Ep 10: Intro to Myopia Management- pt 1
You’ll learn:
What is myopia?
Why do practitioners care about myopia progression?
What are the risk factors for myopia progression?
Review of the various treatment options: progressives, line bifocals, executive bifocals, DIMS, soft contact lenses, orthokeratology, pharmacologics
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Resources/Sources:
Axial length animal studies:
Chicks:
Hammond DS, Wallman J, Wildsoet CF. Dynamics of active emmetropisation in young chicks--influence of sign and magnitude of imposed defocus. Ophthalmic Physiol Opt. 2013 May;33(3):215-26. doi: 10.1111/opo.12056. PMID: 23662956; PMCID: PMC3972214. <http://www.ncbi.nlm.nih.gov/pubmed/23662956>
Liu Y , Wildsoet C . The effect of two-zone concentric bifocal spectacle lenses on refractive error development and eye growth in young chicks. Invest Ophthalmol Vis Sci 2011;52:1078–86.doi:10.1167/iovs.10-5716
Guinea pig
McFadden SA , Tse DY , Bowrey HE , et al . Integration of defocus by dual power Fresnel lenses inhibits myopia in the mammalian eye. Invest Ophthalmol Vis Sci 2014;55:908–17.doi:10.1167/iovs.13-11724
Marmosets
Benavente-Perez A , Nour A , Troilo D . The effect of simultaneous negative and positive defocus on eye growth and development of refractive state in marmosets. Invest Ophthalmol Vis Sci 2012;53:6479–87.doi:10.1167/iovs.12-9822
Monkeys
Arumugam B , Hung L-F , To C-H , et al . The effects of simultaneous dual focus lenses on refractive development in infant monkeys. Invest Ophthalmol Vis Sci 2014;55:7423–32.doi:10.1167/iovs.14-14250
Smith EL 3rd, Hung LF, Huang J. Relative peripheral hyperopic defocus alters central refractive development in infant monkeys. Vision Res. 2009 Sep;49(19):2386-92. doi: 10.1016/j.visres.2009.07.011.
Risk Factors
Pärssinen, O, Kauppinen M. What is the influence of parents' myopia on their children's myopic progression? A 22‐year follow‐up study. Acta Ophthalmologica. 2016 Apr; 94(6):579-585. https://doi.org/10.1111/aos.13043
Deng L, Pang Y. Effect of Outdoor Activities in Myopia Control: Meta-analysis of Clinical Studies. Optom Vis Sci. 2019 Apr;96(4):276-282. doi: 10.1097/OPX.0000000000001357. PMID: 30907857.
Rose KA, Morgan IG, Ip J, Kifley A, Huynh S, Smith W, Mitchell P. Outdoor activity reduces the prevalence of myopia in children. Ophthalmology. 2008 Aug;115(8):1279-85. doi: 10.1016/j.ophtha.2007.12.019. Epub 2008 Feb 21. PMID: 18294691.
Walline JJ. Myopia Control: A Review. Eye Contact Lens. 2016 Jan;42(1):3-8. doi: 10.1097/ICL.0000000000000207. PMID: 26513719.
**Twin study Priscilla was excited about:
Ramessur R, Williams KM, Hammond CJ. Risk factors for myopia in a discordant monozygotic twin study. Ophthalmic Physiol Opt. 2015;35(6):643-651. doi:10.1111/opo.12246
Simple graphic to show the difference between refractive error and axial length
https://bhvi.org/wp-content/uploads/2021/04/BHVI_20200103_Myopia-Management-Axial-Length-Refractive-Error-Guidelines-Flyer.pdf?mc_cid=8baf49777e&mc_eid=55d4238530
Axial Length measurements
Diurnal fluctuations
Stone RA, Quinn GE, Francis EL, Ying GS, Flitcroft DI, Parekh P, Brown J, Orlow J, Schmid G. Diurnal axial length fluctuations in human eyes. Invest Ophthalmol Vis Sci. 2004 Jan;45(1):63-70. doi: 10.1167/iovs.03-0294. PMID: 14691155. https://pubmed.ncbi.nlm.nih.gov/14691155/
Axial length in normal pediatric patients
Hussain RN, Shahid F, Woodruff G. Axial length in apparently normal pediatric eyes. Eur J Ophthalmol. 2014 Jan-Feb;24(1):120-3. doi: 10.5301/ejo.5000328. Epub 2013 Jun 17. PMID: 23787457.
Progressives vs Single vision glasses
Jane Gwiazda, Leslie Hyman, Mohamed Hussein, Donald Everett, Thomas T. Norton, Daniel Kurtz, M. Cristina Leske, Ruth Manny, Wendy Marsh-Tootle, Mitch Scheiman, the COMET Group; 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(4):1492-1500. doi: https://doi.org/10.1167/iovs.02-0816.
PALS for esophoric patients and high accommodative lag
Gwiazda J, Hyman L, Hussein M, Everett D, Norton TT, Kurtz D, Leske MC, Manny R, Marsh-Tootle W, Scheiman M. A randomized clinical trial of progressive addition lenses versus single vision lenses on the progression of myopia in children. Invest Ophthalmol Vis Sci. 2003 Apr;44(4):1492-500. doi: 10.1167/iovs.02-0816. PMID: 12657584. <https://pubmed.ncbi.nlm.nih.gov/12657584/>
Executive line bifocals (+1.50 add with 3 BI prism OU)
Cheng D, Woo GC, Drobe B, Schmid KL. Effect of bifocal and prismatic bifocal spectacles on myopia progression in children: three-year results of a randomized clinical trial. JAMA Ophthalmol. 2014 Mar;132(3):258-64. doi: 10.1001/jamaophthalmol.2013.7623. PMID: 24435660. https://pubmed.ncbi.nlm.nih.gov/24435660/
Stellest Lens by Essilor (news release, ARVO release)
SightGlasses by Essilor (news release)
Why each diopter matters
Bullimore MA & Brennan NA. Myopia control: Why each diopter matters. Optom Vis Sci2019; 96: 463– 465.
Risk vs benefit
Bullimore MA & Ritchey E. Myopia control: An evidence‐based comparison of the benefits and the risks. Optom Vis Sci2019; 96: E‐abstract 190031.
Atropine studies
Yam JC, Jiang Y, Tang SM, Law AKP, Chan JJ, Wong E, Ko ST, Young AL, Tham CC, Chen LJ, Pang CP. Low-Concentration Atropine for Myopia Progression (LAMP) Study: A Randomized, Double-Blinded, Placebo-Controlled Trial of 0.05%, 0.025%, and 0.01% Atropine Eye Drops in Myopia Control. Ophthalmology. 2019 Jan;126(1):113-124. doi: 10.1016/j.ophtha.2018.05.029. Epub 2018 Jul 6. PMID: 30514630.
Pirenzepine
Soft lenses
Biofinity MFCL
https://www.myopiaprofile.com/the-naturalvue-multifocal-contact-lens/
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