Myopi OPTIKERHØJSKOLEN. Danish College of Optometry and Visual Science

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Erick Daniel
5 years ago
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2 Myopi OPTIKERHØJSKOLEN Danish College of Optometry and Visual Science

3 Progression Myopi 9 6, år: 0.50D/år år: 0.05D/år 4,5 2,25 OPTIKERHØJSKOLEN Danish College of Optometry and Visual Science Alder

4 Formfaste

5 Europæere Formfaste 0.52D/ år Ditto med bløde Leslie Donovan (2012) Myopia Progression Rates in Urban Children Wearing Single-Vision Spectacles Asiatere 0.92D/ år

6 Formfaste

7 A B C Steep Corneal Curvature, D Spherical Equivalent, D Run-in Period 2.43 ± ± 0.88 Run-in Period 2.48 ± ± ± ± ± ± 1.16 Brilleglas 4.67 ± 1.36 Baseline Randomization Year 1 Year 2 Year ± ± 1.44 RGP Wearers SCL Wearers Visit ± ± ± ± ± 1.35 Baseline Randomization Year 1 Year 2 Year 3 Visit ± ± ± ± 1.36 Formfaste Konklusion: Ingen reel Lavere myopiprogresssion? Kkon effekt på myopiprogression Axial Length, mm ± ± ± ± ± ± ± ± 0.69 Randomization Year 1 Year 2 Year 3 Samme vækst i øjendybde Visit Figure 2. A, Mean ± SD cycloplegic spherical equivalent refractive error for Walline et al (2006) The contact lens and myopia progression (CLAMP) study. Opht Physiol Optics 2006;26:29

8 Formfaste

9 Større myopiprogression? 0.15 D/år (95% CI: 0.00; 0.29) Ingen studier Effekt finder på effekt myopiprogression? af underkorrektion Adler (2006) The possible effect of undercorrection on myopic progression in children. Ditto på asiatere

10 Formfaste

11 0.19D 0.38D Difference størst ved stort lag Gwiazda et al (2003) A Randomized Clinical Trial of Progressive Addition Lenses versus Single Vision Lenses on the Progression of Myopia in Children. Invest Ophthal Vis Sci

12 Single: Prog. : Difference: (0.06; ,33) Difference størst ved stort lag Gwiazda et al (2003) A Randomized Clinical Trial of Progressive Addition Lenses versus Single Vision Lenses on the Progression of Myopia in Children. Invest Ophthal Vis Sci

13 Formfaste Kun effekt det først år

14 TABLE 3. Differences in Growth in Axial Length with Time Compared to Baseline for Orthokeratology and Control Groups (mm) Study Intervention 6 Months 12 Months 18 Months 24 Months Brilleglas Cho et al. 39 OK vs. SV Walline et al. 40 OK vs. SCL Kakita et al. Formfaste 41 OK vs. SV MCOS OK vs. SV OK, orthokeratology; SV, single-vision spectacles; SCL, soft contact lenses. Langtidseffekt Drop-out? Difference: 0.30 til 0.60D/år Santodomingo-Rubido (2012) Myopia Control with Orthokeratology Contact Lenses in Spain: Refractive and Biometric Changes

15 Formfaste Lovende resultater Kun effekt det først år

16 Brilleglas Bløde i periferi Anstice et al Myopia Pro To perioder Formfaste 1) 0.25±0.27 (SD) 2) 0.20±0.34 (SD) Seneste studie 0.26D / år Anstice (2011) Effect of DF soft CL wear on axial myopia progression in children Walline et al (2013) Multifocal contact lens myopia control

17 Formfaste Lovende resultater Lovende resultater Kun effekt det først år

18 Uafklarede spørgsmål 1. Endnu ikke overbevisende forklaringer på hvorfor og synes at have effekt OPTIKERHØJSKOLEN Danish College of Optometry and Visual Science 2. Langtidseffekt ikke undersøgt Aftager effekt? Rebound effect?

19 Spørgsmål til salen 1. Høj-risiko-strategi Forebyggelse til pt med moderat til høj myopi OPTIKERHØJSKOLEN Danish College of Optometry and Visual Science 2. Masse-strategi Forebyggelse til alle pt Dilemma: Besvær for den enkelte patient vs forebyggelse i befolkning

Clinically Meaningful

Clinically Meaningful Myopia Control Myopia Control -19% -7% 18% 40% 42% 46% 76% Jeffrey J. Walline, OD PhD The Ohio State University College of Optometry Undercorrection GP Bifocal / PAL Pirenzepine Specs OK What is Clinically