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      Retrospective Analysis of Axial Length Changes in Overnight Orthokeratology in an Academic Myopia Control Clinic

      research-article
      , OD 1 , , OD, PhD, FAAO 2 , , OD, PhD, FAAO 2 ,
      Optometry and Vision Science
      Lippincott Williams & Wilkins

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          Abstract

          SIGNIFICANCE

          Although the myopia control efficacy of orthokeratology lenses has been established with clinical trials, reports of axial length change in non–study-based patient care are scarce. This study investigates the use of orthokeratology lenses for myopia control in a clinical population and compares axial elongation against those published in recent clinical investigations.

          PURPOSE

          This study aimed to investigate factors affecting axial elongation during use of orthokeratology lenses for myopia control in an academic clinical setting.

          METHODS

          This study was a retrospective consecutive case series from the Myopia Control Clinic at the Herbert Wertheim School of Optometry at the University of California, Berkeley (Berkeley, CA). Patients ranging from 5 to 18 years old using orthokeratology for at least 1 year were included in the study. Data from 102 patients' eyes were analyzed at baseline (before the initiation of treatment) and after 1 year of wear (12 ± 3 months). Multivariate analysis was undertaken to identify factors significantly associated with axial elongation over this period.

          RESULTS

          Mean (±standard deviation) spherical equivalent refraction and axial length at baseline were −2.54 (±1.21) D and 24.53 (±0.82) mm, respectively. By the 1-year follow-up, eyes had shown significant axial elongation (0.18 ± 0.24 mm; P < .001), which was found to be inversely correlated with age ( P < .001). Race, sex, baseline axial length, and baseline refraction were not significantly associated with axial elongation.

          CONCLUSIONS

          Factors influencing axial length and the magnitude of axial elongation in our orthokeratology patient population are consistent with orthokeratology treatment groups from published randomized clinical trials and support the use of these lenses for myopia control in a clinical practice setting.

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          Most cited references31

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          Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050.

          Myopia is a common cause of vision loss, with uncorrected myopia the leading cause of distance vision impairment globally. Individual studies show variations in the prevalence of myopia and high myopia between regions and ethnic groups, and there continues to be uncertainty regarding increasing prevalence of myopia.
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            Retardation of myopia in Orthokeratology (ROMIO) study: a 2-year randomized clinical trial.

            This single-masked randomized clinical trial aimed to evaluate the effectiveness of orthokeratology (ortho-k) for myopic control. A total of 102 eligible subjects, ranging in age from 6 to 10 years, with myopia between 0.50 and 4.00 diopters (D) and astigmatism not more than 1.25D, were randomly assigned to wear ortho-k lenses or single-vision glasses for a period of 2 years. Axial length was measured by intraocular lens calculation by a masked examiner and was performed at the baseline and every 6 months. This study was registered at ClinicalTrials.gov, number NCT00962208. In all, 78 subjects (37 in ortho-k group and 41 in control group) completed the study. The average axial elongation, at the end of 2 years, were 0.36 ± 0.24 and 0.63 ± 0.26 mm in the ortho-k and control groups, respectively, and were significantly slower in the ortho-k group (P 0.54) but was correlated with the initial age of the subjects (P 1.00D per year) were 65% and 13% in younger (age range: 7-8 years) and older (age range: 9-10 years) children, respectively, in the control group and were 20% and 9%, respectively, in the ortho-k group. Five subjects discontinued ortho-k treatment due to adverse events. On average, subjects wearing ortho-k lenses had a slower increase in axial elongation by 43% compared with that of subjects wearing single-vision glasses. Younger children tended to have faster axial elongation and may benefit from early ortho-k treatment. (ClinicalTrials.gov number, NCT00962208.).
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              • Article: not found

              Increased prevalence of myopia in the United States between 1971-1972 and 1999-2004.

              To compare US population prevalence estimates for myopia in 1971-1972 and 1999-2004. The 1971-1972 National Health and Nutrition Examination Survey provided the earliest nationally representative estimates for US myopia prevalence; myopia was diagnosed by an algorithm using either lensometry, pinhole visual acuity, and presenting visual acuity (for presenting visual acuity > or =20/40) or retinoscopy (for presenting visual acuity -2.0 diopters [D]: 17.5% vs 13.4%, respectively [P -7.9 D: 22.4% vs 11.4%, respectively [P < .001]; < or =-7.9 D: 1.6% vs 0.2%, respectively [P < .001]). When using similar methods for each period, the prevalence of myopia in the United States appears to be substantially higher in 1999-2004 than 30 years earlier. Identifying modifiable risk factors for myopia could lead to the development of cost-effective interventional strategies.
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                Author and article information

                Contributors
                Journal
                Optom Vis Sci
                Optom Vis Sci
                OVS
                Optometry and Vision Science
                Lippincott Williams & Wilkins
                1040-5488
                1538-9235
                September 2023
                29 August 2023
                : 100
                : 9
                : 597-605
                Affiliations
                [1 ]Century Eye Care Medical Center, Gardena, California
                [2 ]Herbert Wertheim School of Optometry at the University of California, Berkeley, Berkeley, California
                [] sarah_singh@ 123456berkeley.edu
                Article
                OVS_230429 00002
                10.1097/OPX.0000000000002060
                10637306
                37639686
                20cc14d0-79ee-447c-9249-326e0673de37
                Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Optometry.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

                History
                : 29 June 2022
                : 23 July 2023
                Categories
                Original Investigation
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