Daily Low-Level Red Light for Spherical Equivalent Error and Axial Length in Children With Myopia: A Randomized Clinical Trial.

Importance: Treatments are needed to slow progression of or reduce incidence of myopia. Objective: To evaluate the efficacy and safety of daily 650-nm low-level red light (LLRL) for myopia treatment. Design, Setting, and Participants: Single-masked, randomized clinical trial at 1 site in China. Baseline measurements were completed from August to September 2021. Participants were children aged 6 to 12 years with spherical equivalent error (SER) of -6 diopters (D) to 3 D. Data were analyzed from March to July 2023. Interventions: Irradiation daily with 650-nm LLRL for 3 minutes twice daily 4 or more hours apart or no intervention. Main Outcomes and Measures: Primary outcomes were changes in cycloplegia SER and axial length (AL) at 6- and 12-month follow-up visits. Safety was assessed on masked fundus photograph evaluations. Results: A total of 336 children were randomly allocated into the LLRL group or control group in a 1:1 ratio. The control group contained 86 female patients (51.2%), and the treatment group contained 90 female patients (53.6%). The mean (SD) age, SER, and AL were 9.0 (1.9) years, -1.3 (1.5) D, and 23.8 (1.0) mm for all patients. A total of 161 (95.8%) in the LLRL group and 159 (94.6%) in the control group returned for the 6-month follow-up. A total of 157 (93.5%) in the LLRL group and 152 (90.5%) in the control group returned for the 12-month follow-up. Mean (SD) changes in SER were 0.15 (0.16) D and -0.26 (0.21) D for the LLRL group and the control group, respectively (difference, -0.41 D; 95% CI, -0.48 to -0.34 D; P < .001), at 6 months and 0.24 (0.27) D and -0.65 (0.33) D for the LLRL group and the control group, respectively (difference, -0.89 D; 95% CI, -0.95 to -0.83 D; P < .001), at 12 months. Mean (SD) changes in AL were -0.06 (0.08) mm and 0.13 (0.12) mm for the LLRL group and control group, respectively (difference, 0.19 mm; 95% CI, 0.16 to 0.22 mm; P < .001), at 6 months and -0.11 (0.10) mm and 0.26 (0.16) mm for the LLRL group and control group, respectively (difference, 0.37 mm; 95% CI, 0.34 to 0.40 mm; P < .001). Masked fundus photograph review did not identify retinal changes in either group. Conclusions and relevance: These findings suggest daily use of 650-nm LLRL for 1 year can slow progression of SER and AL without safety concerns identified. Confirmation of these findings at independent sites seems warranted, as well as determining whether these effects can be sustained with or without continued treatment and whether LLRL has any effect on pathological myopia. Trial Registration: ChiCTR2200058963.

Six-month repeated irradiation of 650 nm low-level red light reduces the risk of myopia in children: a randomized controlled trial.

PURPOSE: To evaluate whether the six-month repeated irradiation of 650 nm low-level red light (LLRL) decreases the risk of myopia onset in children. METHODS: This was a single-masked, randomized controlled trial. A total of 112 children (aged 6-12 years) were enrolled and randomized to the treatment group or control group in a 1:1 ratio. The cycloplegic spherical equivalent error (SER) of children at baseline was -0.5 diopter (D) to 3D. Children in the treatment group were irradiated with the 650 nm LLRL for 6 min daily. No intervention was given to the control. The primary outcomes are myopia incidence, change in cycloplegic SER, and change in axial length (AL). RESULTS: For the treatment group and control group, the six-month myopia incidence rates were 1.8% (95% confidence interval, CI: 0.2-4.9%) and 12.5% (95% CI: 5.5-21.9%), respectively. The difference was significant (p = 0.028). The median changes in AL for the treatment group and control group were -0.02 (interquartile range, IQR: -0.12 to 0.06) mm, and 0.09 (IQR: 0-0.18) mm, respectively. The difference was significant (p < 0.001). The median changes in cycloplegic SER for the treatment group and control group were 0 (IQR: 0-0.25) D, and -0.125 (IQR: -0.375 to 0) D, respectively. The difference was significant (p < 0.001). There was no adverse event. CONCLUSION: The repeated irradiation of 650 nm LLRL may have a strong effect for myopia prevention in children, without risk of adverse events. TRIAL REGISTRATION: this trial is retrospectively registered in the Chinese Clinical Trial Registry ( http://www.chictr.org.cn/ ), the registration number is ChiCTR2200058963.

Investigation of the Efficacy and Safety of 650 nm Low-Level Red Light for Myopia Control in Children: A Randomized Controlled Trial.

INTRODUCTION: To evaluate the 6-month efficacy and safety of 650 nm low-level red light (LLRL) for myopia control in children. METHODS: This was a single-center, single-masked randomized controlled trial. A total of 224 children aged 6-12 years with spherical equivalent error (SER) of - 6 diopter (D) to - 0.5 D were enrolled, and were randomized to LLRL group or control group. Children in the LLRL group underwent treatment twice daily, each lasting for 3 min, there was an interval of at least 4 h between treatments. Children in both groups were allowed to wear single-vision spectacles; no additional intervention was given to the control. The primary outcomes included change in cycloplegic SER and change in axial length (AL) during 6 months. RESULTS: The median 6-month changes in AL of the LLRL and control groups were - 0.06 mm (interquartile range, IQR - 0.15, 0) and 0.14 mm (IQR 0.07, 0.22), respectively. The difference between groups was significant (Z = 10.021, p < 0.001). The median 6-month changes in SER were 0.125 D (IQR 0, 0.375) and - 0.25 D (IQR - 0.5, 0) for the LLRL and control groups, respectively. The difference between groups was significant (Z = 8.827, p < 0.001). Compared with the control, the proportion of children with hyperopic shift in the LLRL group was higher (51.65% vs. 3.41%, p < 0.001), and the proportion of children with shortened AL in the LLRL group was higher (63.74% vs. 2.27%, p < 0.001). No adverse event was observed. CONCLUSION: 650 nm LLRL significantly slowed down the myopia progression in children aged 6-12 years, and there was no observable side effect in the short term.

Clinical features and treatment of near-work-related acquired esotropia.

AIM: To investigate the characteristics of near-work-related esotropia and the clinical efficacy of botulinum toxin type A (BTXA) injection therapy on it. METHODS: A total of 107 patients aged 15-57y with near-work-related esotropia were taken as the BTXA-treated group, and 30 other peers without near-work-related esotropia were included in the control group. All participants were refractive corrected to analyse the clinical characteristics of near-work-related esotropia. All subjects were examined including Worth4 spot examination, stereoscopic vision, strabismus angle, accommodative convergence to accommodation ratio (AC/A), far and near positive and negative convergence, positive and negative fusion range, positive and negative relative accommodation. Clinical efficacy was evaluated at a period of 10mo follow-up. RESULTS: The distant and near stereopsis were found in 84.9% and 77.5% of patients in the BTXA-treated group, respectively. In the control group, all patients had distant and near stereopsis. The incidence of taking off one's glasses to see close objects was significantly higher in the BTXA-treated group than in the control group (P<0.05). The BTXA-treated group showed a smaller range of in-fusion (9.84±5.72)° than the control group (22.04±8.71)° (P<0.05). The near esotropia angle of the BTXA-treated group (17.08±11.98)Δ was significantly smaller than the distant esotropia angle (19.07±11.68)Δ (P<0.05). Ten months after injection, the diplopia and esotropia of most patients underwent improvements after treatment (P<0.05). CONCLUSION: This study reveals that the accommodation function and the habit of near work without wearing spectacles are associated with near-work-related esotropia, while the length of time for near work and the onset time are independent of near-work-related esotropia. Additionally, BTXA injection therapy plays a vital role in relieving diplopia and restoring eye position.

In situ lattice tuning of quasi-single-crystal surfaces for continuous electrochemical modulation.

The ability to control the atomic-level structure of a solid represents a straightforward strategy for fabricating high-performance catalysts and semiconductor materials. Herein we explore the capability of the mechanically controllable surface strain method in adjusting the surface structure of a gold film. Underpotential deposition measurements provide a quantitative and ultrasensitive approach for monitoring the evolution of surface structures. The electrochemical activities of the quasi-single-crystalline gold films are enhanced productively by controlling the surface tension, resulting in a more positive potential for copper deposition. Our method provides an effective way to tune the atom arrangement of solid surfaces with sub-angstrom precision and to achieve a reduction in power consumption, which has vast applications in electrocatalysis, molecular electronics, and materials science.

Electric field-induced switching among multiple conductance pathways in single-molecule junctions.

Here, we report the switching among multiple conductance pathways achieved by sliding the scanning tunneling microscope tip among different binding sites under different electric fields. With an increase in the electric field, high molecular conductance states appear, suggesting the formation of different configurations in single-molecule junctions. The switch can be operated in situ and reversibly, which is also confirmed by the apparent conductance conversion in I-V measurements. Theoretical simulations also agree well with the experimental results, which implies that the electric field enables the possibility to trigger switching in single-molecule junctions.

Selective Fabrication of Single-Molecule Junctions by Interface Engineering.

Recent progress in addressing electrically driven single-molecule behaviors has opened up a path toward the controllable fabrication of molecular devices. Herein, the selective fabrication of single-molecule junctions is achieved by employing the external electric field. For molecular junctions with methylthio (-SMe), thioacetate (-SAc), amine (-NH2 ), and pyridyl (-PY), the evolution of their formation probabilities along with the electric field is extracted from the plateau analysis of individual single-molecule break junction traces. With the increase of the electric field, the SMe-anchored molecules show a different trend in the formation probability compared to the other molecular junctions, which is consistent with the density functional theory calculations. Furthermore, switching from an SMe-anchored junction to an SAc-anchored junction is realized by altering the electric field in a mixed solution. The results in this work provide a new approach to the controllable fabrication and modulation of single-molecule junctions and other bottom-up nanodevices at molecular scales.

Characteristics and Feasibility of Trans-Free Plastic Fats through Lipozyme TL IM-Catalyzed Interesterification of Palm Stearin and Akebia trifoliata Variety Australis Seed Oil.

Akebia trifoliata var. australis seed oil (ASO) was used as an edible oil in China. However, in-depth research studies on ASO have yet to be conducted for production of plastic fats in food industry. In this work, an immobilized lipase from Thermomyces lanuginosus (TL IM) was employed to catalyze palm stearin (PS) with different ratios of ASO in a laboratory-scale operation at 60 °C. The physical properties [e.g., fatty acid profile, slip melting point (SMP), solid fat content (SFC), polymorphic form, and microstructure] of physical blends (PBs) were analyzed and compared with those of the interesterified products (IPs). Results showed that SMPs of IPs (33.20-37.60 °C) decreased compared with those of PBs (48.03-49.30 °C). Meanwhile, IPs showed a good SFC range from 16.11% to 28.29% at 25 °C with mostly ß' polymorphic forms determined by X-ray diffraction analysis. It should be mentioned that no trans fatty acids (TFAs) were detected in any products, suggesting much more health-benefits of IPs. Texture tests showed that PBs (3318.19 ± 86.67 g) were markedly harder than IPs (557.02 ± 12.75 g). Conclusively, our study demonstrated that ASO can be utilized to produce trans-free plastic fats with good qualities through lipase-catalyzed interesterification.

[Accommodation perimeters after phakic posterior chamber implantable contact lens implantation].

OBJECTIVE: To evaluate the change of accommodation function after phakic posterior chamber implantable contact lens (PPC-ICL) implantation for high myopic eyes. METHODS: It was a retrospective case series study. PPC-ICL implantation surgery was performed in 36 eyes of 18 high myopic patients. Uncorrected visual acuity, best-corrected visual accuracy, amplitude of accommodation, pupil distance were tested and AC/A was calculated before, one month and three months after operation. Rank-sum test and variance analysis test was performed for statistic study. RESULTS: Before surgery, long-distance best corrected visual acuity was 0.55 (0.20, 1.50) for left eyes and 0.60 (0.10, 1.20) for right eyes. One and six months after surgery, it was 0.80 (0.40, 1.20), 0.85 (0.50, 1.50) for left eyes and 1.00 (0.30, 1.50), 0.95 (0.30, 1.50) for right eyes, all were improved. The difference between left and right eyes was statistically significant (W value 6.36, 6.18, P < 0.05). One and six months after surgery, uncorrected close-distance visual acuity was 1.00 (1.00, 4.00), 1.00 (1.00, 3.00) for left eyes and 1.00 (1.00, 4.00), 1.00 (1.00, 4.00) for right eyes. The difference for both eyes was not statistically significant compared with preoperative(W value 1.61, 2.72, P > 0.05). At one and six months after surgery, amplitude of accommodation was (8.28 ± 2.12) D, (8.28 ± 2.16) D for left eyes and (8.58 ± 1.98) D, (8.49 ± 2.10) D for right eyes, much better than the result (6.78 ± 1.96) D and (6.69 ± 2.14) D before surgery. The difference was statistically significant (F = 4.36, P < 0.05 and F = 4.04, P < 0.05). At one and six months after surgery, near and distant AC/A ratio were (3.96 ± 1.37) , (4.22 ± 1.33) , (4.78 ± 1.06) and (5.04 ± 1.01) , higher than (4.87 ± 0.97) and (5.23 ± 0.92) before surgery. The difference of near and distant AC/A ratio was statistically significant (F = 3.31, P < 0.05 and F = 4.10, P < 0.05). At one month and six months after surgery, near and distant pupil distance was (58.72 ± 2.78) mm, (61.56 ± 2.50) mm, (58.56 ± 2.4) mm and (61.61 ± 2.52) mm, smaller than that of (59.78 ± 2.39) mm and (62.44 ± 2.48) mm before surgery, but the difference was not statistically significant (F = 1.28, P > 0.05 and F = 0.76, P > 0.05). CONCLUSION: Accommodation parameters after PPC-ICL implantation are improved obviously compared with those before surgery.

Nearwork-induced transient myopia (NITM) in anisometropia.

OBJECTIVE: To assess the magnitude of nearwork-induced transient myopia (NITM) under binocular viewing conditions separately in each eye of individuals with mild to moderate anisometropia to determine the relationship between NITM and their interocular refractive error. METHODS: Forty-three children and young adults with anisometropia [cycloplegic spherical equivalent (SE) difference >1.00 D] were tested (ages 9-28 years). NITM was measured with binocular viewing separately in each eye after binocularly performing a sustained near task (5 D) for 5 min incorporating a cognitive demand using an open-field, infrared autorefractor (Grand-Seiko, WAM-5500). Data were averaged over 10 s bins for 3 min in each eye. Initial NITM, its decay time (DT), and its decay area (DA) were determined. A-scan ultrasound ocular biometry was also performed to determine the axial length of each eye. RESULTS: The more myopic eye exhibited increased initial NITM, DT, and DA as compared to the less myopic eye (0.21 ± 0.16 D vs 0.15 ± 0.13 D, p = 0.026; 108.4 ± 64.3 secs vs 87.0 ± 65.2 secs, p = 0.04; and 17.6 ± 18.7 D*secs vs 12.3 ± 15.7 D*secs, p = 0.064), respectively. The difference in DA and the difference in SE between the more versus less myopic eye were significantly correlated (r = 0.31, p = 0.044). Furthermore, 63% (27/43), 56% (24/43), and 70% (30/43) of the more myopic eyes exhibited increased initial NITM, longer DT, and larger DA, respectively, than found in the less myopic eye. CONCLUSIONS: In approximately two-thirds of the anisometropic individuals, the initial NITM and its decay area were significantly increased in the more myopic eye as compared to the less myopic eye. NITM may play an important role in the development of interocular differences in myopia, although a causal relationship is yet to be established. Furthermore, the findings have potentially important implications regarding accommodative control and interocular accommodative responsitivity in anisometropia, in particular for anisomyopia.

[Clinical observation on visual quality in patients implanted with monofocal and multifocal aspheric intraocular lenses].

OBJECTIVE: To evaluate the visual quality in patients implanted with aspheric diffractive multifocal intraocular lens. METHODS: Prospective nonrandomized controlled study. One hundred cataract eyes in 50 patients were included. Patients received AcrySof IQ ReSTOR IOL (SN6AD3) or AcrySof IQ IOL (SN60WF) implantation. The follow up period was 6 months. The mean of uncorrected distance visual acuity (UCDVA), best corrected distance visual acuity (BCDVA), uncorrected near visual acuity (UCNVA), best distance-corrected near visual acuity (BCNVA) and intermediate uncorrected visual acuity in patients with SN6AD3 and SN60WF was compared preoperatively and postoperatively in all patients. Photopic and mesopic contrast sensitivity function with and without glare were tested at 6 months after operation. Aberrations were recorded postoperatively. Subjective outcomes were assessed by VF-14 questionnaire. The chi-square test was applied to compare categorical variables and the paired-samples t test was used to compare the measure data. RESULTS: Postoperatively, there were no significant differences between groups in spherical equivalent (SE) (t = 0.233, P = 0.876), UCDVA (t = 1.018, P = 0.265) or BCNVA (t = 0.679, P = 0.501). The BCDVA in the monofocal IOL group was better than that in the multifocal IOL group (t = 2.388, P = 0.021). UCNVA improved remarkably after the implantation of multifocal IOL (t = 11.311, P = 0.000). The intermediate UCVA in the monofocal IOL eyes was butter than that in the multifocal IOL at 60 cm (t = 2.414, P = 0.020). The total aberration (F = 5.169, P = 0.041), total low grade (F = 4.973, P = 0.036) and total high grade total aberrations (F = 4.640, P = 0.048) were higher in the multifocal IOL group. There was no difference between these two groups in the defocus (F = 0.862, P = 0.358), astigmatism (F = 3.893, P = 0.052), spherical aberration (F = 1.743, P = 0.055), coma (F = 2.724, P = 0.105) and trefoil (F = 3.014, P = 0.109). Contrast sensitivity in eyes with multifocal IOL was lower than that in eyes with monofocal IOL, especially under mesopic conditions without glare at 6 c/d (t = 2.16, P = 0.041) at 3 c/d (t = 2.329, P = 0.029) and 6 c/d under mesopic conditions with glare (t = 2.087, P = 0.048). Most patients were satisfied with their IOL implantation. Percentage of patients wearing spectacle for distance vision were less than 4% in all groups. Percentage in patients wearing spectacle for near vision in SN60WF and SN6AD3 groups was 60% and 16%, respectively. Percentage of overall spectacle wear was 64% and 24% in patients wearing SN60WF and SN6AD3, respectively. On the questionnaire, patients in multifocal IOL group complained with double vision, trouble in night vision and halo; while patients in monofocal IOL group noted more about near blur. CONCLUSION: Compared with monofocal lenses, multifocal IOL provide greater depth of focus so that better near vision, higher percentage of spectacle independence and satisfactory visual function, are obtained but the contrast sensitivity decreases slightly.

[Primary application and evaluation of a technology for objective measurement of accommodation of human eyes].

OBJECTIVE: To evaluate the practical value of a new technology for objective measurement of accommodation of human eyes. METHODS: It was a comparative study of some techniques for measuring the accommodation of human eyes. Twenty-six outpatients (20 male, 6 female, 10-37 years old) that were suspected to be abnormal in accommodation were examined with Nidek ARK-730 (with software AA-1 inside). The measurement results from the instrument were compared by Kappa test with the clinical impression and comprehensive impression based on measurement results and clinical information. RESULTS: The abnormality rate of accommodation of the patients were 61.5%, 46.2%, 61.5% from the instrument, clinical impression and comprehensive impression respectively. The agreement was weak with Kappa value 0.244 between results from the instrument and clinical impression. The agreement was mild with Kappa value 0.513 between results from the instrument and comprehensive impression. The agreement was high with Kappa value 0.698 between results from clinical impression and comprehensive impression. CONCLUSIONS: The new technology is a progress and complementary to the traditional technology for accommodation examination. With the help of the new technology, some complicated patients could be diagnosed. The diagnose procedure of the instrument remains to be improved. The comprehensive impression based on measurement results and clinical information has more practical value.

[Relationship between ciliary muscle contraction and the pseudo accommodation after the implantation of foldable intraocular lenses].

OBJECTIVE: To investigate the relationship between high frequency component of accommodative microfluctuation (HFC) and the pseudo accommodation after the implantation of foldable intraocular lenses (IOL). METHODS: With ARK-730A accommodation analyzer we checked HFC in 50 cases (50 eyes) of patients who had good pupil reaction to light and the pupil diameter was 2.0 approximately 3.5 mm approximately. Three months after the implantation of foldable IOL, the relationship among ciliary muscle accommodative microfluctuation, IOL movement and pseudo accommodation was analyzed. RESULTS: There was positive correlation between ciliary muscle accommodative microfluctuation and IOL movement (r = 0.702, P < 0.01), between IOL movement and pseudo accommodation (r = 0.861, P < 0.01), and between ciliary muscle accommodative microfluctuation and pseudo accommodation (r = 0.915, P < 0.01). Pseudo accommodation was greater in patients who showed more ciliary muscle accommodative microfluctuation and IOL movement. CONCLUSION: HFC induces IOL movement, and it is one of the most important reasons for pseudo accommodation after foldable IOL implantation.