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This study aimed to investigate the correlation between myopia severity and the stress–strain index (SSI), measured with the Corneal Visualization Scheimpflug Technology (Corvis ST) device. The subjects were divided into two groups, based on both the axial length (AL) and spherical equivalent refraction (SER): 22–26.00 AL group (22 mm < AL < 26.00 mm) associated with SER of less than − 6.00D, and ≥ 26.00 AL group (AL ≥ 26.00 mm) associated with SER over − 6.00D. The differences in the Corvis ST-derived dynamic corneal response parameters and stiffness parameters between the two groups were investigated. The correlation between SSI and AL, SER, age, ratio of AL to radius of corneal curvature (CR) (AL/CR), and axial length minus anterior chamber depth (ACD) (AL-ACD) were analyzed. The SSI (0.95 ± 0.13 in the 22–26.00 AL group and 0.86 ± 0.15 in the ≥ 26.00 AL group) were significantly different between the two groups ( P  < 0.01). In the ≥ 26.00 AL group, there was evidence of a weak negative correlation between SSI and AL (r = − 0.265, P  < 0.01), AL/CR (r = − 0.376, P  < 0.01), and AL-ACD (r = − 0.224, P  < 0.01); and a weak positive correlation between SSI and SER (r = 0.251, P  < 0.01). However, in the 22–26.00 AL group, there was no correlation between SSI and AL, AL-ACD, AL/CR or SER ( P  > 0.05). SSI was significantly correlated with AL, which is the major determinant of SER, in the ≥ 26.00 AL group. This correlation was not affected with CR and ACD, as both AL/CR and AL-ACD also correlated with SSI at the same degree.

Myopia is a global public health concern and a leading cause of distance vision impairment, affecting mainly children and young adults. Although several studies have reported myopia prevalence in Mexico, recent nationwide data, especially regarding high myopia, are lacking following the COVID-19 pandemic. We estimated the prevalence and distribution of low and high myopia in a cohort of Mexican outpatients. A retrospective, cross-sectional, clinic-based study was conducted using anonymized electronic health records from Salud Digna clinics. Data included individuals aged 6-100 years undergoing routine non-cycloplegic eye examinations between January and December 2023. Myopia was defined as spherical equivalent refraction (SER) ≤ -0.50 diopters (D) in the right eye and subclassified into low (-6.0 D < SER ≤ -0.50 D) or high (SER ≤ -6.0 D). Age-standardized prevalence rates were estimated overall and by sex and geographic location. Multinomial logistic regression evaluated potential risk between demographic/clinical background and myopia severity. From 3,507,826 records, 1,337,526 (38.13%) individuals were myopic (median age: 28 years; 61.4% females). Age-standardized rates for total, low, and high myopia were 44.44% (95% CI, 44.36-44.52%), 43.31% (95% CI, 43.24-43.39%), and 1.12% (95% CI, 1.11-1.14%), respectively. Low myopia was more prevalent in males, whereas high myopia predominated in females (both  < 0.001). Both forms were most prevalent in individuals ≤ 10 through 31-40 years, peaking at 64.65 and 1.75% in the 21-30 age group. The Central region, specifically Mexico City, State of Mexico, Puebla, and Tlaxcala, had the highest prevalence of low and high myopia. Mild, moderate, and severe astigmatism significantly increased the myopia risk: 3-, 8-, and 11-fold for low myopia and 5-, 33-, and 100-fold for high myopia (all  < 0.001). Male sex, diabetes, and high blood pressure were associated with a lower risk (all  < 0.001). Astigmatism was a risk factor for myopia, with increasing severity raising the risk of developing both forms of myopia. Although high myopia remains relatively uncommon nationally, its increasing prevalence from childhood to early adulthood highlights the need for early detection and close monitoring to mitigate future visual impairment in Mexico.

PurposeHigh myopia and pathologic myopia are common causes of visual morbidity. Myopic pathology can affect all regions of the retina, though there is currently no classification system to distinguish anterior (peripheral) and posterior (macular) pathology. We hypothesize that these classifications are characterized by distinct demographic and refractive features, highlighting the disparity in types of pathologic myopia.MethodsInstitutional retrospective cohort study. The Stanford University Medical Center Clinical Data Warehouse was used to identify patients with high myopia by ICD-9 and ICD-10 codes. Predetermined ICD diagnoses were then used to classify patients with high myopia into isolated high myopia (IHM), anterior pathologic myopia (APM), posterior pathologic myopia (PPM), and combined pathologic myopia (CPM). A cohort of this population was then manually reviewed to gather refractive data and confirm accuracy of ICD coding.ResultsPatients (3274) were identified with high myopia. Overall, 22.1% individuals met criteria for APM, 10.7% for PPM, 17.0% for CPM, and 50.2% for IHM. We identified a significantly higher frequency of females with PPM compared to APM (62.3 vs. 48.3%; OR, 1.73; 95% CI, 1.34 to 2.25), Asian patients with PPM as compared to APM (42.9 vs. 33.3%; OR, 1.50; 95% CI, 1.16 to 1.95), and younger patients with APM compared to PPM (median 45.3 vs. 63.4 years). The refractive error was significantly more myopic in the CPM (median − 9.8D; interquartile range, IQR 6.7) and PPM (median − 10.5D; IQR 9.8) subgroups as compared to the APM (median − 8.1D; IQR 3.5), and IHM (median − 8.2D; IQR 4.1) subgroups (p = 0.003).ConclusionsHigh myopia may be divided into four distinct subgroups based on presence and location of pathology, which is associated with differences in age, gender, race, and refractive error.

High myopia can lead to pathologic myopia and visual impairment, whereas its causes are unclear. We retrospectively researched high myopia cases from patient records to investigate the association between axial elongation and myopic maculopathy. Sixty-four eyes were examined in patients who visited the department between July 2017 and June 2018, had an axial length of 26 mm or more, underwent fundus photography, and had their axial length measured twice or more. The average axial length was 28.29 ± 1.69 mm (mean ± standard deviation). The average age was 58.3 ± 14.4 years old. Myopic maculopathy was categorized as mild (grades 0 and 1) and severe (grades 2, 3, and 4). The severe group had longer axial lengths than the mild group ( P  < 0.05). Moreover, the severe group exhibited thinner choroidal thickness than the mild group ( P  < 0.05). When subjects were grouped by axial elongation over median value within a year, the elongation group showed thinner central choroidal thickness than the non-elongation group (142.1 ± 91.9 vs. 82.9 ± 69.8, P  < 0.05). In conclusion, in patients with high myopia, the severity of maculopathy correlated with choroidal thickness and axial length. Thinner choroidal thickness was associated with axial elongation based on the baseline axial length.

Objectives By utilizing eye-tracking data, this study aims to evaluate the impact of both mild and moderate myopia and different refractive correction methods on certain types of attention of school-age children. Methods In this prospective case–control study, data was collected from 90 children aged 8 to 10 years old. Participants were classified into three groups based on their spherical lens: mild myopia group (SE: ≤ − 0.50D and > − 3.00D), moderate myopia group (SE: ≤ − 3.00D and > − 6.00D), and control group (SE: ≤ + 0.50D and > − 0.50D). Additionally, children with myopia were subdivided into three subgroups based on refractive correction methods: the uncorrected group, the spectacles corrected group, and the orthokeratology lenses group. The eye-tracking system was used to record and compare attention assessment metrics, including saccade latency, total search time, and saccade accuracy. To enhance result reproducibility, MoCA scale scores were used as a control method to measure attention. Results When categorized by refraction, MoCA scale scores were lower in the moderate myopia group compared to the control group ( p  = 0.011). Saccade latency and total search time were slower in both the mild and moderate myopia groups compared to the control group ( p  < 0.001). A weak positive correlation was observed between spherical lens and total search time ( r  = 0.260, p  = 0.045). When grouped according to correction method, statistically significant differences in saccade latency were evident across all groups (all p  < 0.001); the uncorrected group had the longest latency, whereas the orthokeratology lenses group had the shortest. The orthokeratology lenses group exhibited a shorter total search time compared to the uncorrected group ( p  = 0.018). Conclusions Affected by myopia, impairments and deficits in attention may occur in school-age children and worsen with the progression of myopia. These cognitive dysfunction can be alleviated by timely refractive correction during the plastic cognitive stage. Compared to the spectacles corrected group, the orthokeratology lenses group showed greater improvement in attention among myopic children. What is Known: •  Myopia can affect people's cognition, function, emotions, and so on. What is New: •  We cites eye-movement indicators to quantify the impact of myopia on attention. •  Most people study myopic adults, but we selects school-age children whose cognition is in the plasticity period.

To investigate annual myopia progression in individuals from South Indian states across different age groups, and its association with age of onset and severity of myopia. This retrospective study included the data of 6984 myopes (range: 1-30 years), who visited at least twice to LV Prasad Eye Institute and on whom a standard retinoscopy technique was performed to determine refractive error. Based on spherical equivalent (SE) refractive error, individuals were classified into mild, moderate, high and severe myopic groups. Myopia progression was calculated as difference between SE at 1-year follow-up visit and at baseline. To determine the age-specific myopia progression, individuals were further categorized as myopes who are at least 15 years or younger and those who are above 15. The mean annual progression of myopia was influenced by both the age group (p < 0.001) and severity type of myopia (p < 0.001). The overall mean myopia progression ranged from -0.07 ± 0.02 D (standard error) to -0.51 ± 0.02 D across different age groups with maximum change in refractive error noted in children aged 6-10 years and the least in adults aged 26-30 years. Myopia progression was greater in severe myopes, followed by high, moderate, mild myopes and in individuals aged ≤ 15 years compared to those aged >15 years (-0.45 ± 0.01 vs. 0.14 ± 0.01, p < 0.001). Severe myopes alone had similar annual myopia progression rate irrespective of age (i.e ≤15 and >15 years, p = 0.71). Early onset of myopia was associated with high myopia in adulthood. The magnitude of myopia progression in children from South Indian states is comparable to that of Caucasians and Chinese. The greater progression in 'severe myopes' across different age groups emphasize the need for regular follow-ups, monitoring axial lengths, and anti-myopia strategies to control myopia progression irrespective of the age and degree of myopia.

PurposeTo evaluate the prevalence of dome-shaped macula (DSM) in highly myopic eyes among Chinese Han and to detect the correlation with myopic maculopathy and macular complications.MethodsA total of 736 Chinese Han patients (1384 eyes) with high myopia (refractive error≤6.0 diopters or axial length ≥26.5 mm) are reviewed based on information entered into a high-myopia database at Zhongshan Ophthalmic Centre. Subfoveal choroidal thickness (SFCT) and parafoveal choroidal thickness (PFCT) are measured. The prevalence of DSM in patients with myopic maculopathy is categorised from C0 to C4. Clinical features, including macular complications, SFCT and PFCT, are compared between myopic eyes with and without DSM.ResultsAmong the 1384 eyes, 149 (10.77%) show DSM. In highly myopic eyes without macular complications, the best corrected visual acuity is significantly worse in patients with DSM (p=0.002), and the ratio between subfoveal and parafoveal choroidal thickness (S/PCT) is significantly elevated in patients with DSM (p=0.021). The proportion of foveal schisis (17.24% vs 62.86%) is much lower in eyes with DSM compared with those without DSM. However, the proportions of extrafoveal schisis (39.66% vs 5.37%), foveal serous retinal detachment (SRD) (5.17% vs 0) and epiretinal membrane (ERM) (24.14% vs 10.74%) are much higher in eyes with DSM. The proportion of DSM was lower in C0 and C1, but higher proportion of DSM was found in C3 and C4.ConclusionsDSM is found in 10.77% of highly myopic eyes among Chinese Han. DSM might be a protective mechanism for foveal schisis and a risk factor for extrafoveal schisis, SRD and ERM.

This study examined and compared outcomes of deep learning (DL) in identifying swept-source optical coherence tomography (OCT) images without myopic macular lesions [i.e., no high myopia (nHM) vs. high myopia (HM)], and OCT images with myopic macular lesions [e.g., myopic choroidal neovascularization (mCNV) and retinoschisis (RS)]. A total of 910 SS-OCT images were included in the study as follows and analyzed by k-fold cross-validation (k = 5) using DL's renowned model, Visual Geometry Group-16: nHM, 146 images; HM, 531 images; mCNV, 122 images; and RS, 111 images (n = 910). The binary classification of OCT images with or without myopic macular lesions; the binary classification of HM images and images with myopic macular lesions (i.e., mCNV and RS images); and the ternary classification of HM, mCNV, and RS images were examined. Additionally, sensitivity, specificity, and the area under the curve (AUC) for the binary classifications as well as the correct answer rate for ternary classification were examined. The classification results of OCT images with or without myopic macular lesions were as follows: AUC, 0.970; sensitivity, 90.6%; specificity, 94.2%. The classification results of HM images and images with myopic macular lesions were as follows: AUC, 1.000; sensitivity, 100.0%; specificity, 100.0%. The correct answer rate in the ternary classification of HM images, mCNV images, and RS images were as follows: HM images, 96.5%; mCNV images, 77.9%; and RS, 67.6% with mean, 88.9%.Using noninvasive, easy-to-obtain swept-source OCT images, the DL model was able to classify OCT images without myopic macular lesions and OCT images with myopic macular lesions such as mCNV and RS with high accuracy. The study results suggest the possibility of conducting highly accurate screening of ocular diseases using artificial intelligence, which may improve the prevention of blindness and reduce workloads for ophthalmologists.

Purpose: To compare the Visian Toric Implantable Collamer Lens (TICL), a toric phakic intraocular lens (IOL), and photorefractive keratectomy (PRK) in the correction of moderate to high myopic astigmatism. Methods: This prospective, randomized study consisted of 43 eyes implanted with the TICL (20 bilateral cases) and 45 eyes receiving PRK with mitomycin C (22 bilateral cases) with moderate to high myopia (−6.00 to −20.00 diopters [D] sphere) measured at the spectacle plane and 1.00 to 4.00 D of astigmatism. All patient treatment and follow-up occurred at the Naval Medical Center San Diego. Study follow-up was 1 day, 1 week, 1, 3, 6, and 12 months postoperative. Results: Mean best spectacle-corrected visual acuity (BSCVA), change in BSCVA, proportion of cases with improvement of 1 or more lines of BSCVA, proportion of cases with BSCVA and uncorrected visual acuity (UCVA) 20/12.5 or better, proportion of cases with BSCVA and UCVA 20/16 or better (6 months, 88% vs 54%, P=.002), and predictability ±1.00 D (6 months, 100% vs 67%, P<.001) were all significantly better in the TICL group than the PRK group at all time periods studied postoperatively. Similarly, contrast sensitivity, tested at both the 5% photopic level and the 25% mesopic level, was significantly better at all postoperative time points in the TICL group. Mean spherical equivalent refraction was closer to emmetropia (0.28±0.41 vs 0.76±0.86, P=.005), and predictability ±0.50 D and stability of manifest refraction (±0.50 D and ±1.00 D) were significantly better in the TICL group at all postoperative visits through 6 months. Mean astigmatism correction at 6 months was not significantly different between the two groups (0.52±0.33 vs 0.46±0.35, P=.450). Conclusions: The TICL performed better than PRK in all measures of safety (BSCVA), efficacy (UCVA), predictability, and stability in this comparison, supporting the TICL as a viable alternative to existing refractive surgical treatments. [J Refract Surg. 2007;23:853–867.]

Myopia is a critical public health issue; however, the roles of multidimensional psychological resources (i.e., resilience and emotion regulation) and potential gender differences remain underexplored. This cross-sectional study aimed to investigate the association between latent psychosocial profiles and myopia severity, and to examine the moderating role of gender in this association among adolescents. In total, 1008 Chinese seventh-grade students completed assessments of psychological resilience, emotion regulation, and depressive and anxiety symptoms. Myopia was measured as spherical equivalent refraction (SER). Latent profile analysis (LPA) was used to identify distinct psychological profiles, and moderation analysis tested gender’s role in the profile-myopia association. LPA revealed three distinct psychosocial profiles: \"Low-Resource\", \"Emotion-Driven\", and \"Balanced-Adaptive\". The Low-Resource profile exhibited the highest levels of depression, anxiety, and myopia severity. A significant moderating effect of gender was found. Among females, both the Emotion-Driven and Balanced-Adaptive profiles were associated with significantly less myopia severity compared to the Low-Resource profile—an association not observed in males. Specific psychological resource profiles were linked to myopia severity, a relationship that was significantly moderated by gender and was prominent only in female adolescents. These findings highlight the importance of person-centered approaches and gender-specific considerations in understanding the psychosomatic pathways of myopia.