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Abstract Background To investigate the impact of wearing spectacle lenses with highly aspherical lenslets (HAL) for 3 years and the impact of switching from single-vision lenses (SVL) to HAL on choroidal thickness (ChT). Methods Fifty-one participants who had already worn HAL for 2 years continued wearing them for an additional year (HAL group). Further, 50 and 41 participants who had worn spectacle lenses with slightly aspherical lenslets (SAL) and SVL for 2 years, respectively, switched to wearing HAL for another year (SAL-HAL and SVL-HAL groups). Additionally, 48 new participants aged 10–15 years were enrolled to wear SVL at the third year (new-SVL group). ChT was measured every 6 months throughout the study. Results Significant differences were observed in the changes in ChT among the four groups at the third year (all P 0.05). When comparing the changes in ChT for 3 years among the HAL, SAL-HAL, and SVL-HAL groups, significant differences were found before switching to HAL, but these differences were abolished after all participants switched to HAL. Conclusions Compared to those in the SVL group, choroid thinning was significantly inhibited in all the HAL groups. Wearing HAL for 3 years no longer had a choroidal thickening effect but could still inhibit choroidal thinning compared to wearing SVL. Trial registration The study was registered at the Chinese Clinical Trial Registry (ChiCTR1800017683), http://www.chictr.org.cn/showproj.aspx?proj=29789 .

Abstract Objectives Myopia is a major public health problem and it is essential to find safe and effective means to control its progression. The study design and baseline data are presented for a one-year prospective, double-masked, crossover, randomized clinical trial evaluating the efficacy of single vision spectacle lenses with concentric rings of slightly aspherical contiguous lenslets technology (SAL) on myopia control. Methods One hundred 8- to 13-year old Chinese children with a refractive error of -0.75 D to -4.75 D were assigned to two groups. In Group 1, SAL and single vision lenses were each worn for 6 months, and Group 2 wore the lenses in the reversed order. Primary outcomes are axial length and spherical equivalent of cycloplegic refractive error. Secondary outcomes included corneal thickness, anterior chamber depth, lens thickness, visual acuity, and lens adaptation. Results No significant differences in baseline parameters (cycloplegic spherical equivalent, axial length, age) were found between groups (0.49

Abstract Background With increasing axial length and myopia progression, the micro-structure of the retina and choroid gradually changes. Our study describes the longitudinal changes in retinal and choroidal thickness in school-aged children with myopia and explores the relationship between changes in choroidal thickness and myopia progression. Methods An exploratory analysis of a randomized trial was performed. Children (n = 168, aged 7 to 12 years) with myopia from − 0.75 dioptre (D) to − 4.00 D were enrolled in this prospective longitudinal study. Cycloplegic refraction, axial length (AL), retinal and choroidal thicknesses were measured at baseline and at 1- and 2-year follow-ups. “Rapid progression myopia” was defined as increasing in myopia > 1.00 D and “stable progression myopia” was ≤ 1.00 D during the 2-year follow-up. Factors affecting the changes in choroidal thickness were analysed using linear mixed models. Results AL significantly increased by 0.67 ± 0.24 mm with a myopic shift of − 1.50 ± 0.64 D over the 2 years. The overall retinal thickness increased from 251.12 ± 15.91 µm at baseline to 253.47 ± 15.74 µm at the 2-year follow-up (F = 23.785, P

PurposeTo determine the characteristics of longitudinal choroidal thickness (CT) and axial length (AL) changes in a group of Chinese young adults with various refractive errors.MethodsIn this 2 year prospective cohort study, a total of 291 (314 enrolled at baseline) Chinese medical freshmen aged 18 to 22 years (mean age, 18.7 ± 0.9 years) underwent eye examinations at baseline and follow-up visits, including cycloplegic refraction, ocular biometry measurements, and swept-source optical coherence tomography. Choroidal thickness measurements were performed at nine locations in the macular area.ResultsAt baseline, the CT and AL was significant differences among groups of emmetropia, mild to moderate myopia and high myopia. During a two-year period, there were significant differences found in the changes of the subfoveal CT (p 0.05). The multivariable linear regression analysis showed that baseline subfoveal CT (per 1 μm) was a significant factor affecting the changes of subfoveal CT (p

PurposeSpectacle lenses with arrays of lenslets have gained popularity in myopia control due to their high efficacy, low impact on visual performance, and non-invasiveness. One of the questions regarding their impact on visual performance that still remain is that: do the lenslets impact visual field sensitivity? The current study aims to investigate the impact of wearing spectacle lenses with highly aspherical lenslets (HAL) on the visual field sensitivity.MethodsAn automated static perimetry test (Goldman perimeter target III) was employed to measure the detection sensitivity in the visual field. Targets were white light dots of various luminance levels and size 0.43°, randomly appearing at 76 locations within 30° eccentricity. Twenty-one adult subjects (age 23–61, spherical equivalent refractive error (SER) −8.75 D to +0.88 D) participated in the study. Sensitivities through two lenses, HAL and a single vision lens (SVL) as the control condition, were measured in random order.ResultsThe mean sensitivity differences between HAL and SVL across the 76 tested locations ranged between −1.14 decibels (dB) and 1.28 dB. Only one location at 30° in the temporal visual field reached statistical significance (p < 0.00065) whereby the sensitivity increased by 1.1 dB with HAL. No significant correlation was found between the difference in sensitivity and age or SER. Such a difference is unlikely to be clinically relevant.ConclusionCompared to the SVL, the HAL did not change detection sensitivity to static targets in the whole visual field within 30° eccentricity.

BackgroundThe study sought to investigate the self-reported practices of Singaporean eye care practitioners on myopia management and the interaction between eye care practitioners and parents.MethodsSelf-reported questionnaire (1) to eye care practitioners to understand their clinical practice behavior, their opinion in myopia management (2) to parents on their knowledge of myopia control products and interaction with eye care practitioners.Results80.0% of eye care practitioners prescribe myopia control in their practice but only 33.1% of eye care practitioners prescribed myopia control interventions during the first visit, and only 41.4% of parents were recommended myopia control interventions by eye care practitioners, of which 75.6% followed the recommendations of eye care practitioners. Eye care practitioners (53.1%) prefer atropine the most and parents prefer controlling the amount of time doing near work (54.5%) and outdoor activities (52.5%). Eye care practitioners had the highest influence on the choice of vision correction with 78.8% of parents choosing to follow them. 66.9% of eye care practitioners did not prescribe myopia control interventions during the first visit as they lack myopia progression data from the patient. Eye care practitioners felt that more education on myopia control products (57.7%), hands-on workshops (47.7%) and management of children (44.6%) would encourage them to use myopia control interventions more frequently. 40.0% of the eye care practitioners were concerned about the cost of myopia control products.ConclusionsEye care practitioners strongly influence parents to uptake myopia control interventions. More education and hands-on workshops on myopia and children management can help encourage the use of myopia control interventions by eye care practitioners.

Background/aims To evaluate the predictive performance of various predictors, including non-cycloplegic refractive error, for risk of myopia onset under pragmatic settings.Methods The Wenzhou Medical University Essilor Progression and Onset of Myopia Study is a prospective cohort study of schoolchildren aged 6–10 years from two elementary schools in Wenzhou, China. Non-cycloplegic refraction, ocular biometry and accommodation measurements were performed. Myopia was defined as spherical equivalent (SE) ≤−0.5 diopter (D). ORs using multivariable logistic regression were determined. Area under the curve (AUC) evaluation for predictors was performed.Results Schoolchildren who attended both baseline and 2-year follow-up were analysed (N=1022). Of 830 non-myopic children at baseline, the 2-year incidence of myopia was 27.6% (95% CI, 24.2% to 31.3%). Female gender (OR=2.2), more advanced study grades (OR=1.5), less hyperopic SE (OR=11.5 per D), longer axial length (AL; OR=2.3 per mm), worse presenting visual acuity (OR=2.3 per decimal), longer near work time (OR=1.1 per hour/day) and lower magnitude of positive relative accommodation (PRA; OR=1.4 per D) were associated with myopia onset. PRA (AUC=0.66), SE (AUC=0.64) and AL (AUC=0.62) had the highest AUC values. The combination of age, gender, parental myopia, SE, AL and PRA achieved an AUC of 0.74.Conclusion Approximately one in four schoolchildren had myopia onset over a 2-year period. The predictors of myopia onset include lower magnitude of PRA, less hyperopic SE, longer AL and female gender. Of these, non-cycloplegic SE and PRA were the top single predictors, which can facilitate risk profiling for myopia onset.

PurposeThe current study was to investigate whether myopia affected peripheral motion detection and whether the potential effect interacted with spatial frequency, motion speed, or eccentricity.MethodsSeventeen young adults aged 22–26 years participated in the study. They were six low to medium myopes [spherical equivalent refractions −1.0 to −5.0 D (diopter)], five high myopes ( 0.1). Spatial frequency, speed, and quadrant of the visual field all showed significant effect on the peripheral motion detection threshold.ConclusionThere was no significant difference between the three refractive groups in peripheral motion detection. However, lower motion detection thresholds were associated with higher myopia, mostly for low spatial frequency targets, at 20° in myopic viewers.

PurposeTo investigate changes in blur detection sensitivity in children using orthokeratology (Ortho-K) and explore the relationships between blur detection thresholds (BDTs) and aberrations and accommodative function.MethodsThirty-two children aged 8–14 years old who underwent Ortho-K treatment participated in and completed this study. Their BDTs, aberrations, and accommodative responses (ARs) were measured before and after a month of Ortho-K treatment. A two forced-choice double-staircase procedure with varying extents of blur in three images (Tumbling Es, Lena, and Street View) was used to measure the BDTs. The participants were required to judge whether the images looked blurry. The BDT of each of the images (BDT_Es, BDT_Lena, and BDT_Street) was the average value of the last three reversals. The accommodative lag was quantified by the difference between the AR and the accommodative demand (AD). Changes in the BDTs, aberrations, and accommodative lags and their relationships were analyzed.ResultsAfter a month of wearing Ortho-K lenses, the children’s BDT_Es and BDT_Lena values decreased, the aberrations increased significantly (for all, P ≤0.050), and the accommodative lag decreased to a certain extent [T(31) = 2.029, P = 0.051]. Before Ortho-K treatment, higher-order aberrations (HOAs) were related to BDT_Lena (r = 0.463, P = 0.008) and the accommodative lag was related to BDT_Es (r = −0.356, P = −0.046). After one month, no significant correlations were found between the BDTs and aberrations or accommodative lags, as well as between the variations of them (for all, P ≥ 0.069).ConclusionOrtho-K treatment increased the children’s level of blur detection sensitivity, which may have contributed to their good visual acuity.