Myopic defocus in the evening is more effective at inhibiting eye growth than defocus in the morning: Effects on rhythms in axial length and choroid thickness in chicks.

Animal models have shown that myopic defocus is a potent inhibitor of ocular growth: brief (1-2 h) daily periods of defocus are sufficient to counter the effects of much longer periods of hyperopic defocus, or emmetropic vision. While the variables of duration and frequency have been well-documented with regard to effect, we ask whether the efficacy of the exposures might also depend on the time of day that they are given. We also ask whether there are differential effects on the rhythms in axial length or choroidal thickness. 2-week-old chickens were divided into 2 groups: (1) "2-hr lens-wear". Chicks wore monocular +10D lenses for 2 h per day for 5 days at one of 3 times of day: 5:30 a.m. (n = 11), 12 p.m. (n = 8) or 7:30 p.m. (n = 11). (2) "2-hr minus lens-removal". Chicks wore monocular -10D lenses continually for 7 days, except for a 2-hr period when lenses were removed; the removal occurred at one of 2 times: 5:30 a.m. (n = 8) or 7:30 p.m. (n = 8). Both paradigms exposed eyes to brief myopic defocus that differed in its magnitude, and in the visual experience for the rest of the day. High frequency A-scan ultrasonography was done at the start of the experiment; on the last day, it was done at 6-hr intervals, starting at noon, over 24-hr, to assess rhythm parameters. Refractive errors were measured using a Hartinger's refractometer at the end. In both paradigms, myopic defocus in the evening was significantly more effective at inhibiting eye growth than in the morning ("2-hr lens-wear": X-C: -149 vs -83 μm/5d; "2-hr lens-removal": X-C: 91 vs 245 μm/7d; post-hoc Bonferroni test, p < 0.01 for both). Data for "noon" was similar to that of "evening". In general, the refractive errors were consistent with the eye growth. In both paradigms, a 2-way ANOVA showed that "time of day" accounted for the differences between the morning versus evening groups ("2-hr lens-wear": p = 0.0161; "2-hr lens-removal": p = 0.038). In the "plus-lens" morning exposure, the rhythm in axial length could not be fit to a sinusoid. In both paradigms, the rhythm in axial length for the evening group was phase-advanced relative to noon or morning ("2-hr lens-wear": evening vs noon; 1:24 p.m. vs 6:42 p.m.; "2-hr lens-removal": evening vs morning: 12:15 p.m. vs 6:18 p.m.; p < 0.05 for both). Finally, the amplitude of the rhythm as assessed by the "day vs night" maximum and minimum respectively, was larger in the "evening" than in the "morning" group ("2-hr lens-wear": 88 vs 38 μm; "2-hr lens-removal": 104 vs 48 μm; p < 0.05 for both). For the choroidal rhythm, there was no effect on phase, however, the amplitude was larger in most, but not all, experimental groups. These findings have potential translational applications to myopia prevention in schoolchildren, who are exposed to extended periods of hyperopic defocus during reading sessions, due to the nearness of the page. We propose that bouts of such near-work might best be scheduled later in the day, along with frequent breaks for distance vision.