The Risks and Benefits of Myopia Control
The prevalence of myopia is increasing around the world, stimulating interest in methods to slow its progression. The primary justification for slowing myopia progression is to reduce the risk of vision loss through sight-threatening ocular pathology in later life. The paper analyzes whether the pot...
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| Vydané v: | Ophthalmology (Rochester, Minn.) Ročník 128; číslo 11; s. 1561 |
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| Hlavní autori: | , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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United States
01.11.2021
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| ISSN: | 1549-4713, 1549-4713 |
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| Abstract | The prevalence of myopia is increasing around the world, stimulating interest in methods to slow its progression. The primary justification for slowing myopia progression is to reduce the risk of vision loss through sight-threatening ocular pathology in later life. The paper analyzes whether the potential benefits of slowing myopia progression by one diopter justify the potential risks associated with treatments.
First, the known risks associated with various methods of myopia control are summarized, with emphasis on contact lens wear. Based on available data, the risk of visual impairment and predicted years of visual impairment are estimated for a range of incidence levels. Next, the increased risk of potentially sight threatening conditions associated with different levels of myopia are reviewed. Finally, a model of the risk of visual impairment as a function of myopia level is developed, and the years of visual impairment associated with various levels of myopia and the years of visual impairment that could be prevented with achievable levels of myopia control is estimated.
Assuming an incidence of microbial keratitis between 1 and 25 per 10,000 patient years and that 15% of cases result in vision loss, leads to the conclusion that between 38 and 945 patients need to be exposed to five years of wear to produce 5 years of vison loss. Each additional diopter of myopia is associated with a 57%, 20%, 21%, and 30% increase in the risk of myopic maculopathy, open angle glaucoma, posterior subcapsular cataract, and retinal detachment, respectively. The predicted mean years of visual impairment ranges from 4.42 in a -3 D myope to 9.56 in a -8 D myope and a one diopter reduction would lower these by 0.74 and 1.22 respectively.
The potential benefits of myopia control outweigh the risks: the number needed to treat to prevent 5 years of visual impairment is between 4.1 and 6.8 while fewer than 1 in 38 will experience a loss of vision as a result of myopia control. |
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| AbstractList | The prevalence of myopia is increasing around the world, stimulating interest in methods to slow its progression. The primary justification for slowing myopia progression is to reduce the risk of vision loss through sight-threatening ocular pathologic features in later life. The article analyzes whether the potential benefits of slowing myopia progression by 1 diopter (D) justify the potential risks associated with treatments.PURPOSEThe prevalence of myopia is increasing around the world, stimulating interest in methods to slow its progression. The primary justification for slowing myopia progression is to reduce the risk of vision loss through sight-threatening ocular pathologic features in later life. The article analyzes whether the potential benefits of slowing myopia progression by 1 diopter (D) justify the potential risks associated with treatments.First, the known risks associated with various methods of myopia control are summarized, with emphasis on contact lens wear. Based on available data, the risk of visual impairment and predicted years of visual impairment are estimated for a range of incidence levels. Next, the increased risk of potentially sight-threatening conditions associated with different levels of myopia are reviewed. Finally, a model of the risk of visual impairment as a function of myopia level is developed, and the years of visual impairment associated with various levels of myopia and the years of visual impairment that could be prevented with achievable levels of myopia control are estimated.METHODSFirst, the known risks associated with various methods of myopia control are summarized, with emphasis on contact lens wear. Based on available data, the risk of visual impairment and predicted years of visual impairment are estimated for a range of incidence levels. Next, the increased risk of potentially sight-threatening conditions associated with different levels of myopia are reviewed. Finally, a model of the risk of visual impairment as a function of myopia level is developed, and the years of visual impairment associated with various levels of myopia and the years of visual impairment that could be prevented with achievable levels of myopia control are estimated.Assuming an incidence of microbial keratitis between 1 and 25 per 10 000 patient-years and that 15% of cases result in vision loss leads to the conclusion that between 38 and 945 patients need to be exposed to 5 years of wear to produce 5 years of vision loss. Each additional 1 D of myopia is associated with a 58%, 20%, 21%, and 30% increase in the risk of myopic maculopathy, open-angle glaucoma, posterior subcapsular cataract, and retinal detachment, respectively. The predicted mean years of visual impairment ranges from 4.42 in a person with myopia of -3 D to 9.56 in a person with myopia of -8 D, and a 1-D reduction would lower these by 0.74 and 1.21 years, respectively.RESULTSAssuming an incidence of microbial keratitis between 1 and 25 per 10 000 patient-years and that 15% of cases result in vision loss leads to the conclusion that between 38 and 945 patients need to be exposed to 5 years of wear to produce 5 years of vision loss. Each additional 1 D of myopia is associated with a 58%, 20%, 21%, and 30% increase in the risk of myopic maculopathy, open-angle glaucoma, posterior subcapsular cataract, and retinal detachment, respectively. The predicted mean years of visual impairment ranges from 4.42 in a person with myopia of -3 D to 9.56 in a person with myopia of -8 D, and a 1-D reduction would lower these by 0.74 and 1.21 years, respectively.The potential benefits of myopia control outweigh the risks: the number needed to treat to prevent 5 years of visual impairment is between 4.1 and 6.8, whereas fewer than 1 in 38 will experience a loss of vision as a result of myopia control.CONCLUSIONSThe potential benefits of myopia control outweigh the risks: the number needed to treat to prevent 5 years of visual impairment is between 4.1 and 6.8, whereas fewer than 1 in 38 will experience a loss of vision as a result of myopia control. The prevalence of myopia is increasing around the world, stimulating interest in methods to slow its progression. The primary justification for slowing myopia progression is to reduce the risk of vision loss through sight-threatening ocular pathology in later life. The paper analyzes whether the potential benefits of slowing myopia progression by one diopter justify the potential risks associated with treatments. First, the known risks associated with various methods of myopia control are summarized, with emphasis on contact lens wear. Based on available data, the risk of visual impairment and predicted years of visual impairment are estimated for a range of incidence levels. Next, the increased risk of potentially sight threatening conditions associated with different levels of myopia are reviewed. Finally, a model of the risk of visual impairment as a function of myopia level is developed, and the years of visual impairment associated with various levels of myopia and the years of visual impairment that could be prevented with achievable levels of myopia control is estimated. Assuming an incidence of microbial keratitis between 1 and 25 per 10,000 patient years and that 15% of cases result in vision loss, leads to the conclusion that between 38 and 945 patients need to be exposed to five years of wear to produce 5 years of vison loss. Each additional diopter of myopia is associated with a 57%, 20%, 21%, and 30% increase in the risk of myopic maculopathy, open angle glaucoma, posterior subcapsular cataract, and retinal detachment, respectively. The predicted mean years of visual impairment ranges from 4.42 in a -3 D myope to 9.56 in a -8 D myope and a one diopter reduction would lower these by 0.74 and 1.22 respectively. The potential benefits of myopia control outweigh the risks: the number needed to treat to prevent 5 years of visual impairment is between 4.1 and 6.8 while fewer than 1 in 38 will experience a loss of vision as a result of myopia control. |
| Author | Leveziel, Nicolas Bourne, Rupert R A Flitcroft, D Ian Shah, Sunil Ritchey, Eric R Bullimore, Mark A |
| Author_xml | – sequence: 1 givenname: Mark A surname: Bullimore fullname: Bullimore, Mark A email: bullers2020@gmail.com organization: University of Houston, College of Optometry, Houston, Texas, USA. Electronic address: bullers2020@gmail.com – sequence: 2 givenname: Eric R surname: Ritchey fullname: Ritchey, Eric R organization: University of Houston, College of Optometry, Houston, Texas, USA – sequence: 3 givenname: Sunil surname: Shah fullname: Shah, Sunil organization: Birmingham and Midland Eye Centre, Birmingham, UK; Aston University, Birmingham, UK – sequence: 4 givenname: Nicolas surname: Leveziel fullname: Leveziel, Nicolas organization: Centre Hospitalier Universitaire (CHU) Poitiers, Poitiers, France; University of Poitiers, France; Centre d'Investigation Clinique (CIC 1402), Poitiers, France; Institut National de la Santé et de la Recherche Médicale (INSERM 1084), Poitiers, France; Vision & Eye Research Institute, School of Medicine, Anglia Ruskin University, Cambridge, UK – sequence: 5 givenname: Rupert R A surname: Bourne fullname: Bourne, Rupert R A organization: Vision & Eye Research Institute, School of Medicine, Anglia Ruskin University, Cambridge, UK; Department of Ophthalmology, Cambridge University Hospital, Cambridge, UK – sequence: 6 givenname: D Ian surname: Flitcroft fullname: Flitcroft, D Ian organization: Children's University Hospital, Dublin, Ireland; Technological University Dublin, Dublin, Ireland |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33961969$$D View this record in MEDLINE/PubMed |
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