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Title: Categorisation of myopia progression by change in refractive error and axial elongation and their impact on benefit of myopia control using orthokeratology
Authors: Cho, P 
Cheung, SW 
Boost, MV 
Issue Date: 29-Dec-2020
Source: PLoS one, 29 Dec. 2020, v. 15, no. 12, e0243416
Abstract: Aims: To compare the value of pre-treatment axial elongation (AE) and changes in refractive sphere (M change) for predicting the success in orthokeratology (ortho-k), in order to better identify suitable candidates for myopia control.
Methods: This study further analysed the data of 66 subjects receiving 7-month ortho-k treatment, following a 7-month observation period, during which single-vision spectacles were worn. Rate of myopia progression was determined by AE and M change and subjects categorised as slow, moderate, or rapid progressors based on these changes. Outcomes of myopia control, based on the AE reduction after ortho-k, were classified as ‘ineffectual’, ‘clinically insignificant’, or ‘beneficial’.
Results: Of the 20 subjects, initially categorised as slow by AE and, of whom 95% were similarly categorised by M change, none benefitted from ortho-k. In contrast, of the 22 subjects with moderate AE, 77% and 23% displaying slow and moderate M change, respectively, the majority (73%) benefitted from ortho-k lens wear. The 24 subjects with rapid AE were poorly identified by M change, with only 21% correctly categorised. The vast majority of rapid progressors showed significant benefit after ortho-k.
Conclusion: Progression of AE is a good indicator of subsequent success of ortho-k treatment. Delaying commencement of therapy is prudent for children with slow progression as results indicate that they would be unlikely to benefit from this intervention. As change in refractive error frequently underestimates rapid progression of AE, its value for identifying appropriate candidates for myopia control is poor.
Publisher: Public Library of Science
Journal: PLoS one 
EISSN: 1932-6203
DOI: 10.1371/journal.pone.0243416
Rights: © 2020 Cho et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
The following publication Cho P, Cheung SW, Boost MV (2020) Categorisation of myopia progression by change in refractive error and axial elongation and their impact on benefit of myopia control using orthokeratology. PLoS ONE 15(12): e0243416 is available at
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