京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第18499号 / 医博第3919号 / 新制||医||1005(附属図書館) / 31385 / 京都大学大学院医学研究科医学専攻 / (主査)教授 伊藤 壽一, 教授 河野 憲二, 教授 富樫 かおり / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19266号 / 医博第4030号 / 新制||医||1011(附属図書館) / 32268 / 京都大学大学院医学研究科医学専攻 / (主査)教授 清水 章, 教授 野田 亮, 教授 藤渕 航 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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Yes / Purpose: To investigate whether a genetic risk score (GRS) improved performance of predicting refractive error compared to knowing a child’s number of myopic parents (NMP) alone. Methods: This was a retrospective analysis of data from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort study. Refractive error was assessed longitudinally between age 7–15 using non-cycloplegic autorefraction. Genetic variants (n=149) associated with refractive error from a Consortium for Refractive Error And Myopia (CREAM) genome-wide association study were used to calculate a GRS for each child. Using refractive error at ages 7 and 15 years as the outcome variable, coefficient of determination (R2) values were calculated via linear regression models for the predictors: NMP, GRS and a combined model. Results: Number of myopic parents was weakly predictive of refractive error in children aged 7 years, R2=3.0% (95% CI 1.8–4.1%,p<0.0001) and aged 15 years, R2=4.8% (3.1–6.5%,p<0.0001). The GRS was also weakly predictive;age 7 years, R2=1.1% (0.4–1.9%,p<0.0001) and 15 years R2=2.6% (1.3–3.9%,p<0.0001). Combining the 2 variables gave larger R2 values at age 7, R2=3.7%(2.5–5.0%,p<0.0001) and 15, R2=7.0% (5.0–9.0%,p<0.0001). The combined model improved performance at both ages (both p<0.0001). Conclusion: A GRS improved the ability to detect children at risk of myopia independently of knowing the NMP. We speculate this may be because NMP captures information concerning environmental risk factors for myopia. Nevertheless, further gains are required to make such predictive tests worthwhile in the clinical environment. / The UK Medical Research Council and Wellcome. Grant Number: 102215/2/13/2 The University of Bristol provide core support for ALSPAC PDF. Grant Number: 459KB The College of Optometrists NIHR Senior Research Fellowship. Grant Number: SRF‐2015‐08‐005 23andMe

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Yes / Background: A range of myopia management (MM) contact lenses are becoming available to practitioners. These lenses are designed to slow myopia progression and axial elongation. This study explored the initial experience of participants wearing daily disposable MM contact lenses to investigate established factors previously associated with successful lens wear. Methods: This was a prospective, double-masked, crossover study. Twenty participants aged 18–30 years old were assigned to wear two daily disposable MM lenses in a randomised order. Visual acuity, contrast sensitivity, and amplitude/lag of accommodation were assessed at baseline, post-insertion, and after 2 and 6 h of lens wear. Self-reported lens comfort and vision quality were recorded at the same timepoints, and at 10 h post-insertion. Pairwise comparisons were performed between the two lenses at each timepoint, as well as assessing changes throughout wear. The relationship of the measured parameters to overall lens satisfaction was also assessed. Results: There were no significant differences between the two MM lenses at any timepoint for any of the participant-reported parameters, including overall satisfaction. A small difference in visual acuity was noted at 6 h post-insertion, although this is unlikely to be clinically significant. Comfort decreased throughout the day, most notably at 10 h post-insertion. A moderate positive correlation was observed between participant-reported visual quality and overall satisfaction. A similar pattern was seen for comfort and overall satisfaction. Self-reported vision quality and measured visual acuity were poorly correlated, highlighting the benefit of subjectively assessing the quality of vision with these lenses. Conclusions: The participants demonstrated comparable measures across a range of measures between the two MM lenses. Notably, half of the participants demonstrated a clear lens preference, although the preferred lens varied between individuals. Candidates for MM may benefit from trialling more than one MM lens design, to maximise initial wearing satisfaction. / This project was supported by the British Contact Lens Association Summer Research Scholarship.