Defocus incorporated multiple segments (DIMS) spectacle lenses increase the choroidal thickness: a two-year randomized clinical trial

Rachel Ka Man Chun; Hanyu Zhang; Zhengji Liu; Dennis Yan Yin Tse; Yongjin Zhou; Carly Siu Yin Lam; Chi Ho To

doi:10.1186/s40662-023-00356-z

Defocus incorporated multiple segments (DIMS) spectacle lenses increase the choroidal thickness: a two-year randomized clinical trial

Eye Vis (Lond). 2023 Sep 15;10(1):39. doi: 10.1186/s40662-023-00356-z.

Authors

Rachel Ka Man Chun^{1

2

3}, Hanyu Zhang⁴, Zhengji Liu⁵, Dennis Yan Yin Tse^{5

6

7}, Yongjin Zhou^{6

8}, Carly Siu Yin Lam^{5

6

7}, Chi Ho To^{5

6

7}

Affiliations

¹ Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China. rachel.chun@polyu.edu.hk.
² Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong, China. rachel.chun@polyu.edu.hk.
³ Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Shatin, Hong Kong, China. rachel.chun@polyu.edu.hk.
⁴ School of Medicine, Nankai University, Tianjin, China.
⁵ Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China.
⁶ Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong, China.
⁷ Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Shatin, Hong Kong, China.
⁸ School of Biomedical Engineering, Department of Medical Electronics, Shenzhen University, Shenzhen, China.

Abstract

Background: Myopia control interventions, such as defocus incorporated multiple segments (DIMS) spectacle lenses, have been adopted in school-aged children to reduce the prevalence of myopia and its complications. This study aimed to investigate the effect of DIMS spectacle lenses on subfoveal choroidal thickness (SfChT) over a period of two years, as the choroidal response to myopic control is a crucial factor in exploring its potential effect on predicting myopia progression.

Methods: This study involved a secondary analysis of our previous randomized clinical trial. Myopic school-aged children aged 8-13 years were recruited in a two-year study investigating the effect of DIMS spectacle lenses on myopia progression. The treated group received DIMS spectacle lenses (n = 78), while the control group was treated with a pair of single vision (SV) spectacle lenses (n = 80). SfChT was monitored at 1 week, 1, 3, 6, 12, 18 and 24 months post lens wear using spectral-domain optical coherence tomography and a custom made auto-segmentation algorithm utilizing convolutional neural networks.

Results: SfChT increased significantly after one week of DIMS spectacle lens wear compared to those wearing SV spectacle lenses (adjusted mean change relative to baseline ± SEM at one week; DIMS vs. SV, 6.75 ± 1.52 µm vs. - 3.17 ± 1.48 µm; P < 0.0001, general linear model). The thickness of choroid increased to 13.64 ± 2.62 µm after 12 months of DIMS lens wear while the choroid thinned in SV group (- 9.46 ± 2.55 µm). Choroidal changes demonstrated a significant negative association with axial elongation over two years in both the DIMS and SV groups. Choroidal change at three months significantly predicted the changes in AL at 12 months after controlling the effect of age and gender.

Conclusions: Our study demonstrated a significant choroidal thickening in response to myopic defocus incorporated in a spectacle lens after one week of lens wear, sustained over the two-year study period. The results suggested that choroidal changes at three months may help predict changes in axial length after one year. Trial registration ClinicalTrials.gov. Myopia control with the multi-segment lens. NCT02206217. Registered 29 July 2014, https://clinicaltrials.gov/ct2/show/study/NCT02206217.

Keywords: Choroidal thickness; DIMS; Myopia; Optical defocus.

Associated data

ClinicalTrials.gov/NCT02206217

Abstract

Associated data

Grants and funding