Clinical observation of orthokeratology combined with 0.01% Atropine for controlling low to moderate myopia in adolescents / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the efficacy and safety of orthokeratology combined with 0.01% atropine in controlling low to moderate myopia in adolescents.<p>METHODS: A prospective non-randomized controlled study was conducted among 120 eyes of 120 adolescents with low to moderate myopia. 60 eyes in the control group were treated with orthokeratology, and 60 eyes in the combined group were treated with orthokeratology combined with 0.01% atropine. The best corrected distant visual acuity(BCDVA), best corrected near visual acuity(BCNVA), refraction, axial length, accommodative amplitude, photopic pupil diameter, mesopic pupil diameter, lipid layer thickness(LLT), tear film break up time(BUT)and complications were determined before treatment and at 1a after treatment. <p>RESULTS: There were no significant differences in BCDVA and BCNVA within and between the two groups before and after treatment(<i>P</i>>0.05). After treatment, the spherical equivalents of both groups progressed significantly(<i>P</i><0.01), and the average changes of spherical equivalent refractive error in the combined group and the control group were 0.21(0.03, 0.53)D and 0.40(0.15, 0.74)D respectively(<i>P</i><0.01). The axial lengths of both groups were increased significantly(<i>P</i><0.01), and the axial length elongations of the combined group and the control group were(0.13±0.19)mm and(0.22±0.21)mm respectively(<i>P</i><0.01). There were no significant differences in the accommodative amplitude, photopic and mesopic pupil diameters of the control group before and after treatment(<i>P</i>>0.05). After treatment, the accommodative amplitude of the combined group decreased significantly, while the photopic and mesopic pupil diameters significantly increased, respectively(<i>P</i><0.01). The accommodative amplitude of the combined group was smaller than that of the control group, while the photopic and mesopic pupil diameters were larger than those of the control group at 1a after treatment(<i>P</i><0.01). The LLT and BUT in both groups were significantly reduced from baseline(<i>P</i><0.01), but both showed no significant differences between the two groups at baseline and at 1a after treatment(<i>P</i>>0.05). During the treatment period, there was no difference in the incidence of total adverse reactions between the combined group and the control group(26.7% <i>vs</i> 15.0%, <i>P</i>>0.05). <p>CONCLUSION: Combined treatment with 0.01% atropine and orthokeratology would be a safe and more effective choice of treatment to control the development of myopia in adolescents.

Evaluation of accommodative function in the dominant and non dominant eye

Background: Ocular dominance is the physiological preference of one eye over the other, hence its input is favoured when there is conflicting information to the two eyes. Accommodation is the mechanism by which the eye changes focus from distant to near images and is produced by a change in the shape of the crystalline lens. The aim of this study was to compare the accommodative amplitude, facility and lag in the dominant and non-dominant eye.Methods: This cross sectional study was carried out on 80 visually normal subjects. Ocular dominance was determined using hole-in-the- card method. Amplitude of accommodation, accommodative facility and response was measured monocularly and randomly using push up method, ±2.00DS flipper lenses and Nott technique respectively.Results: Results obtained from the study showed that the right eye was dominant in 62.5% of subjects. The mean (SD) for accommodative amplitude, facility and response (lag) in the dominant eye was 11.08 (2.16) D, 10.00 (1.52) cycles per minute and 0.62 (0.27) respectively. The mean (SD) for accommodative amplitude, facility and lag in the non-dominant eye was 10.98 (2.20) D, 9.86 (1.44) cycles per minute and 0.60 (0.25) D respectively.Conclusions: It may be inferred that the dominant eye has more accommodative amplitude, facility and lag than the non-dominant eye but this difference was not statistically significant.

Dissociated Horizontal Deviation in the Refractive Accommodative Esotropia with Amblyopia

Dissociated horizontal deviation(DHD) is a rare type of dissociative strabismus. It dose not obey the Hering`s law of equal innervation and is expressed in associated with dissociated vertical deviation or asymmetrical nystagmus blockage syndrome. We observed 6 cases of DHD among the patients with refractive accommodative esotropia associated with amblyopia. The mean age of the patients was 3.6 years and the average refractive error was +5.35D in the dominant eyes and +6.29D in the amblyopic eyes. The average visual acuity was 0.38 with the dominant eyes and 0.17 with the amblyopic eyes. The average angle of deviation was 40.0delta with fixation in the dominant eyes and 24.3delta in the amblyopic eyes. The authors speculate that this difference of angle deviation was caused by the weaker accommodative convergence at the time of fixation by the amblyopic eye that appeared to have decreased accommodative amplitudes.