Clinical outcomes and baseline factors associated with one-year axial elongation during orthokeratology wear in children: a retrospective study.
- 1Department of Ophthalmology, The Affiliated Jiangyin Hospital of Nantong University, 163#Shoushan Road, Jiangyin, 214400, China.
- 2Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. [email protected].
- 3Department of Ophthalmology, The Affiliated Jiangyin Hospital of Nantong University, 163#Shoushan Road, Jiangyin, 214400, China. [email protected].
Abstract
Background
Myopia has emerged as a major global public health concern, especially in Asia, with high myopia substantially increasing the risk of complications such as retinal degeneration and glaucoma. This study aimed to evaluate the efficacy of orthokeratology (Ortho-K) in controlling axial length (AL) elongation in myopic children over a one-year period and to identify baseline predictors of treatment response.Methods
This retrospective, single-group, pre-post control study included 122 children (244 eyes) with myopia who were fitted with orthokeratology lenses at Jiangyin People's Hospital between January 2024 and December 2025 and completed one year of follow-up. Baseline data, including age, body mass index (BMI), spherical equivalent (SE), pupil diameter (PD), and axial length (AL) were collected. Changes in AL were analyzed using paired t-tests, Linear mixed-effects model analysis, and receiver operating characteristic (ROC) curve analysis were performed.Results
The mean AL elongation after one year was 0.23 ± 0.15 mm. Linear mixed-effects model analysis of factors associated with one-year axial length growth revealed that baseline age (estimate = - 0.04, p < 0.001), baseline SE (estimate = 0.02, 0.004), baseline BMI (estimate = 0.01, p < 0.001), and baseline pupil diameter (estimate = - 0.08, p < 0.001) were independently associated with AL change. ROC curve analysis identified exploratory cutoff values associated with slower axial elongation during orthokeratology wear, including age 11.50 years (overall), axial length of 24.33 mm, and pupil diameter of 5.10 mm. Sex-stratified analysis suggested age-related differences, with corresponding cutoff values of 10.5 years for males and 11.5 years for females.Conclusions
Children undergoing orthokeratology showed a mean one-year axial elongation of 0.23 mm. Older age, higher baseline myopia, larger pupil diameter and BMI were associated with axial elongation during treatment, with notable sex differences. These findings may help inform individualized orthokeratology management in pediatric myopia.
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BibTeX
@article{cai2026clinical,
title = {{Clinical outcomes and baseline factors associated with one-year axial elongation during orthokeratology wear in children: a retrospective study.}},
author = {Subo Cai and Xiangpeng Zhou and Wuping Xu and Ming Zhang and Guigang Li and Xuedong Xu},
journal = {BMC ophthalmology},
year = {2026},
month = aug,
doi = {10.1186/s12886-026-05167-z},
url = {https://europepmc.org/article/MED/42972531},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Clinical outcomes and baseline factors associated with one-year axial elongation during orthokeratology wear in children: a retrospective study.
AU - Subo Cai
AU - Xiangpeng Zhou
AU - Wuping Xu
AU - Ming Zhang
AU - Guigang Li
AU - Xuedong Xu
PY - 2026
DA - 2026/08/06
JO - BMC ophthalmology
DO - 10.1186/s12886-026-05167-z
UR - https://europepmc.org/article/MED/42972531
AB - Background Myopia has emerged as a major global public health concern, especially in Asia, with high myopia substantially increasing the risk of complications such as retinal degeneration and glaucoma. This study aimed to evaluate the efficacy of orthokeratology (Ortho-K) in controlling axial length (AL) elongation in myopic children over a one-year period and to identify baseline predictors of treatment response.Methods This retrospective, single-group, pre-post control study included 122 children (244 eyes) with myopia who were fitted with orthokeratology lenses at Jiangyin People's Hospital between January 2024 and December 2025 and completed one year of follow-up. Baseline data, including age, body mass index (BMI), spherical equivalent (SE), pupil diameter (PD), and axial length (AL) were collected. Changes in AL were analyzed using paired t-tests, Linear mixed-effects model analysis, and receiver operating characteristic (ROC) curve analysis were performed.Results The mean AL elongation after one year was 0.23 ± 0.15 mm. Linear mixed-effects model analysis of factors associated with one-year axial length growth revealed that baseline age (estimate = - 0.04, p < 0.001), baseline SE (estimate = 0.02, 0.004), baseline BMI (estimate = 0.01, p < 0.001), and baseline pupil diameter (estimate = - 0.08, p < 0.001) were independently associated with AL change. ROC curve analysis identified exploratory cutoff values associated with slower axial elongation during orthokeratology wear, including age 11.50 years (overall), axial length of 24.33 mm, and pupil diameter of 5.10 mm. Sex-stratified analysis suggested age-related differences, with corresponding cutoff values of 10.5 years for males and 11.5 years for females.Conclusions Children undergoing orthokeratology showed a mean one-year axial elongation of 0.23 mm. Older age, higher baseline myopia, larger pupil diameter and BMI were associated with axial elongation during treatment, with notable sex differences. These findings may help inform individualized orthokeratology management in pediatric myopia.
SN - 1471-2415
ER -