Research Update

Research Update Issue 19

July 2018

Eye & Contact Lens, the official journal of the Contact Lens Association of Ophthalmologists (CLAO), and Myopia Society Japan collaborated to present the symposium: Controlling Myopia Progression 

July 2018  
 
 
 
 

Welcome to our monthly research update
 
Research Update is a resource available exclusively to IACLE and BCLA members to support your teaching and practice. Each month we send you a summary of some of the interesting findings appearing in peer-reviewed journals that month. Our aim is to help you keep up to date with the latest contact lens and anterior eye research, and to locate articles when you want to know more about a particular topic.
 
More information on Research Update and how to use it in your contact lens teaching here. Access archived issues via Member Login under Research.
 
 
 
Special Issue – July 2018
 
Controlling Myopia Progression: Where Do We Stand Today?

Eye & Contact Lens, the official journal of the Contact Lens Association of Ophthalmologists (CLAO), and Myopia Society Japan collaborated to present the symposium: Controlling Myopia Progression: Where Do We Stand Today? These reviews and original studies arose from the symposium, and include additional articles commissioned to expand on some topics.

In this first of two issues devoted to myopia topics, the myopia epidemic, new revelations from ongoing research, as well as new and emerging treatments to address and slow myopia progression, are explored.

Here are some excerpts from the issue.

The IACLE Education Team
 
 
 
Journals reviewed in this issue  
  JOURNAL VOLUME AND ISSUE NUMBER
  Eye & Contact Lens 44:4
 
 
 
 
 
 MYOPIA CONTROL
 

Current thoughts and future research
Asbell & Tsubota set the scene by asking some relevant, hard hitting questions: How would you design a trial to determine the safety and efficacy of a treatment to prevent myopia progression? What result would be clinically significant? What is a reasonable risk/safety ratio? How long should treatment be continued? What about rebound when treatment is stopped? What outcome measures are important? What should be the key safety criteria: vision (distance and near), corneal thickness, glare, pupil size, and corneal health?

Eye & Contact Lens 2018;44:4 203-204. Click here to access

 
 
 
 
 
 STUDY DESIGN
 

Principles of myopia control studies
This workshop, sponsored by the US Food and Drug Administration and academic bodies, invited myopia experts from around the world to discuss principles to consider in the design of clinical trials investigating the effectiveness and safety of myopia control devices. Experts discussed parameters such as study endpoints, duration, enrolment criteria, patient-reported outcomes, recruitment and retention. These discussions should help to facilitate the development and evaluation of reasonably safe and effective myopia control devices. The panel recommended a 50% reduction in refractive error progression as clinically meaningful, although the audience suggested allowing for smaller treatment effects, ie a 30% reduction.

Eye & Contact Lens 2018;44:4 205-211. Click here for full text

 
 
 
 
 
 CLINICAL TRIALS
 

How to assess published studies
Although some contact lens clinical trials have demonstrated promising results in slowing the progression of myopia, many of these studies have significant limitations, including short follow-up times, limited randomization and incomplete masking. More robust clinical study designs are needed so that future studies can demonstrate whether CLs, and other medical devices, can be used safely and effectively to control myopia progression. Robboy et al review key studies, and discuss study design and regulatory issues relevant to future trials.

Eye & Contact Lens 2018;44:4 212-219. Click here for abstract

 
 
 
 
 
 CURRENT CONCEPTS
 

Etiology: genetic and environmental
To provide the latest information on etiology and treatment strategies aimed at preserving ocular health, Cooper & Tkatchenko review studies of current treatments for myopia. Animal and human research demonstrates that myopia development is a result of interplay between genetic and environmental factors. Myopia seems to progress most between ages 8-15 and then begins to slow down. Based on ongoing research, new drug targets and drugs for treating myopia are expected soon. Parents should be aware of what is and is not effective, including the risks and benefits associated with each treatment option.

Eye & Contact Lens 2018;44:4 231-247. Click here for full text

 
 
 
 
 
 ORTHOKERATOLOGY
 

Role of OrthoK in myopia control
This review by Lipson et al covers the development of OrthoK, its mechanism of action, evolution and refinement from a refractive option, to its use as a means of slowing myopic progression. Theories and studies as to how OrthoK slows myopia progression in children are also explained. Individual studies and meta-analyses on myopia control with OrthoK have shown a 40-60% mean reduction in rate of refractive change compared with controls using spectacles. OrthoK provides excellent vision, improves vision-related quality of life, is safe, and is able to slow the myopic progression in children, the authors say.

Eye & Contact Lens Lens 2018;44:4 224-230. Click here for full text

 
 
 
 
 
 AXIAL ELONGATION
 

Axial length in myopic progression
Hou et al describe results from the COMET (Correction of Myopia Evaluation Trial) cohort. This trial aimed to describe axial elongation using 14-year longitudinal data in a large (n=431), ethnically diverse group of myopic children, estimate age and axial length (AL) at stabilization, and evaluate associations between the progression and stabilization of AL and myopia. In most participants, AL increased rapidly at younger ages and then slowed and stabilized. The findings support a major role for axial elongation in the progression and stabilization of myopia, and AL as the ocular component whose change is a primary determinant of refractive error.

Eye & Contact Lens 2018;44:4 248-259. Click here for abstract

 
 
 
 
 
 ORTHOKERATOLOGY
 

Corneal power and axial elongation in OK
Santodomingo-Rubido et al examine the correlation between changes in axial length and short-term (3 months post-OK) and long-term (24 months post-OK) changes in corneal power induced by OK with reference to data from their previous MCOS (Myopia Control with Orthokeratology contact lenses in Spain) study. Differences in refractive power 3 and 24 months post-OK in comparison with baseline and relative to the change in central corneal power of 31 white, European, 6-12-year-old subjects were determined. Reduction in central corneal power and relative increase in paracentral and pericentral power induced by OK over 2 years did not correlate with changes in axial length in these white European children.

sEye & Contact Lens 2018;44:4 260-267. Click here for abstract

 
 
 
 
 
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