Retrospective case-series of a myopia control clinic

Abstract

Background: The prevalence of myopia continues to grow, and there are now a number of optical treatment options available to clinicians. However real world clinical data on their effectiveness is sparse. To promote anti-myopia treatments, a specialist Myopia Control Clinic (MCC) opened as a referral clinic at The University of Auckland, New Zealand in 2010, and this is the first comprehensive audit of the clinical outcomes. Case Series: We present a retrospective case series of 110 patients (aged 4 – 33 years, mean: 12.13 ± 4.58 years, 57% female) who attended the MCC between 2010 and 2014. Of these, 56 underwent orthokeratology (OK), 32 wore dual focus soft contact lenses (DFCL), and 22 received advice only. Baseline myopia, vitreous and axial eye length, previous myopia progression, age, number of myopic parents, and gender were not different between OK and DFCL groups at baseline. However, the advice group were older (p = 0.037) and had less previous myopic progression (p = 0.001). Mean follow-up time was 1.30 ± 0.88 and 1.33 ± 0.80 years in OK and SCL groups respectively (p = 0.989). There was a significant reduction in the annualised myopia progression in both treatment groups (OK: -1.17 ± 0.55 to -0.09 ± 017D/yr, p < 0.001, DFCL: -1.15 ± 0.46 to -0.10 ± 0.23D/yr, p < 0.001). There was no difference between OK and DFCL treatment efficacy (p = 0.763), nor in axial or vitreous chamber length changes following treatment (p = 0.184). Only one adverse event was reported over the 4 year period. Conclusions: Contact lenses, whether OK or DFCL, are an effective strategy for targeting myopia progression in children. As there was no difference in the efficacy of the two methods, there are very few barriers in terms of upskilling, chair time, or capital expenditure, for any practitioner to be actively promoting myopia control treatments to at risk groups.