ARVO 2021 latest research updates

Authors: David A. Berntsen(1), Anita T. Gostovic(1), Loraine T. Sinnott(2), Moriah A(2). Chandler, Juan Huang, Ann Morrison, Lisa A. Jones-Jordan, Jeffrey J. Walline,(2) and Donald O. Mutti(2) for the BLINK Study group

1. College of Optometry, University of Houston, Houston, Texas, United States
2. College of Optometry, The Ohio State University, Columbus, Ohio, United States
3. School of Optometry, The University of Alabama at Birmingham, Birmingham, Alabama, United States

The BLINK study found that +2.50 Add centre-distance multifocal contact lenses (MFCLs) slowed myopia progression but the +1.50 Add didn't. Further analysis indicates that increased peripheral defocus created by the +2.50 Add only accounted for around 15% of the myopia control effect, indicating other mechanisms are involved.

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Authors: Rachel Ka-man Chun(1), Zhengji Liu(1), Wing Chun Tang(1), Dennis Yan-yin Tse(1,2), Carly Siu Yin Lam(1,2), Chi Ho To(1,2)

1. Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
2. Centre for Eye and Vision Research Limited, Hong Kong, Hong Kong

This study reported that children wearing DIMS spectacle lenses showed increased sub-foveal choroidal thickness than controls at 1 week which increased in the first 6 months and was maintained at 2 years. There was a correlation between more choroidal thickening and less axial elongation, but choroidal thickening only explained around 8% of the variation in axial length.

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Authors: Rebecca E. Leighton(1), Karen Breslin(1), Sara J. McCullough(1), Patrick Richardson(1), Kathryn J. Saunders(1)

1. Ulster University, Coleraine, Londonderry, United Kingdom 

This study measured central and relative peripheral refraction (RPR) in Caucasian children aged 6-7 years and 12-13 years at baseline and again one year later. There was no correlation found between central and peripheral refraction in the younger group. In the older group, more hyperopic temporal RPR was correlated with a myopic shift, but only explained 10% of the variance in refraction after 12 months.

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Authors: Frank Spors(1), Jie Shen(2), Dorcas Tsang(1), Lance E. McNaughton(3), Donald J. Egan(4)

1. College of Optometry, Western University of Health Sciences, Pomona, California, United States
2. Essilor of America Inc, Dallas, Texas, United States  
3. New England College of Optometry, Boston, Massachusetts, United States
4. University of Pikeville, Pikeville, Kentucky, United States  

Total spherical-like higher-order aberrations (HOA) increased by more than double in the distance-centred +2.50 Add compared to +1.50 Add, with total coma-like HOA increasing further. Since orthokeratology studies have reported an association between more change in HOAs and better myopia control efficacy, this could indicate a mechanism of action in multifocal contact lens myopia control.

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Authors: Paul Chamberlain(1), David Hammond(1), Baskar Arumugam(1), Mark A. Bullimore(2)

1. R&D, Coopervision Inc, Pleasanton, California, United States
2. University of Houston, Houston, Texas, United States

After the 3-year MiSight 1 day clinical trial, the control group children were switched to MiSight. A 'virtual control group' mathematical model, previously published, was utilized to demonstrate a continued myopia control effect across six years, plus effectiveness of treatment for children who commenced wear at age 11-15 years.

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Authors: Xue Li(1,2), Chenglu Ding(1), Yuhao Li(1), Ee Woon Lim, Yi Gao(2,3), Bruno Fermigier, Adeline Yang(2,3), Hao Chen(1,2), Jinhua Bao(1,2)

1. Eye hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
2. Wenzhou Medical University–Essilor International Research Center (WEIRC), China 
3.  R&D AMERA, Essilor International, Singapore 

When looking through the 'treatment zones' of three different types of myopia controlling spectacle lenses with lenslets, visual acuity is reduced by 3-5 letters and mid-to-high frequency contrast sensitivity is mildly affected compared to single vision spectacles. We're yet to learn if small differences between designs may influence patient preference.  

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Authors: Biyue Guo(1), Sin Wan Cheung(1), Pauline Cho(1)

1. School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China

A sample of slow and fast progressors in prior 24 month orthokeratology clinical trials were found to have the same baseline refraction and axial length. The slow progressors were older, and showed 0.5mm smaller treatment zone diameters (TZDs), but there was no difference in induced peripheral myopic shift. There was also no direct correlation between TZD and axial elongation, indicating an intriguing but not yet defined relationship.  

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Authors: Eman A. Alzghoul(1), Pauline Kang, Sieu Khuu

1. University of New South Wales, Sydney, New South Wales, Australia

Young adults fit with CooperVision Proclear multifocal contact lenses showed no loss of peripheral vision detection ability compared to single vision contact lenses. The near add was chosen to generate either a +0.50 or +1.00 of peripheral blur, confirmed by measurement of peripheral refraction. This is a positive indication that fitting multifocal contact lenses in young wearers doesn't impact peripheral visual performance.

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Authors: Qin Wang(1), Feng Pan(1,2)

1. The Hong Kong Polytechnic University, Kowloon, Hong Kong
2. Centre for Eye and Vision Research Limited, Hong Kong, Hong Kong  

This research showed that the concentration of atropine which reaches the retina is 400 times less than by topical administration; and that higher concentrations directly exposed to the mouse retina influence retinal signaling. Whether this is indicates a possible mechanism or unintended impact of atropine, and how this may translate to atropine use in humans, is unknown.

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Authors: Alex Nixon(1), Xu Cheng(1), Noel A. Brennan(1)

1. Johnson and Johnson Vision, Jacksonville, Florida, United States

It's known that emmetropizing children undergo axial eye growth of around 0.1mm per year. Is this amount of growth in myopes also 'physiologic'? In this study, data from the control groups of six myopia control clinical trials was analyzed to find the axial growth component which did not result in a change in refraction. For myopes, this 'physiologic' growth appears to be less than 0.1mm/year, which has implications for judging progression and treatment success.

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Authors: Yee Ling Wong(1,2), Yimin Yuan(2.3), Yang Ding(2,3), Yingying Ye(2,3), Adeline Yang(1,2), Bjorn Drobe(1,2), Hao Chen(2,3), Jinhua Bao(2,3)

1. Essilor International, Singapore
2. Wenzhou Medical University-Essilor International Research Centre, Wenzhou Medical University, China 
3. Wenzhou Medical University, Wenzhou, Zhejiang, China  

Previous multi-ethnicity studies have shown 'normal' axial elongation in emmetropic children to be around 0.1mm / year. In this study, 700 Chinese schoolchildren with stable emmetropia showed 0.2mm per year axial elongation from age 7-11, which reduced with age and ceased at age 15. This appears higher than measured in Singaporean Chinese children in the SCORM study, 20 years ago.

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Authors: Carla Lanca(1), Li Lian Foo(2,3), Marcus Ang(2,4), Chuen Seng Tan(5), Biten Kathrani(6), Hla Myint Htoon(3,7), Donald Tan(2,3), Quan V Hoang(2,4), Noel A. Brennan(6), Seang Mei Saw(1,3), Charumathi Sabanayagam(3,4)

1. Myopia, Singapore Eye Research Institute, Singapore, Singapore 
2. Singapore National Eye Centre, Singapore, Singapore, Singapore
3. Duke-NUS Medical School, Singapore, Singapore 
4. Singapore Eye Research Institute, Singapore, Singapore  
5. National University Singapore Saw Swee Hock School of Public Health, Singapore, Singapore
6. Johnson and Johnson Services Inc, New Brunswick, New Jersey, United States  
7. Singapore Eye Research Institute, Singapore, Singapore

A combination of higher baseline myopia, parental myopia and faster 3-year progression in earlier childhood were strongly predictive of teenage high myopia in this study. Young patients with these combination of factors should receive closer clinical monitoring and timely interventions to slow myopia progression.  

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Authors: Susanne Hopf(1), Franziska Heid(1,2), Christina A. Korb(1), Andreas Schulz(3), Thomas Münzel(4), Philipp S. Wild(2,3), Manfred E. Beutel(5), Irene Schmidtmann(6), Karl J. Lackner(7), Norbert Pfeiffer(1), Alexander K. Schuster(1)

1. Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
2. German Center for Cardiovascular Research (DZHK), Mainz, Germany  
3. Preventive Cardiology and Preventive Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
4. Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Germany  
5. Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Germany
6. Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Germany  
7. Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Germany

This study utilized data from over 15,000 participants aged 35-74 years and found a five-year cumulative incidence (new onset) of myopic maculopathy in the general population of 3 in 1,000. In 509 eyes with over 6D of myopia, 7% had myopic maculopathy and of these 50% worsened over the study period. There was a correlation between higher IOP and progression of maculopathy. This is the first such data available in a European population.  

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Authors: Yu-Chieh Yang(1), Nai-Wei Hsu(2,3), Chiao-Yu Wang(4), Mong-Ping Shyong(4,5), Der-Chong Tsai(3,4)

1. Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua, Taiwan
2. Public Health Bureau, Yilan County Government, Yilan, Taiwan  
3. Community Medicine Research Center & Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
4. Department of Ophthalmology, National Yang-Ming University Hospital, Yilan, Taiwan  
5. Department of Ophthalmology, Suao Branch, Taipei Veterans General Hospital, Yilan, Taiwan

The intervention to increase outdoor time involved country-wide promotion of 2 hours per day spent outdoors, school-based eye examinations and questionnaires in children aged 5-6 years. Utilizing data from over 18,000 children, the prevalence of myopia decreased from 15% in the 2014 cohort (before the intervention) to 8% in 2016 cohort (exposed to the intervention for up to two years) and remained stable for three years thereafter

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Authors: Ranjay Chakraborty(1), Konogan Baranton(2), Daniel Spiegel(3), Pascale Lacan(2), Matthias Guillon(2), Nicola Anstice(1), Coralie Barrau(2), Thierry Villette(2)

1. Optometry, Flinders University, Adelaide, South Australia, Australia
2. Center Innovation & Technologies Europe, Essilor International SAS, Charenton-le-Pont, Île-de-France, France  
3. Essilor Asia Pacific Pte Ltd, Singapore, Singapore, Singapore

Light-emitting glasses worn by young adults for 1-2 hours reduced axial length and increased choroidal thickness by around 20 microns compared to darkness. During the experiment, the participants viewed a colour-muted television at 5 metres in an indoor environment, and the changes regressed within 30 minutes of cessation. A future myopia treatment to increase 'outdoor' time?  

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Authors: Khob R. Bhandari(1), Hanieh Mirhajianmoghadam(1), Lisa A. Ostrin(1)

1. Optometry, University of Houston College of Optometry, Houston, Texas, United States

Young adults wearing the spectacle-mounted Clouclip device to measure viewing behaviour and light exposure also kept an activity diary. Mean daily dioptre-hours, near and intermediate hours and outdoor hours were all subjectively reported at about 150% of the objectively measured hours. This indicates the value of objective measures in research, as well as for potential clinical education and behaviour modification tools in future.  

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