Influence of a long-distance optical imaging workbench on accommodation and choroidal response in myopic children

Clinical relevance Optical approaches to modulating near work may be beneficial in arresting the progression of myopiaBackground To explore whether a long-distance optical image workbench (LOIW) can replace traditional near-distance reading and has beneficial influences on accommodation and choroidal parameters.Methods This self-control study included two sessions. In session 1, an open-field autorefractor measured sustained accommodative response and pupil diameter when participants viewed virtual images from 3.42 m away through LOIW with + 0.50 D over-correction lenses (3.42 m/+0.50 D), LOIW with full-correction lenses (3.42 m/FC), or the visual target at a given distance of 0.33 m with + 0.50 D over-correction lenses (0.33 m/+0.50 D), with full-correction lenses (0.33 m/FC). In session 2, swept-source optical coherence tomography angiography assessed subfoveal choroidal thickness (SFChT), choroidal volume (CV), and choriocapillaris flow void percentage (FV%) at baseline and before and after reading via LOIW with + 0.50 D over-correction lenses (Far/+0.50 D) or in habitual near distance with full-correction (Near/FC) for a sustained 30-min period.Results Thirty-five myopic (mean spherical equivalent refraction: −1.11 ± 0.78 D) children (median [range] age: 8.36 [8–10] years) were analysed. Children viewing virtual images in 3.42 m/+0.50 D exhibited mild-degree accommodative leads (−0.54 ± 0.17 D), much smaller pupil diameter (3.39 ± 0.63 mm) and microfluctuations (0.13 ± 0.04 D); accommodative lags (0.88 ± 0.04 D), larger pupil diameter (5.05 ± 0.75 mm) and microfluctuations (0.88 ± 0.16 D) were observed in 0.33 m/+0.50 D, and the microfluctuations were unstable (F = 2.185, p = 0.038). Compared with baseline data, SFChT, CV, and FV% changed by 13.40 ± 4.71 μm, 0.26 ± 0.21 mm3, and − 0.14%±3.66% in Far/+0.50 D, respectively, while changes under Near/FC were − 10.19 ± 7.48 μm, −0.15 ± 0.22 mm3 and 1.95%±2.92%, respectively. All changes differed significantly between these two conditions (all p < 0.001).Conclusion The long-distance working mode may exert beneficial effects on accommodative and choroidal parameters in myopic children compared with traditional near work.