June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Pupil Size and Myopia Progression in the Bifocal Lenses In Nearsighted Kids (BLINK) Study
Author Affiliations & Notes
  • David A Berntsen
    University of Houston College of Optometry, Houston, Texas, United States
  • Loraine T Sinnott
    The Ohio State University College of Optometry, Columbus, Ohio, United States
  • Anita Ticak Gostovic
    University of Houston College of Optometry, Houston, Texas, United States
  • Moriah A Chandler
    University of Houston College of Optometry, Houston, Texas, United States
  • Amber Gaume Giannoni
    University of Houston College of Optometry, Houston, Texas, United States
  • Danielle J Orr
    The Ohio State University College of Optometry, Columbus, Ohio, United States
  • Maria Walker
    University of Houston College of Optometry, Houston, Texas, United States
  • Lisa Jordan
    The Ohio State University College of Optometry, Columbus, Ohio, United States
  • Jeffrey J Walline
    The Ohio State University College of Optometry, Columbus, Ohio, United States
  • Donald O Mutti
    The Ohio State University College of Optometry, Columbus, Ohio, United States
  • Footnotes
    Commercial Relationships   David Berntsen Visioneering Technologies, Inc., Code C (Consultant/Contractor), Bausch + Lomb, Code F (Financial Support); Loraine Sinnott Bausch + Lomb, Code F (Financial Support); Anita Gostovic Bausch + Lomb, Code F (Financial Support); Moriah Chandler Bausch + Lomb, Code F (Financial Support); Amber Giannoni Bausch + Lomb, Code F (Financial Support), Bruder Healthcare, Code R (Recipient), Pentavision, Code R (Recipient), Bruder Healthcare, Code S (non-remunerative); Danielle Orr Bausch + Lomb, Code F (Financial Support); Maria Walker Bausch + Lomb, Code F (Financial Support); Lisa Jordan Bausch + Lomb, Code F (Financial Support); Jeffrey Walline Bausch + Lomb, Code F (Financial Support); Donald Mutti Bausch + Lomb, Code F (Financial Support)
  • Footnotes
    Support  NIH U10-EY023204, U10-EY023206, U10-EY023208, U10-EY023210, P30-EY007551, UL1-TR002733, and Bausch+ Lomb (contact lens solution)
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 242 – A0096. doi:
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      David A Berntsen, Loraine T Sinnott, Anita Ticak Gostovic, Moriah A Chandler, Amber Gaume Giannoni, Danielle J Orr, Maria Walker, Lisa Jordan, Jeffrey J Walline, Donald O Mutti; Pupil Size and Myopia Progression in the Bifocal Lenses In Nearsighted Kids (BLINK) Study. Invest. Ophthalmol. Vis. Sci. 2022;63(7):242 – A0096.

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

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Abstract

Purpose : The BLINK Study was a 3-year clinical trial that evaluated center-distance multifocal contact lenses (MFCLs) for myopia control and found reduced myopia progression and eye growth with +2.50 add MFCLs compared to single vision contact lenses (SVCLs). This analysis explores whether pupil size influenced the magnitude of the treatment effect.

Methods : Myopic children (n = 294; 7-11 years old; 60% female) were enrolled (mean ± SD age = 10.3 ± 1.2 years) and randomly assigned to one of 3 groups: SVCL, +1.50 MFCL, or +2.50 MFCL. Children had -0.75 D to -5.00 D of myopia (most hyperopic meridian) and <1.00 D astigmatism at enrollment (mean ± SD spherical equivalent = -2.39 ± 1.00 D). Pupil size (right eye) was measured at baseline and each annual visit under photopic (~500 lux) and mesopic (~2 lux) lighting with a NeurOptics VIP-200 pupillometer. Models of the 3-year change (right eye) in cycloplegic spherical equivalent refractive error (RE; measured by autorefraction) and axial length (AL; measured by optical biometry) were fit with mean photopic or mesopic pupil size, either baseline RE or AL, treatment group, sex, study site, and age. Interactions between pupil size and treatment group were evaluated as the main outcome of interest.

Results : Mean (± SD) photopic and mesopic pupil size were 5.0 ± 0.6 mm (range: 3.3 to 6.9 mm) and 6.4 ± 0.7 mm (range: 4.5 to 8.4 mm), respectively, with no difference between treatment groups (photopic p = 0.60; mesopic p = 0.62). When modelling the 3-year change in spherical equivalent RE, neither photopic (p = 0.67; 95% CI: -0.40 to +0.25 D/mm pupil size) nor mesopic pupil size (p = 0.47; 95% CI: -0.41 to +0.19 D/mm pupil size) modified the slowing of myopia progression found in the +2.50 MFCL group (i.e., no treatment by pupil size interaction). With respect to change in AL, neither photopic (p = 0.92; 95% CI: -0.13 to 0.15 mm AL change/mm pupil size) nor mesopic pupil size (p = 0.37; 95% CI: -0.07 to 0.19 mm AL change/mm pupil size) modified the slowing of AL found in the +2.50 MFCL group.

Conclusions : Larger pupils have been hypothesized to have a greater treatment effect with center-distance MFCLs by exposing the retina to additional plus power. Pupil size did not modify the size of the treatment effect when children wore MFCLs in the BLINK Study. These results do not support using pupil size as a criterion when evaluating which myopic children to fit with this MFCL.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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