most significant predictors identified were age, 8 mm sag height difference, 5 mm Kx1, and 7 mm Kx2. SHAP analysis confirmed the importance of these features, particularly the 8 mm sag height difference.ConclusionsThe Logistic Regression model successfully predicted the risk of Ortho-K lens decentration using key corneal morphological metrics and age. This model provides valuable support for clinicians in optimizing Ortho-K lens fitting strategies, potentially reducing the risk of adverse outcomes and improving the quality of vision for patients. Further validation in clinical settings is recommended.

PurposeThis study analyzed the corneal surface shape following overnight orthokeratology with different optical zone diameters.MethodsA total of 82 eyes belonging to 41 myopic children who completed 1 month of the orthokeratology (ortho-k) lens wear at the Eye Hospital of Wenzhou Medical University from January 2022 to January 2023 were retrospectively analyzed. According to the size of the base curve (BC) of ortho-k lens, patients were divided into BC 5.0 and BC 6.0 groups. The changes in decentration distance and corneal refraction of the two groups after the ortho-k lens wear were analyzed. Independent sample t-tests were used to compare these two outcome measures between the two groups.ResultsThe decentration distance of BC 5.0 group (0.37 ± 0.19 mm) was significantly lower than that of BC 6.0 group (0.49 ± 0.25 mm, t = −2.330, p = 0.022). In the BC 5.0 group, the direction of decentration was superonasal in 3 cases, inferonasal in 2 cases, inferotemporal in 21 cases, and superotemporal in 6 cases. In the BC 6.0 group, the direction of decentration was superonasal in 2 cases, inferonasal in 2 cases, inferotemporal in 27 cases, and superotemporal in 19 cases. The optical zone area (8.19 ± 2.96 mm2) and reverse curve zone area (30.05 ± 6.74 mm2) in the BC 5.0 group were significantly lower than in the BC 6.0 group (10.42 ± 2.03 mm2, t = −4.043, p < 0.001; 38.21 ± 4.77 mm2, t = −6.422, p < 0.001). The change in the rate of refraction in the horizontal direction in BC 5.0 group were significant higher than in BC 6.0 group.ConclusionBase curve 5.0 mm ortho-k lens is better positioned than BC 6.0 mm lens. A small BC ortho-k forms a smaller optical zone and reverse curve area, which might get a greater aiameter of alignment curve to facilitate positioning better than the traditional BC lens. In addition, a small BC lens increases positive refraction in the peripheral area, resulting in a greater negative pressure than the traditional BC lens.

Sugi Panneerselvam, Nina Diklich, Jonathan Tijerina, Michelle M Falcone, Kara M Cavuoto Department of Ophthalmology, Bascom Palmer Eye Institute/University of Miami Miller School of Medicine, Miami, FL, USACorrespondence: Kara M Cavuoto, Department of Ophthalmology, Bascom Palmer Eye Institute/University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL, 33136, USA, Tel +1-305-326-6324, Fax +1-305-547-3675, Email kcavuoto@med.miami.eduPurpose: To explore public interest in myopia progression and management and to correlate these trends to available treatments.Methods: Keywords were chosen for interest in myopia overall and those signifying interest in myopia treatments. Treatment options were separated into four main categories: atropine, glasses, contact lenses, and orthokeratology. Search terms were queried across ten years of Google Trends data and the relative search volume was analyzed to quantify the change in search volume over time.Results: A positive linear trend over time was present for all myopia interest keywords except “nearsighted” (p = 0.074) and “near work myopia” (p = 0.086). Interest in the four myopia treatment categories included in this study also displayed a significant positive trend over time. There is also a statistically significant positive correlation between all four treatment options and four of the seven categories of population interest, “myopia control”, “myopia”, “myopia progression”, and “screen time myopia”.Conclusion: This study demonstrates the utility of GT to correlate public interest in myopia treatments over time. All treatment terms had statistically significant linear search volume growth over a ten-year period. The positive correlation between interest in myopia as a health problem and available treatments supports existing evidence that GT can track rising public health concerns and corresponding treatment-seeking behaviors.Keywords: myopia, Google Trends, nearsighted, orthokeratology, atropine

AIM:To investigate the effect of diquafosol sodium(SD)eye drops combined with sodium hyaluronate eye drops on improving tear film stability after wearing orthokeratology lenses.METHODS:Prospective study. A total of 82 patients(82 right eyes)who were recruited from the outpatient department of Anhui Aier Eye Hospital from March to August 2022. Participants were assigned to three groups: sodium hyaluronate(SH)group(30 eyes), SD group(24 eyes), and sodium diquafosol combined with sodium hyaluronate(CG)group(28 eyes)according to random number table method. All groups wore the same brand of orthokeratology lens. Non-invasive tear breakup time(NIBUT), non-invasive tear meniscus height(NITMH)and lipid layer thickness were examined before treatment, and after wearing orthokeratology lens for 1 d, 1 wk, and 1 mo. Corneal spot staining was also recorded.RESULTS:The NITMH and NIBUT of CG group and the SD group at 1 mo after treatment were higher than those before wearing lenses(both P0.05). The incidence of corneal staining did not differ significantly among the groups(P>0.05).CONCLUSION:The combination of diquafosol sodium and sodium hyaluronate eye drops demonstrates a superior effect in improving NIBUT and NITMH after wearing orthokeratology lenses for 1 mo, effectively enhancing tear film stability in patients wearing orthokeratology lenses.

We systematically reviewed the literature on the effects of the coronavirus disease 2019 (COVID-19) pandemic on the progression, prevalence, and incidence of myopia. A comprehensive literature search was performed on PubMed, Cochrane Central Register of Controlled Trials, and Scopus databases. Studies included in the review assessed myopia progression, prevalence, and/or incidence as the primary outcome. Of 523 articles yielded in the initial search, 23 studies (6 cross-sectional and 17 cohort) were eligible for inclusion. Sixteen of these were conducted in China and one each in Hong Kong, Turkey, Spain, Israel, India, Korea, and Tibet. Quality appraisals were conducted with the Joanna Briggs Institute Critical Appraisal Checklists. Of the included studies, a large majority reported a greater myopic shift and increase in myopia prevalence during the COVID-19 pandemic compared to the pre-COVID-19 years. All three studies on myopia incidence showed increased incidence during the COVID-19 pandemic. Myopia progression accelerated during the COVID-19 pandemic, even in individuals using low-concentration atropine eye drops in two studies but not in those using orthokeratology treatment in one study. Overall, the studies found that the COVID-19 pandemic and its associated home confinement measures generally increased myopia progression, prevalence, and incidence, even in individuals using low-concentration atropine eye drops.

Abstract Background The aim was to validate the correlation between corneal shape parameters and axial length growth (ALG) during orthokeratology using Image-Pro Plus (IPP) 6.0 software. Methods This retrospective study used medical records of myopic children aged 8–13 years (n = 104) undergoing orthokeratology. Their corneal topography and axial length were measured at baseline and subsequent follow-ups after lens wear. Corneal shape parameters, including the treatment zone (TZ) area, TZ diameter, TZ fractal dimension, TZ radius ratio, eccentric distance, pupil area, and pupillary peripheral steepened zone(PSZ) area, were measured using IPP software. The impact of corneal shape parameters at 3 months post-orthokeratology visit on 1.5-year ALG was evaluated using multivariate linear regression analysis. Results ALG exhibited significant associations with age, TZ area, TZ diameter, TZ fractal dimension, and eccentric distance on univariate linear regression analysis. Multivariate regression analysis identified age, TZ area, and eccentric distance as significantly correlated with ALG (all P

AIM: To compare the changes in axial length of myopic patients of different ages after wearing orthokeratology lenses with increased compression factor(ICF)or conventional compression factor(CCF)for 2 a.METHODS: Retrospective study. A total of 141 myopia patients(141 right eyes)aged 8 to 15 years who fitted with orthokeratology lenses in the General Hospital of Foshan Aier Eye Hospital from July 2020 to July 2021 were continuously included. They were divided into the CCF group(70 cases, 70 eyes)and the ICF group(71 cases, 71 eyes). The patients in the CCF group were fitted with orthokeratology lens of 0.75 DS CCF, while patients in the ICF group were fitted with orthokeratology lens of 1.25 D ICF. Taking 12 years old as a boundary, these two groups were divided into 8-11 years old and 12-15 years old group. The uncorrected visual acuity(UCVA), horizontal corneal curvature(K1)and corneal staining were recorded for all subjects after wearing lenses for 1 d, 1 wk, 1, 6 mo, 1 and 2 a. The axial length(AL)was recorded after wearing lenses for 6 mo, 1 and 2 a, and the complication and corneal epithelial staining were observed during lens wearing.RESULTS:The improvement of UCVA in the ICF group was faster than that in the CCF group, which were statistical significant after wearing lenses for 1 d, 1 wk and 1 mo, respectively(all P0.05); K1 of the ICF group decreased faster than that of the CCF group, and there were statistical significance at 1 d, 1 wk, and 1 mo after wearing lenses(all P0.05). The axial length growth of patients aged 8-11 years old in the ICF group and CCF group was 0.35±0.17 and 0.48±0.26 mm, respectively(P=0.010), after wearing lenses for 2 a, and the axial length growth of patients aged 12-15 years old in the ICF group and CCF group was 0.16±0.15 and 0.31±0.29 mm, respectively(P=0.011). During the follow-up period, corneal spotting occurred in 6 eyes(8.5%)in the ICF group, and 7 eyes(10%)in the CCF group(P>0.05), all of which were grade 1 spotting.CONCLUSION:Wearing ICF orthokeratology lens is more effective than wearing CCF lenses in controlling the growth of axial length, with faster shaping and more obvious improvement in UCVA, especially for the prevention of high myopia in children under 12 years. Therefore, young children can give priority to wearing lenses that increase the compression factor, and for children over 12 years old, the compression factor of the lens can be selectively increased according to the wearer's eye habits, health status of ocular surface and visual function.

Purpose: To investigate the effect of COVID‐19 home confinement on the efficacy of the interventions for controlling myopia, and to select effective therapies to control myopia during COVID‐19 confinement. Method: Children (n = 164) aged 8–12 years with spherical equivalent refraction of −1.00 to −6.00 diopters were stratified into two age subgroups and randomly allocated into the control, 0.01% atropine, orthokeratology (ortho‐k) and atropine combined ortho‐k (ACO) groups. Axial length (AL) was measured at baseline, 6‐, 12‐, 18‐ and 24‐month visits. The follow‐up spanned the period before the COVID‐19 outbreak, the period of the home confinement, and the period of the school reopening. Hence, the AL change in different periods was collected and compared. Data analysis was performed following the criteria of intention to treat (ITT). Results: All 164 children were involved in the ITT analysis. Compared to control, all interventions can still reduce the AL elongation during the COVID‐19 home confinement period (all p < 0.05). However, the efficacy was compromised: individuals experienced more AL elongation during the COVID‐19 home confinement period in the control, 0.01% atropine and ACO groups (all p < 0.05). Interestingly, in the ortho‐k group, the difference was insignificant (p = 0.178), and the interaction between the intervention type (control vs. ortho‐k) and the confinement severity was significant (p for interaction = 0.041), which is different from the atropine (p for interaction = 0.248) or ACO group (p for interaction = 0.988). These results were stable after being adjusted by other variables based on the multivariable regression model. Conclusion: Ortho‐k was less affected by the COVID‐19 home confinement, which is potentially a better therapy for children in this high‐risk environment. Further investigations are warranted to validate this issue. [ABSTRACT FROM AUTHOR]

Purpose: To assess the impact of 3 months of orthokeratology (ortho‐k) contact lenses (CLs) for myopia correction on the corneoscleral profile, as changes in scleral geometry could serve as indirect evidence of alteration in the corneal biomechanical properties. Methods: Twenty subjects (40 eyes) were recruited to wear ortho‐k lenses overnight; however, after discontinuation (two CL fractures, one under‐correction and two non‐serious adverse events), 16 subjects (31 eyes) finished a 3‐month follow‐up. Corneoscleral topographies were acquired using the Eye Surface Profiler (ESP) system before and after 3 months of lens wear. Steep (SimKs) and flat (SimKf) simulated keratometry and scleral sagittal height measurements for 13‐, 14‐ and 15‐mm chord lengths were automatically calculated by the ESP software. Additionally, sagittal height and slope were calculated in polar format from 21 radii (0–10 mm from the corneal apex) at 12 angles (0–330°). Linear mixed models were fitted to determine the differences between visits. Results: SimKs and SimKf were increased significantly (p ≤ 0.02). The sagittal height in polar format increased significantly (p = 0.046) at a radius of 2.5 mm for 150°, 180°, 210° and 240° orientations and at a radius of 3.0 mm for 210°. Additionally, the slope in polar format significantly decreased (p ≤ 0.04) at radii ranges of 0.0–0.5, 0.5–1.0 and 1.0–1.5 mm for multiple angles and at a radii range of 5.0–5.5 mm for 90°. It also increased significantly (p ≤ 0.045) at a radii range of 1.5–2.0 mm for 30° and at radii ranges of 2.0–2.5, 2.5–3.0 and 3.0–3.5 mm for multiple angles. No significant changes were found for any parameter measured from the scleral area. Conclusions: Three months of overnight ortho‐k lens wear changed the central and mid‐peripheral corneal geometry as expected, maintaining the peripheral cornea and the surrounding sclera stability. [ABSTRACT FROM AUTHOR]

Background: Myopia is one of the eye diseases that can damage the vision of young people. This study aimed to explore the protective role of miR-92b-3p against DNA damage and apoptosis in retinal tissues of negative lens-induced myopic (LIM) guinea pigs by targeting BTG2. Methods: Biometric measurements of ocular parameters, flash electroretinogram (FERG), and retinal thickness (RT) were performed after miR-92b-3p intravitreal injection in LIM guinea pigs. The apoptotic rate was detected by Annexin V-FITC/PI double staining, and the change in mitochondrial membrane potential was measured by JC-1 staining. Retinal apoptosis and expression of p53, BTG2, and CDK2 were explored by TdT-mediated dUTP-biotin nick labeling (TUNEL) and immunofluorescence staining assays, respectively. BTG2 and its upstream and downstream molecules at gene and protein levels in retinal tissues were measured by real-time quantitative PCR (qPCR) and Western blotting. Results: Compared with normal controls (NC), the ocular axial length of LIM guinea pig significantly increased, whereas refraction decreased. Meanwhile, dMax-a and -b wave amplitudes of ERG declined, retinal thickness was decreased, the number of apoptotic cells and apoptotic rate in LIM eyes was exaggerated, and the mitochondrial membrane potential significantly decreased. In addition, results of qPCR and Western blot assays showed that the expression levels of p53, BTG2, CDK2, and BAX in LIM guinea pigs were higher than the levels of the NC group, whereas the BCL-2 expression level was decreased. By contrast, the miR-92b-3p intravitreal injection in LIM guinea pigs could significantly inhibit axial elongation, alleviate DNA damage and apoptosis, and thus protect guinea pigs against myopia. Conclusion: In conclusion, p53 and BTG2 were activated in the retinal tissue of myopic guinea pigs, and the activated BTG2 could elevate the expression of CDK2 and BAX, and attenuate the expression of BCL-2, which in turn promote apoptosis and eventually lead to retinal thinning and impaired visual function in myopic guinea pigs. The miR-92b-3p intravitreal injection can attenuate the elongation of ocular length and retinal thickness, and inhibit the CDK2, BAX, and p53 expression by targeting BTG2, thereby ameliorating DNA damage and apoptosis in LIM guinea pigs and protecting ocular tissues. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the effect of the orthokeratology (OK) lens design, used in the Montreal Experience cohort, on corneal treatment zone characteristics and their relationship to the pupil. METHODS: This retrospective study follows previously published work and refers to the analysis of 4 different OK lenses. Tangential topography maps were obtained at baseline and after 1 month of OK lens wear. The extracted parameters are: distance treatment zone diameter (DTZD (mm)); relative peripheral power (RPP (D)); mid-peripheral width (MPW (mm)); a new concept, the plus power ratio (PPR (%)), corresponding to the coverage of the pupil area by the positive power zones. RESULTS: DTZD and MPW were significantly different between the lens designs (Welch's ANOVA). (DTZD (OK 1: 3.68 ± 0.46 mm; OK 2: 3.06 ± 0.67; OK 3: 2.83 ± 0.54; OK 4: 3.20 ± 0.53) MPW (OK 1: 1.65 ± 0.21 mm; OK 2: 1.31 ± 0.40 mm; OK 3: 1.46 ± 0.17 mm; OK 4: 1.57 ± 0.17 mm)). PPR was significantly lower in OK 1 (40.1 ± 22.1%) than the other designs (OK 2: 53.8 ± 18.4%; OK 3: 60.3 ± 13.6; OK 4: 54.7 ± 15.3). CONCLUSION: This study shows that the corneal response to OK lens wear varies with lens design. When analyzed, topographic analysis shows that OK 1 is associated with a larger DTZD, which produces a lower PPR. This may explain why previously published results showed significantly faster axial length (AL) progression with this lens. [ABSTRACT FROM AUTHOR]

Identification of the baseline chracteristics for children undergoing orthokeratology with relatively fast myopia progression can allow a more accurate determination of the risk/benefit ratio. This study aimed to investigate if baseline corneal biomechanics can classify relatively slow and fast myopia progression in children. Children aged six to 12 years with low myopia (0.50 to 4.00 D) and astigmatism (less than or equal to 1.25 D), were recruited. Participants were randomised to be fitted with orthokeratology contact lenses with a conventional compression factor (0.75 D, n = 29) or an increased compression factor (1.75 D, n = 33). Relatively fast progressors were defined as participants who had axial elongation of 0.34 mm or above per 2 years. A binomial logistic regression analysis and a classification and regression tree model were used in the data analysis. The corneal biomechanics were measured with a bidirectional applanation device. The axial length was measured by a masked examiner. As there were no significant between-group differences in the baseline data (all p > 0.05), data were combined for analysis. The mean ± SD axial elongation for relatively slow (n = 27) and fast (n = 35) progressors were 0.18 ± 0.14 mm and 0.64 ± 0.23 mm per 2 years, respectively. The area under the curve (p2area1) was significantly higher in relatively fast progressors (p = 0.018). The binomial logistic regression and classification and regression tree model analysis showed that baseline age and p2area1 could differentiate between slow and fast progressors over 2 years. Corneal biomechanics could be a potential predictor of axial elongation in orthokeratology contact lens-wearing children. [ABSTRACT FROM AUTHOR]

Background: Myopia significantly decreases the frequency and severity of diabetic retinopathy (DR). The proliferative form of this diabetic complication in the retina is known to be very uncommon in diabetic myopes. The mechanisms of this phenomena are, however, still unclear. Studies on these mechanisms and the clarification of the structural changes in retinal neurons in animal models of both diabetes and myopia are critical to the research of the pathogenesis and further identification of therapeutic and preventive targets for these pathological conditions. Purpose: To examine changes in the retinal brain-derived neurotrophic factor (BDNF) concentration and the relationship of the latter with the structure of retinal neuronal cells in rats with induced both diabetes and axial myopia. Material and Methods: Rats (age, 2 to 10 weeks) were assigned to four groups: group 1 (myopia only, n = 15), group 2 (diabetes only, n = 15), group 3 (myopia plus diabetes, n = 15), and group 4 (healthy controls, n = 10). Axial myopia was produced in two-month-old animals by surgically fusing the eyelids of both eyes. Streptozotocin (STZ) (15 mg/kg body weight, intraperitoneally consequently for 5 days) was used to induce diabetes. Diabetes was induced in group 3 at 3 weeks after the initiation of the experiment. At 2 months, all rats were euthanized under anesthesia, and their eyes were enucleated. To perform a histomorphological study, serial retinal sections were made and stained with hematoxylin and eosin, and microscopy was performed and images were collected and evaluated on a light microscope Jenamed 2. Rat BDNF enzyme-linked immunosorbent kits (Elabscience, Houston, TX) were used to determine BDNF concentrations in retinal supernatant and plasma. Results: Rats with both diabetes and myopia exhibited smaller reductions in plasma and, especially, retinal BDNF concentrations compared to rats with diabetes only. Retinal BDNF concentrations in rats with both diabetes and myopia were 36.1% higher than in rats with diabetes only. Unlike rats with STZ-induced diabetes only, those with STZ-induced diabetes in the presence of experimental myopia exhibited a rather high neuronal cell density in the retinal ganglion cell layer. No noticeable change in the cell density in the inner nuclear layer and photoreceptor layer was observed in the latter animals. Conclusion: Axial length elongation secondary to experimental myopia in animals facilitates the protection against diabetic changes in the retina, which was confirmed at the molecular and morphological levels, with BDNF being a possible component of this protective mechanism. [ABSTRACT FROM AUTHOR]

Background/Aim: Given the characteristics of Serratia marcescens (S. marcescens), this study aimed at investigating its presence in the hands and contact lens cases of orthokeratology wearers, along with the status of bacterial contamination. Patients and Methods: The 39 patients received the questionnaires about the background of orthokeratology and hygiene habits. A total of 39 contact lens cases and 39 hand samples from the patients were collected at Show Chwan Memorial Hospital from June to August in 2020 and sent to National Chung Cheng University for DNA extraction and PCR identification. Results: The results indicated a detection rate of 5.13% for S. marcescens in the contact lens cases and 12.82% in the hand samples. Additionally, 66.67% of contact lens case samples and 30.77% of hand samples found positive for 16s bacterial amplicons. The relationship between hand contamination and the duration of contact lens usage were revealed for both S. marcescens (p=0.021) and 16s bacterial amplicons (p=0.048). Conclusion: The results indicated that hand hygiene is more critical than focusing on contact lens hygiene when it comes to preventing S. marcescens infections. Nevertheless, both proper hand and contact lens hygiene practices can reduce the detection of bacterial eye pathogens, especially a common intestinal bacterium. [ABSTRACT FROM AUTHOR]

Background: The aim was to validate the correlation between corneal shape parameters and axial length growth (ALG) during orthokeratology using Image-Pro Plus (IPP) 6.0 software. Methods: This retrospective study used medical records of myopic children aged 8–13 years (n = 104) undergoing orthokeratology. Their corneal topography and axial length were measured at baseline and subsequent follow-ups after lens wear. Corneal shape parameters, including the treatment zone (TZ) area, TZ diameter, TZ fractal dimension, TZ radius ratio, eccentric distance, pupil area, and pupillary peripheral steepened zone(PSZ) area, were measured using IPP software. The impact of corneal shape parameters at 3 months post-orthokeratology visit on 1.5-year ALG was evaluated using multivariate linear regression analysis. Results: ALG exhibited significant associations with age, TZ area, TZ diameter, TZ fractal dimension, and eccentric distance on univariate linear regression analysis. Multivariate regression analysis identified age, TZ area, and eccentric distance as significantly correlated with ALG (all P < 0.01), with eccentric distance showing the strongest correlation (β = −0.370). The regressive equation was y = 1.870 − 0.235a + 0.276b − 0.370c, where y represents ALG, a represents age, b represents TZ area, and c represents eccentric distance; R2 = 0.27). No significant relationships were observed between the TZ radius ratio, pupillary PSZ area, and ALG. Conclusions: IPP software proves effective in capturing precise corneal shape parameters after orthokeratology. Eccentric distance, rather than age or the TZ area, significantly influences ALG retardation. [ABSTRACT FROM AUTHOR]

Background: Myopia is becoming a huge burden on the world's public health systems. The purpose of this study was to explore the effect of brimonidine in the treatment of form-deprivation myopia (FDM) and the relationship between intraocular pressure (IOP) and myopia development. Methods: Monocular form deprivation myopia (FDM) was induced in three-week-old pigmented male guinea pigs. They were treated with 3 different methods of brimonidine administration (eye drops, and subconjunctival or intravitreal injections). Four different concentrations of brimonidine were tested for each method (2µg/µL, 4µg/µL, 20µg/µL, and 40µg/µL). All treatments continued for a period of 21 days. Tonometry, retinoscopy, and A-scan ultrasonography were used to monitor intraocular pressure, refractive error and axial length (AL), respectively. Results: Treatment with subconjunctival brimonidine at 40µg/µL, and intravitreal brimonidine at 2µg/µL and 4µg/µL, inhibited the development of FDM. The myopic refraction, excessive axial length, and elevation of IOP were significantly decreased. Brimonidine in eye drops was ineffective. Conclusion: Brimonidine at appropriate doses significantly reduced the development of FD myopia in guinea pigs. The IOP may change with FD myopia. [ABSTRACT FROM AUTHOR]

Accumulated evidence has shown that microRNAs (miRNAs) are closely related to the pathogenesis and progression of senile cataracts. Here we investigate the effect of miR-29a-3p in cataractogenesis and determined the potential molecular mechanism involved. In this study, we constructed a selenite cataract model in rats and obtained the miRNAs related to cataracts by whole transcriptome sequencing. To investigate the effect and mechanism of miR-29a-3p on cataracts, we performed several in vivo and in vitro experiments, including CCK8 assay, flow cytometry, luciferase reporter assay, Edu assay, and western blot analysis. Sequencing data showed downregulation of miR-29a-3p in rats with selenite cataracts. Down-regulation of miR-29a-3p could promote lens epithelial cells (SRA01/04) proliferation and inhibit cell apoptosis, and miR-29a-3p silence could inhibit the development of cataracts. Additionally, CAND1 was a direct target gene for miR-29a-3p. These data demonstrate that miR-29a-3p inhibits apoptosis of lens epithelial cells by regulating CAND1, which may be a potential target for senile cataracts. [ABSTRACT FROM AUTHOR]

To observe the effects of oxidative stress on vascular endothelial growth factor (VEGF) and connections of lens epithelial cells. Human lens epithelium of patients with age-related cataract (ARC), both SRA01/04 cells and whole mice lens stimulated by H2O2 were employed. VEGF in human aqueous humor of ARC-patients and the supernatant of SRA01/04 cells was determined by ELISA. The expressions of VEFG in human lens epithelium were detected by immunofluorescence staining. Multiple linear regression analysis and spearman rank-order correlation were used to determine the associations between VEGF and parameters of ARC individuals. In H2O2-induced SRA01/04 cells, Catalase (CAT), PP1 (inhibitor of c-Src kinase) and Avastin (VEGF antibody) were used to inhibit the effects of H2O2, activation of c-Src kinase and VEGF, which were detected by Western blot. The alterations of ZO-1 and N-cadherin were tested by immunofluorescence staining and Western blot. In H2O2-induced whole lens, the changes of opacification area in different treatment of inhibitors were observed. The secretion of VEGF in aqueous humor and expression of VEGF in the lens epithelium of ARC patients increased significantly with age. In H2O2-induced SRA01/04 cells, the VEGF in the supernatant was increased with the culture duration and the dose of H2O2. The expressions of p-Src418 and VEGF were also up-regulated, whereas the expressions of ZO-1 and N-cadherin were down-regulated. CAT effectively prevented these changes induced by H2O2, while PP1 inhibited not only p-Src418 but also up-regulation of VEGF, Avastin partially inhibited VEGF up-regulation. Both PP1 and Avastin prevented down-regulation of ZO-1 and N-cadherin, respectively, but Avastin combined with PP1 had no significant synergistic effects. In H2O2-induced cataract, CAT prevented development of opacification area effectively, and PP1 and Avastin did partially. Oxidative stress disrupts connections of lens epithelial cells by activating c-Src/VEGF, inhibiting which may prevent cataract. [ABSTRACT FROM AUTHOR]

An intriguing question in cognitive neuroscience is whether alpha oscillations shape how the brain transforms the continuous sensory inputs into distinct percepts. According to the alpha temporal resolution hypothesis, sensory signals arriving within a single alpha cycle are integrated, whereas those in separate cycles are segregated. Consequently, shorter alpha cycles should be associated with smaller temporal binding windows and higher temporal resolution. However, the evidence supporting this hypothesis is contentious, and the neural mechanisms remain unclear. In this review, we first elucidate the alpha temporal resolution hypothesis and the neural circuitries that generate alpha oscillations. We then critically evaluate study designs, experimental paradigms, psychophysics, and neurophysiological analyses that have been employed to investigate the role of alpha frequency in temporal binding. Through the lens of this methodological framework, we then review evidence from between-subject, within-subject, and causal perturbation studies. Our review highlights the inherent interpretational ambiguities posed by previous study designs and experimental paradigms and the extensive variability in analysis choices across studies. We also suggest best practice recommendations that may help to guide future research. To establish a mechanistic role of alpha frequency in temporal parsing, future research is needed that demonstrates its causal effects on the temporal binding window with consistent, experimenter-independent methods. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the relationship between relative corneal refractive power shift (RCRPS) and axial length growth (ALG) in bilateral myopic anisometropes treated with orthokeratology. Methods: A total of 102 children with myopic anisometropia in this prospective interventional study were randomly assigned to the spectacle group and orthokeratology group. Axial length (AL) and corneal topography was measured at baseline and the 12-month follow-up visit. ALG was defined as the difference between the two measurements, and RCRPS profiles were calculated from two axial maps obtained. Results: In the orthokeratology group, the ALG in the more myopic eye (0.06 ± 0.15 mm) was significantly smaller than that in the less myopic eye (0.15 ± 0.15 mm, p < 0.001), and the interocular difference in AL significantly decreased following 1-year treatment, from 0.47 ± 0.32 to 0.38 ± 0.28 mm (p < 0.001). However, in the spectacle group, the ALG was similar between the two eyes, and the interocular difference in AL did not change significantly over one year (all p > 0.05). The interocular difference in ALG in the orthokeratology group was significantly correlated with the interocular difference in RCRPS (dRCRPS, β=−0.003, p < 0.001) and the interocular difference in baseline AL (β=−0.1179, p < 0.001), with R2 being 0.6197. Conclusion: Orthokeratology was effective in decreasing the magnitude of anisometropia. The interocular variation in RCRPS is an important factor accounting for the reduction of interocular ALG difference in anisomyopic children post-orthokeratology. These results provide insight into establishing eye-specific myopia control guidelines during orthokeratology treatment for myopic anisometropes. [ABSTRACT FROM AUTHOR]

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We systematically reviewed the literature on the effects of the coronavirus disease 2019 (COVID‑19) pandemic on the progression, prevalence, and incidence of myopia. A comprehensive literature search was performed on PubMed, Cochrane Central Register of Controlled Trials, and Scopus databases. Studies included in the review assessed myopia progression, prevalence, and/or incidence as the primary outcome. Of 523 articles yielded in the initial search, 23 studies (6 cross‑sectional and 17 cohort) were eligible for inclusion. Sixteen of these were conducted in China and one each in Hong Kong, Turkey, Spain, Israel, India, Korea, and Tibet. Quality appraisals were conducted with the Joanna Briggs Institute Critical Appraisal Checklists. Of the included studies, a large majority reported a greater myopic shift and increase in myopia prevalence during the COVID‑19 pandemic compared to the pre‑COVID‑19 years. All three studies on myopia incidence showed increased incidence during the COVID‑19 pandemic. Myopia progression accelerated during the COVID‑19 pandemic, even in individuals using low‑concentration atropine eye drops in two studies but not in those using orthokeratology treatment in one study. Overall, the studies found that the COVID‑19 pandemic and its associated home confinement measures generally increased myopia progression, prevalence, and incidence, even in individuals using low‑concentration atropine eye drops. [ABSTRACT FROM AUTHOR]