Abstract
Purpose :
The prevalence of myopia is increasing worldwide and myopia-associated complications are predicted to be the leading cause of blindness by 2050 (Holden 2016). Multifocal contact lenses (MFCL) were shown to reduce myopia progression by superimposing peripheral myopic defocus, but efficacies varied (Wildsoet 2019). Evidence for reduced accommodation responses (AR) during MFCL wear compared with single vision (SV) CLs has been documented (Gong 2011), possibly lowering the MFCL’s treatment effect. In young adults, AR during MFCL wear can be increased using auditory biofeedback training (Wagner 2020). Here, we assessed how biofeedback training affects AR in children wearing MFCL for myopia management.
Methods :
Habitual MFCL wearers (age 12.3±2.4, n=16, 7 male) were recruited from the Pediatric and Myopia Management Clinics at the University Eye Center, SUNY College of Optometry. AR through SV and MFCLs in the right eye were measured at 2.5D, 3D, and 4D using eccentric infrared photorefraction with SVCL (“SV”) and MFCL (“MF_Pre”). Subjects were then given auditory biofeedback training for 200sec (Wagner 2020) and AR through the MFCLs was measured without feedback immediately after the training (“MF_Post”) and 1 week later (”MF_1week”). AR measured at different time points and AR change from before the training were analyzed using Repeated Measures ANOVA with Bonferroni adjustment.
Results :
Prior to the biofeedback training, eyes wearing MFCLs exhibited significantly reduced AR compared with SVCL wear for various accommodative stimuli (AS, SV vs. MF_Pre, p<.05, Table 1, Fig. 1). Biofeedback training increased AR both immediately after the training and 1 week later (p<.05), with a greater effect for higher AS (p< .05). ASR slope values improved from 0.69 at baseline (MF_Pre) to 0.80 (MF_Post) and 1.00 (MF_1week) after the training, however this change did not reach significance (p=0.07).
Conclusions :
Our findings reveal that, also in children, auditory biofeedback training can increase AR during MFCL wear, with the effect remaining at least over a one-week duration without further training. Longitudinal studies are needed to investigate whether several training sessions lead to sustainedly increased AR in the long-term, turning biofeedback training into a possible adjunct therapy for an improvement of MFCL’s efficacy in reducing myopia progression in children.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.