Dados do Trabalho

Título

PERSPECTIVAS ATUAIS NO CONTROLE DA MIOPIA EM CRIANÇAS E PRE-ADOLESCENTES: UMA REVISAO COMPARATIVA DE ABORDAGENS OTICAS E FARMACOLOGICAS

Resumo

INTRODUÇÃO
A miopia é um distúrbio ocular que afeta 34% da população global. Existem inúmeras abordagens óticas e farmacológicas usadas para retardar a sua progressão, como: Ortoceratologia (Ortho-K), lentes de desfocagem incorporadas de múltiplos segmentos (DIMS), de foco estendido (EDOF), MiSight e atropina 0,01% (ATP). Estima-se que até 2050, metade da população seja míope. Por isso, medidas para controlar a miopia em crianças e pré-adolescentes de 6 a 14 anos devem ser executadas para reduzir sua prevalência e o risco de desenvolver patologias associadas.
METODOLOGIA
Trata-se de uma revisão literária conduzida a partir de artigos indexados na base de dados Pubmed, utilizando os descritores: “myopia progression”, “lenses”, “treatment”, “child”, conectados pelo operador booleano “AND”, resultando em 141 artigos. A escala PRISMA foi usada na seleção com intuito de melhorar esta revisão, onde foram selecionados 38 artigos entre 2019 e 2024. 
REVISÃO SISTEMATIZADA
Estudos mostram que as lentes EDOF e MiSight retardam o avanço da miopia. A EDOF gerou uma lentificação da progressão da miopia, em 32% para o equivalente esférico (SE) e 25% para o alongamento axial (AL), enquanto a MiSight retardou em 59% para SE e 52% para AL. Ambas foram utilizadas na forma descartável, modalidade mais indicada para crianças, evitando efeitos adversos causados por limpeza e armazenamento. A lente DIMS controla a progressão da miopia através de desfocagem e favoreceu na lentificação do AL (62%) e na redução da progressão miópica (52%), além de uma maior eficácia quando combinada com a ATP.
A Ortho-K emprega lentes de contato permeáveis ao O2, deve ser utilizada no período noturno para que haja o remodelamento do epitélio da córnea, correção do erro refrativo e lentificação do AL. É indicado uso contínuo, pois sua interrupção gera uma reversão do formato da córnea em 2 a 4 semanas. Sua combinação com ATP em doses baixas demonstrou mais efetividade, se comparada ao uso isolado. Além disso, o controle da miopia foi melhor através da Ortho-K em crianças com idade superior a 11 anos, porém, em crianças com idade inferior a 10 anos o controle isolado de ATP foi mais eficaz.
CONCLUSÃO
A prevalência da miopia tende a aumentar, portanto, é fundamental que estratégias para sua prevenção e controle sejam implementadas para reduzir o impacto na saúde ocular e melhorar a qualidade de vida. Ademais, deve-se considerar a idade na escolha da abordagem terapêutica para obter um melhor resultado.

Referências Bibliográficas

REFERÊNCIAS BIBLIOGRÁFICAS
Sankaridurg P, Bakaraju RC, Naduvilath T, Chen X, Weng R, Tilia D, et al. Myopia control with novel central and peripheral plus contact lenses and extended depth of focus contact lenses: 2 year results from a randomised clinical trial. Ophthalmic and Physiological Optics [Internet]. 2019 Jun 10;39(4):294–307. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/opo.12621

Álvarez-Peregrina C, Miguel Ángel Sánchez-Tena, Martínez-Pérez C, César Villa-Collar, Montero-Torrejon A, López-Muñoz A, et al. Clinical Evaluation of MyoCare in Europe (CEME): study protocol for a prospective, multicenter, randomized, double-blinded, and controlled clinical trial. Trials. 2023 Oct 17;24(1).

Chamberlain P, Peixoto-de-Matos SC, Logan NS, Ngo C, Jones D, Young G. A 3-year Randomized Clinical Trial of MiSight Lenses for Myopia Control. Optometry and Vision Science [Internet]. 2019 Aug;96(8):556–67. Available from: https://journals.lww.com/optvissci/fulltext/2019/08000/a_3_year_randomized_clinical_trial_of_misight.3.aspx

Weng R, Lan W, Bakaraju RC, Conrad F, Naduvilath T, Yang Z, et al. Efficacy of contact lenses for myopia control: Insights from a randomised, contralateral study design. Ophthalmic and Physiological Optics. 2022 Aug 25;42(6):1253–63.

Walline JJ, Walker MK, Mutti DO, Jones-Jordan LA, Sinnott LT, Giannoni AG, et al. Effect of High Add Power, Medium Add Power, or Single-Vision Contact Lenses on Myopia Progression in Children. JAMA. 2020 Aug 11;324(6):571.

Lin W, Li N, Gu T, Tang C, Liu G, Du B, et al. The treatment zone size and its decentration influence axial elongation in children with orthokeratology treatment. BMC Ophthalmology. 2021 Oct 12;21(1).

Chamberlain P, Lazon de la Jara P, Arumugam B, Bullimore MA. Axial length targets for myopia control. Ophthalmic and Physiological Optics. 2021 May;41(3):523–31.

Cheng X, Xu J, Brennan NA. Accommodation and its role in myopia progression and control with soft contact lenses. Ophthalmic and Physiological Optics. 2019 Apr 17;39(3):162–71.

Yang Y, Cheung SW, Cho P, Vincent SJ. Comparison between estimated and measured myopia progression in Hong Kong children without myopia control intervention. Ophthalmic and Physiological Optics. 2021 Oct;41(6):1363–70.

Rappon J, Chung C, Young G, Hunt C, Neitz J, Neitz M, et al. Control of myopia using diffusion optics spectacle lenses: 12-month results of a randomised controlled, efficacy and safety study (CYPRESS). British Journal of Ophthalmology [Internet]. 2022 Sep 1 [cited 2023 Jan 24]; Available from: https://bjo.bmj.com/content/early/2022/12/08/bjo-2021-321005.abstract

Bao J, Huang Y, Li X, Yang A, Zhou F, Wu J, et al. Spectacle Lenses With Aspherical Lenslets for Myopia Control vs Single-Vision Spectacle Lenses. JAMA Ophthalmology. 2022 May 1;140(5):472.

Lam CSY, Tang WC, Tse DY, Lee RPK, Chun RKM, Hasegawa K, et al. Defocus Incorporated Multiple Segments (DIMS) spectacle lenses slow myopia progression: a 2-year randomised clinical trial. British Journal of Ophthalmology. 2019 May 29;104(3):bjophthalmol-2018-313739.

Chen R, Yu J, Lipson M, Cheema AA, Chen Y, Lian H, et al. Comparison of four different orthokeratology lenses in controlling myopia progression. Contact Lens & Anterior Eye: The Journal of the British Contact Lens Association [Internet]. 2020 Feb 1;43(1):78–83. Available from: https://pubmed.ncbi.nlm.nih.gov/31812507/

Huang Z, Chen XF, He T, Tang Y, Du CX. Synergistic effects of defocus-incorporated multiple segments and atropine in slowing the progression of myopia. Scientific Reports [Internet]. 2022 Dec 24 [cited 2023 Feb 16];12(1):22311. Available from: https://www.nature.com/articles/s41598-022-25599-z

Zhao Q, Hao Q. Comparison of the Clinical Efficacies of 0.01% Atropine and Orthokeratology in Controlling the Progression of Myopia in Children. Ophthalmic Epidemiology. 2021 Jan 20;28(5):376–82.

Choi KY, Chun RKM, Tang WC, To CH, Lam CS, Chan HH. Evaluation of an Optical Defocus Treatment for Myopia Progression Among Schoolchildren During the COVID-19 Pandemic. JAMA Network Open [Internet]. 2022 Jan 14 [cited 2022 Feb 8];5(1):e2143781–1. Available from: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2788118

Huang Y, Li X, Ding C, Chen Y, Chen H, Bao J. Orthokeratology reshapes eyes to be less prolate and more symmetric. Contact Lens and Anterior Eye. 2021 Nov;101532.

Woods J, Jones D, Jones L, Jones S, Hunt C, Chamberlain P, et al. Ocular health of children wearing daily disposable contact lenses over a 6-year period. Contact Lens and Anterior Eye. 2021 Feb;101391.

Jakobsen TM, Møller F. Control of myopia using orthokeratology lenses in Scandinavian children aged 6 to 12 years. Eighteen‐month data from the Danish Randomized Study: Clinical study Of Near‐sightedness; TReatment with Orthokeratology Lenses (CONTROL study). Acta Ophthalmologica. 2021 Jul 7;100(2):175–82.

Lin W, Gu T, Bi H, Du B, Zhang B, Wei R. The treatment zone decentration and corneal refractive profile changes in children undergoing orthokeratology treatment. BMC Ophthalmology. 2022 Apr 18;22(1).

Kim J, Lim DH, Han SH, Chung TY. Predictive factors associated with axial length growth and myopia progression in orthokeratology. Kobashi H, editor. PLOS ONE. 2019 Jun 12;14(6):e0218140.

Yuval C, Otzem C, Laura BS, Shirel R, Dana GN, Atalia W, et al. Evaluating the Effect of a Myopia Control Spectacle Lens Among Children in Israel: 12-Month Results. American Journal of Ophthalmology [Internet]. 2023 Sep 9; Available from: https://www.sciencedirect.com/science/article/pii/S0002939423003513?via%3Dihub

Jones JH, Mutti DO, Jones-Jordan LA, Walline JJ. Effect of Combining 0.01% Atropine with Soft Multifocal Contact Lenses on Myopia Progression in Children. Optometry and Vision Science. 2022 Feb 25;99(5):434–42.

Nakamura Y, Hieda O, Yokota I, Teramukai S, Sotozono C, Kinoshita S. Comparison of myopia progression between children wearing three types of orthokeratology lenses and children wearing single-vision spectacles. Japanese Journal of Ophthalmology. 2021 Jul 22;65(5):632–43.

Bao J, Yang A, Huang Y, Li X, Pan Y, Ding C, et al. One-year myopia control efficacy of spectacle lenses with aspherical lenslets. British Journal of Ophthalmology [Internet]. 2021 Apr 2;106(8). Available from: https://bjo.bmj.com/content/early/2021/04/01/bjophthalmol-2020-318367#ref-13

Chen R, Chen Y, Lipson M, Kang P, Lian H, Zhao Y, et al. The Effect of Treatment Zone Decentration on Myopic Progression during Or-thokeratology. Current Eye Research. 2020 Feb 11;45(5):645–51.

Huang Y, Li X, Wu J, Huo J, Zhou F, Zhang J, et al. Effect of spectacle lenses with aspherical lenslets on choroidal thickness in myopic children: a 2-year randomised clinical trial. British Journal of Ophthalmology [Internet]. 2022 Sep 27; Available from: https://bjo.bmj.com/content/early/2022/09/27/bjo-2022-321815

Li Y, Fu Y, Wang K, Liu Z, Shi X, Zhao M. Evaluating the myopia progression control efficacy of defocus incorporated multiple segments (DIMS) lenses and Apollo progressive addition spectacle lenses (PALs) in 6- to 12-year-old children: study protocol for a prospective, multicenter, randomized controlled trial. Trials. 2020 Mar 19;21(1).

Li Z, Hu Y, Cui D, Long W, He M, Yang X. Change in subfoveal choroidal thickness secondary to orthokeratology and its cessation: a predictor for the change in axial length. Acta Ophthalmologica. 2018 Oct 4;97(3): e454–9.

Chen J, Zhuo R, Chen J, Yang A, Lim EP, Bao J, et al. Spectacle lenses with slightly aspherical lenslets for myopia control: clinical trial design and baseline data. BMC Ophthalmology. 2022 Aug 16;22(1).

Li X, Huang Y, Zhang J, Ding C, Chen Y, Chen H, et al. Treatment zone decentration promotes retinal reshaping in Chinese myopic children wearing orthokeratology lenses. Ophthalmic and Physiological Optics. 2022 May 22;42(5):1124–32.

Fu L, Jiang Y, Lian H, Lou J, Chen R, Li Z, et al. The corneal biomechanical differences after wearing orthokeratology lenses and multifocal soft lenses in children: A self-control study. Contact lens & anterior eye/Contact lens and anterior eye. 2023 Nov 1;102089–9.

Lopes-Ferreira D, Ruiz-Pomeda A, Peréz-Sanchéz B, Queirós A, Villa-Collar C. Ocular and corneal aberrations changes in controlled randomized clinical trial MiSight® Assessment Study Spain (MASS). BMC Ophthalmology. 2021 Mar 1;21(1).

Jakobsen TM, Søndergaard AP, Møller F. Peripheral refraction, relative peripheral refraction, and axial growth: 18‐month data from the randomised study—Clinical study Of Near‐sightedness; TReatment with Orthokeratology Lenses (CONTROL study). Acta Ophthalmologica. 2022 Aug 8;101(1).

HUNG LL, LIAO LL, CHEN HJ, LIN HL, CHANG LC. Factors Associated With Follow-Up Visits in Parents With Myopic Children Wearing Orthokeratology Lens. Journal of Nursing Research. 2022 Sep 6;Publish Ahead of Print.

Huang Y, Zhang Jiali, Yin Z, Yang A, Spiegel D, Björn Drobe, et al. Effects of Spectacle Lenses With Aspherical Lenslets on Peripheral Eye Length and Peripheral Refraction in Myopic Children: A 2-Year Randomized Clinical Trial. Translational Vision Science & Technology. 2023 Nov 13;12(11):15–5.

Zhang HY, Lam CSY, Tang WC, Leung M, To CH. Defocus Incorporated Multiple Segments Spectacle Lenses Changed the Relative Peripheral Refraction: A 2-Year Randomized Clinical Trial. Investigative Opthalmology & Visual Science. 2020 May 27;61(5):53.

Lau JK, Wan K, Cho P. Orthokeratology lenses with increased compression factor (OKIC): A 2-year longitudinal clinical trial for myopia control. Contact Lens and Anterior Eye. 2022 Aug;101745.