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Jo E, Kim SM, Kim JM, Han SY. Changes in ocular biometrics following cycloplegic refraction in strabismic and amblyopic children. Medicine (Baltimore) 2024; 103:e38143. [PMID: 38758890 PMCID: PMC11098244 DOI: 10.1097/md.0000000000038143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 04/15/2024] [Indexed: 05/19/2024] Open
Abstract
This study was aimed to analyze ocular biometric changes following cycloplegia in pediatric patients with strabismus and amblyopia. Cycloplegia is routinely used to measure refractive error accurately by paralyzing accommodation. However, effects on axial length (AL), anterior chamber depth (ACD), keratometry (Km), and white-to-white distance (WTW) are not well studied in this population. This retrospective study examined 797 patients (1566 eyes) undergoing cycloplegic refraction at a Samsung Kangbuk hospital pediatric ophthalmology clinic from 2010 to 2023. Ocular biometry was measured before and after instilling 1% cyclopentolate and 0.5% phenylephrine/0.5% tropicamide. Patients were categorized by strabismus diagnosis, age, refractive error and amblyopia status. Differences in AL, ACD, Km, WTW, and refractive error pre- and post-cycloplegia were analyzed using paired t tests. ACD (3.44 ± 0.33 vs 3.58 ± 0.29 mm, P < .05) and WTW (12.09 ± 0.42 vs 12.30 ± 0.60 mm, P < .05) increased significantly after cycloplegia in all groups except other strabismus subgroup (Cs) in both parameters and youngest subgroup (G1) in ACD. Refractive error demonstrated a hyperopic shift from -0.48 ± 3.00 D to -0.06 ± 3.32 D (P < .05) in overall and a myopic shift from -6.97 ± 4.27 to -8.10 ± 2.26 in high myopia (HM). Also, AL and Km did not change significantly. In conclusion, cycloplegia impacts ocular biometrics in children with strabismus and amblyopia, significantly increasing ACD and WTW. Refractive error shifts hyperopically in esotropia subgroup (ET) and myopically in high myopia subgroup (HM), eldest subgroup (G3) relating more to anterior segment changes than AL/Km. Understanding cycloplegic effects on biometry is important for optimizing refractive correction in these patients.
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Affiliation(s)
- Eunhui Jo
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joon Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - So Young Han
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Sella R, Bu JJ, Lian RR, Hu JQ, Gali HE, Walker EH, Livny E, Afshari NA. Axial length and pharmacologic pupillary dilation in highly myopic patients. Graefes Arch Clin Exp Ophthalmol 2024; 262:1531-1538. [PMID: 37999774 DOI: 10.1007/s00417-023-06296-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 10/19/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023] Open
Abstract
PURPOSE To determine how high myopia impacts pharmacological pupillary dilation, and to evaluate the relationship between the extent of pharmacologic pupillary dilation and axial length. METHODS Patients were grouped into high myopes, defined as one or both eyes having a refractive error greater than - 6 diopters, and controls (between - 2 and + 2 diopters). Dilation was achieved with 1 drop each of tropicamide 1% and phenylephrine 2.5%. Pupil size was measured at full and dim light prior to dilation, then 15 and 30 min after dilation. Biometry was measured for each patient. Statistical analyses were performed using the Mann-Whitney-Wilcoxon tests, two-sample Welch's t-tests, and linear mixed effect models and generalized estimating equations models accounting for inter-eye correlation. RESULTS Forty patients (20 high myopes and 20 controls, 80 eyes total) participated in the study. High myopes had larger pupils at baseline and achieved significantly greater pupillary size (7.08 mm, 95% CI: 6.97 to 7.19 mm) than controls (6.23 mm, 95% CI: 5.94 to 6.52 mm) after 30 min of dilation (P < .0005). Fully dilated pupil size at 30 min was significantly correlated with both refractive error (r = - 0.57, P < .0005) and axial length (r = 0.47, P < .0005). Generalized estimating equations and linear mixed effect models identified other predictive variables of pupil size after dilation including age and white-to-white diameter. CONCLUSIONS Highly myopic patients dilate to a larger pupillary size compared to other patients. Predicting dilation based on extent of myopia could facilitate intraocular surgery planning and reduce clinic wait times for myopic patients.
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Affiliation(s)
- Ruti Sella
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, 9415 Campus Point Dr, La Jolla, CA, 92093, USA
- Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jennifer J Bu
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, 9415 Campus Point Dr, La Jolla, CA, 92093, USA
| | - Rebecca R Lian
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, 9415 Campus Point Dr, La Jolla, CA, 92093, USA
| | - Jenny Q Hu
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, 9415 Campus Point Dr, La Jolla, CA, 92093, USA
| | - Helena E Gali
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, 9415 Campus Point Dr, La Jolla, CA, 92093, USA
| | - Evan H Walker
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, 9415 Campus Point Dr, La Jolla, CA, 92093, USA
| | - Eitan Livny
- Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Natalie A Afshari
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, 9415 Campus Point Dr, La Jolla, CA, 92093, USA.
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Wu S, Hao J, Guo D, Ma Z, Wu Q, Zhang M, Bi H. Characterization of lncRNA and mRNA profiles in ciliary body in experimental myopia. Exp Eye Res 2024; 241:109849. [PMID: 38430983 DOI: 10.1016/j.exer.2024.109849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 02/20/2024] [Accepted: 02/26/2024] [Indexed: 03/05/2024]
Abstract
Currently, researchers have mainly focused on the role of the tissues of the posterior segment of the eyes in the development of myopia. However, the ciliary body, an anterior ocular tissue that contracts to initiate the process of accommodation, may also play an important role in the progression of myopia due to the increased demand for near work. In the present study, we established a lens-induced myopia (LIM) animal model in guinea pigs and investigated the molecular changes in the ciliary body associated with the development of myopia based on RNA sequencing. As a result, 871 differentially expressed (DE) mRNAs and 19 DE lncRNAs were identified in the ciliary body between the LIM group and the normal control group. In addition, the lncRNA-mRNA co-expression analysis was performed to explore the target genes of lncRNAs, which were mainly enriched in the Rap1 signaling pathway, cytokine-cytokine receptor interaction, and complement and coagulation cascades pathways based on the functional enrichment analysis. Among the target genes of lncRNAs, three hub genes, including Ctnnb1, Pik3r1, and Itgb1, were found to be involved in the Rap1 signaling pathway. Interestingly, two crucial genes, Grk1 and Pde6a, which are mainly expressed in retinal photoreceptors, were enriched in visual perception in the ciliary body in functional analysis and were verified to be expressed in the ciliary body. These findings indicate the molecular pathogenetic role of the ciliary body in myopia and provide new insights into the underlying mechanism of myopia development. Further studies are needed to explore the specific contributions of these identified lncRNAs and mRNAs to the development of myopia.
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Affiliation(s)
- Shanshan Wu
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, China; Shandong University of Traditional Chinese Medicine, Jinan, 250002, China
| | - Jiawen Hao
- Shandong University of Traditional Chinese Medicine, Jinan, 250002, China
| | - Dadong Guo
- Shandong Academy of Eye Disease Prevention and Therapy, Medical College of Optometry and Ophthalmology, Shandong University of Traditional Chinese Medicine, Jinan, 250002, China.
| | - Zhongyu Ma
- Shandong University of Traditional Chinese Medicine, Jinan, 250002, China
| | - Qiuxin Wu
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, China
| | - Ming Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Hongsheng Bi
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, 250002, China.
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Yii FS, He M, Chappell F, Bernabeu MO, MacGillivray T, Dhillon B, Tatham A, Strang N. Higher intraocular pressure is associated with slower axial growth in children with non-pathological high myopia. Eye (Lond) 2024; 38:1208-1214. [PMID: 38081936 PMCID: PMC11009290 DOI: 10.1038/s41433-023-02872-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 04/13/2024] Open
Abstract
OBJECTIVES To investigate the association between intraocular pressure (IOP) and axial elongation rate in highly myopic children from the ZOC-BHVI High Myopia Cohort Study. METHODS 162 eyes of 81 healthy children (baseline spherical equivalent: -6.25 D to -15.50 D) aged 7-12 years with non-pathological high myopia were studied over five biennial visits. The mean (SD) follow-up duration was 5.2 (3.3) years. A linear mixed-effects model (LMM) was used to assess the association between IOP (at time point t-1) and axial elongation rate (annual rate of change in AL from t-1 to t), controlling for a pre-defined set of covariates including sex, age, central corneal thickness, anterior chamber depth and lens thickness (at t-1). LMM was also used to assess the contemporaneous association between IOP and axial length (AL) at t, controlling for the same set of covariates (at t) as before. RESULTS Higher IOP was associated with slower axial growth (β = -0.01, 95% CI -0.02 to -0.005, p = 0.001). There was a positive contemporaneous association between IOP and AL (β = 0.03, 95% CI 0.01-0.05, p = 0.004), but this association became progressively less positive with increasing age, as indicated by a negative interaction effect between IOP and age on AL (β = -0.01, 95% CI -0.01 to -0.003, p = 0.001). CONCLUSIONS Higher IOP is associated with slower rather than faster axial growth in children with non-pathological high myopia, an association plausibly confounded by the increased influence of ocular compliance on IOP.
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Affiliation(s)
- Fabian Sl Yii
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK.
- Curle Ophthalmology Laboratory, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK.
| | - Mingguang He
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Centre for Eye Research Australia, The University of Melbourne, Melbourne, Australia
| | - Francesca Chappell
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Miguel O Bernabeu
- Centre for Medical Informatics, Usher Institute, The University of Edinburgh, Edinburgh, UK
- The Bayes Centre, The University of Edinburgh, Edinburgh, UK
| | - Tom MacGillivray
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Curle Ophthalmology Laboratory, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
| | - Baljean Dhillon
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Curle Ophthalmology Laboratory, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
- Princess Alexandra Eye Pavilion, NHS Lothian, Edinburgh, UK
| | - Andrew Tatham
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Princess Alexandra Eye Pavilion, NHS Lothian, Edinburgh, UK
| | - Niall Strang
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
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Norazman FNN, Mohd-Ali B, Syed Mohd Dardin SF, Mohamad Shahimin M, Mohamad Fadzil N, Mohd Saman MN, Mohidin N. Baseline Accommodation and Binocular Vision Measures in Malay Schoolchildren Enrolled in the Myopia Control Study Using Spectacle Lenses in Kuala Lumpur. CLINICAL OPTOMETRY 2024; 16:45-52. [PMID: 38405333 PMCID: PMC10893784 DOI: 10.2147/opto.s432496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 01/22/2024] [Indexed: 02/27/2024]
Abstract
Myopia control lenses have been shown to modify visual function; however, it is arguable if these changes are short-term or long-term. We investigated the changes in accommodative behaviour and binocular vision functions of Malay myopic children who participated in a myopia control trial utilising spectacle lenses (n = 40). This article presents baseline accommodation and binocular vision measurements. The mean (± SD) age, spherical equivalent measured by cycloplegic autorefraction, and axial length (AL) for the right eyes were 10.00 ± 1.47 years, -3.02 ± 1.20 D, and 24.42 ± 0.93 mm, respectively. All participants had good distance and near visual acuities with high-contrast charts (100%), which were significantly better than low-contrast charts (10%) (p < 0.001). The mean (± SD) accommodative lag at baseline was 1.14 ± 0.35 D, while monocular and binocular accommodative amplitudes were 15.35 ± 2.07 D and 16.82 ± 2.27 D, respectively. Malay schoolchildren in this study were more esophoric at near compared to distance, with an accommodative-convergence over accommodation (AC/A) ratio of 5.64 ± 0.66 ∆/D. A higher degree of myopia was found to be associated with a longer AL (r = -0.49, p < 0.05) and higher esophoria at near (r = -0.46, p < 0.05). These baseline measures are consistent with data from other studies showing that myopic children have a high accommodative lag, an elevated AC/A ratio, a longer AL, and are more esophoric at near. The measures reported herein will serve as a basis for examining changes that occur within 12 months of wearing myopia control spectacle lenses.
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Affiliation(s)
- Fatin Nur Najwa Norazman
- Optometry and Vision Science Program and Research Centre for Community Health (Reach), Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Centre for Optometry Studies, Faculty of Health Sciences, Universiti Teknologi MARA Cawangan Selangor, Kampus Puncak Alam, Selangor, 42300, Malaysia
| | - Bariah Mohd-Ali
- Optometry and Vision Science Program and Research Centre for Community Health (Reach), Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Syarifah Faiza Syed Mohd Dardin
- Optometry and Vision Science Program and Research Centre for Community Health (Reach), Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mizhanim Mohamad Shahimin
- Optometry and Vision Science Program and Research Centre for Community Health (Reach), Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norliza Mohamad Fadzil
- Optometry and Vision Science Program and Research Centre for Community Health (Reach), Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Norhafizun Mohd Saman
- Optometry and Vision Science Program and Research Centre for Community Health (Reach), Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norhani Mohidin
- Optometry and Vision Science Program and Research Centre for Community Health (Reach), Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Yu CY, Dong L, Li YF, Wei WB. Vitamin D and myopia: a review. Int Ophthalmol 2024; 44:95. [PMID: 38368573 DOI: 10.1007/s10792-024-03009-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 10/29/2023] [Indexed: 02/19/2024]
Abstract
Myopia is a worldwide public health problem of vision disorder caused by multiple factors, which has posed a huge socioeconomic burden, raising concerns about sight-threatening ocular complications. Vitamin D, as a kind of fat-soluble vitamin, related to time-spent-outdoors, has been considered by extensive studies to have potential relationship with myopia. We reviewed studies published in a decade which estimated the association of blood vitamin D status with myopia and summarized the universality and individuality of all research articles. Several research articles suggested the known environmental risk factors of myopia, including age, gender, ethnicity, education level, parental and school conditions, time-spent-outdoors, and sunlight exposure, and recent epidemiological studies demonstrate that increased vitamin D levels, by virtue of the extended outdoor time, may be an important modifiable factor and a protective effect that delay the progression of myopia in children and adolescents rather than in adults. The genetic studies have been conducted to get access to the evidence of gene polymorphism for explaining the association of serum vitamin D status and myopia, but the precise genetic interpretation of vitamin D and myopia remains unclear so far; on the other hand, the possible mechanisms are various like copolymerization mechanism, calcium homeostasis and imbalance of ciliary muscle function regulation, but nearly all of the investigators are inclined to remain skeptical. This article reviews the age-related epidemiological proofs, existent genetics correlations, possible underlying biological mechanisms and further values for the protective association between vitamin D and myopia, providing the possibility of prevention or postponement for myopia.
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Affiliation(s)
- Chu-Yao Yu
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Lane, Beijing, 100730, China
| | - Li Dong
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Lane, Beijing, 100730, China
| | - Yi-Fan Li
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Lane, Beijing, 100730, China
| | - Wen-Bin Wei
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Lane, Beijing, 100730, China.
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Fernández-Vigo JI, Fernández-Aragón S, de-Pablo-Gómez-de-Liaño L, Fernández-Vigo C, Almorín-Fernández-Vigo I, García-Feijóo J, Fernández-Vigo JA. Assessment of the ciliary muscle and scleral anterior thickness in high myopia by optical coherence tomography. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2024; 99:16-22. [PMID: 38008380 DOI: 10.1016/j.oftale.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/22/2023] [Indexed: 11/28/2023]
Abstract
PURPOSE To assess ciliary muscle (CM) and anterior scleral thickness (AST) dimensions in vivo in high myopia using swept-source optical coherence tomography (SS-OCT) and to compare with emmetropic and hyperopic subjects. METHODS Cross-sectional study that included 34 high myopic patients (≥ -6 diopters [D]), 90 emmetropes (-1 to +1 D) and 38 hyperopic patients (≥ +3.5 D). CM thickness (CMT) and AST were measured in the temporal and nasal quadrants at 1, 2, and 3 mm from the scleral spur using SS-OCT. In addition, the length of the CM (CML) was evaluated. RESULTS The dimensions of the CML and the CMT at any of their measurement points were greater in high myopes and emmetropes than in hyperopes, both in the nasal and temporal quadrants (P < .001). However, there were no differences between high myopes and emmetropes for any of the parameters (P ≥ .076) except for the CMT at 3 mm in the temporal quadrant (P < .001). There were no differences in the AST between high myopes, emmetropes and hyperopes, in any of the measurement points or quadrants studied (P > .05). CONCLUSIONS The SS-OCT allows to measure the CM in vivo, not observing differences in its dimensions between high myopes and emmetropes, but they were smaller in hyperopes. In the measurement of the anterior sclera, no differences were observed between the three groups analyzed according to refraction.
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Affiliation(s)
- J I Fernández-Vigo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain; Centro Internacional de Oftalmología Avanzada, Madrid, Spain.
| | - S Fernández-Aragón
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain; Centro Internacional de Oftalmología Avanzada, Madrid, Spain
| | - L de-Pablo-Gómez-de-Liaño
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain; Departamento de Oftalmología, Hospital 12 de Octubre, Madrid, Spain
| | - C Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain; Centro Internacional de Oftalmología Avanzada, Badajoz, Spain
| | | | - J García-Feijóo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - J A Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain; Departamento de Oftalmología, Universidad de Extremadura, Badajoz, Spain
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Yang ZH, Hao JW, Liu JP, Bao B, Li TL, Wu QX, He MG, Bi HS, Guo DD. Electroacupuncture alleviates ciliary muscle cell apoptosis in lens-induced myopic guinea pigs through inhibiting the mitochondrial signaling pathway. Int J Ophthalmol 2023; 16:1942-1951. [PMID: 38111935 PMCID: PMC10700068 DOI: 10.18240/ijo.2023.12.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 10/19/2023] [Indexed: 12/20/2023] Open
Abstract
AIM To investigate the effect of electroacupuncture (EA) on the mitochondria-dependent apoptotic signaling pathway in the ciliary muscle of guinea pigs with negative lens-induced myopia (LIM). METHODS Guinea pigs were randomly divided into normal control (NC) group, LIM group, LIM+SHAM acupoint (LIM+SHAM) group, and LIM+EA group. Animals in the NC group received no intervention, while those in other three groups were covered with -6.0 diopter (D) lenses on right eyes. Meanwhile, animals in the LIM+EA group received EA at Hegu (LI4) combined with Taiyang (EX-HN5) acupoints, while those in the LIM+SHAM group were treated at sham points. After treatments for 1, 2, and 4wk, morphological changes in ciliary muscles were observed with hematoxylin and eosin (H&E) staining and nick end labeling (TUNEL), and the expression of the mitochondrial apoptotic signaling pathway-related molecules in ciliary muscles was measured by real-time quantitative polymerase chain reaction (qPCR) and Western blot. Additionally, the adenosine triphosphate (ATP) contents were also determined in ciliary muscles. RESULTS Axial length increased significantly in the LIM and LIM+SHAM groups and decreased in the LIM+EA group. The ciliary muscle fibers were broken and destroyed in both LIM and LIM+SHAM groups, whereas those in the LIM+EA group improved significantly. TUNEL assay showed the number of apoptotic cells increased in the LIM and LIM+SHAM groups, whereas reduced in the LIM+EA group. ATP contents showed a significant decrease in the LIM and LIM+SHAM groups, whereas increased after EA treatment. Compared with the NC group, the dynamin-related protein 1 (DRP1), Caspase3, and apoptotic protease activator 1 (APAF1) levels were significantly increased in the LIM group and decreased in the LIM+EA group. CONCLUSION The results provide evidence of EA inhibiting the development of myopia by regulating the mitochondrial apoptotic signaling pathway.
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Affiliation(s)
- Zhao-Hui Yang
- Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
| | - Jia-Wen Hao
- Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
| | - Jin-Peng Liu
- Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
| | - Bo Bao
- Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
| | - Tu-Ling Li
- Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
| | - Qiu-Xin Wu
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Shandong Provincial Clinical Medical Research Center of Optometry and Adolescent Low Vision Prevention and Control, Jinan 250002, Shandong Province, China
| | - Ming-Guang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Hong-Sheng Bi
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Shandong Provincial Clinical Medical Research Center of Optometry and Adolescent Low Vision Prevention and Control, Jinan 250002, Shandong Province, China
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Academy of Eye Disease Prevention and Therapy, Medical College of Optometry and Ophthalmology, Shandong University of Traditional Chinese Medicine, Jinan 250002, Shandong Province, China
| | - Da-Dong Guo
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Academy of Eye Disease Prevention and Therapy, Medical College of Optometry and Ophthalmology, Shandong University of Traditional Chinese Medicine, Jinan 250002, Shandong Province, China
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Kwok HY, Kwok HY, Ng TN, Leung TW, Kang BS, Kee CS. Characteristics of ciliary muscle profile in high myopes measured by swept-source anterior segment optical coherence tomography. PLoS One 2023; 18:e0289135. [PMID: 38033137 PMCID: PMC10688841 DOI: 10.1371/journal.pone.0289135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/11/2023] [Indexed: 12/02/2023] Open
Abstract
OBJECTIVE To characterize and compare the ciliary muscle thickness (CMT) between low and high myopes using swept-source anterior segment optical coherence tomography (AS-OCT). METHODS Forty visually healthy young Chinese adults aged 18-25 years were divided into two groups based on refractive errors: low myopia (n = 20, spherical-equivalent refractive error (SER) between -0.50 D to -3.00 D) and high myopia (n = 20, SER ≤ -6.00 D). Cycloplegic refractions were performed before axial length (AL) and CMT were measured using a partial coherence laser interferometer and an AS-OCT respectively. CMT was measured perpendicularly to the sclera-ciliary muscle interface at 1 mm (CMT_1), 2 mm (CMT_2), and 3 mm (CMT_3) posterior to the scleral spur, and at the location with maximal thickness (CMT_MAX). RESULTS High myopes demonstrated thicker CMT at 2 mm (CMT_2, p = 0.035) and 3 mm (CMT_3, p = 0.003) posterior to the scleral spur, but thinner maximal CMT (CMT_MAX, p = 0.005) than low myopes. The apical CMT_1 and CMT_MAX were also thinner in high myopes than in low myopes (both p< 0.001). CMT_MAX, apical CMT_1, and apical CMT_MAX correlated directly with SER and inversely with AL; in contrast, CMT_2 and CMT_3 showed inverse correlations with SER but direct correlations with AL. CONCLUSION Our findings revealed significant differences in CMT between low and high myopes, with high myopes showing thicker CMT at 2 mm and 3 mm posterior to the scleral spur, but thinner maximal CMT. These results provide new evidence of the potential structural differences in ciliary muscles during myopia development and progression.
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Affiliation(s)
- Hiu Yin Kwok
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR, China
| | - Hoi Yee Kwok
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR, China
| | - Tsz Nok Ng
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR, China
| | - Tsz-wing Leung
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR, China
- Research Centre for Sharp Vision, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR, China
- Centre for Eye and Vision Research Limited, Hong Kong, SAR, China
| | - Byung Soo Kang
- Centre for Eye and Vision Research Limited, Hong Kong, SAR, China
| | - Chea-su Kee
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR, China
- Research Centre for Sharp Vision, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR, China
- Centre for Eye and Vision Research Limited, Hong Kong, SAR, China
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10
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Owusu E, Shasteen NM, Mitchell GL, Bailey MD, Kao CY, Toole AJ, Richdale K, Kulp MT. Impact of accommodative insufficiency and accommodative/vergence therapy on ciliary muscle thickness in the eye. Ophthalmic Physiol Opt 2023; 43:947-953. [PMID: 37184092 DOI: 10.1111/opo.13155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 04/14/2023] [Accepted: 04/16/2023] [Indexed: 05/16/2023]
Abstract
PURPOSE Recent evidence suggests that the ciliary muscle apical fibres are most responsive to accommodative load; however, the structure of the ciliary muscle in individuals with accommodative insufficiency is unknown. This study examined ciliary muscle structure in individuals with accommodative insufficiency (AI). We also determined the response of the ciliary muscle to accommodative/vergence therapy and increasing accommodative demands to investigate the muscle's responsiveness to workload. METHODS Subjects with AI were enrolled and matched by age and refractive error with subjects enrolled in another ciliary muscle study as controls. Anterior segment optical coherence tomography was used to measure the ciliary muscle thickness (CMT) at rest (0D), maximum thickness (CMTMAX) and over the area from 0.75 mm (CMT0.75) to 3 mm (CMT3) posterior to the scleral spur of the right eye. For those with AI, the ciliary muscle was also measured at increasing levels of accommodative demand (2D, 4D and 6D), both before and after accommodative/vergence therapy. RESULTS Sixteen subjects with AI (mean age = 17.4 years, SD = 8.0) were matched with 48 controls (mean age = 17.8 years, SD = 8.2). On average, the controls had 52-72 μm thicker ciliary muscles in the apical region at 0D than those with AI (p = 0.03 for both CMTMAX and CMT 0.75). Differences in thickness between the groups in other regions of the muscle were not statistically significant. After 8 weeks of accommodative/vergence therapy, the CMT increased by an average of 22-42 μm (p ≤ 0.04 for all), while AA increased by 7D (p < 0.001). CONCLUSIONS This study demonstrated significantly thinner apical ciliary muscle thickness in those with AI and that the ciliary muscle can thicken in response to increased workload. This may explain the mechanism for improvement in signs and symptoms with accommodative/vergence therapy.
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Affiliation(s)
- Emmanuel Owusu
- College of Optometry, The Ohio State University, Columbus, Ohio, USA
| | | | - G Lynn Mitchell
- College of Optometry, The Ohio State University, Columbus, Ohio, USA
| | - Melissa D Bailey
- College of Optometry, The Ohio State University, Columbus, Ohio, USA
| | - Chiu-Yen Kao
- Department of Mathematical Sciences, Claremont McKenna College, Claremont, California, USA
| | - Andrew J Toole
- College of Optometry, The Ohio State University, Columbus, Ohio, USA
| | - Kathryn Richdale
- College of Optometry, The Ohio State University, Columbus, Ohio, USA
| | - Marjean T Kulp
- College of Optometry, The Ohio State University, Columbus, Ohio, USA
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11
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Zieliński G, Matysik-Woźniak A, Pająk B, Ginszt M, Rejdak R, Gawda P. Study protocol: Accommodative effects on the musculoskeletal system. PLoS One 2023; 18:e0289347. [PMID: 37506164 PMCID: PMC10381037 DOI: 10.1371/journal.pone.0289347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Accommodation is a phenomenon of the eyeball, which consists of adapting to view objects at different distances. The main aim of this study is to evaluate the effect of accommodations on the musculoskeletal system in myopic and emmetropic subjects. To date, the effect of accommodative paralysis on the musculoskeletal system has not been studied. The research hypothesis based on the current research reports is that accommodation affects the musculoskeletal system in myopic and emmetropic subjects. A smaller aim of the study is to evaluate the effect of unilateral accommodative palsy on the musculoskeletal system in myopic and emmetropic subjects. According to the authors of the previous reports, unilateral accommodative palsy will affect increased musculoskeletal asymmetry in myopic and emmetropic subjects. The surface electromyography (sEMG) of the musculoskeletal system will be performed by using the Noraxon Ultium DTS 8-K MR 3 myo Muscle Master Edition. Cycloftyal (10 mg/ml, eye drops, solution) will be used to paralyze accommodation. After the paralysis of unilateral accommodation, the test will be repeated. Both-sided accommodation will be paralyzed next, and the test will be repeated. The study may provide insight into the effects of accommodation on the musculoskeletal system, and it may also help in understanding the connections between these systems.
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Affiliation(s)
- Grzegorz Zieliński
- Department of Sports Medicine, Medical University of Lublin, Lublin, Poland
| | - Anna Matysik-Woźniak
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
| | - Beata Pająk
- Interdisciplinary Scientific Group of Sports Medicine, Department of Sports Medicine, Medical University of Lublin, Lublin, Poland
| | - Michał Ginszt
- Department of Rehabilitation and Physiotherapy, Medical University of Lublin, Lublin, Poland
| | - Robert Rejdak
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, Lublin, Poland
| | - Piotr Gawda
- Department of Sports Medicine, Medical University of Lublin, Lublin, Poland
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12
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Lanza M, Ruggiero A, Ruggiero M, Iodice CM, Simonelli F. Analysis of Refractive Errors in a Large Italian Cohort of Pediatric Subjects Post the COVID-19 Pandemic. Life (Basel) 2023; 13:1569. [PMID: 37511944 PMCID: PMC10381484 DOI: 10.3390/life13071569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/05/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The prevalence of refractive errors has sharply risen over recent decades. Despite the established role of genetics in the onset and progression of such conditions, the environment was also shown to play a pivotal role. Indeed, the COVID-19 pandemic has majorly impacted people's lifestyles and healthy habits, especially among the youth, which might have led to a significant increase in this trend. Therefore, the aim of this study was to investigate the actual prevalence of refractive errors in a large cohort of pediatric patients. METHODS A large cohort of 496 participants was screened through anamnesis, a non-cycloplegic autorefractometry, a corrected and uncorrected visual acuity assessment, and a questionnaire and was retrospectively evaluated. RESULTS Overall, refractive errors were present in 25.1% of eyes, of which 14.6% were diagnosed with myopia/myopic astigmatism and 10.5% with hyperopia/hyperopic astigmatism. Among the patients enrolled, 298 (60%) had their eyes checked one year earlier or before and 122 (25%) had never had ophthalmological consultations; a total of 105 (21%) needed glasses and 34 (7%) required a change in their previous prescription. A substantial increase in daily electronic device screen exposure was declared by 426 patients (87.6%). CONCLUSIONS Pediatric patients appear to have a higher prevalence of refractive errors than before.
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Affiliation(s)
- Michele Lanza
- Multidisciplinary Department of Medical Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| | - Adriano Ruggiero
- Multidisciplinary Department of Medical Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| | - Matteo Ruggiero
- Multidisciplinary Department of Medical Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| | - Clemente Maria Iodice
- Multidisciplinary Department of Medical Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| | - Francesca Simonelli
- Multidisciplinary Department of Medical Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
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13
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Wagner S, Strasser T. Impact of text contrast polarity on the retinal activity in myopes and emmetropes using modified pattern ERG. Sci Rep 2023; 13:11101. [PMID: 37423936 DOI: 10.1038/s41598-023-38192-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/05/2023] [Indexed: 07/11/2023] Open
Abstract
Environmental factors favoring myopia development are still being studied and there is accumulating evidence for a significant role of nearwork. Recently, reading standard black-on-white text was found to activate the retinal OFF pathway and induce choroidal thinning, which is associated with myopia onset. Contrarily, reading white-on-black text led to thicker choroids, being protective against myopia. Respective effects on retinal processing are yet unknown. Here, we exploratively assessed the impact of contrast polarity on the retinal activity and possible interactions with eccentricity and refractive error. We recorded pattern electroretinograms in myopic and emmetropic adults while presenting a dead leaves stimulus (DLS), overlaid by masks of different size in ring or circle shape, either filled with uniform gray or text of inverted or standard contrast. In myopes, retinal responses for DLS with standard and inverted contrast were larger when the perifovea was stimulated (6-12 deg), however, including the fovea resulted in smaller amplitudes for inverted contrast than in emmetropes. The retina of emmetropes was more sensitive to inverted contrast than to standard and gray within 12 deg, but most sensitive for gray in the perifovea. This demonstrates that the refractive error influences the sensitivity to text contrast polarity, with a special role of the peripheral retina, which is in line with previous studies about blur sensitivity. Defining whether the differences derive from retinal processing or anatomical features of a myopic eye requires further investigation. Our approach might be a first step to explain how nearwork promotes the eye's elongation.
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Affiliation(s)
- Sandra Wagner
- Institute for Ophthalmic Research, University of Tuebingen, Elfriede-Aulhorn-Str. 7, 72076, Tuebingen, Germany.
| | - Torsten Strasser
- Institute for Ophthalmic Research, University of Tuebingen, Elfriede-Aulhorn-Str. 7, 72076, Tuebingen, Germany
- University Eye Hospital Tuebingen, Elfriede-Aulhorn-Str. 7, 72076, Tuebingen, Germany
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14
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Jia WN, Wang QY, Niu LL, Chen ZX, Jiang YX. Morphometric assessment of the ciliary body in patients with Marfan syndrome and ectopia lentis: A quantitative study using ultrasound biomicroscopy: Ciliary body morphology in Marfan syndrome and ectopia lentis. Am J Ophthalmol 2023; 251:24-31. [PMID: 36948371 DOI: 10.1016/j.ajo.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/28/2023] [Accepted: 03/05/2023] [Indexed: 03/24/2023]
Abstract
PURPOSE To explore the biometric characteristics of the ciliary body in patients with Marfan syndrome (MFS) and ectopia lentis (EL). DESIGN Cross-sectional study. METHODS Seventy-two consecutive MFS patients with EL and 72 non-disease controls were recruited. Ciliary body biometric parameters such as ciliary muscle cross-sectional area at 2000 μm from the scleral spur (CMA2000), ciliary muscle thickness at 1000 μm from the scleral spur (CMT1000), and maximum ciliary body thickness (CBTmax) were measured from multiple directions with ultrasound biomicroscopy (UBM). The relationship between ciliary body parameters and other ocular characteristics was also evaluated. RESULTS Average CMA2000, CMT1000, and CBTmax were 0.692 ± 0.015 mm2, 0.405 ± 0.010 mm, and 0.855±0.023 mm in MFS eyes, respectively, and were significantly smaller than controls (all p < 0.001). The prevalence of ciliary body thinning was 22.2% in the MFS group versus 0 in controls (p < 0.001); eyes with more severe EL had smaller CMA2000 (p = 0.050), thinner CMT1000 (p = 0.022) and shorter CBTmax (p = 0.015). Patients with microspherophakia (MSP) had even smaller CMA2000 (p = 0.033) and CMT1000 (p = 0.044) than those without MSP. The most common subluxation direction was in the superonasal quadrant (25, 39.7%), which probably correlates with the thinnest CMT1000 in the inferotemporal quadrant (p = 0.005). CONCLUSIONS MFS patients with EL had thinner ciliary muscles, shorter ciliary processes, and a higher prevalence of ciliary body thinning, especially those with MSP. Both the extent and direction of subluxation were associated with ciliary body biometry.
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Affiliation(s)
- Wan-Nan Jia
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Qian-Yi Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Ling-Ling Niu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Ze-Xu Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China.
| | - Yong-Xiang Jiang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China.
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15
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Mutti DO, Sinnott LT, Zadnik K. Compensation for Vitreous Chamber Elongation in Infancy and Childhood. Optom Vis Sci 2023; 100:43-51. [PMID: 36705714 PMCID: PMC9886320 DOI: 10.1097/opx.0000000000001970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
SIGNIFICANCE The ratios of diopters of change in refractive error produced per millimeter of eye elongation (D/mm) are rarely those predicted from geometric optics because of changes in other ocular components. Quantifying this optical compensation in millimeters instead of ratios reveals some important principles about eye growth and refractive error. PURPOSE The study purpose was to sort total vitreous chamber elongation into millimeters that either contributed (uncompensated) or did not contribute to change in refractive error (compensated). METHODS Participants were infants in the Berkeley Infant Biometry Study (n = 271, ages 3 months to 6 years) or schoolchildren in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (n = 456 emmetropes and 522 myopes, ages 6 to 14 years). Refractive error was measured using cycloplegic retinoscopy in infants (cyclopentolate 1%) and cycloplegic autorefraction in schoolchildren (tropicamide 1% or combined with cyclopentolate 1%). Axial dimensions were assessed using A-scan ultrasonography. Uncompensated millimeters were estimated from ratios of change in refractive error per millimeter of elongation using Gullstrand eye models. Compensated millimeters were the difference between measured elongation and uncompensated millimeters. RESULTS Compensated millimeters exceeded uncompensated millimeters in emmetropic children across ages, but uncompensated millimeters exceeded compensated millimeters in myopic children. Compensated millimeters were highest in infancy and decreased with age, reaching less than 0.10 mm per year by age 10 years in both myopic and emmetropic children. There were no statistically significant differences in compensated millimeters between myopic and emmetropic children between ages 8 and 14 years ( P values from .17 to .73). CONCLUSIONS The ability of the ocular components, primarily crystalline lens, to compensate for vitreous elongation is independent of the higher demands of myopic eye growth. The limited compensation after age 10 years suggests the target for elongation in myopia control needed to arrest myopia progression may be that seen in emmetropes or less.
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Affiliation(s)
| | | | - Karla Zadnik
- The Ohio State University College of Optometry, Columbus, Ohio
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16
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Straßer T, Wagner S. Performance of the Deep Neural Network Ciloctunet, Integrated with Open-Source Software for Ciliary Muscle Segmentation in Anterior Segment OCT Images, Is on Par with Experienced Examiners. Diagnostics (Basel) 2022; 12:diagnostics12123055. [PMID: 36553062 PMCID: PMC9777151 DOI: 10.3390/diagnostics12123055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/24/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022] Open
Abstract
Anterior segment optical coherence tomography (AS-OCT), being non-invasive and well-tolerated, is the method of choice for an in vivo investigation of ciliary muscle morphology and function. The analysis requires the segmentation of the ciliary muscle, which is, when performed manually, both time-consuming and prone to examiner bias. Here, we present a convolutional neural network trained for the automatic segmentation of the ciliary muscle in AS-OCT images. Ciloctunet is based on the Freiburg U-net and was trained and validated using 1244 manually segmented OCT images from two previous studies. An accuracy of 97.5% for the validation dataset was achieved. Ciloctunet's performance was evaluated by replicating the findings of a third study with 180 images as the test data. The replication demonstrated that Ciloctunet performed on par with two experienced examiners. The intersection-over-union index (0.84) of the ciliary muscle thickness profiles between Ciloctunet and an experienced examiner was the same as between the two examiners. The mean absolute error between the ciliary muscle thickness profiles of Ciloctunet and the two examiners (35.16 µm and 45.86 µm) was comparable to the one between the examiners (34.99 µm). A statistically significant effect of the segmentation type on the derived biometric parameters was found for the ciliary muscle area but not for the selective thickness reading ("perpendicular axis"). Both the inter-rater and the intra-rater reliability of Ciloctunet were good to excellent. Ciloctunet avoids time-consuming manual segmentation, thus enabling the analysis of large numbers of images of ample study cohorts while avoiding possible examiner biases. Ciloctunet is available as open-source.
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Affiliation(s)
- Torsten Straßer
- Institute for Ophthalmic Research, University of Tuebingen, 72076 Tuebingen, Germany
- University Eye Hospital Tuebingen, 72076 Tuebingen, Germany
- Correspondence:
| | - Sandra Wagner
- Institute for Ophthalmic Research, University of Tuebingen, 72076 Tuebingen, Germany
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17
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Li M, Luo Z, Yan X, Chen Z. The Anterior Segment Biometrics in High Myopia Eyes. Ophthalmic Res 2022; 66:75-85. [PMID: 35926453 DOI: 10.1159/000526280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/20/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of this study was to investigate and compare the anterior segment biometrics in high myopia and control groups. METHODS Thirty-four eyes of 34 high myopia patients and 42 eyes of 42 control subjects were included. Schlemm's canal (SC) area, trabecular meshwork (TM) thickness and length, scleral spur (SS) length, and anterior scleral thickness (AST) were measured using swept-source optical coherence tomography. Associations between SC area, TM thickness, TM length, SS length, and AST were also estimated. RESULTS SC area, TM thickness, and SS length were significantly associated with AST0 (AST at 0 mm from SS) in both high myopia and control groups. AST0 (702.61 ± 78.05 vs. 729.12 ± 95.87 μm, p = 0.085) and SS length (206.25 ± 52.25 vs. 212.09 ± 51.86 μm, p = 0.556) were not significantly different between high myopia and control groups, whereas SC area (6,622.68 ± 1,130.06 vs. 6,105.85 ± 1,297.84 μm2, p = 0.015) was significantly greater and TM thickness (96.15 ± 34.40 vs. 107.93 ± 29.97 μm, p = 0.048) was significantly thinner in high myopia group than in control group. CONCLUSION SC area and TM thickness were significantly associated with AST0, while AST0 and SS length were not significantly different between high myopia and control groups. The changes in SC and TM dimensions in high myopia eyes might be caused by factors other than AST0 and SS length.
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Affiliation(s)
- Mu Li
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhaoxia Luo
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoqin Yan
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiqi Chen
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Abstract
PURPOSE We conducted a systematic search of literature to understand the various methods of imaging of the ciliary body. METHODS PubMed, Science Direct, Cochrane Library and Google Scholar were searched comprehensively and systematically to find studies related to the various modalities of ciliary body imaging. RESULTS The various ciliary body parameters that have been described are Ciliary body thickness, Ciliary body length, ciliary muscle thickness, ciliary process length, ciliary muscle length, ciliary muscle anterior length, trabecular ciliary process distance and Iris ciliary process distance. The various angles which have been measured, which mostly have a significance in Primary angle closure glaucoma (PACG) are Iris ciliary angle, Trabecular ciliary angle, scleral ciliary process angle. Various authors have defined them in various ways with subtle differences. Plateau iris and PACG mechanisms, not forgetting malignant glaucoma are better understood with imaging of the ciliary body using the ultrasound biomicroscopy (UBM). The anterior segment optical coherence tomography (ASOCT) imaging of the ciliary body has been described albeit with its own disadvantages. A few other fields dependant on the importance of ciliary body imaging are intravitreal injections, pars plana vitrectomy, measurements for implantable collamer lens (ICL) and of utmost importance, the differentiating features of ciliary body masses. CONCLUSION The UBM is still preferred over the ASOCT for imaging of the ciliary body. A lot of lacunae of knowledge still exists and consensus has to be reached on defining all the parameters universally. Future studies will be able to shed more light on the role of the ciliary body in the many ocular disorders mentioned in this review.
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Affiliation(s)
| | - Sirisha Senthil
- VST Centre for Glaucoma Services, L V Prasad Eye Institute, Hyderabad, India
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19
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Trovato Battagliola E, Mangiantini P, D’Andrea M, Malvasi M, Loffredo L, Scalinci SZ, Comberiati AM, Migliorini R, Pacella E. Effect of COVID-19 lockdown on refractive errors in Italian children aged 5-12 years: A multi-center retrospective study. Eur J Ophthalmol 2022; 33:112-122. [PMID: 35678641 PMCID: PMC9189327 DOI: 10.1177/11206721221106135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE to explore the potential consequences of the COVID-19 lockdown on the prevalence of myopia among Italian children aged 5-12 years. MATERIALS AND METHODS retrospective multicenter study conducted in Italy. Population: children aged 5-12. Selection: random selection of children who received an eye exam between 2016 to 2021. Inclusion criteria: healthy children presenting for a routine eye exam. Exclusion criteria: presence of ocular comorbidities other than refractive error, such as blepharoptosis, media opacities, corneal or retinal dystrophies, strabismus, amblyopia, or concurrent therapy with atropine 0.01%. Outcome measure: age and spherical equivalent (SE) measured in diopters (D) in the right eye (RE) in cycloplegia. Statistical analysis: ANOVA test. RESULTS total of 803 children. In the years prior to COVID-19, the mean SE ± SD of healthy age-school children was: 0.54 ± 1.49 D in 2016; 0.43 ± 1.84 D in 2017; 0.34 ± 1.41 D in 2018; 0.35 ± 1.75 D in 2019 (ANOVA, p = .659). In 2021, the mean SE changed to -0.08 ± 1.44 D (ANOVA, p = .005). Mean age was comparable in all groups (ANOVA, p = .307). The prevalence of myopes (SE ≤-0.5D) and hyperopes (SE ≥ 2D) was respectively 24.10% and 9.64% among children aged 60-96 months, and 63.86% and 6.02% among children aged 97-144 months. These values represent a statistically-significant increase in the number of myopes (Chi-square, p = .016) and decrease in the number of hyperopes (Chi-square, p = .001), as compared to previous years (.06 and.48 respectively). CONCLUSION this retrospective study shows a statistically-significant decrease in the mean SE in children aged 5-12 in the year following the COVID-19 lockdown. The percentage of myopes has increased significantly, while the percentage of hyperopes has decreased. The lifestyle changes caused by the lockdown led children to spend more time on near-work activities and digital devices, and less time outdoors. These are known risk factors for the development and progression of myopia. Studies in different countries are encouraged.
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Affiliation(s)
| | - Pietro Mangiantini
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Mattia D’Andrea
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Mariaelena Malvasi
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Lorenzo Loffredo
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | | | - Anna Maria Comberiati
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Raffaele Migliorini
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Elena Pacella
- Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy,Elena Pacella, Department of Sense Organs, University Sapienza, Rome, Policlinico Umberto I, Viale, del Policlinico 155 - 00161 Rome, Italy.
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20
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Kaphle D, Schmid KL, Davies LN, Suheimat M, Atchison DA. Ciliary Muscle Dimension Changes With Accommodation Vary in Myopia and Emmetropia. Invest Ophthalmol Vis Sci 2022; 63:24. [PMID: 35749128 PMCID: PMC9234357 DOI: 10.1167/iovs.63.6.24] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Purpose The purpose of this study was to determine whether accommodation-induced changes in ciliary muscle dimensions vary between emmetropes and myopes, and the effect of the image analysis method. Methods Seventy adults aged 18 to 27 years consisted of 25 people with emmetropia (spherical equivalent refraction [SER] +0.21 ± 0.36 diopters [D]) and 45 people with myopia (−2.84 ± 1.72 D). There were 23 people with low myopia (>−3 D) and 22 people with moderate myopia (−3 to −6 D). Right eye ciliary muscles were imaged (Visante OCT; Carl Zeiss Meditec) at 0 D and 6 D demands. Measures included ciliary muscle length (CML), ciliary muscle curved length (CMLarc), maximum ciliary muscle thickness (CMTmax), CMT1, CMT2, and CMT3 (fixed distances 1–3 mm from the scleral spur), CM25, CM50, and CM75 (proportional distances 25%–75%). Linear mixed model analysis determined effects of refractive groups, race, and demand on dimensions. Significance was set at P < 0.05. Results Myopic eyes had greater CML and CMLarc nasally than emmetropic eyes. Myopic eyes had thicker muscles than emmetropic eyes at nasal positions, except CM25 and CMT3, and at CM75 temporally. During accommodation and only nasally, CML reduced in emmetropic and myopic eyes, and CMLarc reduced in myopic eyes only. During accommodation, both nasally and temporally, muscles thickened anteriorly (CMT1 and CM25) and thinned posteriorly (CMT3 and CM75) except for temporal CM75. Moderate myopic eyes had greater temporal CMLarc than low myopic eyes, and the moderate myopes had thicker muscles both nasally and temporally using fixed and proportional distances. Conclusions People with myopia had longer and thicker ciliary muscles than people with emmetropia. During accommodation, the anterior muscle thickened and the curved nasal muscle length shortened, more in myopic than in emmetropic eyes. The fixed distance method is recommended for repeat measures in the same individual. The proportional distance method is recommended for comparisons between refractive groups.
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Affiliation(s)
- Dinesh Kaphle
- Centre for Vision and Eye Research, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Discipline of Optometry, Faculty of Health, University of Canberra, Bruce ACT 2617, Australia
| | - Katrina L Schmid
- Centre for Vision and Eye Research, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Leon N Davies
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, United Kingdom
| | - Marwan Suheimat
- Centre for Vision and Eye Research, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - David A Atchison
- Centre for Vision and Eye Research, Queensland University of Technology, Kelvin Grove, Queensland, Australia
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21
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Xiong S, He X, Sankaridurg P, Zhu J, Wang J, Zhang B, Zou H, Xu X. Accelerated loss of crystalline lens power initiating from emmetropia among young school children: a 2-year longitudinal study. Acta Ophthalmol 2022; 100:e968-e976. [PMID: 34411434 PMCID: PMC9290480 DOI: 10.1111/aos.15002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/15/2021] [Accepted: 08/04/2021] [Indexed: 11/07/2022]
Abstract
Purpose To determine the characteristics of crystalline lens with varying refractive errors and relationship with axial elongation in young school children. Methods A total of 1465 children aged 6–8 years were examined annually for 2 years. Each participant underwent a series of ophthalmic examinations, including cycloplegic autorefraction, crystalline lens and axial length measurement. Crystalline lens power was determined, and factors associated with different refractive statuses were investigated. Results Crystalline lens power decreased with time; reduction in lens power in Year 1 was greater in children with emmetropia (−0.69 ± 0.59 dioptre [D]) than in those with hyperopia (−0.49 ± 0.56 D) or myopia (−0.45 ± 0.55 D) (p < 0.001). Among the emmetropes, there were no differences in loss of crystalline lens power between those who remained emmetropic (−0.63 ± 0.59 D) and those who became myopic at Year 1 (−0.74 ± 0.61 D) and Year 2 (−0.77 ± 0.57 D, p > 0.05) visits. Among myopes at Year 1 visit, there was a greater reduction at Year 2 in those who had baseline emmetropia (−0.61 ± 0.51 D) than those who had baseline myopia (−0.26 ± 0.49 D, p < 0.001). The trend was similar among children of the same age. There was a significant correlation between changes in lens power and axial elongation in non‐myopia (β = −0.954, p < 0.001) and new myopia (β = −1.178, p < 0.001), but not in established myopia (β = −0.001, p = 0.539). Conclusions There is accelerated loss of lens power in emmetropia and early stage of myopia. However, this loss is retarded when myopia persists and is accompanied by disappearance of the compensatory effect of lens power against axial elongation. These findings provide new insights into human refractive development.
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Affiliation(s)
- Shuyu Xiong
- Department of Preventative Ophthalmology Shanghai Eye Disease Prevention and Treatment Center Shanghai Eye Hospital Shanghai China
- Department of Ophthalmology Shanghai General Hospital Centers of Eye Shanghai Key Laboratory of Ocular Fundus Diseases Shanghai Jiao Tong University Shanghai China
- National Clinical Research Center for Eye Diseases Shanghai China
| | - Xiangui He
- Department of Preventative Ophthalmology Shanghai Eye Disease Prevention and Treatment Center Shanghai Eye Hospital Shanghai China
- Department of Ophthalmology Shanghai General Hospital Centers of Eye Shanghai Key Laboratory of Ocular Fundus Diseases Shanghai Jiao Tong University Shanghai China
- National Clinical Research Center for Eye Diseases Shanghai China
| | | | - Jianfeng Zhu
- Department of Preventative Ophthalmology Shanghai Eye Disease Prevention and Treatment Center Shanghai Eye Hospital Shanghai China
| | - Jingjing Wang
- Department of Preventative Ophthalmology Shanghai Eye Disease Prevention and Treatment Center Shanghai Eye Hospital Shanghai China
| | - Bo Zhang
- Department of Preventative Ophthalmology Shanghai Eye Disease Prevention and Treatment Center Shanghai Eye Hospital Shanghai China
| | - Haidong Zou
- Department of Preventative Ophthalmology Shanghai Eye Disease Prevention and Treatment Center Shanghai Eye Hospital Shanghai China
- Department of Ophthalmology Shanghai General Hospital Centers of Eye Shanghai Key Laboratory of Ocular Fundus Diseases Shanghai Jiao Tong University Shanghai China
- National Clinical Research Center for Eye Diseases Shanghai China
| | - Xun Xu
- Department of Preventative Ophthalmology Shanghai Eye Disease Prevention and Treatment Center Shanghai Eye Hospital Shanghai China
- Department of Ophthalmology Shanghai General Hospital Centers of Eye Shanghai Key Laboratory of Ocular Fundus Diseases Shanghai Jiao Tong University Shanghai China
- National Clinical Research Center for Eye Diseases Shanghai China
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22
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Gajjar S, Ostrin LA. A systematic review of near work and myopia: measurement, relationships, mechanisms and clinical corollaries. Acta Ophthalmol 2022; 100:376-387. [PMID: 34622560 DOI: 10.1111/aos.15043] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 09/02/2021] [Accepted: 09/22/2021] [Indexed: 12/17/2022]
Abstract
After decades of investigation, the role of near work in myopia remains unresolved, with some studies reporting no relationship and others finding the opposite. This systematic review is intended to summarize classic and recent literature investigating near work and the onset and progression of myopia, potential mechanisms and pertinent clinical recommendations. The impact of electronic device use is considered. PubMed and Medline were used to find peer-reviewed cross-sectional and longitudinal studies related to near work and myopia from 1980 to July 2020 using the PRISMA checklist. Studies were chosen using the Joanna Briggs Institute checklist, with a focus on studies with a sample size greater than 50. Studies were independently evaluated; conclusions were drawn per these evaluations. Numerous cross-sectional studies found increased odds ratio of myopia with increased near work. While early longitudinal studies failed to find this relationship, more recent longitudinal studies have found a relationship between myopia and near work. Rather than daily duration of near work, interest has increased regarding absolute working distance and duration of continuous near viewing. Several reports have found that shorter working distances (<30 cm) and continuous near-work activity (>30 min) are risk factors for myopia onset and progression. Novel objective continuously measuring rangefinding devices have been developed to better address these questions. The literature is conflicting, likely due to the subjective and variable nature in which near work has been quantified and a paucity of longitudinal studies. We conclude that more precise objective measures of near viewing behaviour are necessary to make definitive conclusions regarding the relationship between myopia and near work. Focus should shift to utilizing objective and continuously measuring instruments to quantify near-work behaviours in children, followed longitudinally, to understand the complex factors related to near work. A better understanding of the roles of absolute working distance, temporal properties, viewing breaks and electronic device use on myopia development and progression will aid in the development of evidence-based clinical recommendations for behavioural modifications to prevent and slow myopia.
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Affiliation(s)
- Shail Gajjar
- University of Houston College of Optometry Houston TX USA
| | - Lisa A. Ostrin
- University of Houston College of Optometry Houston TX USA
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23
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Chang X, Li M, Lv L, Yan X, Liu Y, Zhu M, Wang J, Wang P, Xiang Y. Assessment of Choroidal Vascularity and Choriocapillaris Blood Perfusion After Accommodation in Myopia, Emmetropia, and Hyperopia Groups Among Children. Front Physiol 2022; 13:854240. [PMID: 35370764 PMCID: PMC8968861 DOI: 10.3389/fphys.2022.854240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/24/2022] [Indexed: 11/15/2022] Open
Abstract
Purpose To investigate choroidal vascularity (CV) and choriocapillaris blood perfusion before and after accommodation in myopia, emmetropia, and hyperopia groups among children. Methods This study included 39 myopic eyes from 22 subjects, 17 emmetropic eyes from 11 subjects, and 18 hyperopic eyes from 10 subjects. All subjects were children. Choroidal thickness (CT) and CV, including total choroidal area (TCA), luminal area (LA), and stromal area (SA) were measured using swept-source optical coherence tomography (SS-OCT). Choriocapillaris luminal area (CLA) was measured using SS-OCT-angiography before and after accommodation (near reading with an additional −3 diopter lens). Results For baseline results, except horizontal CV (showing no significant differences between myopia and emmetropia groups), both horizontal and vertical CT and CV were significantly smaller in the myopia group than in the emmetropia or hyperopia groups. In terms of CLA, no significant differences were observed among the myopia, emmetropia, and hyperopia groups. In addition, only myopic eyes showed significant decreases in CT and CV, whereas most CT and CV of emmetropic and hyperopic eyes showed non-significant decreases after accommodation. Furthermore, accommodation induced no significant changes in CLA in the myopia, emmetropia, or hyperopia groups. Conclusion Myopia had thinner baseline choroid and lower baseline choroidal blood perfusion. Furthermore, myopic eyes were more prone to choroidal thinning and blood perfusion decreases after accommodation.
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Affiliation(s)
- Xuejiao Chang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mu Li
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liang Lv
- Department of Ophthalmology, Hankou Aier Eye Hospital, Wuhan, China
| | - Xiaoqin Yan
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ying Liu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengxia Zhu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junming Wang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Wang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Ping Wang,
| | - Yan Xiang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Yan Xiang,
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24
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Anderson HA, Bailey MD, Manny RE, Kao CY. Ciliary muscle thickness in adults with Down syndrome. Ophthalmic Physiol Opt 2022; 42:897-903. [PMID: 35292999 DOI: 10.1111/opo.12974] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 11/30/2022]
Affiliation(s)
| | - Melissa D Bailey
- College of Optometry, The Ohio State University, Columbus, Ohio, USA
| | - Ruth E Manny
- College of Optometry, The University of Houston, Houston, Texas, USA
| | - Chiu-Yen Kao
- Department of Mathematical Sciences, Claremont McKenna College, California, USA
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25
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Hughes RPJ, Read SA, Collins MJ, Vincent SJ. Axial Elongation During Short-Term Accommodation in Myopic and Nonmyopic Children. Invest Ophthalmol Vis Sci 2022; 63:12. [PMID: 35275173 PMCID: PMC8934556 DOI: 10.1167/iovs.63.3.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Purpose Axial length increases during accommodation in adults and children; however, refractive error group differences are conflicting and have not been explored in pediatric populations. This study aimed to evaluate differences in accommodation-induced axial elongation between myopic and nonmyopic children. Methods A range of ocular biometric measurements were captured during brief accommodation tasks (0, 3, 6, and 9 D) using a Badal optometer mounted to a noncontact optical biometer (Zeiss IOLMaster 700). Reliable measurements were captured for 15 myopic and 15 age- and sex-matched nonmyopic children. The average central corneal thickness (CCT), anterior chamber depth (ACD), crystalline lens thickness (LT), anterior segment length (ASL), vitreous chamber depth (VCD), and axial length (AL) were determined for each accommodation stimulus. Raw measurements of AL and VCD were corrected for the estimated error associated with LT increases during accommodation. Results All biometric parameters, except CCT, changed significantly during accommodation (all P < 0.001). Myopic children exhibited significantly greater accommodation-induced axial elongation than nonmyopic children (P = 0.002) at the 3, 6, and 9 D accommodation stimuli, with a mean difference of 7, 10, and 16 µm, respectively (all pairwise comparisons, P ≤ 0.03). The changes in all other biometric parameters were not different between the refractive error groups (P ≥ 0.23). Conclusions Accommodation-induced axial elongation was greater in myopic than nonmyopic children. This finding could support a potential mechanism linking near work, axial elongation, and myopia development in children or may reflect greater susceptibility to accommodation-induced axial elongation in children with established myopia.
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Affiliation(s)
- Rohan P J Hughes
- Queensland University of Technology, Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Brisbane, Queensland, Australia
| | - Scott A Read
- Queensland University of Technology, Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Brisbane, Queensland, Australia
| | - Michael J Collins
- Queensland University of Technology, Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Brisbane, Queensland, Australia
| | - Stephen J Vincent
- Queensland University of Technology, Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Brisbane, Queensland, Australia
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26
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Xie X, Sultan W, Corradetti G, Lee JY, Song A, Pardeshi A, Yu F, Chopra V, Sadda SR, Xu BY, Huang AS. Assessing accommodative presbyopic biometric changes of the entire anterior segment using single swept-source OCT image acquisitions. Eye (Lond) 2022; 36:119-128. [PMID: 33633350 PMCID: PMC8727625 DOI: 10.1038/s41433-020-01363-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/30/2020] [Accepted: 12/02/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND/OBJECTIVES To evaluate biometric changes throughout the anterior chamber during accommodation and presbyopia using single image acquisition swept-source anterior-segment optical coherence tomography (AS-OCT). SUBJECT/METHODS Anterior-segment images were obtained using a new swept-source AS-OCT device (ANTERION, Heidelberg Engineering) from healthy volunteers (n = 71) across two centers in this prospective observational case series. In one image acquisition, cornea through posterior lens, including the ciliary muscle on both sides of the right eye, was imaged. Subjects undertook no accommodative effort and -1, -3, and -5 D of target vergence. Two-way repeated measures ANOVA modeling was performed for ciliary muscle measurements, lens parameters, aqueous depth (AD), and pupil diameter (PD). The first ANOVA factor was accommodative stimuli, and the second factor included age and refractive status. RESULTS Maximum ciliary muscle thickness increased with accommodative stimuli (p < 0.001), while the distance from the scleral spur to the maximal point on the ciliary muscle and posterior ciliary muscle thickness (CMT2) decreased (p < 0.001-0.002). Older individuals showed no accommodative changes for ciliary muscle parameters, lens thickness, lens vault, PD, and AD (p = 0.07-0.32). Younger- and middle-aged eyes showed statistically significant accommodative structural alterations for these endpoints (p < 0.001-0.002), but with different patterns, including early loss of CMT2 contraction in middle-aged eyes. Within the middle-aged group, myopic eyes maintained better capacity for accommodative structural change. CONCLUSIONS Swept-source AS-OCT demonstrated multiple simultaneous anterior-segment biometric alterations in single acquisition images, including early loss of posterior ciliary muscle function and better maintained capacity for anterior-segment structural change in myopia.
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Affiliation(s)
- Xiaobin Xie
- grid.410318.f0000 0004 0632 3409Eye Hospital of China Academy of Chinese Medical Sciences, Beijing, China ,grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - William Sultan
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - Giulia Corradetti
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - Jong Yeon Lee
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA ,grid.256155.00000 0004 0647 2973Department of Ophthalmology, College of Medicine, Gil Medical Center, Gachon University, Incheon, South Korea
| | - Abe Song
- grid.42505.360000 0001 2156 6853Roski Eye Institute, Department of Ophthalmology, University of Southern California, Los Angeles, CA USA
| | - Anmol Pardeshi
- grid.42505.360000 0001 2156 6853Roski Eye Institute, Department of Ophthalmology, University of Southern California, Los Angeles, CA USA
| | - Fei Yu
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - Vikas Chopra
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - Srinivas R. Sadda
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - Benjamin Y. Xu
- grid.42505.360000 0001 2156 6853Roski Eye Institute, Department of Ophthalmology, University of Southern California, Los Angeles, CA USA
| | - Alex S. Huang
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
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27
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Zhou Q, Gao TY, Fan SJ, Peng Y, Li L, Lin Z, Han W, Lin HS, Wang NL, Liang YB. Intraocular Pressure, Age, and Central Corneal Thickness in a Healthy Chinese Children Population: The Handan Offspring Myopia Study. Ophthalmic Epidemiol 2021; 29:499-506. [PMID: 34542011 DOI: 10.1080/09286586.2021.1966806] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To assess the distribution and factors related to intraocular pressure (IOP) in a Chinese children population in Northern China. METHODS 1,238 offspring aged 6 to 18 years, residing in six villages, were recruited for this current study, the Handan Offspring Myopia Study. Participants underwent an interviewer-administered questionnaire and a complete ocular examination, including standardized measurement of IOP with Perkins applanation tonometry. RESULTS 1,648 eyes of 828 children were included in the analysis. The mean IOP was 13.9 ± 1.6 mmHg. The mean IOP for the study population increased from 13.0 ± 1.5 mmHg for those 6 to 7 years of age to 14.2 ± 1.4 mmHg for those 15 years of age or older (P < .001). The mean central corneal thickness (CCT) was 548.7 ± 32.1 μm, and had no difference among different age groups and gender. In univariate regression analysis, age (0.12 mmHg per 1 year old), height (0.09 mmHg per 5 cm), weight (0.02 mmHg per kg), body mass index (0.07 mmHg per 1 m/kg2), systolic blood pressure (0.06 mmHg per 5 mmHg), CCT (0.06 mmHg per 5 μm), and SE (-0.11 mmHg per 1 D) were correlated with IOP. In multivariate regression analysis, higher IOP was only associated with older ages (p = .002) and thicker CCT (p = .001). CONCLUSION The mean IOP in healthy rural Chinese children aged 6-18 years is about 14 mmHg, which is lower than in adults in the same locality. The mean IOP is slightly increasing with age during childhood, which is opposite to the result among adults. Age and CCT are the major independent factors associated with IOP.
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Affiliation(s)
- Qiang Zhou
- Department Of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Tie Ying Gao
- Department of Ophthalmology, Handan Eye Hospital, Handan, Hebei Province, China
| | - Su Jie Fan
- Department of Ophthalmology, Handan Eye Hospital, Handan, Hebei Province, China
| | - Yi Peng
- Beijing Ophthalmology & Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Lei Li
- Department of Ophthalmology, Handan Eye Hospital, Handan, Hebei Province, China
| | - Zhong Lin
- Department ofGlaucoma, The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wei Han
- Department of Ophthalmology, Handan Eye Hospital, Handan, Hebei Province, China
| | - Hai Shuang Lin
- Department ofGlaucoma, The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ning Li Wang
- Beijing Ophthalmology & Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yuan Bo Liang
- Department ofGlaucoma, The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Glaucoma Institute, Wenzhou Medical University, Wenzhou, Zhejiang, China
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28
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Jin CC, Pei RX, Du B, Liu GH, Jin N, Liu L, Wei RH. Lag of accommodation predicts clinically significant change of spherical equivalents after cycloplegia. Int J Ophthalmol 2021; 14:1052-1058. [PMID: 34282391 DOI: 10.18240/ijo.2021.07.14] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 06/11/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate related factors with the change of spherical equivalents (ΔSE) and determine the suitable predictor of clinically significant ΔSE (≥0.50 D) with cyclopentolate hydrochloride on Chinese children. METHODS A total of 145 right eyes of 145 children aged 4 to 15y were enrolled. Intraocular pressure, axial length and lag of accommodation (LOA) were assessed before cycloplegia induced by 3 drops of 1% cyclopentolate at 5-minute intervals. SE was measured before and 1h after the first drop of cyclopentolate. ΔSE was compared between different gender groups and among refractive groups. Multivariate linear regression analysis was performed to find related factors with ΔSE. ROC analysis was used to figure out the suitable predictor of clinically significant ΔSE. RESULTS For the total 145 eyes, the mean SE reached up to -0.70±1.86 D from -1.30±1.62 D, with the mean ΔSE of 0.60±0.55 D. The mean ΔSE were 0.63±0.55 D and 0.57±0.56 D respectively in the male and female group (P=0.40). The mean ΔSE was significantly different among different refractive groups (P<0.0001), with the ΔSE of hyperopia group (1.12±0.64 D) larger than that of the emmetropia (0.56±0.43 D, P=0.001) and myopia group (0.32±0.28 D, P<0.0001). The ΔSE was correlated with LOA (B=-0.54, P<0.0001), cycloplegic SE (B=0.10, P<0.0001) and age (B=-0.04, P=0.015). ROC curve indicated that LOA predicted clinically significant ΔSE by 82% [area under the curve (AUC)=0.82] alone, while the value was slightly improved to 85% (AUC=0.85) in combination with axial length and 86% (AUC=0.86) in association with axial length as well as age. CONCLUSION After cycloplegia with cyclopentolate, the ΔSE decreases with larger LOA, longer axial length and older age. Specifically, LOA plays a more vital role in predicting clinically significant ΔSE.
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Affiliation(s)
- Cheng-Cheng Jin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Ru-Xia Pei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Bei Du
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Gui-Hua Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Nan Jin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Lin Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Rui-Hua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
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Fernández-Vigo JI, Kudsieh B, Shi H, De-Pablo-Gómez-de-Liaño L, Fernández-Vigo JÁ, García-Feijóo J. Diagnostic imaging of the ciliary body: Technologies, outcomes, and future perspectives. Eur J Ophthalmol 2021; 32:75-88. [PMID: 34233517 DOI: 10.1177/11206721211031409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The ciliary body (CB) is part of the uvea and is a complex, highly specialized structure with multiple functions and significant relationships with nearby structures. Its functions include the aqueous humor (AH) production in the ciliary processes, the regulation of the AH output through the uveoscleral pathway, and accommodation, which depends on the ciliary muscle. Also, the CB is an important determinant of angle width as it forms part of the ciliary sulcus. Until recently, knowledge of the CB was based on histological studies. However, this structure can currently be assessed in vivo using imaging techniques such as ultrasound biomicroscopy (UBM) and optical coherence tomography (OCT). Both techniques have shown good reproducibility of their measurements allowing for quantification of CB dimensions and their localization. In effect, studies have shown a larger CB in myopia and its diminishing size with age. Swept-source OCT devices offer fast, non-invasive high-resolution imaging allowing the identification of multiple structures. UBM requires contact and is uncomfortable for the patient. However, this technique offers deeper imaging and therefore remains the gold standard for assessing the posterior chamber, ciliary processes, or zonula. The clinical utility of CB imaging includes its assessment in different types of glaucoma such as angle-closure, malignant or plateau iris. Diagnostic CB imaging is also invaluable for the assessment of ciliochoroidal detachment when suspected, the position after the implantation of a pre-crystalline or sulcus-sutured lenses, diagnosis or monitoring of cysts or tumors, sclerotomies after retinal surgery, intermediate uveitis, or accommodation.
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Affiliation(s)
- José Ignacio Fernández-Vigo
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain.,Centro Internacional de Oftalmología Avanzada, Madrid, Spain
| | - Bachar Kudsieh
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain.,Department of Ophthalmology, Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Hang Shi
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain.,Centro Internacional de Oftalmología Avanzada, Madrid, Spain
| | - Lucía De-Pablo-Gómez-de-Liaño
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain.,Department of Ophthalmology, Hospital 12 de Octubre, Madrid, Spain
| | - José Ángel Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain.,Centro Internacional de Oftalmología Avanzada, Badajoz, Spain.,Department of Ophthalmology, Universidad de Extremadura, Badajoz, Spain
| | - Julián García-Feijóo
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
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30
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Regal S, Troughton J, Djenizian T, Ramuz M. Biomimetic models of the human eye, and their applications. NANOTECHNOLOGY 2021; 32:302001. [PMID: 33789258 DOI: 10.1088/1361-6528/abf3ee] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 03/31/2021] [Indexed: 06/12/2023]
Abstract
Replicating the functionality of the human eye has been a challenge for more than a century, creating a great wealth of biomimetic and bioinspired devices, and providing ever improving models of the eye for myriad research purposes. As improvements in microelectronics have proceeded, individual components of the eye have been replicated, and models of the optical behaviour of the eye have improved. This review explores both work developed for improving medical components, with an ultimate aim of a fully functioning prosthetic eye, and work looking at improving existing devices through biomimetic means. It is hoped that this holistic approach to the subject will aid in the cross pollination of ideas between the two research foci. The review starts by summarising the reported measurements of optical parameters of various components of the eye. It then charts the development of individual bionic components. Particular focus is put on the development of bionic and biomimetic forms of the two main adaptive components of the eye, namely the lens and the iris, and the challenges faced in modelling the light sensitive retina. Work on each of these components is thoroughly reviewed, including an overview of the principles behind the many different approaches used to mimic the functionality, and discussion of the pros and cons of each approach. This is concluded by an overview of several reported models of the complete or semi-complete eye, including details of the components used and a summary of the models' functionality. Finally, some consideration is given to the direction of travel of this field of research, and which existing approaches are likely to bring us closer to the long term goal of a fully functional analogue of the eye.
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Affiliation(s)
- Simon Regal
- Mines Saint-Etienne, Center of Microelectronics in Provence, Department of Flexible Electronics, F-13541 Gardanne, France
| | - Joseph Troughton
- Mines Saint-Etienne, Center of Microelectronics in Provence, Department of Flexible Electronics, F-13541 Gardanne, France
| | - Thierry Djenizian
- Mines Saint-Etienne, Center of Microelectronics in Provence, Department of Flexible Electronics, F-13541 Gardanne, France
- Al-Farabi Kazakh National University, Center of Physical-Chemical Methods of Research and Analysis, Almaty, Tole bi str., 96A, Kazakhstan
| | - Marc Ramuz
- Mines Saint-Etienne, Center of Microelectronics in Provence, Department of Flexible Electronics, F-13541 Gardanne, France
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31
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Logan NS, Radhakrishnan H, Cruickshank FE, Allen PM, Bandela PK, Davies LN, Hasebe S, Khanal S, Schmid KL, Vera-Diaz FA, Wolffsohn JS. IMI Accommodation and Binocular Vision in Myopia Development and Progression. Invest Ophthalmol Vis Sci 2021; 62:4. [PMID: 33909034 PMCID: PMC8083074 DOI: 10.1167/iovs.62.5.4] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The role of accommodation in myopia development and progression has been debated for decades. More recently, the understanding of the mechanisms involved in accommodation and the consequent alterations in ocular parameters has expanded. This International Myopia Institute white paper reviews the variations in ocular parameters that occur with accommodation and the mechanisms involved in accommodation and myopia development and progression. Convergence is synergistically linked with accommodation and the impact of this on myopia has also been critiqued. Specific topics reviewed included accommodation and myopia, role of spatial frequency, and contrast of the task of objects in the near environment, color cues to accommodation, lag of accommodation, accommodative-convergence ratio, and near phoria status. Aspects of retinal blur from the lag of accommodation, the impact of spatial frequency at near and a short working distance may all be implicated in myopia development and progression. The response of the ciliary body and its links with changes in the choroid remain to be explored. Further research is critical to understanding the factors underlying accommodative and binocular mechanisms for myopia development and its progression and to guide recommendations for targeted interventions to slow myopia progression.
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Affiliation(s)
- Nicola S Logan
- School of Optometry, Aston University, Birmingham, United Kingdom
| | - Hema Radhakrishnan
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Fiona E Cruickshank
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Peter M Allen
- Vision and Hearing Sciences Research Centre, School of Psychology and Sports Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Praveen K Bandela
- Brien Holden Vision Institute, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Leon N Davies
- School of Optometry, Aston University, Birmingham, United Kingdom
| | - Satoshi Hasebe
- Department of Ophthalmology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Safal Khanal
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Katrina L Schmid
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
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Vincent SJ, Collins MJ, Read SA, Carney LG. Myopic anisometropia: ocular characteristics and aetiological considerations. Clin Exp Optom 2021; 97:291-307. [DOI: 10.1111/cxo.12171] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 02/14/2014] [Indexed: 12/20/2022] Open
Affiliation(s)
- Stephen J Vincent
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Leo G Carney
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
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33
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Liu J, Li B, Sun Y, Chen Q, Dang J. Adolescent Vision Health During the Outbreak of COVID-19: Association Between Digital Screen Use and Myopia Progression. Front Pediatr 2021; 9:662984. [PMID: 34113588 PMCID: PMC8185041 DOI: 10.3389/fped.2021.662984] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/27/2021] [Indexed: 12/15/2022] Open
Abstract
The coronavirus (COVID-19) pandemic has impacted education systems globally, making digital devices common arrangements for adolescent learning. However, vision consequences of such behavioral changes are not well-understood. This study investigates the association between duration of daily digital screen engagement and myopic progression among 3,831 Chinese adolescents during the COVID-19 pandemic. Study subjects report an average of 2.70 (SD = 1.77), 3.88 (SD = 2.23), 3.58 (SD = 2.30), and 3.42 (SD = 2.49) hours of television, computer, and smartphone for digital learning use at home, respectively. Researchers analyzed the association between digital screen use and myopic symptoms using statistical tools, and find that every 1 h increase in daily digital screen use is associated with 1.26 OR [Odds Ratio] (95% CI [Confidence Interval: 1.21-1.31, p < 0.001]) higher risks of myopic progression. Using computers (OR = 1.813, 95% CI = 1.05-3.12, p = 0.032) and using smartphones (OR = 2.02, 95% CI = 1.19-3.43, p = 0.009) are shown to be associated with higher risks of myopic progression than television use. Results from additional sensitivity tests that included inverse probability weights which accounted for heterogeneous user profile across different device type categories confirm that these findings are robust. In conclusion, this study finds that daily digital screen use is positively associated with prevalence of myopic progression and holds serious vision health implications for adolescents.
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Affiliation(s)
- Ji Liu
- Faculty of Education, Shaanxi Normal University, Xian, China
| | - Baihuiyu Li
- Faculty of Education, Shaanxi Normal University, Xian, China
| | - Yan Sun
- Faculty of Education, Shaanxi Normal University, Xian, China
| | - Qiaoyi Chen
- School of Basic Medical Sciences, Xian Jiaotong University, Xian, China
| | - Jingxia Dang
- The First Affiliated Hospital, Xian Jiaotong University, Xian, China
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34
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Does anisometropia affect the ciliary muscle thickness? An ultrasound biomicroscopy study. Int Ophthalmol 2020; 40:3393-3402. [PMID: 33083933 DOI: 10.1007/s10792-020-01625-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 07/17/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To compare the ciliary muscle thickness (CMT) of the normal fellow eye to that of the amblyopic eye using ultrasound biomicroscopy (UBM) in patients with unilateral anisometropic amblyopia. METHODS Thirty patients with unilateral anisometropic amblyopia were involved. The patients were divided into two groups: 19 hyperopic and 11 myopic. Axial length (AL) was measured with optic biometry and anterior chamber depth (ACD), iris area, and CMT were measured with UBM. RESULTS The mean age was 34.10 ± 6.61 years. The mean spherical difference between two eyes was 2.59 diopter (D) in hyperopic patients and 3.77D in myopic patients. In the hyperopic patients, nasal CMT1(nCMT), temporal CMT1(tCMT), tCMT2, and tCMT3 values were statistically thinner in amblyopic eyes than healthy eyes (p = 0.036, p = 0.003, p = 0.023, p = 0.005, respectively). ACD values were statistically lower in amblyopic eyes (2.78 ± 0.26 mm) than healthy eyes (2.90 ± 0.21 mm) (p < 0.001). In the myopic patients, nCMT1, nCMT2, nCMT3, tCMT1, tCMT2, and tCMT3 values were statistically thicker in amblyopic eyes than healthy eyes (p = 0.003, p = 0.003, p = 0.005, p = 0.003, p = 0.003, p = 0.019, respectively). ACD values were statistically higher in amblyopic eyes (3.20 ± 0.30 mm) than healthy eyes (3.06 ± 0.29 mm) (p = 0.004). Also, there was no significant difference in the iris area between the amblyopic and normal eyes of the myopic and hyperopic patients (p > 0.05). CONCLUSIONS Amblyopic eyes in patients with unilateral myopic anisometropia have thicker CMT and deeper ACD than healthy eyes. Conversely, amblyopic eyes in patients with unilateral hyperopic anisometropia have thinner CMT and shorter ACD than healthy eyes. There is a positive correlation between AL and CMT.
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35
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Regal S, Troughton J, Delattre R, Djenizian T, Ramuz M. Changes in temperature inside an optomechanical model of the human eye during emulated transscleral cyclophotocoagulation. BIOMEDICAL OPTICS EXPRESS 2020; 11:4548-4559. [PMID: 32923063 PMCID: PMC7449722 DOI: 10.1364/boe.385016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/20/2020] [Accepted: 02/21/2020] [Indexed: 06/11/2023]
Abstract
Currently, many diseases of the eye are treated by laser surgery. An understanding of light propagation and the heating of eye tissue during laser exposure is crucial to improving the outcome of these procedures. Here, we present the development of physical and computational models of the human eye by combining optical light propagation and thermal characteristics. For the physical model, all parts of the eye, including cornea, lens, ciliary body, sclera, aqueous and vitreous humors, and iris, were fabricated using a 3D printed holder and modified polydimethylsiloxane. We also present a computational model based on finite element analysis that allows for a direct comparison between the simulation and experimental measurements. These models provide an opportunity to directly assess the rise in temperature in all eye tissues. The simulated and physical models showed good agreement for the transmission of light at varying incident angles. The heating of optical components was investigated in the retina and the ciliary body during simulated laser surgery. Temperature increases of 45.3°C and 30.6°C in the retina and ciliary bodies, respectively, were found in the physical model after 1 minute of exposure to 186 mW of 850 nm laser radiation. This compared to 29.8°C and 33.9°C increases seen under the same conditions in the simulation model with human eye parameters and 48.1°C and 28.7°C for physical model parameters. These results and these models are very promising for further investigation of the impact of laser surgery.
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Affiliation(s)
- Simon Regal
- Mines Saint-Etienne, Center of Microelectronics in Provence, Department of Flexible Electronics, F-13541 Gardanne, France
| | - Joe Troughton
- Mines Saint-Etienne, Center of Microelectronics in Provence, Department of Flexible Electronics, F-13541 Gardanne, France
| | - Roger Delattre
- Mines Saint-Etienne, Center of Microelectronics in Provence, Department of Flexible Electronics, F-13541 Gardanne, France
| | - Thierry Djenizian
- Mines Saint-Etienne, Center of Microelectronics in Provence, Department of Flexible Electronics, F-13541 Gardanne, France
- Al-Farabi Kazakh National University, Center of Physical-Chemical Methods of Research and Analysis, Almaty, Tole bi str., 96A, Kazakhstan
| | - Marc Ramuz
- Mines Saint-Etienne, Center of Microelectronics in Provence, Department of Flexible Electronics, F-13541 Gardanne, France
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Response to 'Comment on: "Measuring changes in Schlemm's canal and trabecular meshwork in different accommodation states in myopia children: an observational study"'. Eye (Lond) 2020; 35:1785-1786. [PMID: 32690921 DOI: 10.1038/s41433-020-1097-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/05/2020] [Accepted: 07/09/2020] [Indexed: 11/08/2022] Open
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Review of the application of the open-source software CilOCT for semi-automatic segmentation and analysis of the ciliary muscle in OCT images. PLoS One 2020; 15:e0234330. [PMID: 32516331 PMCID: PMC7282635 DOI: 10.1371/journal.pone.0234330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/22/2020] [Indexed: 11/25/2022] Open
Abstract
Presbyopia and myopia research shows a growing interest in ciliary muscle biometry using optical coherence tomography (OCT). Until now, segmentation of the ciliary muscle is often performed manually using either custom-developed programs or image processing software. Here we present a novel software for semi-automatic segmentation of the ciliary muscle. It provides direct import of OCT images in DICOM format, a standardized procedure for segmentation, image distortion correction, the export of anatomical ciliary muscle landmarks, like ciliary muscle apex and scleral spur, as well as a continuous thickness profile of the ciliary muscle as a novel way of analysis. All processing steps are stored as XML files, fostering documentation and reproducibility of research through the possibility of replicating the analysis. Additionally, CilOCT supports batch processing for the automated analysis of large numbers of images and the respective data export to tabulated text files based on the stored XML files. CilOCT was successfully applied in several studies and their results will be summarized in this paper.
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Fernández‐Vigo JI, Shi H, Kudsieh B, Arriola‐Villalobos P, De‐Pablo Gómez‐de‐Liaño L, García‐Feijóo J, Fernández‐Vigo JÁ. Ciliary muscle dimensions by swept-source optical coherence tomography and correlation study in a large population. Acta Ophthalmol 2020; 98:e487-e494. [PMID: 31773907 DOI: 10.1111/aos.14304] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 10/31/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE To examine ciliary muscle (CM) dimensions in vivo by swept-source optical coherence tomography (SS-OCT) in a large healthy population. To assess the reproducibility of CM measurements and correlations with different parameters. METHODS In this cross-sectional study, the following CM measurements were made in 495 eyes of 495 subjects in the temporal and nasal quadrants: length (CML), area (CMA) and thickness at distances of 1000 μm (CMT1), 2000 μm (CMT2) and 3000 μm (CMT3) from the scleral spur using the SS-OCT DRI-Triton® (Topcon, Tokyo, Japan). These dimensions were then assessed for correlations with the factors age, gender, refractive error, anterior chamber angle (ACA) and intraocular pressure (IOP). The reproducibility of CM measurements was determined in 85 of the participants. RESULTS Mean age was 41.4 ± 17.5 years (range 5-83). The following means were recorded as follows: CML = 4.57 ± 0.73 mm (range 2.16-6.97), CMA = 1.35 ± 0.31 mm2 (2.04-5.45), CMT1 = 558 ± 98 μm (299-891), CMT2 = 366 ± 100 μm (89-629) and CMT3 = 210 ± 75 μm (36-655). Negative correlation was detected between CML/CMA and age (R = -0.516/R = -0.404; p < 0.001) and refractive error (R = -0.519/R = -0.538; p < 0.001). No gender differences were observed (p ≥ 0.150). Both CML and CMA were correlated with ACA (R = 0.498 and 0.546; p < 0.001) and slightly with IOP (R = -0.175; p < 0.001). The reproducibility of the CM measurements was excellent (intraclass correlation coefficient ≥0.878). CONCLUSIONS Swept-source optical coherence tomography is a valid tool for in vivo CM measurements. Our data indicate a larger CM in myopes and its diminishing size with age.
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Affiliation(s)
- José Ignacio Fernández‐Vigo
- Department of Ophthalmology Hospital Clínico San Carlos Instituto de Investigación Sanitaria (IdISSC) Madrid Spain
- Centro Internacional de Oftalmología Avanzada Madrid Spain
| | - Hang Shi
- Department of Ophthalmology Hospital Clínico San Carlos Instituto de Investigación Sanitaria (IdISSC) Madrid Spain
- Centro Internacional de Oftalmología Avanzada Madrid Spain
| | - Bachar Kudsieh
- Centro Internacional de Oftalmología Avanzada Madrid Spain
- Department of Ophthalmology Hospital Puerta de Hierro Majadahonda Madrid Spain
| | - Pedro Arriola‐Villalobos
- Department of Ophthalmology Hospital Clínico San Carlos Instituto de Investigación Sanitaria (IdISSC) Madrid Spain
- Centro Internacional de Oftalmología Avanzada Madrid Spain
| | - Lucía De‐Pablo Gómez‐de‐Liaño
- Centro Internacional de Oftalmología Avanzada Madrid Spain
- Department of Ophthalmology Hospital 12 de Octubre Madrid Spain
| | - Julián García‐Feijóo
- Department of Ophthalmology Hospital Clínico San Carlos Instituto de Investigación Sanitaria (IdISSC) Madrid Spain
| | - José Ángel Fernández‐Vigo
- Centro Internacional de Oftalmología Avanzada Madrid Spain
- Department of Ophthalmology Universidad de Extremadura Badajoz Spain
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Repeatability and Validity of Peripheral Refraction with Two Different Autorefractors. Optom Vis Sci 2020; 97:429-439. [PMID: 32511165 DOI: 10.1097/opx.0000000000001520] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE The Welch Allyn SureSight (Welch Allyn, Skaneateles Falls, NY) and Plusoptix PowerRefractor (Plusoptix, Nuremberg, Germany) are often used with infants, but little is known about the repeatability and validity of their peripheral refractive error measurements. Selecting the best instrument will support future refractive error and emmetropization studies. PURPOSE The purpose of this study was to determine the validity and repeatability of peripheral refractive error measurements and peripheral refraction profiles measured with the Welch Allyn SureSight and Plusoptix PowerRefractor compared with the criterion standard Grand Seiko WR-5100K (Grand Seiko Co., Hiroshima, Japan). METHODS Cycloplegic (tropicamide 1%) autorefraction was measured in the right eyes of 21 adult subjects (31.4 ± 10.4 years) with the three instruments in randomized order on two separate visits, at least 24 hours apart, centrally, and at 30 and 20° temporal and nasal gaze. RESULTS The SureSight measurements were within 0.24 D and not significantly different from the Grand Seiko WR-5100K in any gaze (P < .65), whereas the PowerRefractor measurements were more myopic by as much as -0.97 D and significantly different in four of the five gaze directions (P < .04). The 95% limits of agreement between occasions by gaze ranged from ±0.38 to ±0.61 D for the SureSight, similar to or slightly better than the WR-5100K (±0.31 to ±1.51 D) and the PowerRefractor (±0.72 to ±1.71 D). There were no significant differences between visits for any instrument in any gaze (P < .94). The repeatability of the SureSight was also better than that for the Grand Seiko when peripheral refraction was represented by quadratic fits to the data. CONCLUSIONS These findings suggest that the Welch Allyn SureSight is the most suitable portable autorefractor to use to monitor peripheral autorefraction based on better repeatability between occasions and better validity compared with the criterion standard Grand Seiko WR-5100K.
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Disrupted potassium ion homeostasis in ciliary muscle in negative lens-induced myopia in Guinea pigs. Arch Biochem Biophys 2020; 688:108403. [PMID: 32418893 DOI: 10.1016/j.abb.2020.108403] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/09/2020] [Accepted: 05/01/2020] [Indexed: 11/21/2022]
Abstract
Myopia is a main cause of preventable or treatable visual impairment, it has become a major public health issue due to its increasingly high prevalence worldwide. Currently, it is confirmed that the development of myopia is associated with the disorders of accommodation. As a dominant factor for accommodation, ciliary muscle contraction/relaxation can regulate the physiological state of the lens and play a crucial role in the development of myopia. To investigate the relationship between myopia and ciliary muscle, the guinea pigs were randomly divided into a normal control (NC) group and a negative lens-induced myopia (LIM) group, and the animals in each group were further randomly assigned into 2-week (n = 18) and 4-week (n = 21) subgroups in accordance with the duration of myopic induction of 2 and 4 weeks, respectively. In the present study, right eyes of the animals in LIM group were covered with -6.0 D lenses to induce myopia. Next, we performed the haematoxylin and eosin (H&E) staining to observe the pathological change of ciliary muscle, determined the contents of adenosine triphosphate (ATP) and lactate acid (LA), and measured the Na+/K+-ATPase expression and activity in ciliary muscles in both NC and LIM groups. Moreover, we also analyzed the potassium ion (K+) flux in ciliary muscles from 4-week NC and LIM guinea pigs. As a result, we found that the arrangements of ciliary muscles in LIM guinea pigs were broken, dissolved or disorganized; the content of ATP decreased, whereas the content of LA increased in ciliary muscles from LIM guinea pigs. Monitoring of K+ flux in ciliary muscles from LIM guinea pigs demonstrated myopia-triggered K+ influx. Moreover, we also noted a decreased expression of Na+/K+-ATPase (Atp1a1) at both mRNA and protein levels and reduced activity in ciliary muscles from LIM guinea pigs. Overall, our results will facilitate the understanding of the mechanism associated with inhibitory Na+/K+-ATPase in lens-induced myopia and which consequently lead to the disorder of microenvironment within ciliary muscles from LIM guinea pigs, paving the way for a promising adjuvant approach in treating myopia in clinical practice.
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41
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Kudsieh B, Fernández-Vigo JI, Shi H, De Pablo Gómez de Liaño L, Ruiz-Moreno JM, García-Feijóo J, Fernández-Vigo JÁ. Ciliary muscle dimensions measured by swept-source optical coherence tomography in eyes with primary open-angle glaucoma and healthy eyes. Int Ophthalmol 2020; 40:2247-2255. [DOI: 10.1007/s10792-020-01405-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 04/27/2020] [Indexed: 12/17/2022]
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42
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Zhang J, Deng G. Protective effects of increased outdoor time against myopia: a review. J Int Med Res 2020; 48:300060519893866. [PMID: 31854216 PMCID: PMC7607527 DOI: 10.1177/0300060519893866] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 11/19/2019] [Indexed: 12/27/2022] Open
Abstract
Myopia has become a major cause for concern globally, particularly in East Asian countries. The increasing prevalence of myopia has been associated with a high socioeconomic burden owing to severe ocular complications that may occur with progressive myopia. There is an urgent need to identify effective and safe measures to address the growing number of people with myopia in the general population. Among the numerous strategies implemented to slow the progression of myopia, longer time spent outdoors has come to be recognized as a protective factor against this disorder. Although our understanding of the protective effects of outdoor time has increased in the past decade, considerably more research is needed to understand the mechanisms of action. Here, we summarize the main potential factors associated with the protective effects against myopia of increased outdoor time, namely, exposure to elevated levels and shorter wavelengths of light, and increased dopamine and vitamin D levels. In this review, we aimed to identify safe and effective therapeutic interventions to prevent myopia-related complications and vision loss.
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Affiliation(s)
- Jun Zhang
- Department of Ophthalmology, The Third People’s Hospital of Changzhou, Changzhou, Jiangsu, China
| | - Guohua Deng
- Department of Ophthalmology, The Third People’s Hospital of Changzhou, Changzhou, Jiangsu, China
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Pucker AD, Jackson AR, McHugh KM, Mutti DO. Morphological ciliary muscle changes associated with form deprivation-induced myopia. Exp Eye Res 2020; 193:107963. [PMID: 32045599 DOI: 10.1016/j.exer.2020.107963] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 02/02/2020] [Accepted: 02/05/2020] [Indexed: 12/19/2022]
Abstract
Myopic children have larger ciliary muscles than non-myopic children, suggesting that the ciliary muscle may have an impact on or be affected by refractive error development. The guinea pig represents an attractive model organism for myopia development research. The purpose of the study was to investigate whether form deprivation-induced myopia in one or more strains of guinea pig causes thickening of the ciliary muscle as seen in human myopia. Thirty-nine guinea pigs were bred from in-house progenitors obtained from Cincinnati Children's Hospital (Cincinnati) and the United States Army (Strain 13). At 2-4 days of age the right eyes of animals were exposed to form deprivation for 7 days while the fellow eyes served as controls. Refractive error was determined with retinoscopy while vitreous chamber depth (VCD) and axial length (AL) were determined with A-scan ultrasound. Ciliary muscle characteristics (ciliary muscle length, cross-sectional area, volume, cell number, cell size, and smooth muscle actin concentration) were determined histologically with antibody labeling and analyzed according to whether the animal developed axial myopia (anisometropia > -2.00 D with VCD and/or AL differences > 0.1 mm) or was unresponsive. This analysis method yielded four groups with Group 1 having no induced myopia but with axial elongation (n = 11), Group 2 having myopia without vitreous or axial elongation (n = 8), Group 3 having myopia with either vitreous or axial elongation (n = 11), and Group 4 having myopia with both vitreous and axial elongation (n = 8). There were no post-treatment inter-ocular differences between strains or for the overall group of animals for any ciliary muscle variable; however, a higher response group number in multivariate ordinal regression was related to having a treated compared to fellow eye that had a lower smooth muscle actin concentration (p = 0.006), with a shorter ciliary muscle length (p = 0.042), and a less oblate eye shape (p = 0.010). Guinea pig ciliary muscle length and smooth muscle actin concentration were significantly less in the treated eyes of axially myopic animals suggesting that 7 days of form deprivation induced ciliary muscle cellular atrophy or inhibited ciliary muscle growth. Form deprivation myopia in the guinea pig does not result in the increase in ciliary muscle thickness associated with human juvenile and adult myopia.
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Affiliation(s)
- Andrew D Pucker
- University of Alabama at Birmingham, School of Optometry, 1716 University Blvd, Birmingham, AL, USA.
| | - Ashley R Jackson
- Nationwide Children's Hospital, Center for Clinical and Translational Research, 700 Childrens Drive, Columbus, OH, USA.
| | - Kirk M McHugh
- Nationwide Children's Hospital, Center for Clinical and Translational Research, 700 Childrens Drive, Columbus, OH, USA.
| | - Donald O Mutti
- The Ohio State University, College of Optometry, 338 W 10th Ave, Columbus, OH, USA.
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Hagen LA, Gilson SJ, Akram MN, Baraas RC. Emmetropia Is Maintained Despite Continued Eye Growth From 16 to 18 Years of Age. Invest Ophthalmol Vis Sci 2020; 60:4178-4186. [PMID: 31596926 DOI: 10.1167/iovs.19-27289] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To examine, in Norwegian adolescents, to what degree emmetropia and low hyperopia were maintained from 16 to 18 years of age, and if this was the case, whether it was associated with continued coordinated ocular growth. Methods Cycloplegic autorefraction and ocular biometry, including crystalline lens thickness, were measured in 93 Norwegian adolescents (mean age: 16.7 ± 0.3 years; 63.4% females) and repeated after 2 years. Crystalline lens power was determined by ray tracing over a 1-mm pupil, based on the Gullstrand-Emsley model. Serum vitamin D3 concentration was measured at follow-up. Results Emmetropia and low hyperopia (-0.50 diopters [D] < spherical equivalent refractive error [SER] < +2.00 D) were present in 91.4% at baseline and 89.2% at follow-up. The emmetropes and low hyperopes who maintained their refractive error exhibited continued ocular axial growth (+0.059 ± 0.070 mm) together with a decrease in crystalline lens power (-0.064 ± 0.291 D) and a deepening of the anterior chamber (+0.028 ± 0.040 mm). Thinning of the crystalline lens was found in 24%. Overall, the negative change in SER was larger in those with the most negative SER at baseline (R2 = 0.178, P < 0.001), and was associated with increases in vitreous chamber depth and in crystalline lens power (R2 = 0.752, P < 0.001), when adjusted for sex. There was no difference in vitamin D3 level between those who exhibited negative versus positive changes in refractive error. Conclusions The results show that emmetropic and low hyperopic eyes were still growing in late adolescence, with refractive errors being maintained through a coordinated decrease in crystalline lens power.
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Affiliation(s)
- Lene A Hagen
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Stuart J Gilson
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Muhammad Nadeem Akram
- Department of Microsystems, Faculty of Technology, Natural Sciences and Maritime Sciences, University of South-Eastern Norway, Borre, Norway
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
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Shi J, Zhao J, Zhao F, Naidu R, Zhou X. Ciliary muscle morphology and accommodative lag in hyperopic anisometropic children. Int Ophthalmol 2020; 40:917-924. [PMID: 31916057 DOI: 10.1007/s10792-019-01264-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 12/28/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To investigate the cross-sectional area (CSA) and thickness of the ciliary muscle and their correlation with accommodative lag in hyperopic anisometropic children. METHODS Forty children aged between 6 and 10 years with hyperopic anisometropia were recruited. The more hyperopic eye (mean refractive power of 3.51 ± 1.70 D) was compared with the less hyperopic eye (mean refractive power of 0.78 ± 1.41 D). The thickness and CSA of the ciliary muscle were measured with anterior segment optical coherence tomography (OCT) images at four meridians. The differences between the eyes and the correlations between CSA, thickness, axial length and accommodative lag were accessed. RESULTS There was no statistically significant difference in CSA between the two groups at any meridian, except at the inferior meridian (P < 0.05). There was no statistically significant difference in ciliary muscle thickness between eyes at any meridian, except on the temporal and the nasal meridians (P < 0.05). There was a significant difference in the ratio of CSA to axial length at all meridians between the two groups (all P < 0.05). Accommodative lag was 1.65 ± 0.55 D and 0.93 ± 0.45 D in the more and less hyperopic eyes, respectively, which was a statistically significant difference (P < 0.05). There was no significant correlation between the CSA with the axial length and the accommodative lag. CONCLUSIONS This study demonstrated a greater degree of accommodative lag in the more hyperopic eye of anisometropic children. There was no correlation among accommodative lag, axial length and CSA of the ciliary muscle with the degree of hyperopia.
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Affiliation(s)
- Jinglin Shi
- Department of Ophthalmology, Shuguang Hospital, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jing Zhao
- Key NHC Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Chinese Academy of Medical Sciences, Fudan University, 83 FenYang Road, Shanghai, 200031, China
| | - Feng Zhao
- Key NHC Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Chinese Academy of Medical Sciences, Fudan University, 83 FenYang Road, Shanghai, 200031, China.,Department of Ophthalmology, Shuguang Hospital, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Rajeev Naidu
- School of Medicine, The University of Sydney, Camperdown, NSW, Australia
| | - Xingtao Zhou
- Key NHC Key Laboratory of Myopia, Ministry of Health, Department of Ophthalmology, Eye and ENT Hospital, Chinese Academy of Medical Sciences, Fudan University, 83 FenYang Road, Shanghai, 200031, China.
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Aggarwala KRG. Ocular Accommodation, Intraocular Pressure, Development of Myopia and Glaucoma: Role of Ciliary Muscle, Choroid and Metabolism. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2020; 9:66-70. [PMID: 31976346 PMCID: PMC6969557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Ocular accommodation is not just a mechanism for altering curvature of the crystalline lens of the eye, it also enables aqueous humor outflow through the trabecular meshwork, influencing intraocular pressure (IOP). Long term stress on the ciliary muscle from sustained near focusing may initiate myopic eye growth in children and primary open angle glaucoma in presbyopic adults. Multi-factorial studies of ocular accommodation that include measures of IOP, ciliary muscle morphology, anterior chamber depth and assessment of nutritional intake and metabolic markers may elucidate etiology and novel strategies for management of both myopia and chronic glaucoma. Anatomy of the ciliary fibers from anterior insertion in the fluid drainage pathway to their posterior consanguinity with the vascular choroid, alters ocular parameters such as micro-fluctuations of accommodation and pulsatile ocular blood flow that are driven by cardiac contractions conveyed by carotid arteries. Stretching of the choroid has consequences for thinning of the peripheral retina, sclera and lamina cribrosa with potential to induce retinal tears and optic nerve cupping. Early metabolic interventions may lead to prevention or reduced severity of myopia and glaucoma. Finally, it might improve quality of life of patients and decrease disability from visual impairment and blindness.
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Wagner S, Zrenner E, Strasser T. Emmetropes and myopes differ little in their accommodation dynamics but strongly in their ciliary muscle morphology. Vision Res 2019; 163:42-51. [PMID: 31401218 DOI: 10.1016/j.visres.2019.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/23/2019] [Accepted: 08/05/2019] [Indexed: 11/29/2022]
Abstract
Previous work suggested an association between near vision and myopia. We therefore investigated the accommodation process in emmetropes and myopes regarding morphologic changes of the ciliary muscle (CM) and power changes of the lens for different accommodation demands. The temporal CM of 18 emmetropic and 20 myopic students was imaged via anterior segment optical coherence tomography during far and near accommodation (2.5D, 3D, 4D). Additionally, accommodation dynamics to the stimuli pattern far-near-far (15 s each; 2.5D, 3D, 4D) were recorded with eccentric infrared photorefraction. OCT images were processed using custom-developed software facilitating the analysis of selective CM thickness (CMT) readings and CMT profiles. Anterior CMT readings were significantly smaller in myopes. Starting at 1.4 mm posterior to the scleral spur (SP), myopic CM became thicker than emmetropic. Anterior CMT changes (ΔCMT) continuously increased with accommodation demand in myopes while emmetropic ΔCMT only increased from 2.5D to 3D. Compared to emmetropes, myopes showed smaller ΔCMT but increased CM movement relative to SP. There were no significant differences between the groups for accommodation changes from far to near vision and vice versa, velocity, microfluctuations, power spectra or lag of accommodation. At 4 D, larger ΔCMT were associated with lower lens changes for disaccommodation. While CM shape, movement, and thickness showed distinct differences depending on refractive error, emmetropes and myopes did not differ in their dynamic accommodation. Further analysis is necessary to evaluate whether the CM's anatomical shape or predispositions in its intramuscular constituents are causative factors in myopigenesis.
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Affiliation(s)
- Sandra Wagner
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Str. 7, 72076 Tuebingen, Germany.
| | - Eberhart Zrenner
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Str. 7, 72076 Tuebingen, Germany; Werner Reichardt Centre for Integrative Neuroscience (CIN) Tuebingen, Otfried-Mueller-Str. 25, 72076 Tuebingen, Germany
| | - Torsten Strasser
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Str. 7, 72076 Tuebingen, Germany
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Assessment of Changes in Cyliary Muscle in Patients with Hypermetropy Using Mathematical Modeling Methods. ACTA BIOMEDICA SCIENTIFICA 2019. [DOI: 10.29413/abs.2019-4.4.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background. Age-related decline in accommodation in patients with emmetropia, myopia and hyperopia is characterized by multidirectional changes in the thickness of the ciliary muscle and the configuration of the inner apex of the ciliary body. The structural and functional state of the ciliary muscle and its individual components and the patterns of their change with age in patients with hyperopia remain little studied.Aim: to study the structural and functional state of the ciliary muscle and its components in patients with hyperopia using mathematical modeling methods.Methods. 110 patients (220 eyes) with axial hyperopia were examined. The first group consisted of patients aged 18–30 years – 20 people. The second group consisted of 80 patients aged 45–65 years. The control group consisted of 30 healthy volunteers aged from 18 to 30 years. All patients underwent ultrasound biomicroscopy, on the basis of which a spatial-mathematical model was created using the ImageJ software package.Results and conclusion. In patients with hyperopia, in the aging process there is a transformation of the ciliary body and the restructuring of its muscular components. Structural irido-ciliary relationships in young patients with emmetropia and hyperopia significantly differ in the location and configuration of the inner apex of the ciliary body, the degree of emphasis on the circular portion of the ciliary muscle.
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Wagner S, Schaeffel F, Zrenner E, Straßer T. Prolonged nearwork affects the ciliary muscle morphology. Exp Eye Res 2019; 186:107741. [PMID: 31336108 DOI: 10.1016/j.exer.2019.107741] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 11/25/2022]
Abstract
There is evidence for a possible link between myopia development and near vision. We investigated the effect of prolonged nearwork on ciliary muscle (CM) morphology and accommodation in 18 myopic and 17 emmetropic subjects (age 19 to 25). The CM was imaged during far (0.25 D) and near vision (4 D) using optical coherence tomography (OCT), and accommodation to a step pulse (0.25 D - 4 D - 0.25 D, 15 s each) was assessed by eccentric infrared photorefraction before and after a 30-min reading task at 25 cm. OCT images were analyzed using a custom-developed semi-automatic segmentation algorithm to determine CM thickness (CMT) profiles and selective CMT readings. Accommodation was assessed using a non-linear model. On average, the CM got thinner after nearwork, predominantly at 0.0-1.4 mm posterior to the scleral spur in emmetropes, and at 1.0-1.9 mm in myopes. Selective CMT readings confirmed a significant thinning after nearwork (univariate ANOVA F1,66 = 26.313, p < 0.001), without any influence of the subjects' refractive state (F1,66 = 1.887, p = 0.174) or the target distance (F1,66 = 0.014, p = 0.907). The mean accommodation response for targets at infinity was significantly increased after nearwork (F1,32 = 7.775, p = 0.009), with a larger myopic shift in myopes (F1,32 = 11.310, p = 0.002). No change in velocity of accommodation was found. Sharing properties of striated muscles, the CM was expected to increase its thickness, but the opposite was found. Previous studies suggesting sustained nearwork to result in a CM spasm cannot be confirmed by the data presented here. Further research exploring the possible impact of sympathetic innervation is necessary as it is activated during intense nearwork.
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Affiliation(s)
- Sandra Wagner
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Str. 7, 72076, Tuebingen, Germany.
| | - Frank Schaeffel
- Section Neurobiology of the Eye, Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Str. 7, 72076, Tuebingen, Germany.
| | - Eberhart Zrenner
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Str. 7, 72076, Tuebingen, Germany; Werner Reichardt Centre for Integrative Neuroscience (CIN), Otfried-Mueller-Str. 25, 72076, Tuebingen, Germany.
| | - Torsten Straßer
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Str. 7, 72076, Tuebingen, Germany.
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The influence of age, refractive error, visual demand and lighting conditions on accommodative ability in Malay children and adults. Graefes Arch Clin Exp Ophthalmol 2019; 257:1997-2004. [PMID: 31273509 DOI: 10.1007/s00417-019-04405-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 05/30/2019] [Accepted: 06/25/2019] [Indexed: 02/01/2023] Open
Abstract
PURPOSE Near work, accommodative inaccuracy and ambient lighting conditions have all been implicated in the development of myopia. However, differences in accommodative responses with age and refractive error under different visual conditions remain unclear. This study explores differences in accommodative ability and refractive error with exposure to differing ambient illumination and visual demands in Malay schoolchildren and adults. METHODS Sixty young adults (21-25 years) and 60 schoolchildren (8-12 years) were recruited. Accommodative lag and accommodative fluctuations at far (6 m) and near (25 cm) were measured using the Grand Seiko WAM-5500 open-field autorefractor. The effects of mesopic room illumination on accommodation were also investigated. RESULTS Repeated-measures ANOVA indicated that accommodative lag at far and near differed significantly between schoolchildren and young adults [F(1.219, 35.354) = 11.857, p < 0.05]. Post hoc tests using the Bonferroni correction showed that at near, there was a greater lag in schoolchildren (0.486 ± 0.181 D) than young adults (0.259 ± 0.209 D, p < 0.05). Repeated-measures ANOVA also revealed that accommodative lag at near demands differed statistically between the non-myopic and myopic groups in young adults and schoolchildren [F(3.107, 31.431) = 12.187, p < 0.05]. Post hoc tests with Bonferroni correction showed that accommodative lag at near was significantly greater in myopic schoolchildren (0.655 ± 0.198 D) than in non-myopic schoolchildren (0.202 ± 0.141 D, p < 0.05) and myopic young adults (0.316 ± 0.172 D, p < 0.05), but no significant difference was found between myopic young adults (0.316 ± 0.172 D) and non-myopic young adults (0.242 ± 0.126 D, p > 0.05). Accommodative lag and fluctuations were greater under mesopic room conditions for all ages [all p < 0.05]. CONCLUSION Greater accommodative lag was found in myopes than in emmetropes, in schoolchildren than in adults, and under mesopic conditions than under photopic conditions. Accommodative fluctuations were greatest in myopes and in mesopic conditions. These results suggest that differences exist in the amount of blur experienced by myopes and non-myopes at different ages and under different lighting conditions.
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