Explore the vast range of titles available.

Myopic anisometropia (anisomyopia) is a specific type of refractive error that may cause fusion impairment, asthenopia, and aniseikonia. It is sometimes severe enough to reduce the quality of life. Several studies have investigated the treatment effects of orthokeratology (Ortho-K) and topical atropine on anisomyopia control. However, no study has compared these two interventions simultaneously until now. The cohort of this retrospective study included 124 children with anisomyopia who were treated with binocular Ortho-K lenses, 0.01% atropine, or 0.05% atropine. After a 2-year follow-up, the inter-eye difference in axial length (AL) significantly decreased in the Ortho-K group ( P  = 0.015) and remained stable in the two atropine groups. When comparing the myopia control effect, the use of Ortho-K lenses resulted in an obviously smaller change in AL than the use of 0.01% and 0.05% atropine ( P  < 0.01). Ortho-K treatment may reduce the degree of anisomyopia and stabilise the progression of myopia. Hence, Ortho-K might be a better choice for anisomyopic children.

Background Several studies reported the efficacy of orthokeratology for myopia control. Somehow, there is limited publication with follow-up longer than 3 years. This study aims to research whether overnight orthokeratology influences the progression rate of the manifest refractive error of myopic children in a longer follow-up period (up to 12 years). And if changes in progression rate are found, to investigate the relationship between refractive changes and different baseline factors, including refraction error, wearing age and lens replacement frequency. In addition, this study collects long-term safety profile of overnight orthokeratology. Methods This is a retrospective study of sixty-six school-age children who received overnight orthokeratology correction between January 1998 and December 2013. Thirty-six subjects whose baseline age and refractive error matched with those in the orthokeratology group were selected to form control group. These subjects were followed up at least for 12 months. Manifest refractions, cycloplegic refractions, uncorrected and best-corrected visual acuities, power vector of astigmatism, corneal curvature, and lens replacement frequency were obtained for analysis. Results Data of 203 eyes were derived from 66 orthokeratology subjects (31 males and 35 females) and 36 control subjects (22 males and 14 females) enrolled in this study. Their wearing ages ranged from 7 years to 16 years (mean ± SE, 11.72 ± 0.18 years). The follow-up time ranged from 1 year to 13 years (mean ± SE, 6.32 ± 0.15 years). At baseline, their myopia ranged from −0.5 D to −8.0 D (mean ± SE, −3.70 ± 0.12 D), and astigmatism ranged from 0 D to −3.0 D (mean ± SE, −0.55 ± 0.05 D). Comparing with control group, orthokeratology group had a significantly ( p  < 0.001) lower trend of refractive error change during the follow-up periods. According to the analysis results of GEE model, greater power of astigmatism was found to be associated with increased change of refractive error during follow-up years. Conclusions Overnight orthokeratology was effective in slowing myopia progression over a twelve-year follow-up period and demonstrated a clinically acceptable safety profile. Initial higher astigmatism power was found to be associated with increased change of refractive error during follow-up years.

Purpose: To comprehensively assess rebound effects by comparing myopia progression during atropine treatment and after discontinuation. Methods: A systematic search of PubMed, EMBASE, Cochrane CENTRAL, and ClinicalTrials.gov was conducted up to 20 September 2023, using the keywords “myopia,\" “rebound,” and “discontinue.\" Language restrictions were not applied, and reference lists were scrutinized for relevant studies. Our study selection criteria focused on randomized control trials and interventional studies involving children with myopia, specifically those treated with atropine or combination therapies for a minimum of 6 months, followed by a cessation period of at least 1 month. The analysis centered on reporting annual rates of myopia progression, considering changes in spherical equivalent (SE) or axial length (AL). Data extraction was performed by three independent reviewers, and heterogeneity was assessed using I 2 statistics. A random-effects model was applied, and effect sizes were determined through weighted mean differences with 95% confidence intervals Our primary outcome was the evaluation of rebound effects on spherical equivalent or axial length. Subgroup analyses were conducted based on cessation and treatment durations, dosage levels, age, and baseline SE to provide a nuanced understanding of the data. Results: The analysis included 13 studies involving 2060 children. Rebound effects on SE were significantly higher at 6 months (WMD, 0.926 D/y; 95%CI, 0.288–1.563 D/y; p = .004) compared to 12 months (WMD, 0.268 D/y; 95%CI, 0.077–0.460 D/y; p = .006) after discontinuation of atropine. AL showed similar trends, with higher rebound effects at 6 months (WMD, 0.328 mm/y; 95%CI, 0.165–0.492 mm/y; p < .001) compared to 12 months (WMD, 0.121 mm/y; 95%CI, 0.02–0.217 mm/y; p = .014). Sensitivity analyses confirmed consistent results. Shorter treatment durations, younger age, and higher baseline SE levels were associated with more pronounced rebound effects. Transitioning or stepwise cessation still caused rebound effects but combining optical therapy with atropine seemed to prevent the rebound effects. Conclusion: Our meta-analysis highlights the temporal and dose-dependent rebound effects after discontinuing atropine. Individuals with shorter treatment durations, younger age, and higher baseline SE tend to experience more significant rebound effects. Further research on the rebound effect is warranted. Systematic Review Registration: [ https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=463093 ], identifier [registration number]

The study aims to compare the efficacy/safety of femtosecond laser-assisted cataract surgery (FLACS) vs. conventional phacoemulsification cataract surgery (CPCS). A systematic search/analysis of PubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov up to January 2023 was conducted without date/language restrictions. Weighted mean differences, risk ratios, and Hedges’ g with 95% confidence intervals were calculated. The stability of results was assessed using trial sequential analysis (TSA). International Prospective Register of Systematic Reviews Registration No. PROSPERO CRD42023393323. Forty-six randomized controlled trials (8,871 eyes) revealed that FLACS yielded a significantly better corrected distance visual acuity (CDVA) 1 week postoperatively ( P  = 0.011) with no significant differences in CDVA beyond 1 week ( P  = 0.161, 0.429, 0.403), or in uncorrected distance visual acuity ( P  = 0.171, 0.136, 0.322, 0.149), spherical equivalent, or surgically induced astigmatism. Concerning safety outcomes, no significant differences were observed in overall complications ( P  = 0.999). These findings were supported by TSA. Ultimately, the overall complications, patient-reported health, visual, and daily-activity outcomes were not significantly different between FLACS and CPCS. Regarding extended-term and patient-centered outcomes, we identified no substantial disparities in visual acuity, complications, or patient-reported outcomes between FLACS and CPCS. Subgroup analysis showed consistent efficacy and safety across diverse laser platforms. Notably, FLACS exhibited no clear cost-effectiveness advantage over CPCS.

Background: Early-onset myopia increases the risk of irreversible high myopia. Methods: This study systematically evaluated the efficacy and safety of low-dose atropine for myopia control in children with premyopia through meta-analysis using random-effects models. Effect sizes were calculated using risk ratios (RRs) with 95% confidence intervals (CIs). Comprehensive searches of PubMed, EMBASE, Cochrane CENTRAL, and ClinicalTrials.gov were conducted until 20 December 2023, without language restrictions. Results: Four studies involving 644 children with premyopia aged 4–12 years were identified, with atropine concentrations ranging from 0.01% to 0.05%. The analysis focused on myopia incidence and atropine-related adverse events. Lower myopia incidence (RR, 0.62; 95% CI, 0.40–0.97 D/y; p = 0.03) and reduction in rapid myopia shift (≥0.5 D/1y) (RR, 0.50; 95% CI, 0.26–0.96 D/y; p < 0.01) were observed in the 12–24-month period. Spherical equivalent and axial length exhibited attenuated progression in the atropine group. No major adverse events were detected in either group, whereas the incidence of photophobia and allergic conjunctivitis did not vary in the 12–24-month period. Conclusions: Our meta-analysis supports atropine’s efficacy and safety for delaying myopia incidence and controlling progression in children with premyopia. However, further investigation is warranted due to limited studies.

This study assesses the quality of retinal images captured using a non-mydriatic fundus camera within a teleophthalmologic platform in Taiwan. The objective was to evaluate the effectiveness of non-mydriatic fundus cameras for remote retinal screening and identify factors impacting image quality. From June 2020 to August 2022, 629 patients from five rural infirmaries underwent ophthalmic examinations, with fundus images captured without pupil dilation. These images were reviewed by senior ophthalmologists and graded based on quality. The results indicated that approximately 70% of images were of satisfactory diagnostic quality. Risk factors for poor image quality included older age, the presence of cataracts, pseudophakia, and diabetes mellitus. This study demonstrates the feasibility of using non-mydriatic fundus cameras for teleophthalmology, highlighting the importance of identifying and addressing factors that affect image quality to enhance diagnostic accuracy in remote settings.

During and after the COVID-19 pandemic, teleophthalmology provided access to eye care for rural populations. This study aimed to assess the efficacy of and satisfaction with an integrated real-time videoconferencing module. This project incorporated ophthalmic instruments and telecommunication devices and provided on-site consultations via videoconferencing. Both patients and healthcare providers completed satisfaction questionnaires. From May 2020 to May 2021, this project provided eye care services to 395 patients (aged 6–90 years). The most frequent eye condition was chronic conjunctivitis (n = 197), followed by senile cataract (n = 163), dry eye (n = 103), and refractive error (n = 95). Among them, 40 (10.1%) patients were referred to secondary or tertiary hospitals for further evaluation or treatment. In total, 181 recruited respondents provided good satisfaction scores in all dimensions, including quality of medical care (4.50 of 5.00), financial aspects of care (4.48), supportive attitude toward the project (4.47), quality of service (4.40), and quality of telecommunication (4.40). Women had a substantially more supportive attitude toward the project, and 25 healthcare providers provided low ratings in areas representing the quality of telecommunication (4.04) and user-friendliness of the instrument (4.00). This teleophthalmology system provided efficient and satisfactory eye care to participants in remote communities. However, better internet access and training in instrument use can reduce obstacles to the future implementation of the project.

Objectives: To evaluate the efficacy of myopia prevention methods in children without pre-existing myopia. Methods: A network meta-analysis was conducted following the PRISMA-NMA guidelines. Comprehensive searches were performed in PubMed, Embase, and Cochrane CENTRAL databases. The analysis focused on randomized controlled trials evaluating myopia prevention strategies in children without prior myopia. Primary outcomes included annual changes in refraction and axial length, while secondary outcomes encompassed myopia incidence and adverse events. Effect sizes were reported as risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CIs). Data synthesis utilized a random-effects model under a frequentist framework, with intervention efficacy ranked by P-scores. Study quality was assessed using the Cochrane risk-of-bias tool, and robustness was ensured via sensitivity and consistency analyses. Results: Low-level red light therapy and low-dose atropine were the most effective interventions for reducing refractive progression (MD: 0.48 D, 95% CI: 0.38–0.59 D; MD: 0.33 D, 95% CI: 0.23–0.43 D) and axial elongation (MD: −0.23 mm, 95% CI: −0.27 to −0.19 mm; MD: −0.12 mm, 95% CI: −0.16 to −0.08 mm). In addition, both significantly lowered myopia incidence (RR: 0.59, 95% CI: 0.45–0.79; RR: 0.55, 95% CI: 0.41–0.75). Outdoor activities and myopia awareness programs demonstrated moderate efficacy. Adverse events, including photophobia and dry eyes, were minor and self-limiting, with no serious complications reported. Conclusions: Low-level red light therapy and low-dose atropine are the most effective, generally safe strategies for preventing myopia in at-risk children without myopia, while a non-invasive approach, outdoor activities, provides moderate benefits.

Despite high discontinuation rates for myopia optical interventions, limited attention has been given to the potential rebound effects post-discontinuation. This systematic review aims to assess the extent of the rebound effects following the cessation of common clinical optical myopia-control interventions in children. A comprehensive search of PubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov was conducted from inception to October 2023. The rebound effects, defined as changes in the axial length or spherical equivalent during and after treatment cessation, were categorized into four levels. These studies encompassed 703 participants and spanned from 2019 to 2023, with durations of treatment and cessation ranging from 6 months to 3.5 years and from 2 weeks to 5 years, respectively. This review, encompassing 14 studies, revealed a predominant strong rebound effect in orthokeratology (8 studies), a weak rebound effect in multifocal soft contact lenses (4 studies), and a variable rebound effect in peripheral-plus spectacle lenses (2 studies). Notably, with the increasing cessation duration, the rebound effects diminished, potentially linked to the reversal of choroidal thickening and the disappearance of peripheral myopic defocus. In conclusion, a temporal trend of rebound effects exists in all three myopia optical interventions, possibly contributing to their myopia control mechanisms.

Purpose: This study aims to assess the satisfaction, compliance, and side effects among the long-term orthokeratology (Ortho-K) users in a tertiary hospital in Taiwan and analyze the side effects and related risk factors. Methods: Children and their guardians were assessed using a structured and validated questionnaire inquiring about background information, wear and care behaviors, daily activities, satisfaction, and related concerns. Clinical information, including refractive data and side effects, was obtained through patient medical files. Results: Three hundred and five school-aged patients were enrolled, and the average age was 13.13 ± 3.39 years, with an average wearing period of 17.1 ± 8.1 months. Over 83% of the subjects had clear daytime vision all day, around 88% felt satisfied or very satisfied with the results, and 98% exhibited a willingness to continue wearing the Ortho-K lenses. Most guardians (83%) were pleased with the controlling effect of myopic progression. Initial spherical equivalent and regular cleaning of the lens protein significantly correlated with clear day vision. Wearing >6 days/week correlated with less risk of lens binding. Based on the questionnaire, the main reasons for using Ortho-K were effectiveness, safety, and practicality, while the major concerns were discomfort, harmful to the eyes, and no effect. Conclusion: With a comprehensive care program from practitioners and good compliance of users, Ortho-K could be the most effective and satisfactory option for myopic children in Taiwan.