Peripheral myopic defocus signal affects the efficiency of visual information processing in myopic children.

PURPOSE: Spectacle lenses with peripheral lenslets have shown promise for myopia control by providing peripheral myopic defocus signals. Here, we aimed to investigate the impact of prolonged exposure (>6 months) to peripheral myopic defocus on visual information processing in myopic children. METHODS: The study included 30 myopic children who habitually wore spectacle lenses with highly aspherical lenslets (HAL group) and 34 children who habitually wore single-vision (SV group) spectacles. The quick contrast sensitivity function (qCSF) was used to measure contrast sensitivity (CS) under conditions of no or high noise. Both groups were tested with HAL and SV lenses. The perceptual template model was utilised to fit the contrast sensitivity function (CSF) and determine differences in information processing efficiency through internal additive noise ( N add $$ {N}_{\mathrm{add}} $$ ) and perceptual template gain (ß). RESULTS: The areas under the log CSF in the SV group were significantly higher than for the HAL group in both zero-noise conditions with the SV test lens (p = 0.03) and high-noise conditions with the HAL test lens (p = 0.02). For 2 cycle per degree (cpd) stimuli, ß was significantly higher in the SV group with the HAL test lens than in the HAL group (p = 0.02), while there was a trend towards a significant difference in ß for 6 cpd stimuli (p = 0.07). However, there were no significant differences in N add $$ {N}_{\mathrm{add}} $$ between the two groups, with or without noise interference. CONCLUSION: The reduced CS observed in myopic children wearing HAL lenses for 6 months or more may be due to decreased ß. This suggests that prolonged use of spectacle lenses with peripheral myopic defocus signals may compromise the central visual system's ability to process additional external noise, resulting in decreased efficiency in visual information processing.

Effect of spectacle lenses with aspherical lenslets on choroidal thickness in myopic children: a 3-year follow-up study.

BACKGROUND: To investigate the impact of wearing spectacle lenses with highly aspherical lenslets (HAL) for 3 years and the impact of switching from single-vision lenses (SVL) to HAL on choroidal thickness (ChT). METHODS: Fifty-one participants who had already worn HAL for 2 years continued wearing them for an additional year (HAL group). Further, 50 and 41 participants who had worn spectacle lenses with slightly aspherical lenslets (SAL) and SVL for 2 years, respectively, switched to wearing HAL for another year (SAL-HAL and SVL-HAL groups). Additionally, 48 new participants aged 10-15 years were enrolled to wear SVL at the third year (new-SVL group). ChT was measured every 6 months throughout the study. RESULTS: Significant differences were observed in the changes in ChT among the four groups at the third year (all P < 0.05 except for the outer nasal region: P = 0.09), with the new-SVL group showing larger reductions compared with the other three groups. However, none of the three HAL-wearing groups showed significant changes in ChT at the third year (all P > 0.05). When comparing the changes in ChT for 3 years among the HAL, SAL-HAL, and SVL-HAL groups, significant differences were found before switching to HAL, but these differences were abolished after all participants switched to HAL. CONCLUSIONS: Compared to those in the SVL group, choroid thinning was significantly inhibited in all the HAL groups. Wearing HAL for 3 years no longer had a choroidal thickening effect but could still inhibit choroidal thinning compared to wearing SVL. TRIAL REGISTRATION: The study was registered at the Chinese Clinical Trial Registry (ChiCTR1800017683), http://www.chictr.org.cn/showproj.aspx?proj=29789 .

Differential Impact of 0.01% and 0.05% Atropine Eyedrops on Ocular Surface in Young Adults.

Purpose: To evaluate the effect of low-concentration (0.01% and 0.05%) atropine eyedrops on ocular surface characteristics in young adults. Methods: Twenty-six myopic students aged 18 to 30 years were randomly assigned to receive either 0.01% or 0.05% atropine once nightly for 14 days, followed by cessation, with a ≥14-day interval between each administration. Assessments were conducted one, two, seven, and 14 days after using atropine with corresponding timepoints after atropine cessation. Tear meniscus height and first and average noninvasive keratograph tear film breakup time (NIKBUT-first, NIKBUT-average) were measured using Keratograph 5M, whereas the objective scatter index (OSI) was measured by OQAS II devices; the ocular surface disease index (OSDI) score was also obtained. Results: The mean OSI peaked after two days of administration of 0.05% atropine (ß = 0.51, P = 0.001), accompanied by significant decreases in NIKBUT-first (ß = -7.73, P < 0.001) and NIKBUT-average (ß = -8.10, P < 0.001); the OSDI peaked after 14 days (ß = 15.41, P < 0.001). The above parameters returned to baseline one week after atropine discontinuation (all P > 0.05). NIKBUT-first and NIKBUT-average reached their lowest points after 14 days of 0.01% atropine administration (NIKBUT-first: ß = -4.46, P = 0.005; NIKBUT-average: ß = -4.42, P = 0.001), but those significant changes were diminished once atropine treatment stopped. Conclusions: Young adult myopes experienced a significant but temporary impact on the ocular surface with 0.05% atropine administration, whereas 0.01% atropine had a minimal effect. Translational Relevance: The investigation of the ocular surface effects of different concentrations of atropine may inform evidence-based clinical decisions regarding myopia control in young adults.

Effect of myopia-control lenses on central and peripheral visual performance in myopic children.

PURPOSE: To evaluate the short-term effects of three myopia-control lenses, which impose peripheral myopic defocus while providing clear central vision, on central and peripheral visual performance in myopic children. METHODS: Twenty-one myopic children were enrolled in the study. Central visual performance was assessed using the quick contrast sensitivity function. Peripheral visual performance was evaluated by measuring peripheral contrast threshold and global motion perception, while subjects maintained fixation through the central portion of the lens. Single-vision spectacle lenses (SVL), spectacle lenses with highly aspherical lenslets (HAL) and defocus-incorporated soft contact (DISC) lenses were evaluated in random order, followed by orthokeratology (OK) lenses. All tests were performed monocularly on the right eye. RESULTS: The area under the log contrast sensitivity function (AULCSF) with DISC lenses was lower than that with SVL (1.14 vs. 1.40, p < 0.001) and HAL (1.14 vs. 1.33, p = 0.001). HAL increased the temporal visual field contrast threshold compared with OK lenses (p = 0.04), and OK lenses decreased the superior visual field contrast threshold compared with that of SVL (p = 0.04) and HAL (p = 0.005). HAL also increased the peripheral coherence threshold for identifying the contraction movement compared with OK lenses (p = 0.01). CONCLUSIONS: The short-term use of these optical interventions for myopia control exhibited measurable differences in central and peripheral visual performance. Relevant attention could be paid to these differences, especially when children switch to different treatments. DISC lenses exhibited worse central contrast sensitivity than SVL and HAL. Imposing peripheral defocus signals did not affect children's peripheral visual performance compared with SVL. However, considering the poorer peripheral visual performance provided by HAL, OK lenses are recommended for children if there are specific demands for global scene recognition and motion perception.

Eye growth pattern of myopic children wearing spectacle lenses with aspherical lenslets compared with non-myopic children.

INTRODUCTION: To evaluate eye growth of children wearing spectacle lenses with highly aspherical lenslets (HAL), slightly aspherical lenslets (SAL) and single-vision lenses (SVL) compared to eye growth patterns in non-myopes in Wenzhou, China. METHODS: The randomised trial had 170 myopic children (aged 8-13 years) randomly assigned to the HAL, SAL or SVL group. Normal eye growth was examined using 700 non-myopic schoolchildren (aged 7-9 years) in the Wenzhou Medical University-Essilor Progression and Onset of Myopia (WEPrOM) cohort study using logistic function models. Slow, normal and fast eye growth was defined as range of values <25th, 25th-75th and >75th percentiles, respectively. RESULTS: The predicted upper limits of slow eye growth (25th percentile) among non-myopes aged 7-10 years and 11-13 years were 0.20-0.13 and 0.08-0.01 mm (after 2-year period; 0.37-0.33 and 0.29-0.14 mm), respectively, while the upper limits of normal eye growth (75th percentile) were 0.32-0.31 and 0.28-0.10 mm (after 2-year period; 0.58-0.55 and 0.50-0.24 mm), respectively. The 2-year trial had 157 children, 96 of whom wore their lenses full time (everyday ≥12 h/day). The mean 2-year axial length change for HAL, SAL and SVL was 0.34, 0.51 and 0.69 mm (0.28, 0.46 and 0.69 mm in full-time wear), respectively. Slow eye growth was found in 35%, 17% and 2% (44%, 29% and 3% in full-time wear); normal eye growth in 35%, 26% and 12% (44%, 32% and 9% in full-time wear) and fast eye growth in 30%, 57% and 86% (12%, 39% and 88% in full-time wear), respectively (p < 0.001). CONCLUSIONS: The eye growth pattern in approximately 90% wearing HAL full time (compared with about 10% wearing SVL full time) was similar or slower than that of non-myopic children both after 1- and 2-year periods.

Effects of Spectacle Lenses With Aspherical Lenslets on Peripheral Eye Length and Peripheral Refraction in Myopic Children: A 2-Year Randomized Clinical Trial.

Purpose: To investigate changes in peripheral eye length (PEL) and peripheral refraction (PR) in myopic children after wearing spectacle lenses with highly or slightly aspherical lenslets (HAL or SAL) for 2 years. Methods: We recruited 170 children aged 8 to 13 years with myopia between -0.75 diopters (D) and -4.75 D. Participants were randomized to wear HAL, SAL, or single vision spectacle lenses (SVL). PEL and PR were measured at 0° central and 15° and 30° in the nasal and temporal retina every 6 months for 2 years. The relative PR (RPR) was calculated by subtracting central from peripheral values. Results: PELs significantly increased with time (all P < 0.001), with the greatest elongation in the SVL group and the least in the HAL group. In the SVL and SAL groups, axial length elongated faster than the periphery. Whereas in the HAL group, N30 elongated faster than other PELs, axial length elongated less than the periphery. With time, the PR became more negative (all P < 0.001), with the most negative changes in the SVL group and the least negative changes in the HAL group. RPR became more hyperopic in the SVL and SAL groups, but less hyperopic in the HAL group (all P < 0.001). Conclusions: Over the 2-year myopia progression, steeper retina and greater peripheral hyperopic defocus were found in the SVL group. In the SAL group, changes were attenuated. In the HAL group, the retina flattened and peripheral defocus became less hyperopic. Translational Relevance: HAL and SAL lenses had little impact on PEL elongation.

Comparison of visual performance between peripheral gradient high-addition multifocal soft contact lenses and orthokeratology.

PURPOSE: The aim of this study was to evaluate the short-term effects of peripheral gradient high-addition multifocal soft contact lenses (MFSCLs) and orthokeratology (Ortho-K lenses) on visual performance in myopic children. METHODS: Thirty myopic children participated in this prospective study. Each participant wore different sets of lenses in the following sequence: single-vision spectacles (SVSPs) as a control, MFSCLs and Ortho-K lenses. Ocular aberrations, topography, high-contrast visual acuity (HCVA), low-contrast visual acuity (LCVA) and accommodation of the right eye were measured with each type of correction on a different day. RESULTS: Compared with SVSPs, high-addition MFSCLs and Ortho-K lenses significantly increased all items of aberrations (all p < 0.05) except trefoil (p = 0.17). MFSCLs induced less coma, root mean square of the third-order aberration (RMS3) and higher order aberrations than Ortho-K lenses (all p < 0.05). No significant difference in HCVA was found across the three correction types (F = 1.19, p = 0.39). In terms of LCVA, MFSCLs performed significantly poorer than SVSPs (difference, 0.16 logMAR; p = 0.001) and slightly worse than Ortho-K lenses (difference, 0.08 logMAR; p = 0.35). No significant difference in decentration was found between the two types of contact lenses, and no associations were observed between decentration and visual acuity at both high- and low-contrast levels (all p > 0.05). For MFSCLs, decentration was positively related to coma (r = 0.43, p = 0.02) and RMS3 (r = 0.44, p = 0.02), which was not the case for Ortho-K lenses. Accommodative facility was worse with MFSCLs than Ortho-K lenses (p = 0.001). CONCLUSION: Multifocal soft contact lenses differed from Ortho-K lenses in aberration profile and LCVA, although decentration was similar. Decentration <1 mm had minimal influence on both HCVA and LCVA for either type of correction, but significantly increased third-order aberrations for MFSCLs, but not Ortho-K lenses.

Myopia Control Efficacy of Spectacle Lenses With Aspherical Lenslets: Results of a 3-Year Follow-Up Study.

PURPOSE: To investigate myopia control efficacy in children who continued wearing spectacle lenses with highly aspherical lenslets (HAL) or switched from spectacle lenses with slightly aspherical lenslets (SAL) and single-vision spectacle lenses (SVL) to HAL for 1 year after a 2-year myopia control trial. DESIGN: This was a 1-year extension of a randomized clinical trial. METHODS: Of 54 children who had worn HAL for 2 years, 52 continued wearing HAL (HAL1 group), and of the 53 and 51 children who had originally worn SAL or SVL, 51 and 48 switched to wearing HAL (HAL2 and HAL3 groups) in year 3, respectively. A new SVL (nSVL) group of 56 children was recruited, matched for age, sex, cycloplegic spherical equivalent refraction (SER), and axial length (AL) of the HAL3 group at extension baseline, and used for a comparison of third-year changes. SER and AL were measured every 6 months in year 3. RESULTS: During year 3, the mean (SE) myopia progression in the nSVL group was -0.56 (0.05) diopters (D). Compared with nSVL, the changes in SER were less in HAL1 (-0.38 [0.05] D, P = .02), HAL2 (-0.36 [0.06] D, P = .01), and HAL3 (-0.33 [0.06] D, P = .005). The mean (SE) AL elongation in the nSVL group was 0.28 (0.02) mm. Compared with nSVL, the elongation in AL was less in the HAL1 (0.17 [0.02] mm, P < .001), HAL2 (0.18 [0.02] mm, P < .001), and HAL3 (0.14 [0.02] mm, P < .001) groups. Myopia progression and axial elongation were comparable in all 3 HAL groups (all P > .05) in year 3. CONCLUSIONS: Myopia control efficacy has remained in children who wore HAL in the previous 2 years. Children who switched from SAL or SVL to HAL in year 3 had slower myopia progression and axial elongation than that in the control group.

Effect of spectacle lenses with aspherical lenslets on choroidal thickness in myopic children: a 2-year randomised clinical trial.

OBJECTIVE: Spectacle lenses with highly aspherical lenslets (HAL) and slightly aspherical lenslets (SAL) showed effective myopia control. This study was to investigate their effects on macular choroidal thickness (ChT) in myopic children. METHODS: Exploratory analysis from a 2-year, double-masked, randomised trial. 170 children aged 8-13 years with myopia between -0.75D and -4.75D, astigmatism of 1.50D or less, and anisometropia of 1.00D or less were recruited. Participants were randomly assigned in a 1:1:1 ratio to receive HAL, SAL or single vision spectacle lenses (SVL). The subfoveal, parafoveal and perifoveal ChT were evaluated every 6 months. RESULTS: 154 participants completed all examinations. The ChT showed significant changes over time in all three groups in all regions (all p<0.05). The ChTs continuously decreased in the SVL group (ranging from -20.75 (SD 22.34) µm to -12.18 (22.57) µm after 2 years in different regions). Compared with the SVL group, ChT in the SAL group decreased less (ranging from -16.49 (21.27) µm to -5.29 (18.15) µm). In the HAL group, ChT increased in the first year and then decreased in the second year (ranging from -0.30 (27.54) µm to 8.92 (23.97) µm after two years). The perifoveal ChT decreased less than the parafoveal ChT, and the superior region decreased the least. CONCLUSIONS: The ChT of the macula decreased after 2 years of myopia progression with SVL. Wearing spectacle lenses with aspherical lenslets reduced or abolished the ChT thinning and HAL had a more pronounced effect. TRIAL REGISTRATION NUMBER: ChiCTR1800017683.

Refraction development in anisometropic amblyopia with patching therapy.

Purpose: To investigate the development of refraction in anisometropic amblyopia who had been with patching therapy. Methods: We retrospectively reviewed 37,528 medical records of the amblyopes who had been treated with patching therapy between July 2003 and January 2020 at the School of Optometry and Ophthalmology and Eye Hospital of Wenzhou Medical University. We included unilateral anisometropic amblyopia with a follow-up length of not < 2 years. In total, 371 cases were enrolled and followed up for a mean of 4.76 ± 2.11 years. The subjects were then divided into different groups and periods according to their initial spherical equivalent (SE) refractive error and best-corrected visual acuity (BCVA) of the amblyopic eye. Linear mixed-effects models were fitted to calculate the annual change of SE. Results: The annual changes in SE were -0.32 (-0.35 to -0.30) and -0.16 (-0.19 to -0.14) D/yr for the amblyopic eye and the fellow eye, respectively. The annual changes in SE of amblyopic eyes during the treatment period and the successfully treated period were -0.36 (-0.43 to -0.29; 95% CI) and -0.27 (-0.32 to -0.23; 95% CI) D/yr, respectively; the annual SE changes of the fellow eye during the treatment period and the successfully-treated period were -0.07 (-0.14 to -0.01; 95% CI) and -0.18 (-0.22 to -0.14; 95% CI) D/yr, respectively. Conclusion: The amblyopic eye experienced a significantly greater degree of refractive error changes than the fellow eye and underwent a continuous refractive error reduction before and after 7 years old. After the patching therapy was terminated, emmetropization in the amblyopic eye remained synchronized, whereas the refractive error change was increased in the fellow eye.

miR-96-5p regulates cervical cancer cell resistance to cisplatin by inhibiting lncRNA TRIM52-AS1 and promoting IGF2BP2.

MicroRNA (miRNA) and long noncoding RNA (lncRNA) are both regulators of cancer progression. This study sought to discuss the functional mechanism of miR-96-5p/lncRNA TRIM52 antisense RNA 1 (head-to-head; TRIM52-AS1) in cervical cancer (CC) cell resistance to cisplatin (DDP). DDP-resistant CC cell line was established using increasing concentrations of DDP, followed by transfection with miR-96-5p inhibitor, or si-TRIM52-AS1, or insulin-like growth factor 2 mRNA binding protein 2 (IGF2BP2) overexpression vector. Expression levels of miR-96-5p, TRIM52-AS1, and IGF2BP2 were determined. Changes in IC50 value to DDP, cell proliferation, and apoptosis rate were evaluated by cell-counting kit-8 assay, colony formation, and flow cytometry. The bindings of miR-96-5p to IGF2BP2 and TRIM52-AS1 to IGF2BP2 were verified by dual-luciferase or RNA pull-down assays. These experiments revealed an up-expression of miR-96-5p and IGF2BP2 while an under-expression of TRIM52-AS1 in CC cells. After DDP treatment, miR-96-5p inhibition increased apoptosis and decreased proliferation and DDP resistance. miR-96-5p bound to TRIM52-AS1 and downregulated TRIM52-AS1 expression, and TRIM52-AS1 bound to IGF2BP2 to inhibit IGF2BP2 expression. TRIM52-AS1 inhibition or IGF2BP2 overexpression neutralized the inhibition of silencing miR-96-5p on CC cell resistance to DDP. Overall, miR-96-5p improved CC cell resistance to DDP by inhibiting TRIM52-AS1 and promoting IGF2BP2.

The impact of pulmonary tuberculosis on immunological and metabolic features of diabetic patients.

Impaired immune responses have been observed in patients with type-2 diabetes mellitus (T2DM), which increases susceptibility to tuberculosis infection. However, the effect of the tuberculosis infection on the immunological and metabolic features of T2DM is largely unknown. To investigate this question, age- and sex-matched patients with pulmonary tuberculosis (PTB), T2DM, or T2DM combined with PTB were recruited from the Infectious Disease Hospital of Heilongjiang Province between January and September 2020. Healthy subjects were used as controls. Cytokines and chemokines in fasting serum samples were determined using the Quantibody Inflammation Array. Compared with T2DM alone, patients with T2DM combined with PTB have higher fasting blood glucose levels and monocyte counts in circulation. Among the four groups, circulating IL-10 levels peaked in patients with T2DM and PTB (p<0.05). Univariate linear analysis showed that serum IL-10 levels were positively associated with myeloid cells but negatively correlated with lymphocyte counts in these patients (p<0.05). Serum IL-6 levels were 1.6-fold higher in patients with T2DM plus PTB than in those with T2DM alone. In conclusion, PTB infection in patients with T2DM had distinct inflammatory profiles and sustained hyperglycaemia compared with PTB or T2DM alone. IL-10 levels and elevated monocyte counts could be hallmarks of patients with T2DM infected with PTB.

Visual acuity, near phoria and accommodation in myopic children using spectacle lenses with aspherical lenslets: results from a randomized clinical trial.

OBJECTIVES: To investigate the short- and long-term effects of myopia control spectacle lenses with highly aspherical lenslets (HAL) and slightly aspherical lenslets (SAL) on visual function and visual quality using data obtained from a randomized controlled clinical trial. METHODS: This was a prospective, randomized, controlled, and double-blinded study; 170 myopic children aged 8-13 years were randomly assigned to the HAL, SAL, or single-vision spectacle lenses (SVL) groups. Distance and near visual acuity (VA) at high (100%) and low (10%) contrast in photopic and scotopic conditions, near phoria, stereoacuity, and accommodative lag, microfluctuations (AMFs), amplitude (AA) were measured after wearing lenses for 10 min, 6 months, and 12 months. RESULTS: In total, 161 subjects completed all follow-up in 12 months and were included in the analysis. After 10 min of wearing, the HAL and SAL groups had lower scotopic and low-contrast VA than the SVL group (decreased 0.03-0.08 logMAR and 0.01-0.04 logMAR in different VAs in the HAL and SAL groups, respectively, all P < 0.05). The reduction in VA was recovered at 12 months as the HAL and SAL groups exhibited significant VA improvements, and the VA was not different among the three groups (all P > 0.05). The HAL and SAL groups had significantly larger AMFs than the SVL group (HAL vs. SAL vs. SVL: 0.21 ± 0.08 D vs. 0.16 ± 0.05 D vs. 0.15 ± 0.06 D at baseline, 0.19 ± 0.07 D vs. 0.17 ± 0.05 D vs. 0.13 ± 0.07 D at 12 months, all P < 0.05). There were no significant differences in accommodative lag, AA, or phoria between the groups (all P > 0.05). The HAL and SAL groups had reduced stereoacuity compared to the SVL group at baseline (70' vs. 60' vs. 50', P = 0.005), but no difference was observed at 12 months (70' vs. 70' vs. 70', P = 0.11). CONCLUSIONS: HAL and SAL have no significant influence on accommodation and phoria except had larger AMF than SVL. Scotopic VA and low-contrast VA are reduced with short-term HAL and SAL use but recovered to be at same level with the SVL after 1 year of use. Trial registration Chinese Clinical Trial Registry: ChiCTR1800017683. Registered on 9 August 2018. http://www.chictr.org.cn/showproj.aspx?proj=29789.

Spectacle lenses with slightly aspherical lenslets for myopia control: clinical trial design and baseline data.

OBJECTIVES: Myopia is a major public health problem and it is essential to find safe and effective means to control its progression. The study design and baseline data are presented for a one-year prospective, double-masked, crossover, randomized clinical trial evaluating the efficacy of single vision spectacle lenses with concentric rings of slightly aspherical contiguous lenslets technology (SAL) on myopia control. METHODS: One hundred 8- to 13-year old Chinese children with a refractive error of -0.75 D to -4.75 D were assigned to two groups. In Group 1, SAL and single vision lenses were each worn for 6 months, and Group 2 wore the lenses in the reversed order. Primary outcomes are axial length and spherical equivalent of cycloplegic refractive error. Secondary outcomes included corneal thickness, anterior chamber depth, lens thickness, visual acuity, and lens adaptation. RESULTS: No significant differences in baseline parameters (cycloplegic spherical equivalent, axial length, age) were found between groups (0.49 < p < 0.94). All children adapted well to the test lenses and there was no significant difference in visual acuity between the SAL and single vision lenses (p = 0.27). CONCLUSIONS: The children in the two well balanced groups had comparable visual acuity and adapted well to the test lenses. These results imply that visual acuity can be well improved by SAL lenses. Clear visual acuity provides the assurance for good compliance in this longitudinal study.

Genome-wide association meta-analysis of 88,250 individuals highlights pleiotropic mechanisms of five ocular diseases in UK Biobank.

BACKGROUND: Ocular diseases may exhibit common clinical symptoms and epidemiological comorbidity. However, the extent of pleiotropic mechanisms across ocular diseases remains unclear. We aim to examine shared genetic etiology in age-related macular degeneration (AMD), diabetic retinopathy (DR), glaucoma, retinal detachment (RD), and myopia. METHODS: We analyzed genome-wide association analyses for the five ocular diseases in 43,877 cases and 44,373 controls of European ancestry from UK Biobank, estimated their genetic relationships (LDSC, GNOVA, and Genomic SEM), and identified pleiotropic loci (ASSET and METASOFT). FINDINGS: The genetic correlation of common SNPs revealed a meaningful genetic structure within these diseases, identifying genetic correlations between AMD, DR, and glaucoma. Cross-trait meta-analysis identified 23 pleiotropic loci associated with at least two ocular diseases and 14 loci unique to individual disorders (non-pleiotropic). We found that the genes associated with these shared genetic loci are involved in neuron differentiation (P = 8.80 × 10-6) and eye development systems (P = 3.86 × 10-5), and single cell RNA sequencing data reveals their heightened gene expression from multipotent progenitors to other differentiated retinal cells during retina developmental process. INTERPRETATION: These results highlighted the potential common genetic architectures among these ocular diseases and can deepen the understanding of the molecular mechanisms underlying the related diseases. FUNDING: The National Natural Science Foundation of China (61871294), Zhejiang Provincial Natural Science Foundation of China (LR19C060001), and the Scientific Research Foundation for Talents of Wenzhou Medical University (QTJ18023).

Reading speed in school-age children with intermittent exotropia.

Reading speed in intermittent exotropia (IXT) children has been minimally examined. This study assessed reading speed in school-age children with IXT and determined clinical characteristics of IXT that impacted their reading ability. We compared the reading speed of 63 school-age (10-14 years) children with IXT to 44 age-matched normal counterparts. In addition, the correlation between reading speed and clinical characteristics of IXT were evaluated. The reading speed in children with IXT was 231 ± 51 CPM, while reading speed in normal counterparts was 257 ± 33 CPM. Age, gender were found to be factors associated with reading speed in children with IXT. After adjusting for the age and gender, we found a significant correlation between the LogTNO and reading speed in IXT group based on a generalized linear model (p = 0.014). These data show that reading speed was slower in school-age children with IXT assessed with the International Reading Speed Texts. When age and gender were adjusted, poor stereo function at near was found to be related with a slower reading speed.

Development and validation of a novel nomogram for predicting the occurrence of myopia in schoolchildren: A prospective cohort study.

PURPOSE: Myopia is a major public health issue and occurs at young ages. Apart from its high prevalence, myopia results in high costs and irreversible blinding diseases. Accurate prediction of the risk of myopia onset is crucial for its precise prevention. We aimed to develop and validate an effective nomogram for predicting myopia onset in schoolchildren. DESIGN: School-based prospective cohort study. METHODS: A total of 1073 schoolchildren were enrolled from November 2014 to May 2019 in China, and were divided into the training and validation cohorts. Myopia was defined as a spherical equivalent refraction (SER) ≤-0.5 diopters. Predictors of myopia were determined through the least absolute shrinkage and selection operator regression and multivariable Cox proportional hazard model based on the training cohort. The predictive performance of the nomogram was validated internally through time-dependent receiver operating characteristic (ROC) curves, calibration plot, decision curve analysis, and Kaplan-Meier curves. RESULTS: Independent predictors at baseline including gender, SER, axial length, corneal refractive power, and positive relative accommodation were included in the nomogram prediction model. This nomogram demonstrated excellent calibration, clinical net benefit, and discrimination, with all the area under the ROC curves (AUCs) between 0.74 and 0.86 in the training and validation cohorts. The Kaplan-Meier curves showed that 3 distinct risk groups stratified through X-tile analysis were well discriminated and robust among subgroups. The Harrell's C-index and net reclassification improvement demonstrated that the nomogram substantially improved compared with previous models. An online myopia risk calculator was generated for better individual prediction. CONCLUTIONS: The nomogram provides accurate and individual prediction of myopia onset in schoolchildren. External validation is needed to verify the generalizability of this nomogram.

Treatment zone decentration promotes retinal reshaping in Chinese myopic children wearing orthokeratology lenses.

PURPOSE: To investigate whether the treatment zone (TZ) decentration in orthokeratology (OK) lenses affects retinal expansion in Chinese children with myopia. METHODS: Children aged 8 to 13 years (n = 30) were assessed over 13 months comprising 12 months of OK lens wear followed by discontinuation of lens wear for 1 month. Corneal topography was measured at 0, 1, 3, 6, 9, 12 and 13 months. TZ decentration of the OK lens was calculated, and subjects were subdivided into a small decentration group (group S) and a large decentration group (group L) based on the median value of the weighted average decentration (dave ). Central axial length (AL) and peripheral eye lengths (PELs) at the central retina, as well as 10°, 20° and 30° nasally and temporally were measured at 0 and 13 months under cycloplegia. Second-order polynomial (y = ax2 + bx + c) and linear fits (y = Kx + B) were applied to the peripheral relative eye length (PREL), and the coefficients 'a' and 'K' were used to describe the shape of the eye. RESULTS: Mean AL growth for one year was 0.28 ± 0.17 mm. In a multiple linear regression model, AL elongation was related to the baseline age (ß = -0.41, p = 0.01) and the dave (ß = -0.37, p = 0.03) (R2  = 0.34, p = 0.002). When compared with smaller dave (0.45 ± 0.15 mm), a larger dave (0.89 ± 0.17 mm) was associated with slower ocular growth (central: 0.20 ± 0.13 mm vs. 0.35 ± 0.17 mm, p = 0.009; 10° nasal: 0.26 ± 0.18 mm vs. 0.45 ± 0.21 mm, p = 0.02; 10° temporal: 0.17 ± 0.14 mm vs. 0.32 ± 0.19 mm, p = 0.02) and more oblate retina shape ('a': -0.13 ± 0.02 vs. -0.14 ± 0.02, p = 0.02; Knasal : 0.35 ± 0.11 vs. 0.39 ± 0.09, p = 0.02; Ktemporal : -0.42 ± 0.08 vs. -0.46 ± 0.08, p = 0.004). CONCLUSIONS: Greater TZ decentration with the use of OK lenses was associated with slower axial growth and a more oblate retinal shape. TZ decentration caused local defocusing changes, which may inhibit myopic progression. These findings may have important implications for improving optical designs for myopia control.