Safety and efficacy of 0.01% and 0.1% low-dose atropine eye drop regimens for reduction of myopia progression in Danish children: a randomized clinical trial examining one-year effect and safety DOI Creative Commons
Niklas Cyril Hansen, Anders Hvid‐Hansen, Flemming Møller

et al.

BMC Ophthalmology, Journal Year: 2023, Volume and Issue: 23(1)

Published: Oct. 30, 2023

Abstract Background To investigate the efficacy and safety of 0.1% 0.01% low-dose atropine eye drops in reducing myopia progression Danish children. Methods Investigator-initiated, placebo-controlled, double-masked, randomized clinical trial. Ninety-seven six- to twelve-year old myopic participants were loading dose for six months followed by (loading group, Number (N) = 33), twelve (0.01% N 32) or vehicle (placebo, 32). Primary outcomes axial length spherical equivalent refraction. Secondary included adverse events reactions, choroidal thickness ocular biometry. Outcomes measured at baseline three-month intervals. Data was analyzed with linear-mixed model analysis according intention-to-treat. Results Mean elongation 0.10 mm less (95% confidence interval (CI): 0.17; 0.02, adjusted-p 0.06) 0.07 CI: 0.15; 0.00, 0.16) group compared placebo. refraction 0.24 D 0.05; 0.42) 0.19 0.00; 0.38) groups months, placebo (adjusted-p 0.06 0.14, respectively). A total 108 reported during initial six-month period, primarily 14 following switching, all deemed mild except two serious events, unrelated intervention. Conclusions Low-dose are safe over otherwise healthy There may be a modest but clinically relevant reduction children after treatment, effect statistically non-significant multiple comparisons adjustment. After dose-switching approached potentially indicating an early “rebound-effect”. Trial registration this study registered European Clinical Trials Database (EudraCT, number: 2018-001286-16) 05/11/2018 first posted www.clinicaltrials.gov (NCT03911271) 11/04/2019, prior initiation.

Language: Английский

IMI—The Dynamic Choroid: New Insights, Challenges, and Potential Significance for Human Myopia DOI Creative Commons
Lisa A. Ostrin,

Elise Harb,

Debora L. Nickla

et al.

Investigative Ophthalmology & Visual Science, Journal Year: 2023, Volume and Issue: 64(6), P. 4 - 4

Published: May 1, 2023

The choroid is the richly vascular layer of eye located between sclera and Bruch's membrane. Early studies in animals, as well more recent humans, have demonstrated that a dynamic, multifunctional structure, with its thickness directly indirectly subject to modulation by variety physiologic visual stimuli. In this review, anatomy function are summarized links choroid, growth regulation, myopia, animal models, discussed. Methods for quantifying choroidal human associated challenges described, literature examining changes response various stimuli refractive error-related differences summarized, potential implications latter myopia considered. This review also allowed reexamination hypothesis short-term induced pharmacologic, optical, or environmental predictive future long-term axial elongation, speculation thickening can be used biomarker treatment efficacy control therapies, general conclusion current evidence not sufficient.

Language: Английский

Citations

81
Myopia: Histology, clinical features, and potential implications for the etiology of axial elongation DOI Open Access
Jost B. Jonas, Rahul A. Jonas, Mukharram M. Bikbov

et al.

Progress in Retinal and Eye Research, Journal Year: 2022, Volume and Issue: 96, P. 101156 - 101156

Published: Dec. 28, 2022

Language: Английский

Citations

78
The influence of the environment and lifestyle on myopia DOI Creative Commons
Sayantan Biswas,

Antonio El Kareh,

Mariyem Qureshi

et al.

Journal of PHYSIOLOGICAL ANTHROPOLOGY, Journal Year: 2024, Volume and Issue: 43(1)

Published: Jan. 31, 2024

Abstract Background Myopia, commonly known as near-sightedness, has emerged a global epidemic, impacting almost one in three individuals across the world. The increasing prevalence of myopia during early childhood heightened risk developing high and related sight-threatening eye conditions adulthood. This surge rates, occurring within relatively stable genetic framework, underscores profound influence environmental lifestyle factors on this condition. In comprehensive narrative review, we shed light both established potential contributors that affect development progression myopia. Main body Epidemiological interventional research consistently revealed compelling connection between increased outdoor time decreased children. protective effect may primarily be attributed to exposure characteristics natural (i.e., sunlight) release retinal dopamine. Conversely, irrespective time, excessive engagement near work can further worsen onset While exact mechanisms behind exacerbation are not fully comprehended, it appears involve shifts relative peripheral refraction, overstimulation accommodation, or complex interplay these factors, leading issues like image defocus, blur, chromatic aberration. Other spatial frequency visual environment, circadian rhythm, sleep, nutrition, smoking, socio-economic status, education have debatable independent influences development. Conclusion environment exerts significant Improving modifiable key predictors spent outdoors prevent slow intricate connections often obscure findings, making challenging disentangle their individual effects. complexity necessity for prospective studies employ objective assessments, such quantifying work, among others. These crucial gaining more understanding how various modified

Language: Английский

Citations

57
Effect of Repeated Low-level Red Light on Myopia Prevention Among Children in China With Premyopia DOI Creative Commons
Xiangui He, Jingjing Wang, Zhuoting Zhu

et al.

JAMA Network Open, Journal Year: 2023, Volume and Issue: 6(4), P. e239612 - e239612

Published: April 26, 2023

Myopia is a global concern, but effective prevention measures remain limited. Premyopia refractive state in which children are at higher risk of myopia, meriting preventive interventions.To assess the efficacy and safety repeated low-level red-light (RLRL) intervention preventing incident myopia among with premyopia.This was 12-month, parallel-group, school-based randomized clinical trial conducted 10 primary schools Shanghai, China. A total 139 premyopia (defined as cycloplegic spherical equivalence refraction [SER] -0.50 to 0.50 diopter [D] more myopic eye having least 1 parent SER ≤-3.00 D) grades 4 were enrolled between April 1, 2021, June 30, 2021; completed August 31, 2022.Children randomly assigned 2 groups after grade stratification. Children group received RLRL therapy twice per day, 5 days week, each session lasting 3 minutes. The school during semesters home winter summer vacations. control continued usual activities.The outcome 12-month incidence rate ≤-0.50 D). Secondary outcomes included changes SER, axial length, vision function, optical coherence tomography scan results over 12 months. Data from eyes analyzed. Outcomes analyzed by means an intention-to-treat method per-protocol method. analysis participants both baseline, while those who able continue without interruption COVID-19 pandemic.There (mean [SD] age, 8.3 [1.1] years; 71 boys [51.1%]) 68 [48.9%]) group. 40.8% (49 120) 61.3% (68 111) group, relative 33.4% reduction incidence. For did not have treatment secondary pandemic, 28.1% (9 32), 54.1% significantly reduced shifts terms length compared 0.30 [0.27] mm vs 0.47 [0.25] mm; difference, 0.17 [95% CI, 0.11-0.23 mm]; mean -0.35 [0.54] D -0.76 [0.60] D; -0.41 -0.56 -0.26 D]). No visual acuity or structural damage noted on scans group.In this trial, novel for prevention, good user acceptability up within months premyopia.ClinicalTrials.gov Identifier: NCT04825769.

Language: Английский

Citations

49
Innovative Nanotechnology in Drug Delivery Systems for Advanced Treatment of Posterior Segment Ocular Diseases DOI Creative Commons
Yue Wu, Xin Li,

Xueyu Fu

et al.

Advanced Science, Journal Year: 2024, Volume and Issue: 11(32)

Published: June 21, 2024

Abstract Funduscopic diseases, including diabetic retinopathy (DR) and age‐related macular degeneration (AMD), significantly impact global visual health, leading to impaired vision irreversible blindness. Delivering drugs the posterior segment of eye remains a challenge due presence multiple physiological anatomical barriers. Conventional drug delivery methods often prove ineffective may cause side effects. Nanomaterials, characterized by their small size, large surface area, tunable properties, biocompatibility, enhance permeability, stability, targeting drugs. Ocular nanomaterials encompass wide range, lipid nanomaterials, polymer metal carbon quantum dot so on. These innovative materials, combined with hydrogels exosomes, are engineered address mechanisms, macrophage polarization, reactive oxygen species (ROS) scavenging, anti‐vascular endothelial growth factor (VEGF). Compared conventional modalities, nanomedicines achieve regulated sustained delivery, reduced administration frequency, prolonged action, minimized This study delves into obstacles encountered in highlights progress facilitated nanomedicine. Prospectively, these findings pave way for next‐generation ocular systems deeper clinical research, aiming refine treatments, alleviate burden on patients, ultimately improve health globally.

Language: Английский

Citations

24
Optic neuropathy in high myopia: Glaucoma or high myopia or both? DOI
Xiulan Zhang, Jingwen Jiang,

Kangjie Kong

et al.

Progress in Retinal and Eye Research, Journal Year: 2024, Volume and Issue: 99, P. 101246 - 101246

Published: Jan. 21, 2024

Language: Английский

Citations

22
Towards a better understanding of non-exudative choroidal and macular neovascularization DOI
Riccardo Sacconi, Serena Fragiotta, David Sarraf

et al.

Progress in Retinal and Eye Research, Journal Year: 2022, Volume and Issue: 92, P. 101113 - 101113

Published: Aug. 13, 2022

Language: Английский

Citations

64
China Turns to School Reform to Control the Myopia Epidemic: A Narrative Review DOI Creative Commons
Ian G. Morgan,

Catherine L Jan

Asia-Pacific Journal of Ophthalmology, Journal Year: 2022, Volume and Issue: 11(1), P. 27 - 35

Published: Jan. 1, 2022

Myopia is now a major public health issue in parts of East and Southeast Asia, including mainland China. In this region, around 80% students completing 12 years school education are myopic, from 10% to 20% have high myopia excess −6D. Interventions prevent the onset based on increasing time outdoors been implemented at system-wide scale Chinese Taipei (Taiwan) Singapore with some success, but prevalence still remains by international standards. China, until recently, prevention was largely eye exercises, these not sufficient an epidemic. Control progression atropine drops has widely practiced Taiwan, recent practice concentrating low-dose concentrations. Orthokeratology also used across region. Recent research produced both contact spectacle lenses that slow imposing myopic defocus. The new approaches control ready for systematic use, which may be facilitated screening referral. years, renewed emphasis placed China China's President Xi Jinping. addition making use all measures outlined above, seems aiming reforms schooling, reducing educational pressures, particularly early freeing more outdoor play learning. These initiatives crucial control.

Language: Английский

Citations

59
Effects of inflammation on myopia: evidence and potential mechanisms DOI Creative Commons
Ran Xu, Jing Zheng, Longqian Liu

et al.

Frontiers in Immunology, Journal Year: 2023, Volume and Issue: 14

Published: Oct. 2, 2023

As the most common type of refractive error, myopia has become one leading causes visual impairment. With increasing prevalence myopia, there is a growing need to better understand factors involved in its development. Inflammation, fundamental pathophysiological processes humans, rapid response triggered by harmful stimuli and conditions. Although controlled inflammatory responses are necessary, over-activated inflammation soil for many diseases. The impact on received rising attention recent years. Elevated may contribute progression either directly or indirectly inducing scleral remodeling, development also increase ocular inflammation. This article provides comprehensive review interplay between potential biological mechanisms, which present new targets understanding pathology developing therapies.

Language: Английский

Citations

27
Assessing the rebound phenomenon in different myopia control treatments: A systematic review DOI Creative Commons
Miguel Ángel Sánchez‐Tena, Antonio Ballesteros‐Sánchez, Clara Martínez-Pérez

et al.

Ophthalmic and Physiological Optics, Journal Year: 2024, Volume and Issue: 44(2), P. 270 - 279

Published: Jan. 9, 2024

Abstract Purpose To review the rebound effect after cessation of different myopia control treatments. Methods A systematic that included full‐length randomised controlled studies (RCTs), as well post‐hoc analyses RCTs reporting new findings on treatments in two databases, PubMed and Web Science, was performed according to PRISMA statement. The search period between 15 June 2023 30 2023. Cochrane risk bias tool used analyse quality selected studies. Results total 11 were this review. Unifying effects all treatments, mean for axial length (AL) spherical equivalent refraction (SER) 0.10 ± 0.07 mm [−0.02 0.22] −0.27 0.2 D [−0.71 −0.03] 10.2 7.4 months washout, respectively. In addition, spectacles with highly aspherical lenslets or defocus incorporated multiple segments technology, soft multifocal contact lenses orthokeratology showed lower compared atropine low‐level light therapy, a AL SER 0.04 [0 0.08] −0.13 [−0.05 −0.2], Conclusions It appears produce their cessation. Specifically, optical seem less than pharmacological therapies. However, more are required confirm these results.

Language: Английский

Citations

12