Objective Myopia is the refractive error that shows the highest prevalence for younger ages in Southeast Asia and its projection over the next decades indicates that this situation will worsen. Nowadays, several management solutions are being applied to help fight its onset and development, nonetheless, the applications of these techniques depend on a clear and reliable assessment of risk to develop myopia. Methods and analysis In this study, population-based data of Chinese children were used to develop a machine learning-based algorithm that enables the risk assessment of myopia’s onset and development. Cross-sectional data of 12 780 kids together with longitudinal data of 226 kids containing age, gender, biometry and refractive parameters were used for the development of the models. Results A combination of support vector regression and Gaussian process regression resulted in the best performing algorithm. The Pearson correlation coefficient between prediction and measured data was 0.77, whereas the bias was −0.05 D and the limits of agreement was 0.85 D (95% CI: −0.91 to 0.80D). Discussion The developed algorithm uses accessible inputs to provide an estimate of refractive development and may serve as guide for the eye care professional to help determine the individual best strategy for management of myopia.

To evaluate over a 2-year period the efficacy of spectacle lenses incorporating cylindrical annular refractive elements (CARE) in slowing myopia progression compared with single vision (SV) spectacle wear. Double-masked, multicenter, randomized clinical trial. A total of 240 Chinese children aged 6 to 13 years, with a spherical equivalent (SE) refractive error of -0.75 diopters (D) to -5.00 D, were randomized to 1 of 3 groups of SV spectacle lens: CARE spectacles (7-mm central clear zone surrounded by treatment zone incorporating CARE with mean surface power +4.6 D) and CARE S spectacles (9-mm central clear zone surrounded by treatment zone comprising CARE with mean surface power +3.8 D). Cycloplegic SE and axial length (AL) were measured at 6-month intervals. Progression (mean ± SD) in SV-wearing eyes after 24 months of SPL wear was -1.15 ± 0.63 D and 0.59 ± 0.26 mm with SV for SE and AL, respectively. In comparison, myopia progression was significantly slower with both CARE (-0.73 ± 0.63 D/0.40 ± 0.26 mm, P < .0001) and CARE S (-0.80 ± 0.56 D/0.44 ± 0.25 mm, P < .0001). Progression did not differ significantly between CARE lenses. Adjusting for site, group, age, gender, and baseline value at 24 months, CARE showed an absolute difference in SE of 0.44 D (95% CI, 0.21-0.66 D) and CARE S 0.41 D (95% CI, 0.18-0.63D) compared with SV. AL reduction was 0.20 mm (95% CI, 0.10-0.30 mm) with CARE and 0.17 mm (0.07-0.26 mm) with CARE S compared with SV. Over a 2-year period, lenses incorporating CARE significantly slowed myopia progression compared with SV lenses.

Studies have found reduced myopia progression with multifocal contact lenses, albeit with an unclear mechanism behind their protective effect. It is hypothesized that the induced myopic defocus of the addition zones of the multifocal contact lenses leads to choroidal thickening and therefore inhibits eye growth. In the current study, the effect of the optical design of multifocal contact lenses on choroidal thickness was investigated. Eighteen myopic participants wore four different contact lenses ((1) single-vision lenses corrected for distance, (2) single-vision lenses with +2.50 D full-field defocus, (3) Multifocal center-distance design, (4) Multifocal center-near design, both with addition power +2.50 D) for 30 min each on their right eye. Automated analysis of the macular choroidal thickness and vitreous chamber depth were performed before and after the wear of each of the contact lenses. Peripheral refraction profiles in primary gaze were obtained using eccentric photorefraction prior to contact lens wear. Choroidal thickness and vitreous chamber depth showed no significant differences to baseline with any of the contact lenses (all p > 0.05). Choroidal thickness increased by +2.1 ± 11.1 μm with the Multifocal center-distance design, by +2.0 ± 11.1 μm with the full-field defocus lens, followed by the Multifocal center-near design with +1.6 ± 11.3 μm and the single-vision contact lens correcting for distance with +0.9 ± 11.2 μm. Multifocal contact lenses have no significant influence on choroidal thickness after short-term wear. Therefore, changes in choroidal thickness might not be the main contributor to the protective effect of multifocal contact lenses in myopia control.

Introduction: The simulation of vision with intraocular lenses (IOLs) prior to the clinical validation is of great interest for manufacturers as well as clinicians. We have tested the influence of different IOLs on the perception of contrast using different devices. Materials and methods: A Rassow telescope and the VirtIOL have been used to assess the contrast sensitivity function (CSF) through monfocal IOL (CT Asphina 409 MP, IOL 1), multifocal IOL (AT LISA tri 839 MP, IOL 2) and extended-depth-of-focus-IOL (TECNIS Symfony ZXR00, IOL3) in 21 participants, aged between 22 and 29 years. Contrast sensitivity (CS) was tested at various spatial frequencies (3–30 cycles per degree), using the Tuebingen contrast sensitivity test. Results: All tested IOL reduced the CS when compared to measurements with a trial lens correction of refractive errors. The analysis of the area under the curve of the contrast sensitivity function (AUC-CSF) revealed a significant reduction compared to the trial lens correction in case the Rassow telescope was used (IOL 1: P=0.008; IOL2: P<0.001; IOL3: P<0.001) and the same was true for the VirtIOL device for IOL2 and IOL3 (IOL2: P<0.001; IOL3: P<0.001), but not for IOL1 (P=0.192). Interdevice analysis of the AUC-CSF revealed significant differences for IOL1 and IOL2 (IOL1: P=0.025; IOL2: P<0.001), while no difference was found for IOL3 (P=0.092). Bland–Altman analysis as well as intraclass correlations coefficients indicated only weak interdevice agreement for the tested IOL. Conclusion: The assessment of the interdevice analysis for the Rassow telescope and the VirtIOL device revealed only a minor agreement between the two devices. In order to investigate vision with IOLs prior to a clinical validation, the use of the VirtIOL device is recommended.

Purpose: To investigate the inter-device agreement and mean differences between a newly developed digital phoropter and the two standard methods (trial frame and manual phoropter). Methods: Refractive errors of two groups of participants were measured by two examiners (examiner 1 (E1): 36 subjects; examiner 2 (E2): 38 subjects). Refractive errors were assessed using a trial frame, a manual phoropter and a digital phoropter. Inter-device agreement regarding the measurement of refractive errors was analyzed for differences in terms of the power vector components (spherical equivalent (SE) and the cylindrical power vector components J0 and J45) between the used methods. Intraclass correlation coefficients (ICC’s) were calculated to evaluate correlations between the used methods. Results: Analyzing the variances between the three methods for SE, J0 and J45 using a two-way ANOVA showed no significant differences between the methods (SE: p = 0.13, J0: p = 0.58 and J45: p = 0.96) for examiner 1 and for examiner 2 (SE: p = 0.88, J0: p = 0.95 and J45: p = 1). Mean differences and ±95% Limits of Agreement for each pair of inter-device agreement regarding the SE for both examiners were as follows: Trial frame vs. digital phoropter: +0.10 D ± 0.56 D (E1) and +0.19 D ± 0.60 D (E2), manual phoropter vs. trial frame: −0.04 D ± 0.59 D (E1) and −0.12 D ± 0.49 D (E2) and for manual vs. digital phoropter: +0.06 D ± 0.65 D (E1) and +0.08 D ± 0.45 D (E2). ICCs revealed high correlations between all methods for both examiner (p < 0.001). The time to assess the subjective refraction was significantly smaller with the digital phoropter (examiner 1: p < 0.001; examiner 2: p < 0.001). Conclusion: “All used subjective methods show a good agreement between each other terms of ICC (>0.9). Assessing refractive errors using different subjective methods, results in similar mean differences and 95% limits of agreement, when compared to those reported in studies comparing subjective refraction non-cylcoplegic retinoscopy or autorefraction”.

Aims: To evaluate the efficacy of CARE spectacle lenses in slowing myopia progression among European children. Methods: In a 2‐year randomised, parallel‐group, double‐masked, multicentre clinical trial, 234 European children aged 6–13 years were enrolled. All participants were myopic, with a cycloplegic spherical equivalent refractive error (SE) between −0.75 D and −5.00 D, astigmatism ≤1.50 D, anisometropia ≤1.00 D and myopia progression of at least 0.50 D in the previous year. The treatment group received MyoCare spectacle lenses with cylinder annular refractive elements (CARE), the control group single‐vision lenses (SVL). Axial length (AL) and SE were measured at baseline, 6 and 12 months. Wearability questionnaires were administered at 1 week and 3 months. Central and peripheral visual acuity (VA) was recorded at dispensing and after 3 months. Generalised linear models estimated changes in SE and AL, adjusting for lens type, age and baseline measurements. Results: After 12 months, children wearing CARE lenses showed less myopia progression, with a difference in SE and AL progression (compared to SVL) of −0.21 D (CI: 0.10 to 0.32 D) and 0.14 mm (CI: −0.17 to −0.10 mm), respectively. Central VA did not decrease with CARE lenses. Peripheral VA decreased by 0.10 and 0.09 logMAR in the nasal and temporal zones, respectively. Analysis of fast progressors indicated that 39.7% of SVL wearing eyes progressed by ≤−0.50 D/year compared to 21.1% with CARE ( p < 0.01). For AL, 56.0% of SVL children had an elongation ≥0.20 mm compared to 21.3% with CARE ( p < 0.01). Conclusions: In European children, myopia progression was significantly slower with CARE lenses compared with SVL after 1 year of lens wear. Further monitoring will provide a comprehensive evaluation of long‐term efficacy.