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Weekly Changes in Axial Length and Choroidal Thickness in Children During and Following Orthokeratology Treatment With Different Compression Factors.

ABSTRACT: Purpose:To determine the influence of compression factor upon changes in axial length and choroidal thickness during and following orthokeratology treatment. Methods:Orthokeratology lenses of different compression factors (one eye with 0.75 D and the fellow eye with 1.75 D) were randomly assigned to 28 subjects (median [range] age: 9.3 [7.8-11.0] years). Ocular biometrics were measured weekly for 1 month of lens wear and after lens cessation until the refraction stabilized (mean duration: 2.8 ± 0.4 weeks). Changes between eyes, and the associations between axial shortening and choroidal thickening with other ocular biometrics were analyzed. Results:There were no significant between-eye differences in the changes of ocular biometrics (all P > 0.05). After adjusting for paired-eye data, axial length initially decreased by 26 ± 41 ?m (P = 0.03) at week 1, then gradually returned to its original length. An approximate antiphase relationship of choroidal thickness (mean change: 9 ± 12 ?m, P < 0.001) with axial length was observed. A significant rebound in axial length, but not choroidal thickness, occurred during the cessation period. Central corneal thinning and choroidal thickening accounted for 70% of initial axial shortening. Conclusions:Increasing the compression factor by 1.00 D did not affect changes in ocular biometrics in short-term orthokeratology. Significant axial shortening and choroidal thickening were observed during early treatment period. Axial shortening could not be entirely explained by central corneal thinning and choroidal thickening, which warrants further investigation. Translational Relevance:Initial axial shortening in orthokeratology is transient and therefore axial length remains useful for long-term monitoring of axial elongation in children.

SUBMITTER: Lau JK

PROVIDER: S-EPMC6656409 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Weekly Changes in Axial Length and Choroidal Thickness in Children During and Following Orthokeratology Treatment With Different Compression Factors.

Lau Jason K JK Wan Kin K Cheung Sin-Wan SW Vincent Stephen J SJ Cho Pauline P

Translational vision science & technology 20190723 4

<h4>Purpose</h4>To determine the influence of compression factor upon changes in axial length and choroidal thickness during and following orthokeratology treatment.<h4>Methods</h4>Orthokeratology lenses of different compression factors (one eye with 0.75 D and the fellow eye with 1.75 D) were randomly assigned to 28 subjects (median [range] age: 9.3 [7.8-11.0] years). Ocular biometrics were measured weekly for 1 month of lens wear and after lens cessation until the refraction stabilized (mean d ...[more]

PMID: 31360614

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Project description:AimTo explore the photopic pupil size behavior in myopic children undergoing overnight orthokeratology (ortho-k) over 1-year period and its effects on the axial elongation.MethodsA total of 202 Chinese myopic children were enrolled in this prospective clinical trial. Ninety-five subjects in ortho-k group and eighty-eight subjects in spectacle group completed the 1-year study. Axial length (AL) was measured before enrollment and every 6mo after the start of ortho-k. The photopic pupil diameter (PPD) was determined using the Pentacam AXL and measured in an examination room with lighting of 300-310 Lx. Stepwise multiple linear regression analysis was used to identify variables contribution to axial elongation.ResultsCompared with spectacle group, the average 1-year axial elongation was significantly slower in the ortho-k group (0.25±0.27 vs 0.44±0.23 mm, P<0.0001). In ortho-k group, PPDs significantly decreased from 4.21±0.62 mm to 3.94±0.53 mm after 1mo of lens wear (P=0.001, Bonferroni correction) and the change lasts for 3-month visit. No significantly change during the other follow-up visits was found (P>0.05, Bonferroni correction). The 4.81 mm PPD may be a possible cutoff point in the ortho-k group. Subjects with PPD below or equal to 4.81 mm tended to have smaller axial elongation compared to subjects with PPD above 4.81 mm after 1-year period (t=-3.09, P=0.003). In ortho-k group, univariate analyses indicated that those with older age, greater degree of myopia, longer AL, smaller baseline PPD (PPDbaseline) experienced a smaller change in AL. In multivariate analyses, older age, greater AL and smaller PPDbaseline were associated with smaller increases in AL. In spectacle group, PPD tended to be stable (P>0.05, Bonferroni correction) and did not affect axial growth.ConclusionPPDs experience significantly decreases at 1-month and 3-month ortho-k treatment. Children with smaller PPD tend to experience slower axial elongation and may benefit more from ortho-k.

Dataset Information

Weekly Changes in Axial Length and Choroidal Thickness in Children During and Following Orthokeratology Treatment With Different Compression Factors.

Publications

Weekly Changes in Axial Length and Choroidal Thickness in Children During and Following Orthokeratology Treatment With Different Compression Factors.

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