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Effect of optical myopia-control interventions on peripheral vision

Papadogiannis P1 , Börjeson C1 , Lundström L1
1-KTH Royal Institute Of Technology

Animal studies suggest that the peripheral retina has an important role in the regulation of eye growth. Different optical interventions for myopia control aim to manipulate the peripheral image in order to slow the progression of myopia, but it is not yet known what the peripheral effect of these interventions is compared to each other. This study investigates the similarities and dissimilarities of different optical interventions in their effect on peripheral vision with the aim to better understand their treatment properties.
Peripheral (20° nasal visual field) low-contrast (10%) resolution acuity of 2 myopes was evaluated by a two-alternative forced-choice paradigm with four optical myopia control interventions: a) spectacles with horizontal progressive addition (Perifocal from ArtOptica), b) spectacles with highly aspherical lenslets (Stellest from Essilor), c) spectacles with defocus incorporated multiple segments (MiyoSmart from Hoya), and d) multifocal soft contact lenses (MiSight from Cooper Vision). The peripheral acuity thresholds were compared with those of normal monofocal spectacles (control). All measurements were repeated three times and the average thresholds in logMAR as well as the differences from the control were calculated (intervention threshold minus control threshold).
The differences in thresholds from the control case for subject 1 were a) 0.005 logMAR for Perifocal, b) -0.004 logMAR for Stellest, c) 0.019 logMAR for MiyoSmart and d) 0.232 logMAR for Misight. For subject 2 the differences in thresholds were a) 0.038 logMAR for Perifocal, b) 0.076 logMAR for Stellest, c) 0.085 logMAR for MiyoSmart and d) 0.117 for MiSight.
In both subjects, the MiSight intervention reduced peripheral vision more, followed by MiyoSmart. Thus, we can conclude that although all four interventions have been reported to have similar myopia control efficacy, there is a large difference in how much they reduce the retinal contrast. Furthermore, there is substantial variation on individual level. Knowledge of the contrast reduction caused by the intervention in the individual eye may provide cues on how to optimize the treatment effect. It should also be balanced against safety, since large contrast reductions in the periphery hamper daily tasks involving peripheral vision such as detection, orientation, and locomotion.
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