Retinal vessel changes differ in children using two myopia treatments
Longitudinal Retinal Vascular Remodeling in Myopic Children Treated with Orthokeratology or Defocus Lenses: A Two-Year Comparative Study
Computer Vision and Pattern Recognition
Summary
Myopia, or nearsightedness, can worsen as children’s eyes grow longer. The authors studied how two treatments—orthokeratology (OK) lenses and multifocal defocus lenses—affect changes in the tiny blood vessels in the retina and how much the eye lengthens over two years. They found that OK lenses slow eye growth more and cause fewer changes in retinal blood vessels compared to defocus lenses. These differences in blood vessel changes were linked differently to eye growth depending on the treatment.
What this means in practice
- •For eye care professionals: Use retinal vessel measurements alongside axial length to better evaluate and tailor myopia treatments in children for effectiveness monitoring.
- •For medical device developers: Develop imaging tools or software that track retinal vascular changes to inform myopia control lens design and efficacy assessment.$Commercial implications: Enables creation of diagnostic devices that aid in selecting and optimizing myopia control lenses based on retinal vascular remodeling data.
Authors
Zhihao Zhao, Yinzheng Zhao, Jie Zhang, Huiqin Jiang, Yanyu Shangguan, Yanfei Sun, Li Chen, Yanlong Bi, M. Ali Nasseri, Bing Li
Abstract
Purposes: To characterize longitudinal retinal vascular changes in myopic children treated with orthokeratology (OK) or multifocal defocus lenses (Defocus) and to examine their association with axial elongation. Methods: In this retrospective cohort study, 43 myopic children underwent comprehensive clinical examination and fundus photography at baseline, 12 months, and 24 months. Axial length (AL) and spherical equivalent refraction (SER) were recorded at baseline, 6, 12, and 24 months. An automated segmentation model extracted vascular parameters, main vessel angle (MA), branching angle (BA), bifurcation edge angle (BEA), crossover point (COP), and terminal vessel count (TVC). Repeated-measures ANOVA assessed temporal changes. Pearson or Spearman correlations evaluated associations between AL and vascular metrics. Results: Over 24 months, the OK group exhibited significantly slower axial elongation than the Defocus group (0.214 mm and 0.522 mm, p < 0.01). In the OK group, MA and BA decreased modestly, BEA in arteries declined gradually, but COP and TVC remained relatively stable. The Defocus group demonstrated more pronounced decreases in MA and BA, an increase in BEA, and significant reductions in COP and TVC (p < 0.05). Correlation analysis revealed stronger associations between AL and vascular parameters, especially COP and TVC, in the Defocus group at all time points, whereas only BA and BEA correlated with AL in the OK group. Conclusions: OK lenses mitigate axial elongation and induce milder retinal vascular remodeling compared to Defocus lenses. Distinct temporal patterns of vascular metrics changes were observed between the two interventions, and correlate differentially with axial growth.