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. 2023 Mar 1;64(3):31.
doi: 10.1167/iovs.64.3.31.

A Duration-Dependent Interaction Between High-Intensity Light and Unrestricted Vision in the Drive for Myopia Control

Sayantan Biswas  1 , Arumugam R Muralidharan  1   2 , Bjorn Kaijun Betzler  3 , Joanna Marie Fianza Busoy  1 , Veluchamy A Barathi  1   2   3 , Royston K Y Tan  1   2 , Wan Yu Shermaine Low  1 , Dan Milea  1   2   4 , Biten K Kathrani  5 , Noel A Brennan  5 , Raymond P Najjar  1   2   6   7
Affiliations

A Duration-Dependent Interaction Between High-Intensity Light and Unrestricted Vision in the Drive for Myopia Control

Sayantan Biswas et al. Invest Ophthalmol Vis Sci. .

Abstract

Purpose: To evaluate the duration-dependent and synergetic impact of high-intensity light (HL) and unrestricted vision (UnV) on lens-induced myopia (LIM) development in chickens.

Methods: Myopia was induced in one eye in chicks (10 groups, n = 126) from day 1 posthatching (D1) until day 8 (D8) using -10 diopter (D) lenses. Fellow eyes remained uncovered as controls. Nine groups were exposed daily to 2, 4, or 6 hours of HL (15,000 lux), UnV (removal of -10 D lens), or both (HL + UnV). One group served as the LIM group without any interventions. Ocular axial length (AL), refractive error, and choroidal thickness were measured on D1, D4, and D8. Outcome measures are expressed as interocular difference (IOD = experimental eye - control eye) ± SEM.

Results: By D8, LIM increased AL (0.36 ± 0.04 mm), myopic refraction (-9.02 ± 0.37 D), and choroidal thinning (-90.27 ± 16.44 µm) in the LIM group (all, P < 0.001). Compared to the LIM group, exposure to 2, 4, or 6 hours of HL, UnV, or HL + UnV reduced myopic refraction in a duration-dependent manner, with UnV being more effective than HL (P < 0.05). Only 6 hours of HL + UnV (not 2 or 4 hours) prevented LIM and was more effective than UnV (P = 0.004) or HL (P < 0.001) in reducing myopic refraction and more effective than HL (P < 0.001) in reducing axial elongation.

Conclusions: Daily exposure to 2, 4, or 6 hours of HL, UnV, or HL + UnV reduced lens-induced myopic refraction in a duration-dependent manner in chickens. Only 6 hours of HL + UnV completely stopped LIM development. The synergetic effect of HL and UnV is dependent on the duration of the interventions.

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Conflict of interest statement

Disclosure: S. Biswas, None; A.R. Muralidharan, None; B.K. Betzler, None; J.M.F. Busoy, None; V.A. Barathi, None; R.K.Y. Tan, None; W.Y.S. Low, None; D. Milea, None; B.K. Kathrani, Johnson and Johnson Vision Care (E); N.A. Brennan, Johnson and Johnson Vision Care (E); R.P. Najjar, None

Figures

Figure 1.
Figure 1.
Relative spectral power distribution of the background light (LED, 4000K, 2NFLS-NW LED; Super Bright LED, Inc.) and experimental high-intensity light (LED, 4000K; USHIO Lighting).
Figure 2.
Figure 2.
IOD in refraction, axial length, and choroidal thickness on days 1, 4, and 8 of the experimental protocol in the group not exposed to any intervention (LIM) and groups exposed to 2 hours of HL, UnV, or both (HL + UnV). All groups are significantly different from the LIM group: ###P < 0.001, ##P < 0.01, #P < 0.05. For significant group effect: *P < 0.05, **P < 0.01, ***P < 0.001 (two-way repeated-measures ANOVA).
Figure 3.
Figure 3.
IOD in refraction, axial length, and choroidal thickness on days 1, 4, and 8 of the experimental protocol in the group not exposed to any intervention (LIM) and groups exposed to 4 hours of HL, UnV, or both (HL + UnV). All groups are significantly different from the LIM group: ###P < 0.001, ##P < 0.01, #P < 0.05. For significant group effect: *P < 0.05, **P < 0.01, ***P < 0.001 (two-way repeated-measures ANOVA).
Figure 4.
Figure 4.
IOD in refraction, axial length, and choroidal thickness on days 1, 4, and 8 of the experimental protocol in the group not exposed to any intervention (LIM) and groups exposed to 6 hours of HL, UnV, or both (HL + UnV). All groups are significantly different from the LIM group: ###P < 0.001, ##P < 0.01, #P < 0.05. All groups are significantly different from each other: ‡‡‡P < 0.001, ‡‡P < 0.01, ‡P < 0.05. For significant group effect: *P < 0.05, **P < 0.01, ***P < 0.001 (two-way repeated-measures ANOVA).
Figure 5.
Figure 5.
IOD in CCT on days 1, 4, and 8 of the experimental protocol in the group not exposed to any intervention (LIM) and groups exposed to 2 hours (A), 4 hours (B), and 6 hours (C) of HL, UnV, or both (HL + UnV).
Figure 6.
Figure 6.
IOD in ACD on days 1, 4, and 8 of the experimental protocol in the group not exposed to any intervention (LIM) and groups exposed to 2 hours (A), 4 hours (B), and 6 hours (C) of HL, UnV, or both (HL + UnV).
Figure 7.
Figure 7.
Duration-response curve for the IOD in refraction (A), axial length (B), and choroidal thickness (C) in the groups exposed to 2, 4, and 6 hours of HL, UnV, or both (HL + UnV) on day 4 of the experimental protocol. The LIM group that was not exposed to any intervention is represented by a white square and a shaded area for mean ± 95% confidence interval. All groups are different from each other: ‡P < 0.05. HL significantly different from both UnV and HL + UnV: ¶¶¶P < 0.001.
Figure 8.
Figure 8.
Duration-response curve for the IOD in refraction (A), axial length (B), and choroidal thickness (C) in the groups exposed to 2, 4, and 6 hours of HL, UnV, or both (HL + UnV) on day 8 of the experimental protocol. The LIM group that was not exposed to any intervention is represented by a white square and a shaded area for mean ± 95% confidence interval. HL is significantly different from UnV: §P < 0.05, §§§P < 0.001. All groups are different from each other (at least, ‡‡P < 0.01). HL is significantly different from HL + UnV (†††P < 0.001).
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