Significance of Anatomo-Structural Parameters of the Eye in the Effectiveness of Myopia Treatment with Orthokeratology Lenses

Absatarova N. A.
Postgraduate Student¹
ORCID 0000-0002-3766-7517

Usenko V. A.
MD, PhD, Assistant Professor¹
ORCID 0000-0001-7533-7773

1 - Kyrgyz State Medical Institute of Retraining and Advanced Training named after. S. B. Daniyarov, Bishkek, Republic of Kyrgyzstan

Absatarova Nurzida Abdykaymovna, e-mail: nurzid82@mail.ru

The study had no sponsorship.

None declared.

Aim of the study. To study the importance of anatomical and structural parameters of the eye in the effectiveness of treatment with orthokeratological lenses in myopia. 200 eyes (100 patients) were examined, including 160 eyes (80 patients) with myopia – 60 eyes (30 patients) with a mild degree and 100 eyes (50 patients) with an average degree; mean age 12.0± 0.38 years, control group – 40 eyes (20 people) – healthy individuals with emmetropia. Research methods. Along with the generally accepted methods, autorefractometry (Grand Seiko VR-2100), ophthalmometry (Topcon KR-7309), biometry (Zeiss IOLMaster 500), keratotopography (root otopographic system SW-600), accommodation study – AKA-01 device, and Shapovalov S.L. method, skiascopy against the background of cycloplegia, ultrasound of the eye, ultrasound of the retinal vessels, OST-angiography, study of the hydrodynamics of the eye (Glau Test 60). Follow-up in 1-3-6-12-24 Months. Results. With the formation of induced myopia against the background of the use of orthokeratological lenses in mild and moderate myopia, an increase in the difference in corneal curvature between the central and peripheral zones was revealed – the coefficient «Q» is equal to (-) 0,56±0,05 mm and (-) 0,57 ±0,054 mm (Р <0,001), in CG (-) 0,26±0,03 mm; increase in the index (asymmetry) «I-S» – before 2,78±0,18D and 3,22 0,12D (Р <0,001), in CG –>1,2±0,18D (Р <0,01); increase in the frequency of refractive power amplification along the vertical and horizontal meridians (SimK1, Sim K2) by 37% and 44%; Normalization of hydrodynamic parameters: «Po» is normal in в 30%; increase «C» – up to 0,22 мм³/min (Р<0,05); increase in AAA to 7,6 D±0,23  and 8,5D±0,01 (Р <0,05)  and 1,5 times – ZOA; increase in LSC in CAC to 15.0±0.64 cm/sec and in CVD – up to 5.5±0,59 cm/sec (Р <0,05) with choroidal thickening to 301±1,9 мкм (Р <0,05). Effectiveness of treatment with orthokeratological lenses: increase in NCOZ to 0.9-1.0 in 100%; reduction of the degree of myopia to (-) 0.55D±0.21 (P <0.01); lack of reliable stretching of the AXL. Conclusion: One of the additional factors contributing to the effectiveness of the use of orthokeratological lenses in mild and moderate myopia are: activation of accommodation, normalization of hydrodynamics and hemodynamics of the eye.

Myopia, orthokeratological lenses, myopic defocus, accommodation, hydrodynamics and hemodynamics of the eye

10.29234/2308-9113-2024-12-4-85-97

1. Nagorsky P.G., Belkina V.V. Klinicheskoe obosnovanie primeneniya ortokeratologicheskih linz dlya opticheskoj korrekcii i lecheniya progressiruyushchej miopii u detej i podrostkov. Konferenciya oftal'mologov «Nevskie gorizonty» (Sankt-Peterburg 15-16 oktyabrya 2010 g.). [Clinical substantiation of the use of orthokeratological lenses for optical correction and treatment of progressive myopia in children and adolescents Optalmological conference «Nevskie gorizonty». (St. Petersburg, October 15-16, 2010).] St. Petersburg, 2010. Vol. 2, P. 123. (In Russ.)

2. Smirnova A.S., Larshin A.S. Sovremennoe sostoyanie zreniya shkol'nikov: problemy i perspektivy. [The Current State of Schoolchildren Vision: Problems and Prospects.] Glaz [Eye], 2011; (3): 2-8. (In Russ.)

3. Boginskaya O.A. Eksperimental'no-klinicheskoe obosnovanie primeneniya integrirovannoj tekhnologii v lechenii progressiruyushchej blizorukosti u detej. Avtoreferat diss. na soiskanie uchenoj stepeni k.m.n. [Experimental and clinical justification of the use of integrated technology in the treatment of progressive myopia in children. Author’s Abstract, PhD Thesis.] Moscow, 2014. 26 p. (In Russ.)

4. Vitkovskaya O. P. Strategiya ukrepleniya zdorov'ya (Health promotion) v oftal'mologii. [Health promotion strategy in ophthalmology.] RMZh. Klinicheskaya oftal'mologiya [Russian Medical Journal. Clinical Ophtalmology] 2013; 13(3): 88-91. (In Russ.)

5. Oster P.J., Jiang Y. Epidemiology of myopia. Eye 2014; 28(2): 202-208.

6. Hopf S., Pfeiffer N. Epidemiology of myopia. Ophthalmologe 2017: 114(1): 20-23, doi: 10.1007/s 00347-016-0361-2

7. Medina A. The cause of myopia development and progression: Theory, evidence, and treatment. Surv Ophthalmol. 2022; 67(2): 488-509, doi: 10.1016/ j. survophthal.2021.06.005

8. Holden B.A. Fricke T.R., Wilson D.A., et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology 2016; 123(5): 1036-1042.

9. Morgan I.G., Ohno-Matsui K., Saw S.M. Myopia. Lancet 2012; 379: 1739-1748.

10. Tarutta E.P., Verzhanskaya T.Yu. Ortokeratologiya kak sposob korrekcii i lecheniya progressiruyushchej blizorukosti. Refrakcionnye i glazodvigatel'nye narusheniya: trudy mezhdunarodnoj konferencii. [Orthokeratology as a Way of Correction and Treatment of Progressive Myopia. Proceedings of the International Conference «Refractive and oculomotor disorders».] Moscow, 2007. P. 167. (In Russ.)

11. Cho P., Tan Q. Myopia and orthokeratology for myopia control. Clin Exp Optom. 2019: 102(4): 364-377, doi: 10.1111/cxo.12839

12. Lipson M.J., Brooks M.M., Koffler B.H. The role of orthokeratology in myopia control: a review. Eye Contact Lens 2018; 44(4): 224-230, doi: 10.1097/ICL.0000000000000520

13. Si J.K., Tan K., Bi H.S., Guo D.D., Wang X.R. Orthokeratology for myopia control: a meta-analysis. Optom Vis Sci 2015; 92(3): 252-257, doi: 10.1097/OPX.0000000000000505

14. Sun Y., Xu F., Zahng T., et al. Orthokeratology to control myopia progression: a meta-analysis. Plos One 2015; 10(4): e124535, doi: 10.1371/journal.pone.0124535

15. Nagorsky P.G., Glok M.A., Belkina V.V., Chernykh V.V. Izmenenie morfometricheskih parametrov rogovicy u pacientov s miopiej, ispol'zuyushchih ortokeratologicheskie linzy. [Changes in corneal morphometric parameters in patients with myopia using orthokeratological lenses.] Prakticheskaya medicina [Practical Medicine] 2012; (4): 68-71. (In Russ.)

16. Stepanova E.A., Lebedev O.P., Fedorenko A.S. Realii i perspektivy ispol'zovaniya ortokeratologicheskih linz. [Realities and Prospects for the Use of Orthokeratological Lenses.] Prakticheskaya medicina [Practical Medicine] 2017; 2(9): 215-218. (In Russ.)

17. Tarutta E.P., Verzhanskaya T.Yu. Vozmozhnye mekhanizmy tormozyashchego vliyaniya ortokeratologicheskih linz na progressirovanie miopii. [Possible mechanisms of the inhibitory influence of orthokeratological lenses on the progression of myopia.] Rossijskij oftal'mologicheskij zhurnal Russian Ophthalmological Journal 2008; 1(2): 26-30. (In Russ.)

18. Matrosova Y.V. Kliniko-funkcional'nye pokazateli pri ortokeratologicheskoj korrekcii miopii. [Clinical and functional indicators in orthokeratological correction of myopia.] Vestnik Tambovskogo universiteta. Seriya: Estestvennye i tekhnicheskie nauki Bulletin of Tambov University. Series: Natural and Technical Sciences 2016; 21(4): 1613-1617. (In Russ.)

19. Strakhov V.V., Gulidova E.G., Alekseev V.V. Osobennosti techeniya i monitoring progressiruyushchej miopiii v zavisimosti ot oftal'motonusa. [Features of the course and monitoring of progressive myopia depending on ophthalmotonus.] Rossijskij oftal'mologicheskij zhurnal [Russian Ophthalmological Journal] 2011: 4:(4): 66-70. (In Russ.)

20. Alekseev V.N., Egorov E.A., Martynova E.B. O raspredelenii urovnej vnutriglaznogo davleniya v normal'noj populyacii. [On the Distribution of Intraocular Pressure Levels in the Normal Population.] RMZh. Klinicheskaya oftal'mologiya [Russian Medical Journal. Clinical Ophtalmology] 2001; 2(2): 38-40. (In Russ.)

21. Balalin S.V., Trufanova L.P. Oftal'mogipertenzionnyj sindrom i perenapryazhenie akkomodacii, kak faktor riska progressii miopii. [Ophthalmic hypertension syndrome and accommodation overstrain as a risk factor for myopia progression.] Nacional'nyj zhurnal glaukoma [National Journal of Glaucoma] 2019; 18(2): 29-37. (In Russ.)

22. Nugumanova A.M., Samoylov A.N., Khamitova G.Kh. K voprosu o sostoyanii urovnya vnutriglaznogo davleniya pri korrekcii anomalii refrakcii ortokeratologicheskimi linzami. [On the Issue of the State of the Level of Intraocular Pressure in the Correction of Refractive Error by Orthokeratological Lenses.] Prakticheskaya medicina [Practical Medicine] 2012; (4-1): 224-225. (In Russ.)

23. Ezhova E.A., Melikhova N.A., Balalin S.V., Makovkin E.M. Citomorfologicheskie i biomekhanicheskie izmeneniya rogovicy pri ispol'zovanii ortokeratologicheskih linz u detej i podrostkov s miopiej. [Cytomorphological and biomechanical changes in the cornea during the use of OCL in children and adolescents with myopia.] Sibirskij nauchnyj medicinskij zhurnal [Siberian Scientific Medical Journal] 2015; 35(1): 37-41. (In Russ.)

24. Chiang S. T. Effect of retinal image defocus on the thick ness of the human choroid. Ophthalmic Physiol Opt. 2015; 35(4): 405-413, doi: 10.1111/opo.12218

25. Milash S.V. Tarutta E.P. Epishina M.V., Markosyan G.A., Ramazanova K.A. Ocenka tolshchiny horioidei i drugih anatomo-opticheskih parametrov glaza v rannie sroki posle ortokeratologicheskoj korrekcii miopii. [Evaluation of Choroidal Thickness and Anatomical and Optical Parameters of the Eye in the Early Period After Orthokeratology Myopia Correction.] Rossijskij oftal'mologicheskij zhurnal [Russian Ophthalmological Journal] 2019; 12(1), 26-33. (In Russ.)

26. Li Z., Cui D., Hu Y., Ao S., Zenf J., Yang X. Choroidal thickness and axial length changes in myopic children treated with orthokeratology. Contact Lens and Anterior Eye 2017; 40(6): 417-423, doi: 10.1016/j.clae.2017.09.010