Changes in Shape Discrimination Sensitivity Under Glare Conditions After Orthokeratology in Myopic Children: A Prospective Study

PURPOSE: To investigate changes in shape discrimination under mesopic conditions with and without glare after orthokeratology in myopic children. METHODS: This prospective study included 79 eyes of 79 myopic children (ages: 8–16 years). Shape discrimination thresholds (SDTs) were measured using radial frequency patterns, with a radial frequency of 4 cycles/360°, a peak spatial frequency of 3 cycles per degree, a contrast of 20%, and a mean radius of 1.5 degrees. SDT under mesopic conditions with and without glare was measured before orthokeratology and again at 1 week and 1 month after orthokeratology. Changes in the SDTs and their relationships to baseline ocular parameters were analyzed. RESULTS: SDTs with glare decreased significantly at 1 week (−0.08 ± 0.15 log(arcsec), P < 0.001) and 1 month (−0.09 ± 0.15 log(arcsec), P < 0.001) after orthokeratology. SDTs without glare remained stable (P = 0.81 and P = 1.00, respectively). The difference between SDTs with and without glare also decreased significantly at 1 week (−0.10 ± 0.17 log(arcsec), P < 0.001) and at 1 month (−0.08 ± 0.18 log(arcsec), P = 0.001) after orthokeratology. Based on a multivariate analysis, the greater decrease in SDT with glare after 1 month of orthokeratology was associated with a higher baseline spherical equivalent refraction. CONCLUSIONS: Orthokeratology resulted in improved shape discrimination in myopic children under mesopic conditions but only when measured in the presence of glare.