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Choroidal Thickness and Peripheral Myopic Defocus during Orthokeratology.
Optom Vis Sci. 2015 May; 92(5):579-88.OV

Abstract

PURPOSE

To investigate whether significant thickening occurs in the human choroid in response to chronic peripheral myopic defocus during overnight orthokeratology.

METHODS

Subjects were nine children 11 to 15 years old (mean [±SD] age, 13.61 [±1.25] years). Measurements were taken at baseline and after 1, 3, 6, and 9 months of successful orthokeratology. Choroidal thickness in central, superior, temporal, and nasal gazes were measured using the Zeiss Cirrus HD-OCT. The Lenstar LS 900 biometer provided a secondary measure of subfoveal choroidal thickness. Peripheral ocular length was measured in the same four fields of gaze with the Zeiss IOLMaster. Corneal and optical changes from orthokeratology were monitored throughout the study by corneal topography (Humphrey ATLAS), aberrometry (Complete Ophthalmic Analysis System), and central and peripheral autorefraction (Grand Seiko) after tropicamide 1% cycloplegia.

RESULTS

All subjects had acceptable acuity and physiologic response to overnight wear. After 1 month, central refractive error (mean ± SD) became significantly less myopic (-2.25 ± 0.95 diopters [D] vs. -0.24 ± 1.03 D), keratometric values flattened by 1.6 D, the shape factor (Q) became more oblate (-0.28 ± 0.05 vs. +0.34 ± 0.41), and spherical aberration became more positive (+0.14 ± 0.08 μm vs. +0.46 ± 0.15 μm; all p = 0.008). Peripheral refractive error remained -1.0 to -3.5 D myopic in all fields of gaze throughout the study. There were no consistent, significant changes in choroidal thickness or ocular length at any retinal location during the study (all p > 0.051). Lenstar measurement of choroidal thickness was unsuccessful because of the absence of choroidal peaks associated with thicker choroids (rs = -0.66, p < 0.0001).

CONCLUSIONS

The choroid did not show long-term thickening during orthokeratology despite the presence of substantial amounts of peripheral myopic defocus. Apparent inhibition of ocular growth was not attributed to an optical artifact of choroidal thickening, although smaller amounts of thickening or greater biological activity independent of thickening cannot be ruled out.

Authors+Show Affiliations

*OD, MS, FAAO †OD, PhD, FAAO The Ohio State University College of Optometry, Columbus, Ohio (all authors).No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25875682

Citation

Gardner, Dustin J., et al. "Choroidal Thickness and Peripheral Myopic Defocus During Orthokeratology." Optometry and Vision Science : Official Publication of the American Academy of Optometry, vol. 92, no. 5, 2015, pp. 579-88.
Gardner DJ, Walline JJ, Mutti DO. Choroidal Thickness and Peripheral Myopic Defocus during Orthokeratology. Optom Vis Sci. 2015;92(5):579-88.
Gardner, D. J., Walline, J. J., & Mutti, D. O. (2015). Choroidal Thickness and Peripheral Myopic Defocus during Orthokeratology. Optometry and Vision Science : Official Publication of the American Academy of Optometry, 92(5), 579-88. https://doi.org/10.1097/OPX.0000000000000573
Gardner DJ, Walline JJ, Mutti DO. Choroidal Thickness and Peripheral Myopic Defocus During Orthokeratology. Optom Vis Sci. 2015;92(5):579-88. PubMed PMID: 25875682.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Choroidal Thickness and Peripheral Myopic Defocus during Orthokeratology. AU - Gardner,Dustin J, AU - Walline,Jeffrey J, AU - Mutti,Donald O, PY - 2015/4/16/entrez PY - 2015/4/16/pubmed PY - 2015/6/27/medline SP - 579 EP - 88 JF - Optometry and vision science : official publication of the American Academy of Optometry JO - Optom Vis Sci VL - 92 IS - 5 N2 - PURPOSE: To investigate whether significant thickening occurs in the human choroid in response to chronic peripheral myopic defocus during overnight orthokeratology. METHODS: Subjects were nine children 11 to 15 years old (mean [±SD] age, 13.61 [±1.25] years). Measurements were taken at baseline and after 1, 3, 6, and 9 months of successful orthokeratology. Choroidal thickness in central, superior, temporal, and nasal gazes were measured using the Zeiss Cirrus HD-OCT. The Lenstar LS 900 biometer provided a secondary measure of subfoveal choroidal thickness. Peripheral ocular length was measured in the same four fields of gaze with the Zeiss IOLMaster. Corneal and optical changes from orthokeratology were monitored throughout the study by corneal topography (Humphrey ATLAS), aberrometry (Complete Ophthalmic Analysis System), and central and peripheral autorefraction (Grand Seiko) after tropicamide 1% cycloplegia. RESULTS: All subjects had acceptable acuity and physiologic response to overnight wear. After 1 month, central refractive error (mean ± SD) became significantly less myopic (-2.25 ± 0.95 diopters [D] vs. -0.24 ± 1.03 D), keratometric values flattened by 1.6 D, the shape factor (Q) became more oblate (-0.28 ± 0.05 vs. +0.34 ± 0.41), and spherical aberration became more positive (+0.14 ± 0.08 μm vs. +0.46 ± 0.15 μm; all p = 0.008). Peripheral refractive error remained -1.0 to -3.5 D myopic in all fields of gaze throughout the study. There were no consistent, significant changes in choroidal thickness or ocular length at any retinal location during the study (all p > 0.051). Lenstar measurement of choroidal thickness was unsuccessful because of the absence of choroidal peaks associated with thicker choroids (rs = -0.66, p < 0.0001). CONCLUSIONS: The choroid did not show long-term thickening during orthokeratology despite the presence of substantial amounts of peripheral myopic defocus. Apparent inhibition of ocular growth was not attributed to an optical artifact of choroidal thickening, although smaller amounts of thickening or greater biological activity independent of thickening cannot be ruled out. SN - 1538-9235 UR - https://www.unboundmedicine.com/medline/citation/25875682/Choroidal_Thickness_and_Peripheral_Myopic_Defocus_during_Orthokeratology_ L2 - http://dx.doi.org/10.1097/OPX.0000000000000573 DB - PRIME DP - Unbound Medicine ER -