March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Decreasing Peripheral Hyperopia With Distance-centre Relatively-plus Powered Periphery Contact Lenses Reduced The Rate Of Progress Of Myopia: A 5 Year Vision Crc Study
Author Affiliations & Notes
  • Brien A. Holden
    Brien Holden Vision Institute, Sydney, Australia
    School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
  • Padmaja R. Sankaridurg
    Brien Holden Vision Institute, Sydney, Australia
    Vision Cooperative Research Centre, Sydney, Australia
  • Percy Lazon De La Jara
    Brien Holden Vision Institute, Sydney, Australia
    Vision Cooperative Research Centre, Sydney, Australia
  • Thomas Naduvilath
    Brien Holden Vision Institute, Sydney, Australia
    Vision Cooperative Research Centre, Sydney, Australia
  • Arthur Ho
    Brien Holden Vision Institute, Sydney, Australia
    School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
  • Deborah F. Sweeney
    Vision Cooperative Research Centre, Sydney, Australia
    College of Health and Science, University of Western Sydney, Sydney, Australia
  • Maria Markoulli
    Brien Holden Vision Institute, Sydney, Australia
    Vision Cooperative Research Centre, Sydney, Australia
  • Earl L. Smith, III
    Vision Cooperative Research Centre, Sydney, Australia
    College of Optometry, University of Houston, Houston, Texas
  • Jian Ge
    Vision Cooperative Research Centre, Sydney, Australia
    Zhongshan Ophthalmic Center, Guangzhou, China
  • Vision CRC Myopia Clinical Study Group
    Brien Holden Vision Institute, Sydney, Australia
  • Footnotes
    Commercial Relationships  Brien A. Holden, US7025460 , US20070296916 (P); Padmaja R. Sankaridurg, US20070296916 (P); Percy Lazon De La Jara, None; Thomas Naduvilath, None; Arthur Ho, US7025460 , US20070296916 (P); Deborah F. Sweeney, None; Maria Markoulli, None; Earl L. Smith, III, US7025460, US20070296916 (P); Jian Ge, None
  • Footnotes
    Support  Australian Government Cooperative Research Centres Grant Scheme, Vision CRC and Brien Holden Vision Institute Program Grants
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 6300. doi:https://doi.org/
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      Brien A. Holden, Padmaja R. Sankaridurg, Percy Lazon De La Jara, Thomas Naduvilath, Arthur Ho, Deborah F. Sweeney, Maria Markoulli, Earl L. Smith, III, Jian Ge, Vision CRC Myopia Clinical Study Group; Decreasing Peripheral Hyperopia With Distance-centre Relatively-plus Powered Periphery Contact Lenses Reduced The Rate Of Progress Of Myopia: A 5 Year Vision Crc Study. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6300. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To determine whether reducing peripheral hyperopic defocus using distance-centre relatively-plus peripheral power contact lenses slows the rate of progress of myopia.

Methods: : In Phase 1, 40 children aged 8 to 14 years with myopia -0.50 to -4.00 D and cylinder ≤0.75D were randomised to wear soft contact lenses that were either a Test Lens (TL) with relatively narrow central optical zone (2.3mm) with back vertex power to correct the child’s distance vision and a relatively plus (+1.50D) peripheral optical zone, or, a single vision Control Lens (CL) in the same material and monitored for 43±4 months. In Phase 2, the remaining subjects wore TLs in both eyes for a further 2 years. Refractive error (RE) (cycloplegic autorefraction) and axial length (AL) (partial coherence interferometry) were measured 6 monthly. Differences in progression of RE and AL were compared using quadratic fits of a linear mixed model after adjusting for age, gender and ethnicity based on an intent-to-treat principle. Progression within Phase 2 was analyzed using % change relative to Phase 2 baselines.

Results: : 40 children entered; 27, 20 and 16 completed 36±1 and 43±3 months (Phase 1) and 67 ± 3 months (after Phase 2) respectively. The changes in Phase 1 in RE with TCL v CCL were -0.37 ± 0.43D v -0.59 ± 0.32 D; -0.61 ± 0.30D v -0.99 ± 0.46; -0.80 ± 0.37D v -1.31± 0.60D and -0.99 ± 0.58D v -1.63 ± 0.66D at 12, 24, 36 and 43 months respectively. The changes in AL with TCL v CCL were 0.12 ± 0.12 mm v 0.21 ± 0.10mm; 0.22 ± 0.15mm v 0.39 ± 0.17mm; 0.29 ± 0.19mm v 0.53 ± 0.26mm and 0.41 ± 0.24mm v 0.67 ± 0.29mm at 12, 24, 36 and 43 months respectively. The slopes of change in RE and AL over 43 months were significantly less for TCL than CCL (p<0.0001). TCL also reduced LCVA by 0.12 Log MAR units (p=0.021). The slopes for the percent rate of progression for both Phase 1 groups refitted with TCL in Phase 2 were not different (p=0.211 for RE and p=0.796 for AL).

Conclusions: : The peripheral plus design lenses slowed rate of progress of myopia by 39% and axial elongation by 41% over 43 months. When both TL and CL groups from Phase 1 were fitted with TLs in Phase 2 they showed similar % rates of progression. The small sized optic related decrement in central vision with TCL can be avoided by increasing the central optic zone size (Holden et al 2010 ARVO abstract E 2220).

Clinical Trial: : http://www.anzctr.org.au ACTRN12611001148965

Keywords: contact lens • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • myopia 
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