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Practice patterns in the management of fungal and acanthamoeba keratitis: a five‐continent survey

was to estimate the correlation between change in SEQ in D and change in AL in mm in children with low to moderate (between –0.5 and –5.0 D SEQ) progressive myopia. Subjects were myopic children randomized to the control group in the CONTROL study. In brief, the main study was a randomized clinical trial on myopic Scandinavian children allocated either to orthokeratology lenses (intervention group) or single-vision spectacles (control group) with followup visits every 6 months for 18 months. Outcome variables relevant for this study are AL (Lenstar LS900, Haag-Streit, Koeniz, Switzerland) and cycloplegic autorefraction (Shin-Nippon Nvision-K 5001, Kagawa, Japan) at 12-month follow-up. SEQ = spherical power + 1⁄2cylinder power. Inclusion criteria were age 6 to 12 years, myopia 0.5–4.75 D spherical component, regular astigmatism ≤ 2.5 D, anisometropia < 1.5 D SEQ and best-corrected visual acuity (BCVA) ≥78 ETDRS letters in both eyes. Exclusion criterion for the present study was no AL change defined as <0.03 mm AL change during the follow-up period. The study followed the guidelines of the Helsinki Declaration and was approved by the Regional Committee on Health Research Ethics, and written consent forms were signed for all subjects. Twenty-eight of the 30 included subjects completed the 12-month follow-up. Two subjects were excluded because of stable AL, and thus, 26 subjects were eligible for analysis. Right eye was used for analysis. Baseline characteristics for eligible subjects were age 9.96 ( 1.67), male 31%, BCVA 84.1 ( 3.1), SEQ –2.37 D ( 1.20) and AL 24.34 mm ( 0.69). There were strong negative correlations between change in AL and change in SEQ (r ≥ 0.78, p ≤ 0.01, simple linear regressions, Fig. 1). At 12-month follow-up, change of –1 D was equivalent to 0.60 mm longer AL for male subjects and 0.53 mm longer AL for female subjects. Fast myopia progression has been defined as >0.75 D/year (Jong et al. 2018). According to the results of the presentstudy,0.75Disequivalent to0.45 and 0.39 mm of AL progression for malesandfemales, respectively.Suggesting a treatment aim for myopic children at risk of becoming high myopic of <0.5 D/year is equivalent to AL progression <0.30 mm/year and <0.27 mm/year for males and females, respectively. Our sample size was very small and since emmetropic axial growth has been shown to decrease with age (Fledelius et al. 2014) there is a need for future studies, with a larger study sample, that can establish the correlation between change in SEQ and change in AL and divide them in different age groups in order to make age-specific treatment recommendations.