IMI—Onset and Progression of Myopia in Young Adults

Investigative Ophthalmology & Visual Science, Journal Year: 2023, Volume and Issue: 64(6), P. 2 - 2

Published: May 1, 2023

Myopia typically starts and progresses during childhood, but onset progression can occur adulthood. The goals of this review are to summarize published data on myopia in young adults, aged 18 40 years, characterize age group, assess what is currently known, highlight the gaps current understanding. Specifically, peer-reviewed literature was reviewed to: timeline stabilization juvenile-onset myopia; estimate frequency adult-onset evaluate rate regardless onset, both college years later; describe axial elongation myopic adults; identify risk factors for adult progression; report adults who have undergone refractive surgery; discuss management research study design. Adult-onset common, representing a third or more all western populations, less East Asia, where childhood high. Clinically meaningful continues early adulthood may average 1.00 diopters (D) between 20 30 years. Higher levels associated with greater absolute myopia-related ocular disease visual impairment, thus group requires ongoing management. Modalities established control children would be options it difficult predict their efficacy. feasibility studies limited by long duration required.

Language: Английский

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IMI 2023 Digest

Investigative Ophthalmology & Visual Science, Journal Year: 2023, Volume and Issue: 64(6), P. 7 - 7

Published: May 1, 2023

Myopia is a dynamic and rapidly moving field, with ongoing research providing better understanding of the etiology leading to novel myopia control strategies. In 2019, International Institute (IMI) assembled published series white papers across relevant topics updated evidence digest in 2021. Here, we summarize findings key from previous 2 years. Studies animal models have continued explore how wavelength intensity light influence eye growth examined new pharmacologic agents scleral cross-linking as potential strategies for slowing myopia. children, term premyopia gaining interest increased attention early implementation control. Most studies use IMI definitions ≤-0.5 diopters (D) ≤-6.0 D high myopia, although categorization structural consequences remain an issue. Clinical trials demonstrated that newer spectacle lens designs incorporating multiple segments, lenslets, or diffusion optics exhibit good efficacy. considerations factors influencing efficacy soft multifocal contact lenses orthokeratology are discussed. Topical atropine remains only widely accessible treatment. Rebound observed higher concentration not evident lower concentrations optical interventions. Overall, treatments show little adverse effect on visual function appear generally safe, longer wear times combination therapies maximizing outcomes. An emerging category light-based children requires comprehensive safety data enable risk versus benefit analysis. Given success strategies, ethics including arm clinical heavily debated. recommendations trial protocols

Language: Английский

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Mechanisms of emmetropization and what might go wrong in myopia

Vision Research, Journal Year: 2024, Volume and Issue: 220, P. 108402 - 108402

Published: May 4, 2024

Studies in animal models and humans have shown that refractive state is optimized during postnatal development by a closed-loop negative feedback system uses retinal image defocus as an error signal, mechanism called emmetropization. The sensor to detect its sign resides the retina itself. and/or pigment epithelium (RPE) presumably releases biochemical messengers change choroidal thickness modulate growth rates of underlying sclera. A central question arises: if emmetropization operates system, why does it not stop myopia development? Recent experiments young human subjects (1) emmetropic can perfectly distinguish between real positive simulated defocus, trigger transient axial eye shortening or elongation, respectively. (2) Strikingly, myopic has reduced ability inhibit when imposed. (3) bi-directional response elicited with low spatial frequency information below 8 cyc/deg, which makes unlikely optical higher-order aberrations play role. (4) for detection involves comparison blur blue (S-cone) red end spectrum (L + M-cones) but, again, responsive, at least short-term experiments. This suggests cannot fully inhibitory arm loop. As result, open loop, becomes "open-loop".

Language: Английский

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IMI—Nonpathological Human Ocular Tissue Changes With Axial Myopia

Investigative Ophthalmology & Visual Science, Journal Year: 2023, Volume and Issue: 64(6), P. 5 - 5

Published: May 1, 2023

To describe nonpathological myopia-related characteristics of the human eye.Based on histomorphometric and clinical studies, qualitative quantitative findings associated with myopic axial elongation are presented.In myopia, eye changes from a spherical shape to prolate ellipsoid, photoreceptor, retinal pigment epithelium cell density total thickness decrease, most marked in retroequatorial region, followed by equator. The choroid sclera thin, markedly at posterior pole least ora serrata. undergoes alterations fibroblast activity, extracellular matrix content, remodeling. Bruch's membrane (BM) is unrelated length, although BM volume increases. In moderate opening shifts, usually toward fovea, leading overhanging into nasal intrapapillary compartment. Subsequently, absent temporal region (such as parapapillary gamma zone), optic disc takes vertically oval shape, fovea-optic distance elongates without macular elongation, angle kappa reduces, papillomacular vessels nerve fibers straighten stretch. high enlarge, lamina cribrosa, peripapillary scleral flange delta zone) choroidal border tissue lengthen circular zone develop.A thorough characterization ocular myopia importance better understand mechanisms pathological structural changes, psychophysical sequelae visual function.

Language: Английский

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The structure and function of the human choroid

Annals of Anatomy - Anatomischer Anzeiger, Journal Year: 2024, Volume and Issue: 254, P. 152239 - 152239

Published: March 2, 2024

In this manuscript, the structure of human choroid is reviewed with emphasis macro- and microscopic anatomy including Bruch's membrane, choriocapillaris, Sattler's Haller's layer, suprachoroid. We here discuss development choroid, as well question choroidal lymphatics, further neuronal control tissue, pathologic angiogenesis. Wherever possible, functional aspects various structures are included reviewed.

Language: Английский

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Peripheral Choroidal Response to Localized Defocus Blur: Influence of Native Peripheral Aberrations

Investigative Ophthalmology & Visual Science, Journal Year: 2024, Volume and Issue: 65(4), P. 14 - 14

Published: April 5, 2024

Purpose: This study aims to examine the short-term peripheral choroidal thickness (PChT) response signed defocus blur, both with and without native aberrations. examination will provide insights into role of aberration in detecting signs defocus. Methods: The retina (temporal 15°) right eye was exposed a localized video stimulus 11 young adults. An adaptive optics system induced 2D myopic or hyperopic onto stimulus, correcting ocular aberrations (adaptive [AO] NoAO conditions). Choroidal scans were captured using Heidelberg Spectralis OCT at baseline, exposure (10, 20, 30 minutes), recovery phases (4, 8, 15 minutes). Neural network-based automated MATLAB segmentation program measured PChT changes from scans, statistical analysis evaluated effects different optical conditions over time. Results: During phase, exhibited distinct bidirectional alterations, showing average thickening (10.0 ± 5.3 µm) thinning (−9.1 5.5 µm), respectively. In contrast, AO did not demonstrate significant change baseline. baseline occurred for all conditions. unexposed fovea show any ChT change, indicating retinal blur. Conclusions: We discovered that serves as marker especially presence These findings highlight oriented blur cueing sign detection.

Language: Английский

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Defocus incorporated multiple segments (DIMS) spectacle lenses increase the choroidal thickness: a two-year randomized clinical trial

Eye and Vision, Journal Year: 2023, Volume and Issue: 10(1)

Published: Sept. 15, 2023

Myopia control interventions, such as defocus incorporated multiple segments (DIMS) spectacle lenses, have been adopted in school-aged children to reduce the prevalence of myopia and its complications. This study aimed investigate effect DIMS lenses on subfoveal choroidal thickness (SfChT) over a period two years, response myopic is crucial factor exploring potential predicting progression.This involved secondary analysis our previous randomized clinical trial. Myopic aged 8-13 years were recruited two-year investigating progression. The treated group received (n = 78), while was with pair single vision (SV) 80). SfChT monitored at 1 week, 1, 3, 6, 12, 18 24 months post lens wear using spectral-domain optical coherence tomography custom made auto-segmentation algorithm utilizing convolutional neural networks.SfChT increased significantly after one week compared those wearing SV (adjusted mean change relative baseline ± SEM week; vs. SV, 6.75 1.52 µm - 3.17 1.48 µm; P < 0.0001, general linear model). choroid 13.64 2.62 12 thinned (- 9.46 2.55 µm). Choroidal changes demonstrated significant negative association axial elongation both groups. three predicted AL controlling age gender.Our thickening wear, sustained period. results suggested that may help predict length year. Trial registration ClinicalTrials.gov. multi-segment lens. NCT02206217. Registered 29 July 2014, https://clinicaltrials.gov/ct2/show/study/NCT02206217.

Language: Английский

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Myopia Control Effect of Repeated Low-Level Red-Light Therapy Combined with Orthokeratology

Ophthalmology, Journal Year: 2024, Volume and Issue: 131(11), P. 1304 - 1313

Published: May 18, 2024

Language: Английский

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Choroidal Vascularity and Axial Length Elongation in Highly Myopic Children: A 2-Year Longitudinal Investigation

Investigative Ophthalmology & Visual Science, Journal Year: 2024, Volume and Issue: 65(10), P. 7 - 7

Published: Aug. 5, 2024

To examine the influence of subfoveal choroidal thickness (SFCT) and vascularity index (CVI) on axial length (AL) elongation over a 2-year period in highly myopic children.

Language: Английский

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Red light therapy for myopia: Merits, risks and questions

Ophthalmic and Physiological Optics, Journal Year: 2024, Volume and Issue: 44(5), P. 801 - 807

Published: April 2, 2024

The authors declare no conflicts of interest.

Language: Английский

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