The Effects of Repeated Low-Level Red-Light Therapy on the Structure and Vasculature of the Choroid and Retina in Children with Premyopia.

Children Choroid Foveal thickness Myopic shift Optical coherence tomography angiography Premyopia Repeated low-level red light Retina vasculature

Journal

Ophthalmology and therapy
ISSN: 2193-8245
Titre abrégé: Ophthalmol Ther
Pays: England
ID NLM: 101634502

Informations de publication

Date de publication:
10 Jan 2024
Historique:
received: 17 11 2023
accepted: 13 12 2023
medline: 10 1 2024
pubmed: 10 1 2024
entrez: 10 1 2024
Statut: aheadofprint

Résumé

The purpose of this study was to explore the effects of repeated low-level red-light (RLRL) therapy on the structure and vasculature of the choroid and retina in Chinese children with premyopia. This study was a single-center randomized clinical trial. A total of 94 children with premyopia (- 0.50 D < spherical equivalent [SE] ≤  + 0.75 D) were randomly assigned to either the RLRL therapy or control group. Follow-up visits were planned at 1, 3, 6, 9, and 12 months. Optical coherence biometry was used to measure axial length (AL) and anterior segment parameters. Choroidal thickness (CT), retinal thickness (RT), superficial retinal vascular density (SRVD), deep retinal vascular density (DRVD), choriocapillaris perfusion area (CCPA), and choroidal vessel volume (CVV) were measured by optical coherence tomography angiography, centered on the foveal, parafoveal (ParaF), and perifoveal (PeriF) regions. The thickening of the choroid was observed across the entire macular region at different time points in the RLRL therapy group. Relative to the baseline measurement, foveal CT significantly increased at the 1-month follow-up with RLRL therapy, with a mean (± standard deviation [SD]) adjusted change of 16.96 ± 19.87 μm. The greatest magnitude of foveal CT changes was observed at the 3-month visit (an increase of 19.58 ± 20.59 μm), with a slight reduction in the extent of foveal CT increase at the 6-month visit (an increase of 15.85 ± 23.77 μm). The second greatest CT increase was observed at the 9-month visit (an increase of 19.57 ± 35.51 μm), after which the extent of CT increase gradually decreased until the end of the study at the 12-month visit (an increase of 11.99 ± 32.66 μm). We also observed a significant increase in CT in the ParaF and PeriF areas in the RLRL group over 12 months. In contrast, CT across the entire macular region in the control group significantly decreased throughout the follow-up visits (all P < 0.05). Regarding the vascular parameters of the choroid, significant increases in CVV were observed primarily in the ParaF and PeriF regions of the choroid in the RLRL group. In comparison, the control group exhibited decreases in CVV throughout the entire area. Furthermore, notable elevations in CCPA were detected in the PeriF area of the choroid in the RLRL group during the 1-month (an increase of 0.40 mm Our study demonstrated a significant increase in CT and flow in the RLRL-treated eyes throughout the 12-months of the study. Combined with its reduction in spherical equivalent progression and axial elongation, RLRL could be used as an effective therapy for preventing progression in premyopes. ChiCTR2200062028.

Identifiants

DOI: 10.1007/s40123-023-00875-x PMID: 38198054
pubmed: 38198054
doi: 10.1007/s40123-023-00875-x
pii: 10.1007/s40123-023-00875-x
doi:

Types de publication

Journal Article

Langues

eng

Subventions

Organisme : National Natural Science Foundation of China
ID : 82070929.

Informations de copyright

© 2024. The Author(s).

Références

Teasdale T, Goldschmidt E. Myopia and its relationship to education, intelligence and height. Preliminary results from an on-going study of Danish draftees. Acta Ophthalmol. 1988;185:41–3. https://doi.org/10.1111/j.1755-3768.1988.tb02660.x .
doi: 10.1111/j.1755-3768.1988.tb02660.x
Fledelius H. Myopia prevalence in Scandinavia. A survey, with emphasis on factors of relevance for epidemiological refraction studies in general. Acta Ophthalmol. 1988;185:44–50. https://doi.org/10.1111/j.1755-3768.1988.tb02661.x .
doi: 10.1111/j.1755-3768.1988.tb02661.x
Fredrick D. Myopia. BMJ. 2002;324(7347):1195–9. https://doi.org/10.1136/bmj.324.7347.1195 .
doi: 10.1136/bmj.324.7347.1195 pubmed: 12016188 pmcid: 1123161
Liang C, Yen E, Su J, et al. Impact of family history of high myopia on level and onset of myopia. Investig Ophthalmol Vis Sci. 2004;45(10):3446–52. https://doi.org/10.1167/iovs.03-1058 .
doi: 10.1167/iovs.03-1058
Hsu W, Cheng C, Liu J, et al. Prevalence and causes of visual impairment in an elderly Chinese population in Taiwan: the Shihpai Eye Study. Ophthalmology. 2004;111(1):62–9. https://doi.org/10.1016/j.ophtha.2003.05.011 .
doi: 10.1016/j.ophtha.2003.05.011 pubmed: 14711715
Iwase A, Araie M, Tomidokoro A, et al. Prevalence and causes of low vision and blindness in a Japanese adult population: the Tajimi Study. Ophthalmology. 2006;113(8):1354–62. https://doi.org/10.1016/j.ophtha.2006.04.022 .
doi: 10.1016/j.ophtha.2006.04.022 pubmed: 16877074
Xu L, Wang Y, Li Y, et al. Causes of blindness and visual impairment in urban and rural areas in Beijing: the Beijing Eye Study. Ophthalmology. 2006;113(7):1134.e1131-1111. https://doi.org/10.1016/j.ophtha.2006.01.035 .
doi: 10.1016/j.ophtha.2006.01.035
Drobe B, de Saint-André R. The pre-myopic syndrome. Ophthalmic Physiol Optics. 1995;15(5):375–8. https://doi.org/10.1046/j.1475-1313.1995.9500075o.x .
doi: 10.1046/j.1475-1313.1995.9500075o.x
Dirani M, Tong L, Gazzard G, et al. Outdoor activity and myopia in Singapore teenage children. Br J Ophthalmol. 2009;93(8):997–1000. https://doi.org/10.1136/bjo.2008.150979 .
doi: 10.1136/bjo.2008.150979 pubmed: 19211608
Guggenheim J, Pong-Wong R, Haley C, et al. Correlations in refractive errors between siblings in the Singapore cohort study of risk factors for myopia. Br J Ophthalmol. 2007;91(6):781–4. https://doi.org/10.1136/bjo.2006.107441 .
doi: 10.1136/bjo.2006.107441 pubmed: 17135339
Jones L, Sinnott L, Mutti D, et al. Parental history of myopia, sports and outdoor activities, and future myopia. Investig Ophthalmol Vis Sci. 2007;48(8):3524–32. https://doi.org/10.1167/iovs.06-1118 .
doi: 10.1167/iovs.06-1118
Mutti D, Mitchell G, Moeschberger M, et al. Parental myopia, near work, school achievement, and children’s refractive error. Investig Ophthalmol Vis Sci. 2002;43(12):3633–40.
Rose K, Morgan I, Ip J, et al. Outdoor activity reduces the prevalence of myopia in children. Ophthalmology. 2008;115(8):1279–85. https://doi.org/10.1016/j.ophtha.2007.12.019 .
doi: 10.1016/j.ophtha.2007.12.019 pubmed: 18294691
Saw S, Chua W, Hong C, et al. Nearwork in early-onset myopia. Invest Ophthalmol Vis Sci. 2002;43(2):332–9.
pubmed: 11818374
Xiong F, Mao T, Liao H, et al. Orthokeratology and low-intensity laser therapy for slowing the progression of myopia in children. BioMed Res Int. 2021;2021:8915867. https://doi.org/10.1155/2021/8915867 .
doi: 10.1155/2021/8915867 pubmed: 33575355 pmcid: 7861936
Jiang Y, Zhu Z, Tan X, et al. Effect of repeated low-level red-light therapy for myopia control in children: a multicenter randomized controlled trial. Ophthalmology. 2022;129(5):509–19. https://doi.org/10.1016/j.ophtha.2021.11.023 .
doi: 10.1016/j.ophtha.2021.11.023 pubmed: 34863776
Wu H, Chen W, Zhao F, et al. Scleral hypoxia is a target for myopia control. Proc Natl Acad Sci USA. 2018;115(30):E7091–100. https://doi.org/10.1073/pnas.1721443115 .
doi: 10.1073/pnas.1721443115 pubmed: 29987045 pmcid: 6064999
Metlapally R, Wildsoet C. Scleral mechanisms underlying ocular growth and myopia. Prog Mol Biol Transl Sci. 2015;134:241–8. https://doi.org/10.1016/bs.pmbts.2015.05.005 .
doi: 10.1016/bs.pmbts.2015.05.005 pubmed: 26310158 pmcid: 4687967
Xiong R, Zhu Z, Jiang Y, et al. Longitudinal changes and predictive value of choroidal thickness for myopia control after repeated low-level red-light therapy. Ophthalmology. 2023;130(3):286–96. https://doi.org/10.1016/j.ophtha.2022.10.002 .
doi: 10.1016/j.ophtha.2022.10.002 pubmed: 36240954
Nickla D, Wallman J. The multifunctional choroid. Prog Retin Eye Res. 2010;29(2):144–68. https://doi.org/10.1016/j.preteyeres.2009.12.002 .
doi: 10.1016/j.preteyeres.2009.12.002 pubmed: 20044062
Jin P, Zou H, Zhu J, et al. Choroidal and retinal thickness in children with different refractive status measured by swept-source optical coherence tomography. Am J Ophthalmol. 2016;168:164–76. https://doi.org/10.1016/j.ajo.2016.05.008 .
doi: 10.1016/j.ajo.2016.05.008 pubmed: 27189931
Vincent S, Collins M, Read S, et al. Retinal and choroidal thickness in myopic anisometropia. Invest Ophthalmol Vis Sci. 2013;54(4):2445–56. https://doi.org/10.1167/iovs.12-11434 .
doi: 10.1167/iovs.12-11434 pubmed: 23482471
Wei W, Xu L, Jonas J, et al. Subfoveal choroidal thickness: the Beijing eye study. Ophthalmology. 2013;120(1):175–80. https://doi.org/10.1016/j.ophtha.2012.07.048 .
doi: 10.1016/j.ophtha.2012.07.048 pubmed: 23009895
Read S, Collins M, Vincent S, et al. Choroidal thickness in myopic and nonmyopic children assessed with enhanced depth imaging optical coherence tomography. Invest Ophthalmol Vis Sci. 2013;54(12):7578–86. https://doi.org/10.1167/iovs.13-12772 .
doi: 10.1167/iovs.13-12772 pubmed: 24176903
Tan C, Cheong K. Macular choroidal thicknesses in healthy adults–relationship with ocular and demographic factors. Invest Ophthalmol Vis Sci. 2014;55(10):6452–8. https://doi.org/10.1167/iovs.13-13771 .
doi: 10.1167/iovs.13-13771 pubmed: 25228543
Tian L, Cao K, Ma D, et al. Investigation of the efficacy and safety of 650 nm low-level red light for myopia control in children: a randomized controlled Trial. Ophthalmol Ther. 2022;11(6):2259–70. https://doi.org/10.1007/s40123-022-00585-w .
doi: 10.1007/s40123-022-00585-w pubmed: 36208391 pmcid: 9587157
Chen H, Wang W, Liao Y, et al. Low-intensity red-light therapy in slowing myopic progression and the rebound effect after its cessation in Chinese children: a randomized controlled trial. Graefe’s Arch Clin Ophthalmol. 2023;261(2):575–84. https://doi.org/10.1007/s00417-022-05794-4 .
doi: 10.1007/s00417-022-05794-4
Zhou L, Xing C, Qiang W, et al. Low-intensity, long-wavelength red light slows the progression of myopia in children: an Eastern China-based cohort. Ophthalmic Physiol Opt. 2022;42(2):335–44. https://doi.org/10.1111/opo.12939 .
doi: 10.1111/opo.12939 pubmed: 34981548
Jin P, Zou H, Xu X, et al. Longitudinal changes in choroidal and retinal thicknesses in children with myopic shift. Retina. 2019;39(6):1091–9. https://doi.org/10.1097/iae.0000000000002090 .
doi: 10.1097/iae.0000000000002090 pubmed: 29517579
Charman WN, Radhakrishnan H. Peripheral refraction and the development of refractive error: a review. Ophthalmic Physiol Opt. 2010;30(4):321–38. https://doi.org/10.1111/j.1475-1313.2010.00746.x .
doi: 10.1111/j.1475-1313.2010.00746.x pubmed: 20629956
Wallman J, Wildsoet C, Xu A, et al. Moving the retina: choroidal modulation of refractive state. Vision Res. 1995;35(1):37–50. https://doi.org/10.1016/0042-6989(94)e0049-q .
doi: 10.1016/0042-6989(94)e0049-q pubmed: 7839608
Summers J. The choroid as a sclera growth regulator. Exp Eye Res. 2013;114:120–7. https://doi.org/10.1016/j.exer.2013.03.008 .
doi: 10.1016/j.exer.2013.03.008 pubmed: 23528534 pmcid: 3724760
Zhou X, Zhang S, Zhang G, et al. Increased choroidal blood perfusion can inhibit form deprivation myopia in guinea pigs. Invest Ophthalmol Vis Sci. 2020;61(13):25. https://doi.org/10.1167/iovs.61.13.25 .
doi: 10.1167/iovs.61.13.25 pubmed: 33211066 pmcid: 7683853
Chan C, Yu J, Chen L, et al. Posterior pole retinal thickness measurements by the retinal thickness analyzer in healthy Chinese subjects. Retina. 2006;26(2):176–81. https://doi.org/10.1097/00006982-200602000-00009 .
doi: 10.1097/00006982-200602000-00009 pubmed: 16467674
Luo H, Gazzard G, Fong A, et al. Myopia, axial length, and OCT characteristics of the macula in Singaporean children. Invest Ophthalmol Vis Sci. 2006;47(7):2773–81. https://doi.org/10.1167/iovs.05-1380 .
doi: 10.1167/iovs.05-1380 pubmed: 16799013
Zhao Z, Zhou X, Jiang C, et al. Effects of myopia on different areas and layers of the macula: a Fourier-domain optical coherence tomography study of a Chinese cohort. BMC Ophthalmol. 2015;15:90. https://doi.org/10.1186/s12886-015-0080-5 .
doi: 10.1186/s12886-015-0080-5 pubmed: 26231216 pmcid: 4522115
Zhang Z, He X, Zhu J, et al. Macular measurements using optical coherence tomography in healthy Chinese school age children. Invest Ophthalmol Vis Sci. 2011;52(9):6377–83. https://doi.org/10.1167/iovs.11-7477 .
doi: 10.1167/iovs.11-7477 pubmed: 21743016
Wu P, Chen Y, Chen C, et al. Assessment of macular retinal thickness and volume in normal eyes and highly myopic eyes with third-generation optical coherence tomography. Eye (Lond). 2008;22(4):551–5. https://doi.org/10.1038/sj.eye.6702789 .
doi: 10.1038/sj.eye.6702789 pubmed: 17464309
Fang P, Chung M, Yu H, et al. Prevention of myopia onset with 0.025% atropine in premyopic children. J Ocular Pharmacol Ther. 2010;26(4):341–5. https://doi.org/10.1089/jop.2009.0135 .
doi: 10.1089/jop.2009.0135
Yam J, Zhang X, Zhang Y, et al. Effect of low-concentration atropine eyedrops vs placebo on myopia incidence in children: the LAMP2 randomized clinical trial. JAMA. 2023;329(6):472–81. https://doi.org/10.1001/jama.2022.24162 .
doi: 10.1001/jama.2022.24162 pubmed: 36786791 pmcid: 9929700
He M, Xiang F, Zeng Y, et al. Effect of time spent outdoors at school on the development of myopia among children in china: a randomized clinical trial. Jama J Am Med Assoc. 2015;314(11):1142–8.
doi: 10.1001/jama.2015.10803
Jin J, Hua W, Jiang X, et al. Effect of outdoor activity on myopia onset and progression in school-aged children in northeast China: the Sujiatun eye care study. BMC ophthalmol. 2015;15:73. https://doi.org/10.1186/s12886-015-0052-9 .
doi: 10.1186/s12886-015-0052-9 pubmed: 26152123 pmcid: 4495846
He X, Sankaridurg P, Wang J, et al. Time outdoors in reducing myopia: a school-based cluster randomized trial with objective monitoring of outdoor time and light intensity. Ophthalmology. 2022;129(11):1245–54. https://doi.org/10.1016/j.ophtha.2022.06.024 .
doi: 10.1016/j.ophtha.2022.06.024 pubmed: 35779695

Auteurs

Zhuzhu Liu (Z)

Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.

Ziwen Sun (Z)

Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.

Bei Du (B)

Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.

Huaixue Gou (H)

Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.

Biying Wang (B)

Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.

Zeya Lin (Z)

Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.

Nuo Ren (N)

Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.

Emmanuel Eric Pazo (EE)

Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.

Lin Liu (L)

Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China. liulin_117@126.com.

Ruihua Wei (R)

Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China. rwei@tmu.edu.cn.
ORCID: 0000-0002-9708-0355

Classifications MeSH