Comparison of optical myopia control interventions: effect on peripheral image quality and vision

Abstract

This study compares the effects on peripheral vision and image quality of four myopia control interventions: a) Perifocal spectacles/ArtOptica, b) Stellest spectacles/Essilor), c) MiyoSmart spectacles/Hoya and d) MiSight contact lenses/CooperVision. Five subjects participated with habitual or no correction as reference. Three techniques were used: 1) Hartmann-Shack sensors for wavefront errors, 2) double-pass imaging system for point-spread-functions (PSF), and 3) peripheral acuity evaluation. The results show that multiple evaluation methods are needed to fully quantify the optical effects of these myopia control interventions. Perifocal was found to make the relative peripheral refraction (RPR) more myopic in all subjects and to interact with the natural optical errors of the eye, hence showing larger variations in the effect on peripheral vision. MiSight had a smaller effect on RPR, but large effect on peripheral vision. Stellest and MiyoSmart also showed small effects on RPR but had broader double-pass PSFs for all participants, indicating reduced retinal contrast. Reduction in peripheral retinal contrast might thereby play a role in slowing myopia progression even when the peripheral refraction does not turn more myopic.

Fig. 1.

Designs of the four optical myopia control interventions that are reported in this study. A) is the Perifocal lens from ArtOptica, B) is the Stellest lens from Essilor, C) is the MiyoSmart lens from Hoya and D) is the MiSight contact lens from CooperVision.

Fig. 2.

Relative peripheral refraction (RPR) as calculated from simultaneous foveal and peripheral wavefront measurements in the 30° nasal visual field for five subjects with the different myopia control interventions compared to the reference case.

Fig. 3.

Peripheral astigmatism as Jackson cross-cylinder in 90/180 (J0) calculated from wavefront measurements in the 30° nasal visual field for five subjects with the different myopia control interventions compared to the reference case.

Fig. 4.

Peripheral point-spread-functions (PSFs) in the 30° nasal visual field for subject 1, 2, and 3 with the different interventions and measurement techniques, measured and calculated for a 3.5 mm pupil diameter. HSWS: Hartmann-Shack wavefront sensor (technique 1); DP: double-pass (technique 2). Each image is an average of three repetitions.

Fig. 5.

Peripheral through-focus double-pass point-spread-functions (PSFs) in the 30° nasal visual field for subject 2 during one repetition with each intervention, measured for a 3.5 mm pupil diameter. The defocus steps range from -7.95 D in the upper left corner of each panel to +5.95 D in the lower right. The change in defocus between each PSF is 0.1 D, each row therefore corresponds to 1.0 D change in defocus. The colored squares inscribe the 4.0 D region with best PSFs, which were located between -1.95 D and +1.95 D with the reference, Stellest, and MiyoSmart, but between -2.95 D and +0.95 D with Perifocal.

Fig. 6.

Peripheral high contrast grating resolution acuity in the 30° nasal visual field for the five subjects and the different myopia control interventions. Circles indicate repetitions, black lines indicate means of the three repetitions. Lower values correspond to better acuity.

Fig. 7.

Peripheral low contrast (10%) grating resolution acuity in the 20° nasal visual field for the two subjects and the different myopia control interventions. Circles indicate repetitions, black lines indicate means of the three repetitions. Lower values correspond to better acuity.