Time spent outdoors improves success with MiSight 1 day

Paper title: Predicting factors for progression of the myopia in the MiSight assessment study Spain (MASS)

Authors: Francisco Luis Prieto-Garrido (1), Jose Luis Hernandez Verdejo (2), Cesar Villa-Collar (3), Alicia Ruiz-Pomeda (4)

1. Department Optics I: Optometry and Vision, Universidad Complutense de Madrid, Madrid, Spain
2. Department Optometry and Vision, Universidad Complutense Dr Madrid, Madrid, Spain
3. European University of Madrid, Doctoral and Research School, Madrid, Spain
4. Hospital Universitario de Mostoles, Ophthalmology, Madrid, Spain

Date: Jan-Mar 2022

Reference:  Prieto-Garrido FL, Hernández Verdejo JL, Villa-Collar C, Ruiz-Pomeda A. Predicting factors for progression of the myopia in the MiSight assessment study Spain (MASS). J Optom. 2022 Jan-Mar;15(1):78-87. [Link to open access paper]

This study determined which baseline factors are predictive for success in controlling myopia progression in a group of children wearing MiSight 1 day contact lenses. It forms part of the MiSight Assessment Study Spain (MASS) that was designed to assess the efficacy of MiSight contact lenses versus distance single vision spectacles in myopic children.

41 myopic children were fit with MiSight and axial length followed at 2 years. Patients were classified based on specific range of change of axial length at end of each year of treatment as "responders" (AL change <0.11mm/per year) and "non-responders" (AL change >0.11mm/per year).

• Of the 41 patients treated with MiSight, 20 (49%) and 16 (39%) were considered responders in the first and second years of follow-up, respectively
• Time spent outdoors was the only factor associated with smaller axial length growth 
• Importantly, 22 different factors were found to not be associated with axial length elongation: including age, refraction, binocular vision findings, pupil size, time spent on near work and time spent playing sports 
• The decision tree analysis showed that in the responding group spending more than 3 and 4 hours outdoors per week was associated with the best response in the first and second year of treatment respectively.

• Clinically, this indicates that time spent outdoors is the sole factor that can be used to predict success with MiSight contact lenses. Based on this study, spending over 4 hours outdoors per week was associated with the best response. All patients undergoing myopia treatment with MiSight contact lenses should be advised regarding the importance of outdoor time.
• Importantly, this study also demonstrated that other factors, such as baseline age, refraction, binocular vision findings and pupil size, are not predictive of success with MiSight contact lenses.

Previous research has indicated that time spent outdoors is protective against the development of myopia; however, there evidence that it is protective against myopia progression in eyes that are already myopic is less well established (read the article here). To more precisely investigate this relationship, as well as the threshold of time spent outdoors, it would be necessary to carry out additional research with larger samples of children wearing MiSight CLs (or other treatments) and to include longer follow-up periods.

Title: Predicting factors for progression of the myopia in the MiSight assessment study Spain (MASS)

Authors: Francisco Luis Prieto-Garrido, Jose Luis Hernandez Verdejo, Cesar Villa-Collar, Alicia Ruiz-Pomeda

Purpose: To investigate which baseline factors are predictive for success in controlling myopia progression in a group of children wearing MiSight Contact Lens (CLs).

Methods: Myopic patients (n = 41) fitted with MiSight CLs and followed up two years were included in this study. Bivariate analysis, a logistic regression analysis (LG) and a decision tree (DT) approach were used to screen for the factors influencing the success of the treatment. To assess the response, axial length (AL) changes were considered as main variable. Patients were classified based on a specific range of change of axial length at the end of each year of treatment as "responders" (R) (AL change <0.11 mm/per year) and "non-responders" (NR) (AL change ≥0.11 mm/per year).

Results: Of a total of forty-one Caucasian patients treated with MiSight CLs, 21 and 16 were considered responders in the first and the second year of follow-up, respectively. LG analysis showed that the only factor associated with smaller axial length growth was more time spent outdoors (p = 0.0079) in the first year of treatment. The decision tree analysis showed that in the responding group spending more than 3 and 4 h outdoors per week was associated with the best response in the first year and in the second year of treatment respectively.

Conclusion: The LR and the DT approach of this pilot study identifies time spent outdoors as a main factor in controlling axial eye growth in children treated with MiSight CLs.

Abstract link is here