Examination of Myopia Progression and Consequences and Mechanism of Soft Multifocal Contact Lens Myopia Control

BLINK2研究的主要目标是用非侵入性方法确定近视进展的相关性 生物标志物的测量(脉络膜厚度和固有的光敏性视网膜神经节细胞介导) 儿童的瞳孔功能)和室外光线暴露。如果多焦点隐形眼镜延缓了 在眨眼研究期间，近视比单眼隐形眼镜减少30%或更多，我们也将回答 关于治疗效果的后果和机制的重要问题，如是否 多焦点隐形眼镜配戴改变调节功能以及治疗益处是否 转瞬即逝。具体地说，我们将调查近视进展是否因多焦而减慢或只是延缓。 配戴隐形眼镜和近视进展是否有反弹，进展率增加， 停用多焦点隐形眼镜后。 我们将通过确定谁是近视儿童来确定谁将从近视控制中受益最大 最有可能取得进展，从而最大限度地增加受益潜力并将风险降至最低。我们将完成 通过调查最重要的眼部和环境危险因素对病情进展的影响来实现这一目标 最近提出了控制眼睛生长的假想。该项目将收集最广泛的纵向数据集 儿童近视的脉络膜厚度。我们将测试一个重要的问题，即是否有时间在户外 除了这些影响是否中介外，光照还会影响近视发病后的进展 由天生对光敏感的视网膜神经节细胞。如果软性多焦点隐形眼镜显示出有临床意义的 为了减缓近视的进展，我们还将回答临床上经常提出的重要问题 同事们。我们将知道多年配戴多焦点隐形眼镜的调节效果。 孩子们，我们将知道多焦点隐形眼镜是否会减缓或只是延缓近视进展，我们就会知道 停止佩戴软性多焦点隐形眼镜后近视进展是否增加。 这项提案提出的问题的答案可能会改善全球6000万近视儿童的护理 美国。虽然普通近视的后果很少会威胁视力，但 近视患者受到负面影响，治疗近视的医疗费用很高(约4.6美元 1990年为10亿美元)。国家眼科研究所认识到有必要对潜在的治疗方法进行疗效评估 用于延缓近视的发病或减缓近视的进展，例如改变周边散焦的镜片。 BLINK2研究寻求最大化益处，同时降低近视配戴多焦点隐形眼镜的风险 控制，同时回答重要的科学和临床问题的后果和机制 近视进展，这是一个影响美国许多人的问题。

The primary goal of the BLINK2 Study is to determine correlates of myopia progression using non-invasive measurement of biomarkers (choroidal thickness and intrinsically photosensitive retinal ganglion cell-mediated pupil function) and outdoor light exposure in children. If multifocal contact lenses slow the progression of myopia by 30% or more compared to single vision contact lenses during the BLINK Study, we will also answer important questions about the consequences and mechanism of the treatment effect, such as whether multifocal contact lens wear alters accommodative function and whether or not the treatment benefit is transient. Specifically, we will investigate whether myopia progression is slowed or simply delayed by multifocal contact lens wear and whether there is a “rebound” in myopia progression, an increase in progression rate, after discontinuation of multifocal contact lenses. We will identify myopic children who will most benefit from myopia control by determining those who are most likely to progress, thereby maximizing the potential for benefit and minimizing risk. We will accomplish this goal by investigating the effect on progression of the most important ocular and environmental risk factors recently hypothesized to control eye growth. The project will collect the most extensive longitudinal dataset ever on choroidal thickness in childhood myopia. We will test the important question of whether time outdoors and light exposure influence myopia progression after onset in addition to whether these affects are mediated by intrinsically photosensitive retinal ganglion cells. If soft multifocal contact lenses show a clinically meaningful slowing of myopia progression, we will also answer important questions asked routinely by our clinical colleagues. We will know the accommodative effect of multiple years of multifocal contact lens wear in children, we will know if multifocal contact lenses slow or simply delay myopia progression, and we will know whether myopia progression increases following discontinuation of soft multifocal contact lens wear. Answers to questions addressed by this proposal could improve care for 60 million myopic children in the United States. While the consequences of ordinary myopia are rarely sight-threatening, the quality of life for myopic patients is negatively affected and the health care costs to treat myopia are high (approximately $4.6 billion in 1990). The National Eye Institute recognizes the need to "evaluate the efficacy of potential treatments for delaying the onset or for slowing the progression of myopia, such as lenses that alter peripheral defocus." The BLINK2 Study seeks to maximize benefit while lowering the risk of multifocal contact lens wear for myopia control while answering important scientific and clinical questions about the consequences and mechanism of myopia progression, a problem that affects many people in the United States.