{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T17:45:24Z","timestamp":1770140724969,"version":"3.49.0"},"reference-count":25,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T00:00:00Z","timestamp":1663891200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Orthokeratology (ortho-k) is an overnight clinical contact lens wear technique to correct myopia and to reduce myopia progression wearing reverse-geometry rigid gas-permeable lenses. The lens fitting procedure in clinical practice usually requires subjective assessment of fluorescein pattern (fluorescein \u201cbull\u2019s eye\u201d pattern). The aim of this study was to develop a novel tool for fluorescein pattern measurements to reduce subjective practitioner dependency, especially in inexperienced practitioners, in ortho-k practice.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>A new MATLAB customized algorithm to measure the horizontal width of the four main zones of ortho-k fluorescein patterns (central bearing, tear reservoir, mid-peripheral bearing and edge lift) was designed. The algorithm was tested on a small image database consisting of 26 ortho-k fluorescein pattern images of 13 volunteers fitted with reverse geometry lenses (Seefree, Conoptica-Hecht Contactlinsen). The agreement between two independent observers and the ImageJ measurements was determined.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The new clinical tool provided similar measurements to ImageJ software for the central bearing (4.20 \u00b1 0.74 and 4.27 \u00b1 0.69 mm; <jats:italic>P<\/jats:italic> = 0.21), tear reservoir (1.69 \u00b1 0.41 and 1.69 \u00b1 0.45 mm; <jats:italic>P<\/jats:italic> = 0.69), mid-peripheral bearing (1.17 \u00b1 0.11 and 1.13 \u00b1 0.10 mm; <jats:italic>P<\/jats:italic> &lt; 0.01) and edge lift (0.48 \u00b1 0.06 and 0.48 \u00b1 0.06 mm; <jats:italic>P<\/jats:italic> = 0.81) zones. Good agreement between the software (limits of agreement lower than \u00b10.55 mm) and inter-observer measurements (limits of agreement lower than \u00b10.66 mm) was found.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The proposed clinical tool for semiautomatic fluorescein pattern measurements in ortho-k could help to reduce practitioner dependency in fluorescein pattern assessment with future potential to introduce prediction algorithms or artificial intelligence methods in myopia control management.<\/jats:p>\n<\/jats:sec>","DOI":"10.7717\/peerj.14068","type":"journal-article","created":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T07:16:01Z","timestamp":1663917361000},"page":"e14068","source":"Crossref","is-referenced-by-count":4,"title":["Clinical tool to measure fluorescein patterns in orthokeratology"],"prefix":"10.7717","volume":"10","author":[{"given":"Marina","family":"L\u00f3pez Garc\u00eda Rosuero","sequence":"first","affiliation":[{"name":"School of Optometry, Universidad de Valladolid, Valladolid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Arranz Bombin","sequence":"additional","affiliation":[{"name":"School of Optometry, Universidad de Valladolid, Valladolid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2996-4754","authenticated-orcid":true,"given":"Roberto","family":"Romero","sequence":"additional","affiliation":[{"name":"Biomedical Engineering Group, Universidad de Valladolid, Valladolid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Hornero","sequence":"additional","affiliation":[{"name":"Biomedical Engineering Group, Universidad de Valladolid, Valladolid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raul","family":"Martin","sequence":"additional","affiliation":[{"name":"School of Optometry, Universidad de Valladolid, Valladolid, Spain"},{"name":"Biomedical Engineering Group, Universidad de Valladolid, Valladolid, Spain"},{"name":"IOBA Eye Institute, Universidad de Valladolid, Valladolid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4443","published-online":{"date-parts":[[2022,9,23]]},"reference":[{"issue":"6","key":"10.7717\/peerj.14068\/ref-1","doi-asserted-by":"publisher","first-page":"2518","DOI":"10.1167\/iovs.02-0680","article-title":"The effects of overnight orthokeratology lens wear on corneal thickness","volume":"44","author":"Alharbi","year":"2003","journal-title":"Investigative Opthalmology & Visual Science"},{"key":"10.7717\/peerj.14068\/ref-2","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/S0140-6736(86)90837-8","article-title":"Statistical methods for assessing agreement between two methods of clinical measurement","volume":"1","author":"Bland","year":"1986","journal-title":"Lancet"},{"issue":"3","key":"10.7717\/peerj.14068\/ref-3","doi-asserted-by":"publisher","first-page":"e71","DOI":"10.1097\/OPX.0000000000000513","article-title":"Exact parametric confidence intervals for Bland-Altman limits of agreement","volume":"92","author":"Carkeet","year":"2015","journal-title":"Optometry and Vision Science: Official Publication of the American Academy of Optometry"},{"issue":"3","key":"10.7717\/peerj.14068\/ref-4","doi-asserted-by":"publisher","first-page":"1411","DOI":"10.1167\/iovs.16-20594","article-title":"Protective role of orthokeratology in reducing risk of rapid axial elongation: a reanalysis of data from the ROMIO and TO-SEE studies","volume":"58","author":"Cho","year":"2017","journal-title":"Investigative Ophthalmology and Visual Science"},{"issue":"1","key":"10.7717\/peerj.14068\/ref-5","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1080\/02713680590907256","article-title":"The longitudinal orthokeratology research in children (LORIC) in Hong Kong: a pilot study on refractive changes and myopic control","volume":"30","author":"Cho","year":"2005","journal-title":"Current Eye Research"},{"key":"10.7717\/peerj.14068\/ref-6","volume-title":"The contact lens manual. 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