Orthokeratology (ORTHO-K) & Retinal Morphology In Progressive Myopia- A One Year Longitudinal Analysis
Keywords:
Schiff base, Aromatic amines, Ketones, BenzoxazipineAbstract
Background: To investigate the changes in retinal nerve fiber layer (RNFL) thickness, ganglion cell layer (GCL) thickness, inner plexiform layer (IPL) thickness in progressive myopic patients after one year of treatment with orthokeratology (Ortho-K) lenses.
Methods: This prospective, longitudinal study enrolled 49 patients with age upto 20 years with progressive myopia (-1.00 D to -10.00 D & upto -1.00 Dcyl and a documented increase of at least -0.50 D in the past year). All participants were fitted with custom Ortho-K lenses. Ocular examinations were conducted on baseline and every three month and data recorded. Measurements included: best-corrected visual acuity (BCVA), Objective and subjective refraction , axial length (AL) using an IOL Master, and macular and optic disc optical coherence tomography (OCT) to measure RNFL, GCL, and IPL thicknesses. Statistical analysis was performed using paired t-tests and repeated measures ANOVA to compare changes from baseline.
Results: The mean age of study patients was 14.74 ± 3.121 years (range 5-20 years) and predominantly females (59.2% females Vs 40.8% males).The mean global NFL thickness at baseline was [99.96 ± 6.92 µm]. At the 12-month follow-up, the mean global RNFL thickness was [101.1 ± 7.12 µm]. The mean GCL+IPL thickness at baseline was [88.92 ± 7.25 µm]. After one year of Ortho-K wear, the mean GCL+IPL thickness was [89.94 ± 7.25 µm]. A paired t-test revealed no statistically significant difference between baseline and 12-month measurements (p= 0.162). Subgroup analysis of specific quadrants showed minor, non-pathological variations, which did not correlate with the changes in AL. No signs of retinal toxicity or structural damage were observed.
Conclusion: This study confirms that orthokeratology is a safe and effective approach for controlling myopia progression by maintaining stable axial length. It also demonstrates that Ortho-K lenses do not cause thinning of the RNFL, IPL, or GCL layers, suggesting a reduced risk of glaucoma development in progressive myopes who consistently wear Ortho-K lenses.
Downloads
Metrics
References
Angle J, Wissmann DA. The epidemiology of myopia. Am J Epidemiol. 1980; 111:220–8.
Javitt JC, Chiang YP. The socio-economic aspects of laser refractive surgery. Arch Ophthalmol. 1994;112:1526–30.
Wu PC, Huang HM, Yu HJ, Fang PC, Chen CT. Epidemiology of Myopia. Asia Pac J Ophthalmol (Phila) 2016;5(6):386–393.
Rose KA, French AN, Morgan IG. Environmental factors and myopia: paradoxes and prospects for prevention. Asia Pac J Ophthalmol (Phila) 2016;5(6):403–410.
Bourne RRA, Flaxman SR, Braithwaite T, Cicinelli MV, Das A, Jonas JB et al. Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis. Lancet Glob Health. 2017;5(9):e888–97. http://dx.doi.org/10.1016/S2214-109X(17)30293-0 PMID:28779882
Flaxman SR, Bourne RRA, Resnikoff S, Ackland P, Braithwaite T, Cicinelli MV et al. Global causes of blindness and distance vision impairment 1990–2020: a systematic review and meta-analysis. Lancet Glob Health. 2017;5(12):e1221–34. http://dx.doi. org/10.1016/S2214-109X(17)30393-5 PMID:29032195
Divya Agarwal et al. Prevalence of myopia in Indian school children: Meta-analysis of last four decades, October 19, 2020,doi.org/10.1371/journal.pone.0240750
Dr. Mehzabeen Rahman, Dr. (Mrs.) Bhanu Devi , Dr. J.J.Kuli , Dr. (Mrs.) Gourangie Gogoi, A Study On The Refractive Status Of School Going Children Aged Between 10 To 15 Years In Dibrugarh Town, Assam, India, IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 2 Ver. III (Feb. 2015), PP 27-33
Kanthan GL, Mitchell P, Rochtchina E, Cumming RG, Wang JJ. Myopia and the longterm incidence of cataract and cataract surgery: the Blue Mountains Eye Study. Clin Experiment Ophthalmol 2014; 42: 347–53.
Chua WH, Balakrishnan V, Chan YH, Tong L, Ling Y, Quah BL, Tan D. Atropine for the treatment of childhood myopia. Ophthalmology 2006; 113: 2285–91.
Iribarren R. Tropicamide and myopia progression. Ophthalmology 2008; 115:1103–4.
Tan DT, Lam DS, Chua WH, Shu-Ping DF, Crockett RS. One-year multicenter, double-masked, placebo-controlled, parallel safety and efficacy study of 2% pirenzepine ophthalmic gel in children with myopia. Ophthalmology 2005; 112:84–91.
Fulk GW, Cyert LA, Parker DE. A randomized trial of the effect of single-vision vs. bifocal lenses on myopia progression in children with esophoria. Optom Vis Sci. 2000;77:395–401.
Leung JT, Brown B. Progression of myopia in Hong Kong Chinese schoolchildren is slowed by wearing progressive lenses. Optom Vis Sci. 1999;76:346–54.
Sankaridurg P, Donovan L, Varnas S, et al. Spectacle lenses designed to reduce progression of myopia: 12-month results. Optom Vis Sci.,2010;87;631-41
Aller TA, Wildsoet C. Bifocal soft contact lenses as a possible myopia control treatment: a case report involving identical twins. Clin Exp Optom. 2008;91:394–9.
Koffler BH, Sears JJ. Myopia control in children through refractive therapy gas permeable contact lenses: is it for real? Am J Ophthalmol 2013; 156: 1076–81 e1.
Swarbrick HA. Orthokeratology review and update. Clin Exp Optom.2006;89:124–43.
Nichols JJ, Marsich MM, Nguyen M, et al. Overnight orthokeratology. Optom Vis Sci. 2000;77:252–9.
Cho P, Cheung SW, Edwards M. The longitudinal orthokeratology research in children (LORIC) in Hong Kong: a pilot study on refractive changes and myopic control. Curr Eye Res. 2005;30:71–80.
Coletta, N. J. & Watson, T. Efect of myopia on visual acuity measured with laser interference fringes. Vision Res. 46, 636–651 (2006).
Aref AA, Budenz DL. Spectral domain optical coherence tomography in the diagnosis and management of glaucoma. Ophthalmic Surg Lasers Imaging 2010;41:S15-27
Popescu D. P. et al, “Optical coherence tomography: fundamental principles, instrumental designs and biomedical applications,” Biophys. Rev. 3(3), 155–169 (2011).10.1007/s12551-011-0054-7.
Duker JS, Waheed NK, Goldman D. Handbook of Retinal OCT: Optical Coherence Tomography. Saunders; 2014.
Sam Seo et al, “Ganglion cell-inner plexiform layer and retinal nerve fiber layer thickness according to myopia and optic disc area: a quantitative and three-dimensional analysis, BMC Ophthalmology (2017) 17:22 DOI 10.1186/s12886-017-0419-1
Kim MJ, Lee EJ, Kim TW. Peripapillary retinal nerve fibre layer thickness profile in subjects with myopia measured using the Stratus optical coherence tomography. Br J Ophthalmol. 2010;94(1):115–20.
Leung CK, Mohamed S, Leung KS, Cheung CY, Chan SL, Cheng DK, et al. Retinal nerve fiber layer measurements in myopia: An optical coherence tomography study. Invest Ophthalmol Vis Sci. 2006;47(12):5171–6.
Yueh-Chang Lee et al. Effect of Orthokeratology on myopia progression: twelve-year results of a retrospective cohort study, BMC Ophthalmology (2017) 17:243 DOI 10.1186/s12886-017-0639-4
Bourne RRA, Flaxman SR, Braithwaite T, Cicinelli MV, Das A, Jonas JB et al. Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis. Lancet Glob Health. 2017;5(9):e888–97. http://dx.doi.org/10.1016/S2214-109X(17)30293-0 PMID:28779882
Divya Agarwal et al. Prevalence of myopia in Indian school children: Meta-analysis of last four decades, October 19, 2020,doi.org/10.1371/journal.pone.0240750
Wei-Shan Tsai et al. A Comparative study of Orthokeratology and low dose atropine for the treatment of anisomyopia in children. Sci Rep 10, 14176(2020). https://doi.org/10.1038/s41598-020-71142-3.
Yueh-Chang Lee et al. Effect of Orthokeratology on myopia progression: twelve-year results of a retrospective cohort study, BMC Ophthalmol.2017 Dec 8;17(1):243.doi 10.1186/s12886-017-0639-4.
Swarbrick HA. Orthokeratology review and update. Clin Exp Optom. 2006;89:124–43 34. Walline JJ, Jones LA, Sinnott LT. Corneal reshaping and myopia progression. Br J Ophthalmol. 2009;93:1181–5.
Hiraoka T, Kakita T, Okamoto F, et al. Long-term effect of overnight orthokeratology on axial length elongation in childhood myopia: a 5-yearfollow-up study. Invest Ophthalmol Vis Sci. 2012;53:3913–9.
Sezgin Akcay BI, Gunay BO, Kardes E, Unlu C, Ergin A. Evaluation of the ganglion cell complex and retinal nerve fiber layer in low, moderate, and high myopia: a study by RTVue spectral domain optical coherence tomography. Semin Ophthalmol. 2017;32(6):682–688.
Ramakrishnan R, Mittal S, Ambatkar S, et al. Retinal nerve fibre layer thickness measurements in normal Indian population by optical coherence tomography. Indian J Ophthalmol. 2006; 54:11–15.
Salchow DJ, Oleynikov YS, Chiang MF, et al. Retinal nerve fiber layer thickness in normal children measured with optical coherence tomography. Ophthalmology. 2006; 113:786–791.
Christopher Kai-Shun Leung et al, Retinal nerve fiber measurements in myopia: An optical coherence tomography study,Invest Ophthalmol Vis Sci. 2006 Dec;47(12):5171-6.doi:10.1167/iovs.06-0545
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
