Edwin Chan Shih-Yen | PubMed Health

PubMed2005

Myopia and associated pathological complications.

Besides the direct economic and social burden of myopia, associated ocular complications may lead to substantial visual loss. In several population and clinic-based cohorts, case-control and cross-sectional studies, higher risks of posterior subcapsular cataract, cortical and nuclear cataract in myopic patients were reported. Patients with high myopia (spherical equivalent at least -6.0 D) are more susceptible to ocular abnormalities. The prevalent risks of glaucoma were higher in myopic adults, and risks of chorioretinal abnormalities such as retinal detachment, chorioretinal atrophy and lacquer cracks increased with severity of myopia and greater axial length. Myopic adults were more likely to have tilted, rotated, and larger discs as well as other optic disc abnormalities. Often, these studies support possible associations between myopia and specific ocular complications, but we cannot infer causality because of limitations in study methodology. The detection and treatment of possible pathological ocular complications is essential in the management of high myopia. The ocular risks associated with myopia should not be underestimated and there is a public health need to prevent the onset or progression of myopia.

Adolescent↗

PubMed2002

Interventions to retard myopia progression in children: an evidence-based update.

TOPIC: To evaluate the efficacy of interventions such as eyedrops, bifocal lenses, or contact lenses in retarding the progression of myopia in myopic children. CLINICAL RELEVANCE: Myopia is a common ocular disorder, and high myopia (myopia at least -6.0 diopters) is associated with potentially blinding conditions. At present, there are no general guidelines on interventions that may decrease myopia progression in children, but some interventions such as contact lenses are offered on an ad hoc basis. METHODS OR LITERATURE REVIEWED: English and non-English language articles published from 1968 to 2000 were retrieved using a keyword search of MEDLINE, Embase, Cochrane Library, and Science Citation Index databases. Randomized controlled trials with comparisons of the effectiveness of interventions to decrease myopia progression in myopic children were reviewed. RESULTS: Ten clinical trials of different interventions to retard myopia progression were reviewed, including three trials that evaluated atropine and one trial that evaluated soft contact lenses. Atropine eye drops of 0.5% concentration were effective in clinical trials, but no significant effect was found for tropicamide or timolol eyedrops. Five of the six trials on bifocal spectacle lenses with various additions failed to show significant retardation, and results of the remaining trial were barely significant (P = 0.047). A trial of soft contact lenses failed to show significant effects. CONCLUSIONS: The latest evidence from randomized clinical trials does not provide sufficient information to support interventions to prevent the progression of myopia. Long-term large-scale double-masked randomized clinical trials, including cycloplegic refraction, are needed before any recommendations about interventions in clinical practice to prevent high myopia in myopic children are considered.

Atropine↗