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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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AbstractPurposeMaterials and methodsResultsConclusionsSpecial properties and recent advances in the synthesis and biomolecular functionalization of gold nanoparticles (GNPs) have led to the evolution of their use in biomedical applications such as photon radiotherapy. Simulation-based studies on the effect of various parameters that govern the dose enhancement due to utilizing GNPs have facilitated the progress of knowledge in this field. Due to their flexibility and easier accessibility compared with experimental works, simulations have the potential to be considered for pre-clinical tests and, therefore, should be close to the realistic conditions as much as possible.To this aim, the present work investigates the effect of the presence of GNPs that are accumulated in the cytoplasm of the constituent cells in healthy tissues of a human eye phantom, inspired by the published experimental results which report that non-target tissues also receive the drugs containing GNPs. The GNPs’ concentrations are assumed to decrease by moving from the tumor toward the depth of the phantom through a suggested pattern. The MCNPX Monte Carlo code is used for the simulations.The results show that for four concentrations tested, the dose enhancement factor in the shallower layer reaches 6, and decreases to 1.2 in the last layer. The dose enhancements are also examined for critical structures of the iris, cornea, sclera, and lens, showing maximum deviations of about 3 to 200% compared with the absence of GNPs in the healthy tissue. Considering the reported doses to the lens by clinical institutions, the effect of penetration of GNPs to deep layers on treatment time is also investigated.The results show that the penetration of GNPs from the tumor toward healthy tissues strongly controls the dose enhancement over the various eye structures and emphasizes the importance of modeling the GNPs’ distribution in the medium on the overall dose enhancement. Considering the current challenges in the clinical use of GNPs, more effort needs to be made to reach an effective endpoint in treatment. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusionsTo evaluate the protective role of Laurus Nobilis eye drops on selenite-induced cataracts in suckling rabbits.Fifteen male albino suckling rabbits with no signs of ocular inflammation were randomly assigned to three groups: controls (Group A), sodium-selenite group (Group B) and sodium-selenite plus Laurus Nobilis group (Group C). By selenite treatment, cataract formation was experimentally induced and then graded. The grade of oxidative stress was defined in the lens, measuring the concentration of malondialdehyde, alpha-tocopherol, oxidized glutathione, ascorbic acid and hydrogen peroxide, and in blood samples as levels of alpha-tocopherol and malondialdehyde.Mean lens concentrations of GSSG, H2O2, and MDA levels in group B were significantly higher than in both group C and control. Ascorbic acid and alpha-tocopherol concentrations were lower in group B than in both group C and A. As plasma oxidative status markers, the level of MDA was higher in group B respected group C and A. The mean alpha-tocopherol levels in group B were significantly lower than in both group A and group C.In animals treated with Laurus Nobilis-based eye drops, inflammation was inhibited, and lipid peroxidation was significantly reduced. Laurus nobilis leaves extract represents a good source of antioxidant components that may contrast sodium selenite-induced cataractogenesis in suckling rabbits. [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]

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

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

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/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]

Background: The prevalence of myopia among adolescents is increasing precipitously in China, and the popularity of orthokeratology (OK) lenses as an effective treatment for controlling myopia progression is rising. This protocol assessed and compared the clinical dry eye parameters in children and adolescents with myopia treated with spectacles or OK lenses. Methods and analysis: This single-masked randomized control trial will include 300 participants (aged 8–17 years) with myopia treated with OK lens (study group) or spectacles (control group). We will record the ocular surface disease index, visual analog scale score, noninvasive tear breakup time, tear meniscus height, meibomian gland score, ocular redness score, visual acuity, tear Matrix Metalloproteinase-9 concentration, tear Lymphotoxin alpha levels at baseline, and after 1-, 3-, 6-, and 12-month. Discussion: This study will be a standardized, scientific, clinical trial designed to evaluate the dry eye parameters in children and adolescents with myopia treated with OK lenses for myopia control. Ethics and dissemination: This study has been approved by the Ethics Committee of He Eye Specialist Hospital [ethics approval number: IRB(2023)K024.01]. Before participating in the trial, written informed consent will be obtained from all patient's parents or guardians. The findings of this study will be showcased at both local and international conferences and will also be submitted for publication in reputable peer-reviewed journals. Trial registration number: Clinicaltrials.gov: NCT06023108 {2a, 2b}

Myopia is a current worldwide problem, due to a marked increase in its prevalence, all the more important in the age of monitors and working predominantly indoors. This impacts in particular on visual acuity and thus on quality of life, individual performance, with consequences for the labour market and economic implications for public health services. Consequently, much research is focused on modifying the factors that determine the onset and especially the progression of myopia, using various methods, such as the use of anticholinergic agents, the use of progressive lenses (aerial or contact), orthokeratology, refractive surgery techniques, each of which has varying degrees of effectiveness. The aim of this paper is to highlight the association between myopia progression and environmental and occupational factors, and to review currently available strategies for reducing myopia progression.

AIM: To present the 1-year results of a prospective cohort study investigating the efficacy, potential mechanism, and safety of orthokeratology (ortho-k) with different back optic zone diameters (BOZD) for myopia control in children. METHODS: This randomized clinical study was performed between Dec. 2020 and Dec. 2021. Participants were randomly assigned to three groups wearing ortho-k: 5 mm BOZD (5-MM group), 5.5 mm BOZD (5.5-MM group), and 6 mm BOZD (6-MM group). The 1-year data were recorded, including axial length, relative peripheral refraction (RPR, measured by multispectral refractive topography, MRT), and visual quality. The contrast sensitivity (CS) was evaluated by CSV-1000 instrument with spatial frequencies of 3, 6, 12, and 18 cycles/degree (c/d); the corneal higher-order aberrations (HOAs) were measured by iTrace aberration analyzer. The one-way ANOVA was performed to assess the differences between the three groups. The correlation between the change in AL and RPR was calculated by Pearson's correlation coefficient. RESULTS: The 1-year results of 20, 21, and 21 subjects in the 5-MM, 5.5-MM, and 6-MM groups, respectively, were presented. There were no statistical differences in baseline age, sex, or ocular parameters between the three groups (all P>0.05). At the 1-year visit, the 5-MM group had lower axial elongation than the 6-MM group (0.07±0.09 vs 0.18±0.11 mm, P=0.001). The 5-MM group had more myopic total RPR (TRPR, P=0.014), with RPR in the 15°–30° (RPR 15–30, P=0.015), 30°–45° (RPR 30–45, P=0.011), temporal (RPR-T, P=0.008), and nasal area (RPR-N, P

Purpose Methods Results Conclusion To develop and validate an effective nomogram for predicting poor response to orthokeratology.Myopic children (aged 8–15 years) treated with orthokeratology between February 2018 and January 2022 were screened in four hospitals of different tiers (i.e. municipal and provincial) in China. Potential predictors included 32 baseline clinical variables. Nomogram for the outcome (1‐year axial elongation ≥0.20 mm: poor response; <0.20 mm: good response) was computed from a logistic regression model with the least absolute shrinkage and selection operator. The data from the First Affiliated Hospital of Chengdu Medical College were randomly assigned (7:3) to the training and validation cohorts. An external cohort from three independent multicentre was used for the model test. Model performance was assessed by discrimination (the area under curve, AUC), calibration (calibration plots) and utility (decision curve analysis).Between January 2022 and March 2023, 1183 eligible subjects were screened from the First Affiliated Hospital of Chengdu Medical College, then randomly divided into training (n = 831) and validation (n = 352) cohorts. A total of 405 eligible subjects were screened in the external cohort. Predictors included in the nomogram were baseline age, spherical equivalent, axial length, pupil diameter, surface asymmetry index and parental myopia (p < 0.05). This nomogram demonstrated excellent calibration, clinical net benefit and discrimination, with the AUC of 0.871 (95% CI 0.847–0.894), 0.863 (0.826–0.901) and 0.817 (0.777–0.857) in the training, validation and external cohorts, respectively. An online calculator was generated for free access (http://39.96.75.172:8182/#/nomogram).The nomogram provides accurate individual prediction of poor response to overnight orthokeratology in Chinese myopic children. [ABSTRACT FROM AUTHOR]

Purpose: To review the rebound effect after cessation of different myopia control treatments. Methods: A systematic review that included full‐length randomised controlled studies (RCTs), as well as post‐hoc analyses of RCTs reporting new findings on myopia control treatments rebound effect in two databases, PubMed and Web of Science, was performed according to the PRISMA statement. The search period was between 15 June 2023 and 30 June 2023. The Cochrane risk of bias tool was used to analyse the quality of the selected studies. Results: A total of 11 studies were included in this systematic review. Unifying the rebound effects of all myopia control treatments, the mean rebound effect for axial length (AL) and spherical equivalent refraction (SER) were 0.10 ± 0.07 mm [−0.02 to 0.22] and −0.27 ± 0.2 D [−0.71 to −0.03] after 10.2 ± 7.4 months of washout, respectively. In addition, spectacles with highly aspherical lenslets or defocus incorporated multiple segments technology, soft multifocal contact lenses and orthokeratology showed lower rebound effects compared with atropine and low‐level light therapy, with a mean rebound effect for AL and SER of 0.04 ± 0.04 mm [0 to 0.08] and −0.13 ± 0.07 D [−0.05 to −0.2], respectively. Conclusions: It appears that the different treatments for myopia control produce a rebound effect after their cessation. Specifically, optical treatments seem to produce less rebound effect than pharmacological or light therapies. However, more studies are required to confirm these results. [ABSTRACT FROM AUTHOR]

Purpose: With the rising prevalence of myopia, especially among the young, orthokeratology (Ortho‐K) stands out as a promising approach, not only to reduce myopia but also to control the progression of axial length (AL). This study examined how the intersection area between the pupil and defocus ring influenced retinal defocus and axial growth after Ortho‐K. Methods: A case–control study was conducted with 100 participants (100 eyes). Both AL and the refraction difference value (RDV), that is, the peripheral refractive error measured with respect to the central value after wearing Ortho‐K lenses, were determined. Subjects were categorised into two groups based on the size of the intersection area after 3 months of lens wear: Group A (<4.58 mm2) and Group B (≥4.58 mm2). Results: Group B demonstrated significantly lower changes in AL and RDV at 30–40° and 40–53° compared with Group A after 3 months of lens wear (all p < 0.05). After 6 months of lens wear, Group B showed significantly lower changes in AL and RDV in the 40–53° region compared with Group A (all p < 0.05). Correlation analysis revealed that as the intersection area increased, the changes in AL and RDV at 0–53°, 30–40° and 40–53° eccentricity decreased after both 3 and 6 months of lens wear (all p < 0.01). Conclusions: A larger intersection area between the pupil and defocus ring within a certain time period can cause a greater amount of myopic defocus at 30–53° from the fovea. The results suggest that a larger intersection area might lead to more effective control of axial growth. [ABSTRACT FROM AUTHOR]

Plasma-enhanced chemical vapor deposition (PECVD) is a vacuum plasma treatment procedure for the deposition of thin film on a substance, which was first used on orthokeratology lenses (ortho-k lenses) in order to coat polymerized 1-vinyl-2-pyrrolidinone (NVP) and poly(ethylene glycol) methacrylate (PEGMA) on the lenses. First, the surface of ortho-k lenses was pretreated with electrons, radicals, and peroxides for 9 min, under 9 sccm Ar, 36 sccm O2, and 120 W of applied radio frequency (RF) power. NVP and PEGMA were deposited on the surface of lenses through the heating of NVP to 50°C and PEGMA to 43°C. The chamber pressure was maintained at 300 mTorr, with 40 W of applied RF power, 12 sccm Ar, and an 8-cm treatment distance. Obviously decreased water contact angle of NVP/PEGMA-coated lenses exhibited excellent hydrophilicity, which lasted for up to 90 days, and significant lower protein adsorption was observed on NVP/PEGMA-coated lenses. Besides, the MTT assay revealed the great biocompatibility of the coated lenses. Therefore, our results showed that PECVD can be used to prepare NVP/PEGMA-coated ortho-k lenses with excellent long-lasting hydrophilicity and anti-fouling effect. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to explore whether metformin (MET) protects the human lens epithelial cells (HLECs) from high glucose-induced senescence and to identify the underlying mechanisms. Methods: A cellular senescence model was established by treating HLE-B3 cells with D-glucose and then intervened with MET. Concentrations of high glucose (HG) and MET were detected using CCK-8 and western blot. qRT-PCR, western blot, and senescence-associated β-galactosidase (SA-β-gal) were performed to verify the protective effect of MET on senescent HLE-B3 cells. Additionally, western blot and qRT-PCR were conducted to detect the effects of MET on autophagy-related markers p62 and LC3, as well as SIRT1. Results: In vitro, we observed apparent senescence in human lens epithelial cells (HLECs) under high glucose conditions. This was characterized by increased senescence-associated genes p21 and p53. However, the addition of MET significantly reduced the occurrence of HLECs senescence. We also observed that high glucose inhibited both autophagy and SIRT1, which could be restored by MET. Moreover, we verified that the anti-senescence effect of MET was mediated by SIRT1 using SIRT1 activators and inhibitors. Conclusion: We have demonstrated that autophagy and SIRT1 activity are inhibited in HLE-B3 cells using the HG induced senescence model. Furthermore, our results showed that MET can delay senescence by activating SIRT1 and autophagy. These findings suggest that MET may be a promising candidate for alleviating cataract development and provide a direction for further investigation into the underlying molecular mechanisms. [ABSTRACT FROM AUTHOR]

Purpose: Endothelial keratoplasty (EK) is the conventional treatment to improve visual acuity of corneal endothelium decompensation (CED) patients, with other therapies mainly for symptomatic relief. However, the shortage of corneal grafts and other limitations to EK urge the development of novel alternative treatments. In the last decade, novel options have been proposed, yet only a limited number of reviews have systematically reported on outcomes. Therefore, this systematic review evaluates the existing clinical evidence of novel surgical approaches for CED. Method: We identified 24 studies that illustrated the clinical observations of the surgical approaches in interest. We included Descemet stripping only (DSO), Descemet membrane transplantation (DMT) where Descement membrane alone instead of corneal endothelium with cells is transplanted, and cell-based therapy. Results: In general, these therapies may provide visual outcomes comparable with EK under specific conditions. DSO and DMT target CED with relatively healthy peripheral corneal endothelium like Fuchs' corneal endothelial dystrophy, while cell-based therapy offers more versatile applications. Side effects of DSO would decrease with modifications to surgical techniques. Moreover, Rho-associated protein kinase inhibitor adjuvant therapy could enhance clinical results in DSO and cell-based therapy. Conclusion: Long-term controlled clinical trials with larger sample size on the therapies are needed. The simplicity of DSO and the high translational potential of cell-based therapy to treat CED of most etiologies made these two treatment strategies promising. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the potential involvement of vasoactive intestinal polypeptide (VIP) in myopia development and its contribution to the mechanism of action of the anti-myopia drug, atropine. Methods: Thirty-three-week-old guinea pigs were randomly divided into normal control (NC, n = 10), monocularly form-deprived (FDM, n = 10), and FDM treated with 1% atropine (FDM + AT, n = 10) groups. The diopter and axial length were measured at 0, 2, and 4 weeks. Guinea pig eyeballs were removed at week four, fixed, and stained for morphological changes. Immunohistochemistry (IHC) and in situ hybridization (ISH) were performed to evaluate VIP protein and mRNA levels. Results: The FDM group showed an apparent myopic shift compared to the control group. The results of the H&E staining were as follows: the cells of the inner/outer nuclear layers and retinal ganglion cells were disorganized; the choroidal thickness (ChT), blood vessel lumen, and area were decreased; the sclera was thinner, with disordered fibers and increased interfibrillar space. IHC and ISH revealed that VIP's mRNA and protein expressions were significantly up-regulated in the retina of the FDM group. Atropine treatment attenuated FDM-induced myopic shift and fundus changes, considerably reducing VIP's mRNA and protein expressions. Conclusions: The findings of elevated VIP mRNA and protein levels observed in the FDM group indicate the potential involvement of VIP in the pathogenesis and progression of myopia. The ability of atropine to reduce this phenomenon suggests that this may be one of the molecular mechanisms for atropine to control myopia. [ABSTRACT FROM AUTHOR]

The aim was to evaluate the safety, efficacy, and visual performance of an orthokeratology lens with an increased compression factor (ICF) of 1.25 D in a 3-month follow-up. Thirty-six myopic patients (5 males and 31 females; 24.2 ± 5.8 years) were fitted with Alexa AR (Tiedra Farmacéutica S.L., Madrid, Spain) contact lenses (CLs) and twenty participants finished the follow-up. Visual acuity (VA), subjective refraction, primary spherical and primary coma aberrations, keratometry, central pachymetry, and ocular surface evaluation were performed at baseline and after 1 night, 1 week, 1 month, and 3 months of CL wear. The differences among visits were analyzed using a repeated-measures analysis of variance or the Friedman test. The spherical equivalent decreased (p ≤ 0.005), and the uncorrected VA improved (p < 0.001) until the first week. Corneal and ocular aberrations showed a significant increase (p ≤ 0.02). A significant decrease (p < 0.001) was found for keratometry values. No significant changes were observed in either central pachymetry or ocular surface parameters among study visits. In conclusion, an orthokeratology CL with an ICF of 1.25 D provides good safety, efficacy, and visual performance in a 3-month follow-up. Seven days of orthokeratology wear are enough to achieve the full myopic compensation, resulting in satisfactory VA. [ABSTRACT FROM AUTHOR]

Management of vitreoretinal disorders (e.g., neovascular age-related macular degeneration [nAMD] and diabetic macular edema [DME]) have assumed the standard therapy of lifelong anti-VEGF injections with drugs like aflibercept, brolucizumab, ranibizumab and bevacizumab. However, the burden imposed on patients is a major deterrent for continual therapy and recovery. Faricimab, a bispecific antibody, blocking both VEGF-A and Ang-2 molecules, produces a comparable functional and anatomical results, with less injections, significantly reducing patient burden. Visual acuity, safety, adverse effects, and anatomical outcomes are discussed in the pivotal clinical trials (YOSEMITE/RHINE and TENAYA/LUCERNE), and early data from real-world studies (TRUCKEE, TAHOE, FARWIDE-DME, FARETINA and others). In YOSEMITE and RHINE, faricimab demonstrated non-inferior vision gains, better anatomical outcomes compared to aflibercept every 8 weeks. Faricimab in the personalized treatment interval (PTI), after week 96, achieved 12-week interval in 78.1% of the patients and 16-week interval in 62.3%. TENAYA and LUCERNE reported comparable best corrected visual acuity (BCVA) improvement and better anatomic outcomes during head-to-head phase, parallel to aflibercept, at its 8-week treatment schedule. Faricimab in the PTI regimen, after week 96 achieved 12-week interval in 77.8% of the patients and 16-week interval in 63.1%. Safety of faricimab has been comparable to aflibercept in these pivotal trials. Real-world data supports the data from the pivotal studies regarding the efficacy and safety profile of faricimab in heterogenous real world patient population. Moreover, in previously treated patients, it also demonstrated a faster fluid resolution, good safety profile. Considering faricimab has demonstrated anatomic and durability benefit in the treatment of nAMD and DME, additional data from ongoing extension clinical trials, AVONELLE-X and RHONE-X will help understand longer term outcomes for patients treated with faricimab as well as patients switching from aflibercept to faricimab after finishing the pivotal trials. Longer term data from the real-world studies will also continue to contribute to our understanding of long-term efficacy, safety and durability in the real world patient population. [ABSTRACT FROM AUTHOR]

Purpose: Contact lens (CL) wear challenges the balance of the ocular surface environment by increasing water evaporation and tear osmolarity. Maintaining ocular surface homeostasis during CL wear remains a goal of lens manufacturers and an important consideration for eye care professionals. The purpose of this study was to measure the metabolic activity and inflammatory responses of a transformed human corneal epithelial cell (THCEpiC) line under hyperosmotic conditions in the presence of CL packaging solutions. Methods: CL packaging solutions sampled from seven daily disposable silicone hydrogel CL blister packages were prepared at 25% and made hyperosmolar (400 mOsm/kg) with NaCl. THCEpiCs were incubated with each solution for 24 hr, after which cell culture supernatants were collected. THCEpiC metabolic activity was determined by an alamarBlue assay. Concentrations in cell culture supernatants of inflammatory cytokine (interleukin [IL]-6) and chemokine (IL-8), as well as monocyte chemoattractant protein-1 (MCP-1), were quantitated by specific enzyme-linked immunosorbent assays. Results: THCEpiC metabolic activity under hyperosmolar conditions decreased in the presence of somofilcon A and senofilcon A solutions (p=0.04 and 0.004, respectively), but no other solution (all p≥ 0.09). Concentrations of IL-6 increased in the presence of delefilcon A, somofilcon A, narafilcon A, and senofilcon A solutions (all p≤ 0.001), but no other solution (all p≥ 0.08), while those of IL-8 increased in the presence of all solutions (all p≤ 0.03) but kalifilcon A (p> 0.99), and those of MCP-1 increased in the presence of delefilcon A, verofilcon A, somofilcon A, and stenfilcon A solutions (all p< 0.0001), but no other solution (all p> 0.99). Conclusion: CL packaging solutions differ in their capacity to inhibit epithelial inflammation. THCEpiC inflammatory response was less in the presence of a CL packaging solution containing osmoprotectants than in solutions lacking osmoprotectants under moderately hyperosmolar conditions in vitro. Clinical studies are warranted to further substantiate the benefit of osmoprotectants. [ABSTRACT FROM AUTHOR]

Despite high discontinuation rates for myopia optical interventions, limited attention has been given to the potential rebound effects post-discontinuation. This systematic review aims to assess the extent of the rebound effects following the cessation of common clinical optical myopia-control interventions in children. A comprehensive search of PubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov was conducted from inception to October 2023. The rebound effects, defined as changes in the axial length or spherical equivalent during and after treatment cessation, were categorized into four levels. These studies encompassed 703 participants and spanned from 2019 to 2023, with durations of treatment and cessation ranging from 6 months to 3.5 years and from 2 weeks to 5 years, respectively. This review, encompassing 14 studies, revealed a predominant strong rebound effect in orthokeratology (8 studies), a weak rebound effect in multifocal soft contact lenses (4 studies), and a variable rebound effect in peripheral-plus spectacle lenses (2 studies). Notably, with the increasing cessation duration, the rebound effects diminished, potentially linked to the reversal of choroidal thickening and the disappearance of peripheral myopic defocus. In conclusion, a temporal trend of rebound effects exists in all three myopia optical interventions, possibly contributing to their myopia control mechanisms. [ABSTRACT FROM AUTHOR]

PurposeTo evaluate the effect of 0.01% atropine combined with orthokeratology (OK) lens on axial elongation in schoolchildren with myopia.MethodsSixty children aged 8–12 years with spherical equivalent refraction (SER) from -1.00D to -4.00D in both eyes were enrolled in this randomized, double-masked, placebo-controlled, cross-over trial. Children who had been wearing OK lenses for 2 months were randomly assigned into combination group (combination of OK lens and 0.01% atropine) for 1 year followed by control group (combination of OK lens and placebo) for another 1 year or vice versa. This trial was registered in the Chinese Clinical Trial Registry (Number: ChiCTR2000033904, 16/06/2020). The primary outcome was changes in axial length (AL). Data of right eyes were analyzed.ResultsThere were statistically significant differences in the changes in AL between combination and control groups after generalized estimating equation model adjusting for age and baseline SER (p = 0.001). The mean axial elongation difference between combination and control groups was 0.10 mm in the first year (0.10 ± 0.13 mm vs. 0.20 ±0.15 mm; p = 0.01), and 0.09 mm in the second year (0.22 ± 0.10 mm vs. 0.13 ± 0.14 mm; p = 0.01), respectively. The mean axial elongation difference of two groups in the first year was similar to that in the second year during the cross-over treatment.ConclusionIn central Mainland China in myopic children, the treatment of combination therapy is more effective than single OK lens in controlling axial elongation.