Poster Sessions at IMC 2024

The poster sessions at the International Myopia Conference (IMC) 2024 offered an expansive view into the latest research, experimental techniques, and innovative treatments in myopia management. These sessions highlighted the depth and diversity of approaches currently being explored to better understand and control myopia, bringing cutting-edge science and clinical practice one step closer to effective, personalized care solutions. Here, we’ve selected some key posters to summarize.

This research challenges the belief that standard ortho-k lenses are less effective for myopia control in lower myopia below -2.50D spherical equivalent, an assumption which has recently been incorporated into the European Society of Ophthalmology's 2023 Myopia Management Algorithm. A literature review of 14 controlled trials, including participants up to 18 years of age, found no consistent evidence supporting a correlation between lower myopia and lower myopia control efficacy in standard ortho-k designs. All but one study included subjects with refractions below -2.50D. Four studies didn't test this correlation, seven did and found no relationship, and only four studies showed weak or moderate correlations between baseline refraction and myopia control efficacy. On the balance of evidence, this indicates that standard ortho-k lenses are effective across various refractive ranges and questions the validity of prescribing algorithms that recommend against standard ortho-k for lower myopes. This research advocates for broader acceptance of standard ortho-k in clinical practice.  

This study evaluated eye care practitioners’ (ECP) self-identified confidence and barriers in prescribing soft contact lenses (SCL) and orthokeratology (ortho-k) for myopia control in children from 2020 to 2024. Data were collected from online continuing education courses, assessing ECP confidence before and after course completion. Results showed lower pre-course confidence in fitting ortho-k compared to SCL, with a decline in ortho-k confidence from 2020 to 2024. Post-course confidence improved significantly for both lens types, but was still lower for ortho-k. The leading barriers identified were lack of experience and training, with ECPs frequently citing parent and patient concerns for SCL and confidence issues for ortho-k. The study highlights that while education increases confidence, many ECPs still face challenges, indicating the need for ongoing support and training to enhance the broader uptake of pediatric myopia control contact lens prescribing.

From the online course called Myopia Management in Practice which we developed to be globally accessible, we ascertained roadblocks and barriers to myopia management in practice. The course includes surveys conducted before and after the course to assess eye care practitioners' (ECP) confidence and identify challenges in managing myopia in clinical settings, and measured trends from the first participants in 2019 to the most recent in late 2023. Knowledge gaps remain the biggest obstacle to effective myopia management, with growing concerns around clinical communication. While barriers related to practice settings have decreased, access to treatments has become more of a challenge, and the difficulty in selecting appropriate interventions remains unchanged since 2019. This underscores the ongoing need to support ECPs globally in overcoming these barriers to best-practice care.

NThalmic are working from their experience in extended-depth-of-focus (EDOF) to develop novel spectacle and contact lens technologies, including one new spectacle lens film (S.T.O.P) incorporating various optical patterns with elements of 1.8 to 3mm diameter, in axicon (cone) and light sword (non-rotationally symmetric) which provide dynamic retinal stimulus while maintaining on-axis visual performance. Their optical profiling indicates unique properties with larger spatially and temporally varying optical cues for defocus than currently avaiable lenses. What's particularly special about this is the spectacle film Nthalmic are developing is with the intent to signficantly reduce the cost to patient of myopia control treatment. Clinical trials are underway

This randomized controlled trial evaluated the efficacy of combining 0.025% atropine with Defocus Incorporated Multiple Segments (DIMS) spectacle lenses versus 0.025% atropine with SV lenses in controlling myopia progression in European children. The 12-month study involved 56 myopic children aged 4-16 years. Group B (DIMS + atropine) showed significantly less axial elongation (0.07 mm) compared to group A (SV + atropine) (0.20 mm), with a mean difference of -0.13 mm. Notably, 36.7% of children in Group B had no axial elongation, compared to 15.4% in Group A. These findings suggest that combination therapy with DIMS lenses and atropine may provide enhanced control of axial elongation compared to atropine and SV lenses. 

This study examines the potential rebound effect, or accelerated myopia progression, after stopping myopia control treatments. A literature review identified 19 studies across various treatments, including atropine, spectacle lenses, soft contact lenses, orthokeratology, and red-light therapy. The analysis focused on comparing post-treatment myopia progression and axial elongation to untreated control groups, with treatment durations ranging from 6 months to 3.5 years and post-treatment follow-ups lasting up to 2.5 years. The average rebound for optical treatments was minimal, with greater rebound observed in red-light therapy and higher concentrations of atropine. Notably, lower concentrations of atropine and optical treatments showed little to no rebound. The findings support earlier conclusions from the FDA and the International Myopia Institute that rebound effects are generally absent in optical myopia control treatments and lower-dose atropine. Further research is recommended to explore the relationship between treatment efficacy and rebound.

A retrospective analysis was conducted at UC Berkeley’s Myopia Control Clinic to evaluate the efficacy of MiSight 1 day contact lenses in managing myopia in pediatric patients (n=107) over a year (2019-2023). The study measured changes in spherical equivalent refraction (SER) and axial length (AL) in patients who wore the lenses for at least one year. The mean SER progression was 0.30D, and axial elongation was 0.079mm. Despite the cohort's older age and higher baseline myopia compared to previous trials, MiSight 1 day proved effective in slowing myopia progression with no reported adverse events. The study supports its safety and effectiveness in real-world pediatric populations.

This study assessed the impact of glare and luminance levels on contrast sensitivity to differentiate between myopia control spectacle lens designs. Twenty myopic adults participated in a single-visit, double-blind, randomized crossover study comparing lenses with Diffusion Optics Technology (DOT™), Defocus Incorporated Multiple Segments (DIMS), Highly Aspherical Lenslets (HAL), and standard single-vision lenses. Results showed that glare and reduced luminance significantly lowered contrast sensitivity, especially in the peripheral treatment zones. While there was no difference between the lenses under glare conditions, DOT™ lenses performed similarly to single-vision lenses and better than HAL and DIMS lenses under mesopic conditions. 

This study examined the effectiveness of a daily disposable soft contact lens delivering 6 to 8D of relative plus power, significantly more than the typical 2D offered by most myopia control lenses as stated by authors. This study looked at retrospective data and preliminary results from the PROTECT randomized controlled trial (n = 145). Results showed a consistent CARE value of ~0.17 mm across studies at 1 year. Among children (up to 1.75DC), 64 to 95% experienced a change in CSER of less than 0.25 D/year. In 8-13-year-olds, myopia progression was reduced by 68% and axial length by 58%. The catenary multifocal lens is effective across various pupil sizes, with larger pupils showing greater treatment effects. Analytic comparison to other treatments was not undertaken in this study to indicate a dose-response effect, but the results are comparable to similar effective spectacle and contact lens treatments. The ongoing PROTECT trial continues to evaluate its efficacy across populations.