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Comparison of the long-term effects of atropine in combination with Orthokeratology and defocus incorporated multiple segment lenses for myopia control in Chinese children and adolescents

Eye (2024)Cite this article

Subjects

Abstract

Purpose

The aim of this study was to evaluate the efficacy of Orthokeratology (Ortho-K), defocus incorporated multiple segment (DIMS) lens, combined Ortho-K/atropine, and combined DIMS/atropine for myopia control in children.

Methods

A retrospective study included 167 myopic children aged 6–14 years with a spherical equivalent refraction (SER) of −0.75 to −4.00 diopter treated with Ortho-K (OK, n = 41), combined Ortho-K/atropine (OKA, n = 43), DIMS (n = 41), or combined DIMS/atropine (DIMSA, n = 42). Axial length (AL) was measured at baseline and at 3, 6, 9 and 12 months. Axial elongation over time and between groups were analysed.

Results

After 12 months, the AL change was 0.20 ± 0.12 mm, 0.12 ± 0.14 mm, 0.22 ± 0.14 mm, and 0.15 ± 0.15 mm in the OK, OKA, DIMS, and DIMSA, respectively. There was no significant difference in AL change between OK and DIMS. OKA and DIMSA significantly slowed axial elongation compared to OK and DIMS monotherapy. After stratification by age, in the subgroup aged 6–10 years, there was significant difference in AL change between OKA and DIMS (p = 0.013), and no difference between other groups, while in the subgroup aged 10–14 years, the difference between OKA and DIMS became insignificant (p = 0.237), and the difference between OK and OKA, OK and DIMSA, DIMS and DIMSA became significant.

Conclusions

Ortho-K and DIMS lenses show similar reductions in myopia progression among children with low initial myopia. Atropine can significantly improve the efficacy of myopia control of both Ortho-K and DIMS lenses, and this add-on effect is better in older children.

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Fig. 1: Changes in AL in the four treatment groups.
Fig. 2: Pairwise comparison of AL changes in the OK, OKA, DIMS and DIMSA groups at 1 month, 3 months, 6 months, and 12 months of follow-up. AL, axial length.
Fig. 3: Comparison of axial length changes in the four treatment groups in the two age subgroups after 1 year of follow-up.

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Data availability

All data generated or analysed during this study are included in this published article.

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Funding

Funding

This work was supported by National Natural Science Foundation of China (Grant No. 82171092, 82371087), Capital’s Funds for Health Improvement and Research (No. 2022-1G-4083), National Key R&D Program of China (No.2021YFC2702100).

Author information

Authors and Affiliations

  1. Department of Ophthalmology & Clinical Centre of Optometry, Peking University People’s Hospital, Beijing, China

    Tao Tang, Yuchang Lu, Xuewei Li, Heng Zhao, Kai Wang, Yan Li & Mingwei Zhao

  2. Institute of Medical Technology, Peking University Health Science Center, Beijing, China

    Tao Tang, Yuchang Lu, Xuewei Li, Heng Zhao, Kai Wang & Mingwei Zhao

  3. College of Optometry, Peking University Health Science Center, Beijing, China

    Tao Tang, Yuchang Lu, Xuewei Li, Heng Zhao, Kai Wang, Yan Li & Mingwei Zhao

  4. Eye Disease and Optometry Institute, Peking University People’s Hospital, Beijing, China

    Tao Tang, Yuchang Lu, Xuewei Li, Heng Zhao, Kai Wang, Yan Li & Mingwei Zhao

  5. Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China

    Tao Tang, Yuchang Lu, Xuewei Li, Heng Zhao, Kai Wang, Yan Li & Mingwei Zhao

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  1. Tao Tang
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Contributions

KW conceived and designed the experiments. YL and MWZ conceived the work and performed data analysis. TT conceived and designed the experiments, collected data, performed the experiments, analysed the data and wrote the manuscript. YCL, XWL and HZ collected data. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Kai Wang.

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The authors declare no competing interests.

Ethics approval and consent to participate

This study was approved by the institutional research ethics committee of Peking University People’s Hospital. All examinations and management were performed in accordance with the Declaration of Helsinki. Because all data were anonymized and the study was retrospective, no informed permission was necessary for patient enrolment.

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Tang, T., Lu, Y., Li, X. et al. Comparison of the long-term effects of atropine in combination with Orthokeratology and defocus incorporated multiple segment lenses for myopia control in Chinese children and adolescents. Eye (2024). https://doi.org/10.1038/s41433-024-02987-5

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  • DOI: https://doi.org/10.1038/s41433-024-02987-5

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