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Langis Michaud, Patrick Simard, Rémy Marcotte-Collard, Mhamed Ouzzani; THE MONTREAL EXPERIENCE : PART I- BASICS AND TREATMENT ALGORITHM. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2329.
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© ARVO (1962-2015); The Authors (2016-present)
Over the past 10 years, authors refined myopia control strategies (MCS) after following 800 children at the Montreal School of Optometry Clinic (EOUM).
EOUM approach is based on 3 pillars: normal binocular function (BV), control of the central and peripheral blur, and of the environment. A dose-response approach is applied. This means to use/design optical devices bringing the highest convex power in the pupil area, without inducing blur at distance,with no impact on BV. MCS are selected on : rate of progression, age of myopia onset, corneal parameters, pupil area, risk factor for ocular pathology, patient’s lifestyle, compliance. Goal is to generate a customized approach for each patient. In this poster, treatment algorithm is explained. For this study, data are extracted from the file of each patient who: consulted between Jan 2017-Dec 2018 and were kept under the same design/concentration. Clinical population is composed of 310 patients (35% Cauc.-45% Asian), median age of 11 (range 5-18). The treatment options were orthokeratology (4 designs; N=140), multifocal soft contact lenses (SMCL; 5 designs; N=128), and low dose atropine (LDA 0.01%-0.05%; N=42).
Results are analyzed through sophisticated statistical models. The goal of modeling was to assess whether myopia control type had a statistically significant effect on AL progression over time, and, if so, to estimate the 12-24 month progression differences between MCS. Models were fit that accounted for within-subject correlation. Overall results indicate that AL growth, at 1-2 years, was the lowest when using OK lenses (0.13/0.29um [95%CI 0.100.0-158/0.26-0.34] vs SMCL (0.18/0.36um [95%CI 0.14-0.21/0.30-0.41) or LDA (0.19/0.37um [95%CI 0.14-0.25/ 0.29-0.46). OK advantage was statistically significant at 1 year vs SMCL(p=0.03) or LDA(0.034), but not significant at 2 years (SMCL p=0.055; LDA p=0.10). SMCL was comparable to LDA at 1(p=0.54) and 2 years (p=0.77). Detailled results will be presented in part 2.
Montreal experience reveals that customized approach is effective. This means that it brings AL evolution close to non-myopic kids when MCS is properly selected. OK gives better results at 1 year but the 3 methods become similar at 24 months.
This is a 2021 ARVO Annual Meeting abstract.
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