ARVO 2024 latest research updates

The Association for Research in Vision and Ophthalmology (ARVO) 2024 annual conference ran from May 5-9 in Seattle, USA. Bringing together over 11,000 eye researchers to share their latest learnings, we brought you the highlights, hot off the press! From almost 200 myopia abstracts, team Myopia Profile selected 32 - a handful from each day - picked for their relevance to clinical practice.  

Authors: Kate Gifford^1,3, Paul Gifford^1,2

1. Myopia Profile Pty Ltd, Queensland, Australia 
2. Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia 
3. Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia

The globally accessible online course 'Myopia Management in Practice' includes pre- and post-course surveys asking about eye care practitioner (ECP) confidence and roadblocks in clinical myopia management. Consecutive respondent data from 2019 was compared to 2023, finding that pre-course confidence is static (around 2.8 out of 5 on a Likert scale) despite the increased availablity of knowledge, treatments and resources in that time. Post-course confidence has improved though, (4.1 out of 5 in 2023) likely reflecting the latter. ECP knowledge persists as the most dominant barrier to myopia management and clinical communication is an increasing concern. Practice setting barriers have gone down while treatment access barriers have gone up; which intervention to choose is unchanged from 2019 to 2023.

Awarded as an ARVO Hot Topic. 

Link to Abstract

Authors: Weizhong Lan¹, Wei Pan¹, Longbo Wen², Zhiwei Luo², Ian Flitcroft³, Zhikuan Yang¹ 

1. Central South University Aier School of Opthalmology, Changsha, Hunan, China
2. Aier Institute of Optometry and Vision Science, Aier Eye Hospital Group, , China
3.  Technological University Dublin, Dublin, Dublin, Ireland 

A randomised controlled trial assessed whether changing classrooms’ spatial frequency spectra to mimic outdoor scenery impacted myopia onset and progression. Students grade 3-4 (n=912) were randomised to either classrooms decorated with wallpapers of outdoor scenes or traditional rooms with white walls for 1 year. The results showed that students in the outdoor scene classrooms showed less myopic shift compared to traditional classrooms. Hyperopic students in the outdoor scene classrooms had significantly less myopic shift and axial elongation compared to baseline. This suggests that changing the spatial frequency spectra of classroom environments may have a protective effect against myopia onset.

Link to Abstract

Authors: Shengsong Xu¹, Yin Hu¹, Xiao Yang¹ 

1. Sun Yat-Sen University Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Guangzhou, Guangdong, China

In a RCT involving 164 children aged 8-12 yrs, participants were divided into different treatment groups including control, atropine 0.01%, orthokeratology, and combined therapy, with measurements of axial length and choroidal characteristics taken at multiple intervals. The results indicated that all treatments effectively slowed axial length elongation, with combined therapy showing superior effectiveness over monotherapy, and ortho-k particularly beneficial for younger children in enhancing choroidal thickness and maintaining contour stability. In children aged 8-10 years, ortho-k and combo therapy efficacy was similar. The study concluded that combining atropine and ortho-k is more effective in controlling myopia than either treatment alone, particularly in protecting against choroidal thinning and more prolate choroidal contour development observed in the control group. 

Link to Abstract

Authors: Jun Jiang¹, Binbin Su¹, Jingwei Zheng¹ 

1. Wenzhou Medical University Eye Hospital, Wenzhou, Zhejiang, China

This 1-yr clinical trial investigated the efficacy of a novel myopia control spectacle lens design called 'Lenslet-ARray-Integrated' or 'LARI' with positive and negative power lenslets for 240 children aged 6-12yrs. The results showed that both positive and negative powered lenslet designs were similarly effective in slowing refractive and axial length changes versus a single vision lens (44% and 50% axial growth reduction, respectively). Negative powered lenslets were found to have a greater myopia control effect for younger children aged 6-8yrs. More detail about the lens design could help to explore this potential mechanism of conflicting optical signals. Awarded as an ARVO Hot Topic.  

Link to Abstract

Authors:  XUE LI^1,2, Yingying Huang^1,2, Chenyao Liu¹, Ziang Yin¹, Zaifeng Cui¹, Ee Woon Lim^2,3, Bjorn Drobe^2,3, Hao Chen¹, Jinhua Bao^1,2 

1. National Clinical Research Center for Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, , China
2. Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, , China
3. R&D Singapore, Essilor International, , Singapore

This study continued to assess children wearing Highly Aspherical Lenslet (HAL) design spectacle lenses after completing 3 years of previous wear. Changes in axial length and refractive changes for 43 children aged 13 to 18yrs (mean 14.7 years) were recorded over a further 2 year wear period. Myopia control efficacy was compared to progression predictions for spherical equivalent refraction (SER) and axial length (AL) from a single vision control group model. Using this control group modelling, HAL lenses were found to reduce progression by a total of 1.76D (58%) for refraction and 0.73mm (52%) for axial length growth over 5 years. 

Link to Abstract

Authors: Mora Boatman¹, Jeffrey J. Walline¹, Mathew L. Robich¹, Lisa Jordan¹, Catherine McDaniel³, David A. Berntsen², Maria Walker², Justina Raouf Assaad², Elizabeth Day⁴, Moriah A. Chandler², Kimberly J. Shaw¹, Jill A. Myers¹, Donald O. Mutti¹ 

1. College of Optometry, The Ohio State University, Columbus, Ohio, United States
2. College of Optometry, University of Houston, Houston, Texas, United States
3. Dayton Children's Hospital, Dayton, Ohio, United States
4. Athens Eye Care, Athens, Ohio, United States;

The BLINK (Bifocal Lenses in NearSighted Kids) study investigated Biofinity Centre-Distance multifocal soft contact lenses for myopia control, finding the +2.50 Add was effective while +1.50 Add was not. Since seasonal variation has been reported in myopia progression - faster in winter, slower in summer. This same trend was investigated and identified in the BLINK data, with myopia progression in the +2.50 Add MFSCL being a mean of+0.01D in summer and -0.20D in winter. When compared to SV and the +1.50 Add, the myopia control effect was only meaningful in the summer. This indicates the importance of giving treatments 12 months (or at least, another summer!) to measure efficacy. 

Link to Abstract

Authors: Sophie Coverdale¹, Matthew Cufflin¹, Edward Mallen¹, Neema Ghorbani-Mojarrad¹ 

1. Optometry and Vision Science, University of Bradford, Bradford, West Yorkshire, United Kingdom

This prospective study monitored spherical equivalent refractive error (SER) and axial length (AL) and estimated myopia incidence and progression rates for a young adult student cohort. Participants (n = 185) aged 18-25yrs were categorised as 'potential progressors' or 'non-progressors' according to AL change (at least 0.04mm, exceeding the repeatability of the IOL Master). After 12mths, both SER and AL increased and 33% were 'potential progressors'. Greater axial elongation was seen for potential progressors in the first 6 months of the study (Oct-April, including Northern Hemisphere winter). Two key conclusions from this study are that approximately 1/3 of young adult students may experience axial length growth, and this may be influenced by seasonal change. 

Link to Abstract

Authors: Michael Moore¹, Ian Flitcroft¹, Gareth Lingham¹, Eoin Kerin¹, Ernest Kyei Nkansah¹, Matilda Biba¹, James Loughman¹ 

1. Centre for Eye Research Ireland, Technological University Dublin, Dublin, Dublin, Ireland

This large-scale study aimed to describe the natural history of myopia progression in myopic patients aged 18-39 years (n=13,185) using anonymised electronic medical records across Irish optometric practices. While the majority of patients had stable myopia, non-stable myopia was highest in younger patients eg. 18-24 yrs (23.4%) and high myopes over 6D (19.9%). Around 8% of adult high myopes showed fast progression of at least 0.50D/year. Younger age and more myopic SER at baseline were predictive of faster myopic progression, and may benefit from myopia management. 

Link to abstract

Authors: Lihua Li¹, mengdi Li¹, Xiaoyan Yang¹ 

1. Tianjin Eye Hospital, Tianjin, Tianjin, China

The study analyzed data from 4,370 children and found that over one year, axial length (AL) increased by 0.34 mm in myopic, 0.30 mm in emmetropic, and 0.23 mm in hyperopic groups. In all 3 groups, they found that AL change was negatively correlated with distance and near phoria, but only positively correlated with near point of convergence (NPC) in the myopic group. The authors found that axial elongation varies with refractive state, showing faster growth in myopic children with exophoria compared to those with normal or esophoria alignment, and in emmetropic children poor stereopsis is linked to increase refractive growth. 

Link to Abstract

Authors: Shalu Pal¹, Stephanie Fromstein¹, Angela DiMarco², Mira Acs², Barbara Caffery², Sarah Guthrie³, Stephanie Ramdass⁵, Vishakha Thakrar⁶, Matthew Zeidenberg³, Deborah Jones^3,4, Amy Chow^3,4 

1. Clinical Care, Dr. Shalu Pal & Associates, Toronto, Ontario, Canada
2. Clinical Care, Toronto Eye Care, Toronto, Ontario, Canada
3. University of Waterloo, Waterloo, Ontario, Canada
4. Centre for Eye & Vision Research, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
5. Clinical Care, eyecademy, Mississauga, Ontario, Canada
6. Clinical Care, Vaughan Vision Centre, Vaughan, Ontario, Canada

This study evaluated real-world practice of myopia management in Ontario, Canada, evaluating over 1300 patient files across 7 practices. Clinical chart data was evaluated from eye exams between 2017 to 2021, for children aged 6-10 years who were both myopes and pre-myopes. The good news is that while on 2% of myopes were offered myopia treatment in 2017, this increased to 20% in 2021. Recommending lifestyle changes for pre-myopes showed a similar trend. The room-for-improvement news is that generally, our colleagues will counsel patients on myopia treatments earlier now (at around -2.75D in 2017 reduced to just under -2.00 in 2021), but implementation of myopia management is static, and only occuring once children are around -2.75D to -3.00D. This is of course multifactorial, but provides important insight in a country with wide scope of practice and extensive availability of myopia control treatments. 

Link to Abstract

Authors: David A. Berntsen¹, Loraine Sinnott², Danielle J. Orr², Anita Ticak¹, Amber G. Giannoni¹, Lisa Jordan², Donald O. Mutti², Jeffrey J. Walline² 

1. University of Houston College of Optometry, Houston, Texas, United States
2. The Ohio State University College of Optometry, Columbus, Ohio, United States

The BLINK study investigated Biofinity centre-distance multifocal soft contact lenses and found the +2.50 Add was effective for myopia control while +1.50 Add was not. In the BLINK2 study, two years of +2.50 Add wear was followed by a year of single vision SCL wear (11-17 years old). While progression increased minimally, by -0.16D/y and +0.04mm/yr in SV, there was no measured rebound effect, with the myopia control achieved by the +2.50 Add maintained on cessation. This adds to the volume of evidence of a lack of rebound effect with optical treatments. 

Link to Abstract

Authors: Xiu Juan Zhang¹, Yuzhou Zhang¹, Ka Wai Kam¹, Clement C. Tham¹, Li Jia Chen¹, Calvin C P Pang¹, Jason C.S. Yam¹ 

1. The Chinese University of Hong Kong, Hong Kong, Hong Kong

Secondary analysis from the LAMP 2 study evaluated the efficacy of low-concentration atropine eye drops for delaying the onset of myopia in non-myopic children aged 4-9 years (n=353) with SER +1.00 D to 0.00 D and astigmatism less than -1.00 D. Less baseline hyperopic reserve and higher level of parental myopia were two significant risk factors for both myopia onset and myopic shift in non-myopic children. Early intervention with 0.05% atropine may benefit children with reduced hyperopic reserve, to delay myopia onset.

Read our summary on the original LAMP2 study here. 

Link to Abstact

Authors: Jason YAM¹, Xiujuan Zhang¹, Yuzhou Zhang¹, Ka Wai Kam¹, Fangyao Tang¹, Xiangtian Ling¹, Clement C. Tham¹, Li Jia Chen¹, Calvin C P Pang¹ 

1. Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong

Children aged 4-12 years (n=269) completed 5 years of follow-up, to evaluate the long-term efficacy of low-concentration atropine, the proportion of children requiring re-treatment, and the efficacy of re-treatment from years 3 to 5, for children who progressed more than 0.50D/year.

• The first year of the LAMP study was placebo controlled, comparing 0.01%, 0.025% and 0.05% to placebo.
• In the second year, all of the placebo group were switched to 0.05% atropine
• In the third year, around half of each treatment group continued while half stopped, to assess for rebound effects.
• In years 4 and 5, all continued treatment subgroups switched to 0.05% while all treatment cessation subgroups recommenced atropine 0.05% if they showed progression of 0.50D or more in a year.

It was found that 88% of children who had ceased treatment needed re-treatment, which was similar across all concentrations. Once restarted, efficacy with 0.05% was similar to those who were on continued treatment. This indicates firstly that 2-3 years of atropine treatment for children aged 4-12 years at baseline is likely not enough to stabilise myopia, and secondly that re-treatment with 0.05% after a period of cessation (or less effective therapy) can still be effective.

Read our summary of the LAMP three year data here.

Link to Abstract

Authors: James Loughman¹, Gareth Lingham¹, Ernest Kyei Nkansah¹, Emmanuel Kobia-Acquah¹, Ian Flitcroft¹ 

1. Centre for Eye Research Ireland, Technological University Dublin, Dublin, Dublin, Ireland

The Myopia Outcome Study of Atropine in Children (MOSAIC) found a modest myopia control effect of atropine 0.01% at 24 months. In Year 3, two tapering strategies were tested, as well as a cross-over group to 0.05% atropine. Whether atropine 0.01% was ceased abruptly or tapered, there was no rebound effect or difference between the groups. Participants switched to 0.05% showed 0.13D and 0.05mm less progression over this year compared to placebo, and no refraction difference but 0.04m less axial length progression compared to 0.01%. There were no serious adverse events, but 18% of the 0.05% group in this predominantly White, European population showed side effects compared to only 2-3% in 0.01% and placebo groups. Depite this, 0.05% was reported as well tolerated with no discontinuations and only 5% requiring a near add to manage symptoms.  

Link to Abstract

Authors: Karla Zadnik¹, Houman Hemmati², Tung Fong², Simon Chandler² 

1. Optometry, The Ohio State University, Columbus, Ohio, United States
2. Vyluma, Bridgewater, New Jersey, United States

Stage 2 of the CHAMP trial assessed continued use of NVK002 on myopia control and rates of myopia rebound 12mths after ceasing NVK002, by randomly assigning participants to continue with 0.01% treatment drops for 12mths (n = 38) or receive a placebo drop (n =39). Cycloplegic refraction and axial length data were measured at 12mths. Results showed that continued use of NVK002 over a 4th year provided ongoing slowing of myopia progression, with no serious adverse responses. No meaningful myopic rebound effect was seen a year after ceasing NVK002 use, suggesting NVK002 is a safe and effective for myopia control.

Link to Abstract

Authors: Mingguang He¹, Ruilin Xiong², Wei Wang², Xiao Yang² 

1. The Hong Kong Polytechnic University, Hong Kong, Hong Kong
2. Sun Yat-Sen University Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Guangzhou, Guangdong, China

The authors explored the possibility of combination therapy involving orthokeratology (ortho-k) and repeated low-level red-light (RLRL)therapy for children defined as 'poor responders' to ortho-k, defined as progression of at least 0.50mm/year under treatment. These children (n=47) were assigned in a 2:1 ratio to either RLRL and ortho-k (RCO group, n=30) or ortho-k alone (n=17). The test group (RCO) received 3 minutes of RLRL therapy twice a day. The adjusted mean changes in axial length in the RCO group was -0.024mm and ortho-k only group was 0.288mm after 12 months of follow-up. The combination treatment aimed to provide the advantages of “glasses-off” vision during the daytime and effective myopia control. 

Link to Abstract

Authors: Kuang-mon Ashley Tuan ¹

1. Visioneering Technologies Inc, Georgia, United States 

The authors assessed catenary power profile contact lenses that delivers up to +8D add for myopia in children. Children aged 7 to less than 13 years with myopia -0.75D to -5.00D were enrolled from 8 clinical sites and were randomly assigned to SV or caternary curve multifocal contact lenses. Children wearing multifocal lenses experienced a 0.40D (69%) average reduction in myopia progression and 0.17mm (59%) reduction in axial elongation over 12 months, compared to those wearing SV lenses. While 42% of the mutifocal CL wearers showed refractive stability over the year, only 8% of the SVCL group showed the same. These results indicate the lens design’s efficacy in significantly slowing myopia progression and axial elongation in a diverse clinical setting. 

Link to Abstract

Authors: Lauryn McDougal¹, Maher Khushashi¹, Liza Kashif¹, Pablo De Gracia¹ 

1. University of Detroit Mercy School of Optometry, Novi, Michigan, United States

Using Biofinity Multifocal +1.50D and +2.50D and single vision, optical modelling investigated how much myopic defocus is generated based on various pupil sizes and for multiple object vergences (distances). For a 6mm pupil size, the +2.50D lens provided over 60% of visual acuities in front of the retina and 40% behind the retina. The +1.50 Add provided about 56% in front and 44% behind the retina, while SV was 50/50. Since multifocal Cl's offer better visual performance for objects closer to the subject than fixation, and multi-vergence scenes (eg. outdoors) allow the eye to explore a range of visual acuities in front of and behind the retina, outdoor time is modelled by this data to increase the effectiveness of multifocal SCL's for myopia control. 

Link to Abstract

Authors: Donald O. Mutti¹, Loraine Sinnott¹, David A. Berntsen², Lisa Jordan¹, Jeffrey J. Walline¹ 

1. The Ohio State University College of Optometry, Columbus, Ohio, United States
2. University of Houston College of Optometry, Houston, Texas, United States

This study evaluated whether 2 years of previous myopia progression and axial elongation could be used to predict future progression. Myopic children (n=284) aged 7-11 years were randomly assigned either Biofinity soft contact lenses for 3 years in either single vision or centre-distance multifocal with +1.50D or +2.50D add. In terms of axial elongation (mm), fast progressors in the first 2 years continued to show faster elongation in the third year. However, previous rapid refractive (D) myopia progression was unrelated to progression in the third year. This suggests that use of historical myopia progression based on refraction alone may not be useful to identify fast progressors.  

Link to Abstract

Authors: Noel A. Brennan¹, Xu Cheng¹, Mark A. Bullimore² 

1. R&D, Johnson and Johnson Medtech, Jacksonville, Florida, United States
2. Optometry, University of Houston, Houston, Texas, United States

The authors proposed a method to predict the efficacy of myopia treatments over three years using just one year of data. By analyzing 24 cohorts from 10 studies, they found a strong correlation between one-year and three-year efficacy, regardless of treatment type, where three year efficacy is around double the one year result. Note that it's not triple the one year result, because of the initial 'boost' seen in myopia control efficacy and typical progression slowing with time (both trends identified by these authors in previous papers). Despite varying study quality, their analysis suggests that comparing different treatments based on one-year results is valid, potentially reducing the need for lengthy clinical trials and easing regulatory requirements. 

Link to Abstract

Authors: Sergio Díaz-Gómez¹, Mercedes Burgos Martínez², Padmaja Sankaridurg³, Amaia Urkia Solorzano¹, Jesús Carballo⁴, Mónica Velasco² 

1. Ophtalmology, Miranza COI Bilbao, Bilbao, Vizcaya, Spain
2. R&D, Mark Ennovy, Getafe, Madrid, Spain
3. Optometry and Vision, School of Optometry and Vision Science/Faculty of Medicine and Health University New South Wales Sidney, Sidney, New South Wales, Australia
4. School of Optometry and Vision, Universidad Complutense de Madrid, Madrid, Comunidad de Madrid, Spain

This is the first data on the MYLO lens in Caucasian children, following on from Sankaridurg et al 2019's two year RCT in Chinese children. This was a non-randomized study where 98 children wore either the MYLO lens with extended depth of focus optics, or single vision spectacles. After three years, there was 0.74D less myopia progression and 0.42mm less axial elongation in the children wearing MYLO. Questionnaire data on vision and comfort yielded high results and best corrected acuity was reduced by less than one line.

Sergio is pictured above with Elena Prieto from mark'ennovy, manufacturer of the MYLO contact lens. Elena presented data (abstract link) on a small study of children wearing the MYLO lens with astigmatism correction compared to those wearing single vision spectacles. The toric myopia control results appeared to be at least as good as the spherical; although the study was smaller (n=21) and the groups weren't quite matched for age. Over one year, 89% of the CL group progressed <0.20mm compared to 10% in the spectacles group. 

Link to Abstract

Authors: Debbie Laughton¹, Jennifer S. Hill¹, Lucill Wang¹, Marcella Mcparland¹ 

1. SightGlass Vision Inc, California, United States

Children (n=71) children aged 6-13 years were recruited from 5 sites in China and randomly assigned to wear DOT spectacle lenses or SV lenses. Results after 6 months showed that children wearing the DOT lenses showed stability in their myopia, with mean changes of -0.05 mm for axial length and 0.01 D for cycloplegic refraction, where the control group had mean changes of 0.19mm and 0.38D respectively. The study concluded that DOT lenses effectively slow myopia progression, supporting the theory that modulating retinal contrast can be beneficial for controlling myopia. 

Link to Abstract

Authors: Xiaoqin Chen¹, Min Wu², Cui Yu³, Arne Ohlendorf⁴, Sankaridurg Padmaja^4,5, Katharina Rifai⁴, Christina Boeck-Maier⁴, Siegfried Wahl^4,6, Youhua Yang⁴, Yi Zhu⁴, Lihua Li¹ 

1. Tianjin Eye Hospital Optometric Center, Tianjin, China
2. Beijing Tongren Vision Care, Beijing Tongren Hospital,, Capital Medical University, Beijing, China
3. He Eye Specialist Hospital, Shenyang, Liaoning, China
4. ZEISS Vision Care, Aalen, Germany, Carl Zeiss Vision International GmbH, Aalen, Germany, , Germany
5. School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
6. Institute for Ophthalmic Research, Eberhard Karls Universitat Tubingen, Tubingen, Baden-Württemberg, Germany

The eagerly awaited 12 month interim results of the spectacle lens with cylindrical annular refractive elements (CARE) in 240 Chinese children aged 6-13 years investigated two designs: MyoCare (Zeiss) with CARE mean surface power of +4.6D and central clear zone of 7mm and MyoCare S (Zeiss) with CARE mean surface power of +3.8D and 9mm central clear zone. The myopia control effect was similar in both designs - compared to SV, progression was reduced by 0.31D (48%) / 0.13mm (41%) for MyoCare and 0.29D (45%) / 0.11mm (34%) for MyoCare S at 12 months.  

Link to Abstract

Authors: Shruti Nishanth^1,2, Arockia Agila², Maheswari Srinivasan², Nivean madhivanan², Rakhee Shah^3,4 

1. Paediatric Ophthalmology, Maastricht Universitair Medisch Centrum+, Maastricht, Limburg, Netherlands
2. Paediatric Ophthalmology, MN Eye Hospital Private Ltd, Chennai, Tamil Nadu, India
3. Optometry & Visual Sciences, University of London, , United Kingdom
4. Hoya Kabushiki Kaisha, Amsterdam, Netherlands

This prospective, non-randomized study evaluated myopia progression in 50 children aged 7-17yrs and upon identification as a progressor (at least 0.50D in 6 months), they were fit with Defocus Incorporated Multiple Segments (DIMS) spectacle lenses, or continued with single vision (self-selected). After 12mths wear, the control group of 25 age-matched children had progressed -0.75D and 0.3mm. In the DIMS group, 32% of eyes had no refractive progression and 42% of eyes had axial length change of less than 0.1mm, indicating myopia stability. This is the first such data on DIMS efficacy in children of South Asian ethnicity, with results appearing to be in line with those found in the original Hong Kong study.  

Link to Abstract

Authors: Aldo Vagge¹, Antonio Frattolillo², Paolo Nucci³, Francesco Samassa², Guido Barosco², Emilio Rapizzi², Michele Iester¹, Carlo Enrico Traverso¹ 

1. Clinica Oculistica, DINOGMI, IRCCS Ospedale Policlinico San Martino, Genova, Liguria, Italy
2. UOC Oculistica, Ospedale dell'Angelo-Mestre, Mestre, Veneto, Italy
3. Universita degli Studi di Milano, Milano, Italy

This retrospective study evaluated the efficacy of HALT lenses combined with 0.01% atropine eye drops in slowing myopia progression amongst myopic children aged 6-13 years (n=175). Compared to HALT or 0.01% atropine monotherapy, combination treatment showed significantly less myopia progression (D) over 12 months. A significant difference for axial length was only found between combination treatment and atropine groups, but not between combination and HALT. This indicates that HALT and the combination slow axial growth more than 0.01% atropine, but more data would be required to determine an additive effect of the combination for millimetre control as well as dioptre control.  

Link to Abstract

Authors: Leon N. Davies¹, Inderjit Chatha¹, Reena Rani¹, Hiu Yan Lam¹, Nicola S. Logan¹, Amy L. Sheppard¹, James Stuart Wolffsohn¹, Debbie Laughton² 

1. School of Optometry, Aston University College of Health and Life Sciences, Birmingham, Birmingham, United Kingdom
2. SightGlass Vision Inc, Palo Alto, California, United States

Twenty adults age 18-30 wore spherical soft contact lenses to correct their low to moderate myopia, and sequentially wore plano myopia control spectacle lenses with Diffusion Optics Technology (DOT), Defocus Incorporated Multiple Segments (DIMS), Highly Aspherical Lenslets (HAL), and single vision (SV). Hart Chart dynamic vision test showed no differences and no impact of the myopia control designs. All myopia control lens designs performed similarly and no different to single vision for Hart Chart dynamic vision test and Circles Search test through lens centre and lens periphery. Peripheral near acuity threshold and critical print size were affected by DIMS, but HAL and DOT were similar to SV. This data in adults shows dynamic vision performs well across myopia control lens types, with a potential difference between lens types in reading performance. 

Link to Abstract

Authors: Mhairi Day¹, Stephanie Kearney¹ 

1. Department of Vision Sciences, Glasgow Caledonian University, Glasgow, United Kingdom

This study sought to expand on previous findings that showed 30% of patients received successful myopia management treatment in a UK clinic setting. Clinical record data was extracted for a total 40 patients across a range of treatment methods: DIMS lens, multifocal, Ortho-K and dual focus. Treatment efficacy evaluation was made based on axial length data using three efficacy criteria: mean efficacy reported in clinical trials; emmetropic eye growth rate and 'responder' classification by growth of less than 0.11mm/year. The axial length growth rate before treatment of 0.28mm/year compared well to control groups, and was reduced to 0.17mm/year (mean reduction 0.12mm/year) with treatment. By these efficacy criteria, average 'success' rates for the treatments were between 22 and 46%, and the rate of ‘non-responders’ with axial progression of ≥0.11mm/yr was 68%. Larger scale data, evaluating these criteria by age and other factors, would help to illuminate any differences between observed and reported success rates of myopia control treatments. 

Link to Abstract

Authors: NOEMI GUEMES-VILLAHOZ^1,5, Julian Garcia-Feijoo^1,3, Rafael Bella-Gala², Paloma Porras-Angel^4,2, Paula Talavero-Gonzalez¹, Beatriz Martin-Garcia², Alicia Ruiz-Pomeda², Elena Hernandez-Garcia¹, Rosario Gomez-de-Liano^1,3 

1. Ophthalmology, Hospital Clinico San Carlos, Madrid, Comunidad de Madrid, Spain
2. Optometry, Universidad Complutense de Madrid, Madrid, Comunidad de Madrid, Spain
3. Ophthalmology, Universidad Complutense de Madrid Facultad de Medicina, Madrid, Comunidad de Madrid, Spain
4. Foundation for Biomedical Research HCSC, Hospital Clinico San Carlos, Madrid, Comunidad de Madrid, Spain
5. San Carlos Health Research Institute (IdISSC), Hospital Clinico San Carlos, Madrid, Comunidad de Madrid, Spain;

This randomized controlled trial compared the efficacy of combination treatments 0.025% atropine and DIMS lenses with 0.025% atropine and single vision (SV) lenses in slowing myopia progression in European myopic children (n=56) aged 4-16 years over 12 months. Combination treatment with 0.025% atropine and DIMS lenses were more effective than 0.025% atropine and SV lenses in controlling axial elongation, with only 0.07mm growth over 12 months in the combo group compared to 0.20mm in the (slightly younger) atropine group. Definitive data on whether adding 0.05% atropine boosts DIMS efficacy would require comparison to a DIMS monotherapy group, but the small absolute growth indicates a possible synergistic effect. 

Link to Abstract

Authors: Jasmin Rezapour^1,2, Evan Walker², Akram Belghith², Christopher Bowd², Massimo Antonio Fazio^3,8, Anuwat Jiravarnsirikul^2,4, Leslie Hyman⁵, Jost B. Jonas^6,7, Robert Weinreb², Linda M. Zangwill² 

1. Ophthalmology, Universitatsmedizin der Johannes Gutenberg-Universitat Mainz, Mainz, Rheinland-Pfalz, Germany
2. Hamilton Glaucoma Center, Shiley Eye Institute, University of California San Diego Health Sciences, La Jolla, California, United States
3. Biomedical Engineering, School of Engineering, The University of Alabama at Birmingham Department of Medicine, Birmingham, Alabama, United States
4. Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
5. Wills Eye Hospital, Philadelphia, Pennsylvania, United States
6. Universitat Heidelberg Medizinische Fakultat Mannheim, Mannheim, Baden-Württemberg, Germany
7. Institute of Molecular and Clinical Ophthalmology Basel, Basel, Basel-Stadt, Switzerland
8. The University of Alabama at Birmingham Department of Medicine, Birmingham, Alabama, United States

Glaucoma in high myopes can be difficult to diagnose due to the myopic optic nerve changes that have occured. The authors compared glaucomatous to healthy eyes, dividing the groups into no myopia, mild myopia (24-26mm axial length) and high myopia (axial length >26mm). They found that diagnostic accuracy for high myopes was higher using global and infero-temporal peripapillary retinal nerve fibre layer (RNFL) metrics whilst for non-myopes and low myopes it was using Bruch’s membrane opening minimum rim width. Sectoral macular ganglion cell inner plexiform layer was also more accurate than macular RNFL thickness for high myopes. 

Link to Abstract

Authors: Byung Joo Lee¹, So Young Han², Seungeun Choi³, Kyunghee Kim³, Youngmin Huh³, Jihye Lee³ 

1. Department of Ophthalmology, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea (the Republic of)
2. Department of Ophthalmology, Kangbuk Samsung Hospital, Seoul, Seoul, Korea (the Republic of)
3. S-Alpha therapeutics Inc., , Korea (the Republic of)

The authors randomized 60 children (5-12 years) into two groups - the control group wearing spectacles only, and the SAT-001 group where spectacle wearers engage in a program with guided eye movement exercises: including 'eye movement games, relaxation sessions and promotion of a well-lit environment'. At 48 weeks, the SAT-001 showed a small, insignificant reduction in myopic progression (SER change -0.62 D in OS, -0.53 D in OD) compared to the control group (SER change -0.85 D in OS, -0.84 D in OD).  When stratified according to age, the younger SAT-001 group showed significantly less myopia progression (SER change -0.61 D in OS, -0.50 D in OD) compared to controls (mean SER change -1.18 D in OS, -1.22 D in OD). Axial elongation was also smaller in the intervention group (0.38 mm) compared to controls (0.59 mm). 

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Authors:  Kristen L. Kerber¹, Lilly Cheam¹, Serena Beri¹, Fuensanta A. Vera-Diaz¹ 

1. New England College of Optometry, Boston, Massachusetts, United States

Since inaccurate accommodative responses (ARs) to blur may be associated with myopia development, this study measured static and dynamic AR's in young children (mean age 7.5 yrs) every 6 months for 24 months. They were classified as low risk or high risk for myopia based on parental myopia and baseline refraction. All children were emmetropic to start with, with those at low risk and high risk of myopia showing greater static accommodative lags after 18 months. Those at high risk had reduced accuracy of ARs (greater lags) throughout the 24 months, and the difference in both static and dynamic measures increased under binocular conditions. This indicates that differences in AR in young children could be helpful in predicting myopia development.  

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Authors: Maher Khushashi¹, Liza Kashif¹, Lauryn McDougal¹, Sulman Hans¹, Pablo De Gracia¹

1. School of Optometry, University of Detroit Mercy, Detroit, Michigan, United States

In this study, binocular microsaccades were measured with correction of refractive error in an optical system which did not induce any lens magnification or minification. Participants were measured under three conditions: naked eye (refractive error corrected), with Biofinity +1.50D and +2.50D multifocal soft contact lenses. Emmetropes make larger (potentially more accurate) microsaccades in the presence of induced blur, compared to myopes, who take more microsaccades, and even more again when wearing multifocal soft contact lenses. Microsaccades serve to bring the fovea back to fixation - the impact of more saccades on ocular or mental fatigue is not fully known.  

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