Aspheric Lenslets Inhibit Choroidal Thinning, Slow Axial Elongation

Spectacle lenses with slightly (SAL) or highly aspherical lenslets (HAL) can reduce or eliminate macular choroidal thinning, but HAL have a more pronounced effect, according to a study published in the British Journal of Ophthalmology.

Researchers enrolled 170 children with myopia in a double-masked, randomized study and included data from 154 participants in the analysis. Patients were randomly assigned to wear HAL (n=54; mean age, 10.65 years), SAL (n=52; mean age, 10.25 years), or single vision spectacles (n=48, mean age, 10.38 years). Participants underwent cycloplegic examinations and subfoveal, parafoveal and perifoveal choroidal thickness (ChT) were evaluated every 6 months using optical coherence tomography (OCT) over a 2-year period. 

According to the report, ChT changed significantly over time in all 3 cohorts and choroidal regions (all P <.05). Participants in the single vision lens group experienced the most choroidal thinning in all areas (range: −20.75 to −12.18 μm after 2 years). Participants in the SAL cohort experienced a ChT increase over the first 6 months, which decreased during the remaining 18 months. Patients in the HAL group experienced a ChT increase during the first year followed by a ChT decrease during the second year. Participants wearing single vision lenses experienced faster axial elongation over the 2-year study duration compared with study participants wearing both SAL and HAL (P ≤.001 for both). The ChTs of the outer regions decreased less than the inner regions, and the ChTs of the superior regions decreased the least in the parafovea and perifovea in all 3 groups, the report states.

“The macular ChT in myopic children had a lower degree of thinning or an increase after the use of spectacles lenses with aspherical lenslets for 2 years compared with the use of [single vision lenses], and the HAL had a better effect,” according to the researchers. “More attention should be given to the properties of the superior choroid in the clinic rather than only the [subfoveal] choroid.

Study limitations include a single center design and inconsistencies in ChT measurement times between visits, allowing for the possibility of diurnal fluctuations on ChT.