Long -term effects of optical defocus on eye growth and refractogenesis

Elena Tarutta, Narine Khodzhabekyan, Oksana Filinova, Sergei Milash, Galina Kruzhkova

Abstract


Introduction: The aim of this paper was to study the effect of binocular and alternating monocular myopic constant defocus prescribed in spectacle format on myopia onset and progression in children.

Material and methods: 129 children aged 5–12 years were divided into 4 groups: 48 children aged 5–8 years (1ƗƘ group) with emmetropia and risk factors of myopia development were prescribed the continuous wearing of plus lenses to induce myopia of 1.0 D. 46 children aged 7–11 years (2ⁿƈ group) with low myopia from −0.75 to −2.25 D were prescribed 2 pairs of spectacles for alternating continuous wearing. One eye was corrected for distance to obtain residual myopia in spectacles of about 0.50 D, and the fellow eye was corrected to obtain residual or induced myopia of about 1.50 D. The children changed spectacles every day. Control data were obtained from 15 children aged 6–9 years (1ƗƘ control group) with pseudomyopia with no correction administered, and 20 low myopic children aged 7–12 years (2ⁿƈ control group) wearing conventional spectacle correction. Autorefractometry before and after cycloplegia and ultrasound biometry were performed.

Results: A hyperopic shift caused by thinning of the crystalline lens and deepening of the anterior chamber in all patients of the 1ƗƘ group was observed after 1 month and persisted over the follow -up period. Horizontal diameter (HD) increased more than 3 times as much as the axial length (AL). No cases of myopia onset were observed during the 9 -year follow -up period. 36 (81.8%) children of the 2ⁿƈ group had stable refraction over the 4 year follow up, an insigniϐicant increase in the AL and a signiϐicant increase in the HD were revealed. A 3 -year follow -up revealed an increase in cycloplegic refraction in both control groups; the AL increased signiϐicantly, while the HD showed an insigniϐicant increase.

Conclusions: Permanent low myopic defocus of the image in binocular spectacle format inhibits eye growth and refraction shift to myopia in children with low hyperopia, emmetropia and low myopia. The method of alternating monolateral low myopic defocus arrests the myopia progression in 81.8% of children with low myopia for 4 years and 66% for 7 years.


Keywords


emmetropization, refractive development, myopia, optical defocus

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References


Czepita D. Myopia – incidence, pathogenesis, management and new possibilities of treatment. Russ Ophthalmol J 2014;7(1):96-101.

Lin LLK, Shih YF, Hsiao CK, Chen CJ. Prevalence of myopia in Taiwanese schoolchildren: 1983 to 2000. Ann Acad Med Singapore 2004;33(1):27-33.

Vitale S, Sperduto RD, Ferris FL 3rd. Increased prevalence of myopia in the United States between 1971–1972 and 1999–2004. Arch Ophthalmol 2009;127:1632-9.

Curtin BJ, Karlin DB. Axial length measurements and fundus changes of the myopic eye. I. The posterior fundus. Trans Am Opthalmol Soc 1970;68: 312-34.

Pierro L, Camesasca FI, Mischi M, Brancato R. Peripheral retinal changes and axial myopia. Retina 1992;12(1):12-7.

Lim R, Mitchell P, Cumming RG. Refractive associations with cataract: the Blue Mountains Eye Study. Invest Opthalmol Vis Sci 1999;40:3021-6.

Mitchell P, Hourihan F, Sandbach J, Wang JJ. The relationship between glaucoma and myopia: the Blue Mountains Eye Study. Ophthalmology 1999;106:2010-5.

Edwards MH, Li RW, Lam CS, Lew JK, Yu BS. The Hong Kong progressive lens myopia control study: study design and main findings. Invest Ophthalmol Vis Sci 2002;43:2852-8.

Gwiazda J, Hyman L, Hussein M, Everett D, Norton TT, Kurtz D, et al. A randomized clinical trial of progressive addition lenses versus single vision lenses on the progression of myopia in children. Invest Ophthalmol Vis

Sci 2003;44:1492-500.

Gwiazda JE, Hyman L, Norton TT, Hussein M, Marsh -Tootle W, Manny R, et al. Accommodation and related risk factors associated with myopia progression and their interaction with treatment in COMET children. Invest Ophthalmol Vis Sci 2004;45:2143-51.

Chung K, Mohidin N, O’Leary DJ. Undercorrection of myopia enhances rather than inhibits myopia progression. Vision Res 2002;42:2555-9.

Phillips JR. Monovision slows juvenile myopia progression unilaterally. Br J Opthalmol 2005;89:1196-200.

Flitcroft DI. The lens paradigm in experimental myopia: Oculomotor, optical and neurophysiological considerations. Ophthalmic Physiol Opt 1999;19:103-11.

Irving EL, Callender MG, Sivak JG. Inducing ametropias in hatchling chicks by defocus – Aperture effects and cylindrical lenses. Vision Res 1995;35: 1165-74.

Norton TT, Siegwart JT. Animal models of emmetropization: Matching axial length to the focal plane. J Am Optom Assoc 1995;66:405-14.

Schaeffel F, Howland HC. Mathematical model of emmetropization in the chicken. J Opt Soc Am 1988;5:2080-6.

Smith EL, Hung LF, Harwerth RS. Effects of optically induced blur on the refractive status of young monkeys. Vision Res 1994;34:293-301.

Wallman J, Adams JI. Developmental aspects of experimental myopia in chicks: Susceptibility, recovery and relation to emmetropization. Vision

Res 1987;27:1139-63.

Wallman J, Wildsoet C, Xu A, Gottlieb MD, Nickla DL, Marran L, et al. Moving the retina: Choroidal modulation of refractive state. Vision Res 1995;35:37-50.

Wildsoet CF. Active emmetropization -evidence for its existence and ramifications for clinical practice. Ophthalmic Physiol Opt 1997;17: 279-90.

Hung GK, Ciuffreda KJ. Model of human refractive error development. Curr Eye Res 1999;19:41-52.

Hung GK, Ciuffreda KJ. An incremental retinal -defocus theory of the development of myopia. Comments Theoret Biol 2003;8:511-38.

Tarutta EP. An inhibitory effect of penalization (hyperopic overcorrection) on eye growth and refractogenesis. Proceedings of the 10th International

Myopia Conference: Cambridge (UK); 2004. p. 27.

Phillips J. Spectacle lens defocus alters myopia progression rate in schoolchildren. Proceedings of the 10th International Myopia Conference: Cambridge

(UK); 2004. p. 38.

Tarutta EP, Khodzhabekyan NV, Filinova OB, Kruzhkova GV. The inϐluence of permanent dosed low myopic defocus on postnatal refractogenesis. Vestn Ophthalmol 2008;6:21-5.

Grosvenor T, Goss DA. Clinical management of myopia. Boston (MA): Butterwotth -Heinemann; 1999.

Mutti DO, Zadnik K, Fuzaro RE, Friedman NE, Sholtz RI, Adams AJ. Optical and structural development of the crystalline lens in childhood. Invest Ophthalmol Vis Sci 1998;39:120-133.




DOI: https://doi.org/10.21164/pomjlifesci.161

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