AIM:To investigate the effect of peripheral defocus design rigid gas permeable contact lenses(defocus RGPCL)in controlling myopia progression in children aged 6-12 y with high myopia, and to compare the outcomes with traditional single-vision RGPCL and single-vision spectacles.METHODS:This prospective cohort study enrolled children aged 6-12 y with high myopia who visited the Ophthalmology and Optometry Center of Xi'an No.1 Hospital between January 2022 and January 2023. Based on parental preference, participants were divided into three groups: defocused RGPCL group, single-vision RGPCL group, and single-vision spectacles group. The axial length(AL)and cycloplegic spherical equivalent(SE)refraction were compared at baseline, 0.5, 1, 1.5, and 2 y after lens wear. Additionally, AL and SE delay rates were calculated for each group.RESULTS: This study enrolled a total of 90 children with high myopia(180 eyes), with no participants lost to follow-up. Participants were allocated into three groups based on parental preference. Thirty children(60 eyes)were assigned to the peripheral defocus RGPCL group, consisting of 12 boys and 18 girls with a mean age of 9.96±1.56 y; 30 children(60 eyes)to the single-vision RGPCL group, including 15 boys and 15 girls with a mean age of 9.40±1.52 y; and 30 children(60 eyes)to the single-vision spectacles group, with 14 boys and 16 girls and a mean age of 9.80±1.37 y. At 0.5, 1, 1.5, and 2 y lens fitting, AL and SE increased significantly in all three groups(all P<0.05), with the growth rates in the defocused RGPCL group being significantly lower than those in the single-vision RGPCL and single-vision spectacles groups(all P<0.05). At 2 y lens fitting, the AL elongation was 0.22±0.24 mm and the mean SE progression was 0.70±0.70 D in the peripheral defocus RGPCL group; 0.49±0.38 mm and 1.34±0.60 D in the single-vision RGPCL group; and 0.50±0.21 mm and 1.72±0.47 D in the single-vision spectacles group. Using the single-vision spectacles group as the control, the AL delay rate and SE delay rate at 2 y lens fitting were 56.0% and 59.3%, respectively, in the defocused RGPCL group.CONCLUSION:For children with high myopia aged 6-12 y, defocus RGPCLs can effectively and significantly delay AL elongation and SE progression, demonstrating markedly superior control efficacy compared to single-vision RGPCL or single-vision spectacles. Defocused RGPCL can serve as an effective optical intervention for high myopia children.

AIM: To compare the progression of myopia in children wearing orthokeratology lenses combined with low-concentration atropine before and after drug withdrawal, to determine the rebound effect of drug withdrawal in orthokeratology lens wearers, and to analyze its causes based on changes in pupil diameter.METHODS:A prospective case-control study was conducted to collect 80 children with myopia who were treated with orthokeratology lenses combined with 0.01% atropine ophthalmic gel at the Xi'an No.1 Hospital from January to June 2022. One year later, they were divided into a drug withdrawal group(Group A, 40 cases)and a continuous medication group(Group B, 40 cases)based on whether they stopped taking the medication. The progression of myopia before and after drug withdrawal was observed by analyzing changes in axial length(AL)and spherical equivalent(SE)in the group A within 1 a before and after drug withdrawal. The changes in AL, pupil diameter(PD), and SE were compared between the group A and group B within 2 a, and the correlation between PD and AL growth was analyzed.RESULTS:In the group A, the AL increased by 0.17±0.23 and 0.29±0.18 mm at 0.5 and 1 a after drug withdrawal, respectively, which were both greater than before drug withdrawal(t=5.318, 2.983, both P<0.001). There was no statistically significant difference in SE growth between the two time points(P>0.05). There were no statistically significant differences in AL and PD between the group A and group B at baseline, 0.5 and 1 a during combined medication(all P>0.05). At 1.5 a, the AL growth of the group A was greater than that of the group B(0.32±0.27 mm vs 0.26±0.20 mm, t=7.363, P<0.001), and the PD was smaller than that of the group B(3.60±1.25 mm vs 4.12±1.92 mm, t=-7.541, P<0.001). At 2 a, the AL growth of the group A was greater than that of the group B(0.44±0.18 mm vs 0.32±0.14 mm, t=5.709, P<0.001), and the PD was smaller than that of the group B(3.67±1.31 mm vs 4.02±1.67 mm, t=-4.281, P<0.001). Correlation analysis showed a negative correlation between PD and AL growth at 0.5 and 1 a follow-ups over 2 a(R2=-0.156, -0.190, both P<0.001).CONCLUSION: After stopping low-concentration atropine in children wearing orthokeratology lenses, AL increased more rapidly than before drug withdrawal, PD decreased, and SE changed little. Compared with continuous medication, discontinuation of medication led to faster progression of AL with little change in diopter, and the larger the PD during orthokeratology lens wear, the slower the progression of AL.

Objective:To analyze the characteristics of retinal neovascularization and tube diameter and the levels of miR-126 and miR-141-3p in peripheral blood of patients with diabetic retinopathy (DR).Methods:A total of 130 patients with DR Admitted to the Xi′an First Hospital from January 2020 to December 2023 were selected as the study objects (DR group), and 139 patients with type 2 diabetes who did not develop retinopathy during the same period (non-DR group) were selected. The characteristics of retinal neovascularization and tube diameter and the levels of miR-126 and miR-141-3p in peripheral blood were compared between the two groups. The patients with DR were divided into two groups according to whether retinal neovascularization and vascular diameter abnormalities occurred. The levels of miR-126 and miR-141-3p were compared between the two groups. Logistic regression analysis was used to evaluate the relationship between miR-126 and miR-141-3p levels in peripheral blood and retinal neovascularization and vascular diameter abnormalities in DR patients. Receiver operating characteristic (ROC) curve was drawn to examine the predictive efficacy of peripheral blood miR-126 and miR-141-3p levels on retinal neovascularization and tube diameter abnormalities in patients with DR.Results:There were significant differences in retinal neovascularization and vascular diameter between DR And non-DR patients. The retinal features of DR patients were significant, showing that a large number of new blood vessels form in and around the optic disc, spread to the entire retina, and form a fragile network structure, which was easy to be damaged and adhere to the vitreous cortex, and wound not disappear by itself and might invade the vitreous. The vascular diameter varied greatly, partial dilation showed abnormal blood flow, and partial stenosis reflected vascular damage. There was no significant retinal neovascularization in the non-DR group. The levels of miR-126 and miR-141-3p in the DR group were significantly lower than those in the non-DR group (all P<0.05). Among 130 patients with DR, 62 of them had abnormal retinal neovascularization and tube diameter, accounting for 47.69%. The levels of miR-126 and miR-141-3p in peripheral blood of DR patients with retinal neovascularization and vascular diameter abnormalities were lower than those in the non-DR group (all P<0.05). Logistic regression analysis showed that the levels of miR-126 and miR-141-3p in peripheral blood were associated with abnormal retinal neovascularization and tube diameter in DR patients (all P<0.05). ROC curve analysis showed that miR-126 and miR-141-3p had good predictive value for the occurrence of retinal neovascularization and tube diameter abnormalities in patients with DR. Conclusions:Some patients with DR have abnormal characteristics of retinal neovascularization and tube diameter, and peripheral blood miR-126 and miR-141-3p are related to the neovascularization and tube diameter abnormalities in patients with DR.

Objective:To analyze the characteristics of retinal neovascularization and tube diameter and the levels of miR-126 and miR-141-3p in peripheral blood of patients with diabetic retinopathy (DR).Methods:A total of 130 patients with DR Admitted to the Xi′an First Hospital from January 2020 to December 2023 were selected as the study objects (DR group), and 139 patients with type 2 diabetes who did not develop retinopathy during the same period (non-DR group) were selected. The characteristics of retinal neovascularization and tube diameter and the levels of miR-126 and miR-141-3p in peripheral blood were compared between the two groups. The patients with DR were divided into two groups according to whether retinal neovascularization and vascular diameter abnormalities occurred. The levels of miR-126 and miR-141-3p were compared between the two groups. Logistic regression analysis was used to evaluate the relationship between miR-126 and miR-141-3p levels in peripheral blood and retinal neovascularization and vascular diameter abnormalities in DR patients. Receiver operating characteristic (ROC) curve was drawn to examine the predictive efficacy of peripheral blood miR-126 and miR-141-3p levels on retinal neovascularization and tube diameter abnormalities in patients with DR.Results:There were significant differences in retinal neovascularization and vascular diameter between DR And non-DR patients. The retinal features of DR patients were significant, showing that a large number of new blood vessels form in and around the optic disc, spread to the entire retina, and form a fragile network structure, which was easy to be damaged and adhere to the vitreous cortex, and wound not disappear by itself and might invade the vitreous. The vascular diameter varied greatly, partial dilation showed abnormal blood flow, and partial stenosis reflected vascular damage. There was no significant retinal neovascularization in the non-DR group. The levels of miR-126 and miR-141-3p in the DR group were significantly lower than those in the non-DR group (all P<0.05). Among 130 patients with DR, 62 of them had abnormal retinal neovascularization and tube diameter, accounting for 47.69%. The levels of miR-126 and miR-141-3p in peripheral blood of DR patients with retinal neovascularization and vascular diameter abnormalities were lower than those in the non-DR group (all P<0.05). Logistic regression analysis showed that the levels of miR-126 and miR-141-3p in peripheral blood were associated with abnormal retinal neovascularization and tube diameter in DR patients (all P<0.05). ROC curve analysis showed that miR-126 and miR-141-3p had good predictive value for the occurrence of retinal neovascularization and tube diameter abnormalities in patients with DR. Conclusions:Some patients with DR have abnormal characteristics of retinal neovascularization and tube diameter, and peripheral blood miR-126 and miR-141-3p are related to the neovascularization and tube diameter abnormalities in patients with DR.