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  1. Article ; Online: Optical interventions for myopia control.

    Logan, Nicola S / Bullimore, Mark A

    Eye (London, England)

    2023  Volume 38, Issue 3, Page(s) 455–463

    Abstract: A range of optical interventions have been developed to slow the progression of myopia. This review summarizes key studies and their outcomes. Peer-reviewed, randomized controlled clinical trials of at least 18 months duration were identified. Randomized ...

    Abstract A range of optical interventions have been developed to slow the progression of myopia. This review summarizes key studies and their outcomes. Peer-reviewed, randomized controlled clinical trials of at least 18 months duration were identified. Randomized clinical trials were identified and summarised: 13 for spectacles, 5 for overnight orthokeratology, 5 for soft contact lenses, and 3 for orthokeratology combined with low concentration atropine. Overnight orthokeratology trials were the most consistent with 2-year slowing of axial elongation between 0.24 and 0.32 mm. Other modalities were more variable due to the wide range of optical designs. Among spectacle interventions, progressive addition lenses were the least effective, slowing axial elongation and myopia progression by no more than 0.11 mm and 0.31 D, respectively. In contrast, novel designs with peripheral lenslets slow 2-year elongation and progression by up to 0.35 mm and 0.80 D. Among soft contact lens interventions, medium add concentric bifocals slow 3-year elongation and progression by only 0.07 mm and 0.16 D, while a dual-focus design slows 3-year elongation and progression by 0.28 mm and 0.67 D. In summary, all three optical interventions have the potential to significantly slow myopia progression. Quality of vision is largely unaffected, and safety is satisfactory. Areas of uncertainty include the potential for post-treatment acceleration of progression and the benefit of adding atropine to optical interventions.
    MeSH term(s) Humans ; Atropine/therapeutic use ; Axial Length, Eye ; Contact Lenses, Hydrophilic ; Disease Progression ; Myopia/prevention & control ; Myopia/drug therapy ; Orthokeratologic Procedures ; Refraction, Ocular ; Randomized Controlled Trials as Topic
    Chemical Substances Atropine (7C0697DR9I)
    Language English
    Publishing date 2023-09-22
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 91001-6
    ISSN 1476-5454 ; 0950-222X
    ISSN (online) 1476-5454
    ISSN 0950-222X
    DOI 10.1038/s41433-023-02723-5
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  2. Article ; Online: Exemplifying practice-based research: the influence of age on myopia progression.

    Berkow, David / Dunne, Mark / Logan, Nicola S / Anderson, Stephen J

    Clinical & experimental optometry

    2024  , Page(s) 1–5

    Abstract: Clinical relevance: The electronic storage of patient records and modern-day search engines present private practitioners with a unique opportunity to extract valuable data for investigative research purposes. However, practitioners seldom harness this ... ...

    Abstract Clinical relevance: The electronic storage of patient records and modern-day search engines present private practitioners with a unique opportunity to extract valuable data for investigative research purposes. However, practitioners seldom harness this resource and consequently a vast repository of clinical data remains largely unexplored.
    Background: This study, based on real-world data from an optometric practice, stands as an example of how clinicians can actively contribute to research. In doing so it underscores the role played by age in determining the rate of natural myopia progression.
    Methods: A retrospective data analysis of the refractive status, age and optical correction type of participants, was conducted over six years. Forty-four participants were recruited (25 contact lens and 19 spectacle wearers), with a presenting age varying from 5 to 20 years (median, 11 years). Non-cycloplegic, monocular foveal refractions were completed using a ShinNippon open-field autorefractor, corroborated with subjective refraction. The mean spherical equivalent refractive error was calculated for the participants' initial visit (baseline measure) and for a six-year follow-up visit (progression measure), with myopia progression defined as the difference between these measures. Statistical analyses were computed using Decision Tree Analysis, with a significance level set at 95%.
    Results: The participant age at first visit exerted a significant influence on natural myopia progression over the assessment period (F 1,42 = 17.11,
    Conclusions: Utilizing the advantage of small real-world data samples, the benefit of research by private practitioners was demonstrated, providing evidence that the age at which a child first presents for an eye examination is highly influential in determining their rate of myopia progression.
    Language English
    Publishing date 2024-02-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639275-1
    ISSN 1444-0938 ; 0816-4622
    ISSN (online) 1444-0938
    ISSN 0816-4622
    DOI 10.1080/08164622.2024.2309219
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  3. Article ; Online: Effect of peripheral defocus on axial growth and modulation of refractive error in children with anisohyperopia.

    Beasley, Ian G / Davies, Leon N / Logan, Nicola S

    Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)

    2023  Volume 43, Issue 4, Page(s) 805–814

    Abstract: Purpose: To establish whether axial growth and refractive error can be modulated in anisohyperopic children by imposing relative peripheral hyperopic defocus (RPHD) using multifocal soft contact lenses.: Methods: This study is a prospective, ... ...

    Abstract Purpose: To establish whether axial growth and refractive error can be modulated in anisohyperopic children by imposing relative peripheral hyperopic defocus (RPHD) using multifocal soft contact lenses.
    Methods: This study is a prospective, controlled paired-eye study with anisohyperopic children. Axial growth and refractive error were observed without intervention for the first 6 months of the 3-year trial with participants wearing single vision spectacles. Then, participants wore a centre-near, multifocal, soft contact lens (+2.00 D add) in their more hyperopic eye for 2 years, with a single vision contact lens worn in the fellow eye if required. The 'centre-near' portion of the contact lens in the more hyperopic eye corrected distance refractive error while the 'distance' portion imposed hyperopic defocus in the peripheral retina. Participants reverted to single vision spectacles for the final 6 months.
    Results: Eleven participants, mean age of 10.56 years (SD 1.43; range 8.25-13.42), completed the trial. No increase in axial length (AL) was found during the first 6 months in either eye (p > 0.99). Axial growth across the 2-year intervention period was 0.11 mm (SEM 0.03; p = 0.06) in the test eye versus 0.15 mm (SEM 0.03; p = 0.003) in the control eye. AL was invariant during the final 6 months in both eyes (p > 0.99). Refractive error was stable during the first 6 months in both eyes (p = 0.71). Refractive error change across the 2-year intervention period was -0.23 D (SEM 0.14; p = 0.32) in the test eye versus -0.30 D (SEM 0.14; p = 0.61) in the control eye. Neither eye demonstrated a change in refractive error during the final 6 months (p > 0.99).
    Conclusions: Imposing RPHD using the centre-near, multifocal, contact lens specified here did not accelerate axial growth nor reduce refractive error in anisohyperopic children.
    MeSH term(s) Child ; Humans ; Contact Lenses, Hydrophilic ; Eye ; Hyperopia/therapy ; Myopia/therapy ; Prospective Studies ; Refraction, Ocular ; Refractive Errors/therapy ; Retina
    Language English
    Publishing date 2023-04-07
    Publishing country England
    Document type Controlled Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 604564-9
    ISSN 1475-1313 ; 0275-5408
    ISSN (online) 1475-1313
    ISSN 0275-5408
    DOI 10.1111/opo.13139
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  4. Article ; Online: Seeing beyond 2020: what next for refractive error care?

    Ramke, Jacqueline / Logan, Nicola S

    Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)

    2021  Volume 41, Issue 3, Page(s) 457–460

    MeSH term(s) Delivery of Health Care/methods ; Humans ; Refractive Errors/physiopathology ; Refractive Errors/therapy ; Vision, Ocular/physiology
    Language English
    Publishing date 2021-04-07
    Publishing country England
    Document type Editorial
    ZDB-ID 604564-9
    ISSN 1475-1313 ; 0275-5408
    ISSN (online) 1475-1313
    ISSN 0275-5408
    DOI 10.1111/opo.12820
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  5. Article ; Online: Utility of artificial intelligence-based large language models in ophthalmic care.

    Biswas, Sayantan / Davies, Leon N / Sheppard, Amy L / Logan, Nicola S / Wolffsohn, James S

    Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)

    2024  Volume 44, Issue 3, Page(s) 641–671

    Abstract: Purpose: With the introduction of ChatGPT, artificial intelligence (AI)-based large language models (LLMs) are rapidly becoming popular within the scientific community. They use natural language processing to generate human-like responses to queries. ... ...

    Abstract Purpose: With the introduction of ChatGPT, artificial intelligence (AI)-based large language models (LLMs) are rapidly becoming popular within the scientific community. They use natural language processing to generate human-like responses to queries. However, the application of LLMs and comparison of the abilities among different LLMs with their human counterparts in ophthalmic care remain under-reported.
    Recent findings: Hitherto, studies in eye care have demonstrated the utility of ChatGPT in generating patient information, clinical diagnosis and passing ophthalmology question-based examinations, among others. LLMs' performance (median accuracy, %) is influenced by factors such as the iteration, prompts utilised and the domain. Human expert (86%) demonstrated the highest proficiency in disease diagnosis, while ChatGPT-4 outperformed others in ophthalmology examinations (75.9%), symptom triaging (98%) and providing information and answering questions (84.6%). LLMs exhibited superior performance in general ophthalmology but reduced accuracy in ophthalmic subspecialties. Although AI-based LLMs like ChatGPT are deemed more efficient than their human counterparts, these AIs are constrained by their nonspecific and outdated training, no access to current knowledge, generation of plausible-sounding 'fake' responses or hallucinations, inability to process images, lack of critical literature analysis and ethical and copyright issues. A comprehensive evaluation of recently published studies is crucial to deepen understanding of LLMs and the potential of these AI-based LLMs.
    Summary: Ophthalmic care professionals should undertake a conservative approach when using AI, as human judgement remains essential for clinical decision-making and monitoring the accuracy of information. This review identified the ophthalmic applications and potential usages which need further exploration. With the advancement of LLMs, setting standards for benchmarking and promoting best practices is crucial. Potential clinical deployment requires the evaluation of these LLMs to move away from artificial settings, delve into clinical trials and determine their usefulness in the real world.
    MeSH term(s) Humans ; Artificial Intelligence ; Clinical Decision-Making ; Eye ; Judgment ; Ophthalmology
    Language English
    Publishing date 2024-02-25
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 604564-9
    ISSN 1475-1313 ; 0275-5408
    ISSN (online) 1475-1313
    ISSN 0275-5408
    DOI 10.1111/opo.13284
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  6. Article ; Online: IMI-Global Trends in Myopia Management Attitudes and Strategies in Clinical Practice-2022 Update.

    Wolffsohn, James S / Whayeb, Yasmin / Logan, Nicola S / Weng, Rebecca

    Investigative ophthalmology & visual science

    2023  Volume 64, Issue 6, Page(s) 6

    Abstract: Purpose: Surveys in 2015 and 2019 identified a high level of eye care practitioner concern/activity about myopia, but the majority still prescribed single vision interventions to young myopes. This research aimed to provide updated information.: ... ...

    Abstract Purpose: Surveys in 2015 and 2019 identified a high level of eye care practitioner concern/activity about myopia, but the majority still prescribed single vision interventions to young myopes. This research aimed to provide updated information.
    Methods: A self-administered, internet-based questionnaire was distributed in 13 languages, through professional bodies to eye care practitioners globally. The questions examined awareness of increasing myopia prevalence, perceived efficacy and adoption of available strategies, and reasons for not adopting specific strategies.
    Results: Of the 3195 respondents, practitioners' concern about the increasing frequency of pediatric myopia in their practices differed between continents (P < 0.001), being significantly higher in Asia (9.0 ± 1.5 of 10) than other continents (range 7.7-8.2; P ≤ 0.001). Overall, combination therapy was perceived by practitioners to be the most effective method of myopia control, followed by orthokeratology and pharmaceutical approaches. The least effective perceived methods were single vision distance undercorrection, spectacles and contact lenses, as well as bifocal spectacles. Practitioners rated their activity in myopia control between (6.6 ± 2.9 in South America to 7.9 ± 1.2/2.2 in Australasia and Asia). Single-vision spectacles are still the most prescribed option for progressing young myopia (32.2%), but this has decreased since 2019, and myopia control spectacles (15.2%), myopia control contact lenses (8.7%) and combination therapy (4.0%) are growing in popularity.
    Conclusions: More practitioners across the globe are practicing myopia control, but there are still significant differences between and within continents. Practitioners reported that embracing myopia control enhanced patient loyalty, increasing practice revenue and improving job satisfaction.
    MeSH term(s) Humans ; Child ; Myopia/epidemiology ; Contact Lenses ; Vision, Ocular ; Surveys and Questionnaires ; Eyeglasses
    Language English
    Publishing date 2023-04-18
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 391794-0
    ISSN 1552-5783 ; 0146-0404
    ISSN (online) 1552-5783
    ISSN 0146-0404
    DOI 10.1167/iovs.64.6.6
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  7. Article ; Online: Conformation of the anterior segment in human myopia.

    Buckhurst, Hetal / Gilmartin, Bernard / Cubbidge, Robert / Logan, Nicola S

    Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)

    2023  Volume 43, Issue 3, Page(s) 368–376

    Abstract: Purpose: Topography of the in vivo anterior segment is of relevance in understanding its role in myopia and in the development of ocular surgical procedures. Using 3D magnetic resonance (MR) images of the human eye, regional variations in surface area ( ... ...

    Abstract Purpose: Topography of the in vivo anterior segment is of relevance in understanding its role in myopia and in the development of ocular surgical procedures. Using 3D magnetic resonance (MR) images of the human eye, regional variations in surface area (SA) and bulbosity of four anterior segment regions were investigated in association with refractive status (Rx), axial length (AL) and total ocular volume (OV).
    Methods: T2-weighted ocular MR images from 43 adults aged 18-40 years (mean ± SD; 28.65 ± 6.20) comprising 20 non-myopes (≥-0.50) 0.57 ± 1.38 and 23 myopes (<-0.50) -6.37 ± 4.23 MSE (D) were collected. 2D representations of each quadrant (superior-temporal [ST], superior-nasal [SN], inferior-temporal [IT] and inferior-nasal [IN]) of the anterior section (3.5-9 mm) were fitted with second-order polynomials. Polynomials were integrated and rotated about the x-axis to generate SA; dividing the SA by 4 provided relative quadrantial SA. The x
    Results: Significant differences in SA were observed between quadrants (p < 0.001) with differences between ST versus IN, IN versus IT and SN versus IT. An interaction effect (p = 0.01) for Rx suggested smaller temporal (ST and IT) and larger nasal (SN and IN) SA in myopes. AL and myopic Rx were negative correlated (p < 0.05) with SA at IN, SN and IT. OV was significantly associated with SA at ST. Bulbosity showed no regional differences nor an effect of AL or Rx.
    Conclusion: Significant regional variation in SA exists across the anterior segment that is modulated by Rx and AL. It is unclear whether these structural characteristics are a precursor or consequence of myopia and may warrant investigation when developing biomechanical interventions.
    MeSH term(s) Adult ; Humans ; Myopia/diagnosis ; Myopia/pathology ; Eye ; Refraction, Ocular ; Biometry
    Language English
    Publishing date 2023-02-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 604564-9
    ISSN 1475-1313 ; 0275-5408
    ISSN (online) 1475-1313
    ISSN 0275-5408
    DOI 10.1111/opo.13095
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  8. Article ; Online: Size and position of the optic disc crescent in a white European population with myopia.

    Hill, David / Heitmar, Rebekka / Logan, Nicola S

    Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)

    2022  Volume 42, Issue 5, Page(s) 1115–1123

    Abstract: Significance: One of the first clinically observed changes in the retina with progressing myopia is in the form of optic disc crescents. If such a change is predictive of myopia progression, it could aid in myopia management interventions to target ... ...

    Abstract Significance: One of the first clinically observed changes in the retina with progressing myopia is in the form of optic disc crescents. If such a change is predictive of myopia progression, it could aid in myopia management interventions to target those at greatest risk of progression and subsequent ocular morbidity.
    Purpose: To investigate the type, dimension and appearance of optic disc crescents and how they relate to the level of myopia.
    Methods: Retrospective data collection analysing retinal photographs of healthy children and adults with a refractive error of ≤-0.50 D sphere and astigmatism ≤2.00 D. Crescent location, maximum crescent width and vertical disc diameter were measured from retinal images of right eyes only.
    Results: Four-hundred eyes with a mean spherical error (SER) of -0.50 to -14.00 D (aged 7-81 years) were included (83.5% exhibited a discernible crescent). Mean (SD) maximum crescent width was 0.24 (0.24) mm. Univariate analysis showed a significant correlation between crescent width and age (r = 0.26, p < 0.001). SER was correlated with crescent width when controlling for age (r = -0.45, p < 0.001) and to the ratio of crescent width to vertical disc diameter (r = -0.43, p < 0.001). Temporal crescents were the most frequently observed (74%), followed by inferior temporal crescents (17%). One-way between-groups analysis of variance showed a significant difference between crescent locations (F = 5.2, p < 0.001). Post-hoc analysis revealed significant differences in SER between those with no crescent versus an inferior-temporal crescent, as well as differences between those with temporal versus inferior-temporal crescents. Other crescent locations did not differ significantly in the level of myopia. Participants not exhibiting a crescent had the lowest level of myopia (mean [SD] -3.03 [1.97)] D), while those with inferior temporal crescents had a mean (SD) SER of -5.01 (2.37) D.
    Conclusion: In this white European population, higher levels of SER were associated with increasing crescent size. Eyes with inferior temporally located crescents were more myopic.
    MeSH term(s) Adult ; Child ; Humans ; Myopia/diagnosis ; Optic Disk/diagnostic imaging ; Refraction, Ocular ; Refractive Errors ; Retrospective Studies ; Tomography, Optical Coherence/methods
    Language English
    Publishing date 2022-06-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 604564-9
    ISSN 1475-1313 ; 0275-5408
    ISSN (online) 1475-1313
    ISSN 0275-5408
    DOI 10.1111/opo.13018
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  9. Article ; Online: The effect of peripheral defocus on axial growth and modulation of refractive error in hyperopes.

    Beasley, Ian G / Davies, Leon N / Logan, Nicola S

    Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)

    2022  Volume 42, Issue 3, Page(s) 534–544

    Abstract: Purpose: To establish whether axial growth and refractive error can be modulated in hyperopic children by imposing relative peripheral hyperopic defocus using multifocal soft contact lenses.: Methods: A prospective controlled study with hyperopic ... ...

    Abstract Purpose: To establish whether axial growth and refractive error can be modulated in hyperopic children by imposing relative peripheral hyperopic defocus using multifocal soft contact lenses.
    Methods: A prospective controlled study with hyperopic participants allocated to a control or test group. Control group participants were corrected with single vision spectacles and changes to axial length and refractive error were followed for 3 years. For the test group, axial growth and post-cycloplegic refractive error were observed with participants wearing single vision spectacles for the first 6 months of the trial and then corrected with centre-near multifocal soft contact lenses with a 2.00 D add for 2 years. The central 'near' portion of the contact lens corrected distance refractive error while the 'distance' portion imposed hyperopic defocus. Participants reverted to single vision spectacles for the final 6 months of the study.
    Results: Twenty-two participants, mean age 11.13 years (SD 1.72) (range 8.33-13.92), completed the trial. Axial length did not change during the first 6 months in either group (p = 1.00). Axial growth across the 2-year intervention period was 0.17 mm (SEM 0.04) (p < 0.0005) in the test group versus 0.06 mm (SEM 0.07) (p = 0.68) in the control group. Axial length was invariant during the final 6 months in either group (p = 1.00). Refractive error was stable during the first 6 months in both groups (p = 1.00). Refractive error change across the 2-year intervention period was -0.26 D (SEM 0.14) (p = 0.38) in the test group versus -0.01 D (SEM 0.09) (p = 1.00) in the control group. Neither the test (p = 1.00) nor control (p = 0.63) group demonstrated a change in refractive error during the final 6 months.
    Conclusions: The rate of axial growth can be accelerated in children with hyperopia using centre-near multifocal soft contact lenses.
    MeSH term(s) Child ; Contact Lenses, Hydrophilic ; Humans ; Hyperopia/therapy ; Myopia/therapy ; Prospective Studies ; Refraction, Ocular ; Refractive Errors/therapy
    Language English
    Publishing date 2022-02-21
    Publishing country England
    Document type Controlled Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 604564-9
    ISSN 1475-1313 ; 0275-5408
    ISSN (online) 1475-1313
    ISSN 0275-5408
    DOI 10.1111/opo.12951
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  10. Article ; Online: Response to Re: Role of un-correction, under-correction and over-correction of myopia as a strategy for slowing myopic progression.

    Wolffsohn, James S / Logan, Nicola S

    Clinical & experimental optometry

    2020  Volume 103, Issue 3, Page(s) 397–398

    MeSH term(s) Humans ; Myopia ; Refraction, Ocular
    Language English
    Publishing date 2020-04-13
    Publishing country Australia
    Document type Letter ; Comment
    ZDB-ID 639275-1
    ISSN 1444-0938 ; 0816-4622
    ISSN (online) 1444-0938
    ISSN 0816-4622
    DOI 10.1111/cxo.13079
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