Professor Dominique Bremond-Gignac is the Head of Ophthalmology at University Hospital Necker-Enfants Malades of Paris Cité University in Paris, France. In this interview, we chatted with her about her experiences of combination treatment; in particular, with prescribing HOYA MiYOSMART spectacle lenses and atropine for children with myopia.
This prospective observational study found that DIMS spectacle lenses, atropine 0.01% and the combination of the two all showed robust efficacy for myopia control in European children. The combination treatment showed slightly better refractive control than the mono-therapies, but axial length growth was similar in all treatment groups.
In this case, we meet a child whose axial length has progressed 0.4mm in one year, even with myopia control treatment. Yet, his refractive error hasn’t changed. What could cause this and what is the best course of action?
What is the relationship between pupil size and myopia management? As the pupil controls the light input to the retina, does pupil size influence myopia risk or the response to myopia treatments? This review covers atropine’s influence on pupil size, the relationship with treatment zone size in orthokeratology, combination treatments and advice on normal outcomes.
Atropine 0.01% combined with orthokeratology slows axial elongation to less than 0.1mm/year over two years in Chinese children aged 6-11 years. This is the equal-longest study on this topic and first to measure potential mechanisms of pupil size and choroidal thickness. The largest effect of the combination occurred in the first 6 months.
Atropine is a treatment for myopia control, but do combination treatments such as with orthokeratology increase the efficacy? Learn about how well it works, which concentration, for whom it works best, side effects, treatment duration and more.
This meta-analysis of 5 studies of 1, 6 and 12 months duration found that slower axial growth is evident when using orthokeratology in conjunction with atropine as a combined therapy compared to orthokeratology alone. A slowing effect of 0.09mm was seen with the combined approach for up to a 12 month follow-up period. Longer data was not available for the meta-analysis.
Contact lens options are ideal for higher myopes. What about when they have moderate astigmatism as well? This case discusses the evidence base for myopia control options which correct for astigmatism, along with patient-specific considerations and whether a combination treatment with atropine is needed.
In this clinical case, the practitioner is considering whether to start a young patient on a monotherapy or go straight to combination treatment. The discussion includes the recent studies on combination treatment and the best approach for utilizing atropine in view of orthokeratology wear.
Myopia control is vital for children with fast myopia progression. What are the key risk factors for faster myopia progression? What clinical findings indicate a more proactive myopia management strategy may be required? This case describes risk factors and evidence-based treatment options for fast myopia progressors.
