Noel Brennan

• MScOptom PhD FAAO
• Emeritus at Independent

Purpose: To evaluate the impact of optical vs. illuminance factors and their duration-dependency on lens-induced hyperopia (LIH) in chick eyes. Methods: Hyperopia was induced in one eye in chicks (10 groups; n = 126) from day 1 after hatching until day 8 using +10-diopter lenses with fellow eyes as controls. One group (LIH) served as the control...

Purpose: To explore evidence for myopic shift between the ages of 20 and 50 years. Methods: Three usable sets of data with long-term adult refractive progression were identified: (1) US population-based prevalence data for those 18 to 24 years of age in 1971 and 1972 and 45 to 54 years of age from 1999 to 2004; a logit transformation of prevalen...

Purpose When myopia control treatment is discontinued, progression will increase, but does it revert to expected values based on the age and race of the child or does it accelerate further? The latter scenario is considered a rebound. Methods A PubMed search was conducted with the words ‘rebound’ and ‘myopia control’, identifying further papers fr...

Purpose: It has been noted that, at higher prevalences, the rate of change in the prevalence of high myopia seems to be disproportionately greater compared with the rate of change in the prevalence of myopia. A simple, evidence-based explanation for this relationship is offered. Methods: Using a convenience sample of 41 datasets with prevalence...

Purpose It is common to hear talk of ‘responders’ and ‘non‐responders’ with respect to myopia control interventions. We consider the reality of distinguishing these sub‐groups using data from the first year of the Low‐concentration Atropine for Myopia Progression (LAMP) study. Methods The first year of the LAMP study was a robustly designed, place...

PURPOSE Axial elongation is the basis of progression in primary myopia and the preferred metric to monitor its evolution. We conducted a meta-regression to model axial elongation and its associated factors in children with low to moderate myopia. METHODS A comprehensive electronic systematic search was performed using Ovid Medline, EMBASE, and Coc...

PURPOSE: To evaluate the impact of optical versus illuminance factors and their duration-dependency on lens-induced hyperopia (LIH) in chick eyes. METHODS: Hyperopia was induced in one eye in chicks (10 groups, n=126) from day 1 (D1) post-hatching until D8 using +10 D lenses with fellow eyes as controls. One group (LIH) served as the control withou...

Background Myopia affects 1.4 billion individuals worldwide. Notably, there is increasing evidence that choroidal thickness plays an important role in myopia and risk of developing myopia-related conditions. With the advancements in artificial intelligence (AI), choroidal thickness segmentation can now be automated, offering inherent advantages suc...

SIGNIFICANCE The availability of a range of effective myopia control modalities enables the clinician to exercise judgment when discussing the treatment plan with the patient and their parents. This article outlines important considerations beyond efficacy. Clinically meaningful myopia control may be attained with some spectacle lenses, select soft...

We estimate the US prevalence of uncorrectable visual impairment in 2050 accounting for the changing distribution of both age and myopia. Age projections of the US population (from an estimated total of 379 million in 2050), were taken from the US census website. The distribution of myopia, by severity, was calculated from literature-derived preval...

The risk of eye diseases such as myopic macular degeneration increases with the level of myopia, but there is no safe level of myopia and the burden of lower degrees of myopia remains considerable. Effective treatments are available that slow progression and thus limit the final degree of myopia. In this review, the rationale for slowing progressio...

Purpose To evaluate factors influencing stabilisation of myopia in the Singapore Cohort of Risk factors for Myopia. Methods We evaluated the longitudinal natural history of 424 myopic participants from 1999 to 2022. The outcome was the change in myopia from the adolescence follow-up visit (aged 12–19 years) to the adulthood follow-up visit (aged 2...

In the field of myopia control, effective optical or pharmaceutical therapies are now available to patients in many markets. This creates challenges for the conduct of placebo‐controlled, randomised clinical trials, including ethics, recruitment, retention, selective loss of faster progressors and non‐protocol treatments: Ethics: It is valid to que...

Myopia is a globally emerging concern accompanied by multiple medical and socio-economic burdens with no well-established causal treatment to control thus far. The study of the genomics and transcriptomics of myopia treatment is crucial to delineate disease pathways and provide valuable insights for the design of precise and effective therapeutics....

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 u...

PURPOSE To evaluate the duration-dependent and synergetic impact of high-intensity light (HL) and optical refocus (RF) on lens-induced myopia (LIM) development in chickens. METHODS Myopia was induced in one eye in chicks (10 groups, n=126) from day 1 post- hatching (D1) until D8 using -10D lenses. Fellow eyes remained uncovered as controls. Nine g...

Purpose: To identify choroidal characteristics associated with susceptibility to development of naturally occurring and experimentally induced myopia. Methods: We compared choroidal properties between pigmented and albino guinea pig (GP) strains. Biometry, cycloplegic refractive error (RE), and eye wall sublayer thickness were measured from 171...

Purpose: Myopia severity has a profound impact on visual impairment in later life. A patient's final level of myopia may be lowered by myopia control, but also by delaying onset. Here, we evaluate the influence of the age of onset on the final recorded level of myopia. Methods: Data were extracted from: (1) Three prospective cohort studies of my...

Purpose To evaluate efficacy and vision with two prototype myopia control soft contact lenses with non-coaxial ring-focus designs (EE, for enhancing efficacy and EV, enhancing vision) compared to dual-focus (DF) and single-vision (SV) designs. Design Multi-center, 6-month, randomized, controlled, double-masked clinical trial. Participants 199 myo...

Significance: Identifying children at highest risk for rapid myopia progression and/or rapid axial elongation could help prioritize who should receive clinical treatment or be enrolled in randomized clinical trials. Our models suggest that these goals are difficult to accomplish. Purpose: This study aimed to develop models predicting future refr...

Purpose: To characterize initial reduction in axial length (AL) or apparent “shrinkage” during myopia control and its relation to treatment effect size. Methods: Myopic children (N=199, 7 to 12 years of age, -0.75 to - 4.50D of myopia, ≤1.00D astigmatism) were randomly assigned to wear one of four contact lens types bilaterally for 6 months at 9 s...

Purpose: The purpose of this study was to evaluate the association of childhood progression of spherical equivalent (SE) with high myopia (HM) in teenagers in the Singapore Cohort of Risk factors for Myopia (SCORM). Methods: We included 928 SCORM children followed over a mean follow-up of 6.9 ± 1.0 years from baseline (6-11 years old) until thei...

Purpose: To investigate the association between 1-year myopia progression and subsequent 2-year myopia progression among myopic children in the Singapore Cohort Study of the Risk Factors for Myopia. Methods: This retrospective analysis included 618 myopic children (329 male), 7 to 9 years of age (mean age, 8.0 ± 0.8) at baseline with at least tw...

https://www.sciencedirect.com/science/article/abs/pii/S1350946220300951

Purpose : To investigate predictors of myopia progression for subsequent year amongst myopic children in the Singapore Cohort Study of the Risk Factors for Myopia (SCORM). Methods : A total of 674 myopic children (353M, 321F) aged 7 to 10 (mean 8.0 ± 0.9) years from 3 schools at baseline with at least 2 follow-up visits in SCORM were included. Cycl...

Frequent replacement contact lenses made from the etafilcon A hydrogel lens material were introduced onto the market over 30 years ago, and etafilcon A remains the most widely used hydrogel lens material today. Although the prescribing of silicone hydrogel lenses is increasing, millions of lens wearers globally have been wearing hydrogel lenses for...

In this chapter, we present an overview of the major concepts and issues surrounding myopia and pathologic myopia. Myopia is a significant global public health and socioeconomic problem with significant geographic variation in its prevalence. Pathologic myopia, an extreme form of myopia characterized by sight-threatening complications in adults, ha...

Purpose: To examine the rate and types of ocular adverse events among children wearing soft contact lenses. Methods: This study is a retrospective review of ocular adverse event data from six randomized controlled trials among a total of 581 myopic children (aged 7-15 years at baseline) administered daily disposable hydrogel contact lenses (etaf...

Purpose To examine the impact of contact lens optical design on accommodative behaviour of children and the correlation between myopia progression and the accommodative response of the eye while wearing a contact lens designed for myopia control. Methods A post‐hoc analysis was conducted on data from a previously published myopia control trial. A...

Myopia Control Intervention Produces Absolute, Rather than Relative, Treatment Effect Across the Progression Range Invest Ophthalmol Vis Sci. 2019; 60: ARVO eAbstract 4344 Noel A. Brennan1, Xu Cheng1, Mark A. Bullimore2 1R&D, Johnson & Johnson Vision, Jacksonville, Florida, United States 2College of Optometry, University of Houston, Houston, Texas,...

Modelling of cumulative treatment efficacy in myopia progression interventions View Session View Presentation Invest Ophthalmol Vis Sci 2019; 60:ARVO eAbstract 4345 Xu Cheng1, Noel A. Brennan1, Youssef Toubouti1, Mark A. Bullimore2 1Johnson & Johnson Vision, Jacksonville, Florida, United States; 2College of Optometry, University of Houston , Hous...

Significance: Reducing the incidence or prevalence of any disease by 40% is of huge public health significance. Slowing myopia by 1 diopter may do just that for myopic maculopathy-the most common and serious sight-threatening complication of myopia. There is a growing interest in slowing the progression of myopia due to its increasing prevalence a...

Purpose: Decision-making in modern clinical practice is increasingly dependent on evidence-based medicine. Previous analyses of the efficacy of myopia control interventions have delivered results as percentage or absolute reduction in myopia progression over a given time frame. Estimates of longer term efficacy have been constructed around these es...

Purpose: In evidence-based medicine, well-conducted meta-analyses provide the highest quality of scientific evidence. Donovan et al published a meta-analysis of refractive progression among myopes; 1 however, axial length may be a preferred metric to refractive error for assessing myopia as (i) it is significantly associated with retinal disease, (...

Purpose: To subject a number of commonly held beliefs or areas of confusion in the myopia field to scientific scrutiny. Method: A collection of statements about myopia are provided with references to demonstrate that a section of the research or clinical community supports the statement. The topics under discussion are reviewed critically with r...

A ‘universal’ calculator to link data across myopia epidemiology studies Noel A Brennan; Xu Cheng; Youssef Toubouti; Mark A Bullimore Purpose : Refractive error in a population is not normally distributed, but is skewed and leptokurtotic. Epidemiological data for myopia are often presented in different ways, e.g., prevalence based on a certain di...

Dr Noel Brennan and David Ruston discuss the latest findings with etafilcon A daily disposable contact lenses which support the significant role for hydrogel daily disposables in contemporary contact lens practice.

Myopia Control Trial Endpoints: Analyzing Efficacy Noel A. Brennan, Xu Cheng Johnson & Johnson Vision Care, Inc. Purpose: Current descriptors for efficacy endpoints in myopia control trials include mean differences in refractive error change or axial elongation or relative reduction, usually expressed as a percentage, in progression of these varia...

Purpose: This study hypothesized that a traditional high-water contact lens of moderate oxygen transmissibility (Dk/t) is noninferior to common silicone hydrogel (SH) lenses worn for daily wear with respect to measures of hypoxic stress. Methods: Thirty-six habitual contact lens wearers completed wear of three lens types worn in a randomized ord...

Some recent research has resulted in a hypothesis that there is a common 'lid wiper' region that is apposite to the ocular surface or anterior lens surface (where contact lenses are worn), responsible for spreading tears during blinking. In the upper eyelid, it extends about 0.6 mm from the crest of the sharp posterior (inner) lid border (i.e. the...

Background: The aim was to evaluate the effect of ocular topography on soft contact lens fit in Chinese and Caucasians. Method: This study evaluated 547 subjects from two ethnic groups, Caucasian (n = 250) and Chinese (n = 297), at investigational sites in three locations: Wenzhou, China, Melbourne, Australia and Jacksonville, USA. Subjects unde...

Purpose: To determine whether soft contact lenses with positive spherical aberration (+SA) can slow myopia progression. Methods: Eligible subjects (N = 127, primarily Asian) aged 8 to 11 years were randomized to wear either control (spherical design) or test (with +SA) soft daily disposable contact lenses for a minimum of 1 and up to 2 years (tr...

Purpose: To provide comparative ocular topography data from a substantial population of East Asian and white eyes. Methods: This study evaluated 675 subjects from three ethnic groups: white (n = 255), Chinese (n = 299), and Japanese (n = 121) at investigational sites in four locations: Wenzhou, China; Melbourne, Australia; Tokyo, Japan; and Jack...

Purpose: To analyse myopic retinopathy prevalence data for evidence of a discontinuity between low (physiological) and high (pathological) myopia. Method: Data from the three international population based studies that have examined the prevalence of myopic retinopathy at different refractive errors were analysed (Vongphanit et al., 2002; Liu et a...

Abstract: https://doi.org/10.1016/j.clae.2014.11.085

Purpose: Race appears to be associated with myopiogenesis, with East Asians showing high myopia prevalence. Considering structural variations in the eye, it is possible that retinal shapes are different between races. The purpose of this study was to quantify and compare retinal shapes between racial groups using peripheral refraction (PR) and peri...

Jones, L., Brennan, N. A., Gonzalez-Meijome, J., Lally, J., Maldonado-Codina, C., Schmidt, T. A., … Nichols, J. J. (2013). The TFOS International Workshop on Contact Lens Discomfort: Report of the Contact Lens Materials, Design, and Care Subcommittee. Investigative Opthalmology & Visual Science, 54(11), TFOS37. https://doi.org/10.1167/iovs.13-13215

The early focus of contact lens wear and ocular health was on oxygen delivery. However, as we learn more about how the eye works, and investigate how the contact lens interacts with the cornea, the role of the tear film has risen in prominence. A healthy tear film is critical for normal ocular homeostasis, and abnormalities of the tear film are the...

To identify, analyze, and celebrate the most highly cited articles relating to contact lenses and the leading authors, journals, institutions, and countries associated with these publications. To capture all contact lens articles published since 1900, a search equation targeting specific contact lens-related terms in the titles of articles was deri...

Hirsch recently proposed the h-index as a single-number metric to describe the impact of an academic, combining quality with quantity. An index of h indicates that an individual has h publications, which have been cited at least h times. In this paper, the Google Scholar database and Publish or Perish software are used to generate citation metrics...

Although contact lenses were invented over 120 years ago, it is only in the past decade that a solution has been found to the problem of allowing sufficient atmospheric oxygen to permeate the lens and reach the underlying ocular tissues so as to allow normal corneal function and avoid hypoxic complications. That solution is 'silicone hydrogel' mate...

This study was designed to derive central and peripheral oxygen transmissibility (Dk/t) thresholds for soft contact lenses to avoid hypoxia-induced corneal swelling (increased corneal thickness) during open eye wear. Central and peripheral corneal thicknesses were measured in a masked and randomized fashion for the left eye of each of seven subject...

CONTACT LENS-BASED CORRELATES OF SOFT LENS WEARING COMFORT Noel A. Brennan PURPOSE: It has recently been suggested that contact lens comfort is related to contact lens oxygen transmissibility (Dk/t). This investigation searched for correlations between contact lens parameters, specifically Dk/t, modulus and surface co-efficient of friction, and we...

Background: Daily disposable contact lenses are considered to be the pinnacle of safe contact lens wear, yet it has been suggested that it takes some period of wear for the lens surface to reach optimal compatibility with the ocular surface. This study assesses the influence of brief treatment with a conditioning drop on the ocular response to new...

Many hydrogen peroxide systems have recently been introduced to the contact lens market. No two systems are identical, and practitioners are confronted with a great deal of information from the various solution companies. When considered en musse, this information is complex and often contradictory. Here, we review the principles of hydrogen peroxi...

Fern-like crystallisation occurs in many body fluids when sampled and dried, including the tears. Tear ferning has been proposed as a diagnostic test of keratoconjunctivitis sicca (KCS), but the mechanism of reduced ferning in the dry eye is poorly understood. By microscopic examination of tear ferns and review of gynaecological and crystallographi...

Photorefractive keratectomy (PRK) is the alteration of corneal curvature by photoablation with an excimer laser to eliminate or significantly reduce refractive errors. In this paper, we present a comprehensive review of the literature on this procedure, from the principles and development of the laser system, to its clinical application, Melbourne...

Contact lenses are known to produce changes to the ocular tissues, and this review attempts to give a comprehensive assemblage of the knowledge on the aetiology of such changes. To achieve this result, the changes are categorized by structure and function, and discussed according to the temporal nature of occurrence where appropriate. Although asse...

In order to examine perspectives on rigid gas permeable (RGP) material properties, we surveyed 13 RGP lens manufacturers from Australia, New Zealand and the USA, as well as 13 leading contact lens practitioners from Australia. Both manufacturers and practitioners consistently rated rigidity/stability and wettability among the most important propert...

To evaluate corneal endothelial bleb response to wear of silicone-hydrogel contact lenses in eyes of East Asian subjects. A total of 24 subjects of East Asian origin, attended 3 separate sessions for a prospective, single-centre, trial. The following contact lenses were used: ACUVUE ADVANCE with HYDRACLEAR (ADVANCE, -3 dioptres), ACUVUE OASYS with...

To evaluate the clinical performance of comfilcon A (Biofinity) during 12 months of continuous wear compared to other silicone-hydrogel lenses. Forty-five subjects were fitted in one eye with the comfilcon A (test) lens. For 22 subjects, the other eye was fitted with lotrafilcon A (group A) and for the remaining 23 subjects the other eye was fitted...

To measure the oxygen permeability (Dk) and water content (WC) of silicone hydrogel (Si-Hy) contact lens materials. Randomized and masked determinations of the Dk of 5 Si-Hy and two hydrogel materials were made using a modified version of the polarographic measurement method described in ISO 9913-1. Stacks of one to six parallel-sided contact lense...

To examine the clinical performance of two brands of silicone-hydrogel lenses when worn on a daily wear basis. Fifty-six subjects with no ocular disease were enrolled at multiple sites in Australasia. Contact lenses made from galyfilcon A or lotrafilcon A were randomly assigned to each eye of the subject and the lenses were worn on a daily wear bas...

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To identify risk factors for the development of corneal infiltrative events (CIEs) associated with contact lens wear, and to report other relevant clinical characteristics. A series of symptomatic contact lens wearers presenting consecutively to a large hospital clinic over a 1-year period were examined. The clinical severity of any CIE was determi...

The purpose of this study is to compute total corneal oxygen consumption during contact lens wear and consider the concept as an index for describing corneal oxygenation during contact lens wear as opposed to flux, partial pressure, or Dk/t. Estimates of total corneal oxygen consumption were generated using a previously described eight-layer model...

The aim of this study was to compare corneal oxygen flux values derived from an oxygen diffusion model, with estimates from a model in which equivalent oxygen percentage (EOP) values were substituted for the post-lens tear film oxygen tension in Fick's law. A previously described five-layer corneal oxygen diffusion model was found to artefactually...

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To evaluate silicone-hydrogel balafilcon A (PureVision, Bausch & Lomb Inc., Rochester, NY) contact lenses worn on a 30-day continuous wear basis when compared with a traditional hydrogel (Acuvue, Vistakon, Johnson and Johnson Vision Products, Inc., Jacksonville, FL) worn on a 7-day extended wear schedule. Prospective, comparative, paired-eye, inter...