Axial changes and long-term myopia progression with orthokeratology: A risk-stratification study

Area of Science:

• Ophthalmology
• Optometry
• Pediatric Eye Care

Background:

• Orthokeratology is a myopia control method using rigid gas permeable lenses worn overnight.
• Understanding long-term outcomes and predictive factors for myopia progression in children is crucial for effective management.

Purpose of the Study:

• To analyze long-term changes in axial length and anterior segment parameters in children undergoing orthokeratology.
• To identify indicators for predicting 5-year myopia progression risk.

Main Methods:

• Retrospective study of 61 children with 5-year follow-up after orthokeratology lens fitting.
• Stratification into slow (<1 mm/5yr) and rapid (≥1 mm/5yr) axial length elongation groups.
• Monitoring of axial length, lens thickness, anterior chamber depth, and central corneal thickness; statistical analysis including correlation and ROC curves.

Main Results:

• Early axial length elongation (ΔAL₁ to ΔAL₄) strongly correlated with 5-year progression (ΔAL₅).
• Axial elongation cutoffs of 0.155 mm at year 1 (AUC=0.860) and 0.480 mm at year 3 (AUC=0.907) predicted rapid progression.
• Significant time-group interactions observed in axial length, anterior chamber depth, lens thickness, and central corneal thickness.

Conclusions:

• Early and mid-term axial length changes are significant predictors of long-term myopia progression with orthokeratology.
• Axial elongation thresholds at 1 and 3 years allow for early identification of children at high risk for rapid myopia progression.