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International Ophthalmology Jun 2024This meta-analysis reviews the evidence for the risks and benefits associated with orthokeratology (OK) treatment compared with other methods of myopia control in... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
This meta-analysis reviews the evidence for the risks and benefits associated with orthokeratology (OK) treatment compared with other methods of myopia control in children and adults.
METHODS
A systematic search of Cochrane Central Register of Controlled Trials, Pubmed, Embase and Ovid was conducted from database inception to 22nd August 2021. Studies that reported on risks, visual and ocular biometric effects of OK in patients > 5 years of age with myopia (- 0.75 to - 6.00D) were included. Main outcomes are change in axial length and any adverse event.
RESULTS
Fourty-five papers were included in this systematic review and meta-analysis. The quality of data was variable and of moderate certainty, and selection bias likely skewed the results towards a relative benefit for OK. The rate of axial elongation in children was lower for OK treatment compared to other treatment modalities at one year (MD - 0.16 mm, 95% CI - 0.25 to - 0.07). Rate of change in axial length in children rebounded after OK discontinuation compared to participants who continued treatment (MD 0.10 mm, 95% CI 0.06 to 0.14). Adults and children wearing OK were up to 3.79 times more likely to experience an adverse event when compared with conventional contact lenses (OR 3.79, 95% CI 1.24 to ll.), though this evidence base is underdeveloped and requires additional well-designed studies for substantial conclusions to be drawn.
CONCLUSIONS
OK arrests myopia progression while in use, however, there remain unanswered questions about the optimal duration of treatment, discontinuation effects and long-term risk for adverse events.
Topics: Humans; Orthokeratologic Procedures; Myopia; Refraction, Ocular; Visual Acuity; Axial Length, Eye; Contact Lenses; Child; Risk Assessment
PubMed: 38904856
DOI: 10.1007/s10792-024-03175-w -
International Journal of Ophthalmology 2024To figure out whether various atropine dosages may slow the progression of myopia in Chinese kids and teenagers and to determine the optimal atropine concentration for...
AIM
To figure out whether various atropine dosages may slow the progression of myopia in Chinese kids and teenagers and to determine the optimal atropine concentration for effectively slowing the progression of myopia.
METHODS
A systematic search was conducted across the Cochrane Library, PubMed, Web of Science, EMBASE, CNKI, CBM, VIP, and Wanfang database, encompassing literature on slowing progression of myopia with varying atropine concentrations from database inception to January 17, 2024. Data extraction and quality assessment were performed, and a network Meta-analysis was executed using Stata version 14.0 Software. Results were visually represented through graphs.
RESULTS
Fourteen papers comprising 2475 cases were included; five different concentrations of atropine solution were used. The network Meta-analysis, along with the surface under the cumulative ranking curve (SUCRA), showed that 1% atropine (100%)>0.05% atropine (74.9%) >0.025% atropine (51.6%)>0.02% atropine (47.9%)>0.01% atropine (25.6%)>control in refraction change and 1% atropine (98.7%)>0.05% atropine (70.4%)>0.02% atropine (61.4%)>0.025% atropine (42%)>0.01% atropine (27.4%)>control in axial length (AL) change.
CONCLUSION
In Chinese children and teenagers, the five various concentrations of atropine can reduce the progression of myopia. Although the network Meta-analysis showed that 1% atropine is the best one for controlling refraction and AL change, there is a high incidence of adverse effects with the use of 1% atropine. Therefore, we suggest that 0.05% atropine is optimal for Chinese children to slow myopia progression.
PubMed: 38895669
DOI: 10.18240/ijo.2024.06.19 -
Frontiers in Medicine 2024This meta-analysis was conducted to collect all available data and estimate the relationship between refractive error and the risk of diabetic retinopathy (DR) in...
PURPOSE
This meta-analysis was conducted to collect all available data and estimate the relationship between refractive error and the risk of diabetic retinopathy (DR) in patients with diabetes, and to assess whether vision-threatening DR (VTDR) is associated with refractive error.
METHODS
We systematically searched several literature databases including PubMed, Embase, Cochrane Library, Web of Science, CNKI, CBM, Wan Fang Data, and VIP databases. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated using fixed or random effects models. Four models were developed to assess the relationship between refractive error and the risk and DR, VTDR: hyperopia and DR, VTDR; myopia and DR, VTDR; spherical equivalent (SE per D increase) and DR, VTDR; and axial length (AL per mm increase) and DR, VTDR. The included literature was meta-analyzed using Stata 12.0 software, and sensitivity analysis was performed. Publication bias in the literature was evaluated using a funnel plot, Begg's test, and Egger's test.
RESULTS
A systematic search identified 3,198 articles, of which 21 (4 cohorts, 17 cross-sectional studies) were included in the meta-analysis. Meta-analysis showed that hyperopia was associated with an increased risk of VTDR ( 1.23; 95% : 1.08-1.39; = 0.001), but not with DR ( 1.05; 95% : 0.94-1.17; = 0.374). Myopia was associated with a reduced risk of DR ( 0.74; 95% : 0.61-0.90; = 0.003), but not with VTDR ( 1.08; 95% : 0.85-1.38; = 0.519). Every 1 diopter increase in spherical equivalent, there was a 1.08 increase in the odds ratio of DR ( 1.08; 95% : 1.05-1.10; <0.001), but not with VTDR ( 1.05; 95% : 1.00-1.10; = 0.06). AL per mm increase was significantly associated with a decreased risk of developing DR ( 0.77; 95% : 0.71-0.84; <0.001 and VTDR ( 0.63; 95% : 0.56-0.72; <0.001). Analysis of sensitivity confirmed the reliability of the study's findings.
CONCLUSION
This meta-analysis demonstrates hyperopia was associated with an increased risk of VTDR in diabetes patients. Myopia was associated with a reduced risk of DR. AL is an important influencing factor of refractive error. Every 1 mm increase in AL reduces the risk of DR by 23% and the risk of VTDR by 37%.
SYSTEMATIC REVIEW REGISTRATION
identifier: CRD42023413420.
PubMed: 38895184
DOI: 10.3389/fmed.2024.1354856 -
BMC Public Health Jun 2024This study aimed to systematically review epidemiological evidence on associations between screen time exposure and myopia in children and adolescents, and to... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This study aimed to systematically review epidemiological evidence on associations between screen time exposure and myopia in children and adolescents, and to quantitatively evaluate summary effect estimates from existing literature.
METHOD
There were three online databases including PubMed, Embase, and Web of Science, for epidemiological studies on screen time exposure and myopia published before June 1, 2023. The risk of bias was assessed by the Newcastle Ottawa Scale (NOS) checklist. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the correlation between screen time exposure and myopia using random or fixed-effect models by exposure type (categorical/continuous). We also performed subgroup analysis by screen device type, study quality, geographic region, and research period.
RESULTS
We searched 7,571 records from three databases and identified 19 eligible studies, including 14 high-quality studies and 5 moderate-quality studies. Meta-analyses suggested that there was a statistically significant correlation between screen time (high vs. low) and myopia. The pooled ORs with 95%CIs were respectively 2.24 (1.47-3.42) for cross-sectional studies, and 2.39 (2.07-2.76) for cohort studies. We also found a significant association between continuous exposure to screen time (per 1 h/d increase) and myopia in cohort studies. The pooled ORs with 95%CIs were 1.07 (1.01-1.13). In subgroup analysis stratified by screen device type in cross-sectional studies, screen time exposures from computers (categorical: OR = 8.19, 95%CI: 4.78-14.04; continuous: OR = 1.22, 95%CI: 1.10-1.35) and televisions (categorical: OR = 1.46, 95%CI: 1.02-2.10) were associated with myopia, while smartphones were not. Although publication bias was detected, the pooled results did not show significant changes after adjustment using the trim and fill method.
CONCLUSION
Our findings support that screen time exposure was significantly associated with myopia in children and adolescents. Notably, screen time exposure from computers may have the most significant impact on myopia.
Topics: Humans; Screen Time; Myopia; Child; Adolescent
PubMed: 38890613
DOI: 10.1186/s12889-024-19113-5 -
Eastern Mediterranean Health Journal =... May 2024The recent increase in myopia is a major public health concern worldwide, including in the Eastern Mediterranean Region (EMR). (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The recent increase in myopia is a major public health concern worldwide, including in the Eastern Mediterranean Region (EMR).
AIM
To provide data on the prevalence of myopia among school-age children in the EMR.
METHODS
This study was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) protocol. We searched the Web of Sciences, Scopus, Index Medicus for the Eastern Mediterranean Region, ProQuest, PubMed, and Medline for studies on the prevalence of myopia in the EMR published from January 2000 to May 2022. The data were analysed using MedCalc version 19.6.1 and myopia was defined as refractive error ≥ 0.50 D. The overall pooled prevalence of myopia was estimated using a random-effects model and its associated 95% confidence intervals.
RESULTS
The meta-analysis included 27 quality-assessed studies from 13 countries among 51 111 school-age children. The overall pooled prevalence of childhood myopia from 2000 to 2022 was 5.23%, which was significantly higher among females than males (4.90% vs 3.94%). The prevalence of myopia was significantly higher among children aged 11-17 years than among those aged 5-10 years (7.50% vs 3.90%). There was a higher prevalence of myopia with cycloplegic refraction than noncycloplegic refraction (5.95% vs 3.73%). There was highly significant heterogeneity between the studies.
CONCLUSION
Prevalence of myopia among school-age children in the EMR was high, particularly among older children, and it was more common among females. Early intervention to slow myopia progression is essential in the EMR to protect children from irreversible vision loss.
Topics: Humans; Myopia; Prevalence; Child; Adolescent; Male; Female; Child, Preschool; Middle East; Mediterranean Region
PubMed: 38808408
DOI: 10.26719/2024.30.4.312 -
Frontiers in Public Health 2024Twenty-four-hour movement behaviors have significant implications for physical and mental health throughout one's lifespan. Consistent with movement behaviors, several... (Meta-Analysis)
Meta-Analysis
UNLABELLED
Twenty-four-hour movement behaviors have significant implications for physical and mental health throughout one's lifespan. Consistent with movement behaviors, several countries have formulated and published 24-h movement guidelines. This review summarized the studies related to 24-h movement guidelines among children and adolescents from six databases (MEDLINE, EMBASE, PubMed, Web of Science, CINAHL, and SPORTDiscus). In a total of 61 studies that discussed compliance with 24-h movement guidelines, the overall adherence rate was very low (7.1%), with boys exceeding girls, children surpassing adolescents, and regional differences. A total of 39 studies examined the associations between 24-h movement guidelines and health indicators. Findings indicated that meeting all three guidelines was favorably associated with adiposity, cardiometabolic health, mental and social health, physical fitness, health-related quality of life, academic achievement, cognitive development, perceived health, dietary patterns, and myopia. Future research should utilize longitudinal and experimental designs to enhance our understanding of the associations between 24-h movement guidelines and health indicators, thereby aiding the formulation and refinement of such guidelines.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, CRD42023481230.
Topics: Humans; Adolescent; Child; Exercise; Child, Preschool; Female; Male; Quality of Life
PubMed: 38774055
DOI: 10.3389/fpubh.2024.1351972 -
Clinics (Sao Paulo, Brazil) 2024Low-Level Red-Light (LLRL) Therapy is a safe and natural way to promote healing and reduce inflammation in the body. When it comes to treating myopia in children, LLRL... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Low-Level Red-Light (LLRL) Therapy is a safe and natural way to promote healing and reduce inflammation in the body. When it comes to treating myopia in children, LLRL therapy is recent, and its efficacy and safety still are not clear.
METHODS
A systematic review and meta-analysis of the literature for LLRL was conducted in accordance with the PRISMA guidelines on November 5, 2022. Databases, including PUBMED, Cochrane Library, Web of Science, and Embase were queried. A meta-analysis of random effects was conducted. Inclusion criteria included Randomized Controlled Trials (RCTs) or observational studies where LLRL therapy was used in children (3‒15 years old) with myopia. Exclusion criteria were studies with other ocular abnormalities. Efficacy was evaluated through the mean change in Axial Length (AL) and cycloplegic Spherical Equivalent Error (SER), while safety was evaluated by monitoring adverse effects.
RESULTS
A total of 5 final studies were included (4 RCTs, and 1 observational), in which 685 total patients were analyzed. The mean age was 9.7 ± 0.66 years, with 48,2% female patients. The number of eyes in the LRLL arm is 714 and, in the control, arm is 656. LLRL showed better results in SER and AL mean change (OR = 0.58; 95% CI 0.33 to 0.83; p < 0.00001, and MD -0.33; 95% CI -0.52 to -0.13; p = 0.001, respectively), in comparison to the control group. There was no significant difference in adverse effects between groups (MD = 5.76; 95% CI 0.66 to 50.14; p = 0.11).
CONCLUSION
LLRL therapy is a non-invasive, effective, and safe short-term treatment option; however, long-term evaluation, particularly in comparison to other therapies, requires additional investigation.
Topics: Humans; Child; Myopia; Low-Level Light Therapy; Randomized Controlled Trials as Topic; Treatment Outcome; Female; Adolescent; Male; Child, Preschool
PubMed: 38723579
DOI: 10.1016/j.clinsp.2024.100375 -
Cureus Apr 2024A significant contributor to blindness and visual impairment globally is uncorrected refractive error. To plan effective interventions, eye care professionals must... (Review)
Review
A significant contributor to blindness and visual impairment globally is uncorrected refractive error. To plan effective interventions, eye care professionals must promptly identify people at a high risk of acquiring myopia, and monitor disease progress. Artificial intelligence (AI) and machine learning (ML) have enormous potential to improve diagnosis and treatment. This systematic review explores the current state of ML and AI applications in the diagnoses and treatment of refractory errors in optometry. A systematic review and meta-analysis of studies evaluating the diagnostic performance of AI-based tools in PubMed was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. To find relevant studies on the use of ML or AI in the diagnosis or treatment of refractive errors in optometry, a thorough search was conducted in various electronic databases such as PubMed, Google Scholar, and Web of Science. The search was limited to studies published between January 2015 and December 2022. The search terms used were "refractive errors," "myopia," "optometry," "machine learning," "ophthalmology," and "artificial intelligence." A total of nine studies met the inclusion criteria and were included in the final analysis. ML is increasingly being utilized for automating clinical data processing as AI technology progresses, making the formerly labor-intensive work possible. AI models that primarily use a neural network demonstrated exceptional efficiency and performance in the analysis of vast medical data, rivaling board-certified, healthcare professionals. Several studies showed that ML models could support diagnosis and clinical decision-making. Moreover, an ML algorithm predicted future refraction values in patients with myopia. AI and ML models have great potential to improve the diagnosis and treatment of refractive errors in optometry.
PubMed: 38711688
DOI: 10.7759/cureus.57706 -
Ophthalmic Research May 2024Spending more time outdoors was treated as a safe and cost-effective method to prevent and control myopia. While prior research has established an inverse association...
INTRODUCTION
Spending more time outdoors was treated as a safe and cost-effective method to prevent and control myopia. While prior research has established an inverse association between outdoor time and the risk of myopia onset, the effect of increasing outdoor time in delaying the progression of myopia remains a subject of debate. The present meta-analysis aimed to assess the relationship between outdoor time and the myopia onset, and further examine whether there is a dose-response relationship between outdoor time and the risk of myopia onset. Meanwhile, perform whether the outdoor time is related to delaying the progression of myopia.
METHODS
Studies were retrieved from PubMed, Web of Science, Embase, Medline, and the Cochrane Database, spanning from their inception to February 2023. 3 cohort studies and 5 prospective intervention studies were included, with a total of 12,922 participants aged 6 to 16 years.
RESULTS
Comparing the highest with the lowest exposure levels of time spent outdoors, the highest outdoor time was strongly associated with a reduced risk of myopia onset (OR: 0.53; 95% CI: 0.34, 0.82). A non-linear dose-response relationship was found between outdoor time and myopia onset risk. Compared to 3.5 hours of outdoor time per week, an increase to 7, 16.3, and 27 hours per week corresponded with a respective reduction in the risk of myopia onset by 20%, 53%, and 69%. Among children and adolescents who were not myopic, spending more time outdoors significantly slowed down the speed of change in spherical equivalent refractive (SER) (WMD=0.10D, 95%CI: 0.07, 0.14) and axial length (AL) (WMD=-0.05mm, 95%CI: -0.06, -0.03). Among children and adolescents who were already myopic, spending more time outdoors did not slow myopia progression.
CONCLUSIONS
Overall, spending more time outdoors can prevent the onset of myopia, but it doesn't seem to slow its progression. Further studies are needed to better understand these trends.
PubMed: 38710180
DOI: 10.1159/000539229 -
BMC Ophthalmology Apr 2024This study aims to compare the efficacy of peripheral add multifocal soft contact lenses (SCLs) (excluding bifocal SCLs) with single vision contact lenses or spectacles... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
This study aims to compare the efficacy of peripheral add multifocal soft contact lenses (SCLs) (excluding bifocal SCLs) with single vision contact lenses or spectacles in controlling myopia progression.
METHOD
A comprehensive literature search was conducted in the Pubmed, EMBASE, Web of Science, and Cochrane Library databases until October 2023. The literature was thoroughly screened based on predetermined eligibility criteria. Pooled odds ratios (ORs) were calculated for dichotomous data and weighted mean differences (WMD) for continuous data.
RESULTS
A total of 11 articles comprising 787 participants were included in this meta-analysis. Our pooled results demonstrated that the peripheral add multifocal SCLs groups exhibited significantly reduced refraction progression (MD = 0.20; 95%CI, 0.14 ∼ 0.27; P<0.001) and less axial length elongation (MD=-0.08; 95%CI, -0.09∼-0.08; P<0.001) compared to the control group. There was no significant difference in high-contrast logMAR distance visual acuity between the two groups (MD = 0.01; 95%CI, -0.00 ∼ 0.02; P = 0.19). However, the group using single-vision lenses had better low-contrast logMAR distance visual acuity compared to those using peripheral add multifocal SCLs (MD = 0.06; 95%CI, 0.02 ∼ 0.10; P = 0.004). Data synthesis using a random-effects model indicated an incidence of contact lens-related adverse events of 0.065 (95%CI, 0.048 ∼ 0.083).
CONCLUSIONS
The present meta-analysis signifies that peripheral defocus modifying contact lenses are effective in slowing down the progression of myopia and reducing axial elongation.
Topics: Humans; Myopia; Visual Acuity; Contact Lenses, Hydrophilic; Refraction, Ocular; Vision Tests; Vision Disorders
PubMed: 38627653
DOI: 10.1186/s12886-024-03408-7