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Background To evaluate the impact of parental myopia and outdoor time on myopia among students in Wenzhou. Methods We examined 1388 primary students from first grade to third grade in Wenzhou from September 2012 to March 2015. We performed noncycloplegic refractometry on each student every six months and axial length (AL) measurements every year. At the commencement of our study, children were asked to complete a questionnaire regarding near work activity and outdoor activity, whereas parents were asked to complete a self-administered questionnaire regarding their background circumstances and their history of myopia. Results A total of 1294 students (93.2%) returned for follow-up examinations. Children with initial and final no myopia spent more time on outdoor activities than those with new onset myopia (1.92 vs. 1.81 h/d, p  = 0.022), and elongation of AL in children with a high level (> 2.5 h/day) of outdoor time (0.22 ± 0.13 mm/Y) was less than those with a low level (≤ 1.5 h/day) of outdoor time (0.24 ± 0.14 mm/Y, p  = 0.045). The proportion of rapid myopia progression (≤-0.5D/Y) was 16.7%, 20.2% and 31.5% among the children with no myopic parent, one myopic parent and two myopic parents, respectively (X 2  = 28.076, p  < 0.001), and the elongation of AL in children among different numbers of myopic parents was significantly different ( p  < 0.001). A high level of outdoor time was a protective factor for children with one myopic parent (HR 0.49, 95% CI 0.27–0.88; p  = 0.018). Conclusions In this sample, parental myopia and outdoor time were associated with myopia in children. A high level of outdoor time was a protective factor for children with one myopic parent.

Background To study the baseline factors that related to faster axial elongation after orthokeratology (OK) treatment and the characteristics of cases with axial length decrease in a group of myopia children. Methods This is a retrospective study. The records of 73 children who had wear OK lens for at least one year were reviewed. Only the data of right eyes were included. Baseline data included: age, gender, parental myopia, refractive error, corneal power, central corneal thickness, axial length and anterior chamber depth. Corneal power, central corneal thickness, anterior chamber depth and axial length after one-year of OK lens wear were also collected. The related factors affecting axial length change were analyzed. A comparison was made on the cases of axial length increase and axial length decrease. Results Of the 73 eyes, axial length increased by 0.18 ± 0.17 mm ( P  < 0.001) after one year of OK lens wear. Correlation analysis showed that one-year axial length change was negatively correlated with age and positively correlated with the parental myopia and baseline myopia. Stepwise multiple linear regression analysis showed that the factors associated with faster axial elongation were lower baseline myopic spherical equivalent ( P  = 0.018), higher parental myopia degree ( P  = 0.026), and younger age at the onset of lens wear. ( P  = 0.039). Nine eyes showed negative axial growth (−0.06 ± 0.04 mm), and had older initial age of lens wear, higher baseline myopic spherical equivalent, and lager baseline corneal power , when c ompared with cases of axial length increase . Conclusions Myopia children with lower baseline myopic spherical equivalent, younger initial age and higher parental myopia had faster axial elongation after orthokeratology treatment. More aggressive treatment should be considered. In children with slow axial elongation, OK lens wear may lead to negative axial growth. Whether there are reasons other than central corneal thinning and choroidal thickening needs further study.

The prevalence of children myopia in Taiwan is among the highest in the world. The study aimed to understand the status of the final prescription of the spectacle prescribed by the Taiwan optometrists when they conducted the visual inspection of elementary school, middle school and high school students, and to evaluate the influencing factors of their decision-making behavior. Among the attendants of the continuing education course activities held by optometrist associations in Taiwan, an anonymous questionnaire survey was given on the spot to optometrists who have passed the national examination. This study received 442 questionnaire surveys, including 174 optometrists and 268 assistant optometrists. The data were analyzed by using chi-square test in IBM SPSS. There are statistically significant differences in the decision-making of spectacle prescription for myopia of -1.00D~-1.50D and -2.25D~-2.50D in the primary school stage between optometrists and assistant optometrists. There are also significant differences for myopia of -2.25D and above in the middle school students. By the time of high school, there are significant differences for myopia from -0.75D to -3.25D and above. The higher the grade, the greater the difference in the final prescription of the spectacles given. As for the judgment factors of the final prescription, only children among elementary school and junior high school show a statistically significant difference in professional judgment between optometrists and assistant optometrists. There is no significant difference in the judgment factors for high school children. Depending on the educational level of optometrists and assistant optometrists and their distribution area, the prescription decisions are also different. The optometrists prefer to prescribe full correction for schoolchildren, while the assistant optometrists mostly prescribe under-correction in prescriptions for low-degree myopia and lower grades. Further investigation is needed to study its impact on children's visual health.

Atropine is used to treat myopia, and choroidal thickness (ChT) has been suggested as a biomarker for treatment response. However, randomized controlled trials (RCTs) have reported inconsistent results regarding their efficacy. This study aimed to assess the effect of atropine on ChT in children with myopia. A systematic review and meta-analysis of RCTs was conducted using PubMed, Cochrane, Embase, and Web of Science databases, including trials registered online, from inception to March 2025. Eligible studies were those that involved patients aged <18 years with myopia treated using atropine sulfate eye drops and reported ChT outcomes. Meta-regression and the Cochrane test were used to assess heterogeneity, respectively. Publication bias was evaluated using Funnel plots and Egger's and Begg's tests. Sensitivity analysis was used to examine the impact of individual studies. Overall, 11 RCTs involving 1,784 eyes of children with myopia were included. Four doses of atropine (0.01, 0.025, 0.05, and 0.1%) were administered. Subfoveal ChT (SFChT) significantly thickened in the atropine group compared with the control group (placebo or spectacles) during the trial periods [weighted mean difference (WMD): 11.83 μm, 95% confidence interval (CI): 0.88-22.79 μm,  = 98.8%,  = 0.000]. Additionally, 0.01% atropine showed the best effect in ChT changes at superior 1 and inferior 1 compared with control. Notably, 0.05% atropine demonstrated the most significantly thickened SFChT (WMD: 25.70 μm, 95% CI: 17.46-33.94 μm), had the best spherical equivalent control (WMD: 0.54 D, 95% CI: 0.38-0.70 D), and had the least axial length elongation (WMD: -0.21 mm, 95% CI: -0.28 to 0.14 mm). The results showed that atropine may increase ChT than control. Notably, 0.05% atropine may demonstrate the most favorable outcomes for ChT, spherical equivalent, and axial length. https://inplasy.com/?s=INPLASY202320027.

Objective To observe the efficacy and safety of posterior sclera reinforcement over time. Methods This retrospective single-arm cohort study included children with high myopia who underwent the modified Snyder-Thompson type posterior sclera reinforcement surgery from 03/2015 to 08/2018 at Fuzhou Children’s Hospital of Fujian Medical University. Axial length (AL), corneal radius of curvature (CRC), AL/CRC, refractive error, and best-corrected visual acuity (BCVA) were observed from 1 year before the operation to 2 years after. Results Nineteen children (33 eyes) with high myopia were included. The patients were 4.9 ± 2.7 (range, 2–10) years of age (three patients were 10 years old, all others were ≤ 7 years old). AL increased from 1 year before surgery to 2 years after surgery (from 25.31 ± 1.59 to 26.76 ± 1.52, P  < 0.001). The refractive error was smaller 1 year before surgery than at the other timepoints (all P  < 0.05). BCVA improved over time ( P  < 0.001). Changes over time were also observed in horizontal CRC (hCRC), AL/hCRC, AL/vertical CRC (vCRC), and AL/CRC (all P  < 0.001), but not in vCRC ( P = 0.304). The increase of AL at 2 years after surgery was smaller than at 1 year before surgery and 1 year after surgery (both P  < 0.001). The increase of AL/CRC at 2 years after surgery was smaller than at 1 year before surgery (0.04 ± 0.04 vs. 0.07 ± 0.04; P  = 0.008). Conclusion In the short term, posterior scleral reinforcement surgery can delay the increase of AL of progressive high myopia.

Background To investigate changes in choriocapillaris blood flow density (CFD) and identify factors influencing axial elongation in Chinese children and adolescents with mild to moderate myopia. Methods A hospital-based cross-sectional study was conducted. A total of 288 participants aged 8 to 15 years were recruited from Tianjin Eye Hospital, including 186 children and adolescents with myopia and 102 age-matched participants without refractive error who served as the control group. Based on cycloplegic spherical equivalent (SE), the myopic participants were further categorized into moderate and mild myopia groups. Refractive power was determined through refraction tests, while various parameters—including axial length (AL) and choriocapillaris flow density (CFD)—were obtained through ophthalmic examinations. Statistical analyses were performed to examine changes in CFD and to identify factors associated with axial length. Results AL and SE differed significantly among all three groups (all P  < 0.001). SFCT was significantly lower in the moderate myopia group compared to the mild myopia and control groups ( P  < 0.05 for both comparisons), while no significant differences in SFCT or FRT were found between the mild myopia and control groups(all P  > 0.05).CFD-peri was significantly lower in the moderate myopia group compared to both the mild myopia and control groups ( P  = 0.006 and P  < 0.001, respectively), while no significant differences were found in CFD-fovea or CFD-para among the three groups( P  > 0.05).Spearman correlation analysis revealed significant negative correlations between AL and SE ( r = -0.770), SFCT ( r = -0.170), CFD-fovea ( r = -0.347), CFD-para ( r = -0.368), and CFD-peri ( r = -0.359) (all P  < 0.01). Hierarchical regression analysis identified SE (β = -0.751, P  < 0.001) and CFD-peri (β = -0.118, P  = 0.005) as independent predictors of axial length, with the final model explaining 71.5% of its variance (R² = 0.715). Conclusion Choriocapillaris blood flow density in the macular region changes in the early stages of myopia, showing decreases in the perifoveal region. Both SE and CFD-peri may serve as potential biomarkers for predicting axial length elongation in the early stage of myopia.

Purpose: The coronavirus disease 2019 (COVID-19) pandemic profoundly impacts lifestyle habits and myopia control in children worldwide. This study investigated the changes in eyecare habits, orthokeratology compliance, axial length, and time interval of follow-up visits during home confinement in the COVID-19 pandemic in Taiwan. Methods: This investigation was part of a prospective study undertaken to evaluate the effectiveness of a mobile application. A semi-structured telephone interview was conducted with parents retrospectively to document eyecare habits and myopia control during the COVID-19 home confinement. Results: Thirty-three children with myopia participated in the follow-up of orthokeratology lenses for 2 years. The children's time viewing digital devices such as tablets and televisions significantly increased during the COVID-19 pandemic (P < 0.05). An analysis using McNemar's test found that the proportional growth of axial length <0.2 mm in 2021 was significantly higher than that in 2020 (77.42% vs. 58.06%, P < 0.05). In the multivariate logistic regression analysis, onset <10 years of age (P = 0.001) and parents with high myopia (P < 0.001) were independent risk factors for the growth of axial length ≥0.2 mm in 2021. Conclusion: The suspension of face-to-face classes and after-school tutorials benefited myopic axial elongation in children during COVID-19 home confinement. The use of digital devices and staying indoors may not be the exclusive reasons for myopia progression. Educating parents about the influence of extra learning classes after school on myopia progression would be prudent.

To evaluate the effect of oral Difrarel on progression of high myopia in children and to study myopia course after its discontinuation. A total of 64 highly myopic children were enrolled in this study. Patients were divided into two equal groups: group 1 was administered Difrarel for 1 year and stopped its intake for another year, and group 2 (control) did not take Difrarel. Refraction and axial length of the right eye of every subject were measured every 6 months in both groups. Each group had 32 eyes of 32 patients. The mean age was 9.34±2.27 years in group 1 and 9.33±2.2 years in group 2. Mean refraction and axial length at the start of the study were -10.78±2.6 D and 23.7±1.2 mm, respectively, in group 1, and -10.5±2.55 D and 23.9±1.4 mm in group 2. Refraction and axial length measurements every 6 months revealed statistically significant lower numbers in group 1 than group 2 after 1 year. After discontinuation of the drug, the difference between both groups remained significant. Oral Difrarel slowed axial elongation and stopped myopia progression in children with high myopia. The drug effect was consistent after its discontinuation for 1 year.

Background: To determine the change in refractive error and the incidence of myopia among school-aged children in the Yongchuan District of Chongqing City, Western China. Methods: A population-based cross-sectional survey was initially conducted in 2006 among 3070 children aged 6 to 15 years. A longitudinal follow-up study was then conducted 5 years later between November 2011 and March 2012. Refractive error was measured under cycloplegia with autorefraction. Age, sex, and baseline refractive error were evaluated as risk factors for progression of refractive error and incidence of myopia. Results: Longitudinal data were available for 1858 children (60.5%). The cumulative mean change in refractive error was -2.21 (standard deviation [SD], 1.87) diopters (D) for the entire study population, with an annual progression of refraction in a myopic direction of -0.43 D. Myopic progression of refractive error was associated with younger age, female sex, and higher myopic or hyperopic refractive error at baseline. The cumulative incidence of myopia, defined as a spherical equivalent refractive error of -0.50 D or more, among initial emmetropes and hyperopes was 54.9% (95% confidence interval [CI], 45.2%-63.5%), with an annual incidence of 10.6% (95% CI, 8.7%-13.1%). Myopia was found more likely to happen in female and older children. Conclusions: In Western China, both myopic progression and incidence of myopia were higher than those of children from most other locations in China and from the European Caucasian population. Compared with a previous study in China, there was a relative increase in annual myopia progression and annual myopia incidence, a finding which is consistent with the increasing trend on prevalence of myopia in China.

INTRODUCTION: To compare the refractive measures of preterm and full-term children aged 1 year old. METHODS: Fifty two eyes of 26 preterm children and 44 eyes of 22 term children were included in this study. Group 1 consisted of full-term subjects (mean GA 38.7 weeks), group 2 consisted of (mean GA 31.6 weeks) preterm subjects with no retinopathy of prematurity (ROP) and group 3 was included preterm subjects (mean GA 27.8 weeks) affected by ROP which required no treatment. All patients had undergone control examinations of autorefraction by Plusoptix S08 (PX) without cycloplegia and than fundoscopic evaluation at first year. The obtained refraction values were recorded as spherical equivalent (SE). The mean SE between the groups was compared statistically. RESULTS: Mean SE of group 1 was statistically significant compared to group 2 and 3 (p<0.01), difference in SE between group 2 and 3 was weaker but also significant (p<0.05). The rate of myopia in ROP (+) group 3 (45%) was higher than group 1 (16%) and group 2 (38%) and the rate of hyperopia in group 1 (52%) was quite higher than group 2 (%13) and group 3 (%10). The percentage of astigmatism were significantly higher in group 2 (85%) and 3 (53%) than group 1 (25%). DISCUSSION AND CONCLUSION: Refractive errors are more often in preterm infants even in the absence of ROP. Therefore screening for refractive errors in preterm children is important to prevent amblyopia.