This year, the annual Association for Research in Vision and Ophthalmology (ARVO) was held in Vancover 2019 from April 28th到5月2日nd。查看近视资料Facebook组以获取单个现场帖子，但这是会议上出色的新研究的摘要。单击标题以获取更多信息以及指向演示文稿摘要的链接。您会在此博客的末尾找到指向Arvo最新第2部分和第3部分的链接。
Get ready for your views to be changed on how we discuss efficacy of myopia treatments. Here’s Xu Cheng (Cathy), Noel Brennan and Mark Bullimore presenting their important work on understanding whether efficacy is relative (a percentage) or absolute. Analysing 93 datasets of a variety of treatment vs control, it revealed the typical trend of efficacy being much higher in the initial year compared to following years. This is why shorter studies frequently show higher % treatment effects.
这表明趋势lines for numerous OrthoK, soft multifocal CLs and bifocal / progressive spectacle treatments. When the big initial response and reduced response in subsequent years is plotted, there’s a pretty clear picture that the treatment appears to plateau out to an absolute effect, of around 0.45mm (in OrthoK) or 1D (bifocal specs). Look how it also shows similarity between the treatments.
Now look at the conclusions and accompanying chart. The authors propose that it may not be appropriate to extrapolate something like 50% across many years of potential childhood progression - they’ve coined the termCumulative Absolute Reduction in axial Elongation; the ‘CARE’ factor!
这些家伙并没有试图使您对近视控制的价值感到沮丧，而只是为了确保一种理解疗效和解释研究的适当和基于证据的方法。那么，值得只有0.45毫米或减少近视的1d的1D？答案是肯定的！Mark和Noel在AAO2018提出的更多工作shown a reduction in the risk of myopic maculopathy of 40% for each 1D reduction in myopia. (请查看有关“为什么1D重要”的博客文章，以获取更多信息）。
UNSW和BHVI的Divya Jagadeesh及其同事在基线和12个月后评估了28个近视儿童的56眼的眼底图像。他们使用半自动化分析发现了一个多因素模型，包括Fovea-tos-disc距离，圆盘倾斜，颞新月，与椎间盘的血管角度和眼底底部缝线，可以占轴向长度方差的63％。
The clinical relevance? In future, perhaps the work of these clever people will lead to development of a computerised fundus image analysis which can predict myopia progression to guide our interventions, or even to ‘measure’ axial length from fundus features.
Yee Ling Wong and colleagues in Singapore examined the 6 year incidence of myopic macular degeneration (MMD) in more than 6,000 adults over 40 years of age, showing a low incidence of MMD (1.7%) and relatively low progression (17.3%) in those with existing MMD. More severe MMD, as graded by the META-PM system, was at greater risk of progression. Fundus tesselation at baseline was the strongest predictor of future MMD. Older age, higher myopia and longer axial length were associated with incidence (new onset) of MMD, while age wasn’t a factor in likelihood of MMD progression - myopia and axial length were.
这些数字似乎很低，但影响较大。温和的MMD会影响最佳校正的视力和功能，同时发现严重的MMD会影响阅读，流动性和情感质量分数。
Just as we’re diligent to avoid the disaster of end stage glaucoma with early intervention, this is more indication of the importance of early intervention in progressive childhood and high adult myopia to avoid the disaster of severe MMD.
Seang-Mei看到，Zhi-dah SOH及其同事比较了芬兰和新加坡儿童的三年近视进展率。分析了低近视儿童（-0.50至-3.00）的匹配数据集，并具有有趣的结果。
Finish and Singaporean myopes aged 9-13 years at baseline had similar amounts of progression during the study, around -1.50D. Younger Singaporean children, aged 7-8 years, progressed -2.5D in three years. These results indicate that the younger age is related to both duration and speed of progression, and being a low myope at 7-8 is a risk factor for significant amounts of progression.
父母对近工作和每天室外时间的调查表明；
- Near work: Finland = 1.8 hours, Singapore = 3.5 hours
- Outdoor time: Finland = 3.5 hours, Singapore = 0.5 hours
当它们的近视进展相同时，我们可以从这些视觉环境统计数据中解释什么？另一个会议表明，我们不能完全注销户外时间对近视进展的影响；人们同意，户外时间对延迟近视发作有重大影响，但是尽管有一些证据，但仍有猜想。芬兰 - 辛格拉尔的比较可能表明，尽管近视毫无疑问非常复杂，但它的某些因素是全球性的。
中国眼动锻炼不会影响近视的进展。现在，阅读最后一句话，您可能会嘲笑和呕吐，甚至翻了个白眼（就像数百万中国儿童每天都在做），但这在中国是一个公共卫生问题。作为抽象状态；“每天的眼睛锻炼按摩周围针灸压力点已成为中国在学校的国家视觉护理政策的一部分，大约50年了”。由于持续的信念会削弱眼睛，因此儿童遭受了未矫正的近视，这也是一个真正的问题。因此，这是一项需要完成的研究。在21个月后跟进后，几乎有900名“锻炼者”和“非锻炼者”在近视进展或戴眼镜的频率上没有差异。
拉曼·古普塔（Raman Gupta）（下图）研究了通过测量模拟的单眼和双眼条件下的适应性滞后，稳定性和视力质量来促成近视发展的因素。他及其同事发现，折射状态在更近的距离时不那么稳定，所有儿童在20-33厘米的阅读距离时表现出适应性的滞后，典型的即时消息传递文本大小是可以从模拟显示器（模拟显示器）中解析的最小文本大小的两倍，，这些大小是模拟显示器的最小文本大小，，这些文本大小是两倍即使存在滞后。这意味着眼睛没有理由可以容纳更多以减少滞后，因为这样做不会显着提高图像的清晰度 - 换句话说，眼睛，可能像许多生物系统一样有效（或懒惰！）。这项工作并不能证明屏幕是造成近视发育的一个因素，但是它确实增加了知识，即使用屏幕会产生光学环境的类型，即高局部散热器，被怀疑是对眼睛生长的刺激。
Of particular interest is that they found the accommodation response was less accurate at around 2-3D of stimulus than at higher or lower stimulus. As objects are brought closer (from a distance), the accommodation response becomes less accurate at around 50 to 33cm, but regains accuracy at distances closer than 33cm. It raises more questions!
关于凯特
凯特·吉福德博士is a clinical optometrist, researcher, peer educator and professional leader from Brisbane, Australia, and a co-founder of Myopia Profile.
关于保罗
Dr Paul Gifford是研究科学家和industry innovator based in Brisbane, Australia, and co-founder of Myopia Profile.
