Relationship between biometry, fovea, and choroidal thickness in Nigerian children with myopia

Background: Understanding the relationship between biometric and structural changes in childhood myopia is necessary to effectively manage myopia progression. Aim: To determine the relationship between ocular biometry, fovea and sub-fovea choroidal thickness in school-aged children with myopia of Nigerian descent. Setting: Abuja, Nigeria. Methods: This study involved 189 children (117 girls and 72 boys), and myopia was defined as cycloplegic spherical equivalent refraction (SER) of ≤ −0.50 D. Keratometry values, biometry data, fovea and sub-foveal choroidal thickness (SFChT) values were obtained from medical records retrospectively and analysed. Results: The median age was 13 years (interquartile range [IQR]: 5). The median SER, fovea and SFChTs were −2.63 D (IQR: 3.38), 249 μm (IQR: 118) and 225 μm (IQR: 341), respectively. Male children had flatter corneas, thicker fovea and thinner SFChT compared to female children. The vitreous chamber and axial length were longer and sub-fovea choroid was thinner in children with high myopia. There was a weak but significant positive correlation between myopia and sub-fovea choroidal thickness (r = 0.270 respectively, P  0.01). A moderate negative correlation was found between myopia and vitreous chamber depth (r = −0.536, P  0.001), and a strong negative correlation was found between myopia and axial length (r = −0.706, P  0.001). Conclusion: Myopia in school-aged Nigerian children is associated with sub-fovea choroidal thinning, increased vitreous chamber depth and axial elongation. Contribution: This study provides data on the relationship between ocular biometry, fovea and sub-foveal choroidal thickness in school-aged Nigerian children with myopia

[In Press] Trends in myopia management attitudes and strategies in clinical practice : survey of eye care practitioners in Africa

Purpose: There remains a lack of information on the perception and adoption of myopia control strategies among African eye care practitioners (ECPs). This study provides an African perspective to similar previous studies conducted in other parts of the world. Methods: A self-administered survey in English and French was distributed to ECPs across Africa. The items on the questionnaire assessed their level of concern about the increasing prevalence of paediatric myopia, perceived efficacy, opinions on, and adoption of various myopia management modalities. Results: Responses were obtained from 330 ECPs working in 23 African countries. Respondents were highly concerned about the increasing prevalence of paediatric myopia in their clinic (median 8/10) and perceived approved myopia control soft contact lenses as the most effective at slowing myopia progression (mean perceived reduction in myopia progression ± SD; 53.9 ± 27.1%), followed by single vision spectacles (53.1 ± 30.9%), and orthokeratology (52.8 ± 28.0%). Multifocal soft contact lenses (40.4 ± 25.8%) and pharmaceutical agents such as topical atropine drops (39.5 ± 27.1%) were perceived as least effective in slowing myopia progression. Although ECPs reported being aware of various myopia control strategies, they still mainly prescribed single vision spectacles to a large proportion (64.3 ± 29.9%) of young progressing myopes. Nearly one-third (27%) of ECPs who prescribed single vision lenses stated they were concerned about the cost implications to patients. Other reported concerns included safety of, and inadequate information about myopia control options. Conclusions: African ECPs continue to prescribe single vision lenses for progressing myopes despite being aware of the various myopia control options. Practitioners’ perceptions of the efficacy of several modalities to slow myopia progression do not align with the current best evidence. Clear practice guidelines and continuing education on myopia control are warranted to inform and guide the management of myopic patients in Africa