Time Course of Perceived Visual Distortion and Axial Length Growth in Myopic Children Undergoing Orthokeratology

Guihua Liu, Yiyuan Wu, Hua Bi, Biying Wang, Tianpu Gu, Bei Du, Jianliang Tong, Bin Zhang, Ruihua Wei, Guihua Liu, Yiyuan Wu, Hua Bi, Biying Wang, Tianpu Gu, Bei Du, Jianliang Tong, Bin Zhang, Ruihua Wei

Abstract

Purpose: To establish the time course of the subjective visual function changes during the first month of orthokeratology treatment in myopic children, and to investigate how the time course variations are associated with the objective optical quality changes and the axial length growth (ALG) after 1 year of treatment. Methods: A total of 58 myopic children aged from 8 to 16 years participated in this self-controlled prospective study. All subjects were fitted with designed spherical four-zone orthokeratology lenses. Subjective visual function was evaluated with orientation discrimination threshold (ODT), and objective optical quality was quantified with the high-order aberration root-mean-square (HOA-RMS) and the changing speed of HOA. The measurements were done before the lens fitting and 1 day, 1-, 2-, and 4-weeks after lens wear. Axial length was obtained at baseline and 1-year follow-up, and ALG was defined as the difference. One-way ANOVA was conducted to compare the difference for statistical analysis. Results: After lens fitting, the ODT time courses peaked on day 1 in 28 children, 1 week in 15 children, 2 weeks in 11 children, and 4 weeks in 4 children. In contrast, the HOA-RMS steadily rose during the first month, and the changing speed of HOA was only transiently elevated on day 1 after the initial lens wear. The ALG was 0.12 ± 0.20 mm in subjects whose ODT peaked at day 1, 0.08 ± 0.09 mm in subjects whose ODT peaked on 1-week, and 0.12 ± 0.15 mm in subjects whose ODT peaked on 2-week or later. There was no difference in axial growth among the subjects whose ODT peaked at different days (P = 0.734). Conclusion: While half ODT time course resembled the changing speed of HOA with a transient elevation on day 1, about a quarter of the ODT time course resemble the steadily rising of HOA-RMS, and the rest was located in the middle. The ALGs in children with different types of ODT time courses were similar.

Keywords: axial length; high-order aberration; orientation discrimination threshold; orthokeratology; visual distortion.

Conflict of interest statement

JT hold patents (8092025, 7806528) on the ODT described in this article. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Liu, Wu, Bi, Wang, Gu, Du, Tong, Zhang and Wei.

Figures

FIGURE 1
FIGURE 1
High-order aberration (HOA) measurement schedule. (A) A subject’s HOA-RMS. (B) The subject’s changing speed of HOA at each follow-up visit.
FIGURE 2
FIGURE 2
Methods to measure ODT. (A) The subject’s task was to answer which interval contains the parallel lines, 1st or 2nd. (B) A subject’s ODT measured at each follow-up visit.
FIGURE 3
FIGURE 3
Time courses separated according to the ODT peaking time. Top row: discrimination threshold (ODT), Middle row: Residua Mean Square (RMS) of high-order aberrations (HOA), Bottom row: changing speeding of HOA. The left column shows subjects whose ODT peaked at day 1 (red shade); the middle column shows subjects whose ODT peaked at 1 week (gray shade), and the right two columns show subjects whose ODT peaked at 2 weeks (blue shade) or 4 weeks (purple shade), respectively.
FIGURE 4
FIGURE 4
Time courses of spherical aberration (A), horizontal coma (B), and vertical coma (C). Redline: subjects whose ODT peaked at day 1, black line: subjects whose ODT peaked at 1 week, blue line: subjects whose ODT peaked at 2 weeks, and purple line: subjects whose ODT peaked at 4 weeks. The shaded area indicates mean ± one standard error.
FIGURE 5
FIGURE 5
The averaged ODT time course for subjects grouped by age.
FIGURE 6
FIGURE 6
The decomposition of ODT time course. (A) The ODT time course is decomposed as a linear combination of the time courses of HOA-RMS and HOA changing speed. (B) The distribution of coefficients of subjects peaked at day 1 (red), day 7 (black), and at or after day 14 (blue). SPD, speed. * means multiplication.
FIGURE 7
FIGURE 7
The correlation between axial length growth and age. Circles indicating subjects whose ODT peaked at day 1 (red), 1 week (black), and 2 weeks or later (blue).

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