Background: Large language models (LLMs) are gaining popularity in solving ophthalmic problems. However, their efficacy in patient education regarding orthokeratology, one of the main myopia control strategies, has yet to be determined.
Methods: This cross-sectional study established a question bank consisting of 24 orthokeratology-related questions used as queries for GTP-4, Qwen-72B, and Yi-34B to prompt responses in Chinese. Objective evaluations were conducted using an online platform. Subjective evaluations including correctness, relevance, readability, applicability, safety, clarity, helpfulness, and satisfaction were performed by experienced ophthalmologists and parents of myopic children using a 5-point Likert scale. The overall standardized scores were also calculated.
Results: The word count of the responses from Qwen-72B (199.42 ± 76.82) was the lowest (P < 0.001), with no significant differences in recommended age among the LLMs. GPT-4 (3.79 ± 1.03) scored lower in readability than Yi-34B (4.65 ± 0.51) and Qwen-72B (4.65 ± 0.61) (P < 0.001). No significant differences in safety, relevance, correctness, and applicability were observed across the three LLMs. Parental evaluations rated all LLMs an average score exceeding 4.7 points, with GPT-4 outperforming the others in helpfulness (P = 0.004) and satisfaction (P = 0.016). Qwen-72B's overall standardized scores surpassed those of the other two LLMs (P = 0.048).
Conclusions: GPT-4 and the Chinese LLM Qwen-72B produced accurate and beneficial responses to inquiries on orthokeratology. Further enhancement to bolster precision is essential, particularly within diverse linguistic contexts.
{"title":"Evaluation of large language models for providing educational information in orthokeratology care.","authors":"Yangyi Huang, Runhan Shi, Can Chen, Xueyi Zhou, Xingtao Zhou, Jiaxu Hong, Zhi Chen","doi":"10.1016/j.clae.2025.102384","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102384","url":null,"abstract":"<p><strong>Background: </strong>Large language models (LLMs) are gaining popularity in solving ophthalmic problems. However, their efficacy in patient education regarding orthokeratology, one of the main myopia control strategies, has yet to be determined.</p><p><strong>Methods: </strong>This cross-sectional study established a question bank consisting of 24 orthokeratology-related questions used as queries for GTP-4, Qwen-72B, and Yi-34B to prompt responses in Chinese. Objective evaluations were conducted using an online platform. Subjective evaluations including correctness, relevance, readability, applicability, safety, clarity, helpfulness, and satisfaction were performed by experienced ophthalmologists and parents of myopic children using a 5-point Likert scale. The overall standardized scores were also calculated.</p><p><strong>Results: </strong>The word count of the responses from Qwen-72B (199.42 ± 76.82) was the lowest (P < 0.001), with no significant differences in recommended age among the LLMs. GPT-4 (3.79 ± 1.03) scored lower in readability than Yi-34B (4.65 ± 0.51) and Qwen-72B (4.65 ± 0.61) (P < 0.001). No significant differences in safety, relevance, correctness, and applicability were observed across the three LLMs. Parental evaluations rated all LLMs an average score exceeding 4.7 points, with GPT-4 outperforming the others in helpfulness (P = 0.004) and satisfaction (P = 0.016). Qwen-72B's overall standardized scores surpassed those of the other two LLMs (P = 0.048).</p><p><strong>Conclusions: </strong>GPT-4 and the Chinese LLM Qwen-72B produced accurate and beneficial responses to inquiries on orthokeratology. Further enhancement to bolster precision is essential, particularly within diverse linguistic contexts.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102384"},"PeriodicalIF":4.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-10DOI: 10.1016/j.clae.2025.102386
Eihab Eltantawy
Purpose: To determine the influence of scleral toricity on the extent of lens contact and in-vivo flexure using anterior segment optical coherence tomography (AS-OCT), and to identify variables related to lens decentration.
Methods: Scleral toricity at a chord of 15 mm was measured using Pentacam corneoscleral profilometry (CSP) from 10 healthy young participants (22 ± 2 years) with normal corneas. Participants were fitted with the same 16.0 mm rotationally symmetric scleral lens design (hexafocon A material). AS-OCT was used in conjunction with ImageJ analysis to document the disparity of lens contact at the 15 mm chord primary toric meridians and to assess lens flexure. Additionally, central fluid reservoir (FR) depth and lens decentration were measured.
Results: A significant correlation was found between scleral toricity (mean 155 ± 95 μm) and both the magnitude of lens flexure, and the disparity in lens contact between the scleral primary toric meridians at the 15 mm chord diameter (r = 0.83, p = 0.003 and rs = 0.83, p = 0.005 respectively). Mean lens decentration values were 0.30 ± 0.18 mm inferior-temporal net decentration, 0.26 ± 0.16 mm inferior decentration and 0.13 ± 0.1 mm temporal decentration. This was significantly associated with central FR depth (rs = 0.91, p = 0.0005 and rs = 0.73, p = 0.02 and rs = 0.71, p = 0.03 respectively). No significant correlation was found between lens decentration and scleral toricity (p > 0.05).
Conclusion: Scleral toricity was significantly associated with AS-OCT measured lens flexure and contact disparity at primary toric landing locations defined by profilometry. Reducing central FR depth appears to be a good strategy for improved lens centration. Whilst equalising lens contact along toric meridians is beneficial for addressing lens flexure, the influence of this on centration is less clear.
{"title":"Assessing scleral toricity induced lens flexure and contact disparity using anterior segment optical coherence tomography.","authors":"Eihab Eltantawy","doi":"10.1016/j.clae.2025.102386","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102386","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the influence of scleral toricity on the extent of lens contact and in-vivo flexure using anterior segment optical coherence tomography (AS-OCT), and to identify variables related to lens decentration.</p><p><strong>Methods: </strong>Scleral toricity at a chord of 15 mm was measured using Pentacam corneoscleral profilometry (CSP) from 10 healthy young participants (22 ± 2 years) with normal corneas. Participants were fitted with the same 16.0 mm rotationally symmetric scleral lens design (hexafocon A material). AS-OCT was used in conjunction with ImageJ analysis to document the disparity of lens contact at the 15 mm chord primary toric meridians and to assess lens flexure. Additionally, central fluid reservoir (FR) depth and lens decentration were measured.</p><p><strong>Results: </strong>A significant correlation was found between scleral toricity (mean 155 ± 95 μm) and both the magnitude of lens flexure, and the disparity in lens contact between the scleral primary toric meridians at the 15 mm chord diameter (r = 0.83, p = 0.003 and r<sub>s</sub> = 0.83, p = 0.005 respectively). Mean lens decentration values were 0.30 ± 0.18 mm inferior-temporal net decentration, 0.26 ± 0.16 mm inferior decentration and 0.13 ± 0.1 mm temporal decentration. This was significantly associated with central FR depth (r<sub>s</sub> = 0.91, p = 0.0005 and r<sub>s</sub> = 0.73, p = 0.02 and r<sub>s</sub> = 0.71, p = 0.03 respectively). No significant correlation was found between lens decentration and scleral toricity (p > 0.05).</p><p><strong>Conclusion: </strong>Scleral toricity was significantly associated with AS-OCT measured lens flexure and contact disparity at primary toric landing locations defined by profilometry. Reducing central FR depth appears to be a good strategy for improved lens centration. Whilst equalising lens contact along toric meridians is beneficial for addressing lens flexure, the influence of this on centration is less clear.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102386"},"PeriodicalIF":4.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-09DOI: 10.1016/j.clae.2025.102381
Md Abdullah Aziz, Furqan Maulvi, Ditixa T Desai, Rajesh Kuppusamy, Kishor Mazumder, Alex Hui, Fiona Stapleton, Mark Willcox
Purpose: Myopia or near-sightedness is a global vision problem. Atropine eye drops and myopia-controlling contact lenses can help to slow down its progression, but neither is sufficient alone. The present research work was conducted to design a contact lens embedded with an atropine base within a microemulsion system. The goal was to improve the stability of atropine base and facilitate its release from the lens, preventing the rapid clearance observed with atropine eye drops.
Methods: Two microemulsions, one with a pH of 7.4 and the other with a pH of 6.5, were developed using the surfactant D-alpha-tocopherol polyethylene glycol 1000 succinate (TPGS), the co-surfactant polyethylene glycol 400 (PEG 400), the emulsifier Capmul MCM C8, atropine base, and phosphate-buffered saline (PBS). The microemulsions were kept at room temperature (21 °C) and the amount of the atropine base in microemulsions were checked periodically over one year using reverse-phase High Performance Liquid Chromatography (RPHPLC) to determine its stability. The globule size of the formulations was measured using a zetasizer. MiSight contact lenses were soaked in the atropine base microemulsion formulations for 24 h, and the amount of atropine base loaded into contact lenses and released in PBS was measured by a RPHPLC. ISO 10993-5 guidelines were used to measure the in vitro cytotoxicity of atropine base loaded contact lenses.
Results: The atropine base was more stable in the microemulsion at pH 6.5 (ME 6.5) with less than 4 % degradation, compared to a 10 % degradation at pH 7.4 (ME 7.4). The globule sizes of the microemulsions ranged between 17-21 nm. MiSight lenses absorbed4.25 ± 1.67 µg atropine base from ME 6.5, with the majority of the atropine base (3.52 ± 0.03 µg) released within 2 h. However, elutes from atropine base loaded contact lenses were toxic to human corneal epithelial cells (HCECs), reducing cell viability to less than 5 % after 24 h.
Conclusions: While the microemulsions were stable and the contact lenses released sufficient amounts of atropine base, future studies are needed to address the toxicity issue.
{"title":"Designing a contact lens with atropine base using a microemulsion technique.","authors":"Md Abdullah Aziz, Furqan Maulvi, Ditixa T Desai, Rajesh Kuppusamy, Kishor Mazumder, Alex Hui, Fiona Stapleton, Mark Willcox","doi":"10.1016/j.clae.2025.102381","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102381","url":null,"abstract":"<p><strong>Purpose: </strong>Myopia or near-sightedness is a global vision problem. Atropine eye drops and myopia-controlling contact lenses can help to slow down its progression, but neither is sufficient alone. The present research work was conducted to design a contact lens embedded with an atropine base within a microemulsion system. The goal was to improve the stability of atropine base and facilitate its release from the lens, preventing the rapid clearance observed with atropine eye drops.</p><p><strong>Methods: </strong>Two microemulsions, one with a pH of 7.4 and the other with a pH of 6.5, were developed using the surfactant D-alpha-tocopherol polyethylene glycol 1000 succinate (TPGS), the co-surfactant polyethylene glycol 400 (PEG 400), the emulsifier Capmul MCM C8, atropine base, and phosphate-buffered saline (PBS). The microemulsions were kept at room temperature (21 °C) and the amount of the atropine base in microemulsions were checked periodically over one year using reverse-phase High Performance Liquid Chromatography (RPHPLC) to determine its stability. The globule size of the formulations was measured using a zetasizer. MiSight contact lenses were soaked in the atropine base microemulsion formulations for 24 h, and the amount of atropine base loaded into contact lenses and released in PBS was measured by a RPHPLC. ISO 10993-5 guidelines were used to measure the in vitro cytotoxicity of atropine base loaded contact lenses.</p><p><strong>Results: </strong>The atropine base was more stable in the microemulsion at pH 6.5 (ME 6.5) with less than 4 % degradation, compared to a 10 % degradation at pH 7.4 (ME 7.4). The globule sizes of the microemulsions ranged between 17-21 nm. MiSight lenses absorbed4.25 ± 1.67 µg atropine base from ME 6.5, with the majority of the atropine base (3.52 ± 0.03 µg) released within 2 h. However, elutes from atropine base loaded contact lenses were toxic to human corneal epithelial cells (HCECs), reducing cell viability to less than 5 % after 24 h.</p><p><strong>Conclusions: </strong>While the microemulsions were stable and the contact lenses released sufficient amounts of atropine base, future studies are needed to address the toxicity issue.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102381"},"PeriodicalIF":4.1,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Response to the Letter to the Editor.","authors":"Anitha Arvind, Rakesh Nanjappa, Krishna Kumar Gupta, Rute J Macedo-de-Araújo, Daddi Fadel","doi":"10.1016/j.clae.2025.102379","DOIUrl":"https://doi.org/10.1016/j.clae.2025.102379","url":null,"abstract":"","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":" ","pages":"102379"},"PeriodicalIF":4.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clae.2024.102258
Jacinto Santodomingo-Rubido , Sin-Wan Cheung , César Villa-Collar , the ROMIO/MCOS/TO-SEE Groups
Purpose
To evaluate the safety of orthokeratology contact lens wear in slowing the axial elongation of the eye in myopic children.
Methods
Safety data from three prospective studies, which evaluated the use of orthokeratology for slowing myopia progression in children in comparison to a parallel control group of single-vision spectacle lens wearers over a 2-year period, were pooled together for analysis. The primary and secondary safety endpoints are the comparisons of adverse events and slit-lamp findings grades ≥ 2 between orthokeratology and control groups, respectively.
Results
Collectively, data from 125 orthokeratology and 118 control subjects were analyzed in this study. Of these, 101 (81 %) and 88 (75 %) orthokeratology and control subjects completed the 2-year follow-up period, respectively. Nineteen orthokeratology subjects experienced 28 adverse events, of which 6 were significant, whereas just one adverse event was found in the control group; this difference was statistically significant (p < 0.001). Most adverse events found in the orthokeratology group were corneal in nature, primarily corneal abrasion/staining, accounting for around 40 % of all adverse events. Of the 28 adverse events, only 18 (3 significant) are likely to be contact lens-related, leading to incidence rates of total and device-related adverse events per 100 patient years of lens wear (95 % confidence intervals) of 13.1 (9.2–18.2) and 8.4 (5.4–10.7), respectively. No significant differences were found between groups in the total number of silt-lamps findings with grades ≥ 2 (p > 0.05).
Conclusion
Around 13% of eyes wearing overnight orthokeratology contact lenses are likely to experience an adverse event over one year of lens wear, with this figure being lower when considering device-related adverse events alone. No serious adverse events were found, with most being non-significant. These results inform eye care practitioners on the safety of orthokeratology lenses when prescribed for slowing myopia progression to myopic children.
{"title":"The safety of orthokeratology contact lens wear in slowing the axial elongation of the eye in children","authors":"Jacinto Santodomingo-Rubido , Sin-Wan Cheung , César Villa-Collar , the ROMIO/MCOS/TO-SEE Groups","doi":"10.1016/j.clae.2024.102258","DOIUrl":"10.1016/j.clae.2024.102258","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the safety of orthokeratology contact lens wear in slowing the axial elongation of the eye in myopic children.</div></div><div><h3>Methods</h3><div>Safety data from three prospective studies, which evaluated the use of orthokeratology for slowing myopia progression in children in comparison to a parallel control group of single-vision spectacle lens wearers over a 2-year period, were pooled together for analysis. The primary and secondary safety endpoints are the comparisons of adverse events and slit-lamp findings grades ≥ 2 between orthokeratology and control groups, respectively.</div></div><div><h3>Results</h3><div>Collectively, data from 125 orthokeratology and 118 control subjects were analyzed in this study. Of these, 101 (81 %) and 88 (75 %) orthokeratology and control subjects completed the 2-year follow-up period, respectively. Nineteen orthokeratology subjects experienced 28 adverse events, of which 6 were significant, whereas just one adverse event was found in the control group; this difference was statistically significant (p < 0.001). Most adverse events found in the orthokeratology group were corneal in nature, primarily corneal abrasion/staining, accounting for around 40 % of all adverse events. Of the 28 adverse events, only 18 (3 significant) are likely to be contact lens-related, leading to incidence rates of total and device-related adverse events per 100 patient years of lens wear (95 % confidence intervals) of 13.1 (9.2–18.2) and 8.4 (5.4–10.7), respectively. No significant differences were found between groups in the total number of silt-lamps findings with grades ≥ 2 (p > 0.05).</div></div><div><h3>Conclusion</h3><div>Around 13% of eyes wearing overnight orthokeratology contact lenses are likely to experience an adverse event over one year of lens wear, with this figure being lower when considering device-related adverse events alone. No serious adverse events were found, with most being non-significant. These results inform eye care practitioners on the safety of orthokeratology lenses when prescribed for slowing myopia progression to myopic children.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 1","pages":"Article 102258"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To observe whether the effect of orthokeratology (OK) lenses on myopia control in children with allergic conjunctivitis (AC) after three years of wear differs from that in children without allergic conjunctivitis (nAC) and to identify the potential influencing factors.
Methods
This was a retrospective case–control study. Patients aged 8–15 years who were fitted with OK lenses in 2019 were collected. A three-year follow-up was also conducted, documenting all corneal adverse events (AEs) and the increase in axial length (AL) of the eye after three years of wearing OK lenses. Patients were divided into groups with and without AC based on their medical history and physical signs at the initial fitting. Baseline data and AL elongation after three years were compared between the two groups.
Results
A total of 309 patients were included in this study, with 47 in the AC group and 262 in the nAC group. There were no statistically significant differences between the two groups in terms of age, sex, spherical equivalent (SE), AL of the eye and environment. After three years of OK lens wear, the AL elongation in the AC group was 0.96 ± 0.45 mm, whereas it was 0.69 ± 0.45 mm in the nAC group (P < 0.001). The extent of AL elongation in AC patients was significantly greater than that in nAC patients. During the three-year follow-up period, the duration of OK lenses discontinuation due to corneal AEs in the AC group was greater than that in the nAC group (P < 0.05).
Conclusions
This study found that allergic conjunctivitis can affect the efficacy of OK lenses in controlling myopia after three years of treatment.
背景：目的：观察过敏性结膜炎（AC）患儿配戴正角膜塑形镜（OK）三年后，其近视控制效果是否与无过敏性结膜炎（nAC）患儿不同，并找出潜在的影响因素：这是一项回顾性病例对照研究。方法：这是一项回顾性病例对照研究，收集了在 2019 年配戴 OK 镜片的 8-15 岁患者。同时还进行了为期三年的随访，记录了所有角膜不良事件（AE）以及配戴 OK 镜三年后眼轴长度（AL）的增加情况。根据患者的病史和初次验配时的体征，将患者分为有角膜刺激症状和无角膜刺激症状两组。比较两组患者的基线数据和三年后的AL伸长率：本研究共纳入 309 名患者，其中 AC 组 47 人，nAC 组 262 人。两组患者在年龄、性别、球面等值（SE）、眼球角膜厚度（AL）和环境方面均无统计学差异。佩戴 OK 镜三年后，AC 组的 AL 伸长率为 0.96 ± 0.45 毫米，而 nAC 组为 0.69 ± 0.45 毫米（P 结论：AC 组的 AL 伸长率为 0.96 ± 0.45 毫米，而 nAC 组为 0.69 ± 0.45 毫米）：本研究发现，过敏性结膜炎会影响 OK 镜三年后控制近视的效果。
{"title":"Long-term effect of orthokeratology on controlling myopia progression in children with allergic conjunctivitis","authors":"Xiaoguang Niu , Hongda Zhang , Mengxue Zhang , Shujuan Wu , Guimei Xia , Man Xu","doi":"10.1016/j.clae.2024.102280","DOIUrl":"10.1016/j.clae.2024.102280","url":null,"abstract":"<div><h3>Background</h3><div>To observe whether the effect of orthokeratology (OK) lenses on myopia control in children with allergic conjunctivitis (AC) after three years of wear differs from that in children without allergic conjunctivitis (nAC) and to identify the potential influencing factors.</div></div><div><h3>Methods</h3><div>This was a retrospective case–control study. Patients aged 8–15 years who were fitted with OK lenses in 2019 were collected. A three-year follow-up was also conducted, documenting all corneal adverse events (AEs) and the increase in axial length (AL) of the eye after three years of wearing OK lenses. Patients were divided into groups with and without AC based on their medical history and physical signs at the initial fitting. Baseline data and AL elongation after three years were compared between the two groups.</div></div><div><h3>Results</h3><div>A total of 309 patients were included in this study, with 47 in the AC group and 262 in the nAC group. There were no statistically significant differences between the two groups in terms of age, sex, spherical equivalent (SE), AL of the eye and environment. After three years of OK lens wear, the AL elongation in the AC group was 0.96 ± 0.45 mm, whereas it was 0.69 ± 0.45 mm in the nAC group (<em>P</em> < 0.001). The extent of AL elongation in AC patients was significantly greater than that in nAC patients. During the three-year follow-up period, the duration of OK lenses discontinuation due to corneal AEs in the AC group was greater than that in the nAC group (<em>P</em> < 0.05).</div></div><div><h3>Conclusions</h3><div>This study found that allergic conjunctivitis can affect the efficacy of OK lenses in controlling myopia after three years of treatment.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 1","pages":"Article 102280"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clae.2024.102186
Shudan Lin , Chunhua Zhang , Xiaojun Chen , Dandan Jiang , Yanhui Wang , Bing Sun , Juan He , Yanyan Chen
Purpose
Non-adherence to standard wear, care, and follow-up procedures is a major risk factor for contact lens-related complications. The effectiveness of orthokeratology largely depends on the wearer's adherence. However, a deficiency in scales capturing adherence beliefs pertinent to orthokeratology exacerbates the lack of guidance for effective intervention strategies. The purpose of this study is to develop and evaluate the psychometric properties of a new scale based on the Theory of Planned Behavior that assesses the level of adherence among ortho-k wearers.
Methods
This study involved three stages following the STROBE checklist: (1) developing initial scale items based on the Theory of Planned Behavior, a literature review, and a qualitative study; (2) evaluation of content and face validity; (3) psychometric testing on 296 participants. Item analysis, based on Classical Test Theory, assessed the overall consistency, reliability, and validity of the scale.
Results
The final 37-item Beliefs about the Orthokeratology Lens Compliance Scale (BOLCS) comprises 11 dimensions. The Cronbach's alpha coefficients for each dimension ranged from 0.560 to 0.798. The folded half reliabilities were 0.845, and the combined reliabilities ranged from 0.676 to 0.793, indicating strong reliability. Item-level CVI (I-CVI) and scale-level CVI/average (S-CVI/Ave) values, assessed by the panel, ranged from 0.71 to 1 and 0.954, respectively. Exploratory and confirmatory factor analyses supported a factor structure consistent with the theoretical model.
Conclusions
The scale's construction adhered to a standardized process, yielding preliminary validation results with satisfactory reliability and validity.
{"title":"Development and psychometric evaluation of beliefs about the orthokeratology lens compliance scale (BOLCS): Based on the theory of planned behavior","authors":"Shudan Lin , Chunhua Zhang , Xiaojun Chen , Dandan Jiang , Yanhui Wang , Bing Sun , Juan He , Yanyan Chen","doi":"10.1016/j.clae.2024.102186","DOIUrl":"10.1016/j.clae.2024.102186","url":null,"abstract":"<div><h3>Purpose</h3><div><span>Non-adherence to standard wear, care, and follow-up procedures is a major risk factor for contact lens-related complications. The effectiveness of orthokeratology largely depends on the wearer's adherence. However, a deficiency in scales capturing adherence beliefs pertinent to orthokeratology exacerbates the lack of guidance for effective intervention strategies. The purpose of this study is to develop and evaluate the psychometric<span> properties of a new scale based on the Theory of Planned Behavior that assesses the level of adherence among </span></span><em>ortho</em>-k wearers.</div></div><div><h3>Methods</h3><div><span><span><span><span><span>This study involved three stages following the STROBE<span> checklist: (1) developing initial scale items based on the </span></span>Theory of Planned Behavior, a </span>literature review<span>, and a qualitative study; (2) evaluation of content and </span></span>face validity; (3) </span>psychometric testing<span> on 296 participants. Item analysis, based on </span></span>Classical Test Theory, assessed the overall consistency, reliability, and validity of the scale.</div></div><div><h3>Results</h3><div>The final 37-item Beliefs about the Orthokeratology Lens<span><span> Compliance Scale (BOLCS) comprises 11 dimensions. The Cronbach's alpha coefficients for each dimension ranged from 0.560 to 0.798. The folded half reliabilities were 0.845, and the combined reliabilities ranged from 0.676 to 0.793, indicating strong reliability. Item-level CVI (I-CVI) and scale-level CVI/average (S-CVI/Ave) values, assessed by the panel, ranged from 0.71 to 1 and 0.954, respectively. Exploratory and </span>confirmatory factor analyses supported a factor structure consistent with the theoretical model.</span></div></div><div><h3>Conclusions</h3><div>The scale's construction adhered to a standardized process, yielding preliminary validation results with satisfactory reliability and validity.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 1","pages":"Article 102186"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clae.2024.102337
Qiong Xu , Yan Li , Xuewei Li , Yue Wen , Tao Tang , Jia Qu , Mingwei Zhao , Kai Wang
Background
To assess the predictive value of pretreatment corneal elevation asymmetry vector (CEAV) for severe orthokeratology (Ortho-k) lens decentration (LD) in Chinese myopic adolescents.
Methods
A retrospective analysis of 247 myopic participants over one year employed a novel MATLAB algorithm to calculate CEAV and precise LD vector. Subjects were categorized into mild (<1 mm) and severe (≥1 mm) yearly averaged LD (YALD) groups. Logistic regression and ROC analysis evaluated the relationship between corneal parameters and severe YALD.
Results
LD reached stability within the first month, with severe YALD compromising visual quality and corneal health. Notably, univariate linear regression revealed a paradoxical correlation between axial length elongation (ALE) and YALD: ALE negatively correlated with YALD in the mild group (standardised β = -0.546, P < 0.05), contrasting with a positive correlation in the severe group (standardised β = 0.599, P < 0.05). Horizontal CEAV (standardised β = − 0.237, < 0.05) and curvature differences between nasal and temporal quadrants at 8 mm (KTN) (standardised β = 0.227, P < 0.01) significantly correlated with horizontal YALD, while vertical CEAV vector associated with vertical YALD (standardised β = − 0.237, < 0.05). Multivariate analysis identified CEAV as an independent predictor of severe YALD (OR = 3.145, 95 % CI: 1.334 ∼ 4.607, P < 0.01). Other risk factors included larger horizontal visible iris diameter (HVID) (OR = 2.430, 95 % CI:0.6136 ∼ 10.07, P < 0.05), corneal astigmatism (CA) (OR = 1.506, 95 % CI: 1.017 ∼ 2.244, P < 0.05), and KTN (OR = 1.864, 95 % CI: 0.934 ∼ 3.864, P < 0.05). CEAV magnitude alone predicted severe YALD with AUC = 0.698 (95 %CI: 0.615–0.783, P < 0.001), improving to AUC = 0.732 (95 % CI: 0.660–0.805, P < 0.001) when combined with other risk factors.
Conclusions
Pretreatment CEAV may emerge as a viable predictor of severe Ortho-k YALD, warranting its consideration in further tailored lens fitting to improve outcomes.
背景：评价预处理角膜高度不对称矢量（CEAV）对中国青少年近视严重角膜塑形术（orthokeratology, orthok）晶状体离体（lens decentralation， LD）的预测价值。方法：对247例1年以上的近视患者进行回顾性分析，采用一种新颖的MATLAB算法计算CEAV和精确LD向量。受试者被分为轻度（结果：LD在第一个月内达到稳定，严重的YALD损害视觉质量和角膜健康）。值得注意的是，单变量线性回归揭示了轴向伸长（ALE）与YALD之间的矛盾相关性：轻度组ALE与YALD呈负相关（标准化β = -0.546, P < 0.05），而重度组ALE与YALD呈正相关（标准化β = 0.599, P < 0.05）。水平CEAV（标准化β = - 0.237, < 0.05）和8 mm （KTN）鼻部和颞部曲率差（标准化β = 0.227, P < 0.01）与水平YALD显著相关，而垂直CEAV矢量与垂直YALD相关（标准化β = - 0.237, < 0.05）。多因素分析证实CEAV是严重YALD的独立预测因子（OR = 3.145, 95% CI: 1.334 ~ 4.607, P < 0.01）。其他危险因素包括较大的水平可见虹膜直径（HVID） （OR = 2.430, 95% CI:0.6136 ~ 10.07, P < 0.05）、角膜散光（CA） （OR = 1.506, 95% CI: 1.017 ~ 2.244, P < 0.05）和KTN （OR = 1.864, 95% CI: 0.934 ~ 3.864, P < 0.05）。单独CEAV大小预测严重YALD的AUC = 0.698 (95% CI: 0.615 ~ 0.783, P < 0.001)，联合其他危险因素预测严重YALD的AUC = 0.732 （95% CI: 0.66 ~ 0.805, P < 0.001）。结论：预处理CEAV可能成为严重的orthok - YALD的可行预测指标，需要在进一步定制晶状体配合术中考虑其以改善预后。
{"title":"Corneal elevation asymmetry vector: Viable predictor of severe one-year-averaged orthokeratology lens decentration","authors":"Qiong Xu , Yan Li , Xuewei Li , Yue Wen , Tao Tang , Jia Qu , Mingwei Zhao , Kai Wang","doi":"10.1016/j.clae.2024.102337","DOIUrl":"10.1016/j.clae.2024.102337","url":null,"abstract":"<div><h3>Background</h3><div>To assess the predictive value of pretreatment corneal elevation asymmetry vector (CEAV) for severe orthokeratology (Ortho-k) lens decentration (LD) in Chinese myopic adolescents.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 247 myopic participants over one year employed a novel MATLAB algorithm to calculate CEAV and precise LD vector. Subjects were categorized into mild (<1 mm) and severe (≥1 mm) yearly averaged LD (YALD) groups. Logistic regression and ROC analysis evaluated the relationship between corneal parameters and severe YALD.</div></div><div><h3>Results</h3><div>LD reached stability within the first month, with severe YALD compromising visual quality and corneal health. Notably, univariate linear regression revealed a paradoxical correlation between axial length elongation (ALE) and YALD: ALE negatively correlated with YALD in the mild group (standardised β = -0.546, P < 0.05), contrasting with a positive correlation in the severe group (standardised β = 0.599, P < 0.05). Horizontal CEAV (standardised β = − 0.237, < 0.05) and curvature differences between nasal and temporal quadrants at 8 mm (K<sub>TN</sub>) (standardised β = 0.227, P < 0.01) significantly correlated with horizontal YALD, while vertical CEAV vector associated with vertical YALD (standardised β = − 0.237, < 0.05). Multivariate analysis identified CEAV as an independent predictor of severe YALD (OR = 3.145, 95 % CI: 1.334 ∼ 4.607, P < 0.01). Other risk factors included larger horizontal visible iris diameter (HVID) (OR = 2.430, 95 % CI:0.6136 ∼ 10.07, P < 0.05), corneal astigmatism (CA) (OR = 1.506, 95 % CI: 1.017 ∼ 2.244, P < 0.05), and K<sub>TN</sub> (OR = 1.864, 95 % CI: 0.934 ∼ 3.864, P < 0.05). CEAV magnitude alone predicted severe YALD with AUC = 0.698 (95 %CI: 0.615–0.783, P < 0.001), improving to AUC = 0.732 (95 % CI: 0.660–0.805, P < 0.001) when combined with other risk factors.</div></div><div><h3>Conclusions</h3><div>Pretreatment CEAV may emerge as a viable predictor of severe Ortho-k YALD, warranting its consideration in further tailored lens fitting to improve outcomes.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 1","pages":"Article 102337"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clae.2024.102289
Ruveyde Bolac, Merve Beyza Yıldız, Oksan Alpogan, Yasemin Un, Mehmet Serhat Mangan
Purpose
To evaluate the conjunctival/episcleral thickness (CET) and anterior scleral thickness (AST) in patients with keratoconus with an extended duration of mini-scleral contact lens wear by utilizing anterior segment optical coherence tomography (ASOCT).
Methods
This study included 17 eyes of 17 patients with keratoconus with mini-scleral contact lens wear (Group 1), 20 eyes of 20 patients with keratoconus without any contact lens wear (Group 2), and 20 eyes of 20 healthy controls (Group 3). CET and AST were measured using AS-OCT (Triton, Topcon, Japan) at 1, 2, and 3 mm posterior to the scleral spur in the nasal, temporal, superior, and inferior quadrants.
Results
The median age of the mini-scleral contact lens group was 26, and the number of male patients was 14 (82.4 %). The superior CET values at 1 mm, 2 mm, and 3 mm statistically differed between the groups, with Group 1 having significantly lower values than Group 3 and Group 2 having statistically similar values to the remaining two groups. The inferior CET at 2 mm was lower in Groups 1 and 2 than in Group 3. The inferior CET at 3 mm was lower in Group 1 compared to Groups 2 and 3.
AST was similar between the groups at all measured quadrants and distances. The duration of lens wear had a strong, statistically significant, negative correlation with the superior CET at 2 mm (rho: −0.847, p < 0.001) and a moderate, statistically significant, negative correlation with the superior CET at 3 mm (rho: −0.506, p < 0.038).
Conclusions
In this study, it was found that mini-scleral contact lens usage causes thinning in the conjunctival-episcleral layer, especially in the superior and inferior quadrants, but does not affect scleral thickness. AS-OCT is a non-invasive and clinically applicable technique for assessing the impact of contact lens use on the conjunctiva/episclera and sclera.
{"title":"The effect of extended periods of mini-scleral lens wear on the conjunctival/episcleral and scleral thickness","authors":"Ruveyde Bolac, Merve Beyza Yıldız, Oksan Alpogan, Yasemin Un, Mehmet Serhat Mangan","doi":"10.1016/j.clae.2024.102289","DOIUrl":"10.1016/j.clae.2024.102289","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the conjunctival/episcleral thickness (CET) and anterior scleral thickness (AST) in patients with keratoconus with an extended duration of mini-scleral contact lens wear by utilizing anterior segment optical coherence tomography (ASOCT).</div></div><div><h3>Methods</h3><div>This study included 17 eyes of 17 patients with keratoconus with mini-scleral contact lens wear (Group 1), 20 eyes of 20 patients with keratoconus without any contact lens wear (Group 2), and 20 eyes of 20 healthy controls (Group 3). CET and AST were measured using AS-OCT (Triton, Topcon, Japan) at 1, 2, and 3 mm posterior to the scleral spur in the nasal, temporal, superior, and inferior quadrants.</div></div><div><h3>Results</h3><div>The median age of the mini-scleral contact lens group was 26, and the number of male patients was 14 (82.4 %). The superior CET values at 1 mm, 2 mm, and 3 mm statistically differed between the groups, with Group 1 having significantly lower values than Group 3 and Group 2 having statistically similar values to the remaining two groups. The inferior CET at 2 mm was lower in Groups 1 and 2 than in Group 3. The inferior CET at 3 mm was lower in Group 1 compared to Groups 2 and 3.</div><div>AST was similar between the groups at all measured quadrants and distances. The duration of lens wear had a strong, statistically significant, negative correlation with the superior CET at 2 mm (rho: −0.847, p < 0.001) and a moderate, statistically significant, negative correlation with the superior CET at 3 mm (rho: −0.506, p < 0.038).</div></div><div><h3>Conclusions</h3><div>In this study, it was found that mini-scleral contact lens usage causes thinning in the conjunctival-episcleral layer, especially in the superior and inferior quadrants, but does not affect scleral thickness. AS-OCT is a non-invasive and clinically applicable technique for assessing the impact of contact lens use on the conjunctiva/episclera and sclera.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 1","pages":"Article 102289"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To evaluate the impact of short-term scleral lens (SL) wear on anterior chamber (AC) dimension and central corneal thickness (CCT) in healthy Chinese people.
Methods
This is a prospective, daily wear study. Eligible participants were dispensed SLs to correct refractive errors. Anterior segment (AS) parameters were measured by AS optical coherence tomography (AS-OCT) before, during, and after 2 and 4 hours of lens wear. Repeated-measures analysis of variance (ANOVA) was used to analyze the changes in AS parameters over time.
Results
Twelve subjects (10 females and 2 males) with a mean age of 25.3 ± 3.8 years (ranging from 21 to 34 years) were recruited. The AC parameters, including anterior chamber depth (ACD) from the endothelium (endo-ACD), angle opening distance at 500 μm (AOD500), and trabecular-iris space area at 500 μm (TISA500), significantly decreased after wearing SLs for 4 hours (P<0.05). CCT increased by 12 μm (2.29 %) after wearing SLs for 4 hours (P=0.013).
Conclusion
This study suggests that SL wear has a significant impact on AS dimensions in patients with healthy corneas in the short term with SL in situ, but tend to recover quickly after SL removal. Further research is needed to determine whether the change in AS dimensions during SL wear affects aqueous humor (AH) outflow and causes changes in intraocular pressure (IOP).
{"title":"Changes in anterior segment after short-term scleral lens wear in healthy Chinese population","authors":"Qianni Jiang , Zhe Zhang , Lingling Niu , Bingjie Wang , Daddi Fadel , Ruihua Wei , Zhi Chen","doi":"10.1016/j.clae.2024.102291","DOIUrl":"10.1016/j.clae.2024.102291","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the impact of short-term scleral lens (SL) wear on anterior chamber (AC) dimension and central corneal thickness (CCT) in healthy Chinese people.</div></div><div><h3>Methods</h3><div>This is a prospective, daily wear study. Eligible participants were dispensed SLs to correct refractive errors. Anterior segment (AS) parameters were measured by AS optical coherence tomography (AS-OCT) before, during, and after 2 and 4 hours of lens wear. Repeated-measures analysis of variance (ANOVA) was used to analyze the changes in AS parameters over time.</div></div><div><h3>Results</h3><div>Twelve subjects (10 females and 2 males) with a mean age of 25.3 ± 3.8 years (ranging from 21 to 34 years) were recruited. The AC parameters, including anterior chamber depth (ACD) from the endothelium (<em>endo</em>-ACD), angle opening distance at 500 μm (AOD500), and trabecular-iris space area at 500 μm (TISA500), significantly decreased after wearing SLs for 4 hours (P<0.05). CCT increased by 12 μm (2.29 %) after wearing SLs for 4 hours (P=0.013).</div></div><div><h3>Conclusion</h3><div>This study suggests that SL wear has a significant impact on AS dimensions in patients with healthy corneas in the short term with SL in situ, but tend to recover quickly after SL removal. Further research is needed to determine whether the change in AS dimensions during SL wear affects aqueous humor (AH) outflow and causes changes in intraocular pressure (IOP).</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 1","pages":"Article 102291"},"PeriodicalIF":4.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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