Asia-Pacific Journal of Ophthalmology最新文献_第3页

Associations of optic nerve head morphology and peripapillary retinal nerve fibre layer thickness with myopic severity and treatment in children 儿童视神经头形态和毛周视网膜神经纤维层厚度与近视严重程度和治疗的关系

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2024-11-01 DOI: 10.1016/j.apjo.2024.100112

Bryan Sim , Rachel S. Chong , Hla Myint Htoon , Maithily Balakrishnan , Noel A. Brennan , Audrey Chia

Purpose

This study aimed to investigate the longitudinal associations between myopic optic disc features and optical coherence tomography (OCT) measurements of peripapillary retinal nerve fibre layer (RNFL) thickness in young myopic children in Singapore.

Methods

A prospective, single-site cohort study was conducted, involving children aged 7–16 years who participated in the PROM-Kids clinical cohort study from 2019 to 2022. Participants underwent annual assessments, including cycloplegic refraction, axial length measurements, fundus photography, and OCT imaging, with ocular magnification correction. Children were classified into low (LM, 0 to −3D), moderate (MM, −3.01 to −6D), and high (HM, > −6D) myopia, with or without treatment.

Results

Data from 1000 children (right eye) were analyzed, including 521 with 2-year follow-up. At baseline, the mean age was 10.2 ± 1.6 years, with 46.4 % male and 90.7 % ethnic Chinese. HM children were older and exhibited greater optic disc tilt (ODT, 92 % vs. 80 %) and more peripapillary atrophy (PPA, 94 % vs. 73 %) compared to LM children. RNFL thickness decreased in the superior, inferior, and nasal quadrants but increased in the temporal quadrant with higher myopia. In the follow-up cohort, myopia progression was associated with thicker temporal quadrant and average RNFL, particularly in younger children. Prior treatment with myopia-control lenses was also associated with increased RNFL thickness in the superior quadrant.

Conclusion

Optic disc changes occur early in life, even in low myopia. Increasing myopia is linked to varying RNFL thickness across quadrants and may be influenced by age and myopia treatment.

目的：本研究旨在调查新加坡青少年近视儿童的近视视盘特征与光学相干断层扫描（OCT）测量的毛细血管周围视网膜神经纤维层（RNFL）厚度之间的纵向关联：我们开展了一项前瞻性、单点队列研究，研究对象是2019年至2022年参加PROM-Kids临床队列研究的7至16岁儿童。参与者每年接受一次评估，包括屈光度数、轴向长度测量、眼底照相和 OCT 成像，并进行眼球放大校正。儿童被分为低度（LM，0 至 -3D）、中度（MM，-3.01 至 -6D）和高度（HM，> -6D）近视，无论是否接受治疗：分析了 1,000 名儿童（右眼）的数据，其中 521 名儿童接受了为期 2 年的随访。基线平均年龄为（10.2 ± 1.6）岁，46.4%为男性，90.7%为中国人。与LM儿童相比，HM儿童年龄更大，视盘倾斜度（ODT，92%对80%）更大，毛细血管周围萎缩（PPA，94%对73%）更多。近视度数越高，上象限、下象限和鼻象限的 RNFL 厚度越低，而颞象限的 RNFL 厚度则越高。在随访队列中，近视度数加深与颞象限和平均 RNFL 变厚有关，尤其是年龄较小的儿童。曾接受近视控制镜片治疗也与上象限RNFL厚度增加有关：结论：即使是低度近视，视盘也会在生命早期发生变化。近视度数的增加与不同象限的 RNFL 厚度有关，并可能受到年龄和近视治疗的影响。

{"title":"Associations of optic nerve head morphology and peripapillary retinal nerve fibre layer thickness with myopic severity and treatment in children","authors":"Bryan Sim , Rachel S. Chong , Hla Myint Htoon , Maithily Balakrishnan , Noel A. Brennan , Audrey Chia","doi":"10.1016/j.apjo.2024.100112","DOIUrl":"10.1016/j.apjo.2024.100112","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to investigate the longitudinal associations between myopic optic disc features and optical coherence tomography (OCT) measurements of peripapillary retinal nerve fibre layer (RNFL) thickness in young myopic children in Singapore.</div></div><div><h3>Methods</h3><div>A prospective, single-site cohort study was conducted, involving children aged 7–16 years who participated in the PROM-Kids clinical cohort study from 2019 to 2022. Participants underwent annual assessments, including cycloplegic refraction, axial length measurements, fundus photography, and OCT imaging, with ocular magnification correction. Children were classified into low (LM, 0 to −3D), moderate (MM, −3.01 to −6D), and high (HM, > −6D) myopia, with or without treatment.</div></div><div><h3>Results</h3><div>Data from 1000 children (right eye) were analyzed, including 521 with 2-year follow-up. At baseline, the mean age was 10.2 ± 1.6 years, with 46.4 % male and 90.7 % ethnic Chinese. HM children were older and exhibited greater optic disc tilt (ODT, 92 % vs. 80 %) and more peripapillary atrophy (PPA, 94 % vs. 73 %) compared to LM children. RNFL thickness decreased in the superior, inferior, and nasal quadrants but increased in the temporal quadrant with higher myopia. In the follow-up cohort, myopia progression was associated with thicker temporal quadrant and average RNFL, particularly in younger children. Prior treatment with myopia-control lenses was also associated with increased RNFL thickness in the superior quadrant.</div></div><div><h3>Conclusion</h3><div>Optic disc changes occur early in life, even in low myopia. Increasing myopia is linked to varying RNFL thickness across quadrants and may be influenced by age and myopia treatment.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"13 6","pages":"Article 100112"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715104","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}

引用次数: 0

Bilateral Coats’ disease in a 5-year-old boy 1例5岁男童双侧科茨病。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2024-11-01 DOI: 10.1016/j.apjo.2024.100119

Meng-Chen Chiang , Shawn H. Tsai , Nan-Kai Wang , Yung-Jen Lai

引用次数: 0

Ophthalmology training trends: Insights from an anonymised survey of Australian ophthalmology trainees 眼科培训趋势：来自澳大利亚眼科学员匿名调查的见解。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2024-11-01 DOI: 10.1016/j.apjo.2024.100120

William B. Yates, Adrian T. Fung, Clare Fraser, Robert Griffits, Anne Lee, Peter J. McCluskey

引用次数: 0

Challenges in myopia management and prevention: A call to action 近视管理和预防面临的挑战：行动呼吁。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2024-11-01 DOI: 10.1016/j.apjo.2024.100111

Enne Hiu Ying Leung, Sun Li, Lizhen Chen, Dennis Shun Chiu Lam

引用次数: 0

Is there an impending epidemic of myopia in Southeast Asia? An appraisal of the evidence 东南亚近视流行在即吗？证据的评估。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2024-11-01 DOI: 10.1016/j.apjo.2024.100113

Ian George Morgan

Predictions on the future prevalence of myopia suggest one of the Global Burden of Disease regions will develop an epidemic like in East Asia and Singapore in Southeast Asia. This paper analyses the available evidence on prevalence of myopia in this region, concluding that the bulk of the evidence suggests that the prevalence of myopia at the end of schooling is still modest, although two papers suggest that in young adults in Thailand and Indonesia, the prevalence of myopia may be approaching levels typical of the epidemic of myopia. It also analyses an indicator of expected years of education at school entry, as well as current educational levels of adults, using data from the calculation of the UN Human Development Index. It then analyses the results obtained by the countries of the Southeast Asian region in the PISA international surveys of student achievement. Neither of these educational indicators suggests an impending epidemic of myopia. There is a need for more data to clarify this uncertainty. It is suggested that future collection of data concentrate on determining the prevalence of myopia in young adults finishing their schooling. Even methodology as simple as determining levels of lowered visual acuity in senior school students should be sufficient to resolve the uncertainty. This group provides a sound basis for the prediction of future levels of myopia in the adult population, and avoids the impact of the high levels of myopia and high myopia associated with cataract development that occur in much of Southeast Asia.

对未来近视发病率的预测表明，全球疾病负担地区之一将像东亚和东南亚的新加坡那样发展成流行病。本文分析了该地区近视患病率的现有证据，得出结论认为，大部分证据表明，在学校结束时，近视患病率仍然不高，尽管有两篇论文表明，在泰国和印度尼西亚的年轻人中，近视患病率可能接近近视流行的典型水平。它还利用联合国人类发展指数的计算数据，分析了一项关于入学时预期受教育年限的指标，以及成年人目前的教育水平。然后分析了东南亚地区国家在PISA国际学生成绩调查中获得的结果。这些教育指标都没有表明近视即将流行。需要更多的数据来澄清这种不确定性。建议未来的数据收集集中在确定完成学业的年轻人近视的患病率上。即使是像确定高中学生视力下降水平这样简单的方法，也应该足以解决这种不确定性。这一群体为预测未来成人近视水平提供了良好的基础，并避免了东南亚大部分地区发生的高度近视和与白内障发展相关的高度近视的影响。

{"title":"Is there an impending epidemic of myopia in Southeast Asia? An appraisal of the evidence","authors":"Ian George Morgan","doi":"10.1016/j.apjo.2024.100113","DOIUrl":"10.1016/j.apjo.2024.100113","url":null,"abstract":"<div><div>Predictions on the future prevalence of myopia suggest one of the Global Burden of Disease regions will develop an epidemic like in East Asia and Singapore in Southeast Asia. This paper analyses the available evidence on prevalence of myopia in this region, concluding that the bulk of the evidence suggests that the prevalence of myopia at the end of schooling is still modest, although two papers suggest that in young adults in Thailand and Indonesia, the prevalence of myopia may be approaching levels typical of the epidemic of myopia. It also analyses an indicator of expected years of education at school entry, as well as current educational levels of adults, using data from the calculation of the UN Human Development Index. It then analyses the results obtained by the countries of the Southeast Asian region in the PISA international surveys of student achievement. Neither of these educational indicators suggests an impending epidemic of myopia. There is a need for more data to clarify this uncertainty. It is suggested that future collection of data concentrate on determining the prevalence of myopia in young adults finishing their schooling. Even methodology as simple as determining levels of lowered visual acuity in senior school students should be sufficient to resolve the uncertainty. This group provides a sound basis for the prediction of future levels of myopia in the adult population, and avoids the impact of the high levels of myopia and high myopia associated with cataract development that occur in much of Southeast Asia.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"13 6","pages":"Article 100113"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779156","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}

引用次数: 0

Differences in anterior ocular biometric characteristics among 6-year-old children with different myopic shift rates: A 2-year longitudinal study 不同近视移位率的6岁儿童前眼生物特征的差异：一项2年的纵向研究。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2024-11-01 DOI: 10.1016/j.apjo.2024.100116

Yu Zhao , Yuhao Ye , Jingbin Geng , Jiayi Zhang , Zhe Zhang , Yiyong Xian , Yangyi Huang , Fang Liu , Ye Xu , Xingtao Zhou

Background

To investigate longitudinal changes in anterior ocular features during slow and fast myopic shift in 6-year-old children.

Methods

In total, 242 eyes of first-year primary school children in Shanghai, China, were included in this study. All children underwent an initial examination and were subsequently followed-up for two years. All participants underwent comprehensive examinations, including ocular biometric assessment and cycloplegic autorefraction. Children were divided into two groups based on the degree of myopic shift in 2 years: group A (slow myopic shift, < 1.0 D, N = 145) and group B (fast myopic shift, > 1.0 D, N = 88). Detailed anterior ocular biometric data were compared between the two groups.

Results

In both groups, the axial length and anterior chamber depth (ACD) increased significantly over the follow-up period (P < 0.001). Anterior corneal surface curvature showed a flattening trend in both flat and steep meridians in group A, while these parameters exhibited steepening changes in group B. Lens thickness (LT) decreased significantly from 3.60 ± 0.20 mm to 3.45 ± 0.17 mm in group B (P < 0.001), but not in group A (P = 0.387). The average lens tilt significantly decreased from 5.21 ± 1.26° to 4.95 ± 1.23° in group A (P = 0.043), but it exhibited no significant change in group B (P = 0.181). Furthermore, LT and ACD were significantly correlated with spherical equivalent changes (P < 0.01).

Conclusions

Children with slow and fast myopic shift demonstrated comparable ACD deepening changes but showed distinct variations in corneal curvature and lens characteristics.

背景：探讨6岁儿童慢速和快速近视眼移位时眼前特征的纵向变化。方法：以上海市小学一年级儿童242只眼为研究对象。所有儿童都接受了初步检查，随后随访两年。所有参与者都进行了全面的检查，包括眼部生物特征评估和睫状体麻痹性自屈光。根据2年内近视移位程度分为两组：A组（慢速近视移位，< 1.0 D, N = 145）和B组（快速近视移位，< 1.0 D, N = 88）。比较两组患者详细的眼前生物特征数据。结果：两组患者的轴长和前房深度（ACD）在随访期间均显著增加（P < 0.001）。a组和B组的角膜前表面曲率均呈扁平化趋势，B组的晶状体厚度由3.60±0.20mm下降至3.45±0.17mm (P < 0.001)， a组无明显差异（P = 0.387）。A组平均晶状体倾斜度由5.21±1.26°降至4.95±1.23°（P = 0.043），而B组无显著变化（P = 0.181）。此外，LT和ACD与球当量变化呈极显著相关（P < 0.01）。结论：慢速和快速近视眼患儿的ACD加深变化具有可比性，但角膜曲率和晶状体特征存在明显差异。

{"title":"Differences in anterior ocular biometric characteristics among 6-year-old children with different myopic shift rates: A 2-year longitudinal study","authors":"Yu Zhao , Yuhao Ye , Jingbin Geng , Jiayi Zhang , Zhe Zhang , Yiyong Xian , Yangyi Huang , Fang Liu , Ye Xu , Xingtao Zhou","doi":"10.1016/j.apjo.2024.100116","DOIUrl":"10.1016/j.apjo.2024.100116","url":null,"abstract":"<div><h3>Background</h3><div>To investigate longitudinal changes in anterior ocular features during slow and fast myopic shift in 6-year-old children.</div></div><div><h3>Methods</h3><div>In total, 242 eyes of first-year primary school children in Shanghai, China, were included in this study. All children underwent an initial examination and were subsequently followed-up for two years. All participants underwent comprehensive examinations, including ocular biometric assessment and cycloplegic autorefraction. Children were divided into two groups based on the degree of myopic shift in 2 years: group A (slow myopic shift, < 1.0 D, N = 145) and group B (fast myopic shift, > 1.0 D, N = 88). Detailed anterior ocular biometric data were compared between the two groups.</div></div><div><h3>Results</h3><div>In both groups, the axial length and anterior chamber depth (ACD) increased significantly over the follow-up period (<em>P</em> < 0.001). Anterior corneal surface curvature showed a flattening trend in both flat and steep meridians in group A, while these parameters exhibited steepening changes in group B. Lens thickness (LT) decreased significantly from 3.60 ± 0.20 mm to 3.45 ± 0.17 mm in group B (<em>P</em> < 0.001), but not in group A (<em>P</em> = 0.387). The average lens tilt significantly decreased from 5.21 ± 1.26° to 4.95 ± 1.23° in group A (P = 0.043), but it exhibited no significant change in group B (<em>P</em> = 0.181). Furthermore, LT and ACD were significantly correlated with spherical equivalent changes (<em>P</em> < 0.01).</div></div><div><h3>Conclusions</h3><div>Children with slow and fast myopic shift demonstrated comparable ACD deepening changes but showed distinct variations in corneal curvature and lens characteristics.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"13 6","pages":"Article 100116"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816823","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}

引用次数: 0

Safety of repeated low-level red-light therapy for myopia: A systematic review 重复低强度红光疗法治疗近视的安全性：系统回顾。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2024-11-01 DOI: 10.1016/j.apjo.2024.100124

Yanping Chen , Ruilin Xiong , Shaopeng Yang , Ziyu Zhu , Huangdong Li , Kaidi Xiang , Nathan Congdon , Wei Wang , Mingguang He

Purpose

Establishing the safety profile of repeated low-level red-light (RLRL) therapy is necessary prior to its widespread clinical implementation.

Methods

We conducted a systematic review (International Prospective Register of Systematic Reviews, CRD42024516676) of articles across seven databases from inception through February 10, 2024, with keywords related to myopia and RLRL therapy. Pooled safety outcomes and risk-to-benefit ratios were reported, and incidence of side effects was compared with other antimyopia interventions.

Results

Among 689 screened articles, 20 studies (2.90 %; median duration 9 months, longest 24 months) were analysed, encompassing 2380 participants aged 3–18 years and 1436 individuals undergoing RLRL therapy. Two case reports described an identical patient with reversible decline in visual acuity and optical coherence tomography (OCT) abnormalities, completely resolved 4 months after treatment cessation. No cases of permanent vision loss were reported. Temporary afterimage was the most common ocular symptom following treatment, resolving within 6 minutes in reported studies. The number needed to harm outweighed the number needed to treat by a ratio of 12.7–21.4 for a person with –3D to –8D myopia treated with RLRL therapy. Incidence of side effects from RLRL was 0.088 per 100 patient-years (95 % confidence interval, 0.02–0.50).

Conclusions

No irreversible visual function loss or ocular structural damage was identified with RLRL. Fundus photography and OCT before and during therapy, alongside home monitoring of visual acuity and duration of afterimages, are necessary to identify side effects. Further adequately powered studies of longer duration are needed to evaluate long-term safety of RLRL.

目的：在临床广泛应用前，有必要建立重复低水平红灯（RLRL）治疗的安全性。方法：我们对7个数据库从成立到2024年2月10日的文章进行了系统评价（国际前瞻性系统评价注册表，CRD42024516676），关键词为近视和RLRL治疗。报告了综合安全结果和风险收益比，并比较了其他抗近视干预措施的副作用发生率。结果：689篇筛选文献中，20篇研究(2.90%；中位持续时间9个月，最长24个月)，包括2380名3至18岁的参与者和1436名接受RLRL治疗的个体。两例病例报告描述了同一例患者的可逆性视力下降和光学相干断层扫描（OCT）异常，在停止治疗4个月后完全消退。无永久性视力丧失病例报告。暂时性后像是治疗后最常见的眼部症状，在报道的研究中，在6分钟内消失。对于接受RLRL治疗的-3D至-8D近视患者，伤害所需的数量比治疗所需的数量多12.7比21.4。RLRL的副作用发生率为0.088 / 100患者年（95%可信区间，0.02-0.50）。结论：无不可逆性视功能丧失或眼结构损伤。治疗前和治疗期间眼底摄影和OCT，以及家庭视力监测和后像持续时间，是识别副作用的必要条件。评估RLRL的长期安全性需要进一步的、有充分证据的、持续时间更长的研究。

{"title":"Safety of repeated low-level red-light therapy for myopia: A systematic review","authors":"Yanping Chen , Ruilin Xiong , Shaopeng Yang , Ziyu Zhu , Huangdong Li , Kaidi Xiang , Nathan Congdon , Wei Wang , Mingguang He","doi":"10.1016/j.apjo.2024.100124","DOIUrl":"10.1016/j.apjo.2024.100124","url":null,"abstract":"<div><h3>Purpose</h3><div>Establishing the safety profile of repeated low-level red-light (RLRL) therapy is necessary prior to its widespread clinical implementation.</div></div><div><h3>Methods</h3><div>We conducted a systematic review (International Prospective Register of Systematic Reviews, CRD42024516676) of articles across seven databases from inception through February 10, 2024, with keywords related to myopia and RLRL therapy. Pooled safety outcomes and risk-to-benefit ratios were reported, and incidence of side effects was compared with other antimyopia interventions.</div></div><div><h3>Results</h3><div>Among 689 screened articles, 20 studies (2.90 %; median duration 9 months, longest 24 months) were analysed, encompassing 2380 participants aged 3–18 years and 1436 individuals undergoing RLRL therapy. Two case reports described an identical patient with reversible decline in visual acuity and optical coherence tomography (OCT) abnormalities, completely resolved 4 months after treatment cessation. No cases of permanent vision loss were reported. Temporary afterimage was the most common ocular symptom following treatment, resolving within 6 minutes in reported studies. The number needed to harm outweighed the number needed to treat by a ratio of 12.7–21.4 for a person with –3D to –8D myopia treated with RLRL therapy. Incidence of side effects from RLRL was 0.088 per 100 patient-years (95 % confidence interval, 0.02–0.50).</div></div><div><h3>Conclusions</h3><div>No irreversible visual function loss or ocular structural damage was identified with RLRL. Fundus photography and OCT before and during therapy, alongside home monitoring of visual acuity and duration of afterimages, are necessary to identify side effects. Further adequately powered studies of longer duration are needed to evaluate long-term safety of RLRL.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"13 6","pages":"Article 100124"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821855","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}

引用次数: 0

Effect of school entrance age on myopia among primary schoolchildren using mixed-effect model: The Shantou Myopia Study (SMS) 入学年龄对小学生近视的影响——基于混合效应模型的汕头近视研究

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2024-11-01 DOI: 10.1016/j.apjo.2024.100121

Hongxi Wang , Linrong Wu , Yuancun Li , Xin Tan , Jianwei Lin , Kunliang Qiu , Yali Du , Shengjie Yin , Binyao Chen , Jiao Jiang , Hailiu Chen , Mingzhi Zhang

Purpose

To investigate the association between children's school entrance age and refractive status and prevalence of myopia in southern China.

Methods

Population-based Cross-sectional study was conducted from September 2020 to June 2021 in Shantou, southern China, enrolling primary schoolchildren in the city. The school entrance age was calculated as the months from the birth date to the entrance date, divided by 12. Non-cycloplegic refraction and uncorrected visual acuity test were conducted. Myopia was defined as spherical equivalent refraction (SER) < -0.50D with an uncorrected distant visual acuity < Snellen 20/20. We explored the association between the SER and the school entrance age, with the clustering effect within schools adjusted by the linear mixed-model.

Results

We enrolled 410,080 primary schoolchildren, with a mean age of 9.8 ± 1.6 years. The overall prevalence of myopia was 42.04 %. The mean SER of myopic children was − 2.15 ± 1.70 D. The mixed-effects model revealed a significant correlation between the school entrance age and the SER and the prevalence of myopia. One year later for school entrance age would independently result in a less myopic SER of 0.352 D, and significantly decrease the prevalence of myopia. Children born before September 1st had significantly more myopic SER than those born after September 1st.

Conclusions

Early school entrance, rather than age or prolonged exposure to schooling, was an independent risk factor for myopia. It is important to put forward some scientific and effective measures, preventing children from early exposure to task-heavy school life and near work.

目的：探讨中国南方地区儿童入学年龄与屈光状态和近视患病率的关系。方法：于2020年9月至2021年6月在中国南方汕头市开展基于人群的横断面研究，招募该市小学生。入学年龄的计算方法是：从出生日期到入学日期的月份除以12。进行非睫状体麻痹性屈光和未矫正视力测试。近视定义为球面等效屈光度(SER) < -0.50D，未矫正的远视灵敏度< Snellen 20/20。我们探索了SER与入学年龄之间的关系，并通过线性混合模型调整了学校内的聚类效应。结果：共纳入小学生410080人，平均年龄9.8±1.6岁。总体近视患病率为42.04%。近视儿童的平均SER为-2.15±1.70 d，混合效应模型显示入学年龄、SER与近视发生率有显著相关。入学年龄晚一年独立导致近视SER降低0.352 D，并显著降低近视发生率。9月1日前出生的儿童近视SER显著高于9月1日后出生的儿童。结论：早期入学是近视的独立危险因素，而不是年龄或长期受教育。重要的是要提出一些科学有效的措施，防止儿童过早接触繁重的学校生活和近距离的工作。

{"title":"Effect of school entrance age on myopia among primary schoolchildren using mixed-effect model: The Shantou Myopia Study (SMS)","authors":"Hongxi Wang , Linrong Wu , Yuancun Li , Xin Tan , Jianwei Lin , Kunliang Qiu , Yali Du , Shengjie Yin , Binyao Chen , Jiao Jiang , Hailiu Chen , Mingzhi Zhang","doi":"10.1016/j.apjo.2024.100121","DOIUrl":"10.1016/j.apjo.2024.100121","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the association between children's school entrance age and refractive status and prevalence of myopia in southern China.</div></div><div><h3>Methods</h3><div>Population-based Cross-sectional study was conducted from September 2020 to June 2021 in Shantou, southern China, enrolling primary schoolchildren in the city. The school entrance age was calculated as the months from the birth date to the entrance date, divided by 12. Non-cycloplegic refraction and uncorrected visual acuity test were conducted. Myopia was defined as spherical equivalent refraction (SER) < -0.50D with an uncorrected distant visual acuity < Snellen 20/20. We explored the association between the SER and the school entrance age, with the clustering effect within schools adjusted by the linear mixed-model.</div></div><div><h3>Results</h3><div>We enrolled 410,080 primary schoolchildren, with a mean age of 9.8 ± 1.6 years. The overall prevalence of myopia was 42.04 %. The mean SER of myopic children was − 2.15 ± 1.70 D. The mixed-effects model revealed a significant correlation between the school entrance age and the SER and the prevalence of myopia. One year later for school entrance age would independently result in a less myopic SER of 0.352 D, and significantly decrease the prevalence of myopia. Children born before September 1st had significantly more myopic SER than those born after September 1st.</div></div><div><h3>Conclusions</h3><div>Early school entrance, rather than age or prolonged exposure to schooling, was an independent risk factor for myopia. It is important to put forward some scientific and effective measures, preventing children from early exposure to task-heavy school life and near work.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"13 6","pages":"Article 100121"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791013","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}

引用次数: 0

The concept of cone opponency may extend beyond accommodation, to myopiagenesis and emmetropization, for a better peripheral defocus lens 视锥对立的概念可以从调节延伸到近视形成和正视化，以获得更好的外周离焦透镜。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2024-11-01 DOI: 10.1016/j.apjo.2024.100125

Edward S.F. Liu , Mary Kim Elizabeth Tan Cudia , Graham K.Y. Wong , Chung-Nga Ko , Dennis S.C. Lam

Myopia has ever-rising prevalence in the past few decades globally. Its pathogenesis is still not adequately elucidated especially at the signal transduction level. For the environmental risk factors, there is a large body of fragmented knowledge about the visual inputs for accommodation, myopiagenesis and emmetropization, with the latter two being essentially local processes. The red-green and yellow-blue chromatic pathways, together with the underlying L–M and S–(L+M) cone opponency, seem to be the common denominator amongst them. In this review, experimental and observational evidence are summarized to delineate the interplay of them. This review may establish the pivotal role of longitudinal chromatic aberration (LCA) for a mechanistic approach to future research in myopia control. This review looks into the mechanistic processes underlying myopiagenesis and emmetropization, specifically focusing on chromatic aberration and cone opponency in vision as pivotal components. The roles of longitudinal chromatic aberration (LCA) and cone contrast in myopia onset and development are intriguing. How visual input and chromatic pathways (specifically, red-green and blue-yellow cone opponency) contribute to accommodation that may trigger emmetropization mechanisms, thereby influencing eye growth patterns are explored and discussed. In brief, this manuscript delves into the physiology of visual processing and highlights a foundational aspect of visual science that may account for a “Go” or “Stop” signaling in axial eye growth. It further proposes a metric to gauge myopia-inhibiting optical devices such as the peripheral defocus lenses, for its best iteration. Future research in the above-mentioned areas is warranted.

在过去的几十年里，近视在全球范围内的发病率不断上升。其发病机制仍未充分阐明，特别是在信号转导水平。对于环境风险因素，关于适应、近视发生和都市化的视觉输入有大量的碎片化知识，后两者本质上是局部过程。红绿和黄蓝的颜色路径，以及潜在的L-M和S-(L+M)视锥对立，似乎是它们之间的共同点。在这篇综述中，总结了实验和观测证据来描述它们之间的相互作用。本文综述了纵向色差（LCA）在近视控制中的关键作用，为今后的研究提供了一种机制途径。本文综述了近视发生和正视化的机制过程，特别关注视觉中的色差和视锥对立作为关键成分。纵向色差（LCA）和视锥对比在近视发生和发展中的作用令人感兴趣。探索和讨论了视觉输入和色彩通路（特别是红绿和蓝黄视锥对立）如何促进可能触发正视化机制的调节，从而影响眼睛的生长模式。简而言之，本文深入研究了视觉处理的生理学，并强调了视觉科学的一个基础方面，这可能解释了轴眼生长中的“走”或“停”信号。它进一步提出了一种度量标准来衡量近视抑制光学设备，如外围离焦透镜，以获得最佳迭代。今后在上述领域的研究是有必要的。

{"title":"The concept of cone opponency may extend beyond accommodation, to myopiagenesis and emmetropization, for a better peripheral defocus lens","authors":"Edward S.F. Liu , Mary Kim Elizabeth Tan Cudia , Graham K.Y. Wong , Chung-Nga Ko , Dennis S.C. Lam","doi":"10.1016/j.apjo.2024.100125","DOIUrl":"10.1016/j.apjo.2024.100125","url":null,"abstract":"<div><div>Myopia has ever-rising prevalence in the past few decades globally. Its pathogenesis is still not adequately elucidated especially at the signal transduction level. For the environmental risk factors, there is a large body of fragmented knowledge about the visual inputs for accommodation, myopiagenesis and emmetropization, with the latter two being essentially local processes. The red-green and yellow-blue chromatic pathways, together with the underlying L–M and S–(L+M) cone opponency, seem to be the common denominator amongst them. In this review, experimental and observational evidence are summarized to delineate the interplay of them. This review may establish the pivotal role of longitudinal chromatic aberration (LCA) for a mechanistic approach to future research in myopia control. This review looks into the mechanistic processes underlying myopiagenesis and emmetropization, specifically focusing on chromatic aberration and cone opponency in vision as pivotal components. The roles of longitudinal chromatic aberration (LCA) and cone contrast in myopia onset and development are intriguing. How visual input and chromatic pathways (specifically, red-green and blue-yellow cone opponency) contribute to accommodation that may trigger emmetropization mechanisms, thereby influencing eye growth patterns are explored and discussed. In brief, this manuscript delves into the physiology of visual processing and highlights a foundational aspect of visual science that may account for a “Go” or “Stop” signaling in axial eye growth. It further proposes a metric to gauge myopia-inhibiting optical devices such as the peripheral defocus lenses, for its best iteration. Future research in the above-mentioned areas is warranted.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"13 6","pages":"Article 100125"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812099","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}

引用次数: 0

Visualization of the scleral structure changes at various stages of eyes with myopic maculopathy using polarization-sensitive OCT 利用偏光敏感OCT观察近视黄斑病变不同阶段的巩膜结构变化。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Asia-Pacific Journal of Ophthalmology

Pub Date : 2024-11-01 DOI: 10.1016/j.apjo.2024.100117

Keigo Sugisawa , Hiroyuki Takahashi , Masahiro Yamanari , Michiaki Okamoto , Tae Igarashi-Yokoi , Takeshi Azuma , Takayuki Miki , Hongshuang Lu , Yijin Wu , Jianping Xiong , Kyoko Ohno-Matsui

Purpose

To observe the detailed structures of the inner and outer sclera at various stages of myopic maculopathy using polarization-sensitive optical coherence tomography (PS-OCT).

Methods

A PS-OCT system was developed for imaging the posterior eye using a swept laser. Data from highly myopic patients who underwent PS-OCT examination between May and June 2019 were used to generate birefringence images (showing scleral fiber density), optic axis images (visualizing the orientation of scleral fibers), and streamline images (providing 3D reconstructions to visualize scleral fiber stream).

Results

A total of 89 eyes of 65 patients with high myopia were examined and analyzed for this study. The mean axial length was 30.4 ± 1.8 mm. In highly myopic eyes with a thin choroid, PS-OCT visualized the detailed structure of the sclera, and the optic axis images differentiated the direction of the inner and outer scleral fibers. In the optic axis and streamline images, the inner layer of the sclera contained radial fibers extending from the optic disc. In contrast, the outer layer of the sclera contained vertical fibers. With the progression of myopia, highly birefringent fibers first disappear in the inner scleral layer, followed by thinning of the inner layer itself. Subsequently, in the outer scleral layer, the number of highly birefringent fibers decreased. As myopic maculopathy worsened, the inner and outer layers of the sclera disintegrated.

Conclusions

PS-OCT is useful for observing the structures of the inner and outer sclera in various conditions of myopic maculopathy.

目的：应用偏振敏感光学相干断层扫描（PS-OCT）观察不同阶段近视黄斑病变的内、外巩膜的详细结构。方法：采用扫描激光对后眼进行PS-OCT成像。2019年5月至6月期间接受PS-OCT检查的高度近视患者的数据用于生成双折射图像（显示巩膜纤维密度）、光轴图像（可视化巩膜纤维方向）和流线图像（提供3D重建以可视化巩膜纤维流）。结果：本研究共对65例高度近视患者89只眼进行检查和分析。平均轴长30.4±1.8mm。在巩膜薄的高度近视眼，PS-OCT显示了巩膜的详细结构，光轴图像区分了巩膜内外纤维的方向。在视轴和流线图像中，巩膜内层包含从视盘延伸出来的径向纤维。相反，巩膜外层含有垂直纤维。随着近视的发展，高度双折射纤维首先在巩膜内层消失，然后内层本身变薄。随后，在巩膜外层，高双折射纤维的数量减少。随着近视黄斑病变的恶化，巩膜内层和外层发生崩解。结论：PS-OCT可用于观察各种近视黄斑病变的内、外巩膜结构。

{"title":"Visualization of the scleral structure changes at various stages of eyes with myopic maculopathy using polarization-sensitive OCT","authors":"Keigo Sugisawa , Hiroyuki Takahashi , Masahiro Yamanari , Michiaki Okamoto , Tae Igarashi-Yokoi , Takeshi Azuma , Takayuki Miki , Hongshuang Lu , Yijin Wu , Jianping Xiong , Kyoko Ohno-Matsui","doi":"10.1016/j.apjo.2024.100117","DOIUrl":"10.1016/j.apjo.2024.100117","url":null,"abstract":"<div><h3>Purpose</h3><div>To observe the detailed structures of the inner and outer sclera at various stages of myopic maculopathy using polarization-sensitive optical coherence tomography (PS-OCT).</div></div><div><h3>Methods</h3><div>A PS-OCT system was developed for imaging the posterior eye using a swept laser. Data from highly myopic patients who underwent PS-OCT examination between May and June 2019 were used to generate birefringence images (showing scleral fiber density), optic axis images (visualizing the orientation of scleral fibers), and streamline images (providing 3D reconstructions to visualize scleral fiber stream).</div></div><div><h3>Results</h3><div>A total of 89 eyes of 65 patients with high myopia were examined and analyzed for this study. The mean axial length was 30.4 ± 1.8 mm. In highly myopic eyes with a thin choroid, PS-OCT visualized the detailed structure of the sclera, and the optic axis images differentiated the direction of the inner and outer scleral fibers. In the optic axis and streamline images, the inner layer of the sclera contained radial fibers extending from the optic disc. In contrast, the outer layer of the sclera contained vertical fibers. With the progression of myopia, highly birefringent fibers first disappear in the inner scleral layer, followed by thinning of the inner layer itself. Subsequently, in the outer scleral layer, the number of highly birefringent fibers decreased. As myopic maculopathy worsened, the inner and outer layers of the sclera disintegrated.</div></div><div><h3>Conclusions</h3><div>PS-OCT is useful for observing the structures of the inner and outer sclera in various conditions of myopic maculopathy.</div></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":"13 6","pages":"Article 100117"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791017","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}

引用次数: 0