Myopia is a leading cause of preventable blindness. Although, multiple cross-sectional epidemiological studies have confirmed that there is a high prevalence of myopia in high school-aged students in China. However, few longitudinal studies have been performed to assess junior high school students. In the present study, we investigate changes in the prevalence of myopia in third year junior high school (grade 9) students in the Haidian District of Beijing, China, from 2006 to 2015. A retrospective, longitudinal cohort study was performed over 10 years. A total of 37,424 third-year middle school (grade 9) students from 8 junior high schools in Haidian district, Beijing, were included. Participants underwent a comprehensive ophthalmic examination in which they were evaluated using autorefraction under cycloplegia and submitted to retinoscopy to assess accuracy. According to the spherical equivalent refraction (SER) of the right eye, subjects were separated into the following groups: non-myopia, −0.5 ≤ SER diopters (D); low myopia, −3.0 ≤ SER < −0.5 D; moderate myopia, −6.0 ≤ SER < −3.0 D; and high myopia, SER > −6.0 D. The following characteristics were measured: refractive error; the proportion of subjects with non- myopia, low myopia, moderate myopia and high myopia; and the difference in the prevalence of myopia between male and female subjects. From 2006 to 2015, the prevalence of non-myopia (from 44.05% to 34.52%) and low myopia (from 32.27% to 20.73%) decreased, while the prevalence of moderate myopia (from 19.72% to 38.06%) and high myopia (from 3.96% to 6.69%) significantly increased. For refractive error, the worse eye was −2.23 ± 2.42 D (median, −1.75; range − 12.75 to +8.50) in 2006 and −3.13 ± 2.66 D (median, −2.75; range − 12.75 to +8.50) in 2015. When the entire population was considered, the overall prevalence of myopia increased from 55.95% in 2005 to 65.48% in 2015. There was a significant positive relationship between the year and the prevalence of myopia in both girls and boys. Girls were more likely than boys to have myopia (odds ratio, 1.43 [95% CI, 1.14–1.96]), especially moderate myopia, and the prevalence of moderate and high myopia were higher in girls than in boys. During the last 10 years, the prevalence of myopia significantly increased on an annual basis among third-year junior high school students in the Haidian District of Beijing, China. The total prevalence of myopia was significantly higher in girl than in boy participants. The refractive status of this age group deserves particular attention.

To investigate the 12-month effectiveness of Diverse Segmented Defocus Optics (DSDO) and Defocus Incorporated Multiple Segments (DIMS) spectacle lenses in a real-world clinical population in myopic and pre-myopic Chinese children. About 364 subjects prescribed DSDO or DIMS were enrolled. Axial length (AL) and cycloplegic spherical equivalent refraction (SER) changes over 12 months were measured. The subjects were further divided into age sub-group (6-9; 10-14) and SER sub-group (+0.75D≤SER<-0.50D; -0.50D≤SER<-2.00D; -2.00D≤SER<-4.00D; SER≤-4.0D). Contrast sensitivity and visual experience were also reported. The rate of myopia progression was compared with historical single-vision spectacles (SVS) lenses data to evaluate the effectiveness of the regime. 317 subjects were analyzed. At 12-month, AL changes in the DSDO and DIMS group were 0.16±0.16 mm and 0.21±0.22 mm, respectively (P = 0.0202). DSDO spectacle lenses had better control effect in +0.75D≤SER<-0.50D and SER≤-2.0D sub-groups. The proportion of participants had no greater than 0.20 mm AL elongation was 65.00% and 55.41% of in DSDO and DIMS group separately. Myopia control effect in DSDO group was 47%-69% and 33%-62% in DIMS group compared to historical SVS lenses. Both DSDO and DIMS spectacle lenses retarded AL elongation. DSDO showed more stable myopia control effect comparing to DIMS, especially in groups of SER≤-2.0D sub-groups and older patients. DSDO showed initial potential myopia prevention effect in pre-myopic children compared with historical SVS lenses data. However, the small sample and no control group in pre-myopes of this study are key limitations. Further research is needed to confirm and understand DSDO's role for pre-myopic children.

Importance: With growing myopia prevalence worldwide, effective strategies to prevent early-onset myopia are needed.Objective: To evaluate the efficacy of diversified segmental defocus optimization (DSDO) spectacle lenses with or without 0.01% atropine for myopia prevention.Design, Setting, and Participants: This was 1-year randomized placebo-controlled double-masked clinical trial conducted in the Department of Ophthalmology at Peking University People’s Hospital from November 2023 to December 2024. Children aged 5 to 12 years with spherical equivalent refraction (SER) of 0.00 to 1.00 diopters (D) after cycloplegia were included, excluding those with ocular diseases, systemic diseases, or previous use of optical or pharmaceutical myopia control methods.Interventions: Participants were randomly assigned in a 1:1:1 ratio to receive DSDO spectacles with placebo eye drops (DSDO group), DSDO spectacles with 0.01% atropine eye drops (DSDOA group), or single-vision spectacles with placebo eye drops (control group).Main Outcomes and Measures: The primary outcomes were the cumulative incidence rate of myopia (defined as SER ≤−0.50 D) and the percentage of participants with fast myopic shift (defined as a spherical equivalent myopic shift ≥0.50 D) over 1 year. Secondary outcomes included changes in SER, axial length, and subfoveal choroidal thickness.Results: Of the 450 children initially randomized (DSDO group: mean [SD] age, 7.05 [0.12] years; 77 [51.3%] male; DSDOA group: mean [SD] age, 7.02 [0.14] years; 73 [48.7%] male; control group: mean [SD] age, 7.01 [0.11] years; 78 [52.0%] male), 370 (82.2%) completed the study, including 121 in the DSDO group, 125 in the DSDOA group, and 124 in the control group. The 1-year cumulative incidence rates of myopia in the DSDO, DSDOA, and control groups were 5.8% (7/121), 4.8% (6/125), and 15.3% (19/124), respectively, and the percentages of participants with fast myopic shift after 1 year were 15.7% (19/121), 9.6% (12/125), and 42.7% (53/124). Both DSDO and DSDOA groups showed significantly lower 1-year cumulative myopia incidence (DSDO: difference, 9.5%; 95% CI, 1.9-17.5; P = .02; DSDOA: difference, 10.5%; 95% CI, 3.3-18.4; P = .006) and the percentage of patients with fast myopic shift (DSDO: difference, 27.0%; 95% CI, 16.1-37.3; P < .001; DSDOA: difference, 33.1%; 95% CI, 23.1-42.8; P < .001) vs control. No significant differences were observed between DSDO and DSDOA groups.Conclusions and Relevance: These data suggest that daily use of DSDO spectacles delays the onset of myopia among children without myopia, supporting DSDO spectacles without atropine as an alternative preventive method for children without myopia if supported with longer follow-up and replication by others.Trial Registration: Chinese Clinical Trial Registry: ChiCTR2300077307

Purpose: To investigate the impact of vergence dysfunction on myopia progression in children with Defocus incorporated multiple segments (DIMS) spectacle lenses. Patients and Methods: We retrospectively enrolled children prescribed DIMS spectacle lenses to slow myopic progression. Baseline vergence dysfunction was determined according to phoria at distance and near. Axial length (AL) measurement and cycloplegic subjective refraction were performed before fitting the lenses and at six-month and one-year follow-ups. The six-month and one-year AL and spherical equivalent (SE) change from baseline were calculated and compared in subgroups stratified with the type of vergence dysfunction. Results: Two hundred and ninety-two myopic children were included. Significant AL elongation and SE progression were observed at six months and one year (P < 0.05 for all comparisons). Multiple regression demonstrated that AL elongation at six months (P < 0.001) and one year (P < 0.001) was negatively correlated with age, and SE progression at six months was associated with age (P = 0.002). The AL elongation at six months in children with convergence excess was significantly greater than in normal myopic subjects (P = 0.011) and subjects with convergence insufficiency (P = 0.008), divergence excess (P = 0.007), divergence insufficiency (P = 0.024) and basic esophoria (P = 0.048) at six months. Conclusion: The present research demonstrated that vergence dysfunction influences myopia progression for myopic children with DIMS, and the children with convergence excess suffer from the greatest myopia progression among different types of vergence dysfunction.

Objectives To examine the ocular biometric parameters and predict the annual growth rate of the physiological axial length (AL) in Chinese preschool children aged 4–6 years old. Methods This retrospective cross-sectional study included 1090 kindergarten students (1090 right eyes) between the ages of 4 and 6 years from Pinggu and Chaoyang District, Beijing. Dioptre values were ascertained following cycloplegic autorefraction. Predicted AL was obtained through the application of the Gaussian process regression model as an optimisation technique. Subsequently, the annual growth rate of physiological AL for non-myopic preschool children (n=1061) was computed via the backward difference method. Results In total, 85.4% of preschool children (931 individuals) had hyperopic refractive status in the 4–6 years age group, while only 2.7% (29 individuals) showed myopia. Boys had longer AL, larger AL-to-corneal radius ratio, deeper anterior chamber depth and lower lens power. The average physiological axial growth for boys and girls ranged from 0.050 mm/year to 0.165 mm/year and 0.063 mm/year to 0.168 mm/year, respectively. As age increased, the physiological AL growth in non-myopic cases decreased. Additionally, as hyperopic spherical equivalent refraction error lessened, the physiological AL growth component slowed down. Conclusions In preschool children, refractive development predominantly exhibits mild hyperopia. The concept of physiological AL provides valuable insights into the complexities of ocular development.

Purpose: This study aimed to identify the key demographic, biometric, and behavioral factors that impact the treatment effect of Ortho-K in low myopia and to discover the management ideas for low myopes undergoing Ortho-K treatment. Methods: A 12-month retrospective study examined 380 individuals who received Ortho-K treatment. Stratification and multinomial logistic regression were conducted to identify biometric features and behavioral indicators associated with Ortho-K treatment outcomes in low myopes. Results: The 12-month axial length growth was significantly longer in the low myopia group than in the moderate myopia group (P<0.0001). Multivariate logistic regression analysis showed that Ortho-K only was 2.23 times more likely to have rapid axial growth than Ortho-K combined with 0.01% atropine in patients with low myopia (P=0.01; odds ratio [OR]=2.23; 95% confidence interval [CI], 1.19–4.20). Multinomial logistic regression analyses showed that in patients with low myopia, female sex (P<0.0001; OR=0.4; 95% CI, 0.22–0.72), young age (P=0.01; OR=0.79; 95% CI, 0.66–0.93), flatter K mean (P=0.004; OR=0.74; 95% CI, 0.61–0.91), and having two myopic parents (P=0.03; OR=0.18; 95% CI, 0.05–0.71) were associated with worse treatment outcomes. A diet rich in white meats, such as fish and duck (P=0.01; OR=0.06; 95% CI, 0.01–0.54), was protective behavioral factors associated with slower axial length growth in children with low myopia. Conclusions: Patients with low myopia who exhibit one or more of the demographic and biometric risk factors (young age, female, flat mean K, and two myopic parents) require heightened attention in clinic settings because of their increased risk of myopia progression. Ortho-K combined with 0.01% atropine may achieve better efficacy than Ortho-K only in low myopes. A diet rich in white meat is protective and controlled behavioral factors for these patients.