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Langis Michaud; THE MONTREAL EXPERIENCE: A RETROSPECTIVE STUDY OF THE MANAGEMENT OF MYOPIA AND AXIAL LENGTH PROGRESSION ON 469 SUBJECTS. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5817.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the efficacy of myopia control strategies on a population of myopic patients
This is a retrospective study. The chart of every young (< 20 y.o.) myopic (>-0.50D) subject seen at U de Montreal clinic between 2012-2017, followed for at least 5 months, was reviewed. The subject had been managed with one of the following methods: orthokeratology lenses (OK), distance centered multifocal soft contact lenses (SMF) or t low-dose atropine (0.01%) drops. Data collected include age, gender, ethinicity, and control type along with baseline ocular parameters and refractive errors at every visit.
Out of 680 files retrieved from database, 469 were kept for analysis. Subjects were assigned to groups based on their gender (male/female), ethnicity, and refractive error at baseline (low (0-3D), moderate (3-6D), high myopia (>6D)). Female /Male (F/M) and Asian/Caucasian (A/C) ratio were similar (55/45%). Subjects’ ages were 10.8 + 2.5 years (M), and 11.4 + 2.3 years (F). MCS relied mostly on standard (62%) and customized (13%) OK lens designs, followed by SMF (20%) and low-dose atropine (0.01%) for 5 % of the subjects.Results indicate an annual progression of OD -0.24 + 0.31; OS -0.26 + 0.33 for CM; with no significant difference with other groups. Overall, this progression represent 50% control over natural evolution already reported. Axial length progression was near 0.15 mm for all groups with no significant differences among then. These results represent also 50% vs known natural progressions.A deeper analysis shows that OK strategy offers a better outcome than SMF. This is especially true for low myopic AM, CF and for moderate CM. The same trend is observed for AL. The usage of atropine allowed to limit myopia progression but less AL.
These results confim that myopia control strategies offer a global reduction of 50% of the natural progression. More specifically, this study showed that OK strategy may be slightly better than SMF, especially for moderate and high CF myopes. The use of low-dose atropine as a stand-alone therapy was successful to control refractive error but less the axial length. Results vary greatly among subjects. This implies a need for full customization of the strategies and lens designs to optimize results.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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