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Evidence from human studies of ocular accommodation and studies of animals reared in monochromatic conditions suggest that chromatic signals can guide ocular growth. We hypothesized that ocular biometric response in humans can be manipulated by simulating the chromatic contrast differences associated with imposition of optical defocus. The red, green, and blue (RGB) channels of an RGB movie of the natural world were individually incorporated with computational defocus to create two different movie stimuli. The magnitude of defocus incorporated in the red and blue layers was chosen such that, in one case, it simulated +3 D defocus, referred to as color-signed myopic (CSM) defocus, and in another case it simulated -3 D defocus, referred to as color-signed hyperopic (CSH) defocus. Seventeen subjects viewed the reference stimulus (unaltered movie) and at least one of the two color-signed defocus stimuli for ∼1 hour. Axial length (AL) and choroidal thickness (ChT) were measured immediately before and after each session. AL and subfoveal ChT showed no significant change under any of the three conditions. A significant increase in vitreous chamber depth (VCD) was observed following viewing of the CSH stimulus compared with the reference stimulus (0.034 ± 0.03 mm and 0 ± 0.02 mm, respectively; p = 0.018). A significant thinning of the crystalline lens was observed following viewing of the CSH stimulus relative to the CSM stimulus (-0.033 ± 0.03 mm and 0.001 ± 0.03 mm, respectively; p = 0.015). Differences in the effects of CSM and CSH conditions on VCD and lens thickness suggest a directional, modulatory influence of chromatic defocus. On the other hand, ChT responses showed large variability, rendering it an unreliable biomarker for chromatic defocus-driven responses, at least for the conditions of this study.

PURPOSE: This report aims to present biometry challenges and solutions for a patient with the longest eyes we have encountered to date. OBSERVATIONS: A 41-year-old woman with a history of Crouzon syndrome, extreme axial myopia, and posterior segment staphylomas was referred for cataract evaluation. Optical biometry was attempted using two partial coherence interferometry and optical low-coherence reflectometry devices that were available in 2011. Neither device could measure the axial length (AL) of either eye, unfortunately. We were able to measure them by A scan ultrasound, however, with results of 40.59 mm for the right eye and 38.29 mm for the left eye. Shortly thereafter, she underwent uncomplicated phacoemulsification with posterior chamber intraocular lens implantation under topical anesthesia. Twelve years later, she returned for repeat optical biometry with 3 newer generation devices, 2 of which utilized swept-source optical coherence tomography (SS-OCT). Only 1 SS-OCT device, the Argos biometer, was able to obtain AL measurements, and they were 40.54 mm and 40.84 mm for the right and left eyes, respectively. CONCLUSIONS AND IMPORTANCE: Biometry measurement using optical biometers on a patient with ALs greater than 40 mm was impossible in 2011 because of the relatively short gate for acceptable readings. Ultrasound biometry can also be challenging due to the presence of posterior staphylomas. However, a newer SS-OCT with a longer AL measurement capability enabled readings to be obtained more recently.

Introduction: Our aim in this work was to investigate the macular choroidal thickness (ChT) changes in 6–12-year-old Danish children with myopia during 2 years of low-dose atropine treatment and 1-year wash-out vs. placebo in an investigator-initiated, placebo-controlled, double-blind randomized clinical trial. Methods: Ninety-seven participants were randomized to either 0.01% for 2 years, 0.1% loading dose for 6 months followed by 0.01% for 18 months, or placebo, then a 1-year wash-out. The primary outcome was ChT in the sub-foveal and inner and outer superior, nasal, inferior, and temporal sectors. The secondary outcome was axial length (AL). Outcomes were measured at baseline and 6, 12, 24, and 36 months. One-way analysis of variance was used to detect baseline ChT differences between AL-stratified groups (< 24 mm, 24–25 mm, or > 25 mm). To determine the longitudinal changes in ChT and its effect on AL, all eyes were included in linear mixed modeling with individual eyes nested in the study ID as a random effect. Results: Longer eyes had significantly thinner ChT in all choroidal sectors (adj-P < 0.01) at baseline. There was no statistically significant change in any ChT sector after 3 years in the placebo group. Sub-foveal and nasal ChT in the 0.1% loading dose and 0.01% group were not significantly different from placebo after 2-year treatment. In the placebo group, a 1-mm increase in AL was significantly associated with a 47-µm thinner nasal ChT after 3 years (95% confidence interval (CI): – 55; – 38, adj-P < 0.001). A 10-µm thicker nasal choroid at baseline was associated with 0.13 mm (95% CI: 0.009; 0.017, adj-P < 0.001) less 3-year axial elongation. Conclusions: The ChT in Danish children with myopia remained stable over the 3-year follow-up. A thinner choroid at myopia onset might predispose to increased axial elongation. Treatment with 0.01% atropine did not change the ChT. We speculate that low-dose atropine does not primarily reduce myopia progression via a choroidal mechanism. Trial Registration: ClinicalTrials.gov identifier, NCT03911271. [ABSTRACT FROM AUTHOR]

The protective effects of time spent outdoors emphasize the major role of daylight in myopia. Based on the pathophysiology of myopia, the impact of blue light stimulation on the signaling cascade, from melanopsin at the blind spot to clinically relevant biomarkers for myopia, was investigated. Parameters and site of light stimulation are mainly defined by the photopigment melanopsin, that is sensitive to blue light with a peak wavelength of 480 nm and localized on the intrinsically photosensitive retinal ganglion cells (ipRGC) whose axons converge to the optic disc, corresponding to the physiological blind spot. Blue light at the blind spot (BluSpot) stimulation provides the opportunity to activate the vast majority of ipRGC and avoids additional involvement of rods and cones which may exert incalculable effects on the signaling cascade. Experimental studies have applied anatomical, histochemical, electrophysiological, imaging, and psychophysical methods to unravel the mode of action of BluSpot stimulation. Results indicate activation of melanopsin, improvement of contrast sensitivity, gain in electrical retinal activity, and increase of choroidal thickness following BluSpot stimulation. Short-term changes of clinically relevant biomarkers lead to the hypothesis that BluSpot stimulation may exert antimyopic effects with long-term application. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusions To evaluate the effectiveness of 12 months of spectacle lens wear incorporating cylindrical annular refractive elements (CARE) in slowing myopia progression compared to single vision (SV) spectacle wear.In an ongoing 2‐year prospective, double‐masked, multi‐centre clinical trial, 240 Chinese children aged 6–13 years, spherical equivalent refractive error (SE) −0.75 D to −5.00 D were randomised to one of three groups of 80 participants each to wear: SV spectacle lens (N = 80), CARE spectacles (7 mm central clear zone surrounded by treatment zone incorporating CARE with mean surface power of +4.6 D) and CARE S (9 mm central clear zone surrounded by treatment zone comprising CARE with mean surface power of +3.8 D). Cycloplegic SE and axial length (AL) were measured at 6‐month intervals.Compared to baseline, changes in SE and AL were significantly different between the groups at both 6 and 12 months (p < 0.001, linear mixed model). Adjusting for site, group, parental myopia and age, at 12 months, the estimated change in SE and AL with 95% CI with SV was −0.65 D (CI: −0.56 to −0.74 D)/0.32 mm (CI: 0.29–0.36 mm). In comparison, the estimated change in SE/AL at 12 months with CARE was −0.35 D (−0.26 to −0.44 D)/0.19 mm (0.15–0.22 mm) and with CARE S was −0.36 D (−0.27 to −0.46 D)/0.21 mm (0.18–0.25 mm) at 12 months. Progression was slower with CARE and CARE S compared to SV (p < 0.05) but did not differ from each other (p = 0.793 and 0.336 for SE and AL, respectively).In children with myopia, after 12 months of lens wear, both CARE and CARE S spectacle lenses significantly slowed myopia progression compared to SV lenses. [ABSTRACT FROM AUTHOR]

Purpose Method Results Conclusion To summarise pooled estimates of the efficacies of various myopia control interventions, as drawn from published meta‐analyses.PubMed, SCOPUS and Web of Science were searched from inception to February 2024 for systematic reviews and meta‐analyses reporting treatment effects of various myopia control strategies. The qualities of the included meta‐analyses were assessed using the 16‐item A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2. An intervention was defined as having a clinically significant effect if it resulted in a change in spherical equivalent refraction (SER) of ≥0.50 D/year or axial length (AL) change of ≤−0.18 mm/year.A total of 38 studies were identified. The overall respective changes in SER and AL, mean difference (95% CI) were high‐concentration (≥0.5%) atropine 0.67 D (0.58–0.77) and −0.24 mm (−0.36 to −0.11); moderate‐concentration (>0.05% to <0.5%) atropine 0.48 D (0.34–0.62) and −0.23 mm (−0.27 to −0.19); low‐concentration (0.01%, 0.025%, 0.05%) atropine 0.33 D (0.23–0.43) and −0.14 mm (−0.19 to −0.09); orthokeratology −0.47 mm (−0.66 to −0.28); peripheral plus soft contact lenses 0.30 D (0.18–0.42) and −0.35 mm (−0.62 to −0.08); peripheral plus spectacles 0.77 D (0.40–1.14) and −0.43 mm (−0.78 to −0.08); multifocal spectacles 0.21 D (0.11–0.31); repeated low‐level red light therapy 0.55 D (0.46–0.65) and −0.25 mm (−0.29 to −0.20); outdoor time 0.17 D (0.16–0.18) and −0.04 mm (−0.06 to −0.01).High and moderate concentrations of atropine, orthokeratology, peripheral plus spectacles and repeated low‐level red light demonstrated clinically significant effects on slowing AL elongation, while high and moderate concentrations of atropine, peripheral plus spectacles and repeated low‐level red light demonstrated clinically significant effects on slowing SER progression. [ABSTRACT FROM AUTHOR]

We studied which retinal area controls short-term axial eye shortening when human subjects were exposed to + 3.0D monocular defocus. A custom-built infrared eye tracker recorded the point of fixation while subjects watched a movie at a 2 m distance. The eye tracker software accessed each individual movie frame in real-time and covered the points of fixation in the movie with a uniform grey patch. Four patches were programmed: (1) foveal patch (0–3 degrees), (2) annular patch (3–9 deg), (3) foveal patch (0–3 deg) combined with an annular patch (6–9 deg), and (4) full-field patch where only 6–10 deg were exposed to the defocus. Axial eye shortening was elicited similarly with full-field positive defocus and with the foveal patch, indicating that the fovea made only a minor contribution (-11 ± 12 μm vs. -14 ± 17 μm, respectively, n.s.). In contrast, patching a 3–9 degrees annular area or fovea together with an annular area of 6–9 degrees, completely suppressed the effect when compared with full-field defocus (+ 3 ± 1 μm or -2 ± 13 μm vs. -11 ± 12 μm, respectively, p < 0.001). Finally, we found that the near-peripheral retina (6–10 degrees) is a "sweet spot" for positive defocus detection and alone can regulate eye growth control mechanism, and perhaps long-term refractive development (-9 ± 8 μm vs. full-field: -11 ± 12 μm, n.s.). [ABSTRACT FROM AUTHOR]

Background: To evaluate repeatability and agreement in measurements of total corneal astigmatism (TCA) in keratoconic eyes, using four optical coherence tomography (OCT)‐based devices: Anterion, Casia SS‐1000, IOLMaster 700, and MS‐39. Methods: Three consecutive measurements were taken with each device in 136 eyes. TCA values were converted into components J0 and J45. The Anterion and the IOLMaster 700 also provided axial length (AL) measurements. The repeatability was calculated using pooled within‐subject standard deviation (Sw). The agreement among the four devices was assessed by pairwise comparisons and Bland–Altman plots. Results: For all devices, the repeatability of TCA measurements showed Sw ≤0.23 D for TCA magnitude, ≤0.14 D for J0, and ≤0.12 D for J45. There were statistically significant differences in TCA magnitude for each pair, except for IOLMaster 700 with MS‐39, and Anterion with MS‐39. The repeatability (Sw) of axis measurements had a statistically significant negative correlation with the TCA magnitude (p < 0.001 for all devices). Both Anterion and IOLMaster 700 had high repeatability in AL measurements (Sw: 0.007 mm for Anterion and 0.009 mm for IOLMaster 700). The difference in AL between the two was 0.015 ± 0.033 mm (p < 0.001). Conclusions: All four devices showed good repeatability in TCA measurements in keratoconic eyes, the agreement for TCA measurements between the tested devices was generally low. Anterion and IOLMaster 700 showed good repeatability and agreement in AL measurements. [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: Given the potential role of light and its wavelength on ocular growth, this study investigated the effect of short‐term exposure to red, cyan and blue light on ocular biometry in humans. Methods: Forty‐four young adults and 20 children, comprising emmetropes and myopes, underwent 2‐h sessions of cyan (507 nm), red (638 nm) and broadband white light on three separate days via light‐emitting glasses. Additionally, young adults were exposed to blue light (454 nm) on an additional day. Axial length (AL) and choroidal thickness (CT) were measured in the right eye before the light exposure (0 min), after 60 and 120 min of exposure and 30 min after light offset using an optical biometer and optical coherence tomographer, respectively. Results: Compared to broadband light, exposure to red light resulted in a significant increase in AL (mean difference between white and red light at 120 min, +0.007 mm [0.002]), but no significant change in CT, while cyan light caused a significant AL reduction (−0.010 mm [0.003]) and choroidal thickening (+0.008 mm [0.002]) in young adults (p < 0.05). Blue light caused a significant decrease of −0.007 mm (0.002) in young adult eyes at 60 min (p < 0.05). In children, cyan light led to a significant reduction in AL (−0.016 mm [0.004]) and strong sustained choroidal thickening (+0.014 mm [0.004]) compared to broadband light at 120 min (p < 0.05). The effects of cyan light on AL and CT were found to be stronger in myopic young adults and emmetropic children. The opposing effects of red and cyan light on ocular biometry were similar between the two age groups (p > 0.05). Conclusions: Exposure to cyan light resulted in AL reduction and choroidal thickening in both young adults and children. Further research is needed to determine the application of these results in developing interventions for myopia control. [ABSTRACT FROM AUTHOR]

Purpose: It is common to hear talk of 'responders' and 'non‐responders' with respect to myopia control interventions. We consider the reality of distinguishing these sub‐groups using data from the first year of the Low‐concentration Atropine for Myopia Progression (LAMP) study. Methods: The first year of the LAMP study was a robustly designed, placebo‐controlled trial of three different low concentrations of atropine using a large sample size (N > 100 randomised to each group). The authors subsequently published mean axial elongation and myopia progression rates by age group. We used these data to calculate efficacy in terms of both absolute reduction in myopic progression and absolute reduction in axial elongation for each of the different atropine concentrations at each age group. We then compared these efficacy data to the overall progression for each of the two progression metrics. Results: Plotting efficacy as a function of overall myopia progression and axial elongation for each of the different atropine concentrations demonstrates the invariant nature of efficacy, in terms of clinically meaningful reduction in progression, despite a substantial range of underlying overall progression. That is, faster progressors—the so‐called non‐responders—achieved similar reduction in axial elongation and myopia progression as the slower progressors—the so‐called responders—within the various atropine treatment groups. Conclusion: The use of the terms, responders and non‐responders, during myopia progression interventions is not supported by evidence. Those designated as such may simply be slower or faster progressors, who, on average achieve the same benefit from treatment. [ABSTRACT FROM AUTHOR]

Background: Dietary factors have been suggested as potential risk factors for myopia, but research findings on this relationship are inconclusive. The potential predisposing or protective role of macronutrient (carbohydrate, protein, fat) intake in the development of myopia was systematically reviewed, followed by data synthesis by meta-analysis. Methods: A systematic search was conducted in PubMed, Web of Science, Scopus, and Google Scholar up to the end of June 2023 to identify all relevant studies. All observational studies that assessed the relationship between macronutrient intake with myopia, axial length (AL) of eyes and spherical equivalent refractive error (SE) on individuals younger than 18 years old were included. Results: After removing duplicates and screening studies, four studies were included in the systematic review and meta-analysis. Pooled odds ratios regarding the association between myopia development and nutritional intake were 1.01 (95% CI: 0.94, 1.08), 0.97 (95% CI: 0.86, 1.08), and 0.99 (95% CI: 0.83, 1.18) for carbohydrates, proteins, and fats, respectively, indicating no significant associations. Intake of carbohydrates, proteins, and fats was not significantly associated with either SE or AL. Conclusions: Intake of carbohydrates, fats, or proteins did not influence the risk of myopia. The relationship between the intake of other macronutrients and myopia is suggested to be scrutinized in future studies. Registration: The systematic review protocol was registered on PROSPERO (registration number: CRD42024541369). [ABSTRACT FROM AUTHOR]

Purpose: Vision-threatening diabetic retinopathy (VTDR) included severe non-proliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR) and clinically significant diabetic macular edema (DME). To compare the axial length (AL) and assess its influence on VTDR across different ages. Methods: A retrospective cohort study. Medical chart review was performed in 736 consecutive patients with VTDR. The patients were divided into young (≤ 45 years) and elderly group (> 45 years) based on their age at the diagnosis of VTDR. After at least one year of standardized treatments, all eligible patients were followed up. The main outcome measures included the presence of tractional retinal detachment (TRD) involving foveal, final best-corrected visual acuity (BCVA), the development of neovascular glaucoma (NVG), and recurrent vitreous hemorrhage (VH) post-vitrectomy. ALs were compared between two age groups. The impact of AL on clinical outcomes was determined by logistic analyses after controlling for systemic parameters. Results: The study included 144 patients ≤ 45 years and 592 patients > 45 years. Young patients had significantly longer AL than elderly participants (23.9 mm vs 23.0 mm, p < 0.001). Over a median follow-up of 25.9 months, a larger proportion of young patients developed TRD (34.7% vs 16.2%, p < 0.001) and recurrent VH (18.6% vs 10.3%, p = 0.040) than elderly patients. In elderly group, longer AL is an independent protective factor in preventing TRD (odds ratio [OR], 0.5; 95% confidence interval [CI], 0.4–0.7; P < 0.001). However, this beneficial effect was not observed in young patients. Conclusions: Young patients with VTDR exhibited significantly longer AL but more aggressive clinical signs with compromised prognosis. In elderly group, a longer AL independently reduced the risk of TRD, while this protective effect did not exist for young patients. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions To determine the regional and ethnic differences in ocular axial elongation and refractive error progression in myopic and non‐myopic children.A retrospective analysis of 15 longitudinal clinical and population‐based studies was conducted in the UK, Sweden, Australia (classified as European), China, and Vietnam (classified as East Asian) between 2005 and 2021. A total of 14,593 data points from 6208 participants aged 6–16 years with spherical equivalent from +6 to −6 D were analysed. Progression was annualised from longitudinal axial length and cycloplegic spherical equivalent (SE) refraction. Generalised estimating equation models including main effects and interactions were used for model building. Age and region‐specific estimates for myopes and non‐myopes and confidence intervals are reported.Factors affecting axial elongation and SE progression in children included being myopic, followed by age, region/ethnicity and sex. The magnitude of regional/ethnic differences was dependent on myopia and age. Axial elongation and SE progression were lower in European compared with East Asian children, but differences were reduced with increasing age and differences in axial elongation were larger in myopes than non‐myopes. Age‐specific regional/ethnic differences indicated that axial elongation for a 6‐year‐old East Asian myopic child was greater than a European child by 0.15 mm/year (0.58 vs. 0.43 mm/year) and by 0.09 mm/year (0.35 vs. 0.26 mm/year) for a 10‐year‐old myope. SE progression was lower in a 6‐year‐old European myope by 0.48 D/year and at 10 years of age by 0.34 D/year compared with an East Asian myope.There are regional/ethnic differences in age‐specific refractive and axial growth patterns in both myopic and non‐myopic eyes, with more marked differences in younger East Asian children who demonstrated a higher axial growth and greater negative SE shift than their non‐Asian peers. Regional/ethnic differences in progression reflect environmental and ethnic variations. Age and region/ethnicity‐specific estimates could contribute as a reference for future comparisons. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusions When myopia control treatment is discontinued, progression will increase, but does it revert to expected values based on the age and race of the child or does it accelerate further? The latter scenario is considered a rebound.A PubMed search was conducted with the words ‘rebound’ and ‘myopia control’, identifying further papers from reviews. Inclusion was limited to prospective studies with ≥6 months of treatment, ≥3 months of data following cessation and with axial length data, which allowed calculation of rebound. Nineteen studies were identified, comprising 24 treatment groups. In 10 studies, untreated control children were followed both throughout the treatment and cessation periods, allowing for a concurrent comparison group. In three studies, a control group was followed for 1 or 2 years and thereafter received the treatment under evaluation. Later, treatment ceased in the originally treated children. Finally, six studies were cross‐over designs. For these latter two study designs, initial axial elongation and myopia progression in the control group were extrapolated to the cessation period, accounting for annual slowing. Values from durations of <1 year were annualised.The mean annualised rebound was +0.05 ± 0.10 mm and −0.09 ± 0.24 D for axial length and myopia progression, respectively, and these were correlated (r2 = 0.59, p < 0.001). Rebound was associated with 1‐year treatment efficacy (r2 = 0.43, p < 0.001). The mean annualised rebound with optical corrections was −0.01 ± 0.03 mm. Five of the six highest rebound values (≥0.14 mm) were from red light therapy and atropine studies. Rebound ranged from +0.03 to +0.14 mm for overnight orthokeratology.Consistent with previous statements, no evidence for rebound was found for myopia control spectacles and soft contact lenses. Future research should explore the influence of age and magnitude of treatment efficacy on rebound. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusions To determine how corneoscleral geometry changes with axial length and to assess the usefulness of including the sagittal configuration of the anterior segment when predicting the axial length.An observational study was performed including 96 healthy subjects (96 eyes). Axial length was calculated from optical biometry (IOL Master 500). Corneal curvature and scleral sagittal height parameters at 13, 14 and 15 mm were obtained automatically using corneoscleral topography (eye surface profiler; ESP). In addition, corneal and scleral sagittal heights at numerous locations (21 radii: 0–10 mm from the corneal apex at 12 angles: 0–330°) were calculated using the raw height data extracted from the ESP. The relationships between axial length and the study parameters were analysed using Pearson correlation analysis. The equations for the prediction of axial length were obtained by fitting multiple linear regression models.The temporal‐nasal scleral asymmetry at 13‐, 14‐ and 15‐mm chord lengths was significantly correlated with axial length (r2 ≤ 0.26; p < 0.001). Significant inverse correlations were found between the temporal scleral sagittal height and axial length (r2 ≤ 0.28; p ≤ 0.02). The nasal scleral sagittal height was not associated with axial length. Three significant multiple linear regression models were fitted based on spherical equivalent, corneal radius and scleral asymmetry at 13 (r2 = 0.79; p < 0.001), 14 (r2 = 0.80; p < 0.001) and 15 (r2 = 0.80; p < 0.001) mm chord lengths.Larger ocular globes show reduced temporal‐nasal scleral asymmetry, mainly due to the lower sagittal height of the temporal sclera. Thus, the geometry of the temporal scleral may be a factor of interest during myopia progression. [ABSTRACT FROM AUTHOR]

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AIM: To assess the association between the Dem, axial length/corneal radius ratio(AL/CR ratio), and the refractive status of children aged 3 to 14, compare the efficiency of Dem with AL/CR ratio in predicting myopia, and to explore a more effective method for quantitatively predicting the refractive state of children.METHODS: This cross-sectional study involved 519 children aged 3 to 14, including 519 eyes(data from the right eyes were used). All participants were out-patients at the ophthalmic clinic of Xi'an No.1 Hospital from March 2021 to December 2022. The axial length(AL), keratometry(K), Dem, and spherical equivalent refraction(SER)were recorded before ciliary paralysis, and myopia was defined when the SER ≤-0.50 D.RESULTS: There was a positive correlation between SER and Dem(r=0.88, P

Abstract We compared axial length (AL) measurements using spectral-domain optical coherence tomography (SD-OCT)-based and partial coherence interferometry (PCI)-based biometry in eyes with various chorioretinal diseases. Medical records were retrospectively analyzed in 123 eyes from 73 patients who underwent AL measurements using SD-OCT and PCI. AL values were highly consistent by both measurements (ICC = 0.996 in SD-OCT and 0.995 in PCI-based biometry). The mean difference in AL between the two instruments was − 0.09 ± 0.17 mm, which was significant (P

Abstract We studied which retinal area controls short-term axial eye shortening when human subjects were exposed to + 3.0D monocular defocus. A custom-built infrared eye tracker recorded the point of fixation while subjects watched a movie at a 2 m distance. The eye tracker software accessed each individual movie frame in real-time and covered the points of fixation in the movie with a uniform grey patch. Four patches were programmed: (1) foveal patch (0–3 degrees), (2) annular patch (3–9 deg), (3) foveal patch (0–3 deg) combined with an annular patch (6–9 deg), and (4) full-field patch where only 6–10 deg were exposed to the defocus. Axial eye shortening was elicited similarly with full-field positive defocus and with the foveal patch, indicating that the fovea made only a minor contribution (-11 ± 12 μm vs. -14 ± 17 μm, respectively, n.s.). In contrast, patching a 3–9 degrees annular area or fovea together with an annular area of 6–9 degrees, completely suppressed the effect when compared with full-field defocus (+ 3 ± 1 μm or -2 ± 13 μm vs. -11 ± 12 μm, respectively, p

Abstract The protective effects of time spent outdoors emphasize the major role of daylight in myopia. Based on the pathophysiology of myopia, the impact of blue light stimulation on the signaling cascade, from melanopsin at the blind spot to clinically relevant biomarkers for myopia, was investigated. Parameters and site of light stimulation are mainly defined by the photopigment melanopsin, that is sensitive to blue light with a peak wavelength of 480 nm and localized on the intrinsically photosensitive retinal ganglion cells (ipRGC) whose axons converge to the optic disc, corresponding to the physiological blind spot. Blue light at the blind spot (BluSpot) stimulation provides the opportunity to activate the vast majority of ipRGC and avoids additional involvement of rods and cones which may exert incalculable effects on the signaling cascade. Experimental studies have applied anatomical, histochemical, electrophysiological, imaging, and psychophysical methods to unravel the mode of action of BluSpot stimulation. Results indicate activation of melanopsin, improvement of contrast sensitivity, gain in electrical retinal activity, and increase of choroidal thickness following BluSpot stimulation. Short-term changes of clinically relevant biomarkers lead to the hypothesis that BluSpot stimulation may exert antimyopic effects with long-term application.

Abstract Introduction Our aim in this work was to investigate the macular choroidal thickness (ChT) changes in 6–12-year-old Danish children with myopia during 2 years of low-dose atropine treatment and 1-year wash-out vs. placebo in an investigator-initiated, placebo-controlled, double-blind randomized clinical trial. Methods Ninety-seven participants were randomized to either 0.01% for 2 years, 0.1% loading dose for 6 months followed by 0.01% for 18 months, or placebo, then a 1-year wash-out. The primary outcome was ChT in the sub-foveal and inner and outer superior, nasal, inferior, and temporal sectors. The secondary outcome was axial length (AL). Outcomes were measured at baseline and 6, 12, 24, and 36 months. One-way analysis of variance was used to detect baseline ChT differences between AL-stratified groups ( 25 mm). To determine the longitudinal changes in ChT and its effect on AL, all eyes were included in linear mixed modeling with individual eyes nested in the study ID as a random effect. Results Longer eyes had significantly thinner ChT in all choroidal sectors (adj-P

Purpose To determine myopic progression, axial length elongation, best-corrected visual acuity (BCVA), pupil dilation, and accommodation amplitude following 24 months of Atropine 0.01% usage among progressive myopic patients. Methods Fifty-one progressive myopic patients (age range, 3.5–17 years) were included in the present study. Fifteen patients were excluded due to loss to follow-up (eight patients) and Atropine complications (seven patients) and 36 patients continued therapy. Myopic progression, axial length, far and near BCVA, pupil diameter, and accommodation amplitude were measured at baseline examination and repeated every 6 months up to 2 years. All patients were recommended to instill one drop of Atropine 0.01% in each eye every night. Absolute success of therapy was defined as myopic progression ≤0.50 diopter (D) and axial length growth ≤0.2 mm per year. Results Mean myopic progression was 0.16 and 1.28 D and mean axial length change was 0.05 and 0.69 mm at months 12 and 24, respectively. Pupil dilation was 1.26 and 1.84 mm and accommodation reduction was 3.38 and 3.37 D at the same follow-ups, while BCVA was not changed. Absolute success rate for myopic progression control was 56.8% at 12 months and 70.8% at 24 months follow-up. In addition, the success rate in respect to axial length changes was 44.4% and 58.3% at the same time points. Conclusions Atropine 0.01% can slow myopic progression and axial length elongation at least in 50% of myopic cases at 12- and 24-month follow-up with no significant complications. Therefore, Atropine therapy is recommended in cases of progressive myopia in children and teenagers.

Abstract Background Dietary factors have been suggested as potential risk factors for myopia, but research findings on this relationship are inconclusive. The potential predisposing or protective role of macronutrient (carbohydrate, protein, fat) intake in the development of myopia was systematically reviewed, followed by data synthesis by meta-analysis. Methods A systematic search was conducted in PubMed, Web of Science, Scopus, and Google Scholar up to the end of June 2023 to identify all relevant studies. All observational studies that assessed the relationship between macronutrient intake with myopia, axial length (AL) of eyes and spherical equivalent refractive error (SE) on individuals younger than 18 years old were included. Results After removing duplicates and screening studies, four studies were included in the systematic review and meta-analysis. Pooled odds ratios regarding the association between myopia development and nutritional intake were 1.01 (95% CI: 0.94, 1.08), 0.97 (95% CI: 0.86, 1.08), and 0.99 (95% CI: 0.83, 1.18) for carbohydrates, proteins, and fats, respectively, indicating no significant associations. Intake of carbohydrates, proteins, and fats was not significantly associated with either SE or AL. Conclusions Intake of carbohydrates, fats, or proteins did not influence the risk of myopia. The relationship between the intake of other macronutrients and myopia is suggested to be scrutinized in future studies. Registration The systematic review protocol was registered on PROSPERO (registration number: CRD42024541369).

Abstract Purpose Vision-threatening diabetic retinopathy (VTDR) included severe non-proliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR) and clinically significant diabetic macular edema (DME). To compare the axial length (AL) and assess its influence on VTDR across different ages. Methods A retrospective cohort study. Medical chart review was performed in 736 consecutive patients with VTDR. The patients were divided into young (≤ 45 years) and elderly group (> 45 years) based on their age at the diagnosis of VTDR. After at least one year of standardized treatments, all eligible patients were followed up. The main outcome measures included the presence of tractional retinal detachment (TRD) involving foveal, final best-corrected visual acuity (BCVA), the development of neovascular glaucoma (NVG), and recurrent vitreous hemorrhage (VH) post-vitrectomy. ALs were compared between two age groups. The impact of AL on clinical outcomes was determined by logistic analyses after controlling for systemic parameters. Results The study included 144 patients ≤ 45 years and 592 patients > 45 years. Young patients had significantly longer AL than elderly participants (23.9 mm vs 23.0 mm, p

Abstract Myopia is a global public health concern, with a higher prevalence in women than that in male. As the relationship between sex hormone and myopia remains unclear, we aimed to reveal the relationship between sex hormone and myopia by removing the ovaries of mice and measuring changes in ocular parameters related to myopia. Lens-induced myopia (LIM) surgeries were performed on 3-week-old male mice and age-matched female mice to evaluate the effects of sex on myopia development, which indicated a high degree of myopia and rapid progression of axial elongation in male mice. Bilateral ovariectomy (OVX) performed on 4-week-old female mice induced myopic refraction status in ovariectomized mice. Although axial length elongation was larger in ovariectomized mice than that in sham control mice, the result was insignificant. To further reveal the relationship between female sex hormones and myopia, LIM combined with OVX was performed, which revealed a magnified myopic refraction status in ovariectomized mice. Nevertheless, elongation of the anterior chamber depth in the − 30 D lens-treated eyes significantly increased in LIM + OVX mice compared with the frame-treated eyes in LIM + OVX mice and − 30 D lens-treated eyes in LIM + Sham surgery mice. Sex hormones play a role in regulating myopia development in female mice.

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 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

Abstract Purpose To compare the biometric measurements obtained from the Pentacam AXL Wave, IOLMaster 700, and ANTERION and calculate the recommended intraocular lens power using the Barrett Formulae. Methods This was a retrospective cross-sectional study of patients who underwent biometry using the Pentacam AXL Wave, IOLMaster 700, and ANTERION. Flat keratometry (K1), steep keratometry (K2), anterior chamber depth (ACD), and axial length (AL) from each device were measured and compared. These parameters were used to calculate the recommended IOL powers using the Barrett formula. Results The study included 252 eyes of 153 patients. The IOLMaster had the highest acquisition rate among the two biometers. The Pentacam obtained the shortest mean AL, the IOLMaster measured the highest mean keratometry values, and the ANTERION measured the highest mean ACD. In terms of pairwise comparisons, keratometry and axial length were not significantly different between the Pentacam-IOLMaster and ANTERION-IOLMaster groups, while the rest of the pairwise comparisons were statistically significant. In nontoric and toric eyes, 35–45% of patients recommended the same sphere of IOL power. In another 30–40%, the Pentacam and ANTERION recommended an IOL power one step greater than that of the IOLMaster-derived data. 50% of the study population recommended the same toric-cylinder IOL power. Conclusions The Pentacam AXL Wave, IOLMaster 700, and ANTERION can reliably provide data for IOL power calculations; however, these data are not interchangeable. In nontoric and toric eyes, 35–45% of cases recommended the same sphere IOL power, and in another 30–40%, the Pentacam and ANTERION recommended one-step higher IOL power than the IOLMaster-derived data. In targeting emmetropia, selecting the first plus IOL power is advisable when using the Pentacam and ANTERION to approximate the IOL power calculations recommended by the IOLMaster 700.

Xixuan Zhao,1– 4 Yining He,5 Juzhao Zhang,1– 3 Senlin Lin,1– 3 Haidong Zou,1– 4 Yingyan Ma1– 4 1Shanghai Eye Diseases Prevention & Treatment Center/ Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China; 2National Clinical Research Center for Eye Diseases, Shanghai, People’s Republic of China; 3Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, People’s Republic of China; 4Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 5Biostatistics Office of Clinical Research Unit, Shanghai Ninth People’s Hospital, Shanghai, People’s Republic of ChinaCorrespondence: Yingyan Ma; Haidong Zou, Email mYy_29@163.com; zouhaidong@sjtu.edu.cnAbstract: Myopia is increasingly prevalent in children. Its association with insufficient sleep has been studied, yielding inconsistent findings. This review aims to assess the association of insufficient sleep with myopia and myopia-related refractive parameters in children. A total of 657 articles were identified, of which 40 were included in the systematic review and 33 were included in the meta-analysis. Results showed that insufficient sleep was significantly associated with an increased prevalence of myopia (odds ratio [OR] = 1.59; 95% confidence interval [CI] = 1.31, 1.95; I2 = 99%), and an increased prevalence of high myopia (OR = 3.36; 95% CI = 1.26, 9.00; I2 = 96%). Shorter sleep duration was significantly linked to faster changes in axial length (AL) (β = 0.05; 95% CI = 0.02, 0.08; I2 = 0%). However, correlation between insufficient sleep and the incidence of myopia, spherical equivalent refraction, corneal curvature radius (CR) and AL/CR were insignificant. Moreover, the effect of insufficient sleep on premyopia and astigmatism was not well-studied. The results of this study suggest that insufficient sleep may be an important risk factor for the development of myopia in school-aged children. Therefore, in addition to ensuring sufficient outdoor activities and reducing near work, it is necessary to inform children and parents about the importance of adequate sleep to mitigate the risk of myopia.Keywords: insufficient sleep, myopia, children, axial length, refractive parameters

Abstract Objectives This retrospective analysis evaluates the treatment success of “Defocus Incorporated Multiple Segments” (DIMS) spectacle lenses in a real-life clinical setting in Germany. Materials and methods Axial length (AL) and objective refraction of 166 eyes treated with DIMS at baseline and 12-month follow-up were analyzed. Annual AL growth rate within the range of physiological growth rate was considered a successful treatment. Myopia progression of ≥ -0.5 D/yr accounted as treatment success. Differences in percentages of treatment success of subgroups depending on baseline AL and age against treatment success of the total population were investigated. Results Considering all eyes, treatment success regarding AL growth and myopia progression was achieved in 46% and 65%, respectively. Male eyes with moderate AL showed treatment success in a higher proportion (73%, p

Abstract To compare the corneal biomechanical parameters measured by Corvis ST in subjects with varying degrees of myopia. And the factors that may affect corneal biomechanical properties were also investigated. Participants in this prospective cross-sectional study were classified into three groups according to spherical equivalent (SE) and axial length (AL): Non-myopia (NM, SE > − 0.50 D and AL

AIM:To observe the different effects of three intervention approaches on related biometric parameters in children diagnosed with latent myopia, and to investigate different control effects on children with latent myopia.METHODS:Prospective cohort concurrent controls trials. A total of 60 cases(120 eyes)of children who were initially diagnosed as latent myopia and untreated previously at ophthalmology clinic of the Affiliated Hospital of Chengde Medical University from December 2021 to May 2022 were recruited. They were randomly divided into three groups, with 20 cases(40 eyes)in group A treated with 0.01% Atropine eye drops, 20 cases(40 eyes)in group B treated with vision training with a flip chart, and 20 cases(40 eyes)in group C treated with esculin and digitalis glycosides eye drops. They were followed-up for 12 mo, and the spherical equivalent(SE), axial length(AL), corneal curvature(CC), accommodative facility(AF), and macular retinal thickness of the three groups of children were compared at 6 and 12 mo post-intervention.RESULTS:Significant statistical differences were found in AL, SE and AF of the three groups of children at 6 and 12 mo(all P0.05). The retinal thickness of the temporal, nasal, inferior and macular fovea of the outer ring at 6 and 12 mo after intervention in the three groups was significantly different from that at the initial diagnosis(all P0.05).CONCLUSION:When it comes to preventing and controlling myopia, 0.01% Atropine is more effective than flip chart training and esculin and digitalis glycosides eye drops. Therefore, the administration of 0.01% atropine and the implementation of flip chart training can effectively slow down the advancement of latent myopia.

Abstract Purpose To investigate the correlation between whole eye movement (WEM) parameters measured using Corvis ST and axial length (AL) to explore whether AL affects WEMs. Methods This single-center, cross-sectional study included data from healthy subjects and patients preparing for refractive surgery at the Qingdao Eye Hospital of Shandong First Medical University. Data were collected from July 2021 to April 2022. We first determined the correlations of WEMs at the time of corneal first applanation (A1_WEM), highest concavity (HC_WEM), and second applanation (A2_WEM), as well as the maximum value of WEM (WEM_Max) with AL. Subsequently, we established a series of regression models to analyze the relationships between different WEM values and AL. Results AL was negatively correlated with HC_WEM, A2_WEM, and WEM_Max (r = − 0.28, − 0.23, and − 0.22, respectively; P

Asaf Achiron,1 Tal Yahalomi,2 Amit Biran,1 Eliya Levinger,1 Eyal Cohen,1 Uri Elbaz,3 Asim Ali,4,5 Kamiar Mireskandari,4,5 Raimo Tuuminen,6,7 Oleksiy V Voytsekhivskyy8 1Tel Aviv Sourasky Medical Center, Tel Aviv, Israel and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; 2Department of Ophthalmology, Samson Assuta Ashdod Hospital and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er Sheva, Israel; 3Department of Ophthalmology, Rabin Medical Center, Petach-Tikva and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; 4Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada; 5Department of Ophthalmology and Vision Sciences, the Hospital for Sick Children, Toronto, Ontario, Canada; 6Helsinki Retina Research Group, Faculty of Medicine, University of Helsinki, Helsinki, Finland; 7Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland; 8Kyiv Clinical Ophthalmology Hospital Eye Microsurgery Center, Kyiv, UkraineCorrespondence: Oleksiy V Voytsekhivskyy, Kyiv Clinical Ophthalmology Hospital Eye Microsurgery Center, Komarov Ave. 3, Medical City, Kyiv, 03680, Ukraine, Tel +38067-584-28-11, Email iolpower@ukr.netPurpose: To compare the accuracy of 16 intraocular lens (IOL) power calculation formulas in pediatric cataract eyes.Patients and Methods: The data records of pediatric patients who had been implanted with three IOL models (SA60AT, MA60AC, and enVista-MX60) between 2012 and 2018 were analyzed. The accuracy of 16 IOL power calculation methods was evaluated: Barrett Universal II (BUII), Castrop, EVO 2.0, Haigis, Hill-RBF 3.0, Hoffer Q, Hoffer QST, Holladay 1, Kane, LSF AI, Naeser 2, Pearl-DGS, SRK/T, T2, VRF, and VRF-G. The non-optimized (ULIB/IOLcon) and optimized constants were used for IOL power calculation. The mean prediction error (PE), Performance Index (FPI), and all descriptive statistics were calculated.Results: Ninety-seven eyes of 97 pediatric patients aged 13.2 (IQR 11.2– 17.1) were included. No statistically significant difference (HS-test) was observed (p > 0.818) except for the Hoffer Q, and Naeser 2 (P = 0.014). With optimized lens constants, the best FPI indices were obtained by Hoffer Q (0.256) and VRF-G (0.251) formulas, followed by Hill-RBF 3.0 and BUII, with an index of 0.248. The highest FPI indices with non-optimized constants showed SRK/T and T2 formulas (0.246 and 0.245, respectively), followed by VRF-G and Holladay 1, with an index of 0.244. The best median absolute error values (MedAE) were achieved by Hoffer Q (0.50 D), VRF-G (0.53 D), and Hill-RBF 3.0 (0.54 D), all P ≥ 0.074.Conclusion: Our results place the Hoffer Q, VRF-G, Hill-RBF 3.0, and BUII formulas as more accurate predictors of postoperative refraction in pediatric cataract surgery.Keywords: IOL power, formulas, pediatric eyes, calculation, axial length

Abstract Background Assessing refractive errors under cycloplegia is recommended for paediatric patients; however, this may not always be feasible. In these situations, refraction has to rely on measurements made under active accommodation which may increase measurements variability and error. Therefore, evaluating the accuracy and precision of non-cycloplegic refraction and biometric measurements is clinically relevant. The Myopia Master, a novel instrument combining autorefraction and biometry, is designed for monitoring refractive error and ocular biometry in myopia management. This study assessed its repeatability and agreement for autorefraction and biometric measurements pre- and post-cycloplegia. Methods A prospective cross-sectional study evaluated a cohort of 96 paediatric patients that underwent ophthalmologic examination. An optometrist performed two repeated measurements of autorefraction and biometry pre- and post-cycloplegia. Test-retest repeatability (TRT) was assessed as differences between consecutive measurements and agreement as differences between post- and pre-cycloplegia measurements, for spherical equivalent (SE), refractive and keratometric J0/J45 astigmatic components, mean keratometry (Km) and axial length (AL). Results Cycloplegia significantly improved the SE repeatability (TRT, pre-cyclo: 0.65 D, post-cyclo: 0.31 D). SE measurements were more repeatable in myopes and emmetropes compared to hyperopes. Keratometry (Km) repeatability did not change with cycloplegia (TRT, pre-cyclo: 0.25 D, post-cyclo:0.27 D) and AL repeatability improved marginally (TRT, pre-cyclo: 0.14 mm, post-cyclo: 0.09 mm). Regarding pre- and post-cycloplegia agreement, SE became more positive by + 0.79 D, varying with refractive error. Myopic eyes showed a mean difference of + 0.31 D, while hyperopes differed by + 1.57 D. Mean keratometry, refractive and keratometric J0/J45 and AL showed no clinically significant differences. Conclusions Refractive error measurements, using the Myopia Master were 2.5x less precise pre-cycloplegia than post-cycloplegia. Accuracy of pre-cycloplegic refractive error measurements was often larger than the clinically significant threshold (0.25 D) and was refractive error dependent. The higher precision compared to autorefraction measurements, pre- and post-cycloplegia agreement and refractive error independence of AL measurements emphasize the superiority of AL in refractive error monitoring.

AIM: To analyze ocular biometric parameters among candidates for cataract surgery.METHODS: This cross-sectional study was conducted on 4 607 cataract patients(4 607 eyes)in Farabi Eye Hospital, Tehran, Iran from January 2017 to September 2021. Axial length(AL), keratometry(Kf, Ks and Km), and anterior chamber depth(ACD)were assessed using IOLMaster 700. All eyes were categorized into three groups based on AL: short eyes(22 mm25 mm)and ACD as follows: low(3.00 mm3.60 mm).RESULTS: The mean age of patients was 60.3±14.1(range 8-95)years [2 243(48.69%)female and 2 364(51.31%)male]. The AL, ACD and mean keratometry ranges were 23.1 to 23.4 mm, 3.1 to 3.2 mm and 44.50 to 45.00 diopter(D), respectively. The mean amount of ACD in the long eyes group was significantly higher than the normal and short eyes group(P

AIM:To observe the accuracy of infiltrating B ultrasound guided A-scan segment biometric measurement of axial length in dense cataract.METHODS: Perspective study. A total of 86 patients(90 eyes)with dense cataract were selected from Chengdu Aier Eye Hospital from August 2020 to August 2022. There were 61 males(59 eyes)males and 25 females(31 eyes)females, with an average age of 66.49±14.55 years. The axial length(AL), anterior chamber depth(ACD)(including corneal thickness), corneal curvature(K), lens thickness(LT), central corneal thickness(CCT), and white-to-white(WTW)were measured preoperatively by contact A-scan, infiltrating B ultrasound guided segmented A-scan, and IOL Master 700, respectively. At 1 wk postoperatively, AL was retested by IOL Master 700 in aphakic mode. Furthermore, the agreements and correlations of AL obtained by the three kinds of devices were analyzed.RESULTS:The AL measured by contact A-scan and infiltrating B ultrasound guided segmented A-scan were 23.40(22.63, 23.89)mm and 23.70(23.04, 24.25)mm, respectively, and the AL measured by IOL Master 700 at 1 wk postoperatively was 23.72(23.01, 24.27)mm. There were statistical significant difference in AL measured by the three methods(P=0.018), while there were no statistical significant difference in AL measured by infiltrating B ultrasound guided segmented A-scan and IOL Master 700(P=0.991). Bland-Altman analysis showed that there was a good agreement in AL measured by infiltrating B ultrasound guided segmented A-scan and IOL Master 700(P=0.0809). The AL measured by infiltrating B ultrasound guided segmented A-scan and IOL Master 700 was positively correlated(rs=0.992, P

Myopia is becoming more and more common all over the world, and the incidence of myopia is gradually increasing. Many treatments have been used to prevent and control myopia, including optics, drugs, environment or behavior, but the results are different and lack standardization. At present, many experiments have proved that peripheral defocus technology has a certain effect on myopia control. Based on this technology, three kinds of framed eyeglass lenses with peripheral defocus design, namely defocus incorporated multiple segments(DIMS), highly aspherical lenslets(HAL)and cylindrical annular reactive elements(CARE), are commonly used in medical and optometry institutions in China. These lenses provide not only clear vision in the central area, but also a certain amount of myopic defocus in the periphery to control the progression of myopia. This paper aims to focus on the design principle and myopia prevention and control effect of the above three peripheral defocus lenses, and evaluate their effectiveness in clinical practice.

AIM: To evaluate the value of the ratio of axial length to corneal radius of curvature(AL/CR)in the diagnosis of myopia in children and adolescents.METHODS: The refraction and ocular biometric parameters of 2 182 cases of children and adolescents(4 364 eyes)who initially visited the optometry clinic of the Second People's Hospital of Beihai from January 2022 to December 2023 were collected and analyzed.RESULTS: The receiver operating characteristic curve(ROC curve)showed that AL/CR had a higher area under the curve(AUC=0.925, 95%CI: 0.917-0.933)in diagnosing myopia. When AL/CR was 3.053, the Youden index was the largest. As the threshold of AL/CR decreased, the sensitivity of myopia diagnosis increased, while the specificity decreased. Compared with screening myopia, the sensitivity of AL/CR=3.053 in diagnosing myopia was low, but the specificity was high, especially in the cases of hyperopia and pre-myopia.CONCLUSION: The accuracy of AL/CR in diagnosing myopia is superior to that of axial length and average corneal curvature, with higher specificity. As the threshold of AL/CR decreases, the sensitivity of diagnosing myopia increases, but the specificity decreases. In cases of hyperopia and pre-myopia, the specificity of AL/CR in diagnosing myopia is higher than that of screening myopia.

Abstract Objective This study aimed to compare the one-year efficacy of myopia prevention and control using three optical intervention methods - single vision lens (SVL), highly aspherical lenslet (HAL), and orthokeratology (OK) lens - in children with low myopia. Methods A cohort of 150 children aged 7–13 years with low myopia was recruited and divided into three groups: SVL (n = 50), HAL (n = 50), and OK lens group (n = 50), based on their preference for glasses. Follow-up assessments were carried out over one year, focusing on data from the right eye for statistical analysis. Baseline characteristics such as gender, age, axial length (AL), spherical equivalent refractive error (SER), flat keratometry (K1), steep keratometry (K2), anterior chamber depth (ACD), white-to-white corneal diameter (WTW), and non-contact tonometry (NCT) measurements were gathered and compared among the three groups before any intervention. Changes in AL growth after 1 year of intervention were assessed across the three groups. Subsequently, the AL growth control rates between the HAL and OK lens groups were compared, with the SVL group serving as the reference standard. Results The study found no statistically significant variances in baseline characteristics (gender, age, SER, AL, K1, K2, WTW, and NCT) among the SVL, HAL, and OK lens groups (all p > 0.05). Following a one-year intervention, AL growth rates were as follows: HAL group (0.163 ± 0.113 mm)

Abstract Background This study assessed the agreement of ocular parameters of patients with myopia measured using Colombo intraocular lens (IOL) 2 and IOLMaster 700. Methods Eighty patients (male, 22; average age, 29.14 ± 7.36 years) with myopia (159 eyes) were included in this study in May 2023. The participants’ axial length (AXL), central corneal thickness (CCT), lens thickness (LT), white-to-white distance (WTW), front flat (K1), steep (K2), mean (Km) corneal keratometry, astigmatism (Astig), J0 vector, and J45 vector were measured using the IOLMaster 700 and Colombo IOL 2. The measurements from both devices were compared using the generalized estimating equation, correlation analysis, and Bland-Altman plots. Results With the Colombo IOL 2, lower values for K2 and J0 (odds ratio [OR] = 0.587, p = 0.033; OR = 0.779, p

Abstract Background To compare the surgical outcomes of the inverted internal limiting membrane (ILM) flap technique and ILM insertion for macular hole (MH) without retinal detachment in eyes with extremely high myopia. Methods In this retrospective study, we analyzed 22 eyes with an axial length ≥ 30.0 mm that had underwent MH surgery between April 2015 and August 2021. The surgical procedures involved either an inverted ILM flap or ILM insertion. The outcomes were compared between the two techniques. Closure of the MH was confirmed by optical coherence tomography (OCT). The best-corrected visual acuity (BCVA) was measured before and after surgery. Associated complications were documented. Results The median of axial length was 30.64 mm (range, 30.0-34.42). The MH closed in 100% (22/22) eyes and did not recur with a median follow-up of 12.5 months. For the inverted ILM flap technique, the median BCVA improved significantly from 0.80 logarithm of the minimum angle of resolution (logMAR) (range, 0.40-2.00) before surgery to 0.70 logMAR (range, 0.09–1.52) after surgery (p = 0.002). In addition, the median of final BCVA was better for the inverted ILM flap than ILM insertion (0.7 logMAR V.S. 1.00 logMAR; p = 0.016). Conclusions In eyes with extremely high myopia, despite comparable effects on MH closure for both ILM insertion and the inverted ILM flap, the later technique achieved significantly better visual outcomes.

Abstract We aim to observe the posterior scleral reinforcement (PSR) clinical outcomes of children with high myopia and analyze the retinal vessel alteration before and after PSR by using angiography optical coherence tomography (angio-OCT). Fifty-six pediatric participants (112 eyes) clinically diagnosed high myopia were recruited and were treated by PSR in Shanghai Children’s Hospital from June 1, 2021 to May 1, 2023. The average age ranged from 5.42 to 14.83 years (mean 8.83 years) and mean follow up duration was 8.7 months (3–24 months). The axial length (AL) was significantly shortened after PSR (p

Background: The prevalence of myopia in the 5–15-year age group in India has been 7.5% over the past four decades. While ocular growth and physical growth occur simultaneously during early life, the existence of a common regulatory system for both is still debated. Aims and Objectives: This study aims to analyze the ocular biometry and anthropometric values of young myopes and emmetropes aged 18–25 years. Materials and Methods: This case–control study involved a sample size of 86 participants. Corneal curvature was measured using keratometry, while A-scan ultrasonography was utilized to measure axial length, lens thickness, anterior chamber depth, and vitreous chamber depth. Results: The results indicated that there were no significant differences in ocular biometry and anthropometric values between the case and control groups, except for corneal thickness and axial length. The mean corneal thickness was found to be 549.64 μm in the case group and 566.05 μm in the control group, while the mean axial length was 24.70 mm in the case group and 23.41 mm in the control group. An increase in height was correlated with longer axial length in myopes. Conclusion: There was no difference in anthropometry and ocular biometry in emmetropes and myopes in the age group of 18–25 years of age. Myopes tend to have thinner corneas, which should be taken into consideration before performing refractive surgeries. The presence of thin corneas in individuals with myopia can result in inaccurately low measurements of intraocular pressure, potentially hampering the early detection of glaucoma within this high-risk demographic.

AIM: To investigate the clinical features of the ocular surface in patients with different degrees of myopia. METHODS: A cross-sectional study was conducted involving 122 participants with myopia in Beijing Tongren Hospital from February to June, 2023. After completing the Ocular Surface Disease Index (OSDI) score scale, measurements were taken for refraction, biometric parameters and ocular surface parameters. The prevalence, severity and related parameters of the dry eye among different groups based on axial length (AL) were compared. Correlation analysis was performed between ocular surface parameters and refraction/biometric measurement parameters. RESULTS: Statistically significant differences were observed in refractive error, corneal thickness, anterior chamber depth, and subfoveal choroidal thickness among the groups (all P

Introduction: Topographic measurement of corneal astigmatism is the current standard of care because, in addition to measuring corneal astigmatism, it identifies irregular astigmatism, which may limit optimum surgical results. The present study focuses on the use of topography to measure Surgically Induced Astigmatism (SIA), which is not a routine practice in most institutions, and compares it with keratometry values of corneal astigmatism. The present study highlights the accuracy of topography in the measurement of astigmatism, with its additional benefits being the measurement of irregular astigmatism and assessment of tear film status. Aim: To compare SIA using topography and keratometry in patients undergoing phacoemulsification and Small Incision Cataract Surgery (SICS). Materials and Methods: The present study was a prospective, interventional study conducted in the Ophthalmology Department of Bharti Vidyapeeth (deemed to be University) Medical College and Hospital, Sangli, Maharashtra, India for 18 months (November 2019 to April 2021). A total of 100 cases (100 eyes) with cataracts were randomly divided into Group-A (n=50) and Group-B (n=50), respectively, underwent Phacoemulsification and SICS. Before the surgery, the astigmatism of each patient was noted by both topography and keratometry. On the 45th postoperative day, patients’ Uncorrected Visual Acuity (UCVA), Best Corrected Visual Acuity (BCVA), automated keratometry readings, and corneal topography readings were taken, based on which SIA was calculated by SIA calculator version 2.0. The mean SIA in both groups was calculated and compared. An unpaired t-test was used to compare the mean of different variables in the two groups, Group-A and Group-B. A p-value of

Purpose: To compare the biometric measurements obtained from the Pentacam AXL Wave, IOLMaster 700, and ANTERION and calculate the recommended intraocular lens power using the Barrett Formulae. Methods: This was a retrospective cross-sectional study of patients who underwent biometry using the Pentacam AXL Wave, IOLMaster 700, and ANTERION. Flat keratometry (K1), steep keratometry (K2), anterior chamber depth (ACD), and axial length (AL) from each device were measured and compared. These parameters were used to calculate the recommended IOL powers using the Barrett formula. Results: The study included 252 eyes of 153 patients. The IOLMaster had the highest acquisition rate among the two biometers. The Pentacam obtained the shortest mean AL, the IOLMaster measured the highest mean keratometry values, and the ANTERION measured the highest mean ACD. In terms of pairwise comparisons, keratometry and axial length were not significantly different between the Pentacam-IOLMaster and ANTERION-IOLMaster groups, while the rest of the pairwise comparisons were statistically significant. In nontoric and toric eyes, 35–45% of patients recommended the same sphere of IOL power. In another 30–40%, the Pentacam and ANTERION recommended an IOL power one step greater than that of the IOLMaster-derived data. 50% of the study population recommended the same toric-cylinder IOL power. Conclusions: The Pentacam AXL Wave, IOLMaster 700, and ANTERION can reliably provide data for IOL power calculations; however, these data are not interchangeable. In nontoric and toric eyes, 35–45% of cases recommended the same sphere IOL power, and in another 30–40%, the Pentacam and ANTERION recommended one-step higher IOL power than the IOLMaster-derived data. In targeting emmetropia, selecting the first plus IOL power is advisable when using the Pentacam and ANTERION to approximate the IOL power calculations recommended by the IOLMaster 700. [ABSTRACT FROM AUTHOR]

Objectives: This retrospective analysis evaluates the treatment success of "Defocus Incorporated Multiple Segments" (DIMS) spectacle lenses in a real-life clinical setting in Germany. Materials and methods: Axial length (AL) and objective refraction of 166 eyes treated with DIMS at baseline and 12-month follow-up were analyzed. Annual AL growth rate within the range of physiological growth rate was considered a successful treatment. Myopia progression of ≥ -0.5 D/yr accounted as treatment success. Differences in percentages of treatment success of subgroups depending on baseline AL and age against treatment success of the total population were investigated. Results: Considering all eyes, treatment success regarding AL growth and myopia progression was achieved in 46% and 65%, respectively. Male eyes with moderate AL showed treatment success in a higher proportion (73%, p < 0.01; 89%, p < 0.01); eyes with high AL showed treatment success in a lower proportion (25%, p < 0.01; 51%, n.s.). Female eyes showed the same trend but without statistical significance (moderate AL: 49%; 68%; high AL: 40%; 62%). Younger children showed treatment success in a lower proportion (male: 11%, p < 0.01; 38%, p < 0.05; female: 25%, p < 0.01; 42%, p < 0.01). Older children showed treatment success in a higher proportion (male: 60%, p < 0.05; 78% p < 0.05; female: 53%, n.s.; 77% p < 0.05). Conclusions: Eyes with moderate baseline AL and of older children showed treatment success after 12 months of DIMS treatment. Eyes with a high baseline AL and of younger children showed treatment success in a smaller proportion, therefore combination treatment should be considered. In future studies, males and females should be assessed separately. [ABSTRACT FROM AUTHOR]

To compare the corneal biomechanical parameters measured by Corvis ST in subjects with varying degrees of myopia. And the factors that may affect corneal biomechanical properties were also investigated. Participants in this prospective cross-sectional study were classified into three groups according to spherical equivalent (SE) and axial length (AL): Non-myopia (NM, SE > − 0.50 D and AL < 26 mm), Mild-to-moderate myopia (MM, − 6.00 D < SE ≤ − 0.50 D and AL < 26 mm), high myopia (HM, SE ≤ − 6.00 D or AL ≥ 26 mm). Ten corneal biomechanical parameters were finally included. Linear mixed-effects model accounting for using both eyes in the same participant was carried out to evaluate how the corneal biomechanical parameter was influenced by varying degrees of myopia after adjusting for biomechanically corrected intraocular pressure (bIOP) and central corneal thickness (CCT). Further, multiple linear regression was performed to explore the correlation between corneal biomechanical parameter and SE, AL, bIOP or CCT. A total of 304 eyes from 224 healthy myopic subjects were recorded. There were 95 eyes with NM, 122 eyes with MM, and 87 eyes with HM. After adjusting for bIOP and CCT, eyes with high myopia showed shorter highest concavity time (HC-time, p = 0.025), greater peak distance (PD, p = 0.001), greater deflection amplitude (DA-Max, p = 0.002), smaller whole eye movement (WEM-Max, p < 0.001) and reduced stiffness parameter (SP-A1, p < 0.001). Multiple regression analysis showed that five parameters (HC-time, p < 0.001; PD, p < 0.001; DA-Max, p = 0.001; WEM-Max, p < 0.001; and SP-A1, p < 0.001) of Corvis ST were significantly correlated with AL, and one parameter (Corvis biomechanical index, p = 0.016) has significant relationship with SE. With the increase of myopia, significant changes in several corneal biomechanical parameters indicated a progressive decrease in corneal stiffness, independent of bIOP and CCT. Corneal biomechanical parameters may be predictors of scleral mechanical strength in high myopia, which has certain application value in clinical management of myopia. [ABSTRACT FROM AUTHOR]