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      The relationship between baseline axial length and axial elongation in myopic children undergoing orthokeratology

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          Abstract

          Purpose

          To investigate the correlation between the baseline axial length (AL) and axial elongation in myopes undergoing orthokeratology (ortho‐k).

          Methods

          This was a retrospective study. During the 1‐year follow‐up, 1176 children (aged 8–14 years) were included and divided into an ortho‐k group ( n = 588) and a single‐vision spectacle group ( n = 588). The ortho‐k group participants (8–11 years of age) who completed the 3‐year follow‐up ( n = 150) were further divided into three subgroups stratified by their baseline AL: subgroup 1 (AL < 24.5 mm), subgroup 2 (24.5 ≤ AL < 26 mm) and subgroup 3 (AL ≥ 26 mm). AL was measured at baseline and during the annual visit.

          Results

          The ortho‐k group exhibited slower 1‐year axial elongation (39% reduction) than the spectacle group. The 1‐year axial elongation was negatively correlated with initial age in both groups. A negative association between 1‐year axial elongation and baseline AL was observed in the ortho‐k group but not in the spectacle group. However, this relationship only existed in ortho‐k participants 8–11 years of age. For the younger ortho‐k participants who completed the 3‐year follow‐up, the annual axial elongation was significantly higher in subgroup 1 for the first and second years but not in the third year compared with subgroups 2 and 3.

          Conclusion

          Axial elongation was negatively correlated with baseline AL in the ortho‐k group. Children aged 8–11 years with longer baseline AL (≥24.5 mm) demonstrated slower annual axial elongation during the first 2 years of ortho‐k treatment, which may provide insight into establishing individual guidelines for controlling myopia using ortho‐k in children with different baseline characteristics.

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          Most cited references40

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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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              Myopia

              Myopia, also known as short-sightedness or near-sightedness, is a very common condition that typically starts in childhood. Severe forms of myopia (pathologic myopia) are associated with a risk of other associated ophthalmic problems. This disorder affects all populations and is reaching epidemic proportions in East Asia, although there are differences in prevalence between countries. Myopia is caused by both environmental and genetic risk factors. A range of myopia management and control strategies are available that can treat this condition, but it is clear that understanding the factors involved in delaying myopia onset and slowing its progression will be key to reducing the rapid rise in its global prevalence. To achieve this goal, improved data collection using wearable technology, in combination with collection and assessment of data on demographic, genetic and environmental risk factors and with artificial intelligence are needed. Improved public health strategies focusing on early detection or prevention combined with additional effective therapeutic interventions to limit myopia progression are also needed.
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                Author and article information

                Contributors
                rwei@tmu.edu.cn
                Journal
                Ophthalmic Physiol Opt
                Ophthalmic Physiol Opt
                10.1111/(ISSN)1475-1313
                OPO
                Ophthalmic & Physiological Optics
                John Wiley and Sons Inc. (Hoboken )
                0275-5408
                1475-1313
                15 November 2022
                January 2023
                : 43
                : 1 ( doiID: 10.1111/opo.v43.1 )
                : 122-131
                Affiliations
                [ 1 ] Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry Tianjin Medical University Eye Hospital Tianjin China
                [ 2 ] Euclid China (Euclid Trading (Shanghai) Ltd.) Shanghai China
                Author notes
                [*] [* ] Correspondence

                Ruihua Wei, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.

                Email: rwei@ 123456tmu.edu.cn

                Author information
                https://orcid.org/0000-0002-9708-0355
                Article
                OPO13070 OPO-OA-3810.R1
                10.1111/opo.13070
                10100030
                36377631
                cb6ea7a4-bbbc-40bf-8c1e-40765362de07
                © 2022 The Authors. Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 07 August 2022
                : 15 June 2022
                : 18 October 2022
                Page count
                Figures: 6, Tables: 1, Pages: 10, Words: 6048
                Funding
                Funded by: National Natural Science Foundation of China , doi 10.13039/501100001809;
                Award ID: 82070929
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                January 2023
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.7 mode:remove_FC converted:13.04.2023

                axial elongation,axial length,myopia control,orthokeratology

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