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Moore M, Loughman J, Butler JS, Ohlendorf A, Wahl S, Flitcroft DI. The Refractive Error and Vision Impairment Estimation with Spectacle Data Study. OPHTHALMOLOGY SCIENCE 2022; 2:100092. [PMID: 36246180 PMCID: PMC9562346 DOI: 10.1016/j.xops.2021.100092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/23/2021] [Accepted: 12/13/2021] [Indexed: 11/08/2022]
Abstract
Purpose To investigate whether spectacle lens sales data can be used to estimate the population distribution of refractive error among patients with ametropia and hence to estimate the current and future risk of vision impairment. Design Cross-sectional study. Participants A total of 141 547 436 spectacle lens sales records from an international European lens manufacturer between 1998 and 2016. Methods Anonymized patient spectacle lens sales data, including refractive error information, was provided by a major European spectacle lens manufacturer. Data from the Gutenberg Health Survey was digitized to allow comparison of a representative, population-based sample with the spectacle lens sales data. A bootstrap analysis was completed to assess the comparability of both datasets. The expected level of vision impairment resulting from myopia at 75 years of age was calculated for both datasets using a previously published risk estimation equation combined with a saturation function. Main Outcome Measures Comparability of spectacle lens sales data on refractive error with typical population surveys of refractive error and its potential usefulness to predict vision impairment resulting from refractive error. Results Equivalent estimates of the population distribution of spherical equivalent refraction can be provided from spectacle lens data within limits. For myopia, the population distribution was equivalent to the Gutenberg Health Survey (≤ 5% deviation) for levels of –2.0 diopters (D) or less, whereas for hyperopia, the distribution was equivalent (≤ 5% deviation) for levels of +3.0 D or more. The estimated rates of vision impairment resulting from myopia were not statistically significantly different (chi-square, 182; degrees of freedom, 169; P = 0.234) between the spectacle lens dataset and Gutenberg Health Survey dataset. Conclusions The distribution of refractive error and hence the risk of vision impairment resulting from refractive error within a population can be determined using spectacle lens sales data. Pooling this type of data from multiple industry sources could provide a cost-effective, timely, and globally representative mechanism for monitoring the evolving epidemiologic features of refractive error and associated vision impairment.
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152
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Pärssinen O, Kauppinen M. Associations of near work time, watching TV, outdoors time, and parents' myopia with myopia among school children based on 38-year-old historical data. Acta Ophthalmol 2022; 100:e430-e438. [PMID: 34291573 DOI: 10.1111/aos.14980] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/01/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE To study the prevalence and risk factors of myopia with data from a questionnaire study conducted in 1983 among Finnish school children. METHODS School children (n = 4 961) from the 1st, 5th and 8th grades of school (7-, 11- and 15-year-olds) in Central Finland were screened for vision followed by a questionnaire, which was returned by 4 352 (87.7%) participants. Myopia was categorized based on the questionnaire. Items concerned daily time spent on near work and outdoor activities, excluding time spent at school, watching TV and parental myopia and the associations of myopia with these factors were studied. RESULTS The prevalence of myopia was 3%, 15% and 27% among the 7-, 11- and 15-year-olds, and if daily near work at home was ≤1 hr, myopia prevalence was 0.5%, 3.3% and 17.6%, respectively. The adjusted risk of myopia for each daily near work hour was OR 1.476 (95% confidence interval 1.099-1.984, p = 0.010), OR 1.346 (1.170-1.584, p < 0.001) and OR 1.206 (1.076-1.352, p = 0.001), in the 3 age groups, respectively. The adjusted risk of myopia for each daily hour spent outdoors was OR 0.764 (0.648-0.900, p = 0.001) in the 11-year-olds and OR (0.840, 0.743-0.950, p = 0.005) in the 15-year-olds. Outdoors time prevented myopia at different levels of near work, although less at the highest levels, and near work increased risk of myopia with the level of outdoors time. If the ratio between near work and outdoors time was ≤0. 5 or >1.5, the prevalence of myopia was 1.4% versus 5.6%, 6.3% versus 24.7% and 15.9% versus 36.9%, among the 7-, 11- and 15-year-olds, respectively. The higher prevalence of myopia among the 11- and 15-year-old girls than boys was explained by more near work and less outdoor time among the girls. Having two myopic parents roughly doubled the risk of myopia compared to if one myopic parent in the 11- and 15-year-olds. CONCLUSIONS Myopic parents, greater near work time, less outdoors time, a higher near work/outdoors ratio, and being a girl increased the risk of myopia. Myopia was rare in the 7- and 11-year-olds if daily near work at home did not exceed one hour or if the near work/outdoors ratio was not higher than 0.5. Outdoors time was associated with the prevalence of myopia at all levels of near work, although the association was weaker at the highest level.
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Affiliation(s)
- Olavi Pärssinen
- Department of Ophthalmology Central Hospital of Central Finland Jyväskylä Finland
- Gerontology Research Center and Faculty of Sport and Health Sciences University of Jyvaskylä Jyväskylä Finland
| | - Markku Kauppinen
- Gerontology Research Center and Faculty of Sport and Health Sciences University of Jyvaskylä Jyväskylä Finland
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153
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Bhandari KR, Shukla D, Mirhajianmoghadam H, Ostrin LA. Objective Measures of Near Viewing and Light Exposure in Schoolchildren during COVID-19. Optom Vis Sci 2022; 99:241-252. [PMID: 35086121 PMCID: PMC8897254 DOI: 10.1097/opx.0000000000001871] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Wearable sensors provide the opportunity for continuous objective measurement of the visual environment with high resolution. Our findings show that absolute and temporal properties of near viewing and time outdoors vary between myopic and nonmyopic schoolchildren, which are important considerations when studying refractive error pathogenesis. PURPOSE Numerous behavioral factors, including near work, time outdoors, electronic device use, and sleep, have been linked to myopia. The purpose of this study was to assess behaviors using subjective and objective methods in myopic and nonmyopic schoolchildren in the United States. METHODS Forty children (aged 14.6 ± 0.4 years) simultaneously wore two sensors for 1 week, a Clouclip for objective measurement of near viewing and light exposure and an Actiwatch for objective measurement of activity and sleep. Parents completed an activity questionnaire for their child. Near-viewing distance, daily duration, short-duration (>1 minute) and long-duration (>30 minutes) near-viewing episodes, light exposure, time outdoors, electronic device use, and sleep duration were analyzed by refractive error group and day of the week. RESULTS Objectively measured daily near-viewing duration was 6.9 ± 0.3 hours. Myopes spent more time in near + intermediate viewing than nonmyopes (P = .008) and had higher diopter hours (P = .03). Short- and long-duration near-viewing episodes were similar between groups (P < .05 for both). Daily light exposure and time outdoors were significantly lower for myopes (P < .05 for both). Electronic device use (12.0 ± 0.7 hours per day) and sleep duration (8.2 ± 0.2 hours per night) were similar between groups (P > .05 for both). CONCLUSIONS Objective and subjective measures confirm that myopic and nonmyopic schoolchildren exhibit different behaviors. Combining wearable sensors with questionnaires provides a comprehensive description of children's visual environment to better understand factors that contribute to myopia.
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Affiliation(s)
| | - Divya Shukla
- University of Houston College of Optometry, Houston, Texas
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154
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Nguyen HTT, Hoang TT, Pham CM, Nguyen TM, Dang TM, Fricke TR. Prevalence and related factors of myopic retinopathy - a hospital-based cross-section study in Vietnam. Clin Exp Optom 2022; 106:427-430. [PMID: 35188078 DOI: 10.1080/08164622.2022.2039555] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
CLINICAL RELEVANCE Myopia prevention and anti-myopia treatment is of great importance in South East Asia. BACKGROUND To evaluate the prevalence and related factors of myopic retinopathy in Vietnam. METHODS A cross-sectional study was conducted on 168 eyes of 88 patients with high myopia presenting to the Refraction Department of Vietnam National Eye Hospital. Inclusion criteria were high myopia (≤-6.00D with cycloplegic retinoscopy). Consecutive presenting patients recruited between January 2020 and August 2020 consented to participate. RESULTS Participant age range was 12-47 years. Peripapillary atrophy was present in 70.2% of participants, most commonly atrophy of one-quarter of the disc (38.7%). Central retinal changes were present in 66.1% of participants, subclassified as tessellated fundus in 60.7%, diffuse chorioretinal atrophy in 4.2% and patchy chorioretinal atrophy in 1.2%. Peripheral retinal lesions were present in 43.5% of participants, consisting of white-without-pressure in 32.1%, lattice degeneration in 16.1%, snail track degeneration in 4.2% and microcystoid degeneration in 1.2%. Myopia ≤-8.00D and axial length ≥26.5 mm were associated with additional risk of posterior ocular complications. Furthermore, age ≥19 years increased risk of central myopic retinopathy and ≥10 years since initial myopia diagnosis increased the risk of peripapillary atrophy and central retinal changes. Other factors such as the age of onset of myopia and family myopia history did not appear to alter the risk of peripheral retina damage. CONCLUSIONS Retinal disorders were common in Vietnamese people with high myopia. Within the current cohort with high myopia, myopia ≤-8.00D and axial length ≥26.5 mm were associated with a significant further elevation of risk.
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Affiliation(s)
| | - Tung Thanh Hoang
- Hanoi Medical University, Hanoi, Vietnam.,Save Sight Institute, University of Sydney, New South Wales, Australia
| | | | | | - Trung M Dang
- Eye Clinic Albury-Wodonga, Albury, New South Wales, Australia
| | - Timothy R Fricke
- Brien Holden Vision Institute, Sydney, New South Wales, Australia.,Department of Optometry and Vision Sciences, University of Melbourne, Victoria, Australia.,School of Optometry and Vision Science, University of New South Wales, New South Wales, Australia
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155
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Li X, Lin H, Jiang L, Chen X, Chen J, Lu F. Low Serum Vitamin D Is Not Correlated With Myopia in Chinese Children and Adolescents. Front Med (Lausanne) 2022; 9:809787. [PMID: 35186996 PMCID: PMC8856508 DOI: 10.3389/fmed.2022.809787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose This cross-sectional study investigated the association between serum 25-hydroxyvitamin D [25(OH)D] concentration and myopia in two groups of Chinese children aged 6–14 years from different geographic and economic locations. Methods A total of 294 children from a lowland area and 89 from a highland area were enrolled as two groups of study subjects. The visual acuity, ocular biometry, and automated refraction were measured. The serum level of 25(OH)D was determined by chemiluminescence immunoassay. Near vision and outdoor exposure durations were assessed with a questionnaire interview. Data were analyzed for differences using Chi-square and Wilcoxon rank sum tests. The risk factors were evaluated using logistic regression analysis. Results We found that the serum level of 25(OH)D of the subjects from lowland area was 20.9 ng/mL which was higher than that of subjects from highland area (16.9 ng/mL). The median spherical equivalent refraction (SER) was −0.25 diopters(D) in lowland subjects and −0.63D in highland subjects. The prevalence of myopia was 45.2% in lowland subjects and 55.1% in highland subjects. The average axial length was similar, 23.6 mm and 23.1 mm in lowland and highland subjects, respectively. We found no statistical difference between the average SER and serum 25(OH)D concentration in subjects of either lowland or highland area. The ratio of myopia to non-myopia was also similar in subjects with three levels (sufficient, deficient, and insufficient) of serum 25(OH)D in these two areas. Conclusions There is no association between serum 25(OH)D concentration and myopia in the 6–14 years old Chinese children.
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Affiliation(s)
- Xiaoman Li
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Haishuang Lin
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- Wenzhou Medical University, Wenzhou, China
| | - Longfei Jiang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Xin Chen
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Jie Chen
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- *Correspondence: Jie Chen
| | - Fan Lu
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- Fan Lu
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156
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Dhakal R, Shah R, Huntjens B, Verkicharla PK, Lawrenson JG. Time spent outdoors as an intervention for myopia prevention and control in children: an overview of systematic reviews. Ophthalmic Physiol Opt 2022; 42:545-558. [PMID: 35072278 PMCID: PMC9305934 DOI: 10.1111/opo.12945] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 12/02/2021] [Accepted: 12/04/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE Outdoor light exposure is considered a safe and effective strategy to reduce myopia development and aligns with existing public health initiatives to promote healthier lifestyles in children. However, it is unclear whether this strategy reduces myopia progression in eyes that are already myopic. This study aims to conduct an overview of systematic reviews (SRs) reporting time spent outdoors as a strategy to prevent myopia or slow its progression in children. METHODS We searched the Cochrane Library, EMBASE, MEDLINE and CINAHL from inception to 1 November 2020 to identify SRs that evaluated the association between outdoor light exposure and myopia development or progression in children. Outcomes included incident myopia, prevalent myopia and change in spherical equivalent refraction (SER) and axial length (AL) to evaluate annual rates of myopia progression. The methodological quality and risk of bias of included SRs were assessed using the AMSTAR-2 and ROBIS tools, respectively. RESULTS Seven SRs were identified, which included data from 47 primary studies with 63,920 participants. Pooled estimates (risk or odds ratios) consistently demonstrated that time outdoors was associated with a reduction in prevalence and incidence of myopia. In terms of slowing progression in eyes that were already myopic, the reported annual reductions in SER and AL from baseline were small (0.13-0.17 D) and regarded as clinically insignificant. Methodological quality assessment using AMSTAR-2 found that all reviews had one or more critical flaws and the ROBIS tool identified a low risk of bias in only two of the included SRs. CONCLUSION This overview found that increased exposure to outdoor light reduces myopia development. However, based on annual change in SER and AL, there is insufficient evidence for a clinically significant effect on myopia progression. The poor methodological quality and inconsistent reporting of the included systematic reviews reduce confidence in the estimates of effect.
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Affiliation(s)
- Rohit Dhakal
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India.,Centre for Applied Vision Research, School of Health Sciences, City, University of London, London, UK
| | - Rakhee Shah
- Centre for Applied Vision Research, School of Health Sciences, City, University of London, London, UK
| | - Byki Huntjens
- Centre for Applied Vision Research, School of Health Sciences, City, University of London, London, UK
| | - Pavan K Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - John G Lawrenson
- Centre for Applied Vision Research, School of Health Sciences, City, University of London, London, UK
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157
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Suh YW, Ha SG, Kim SH. Effect of Classroom Illuminance on the Development and Progression of Myopia in School Children. KOREAN JOURNAL OF OPHTHALMOLOGY 2022; 36:194-201. [PMID: 35067020 PMCID: PMC9194730 DOI: 10.3341/kjo.2021.0170] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 12/28/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- Young-Woo Suh
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Suk-Gyu Ha
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Seung-Hyun Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
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158
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Gopalakrishnan A, Hussaindeen JR, Sivaraman V, Swaminathan M, Wong YL, Armitage JA, Gentle A, Backhouse S. Prevalence of myopia among urban and suburban school children in Tamil Nadu, South India: findings from the Sankara Nethralaya Tamil Nadu Essilor Myopia (STEM) Study. Ophthalmic Physiol Opt 2022; 42:345-357. [PMID: 35019150 PMCID: PMC9304285 DOI: 10.1111/opo.12943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 12/13/2021] [Accepted: 12/22/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To report the baseline prevalence of myopia among school children in Tamil Nadu, South India from a prospective cohort study. METHODS Children between the ages of 5 and 16 years from 11 schools in two districts of Tamil Nadu underwent vision screening. All children underwent visual acuity assessment using a Pocket Vision Screener followed by non-cycloplegic open-field autorefraction (Grand Seiko WAM-5500). Myopia was defined as a spherical equivalent (SE) refraction of ≤-0.75 D and high myopia was defined as SE ≤ -6.00 D. Distribution of refraction, biometry and factors associated with prevalence of myopia were the outcome measures. RESULTS A total of 14,699 children completed vision screening, with 2% (357) of them having ocular abnormalities other than refractive errors or poor vision despite spectacle correction. The remaining 14,342 children (7557 boys; 52.69%) had a mean age of 10.2 (Standard Deviation [SD] 2.8) years. A total of 2502 had myopia in at least one eye, a prevalence of 17.5% (95% CI: 14.7-20.5%), and 74 (0.5%; 95% CI: 0.3-0.9%) had high myopia. Myopia prevalence increased with age (p < 0.001), but sex was not associated with myopia prevalence (p = 0.24). Mean axial length (AL; 23.08 (SD = 0.91) mm) and mean anterior chamber depth (ACD; 3.45 (SD = 0.27) mm) positively correlated with age (p < 0.001). The mean flat (K1; 43.37 (SD = 1.49) D) and steep (K2; 44.50 (SD = 1.58) D) corneal curvatures showed negative correlation with age (p = 0.02 and p < 0.001, respectively). In the multivariable logistic regression, older age and urban school location had higher odds for prevalence of myopia. CONCLUSION The baseline prevalence of myopia among 5- to 16-year-old children in South India is larger than that found in previous studies, indicating that myopia is becoming a major public health problem in this country.
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Affiliation(s)
- Aparna Gopalakrishnan
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai, India.,School of Medicine, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | | | - Viswanathan Sivaraman
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai, India
| | - Meenakshi Swaminathan
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai, India
| | - Yee Ling Wong
- R&D AMERA, Essilor International, Singapore, Singapore
| | - James A Armitage
- School of Medicine, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Alex Gentle
- School of Medicine, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Simon Backhouse
- School of Medicine, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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159
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Comparative Study of Refraction between Wave Front-Based Refraction and Autorefraction without and with Cycloplegia in Children and Adolescents. CHILDREN 2022; 9:children9010088. [PMID: 35053713 PMCID: PMC8774470 DOI: 10.3390/children9010088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/21/2021] [Accepted: 01/07/2022] [Indexed: 11/25/2022]
Abstract
The main aim of this study was to compare refraction measurements with and without cycloplegia from two refractors devices, (TRK-2P autorefractometer (TRK-2P) and wavefront-based refraction Visionix 130 (VX130)) in children and adolescents. This descriptive observational study included 20 myopic eyes and 40 hyperopic eyes measured in two different Spanish hospitals. Cycloplegia was carried out by three drops of cyclopentolate hydrochloride 1% (Colircusí cycloplegic, Alcon Healthcare S.A., Barcelona). The mean age of the myopia group was 12.40 ± 3.48 years; for the hyperopia group, the mean age was 7.37 ± 2.47 years. In the myopia group, autorefraction and wavefront-based refraction did not show clinically significant differences in any components between with and without cycloplegia. The hyperopia group showed statistical and clinically significant differences in sphere and SE components between relaxed and non-relaxed states of accommodation, although the cylindrical components were not clinically different. In this study, we considered a value of ≥0.50D as a clinically significant difference in refraction. Therefore, both devices were capable of obtaining accurate refractions without cyclopegia in myopia children, although they did not avoid instrument myopia and accommodation involved in hyperopia children. Moreover, both refractometers could be useful for astigmatism monitoring in children without the need for cycloplegic drops.
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160
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Yang Q, Tan QQ, Lan CJ, Lv BZ, Zhou GM, Zhong WQ, Gu ZM, Mao YM, Liao X. The Changes of KCNQ5 Expression and Potassium Microenvironment in the Retina of Myopic Guinea Pigs. Front Physiol 2021; 12:790580. [PMID: 35002772 PMCID: PMC8733613 DOI: 10.3389/fphys.2021.790580] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/07/2021] [Indexed: 11/13/2022] Open
Abstract
KCNQ5 is suggestively associated with myopia, but its specific role in the myopic process has not been studied further. The aim of this study was to investigate the expression of potassium channel gene KCNQ5 and the changes of K+ microenvironment within the retina of form deprivation myopia (FDM) guinea pigs. A total of 60 guinea pigs were randomly divided into the normal control (NC) group, the self-control (SC) group, and the form-deprivation (FD) group for different treatments. Molecular assays and immunohistochemistry (IHC) were conducted to measure the expression and distribution of KCNQ5-related gene and protein in the retina. We determined the K+ concentration in the retina. In addition, the possible effects of form deprivation on potassium ionic currents and the pharmacological sensitivity of KCNQ5 activator Retigabine and inhibitor XE991 to the M-current in RPE cells were investigated using the patch-clamp technique. As a result, FD eyes exhibited more myopic refraction and longer AL. The mRNA and protein levels of KCNQ5 significantly decreased in the FD eyes, but the K+ concentration increased. In addition, the M-type K+ current [IK(M)] density decreased in FD RPE cells, and were activated or inhibited in a concentration-dependent manner due to the addition of Retigabine or XE991. Overall, KCNQ5 was significantly downregulated in the retina of FD guinea pigs, which may be associated with the increasing K+ concentration, decreasing IK(M) density, and elongating ocular axis. It suggested that KCNQ5 may play a role in the process of myopia, and the intervention of potassium channels may contribute to the prevention and control of myopia.
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Affiliation(s)
- Qin Yang
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- Department of Ophthalmology and Optometry, North Sichuan Medical College, Nanchong, China
- The Translational Medicine Research Center and the Hepatobiliary Research Institute (North Sichuan Medical College), Nanchong, China
| | - Qing Qing Tan
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- Department of Ophthalmology and Optometry, North Sichuan Medical College, Nanchong, China
| | - Chang Jun Lan
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- Department of Ophthalmology and Optometry, North Sichuan Medical College, Nanchong, China
| | - Bo Zhen Lv
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Gui Mei Zhou
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- Department of Ophthalmology and Optometry, North Sichuan Medical College, Nanchong, China
| | - Wei Qi Zhong
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- Department of Ophthalmology and Optometry, North Sichuan Medical College, Nanchong, China
- The Translational Medicine Research Center and the Hepatobiliary Research Institute (North Sichuan Medical College), Nanchong, China
| | - Zhi Ming Gu
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- Department of Ophthalmology and Optometry, North Sichuan Medical College, Nanchong, China
- The Translational Medicine Research Center and the Hepatobiliary Research Institute (North Sichuan Medical College), Nanchong, China
| | - Yu Mei Mao
- The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xuan Liao
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
- Department of Ophthalmology and Optometry, North Sichuan Medical College, Nanchong, China
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161
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Ohno-Matsui K, Scholl HPN. Having one of the fastest growing unmet needs in ophthalmology reflected in editorial activities: Myopia. Ophthalmic Res 2021; 65:1-3. [PMID: 34856546 DOI: 10.1159/000521194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hendrik P N Scholl
- Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland
- Department of Ophthalmology, University of Basel, Basel, Switzerland
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162
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Furuse T, Hasebe S, Tokutake T. Peripheral refraction in Japanese schoolchildren with low to moderate myopia. Jpn J Ophthalmol 2021; 66:74-80. [PMID: 34855122 DOI: 10.1007/s10384-021-00880-2] [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] [Received: 06/05/2021] [Accepted: 08/26/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To report the profile of peripheral refraction in Japanese children with mild to moderate myopia and compare it with reported data from other countries. STUDY DESIGN Cross-sectional study. METHODS Subjects were 76 Japanese children with myopia (mean± SD [range] spherical equivalent, -3.04±0.98 [-0.50 to -4.50] D; mean age, 10.0±1.5 [6-12] years). We performed cycloplegic refraction using an open-field autorefractor FR-5000 (Grand Seiko) while the subject looked at external fixation targets located at 0, ±15, ±30 degrees from the center along the horizontal meridian. Only the right eye data were analyzed after converting the readings to the power vector of M (spherical equivalent), J180, and J45. RESULTS The profile showed a clear hyperopic shift of M from the fovea to the peripheral retina, although a wide inter-subject variation existed. At the gaze positions of ±30 degrees, the mean relative M were +1.16±0.89 D and +1.64±1.02 D (nasal and temporal retina, respectively). Those for J180 were -0.94±0.30 D and -0.70±0.30 D (nasal and temporal retina, respectively). The mean J45 remained small (≦ 0.17 D) within this range of eccentricity. There was no correlation between the relative M at the gaze position of -30 degrees and on-axis refraction, axial length, or children's age (p > 0.05). CONCLUSIONS The profile of peripheral refraction was similar to that reported in children with moderate to high myopia in other East Asian countries. In this cohort, we did not find evidence supporting a hypothesis that greater myopia and longer axial length are associated with a greater peripheral hyperopic shift of the refraction.
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Affiliation(s)
- Takashi Furuse
- Department of Ophthalmology 2, Kawasaki Medical School, 2-6-1 Nakasange, Kita-ku, Okayama City, Okayama, 700-8505, Japan. .,Department of Ophthalmology, Kawasaki Medical School General Medical Center, Okayama City, Japan.
| | - Satoshi Hasebe
- Department of Ophthalmology 2, Kawasaki Medical School, 2-6-1 Nakasange, Kita-ku, Okayama City, Okayama, 700-8505, Japan.,Department of Ophthalmology, Kawasaki Medical School General Medical Center, Okayama City, Japan
| | - Tomoki Tokutake
- Department of Ophthalmology, Kawasaki Medical School General Medical Center, Okayama City, Japan
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Thakur S, Dhakal R, Verkicharla PK. Short-Term Exposure to Blue Light Shows an Inhibitory Effect on Axial Elongation in Human Eyes Independent of Defocus. Invest Ophthalmol Vis Sci 2021; 62:22. [PMID: 34935883 PMCID: PMC8711007 DOI: 10.1167/iovs.62.15.22] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Given the potential role of light and its wavelength on ocular growth, we investigated the effect of short-term exposure to the red, green, and blue light on ocular biometry in the presence and absence of lens-induced defocus in humans. Methods Twenty-five young adults were exposed to blue (460 nm), green (521 nm), red (623 nm), and white light conditions for 1-hour each on 4 separate experimental sessions conducted on 4 different days. In each light condition, hyperopic defocus (3D) was induced to the right eye with the fellow eye experiencing no defocus. Axial length and choroidal thickness were measured before and immediately after the light exposure with a non-contact biometer. Results Axial length increased from baseline after red light (mean difference ± standard error in the defocussed eye and non-defocussed eye = 11.2 ± 2 µm and 6.4 ± 2.3 µm, P < 0.001 and P < 0.01, respectively) and green light exposure (9.2 ± 3 µm and 7.0 ± 2.5 µm, P < 0.001 and P < 0.001) with a significant decrease in choroidal thickness (P < 0.05, both red and green light) after 1-hour of exposure. Blue light exposure resulted in a reduction in axial length in both the eyes (−8.0 ± 3 µm, P < 0.001 in the defocussed eye and −6.0 ± 3 µm, P = 0.11 in the non-defocused eye) with no significant changes in the choroidal thickness. Conclusions Exposure to red and green light resulted in axial elongation, and blue light resulted in inhibition of axial elongation in human eyes. Impact of such specific wavelength exposure on children and its application in myopia control need to be explored.
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Affiliation(s)
- Swapnil Thakur
- Myopia Research Lab - Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India and Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
| | - Rohit Dhakal
- Myopia Research Lab - Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India and Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
| | - Pavan K Verkicharla
- Myopia Research Lab - Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India and Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
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164
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Kaymak H, Graff B, Neller K, Langenbucher A, Seitz B, Schwahn H. [Myopia treatment and prophylaxis with defocus incorporated multiple segments spectacle lenses]. Ophthalmologe 2021; 118:1280-1286. [PMID: 34236491 PMCID: PMC8648703 DOI: 10.1007/s00347-021-01452-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/09/2021] [Accepted: 06/16/2021] [Indexed: 12/17/2022]
Abstract
Excessive axial eye growth in children and adolescents leads to progressive myopia and can result in severe ocular diseases in adulthood. Various strategies have already been developed to inhibit progression of myopia. The novel single vision lens presented in this article features the defocus incorporated multiple segments (DIMS) technology and adds an easy to use, noninvasive option to the portfolio of myopia treatment. Initial studies showed promising results with only a very low side effect profile.
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Affiliation(s)
- Hakan Kaymak
- Internationale Innovative Ophthalmochirurgie GbR, Theo-Champion-Str. 1, 40549, Düsseldorf, Deutschland.
- Institut für Experimentelle Ophthalmologie, Universitätsklinikum des Saarlandes UKS, Homburg/Saar, Deutschland.
| | - Birte Graff
- Internationale Innovative Ophthalmochirurgie GbR, Theo-Champion-Str. 1, 40549, Düsseldorf, Deutschland
- Institut für Experimentelle Ophthalmologie, Universitätsklinikum des Saarlandes UKS, Homburg/Saar, Deutschland
| | - Kai Neller
- Internationale Innovative Ophthalmochirurgie GbR, Theo-Champion-Str. 1, 40549, Düsseldorf, Deutschland
- Institut für Experimentelle Ophthalmologie, Universitätsklinikum des Saarlandes UKS, Homburg/Saar, Deutschland
| | - Achim Langenbucher
- Institut für Experimentelle Ophthalmologie, Universitätsklinikum des Saarlandes UKS, Homburg/Saar, Deutschland
| | - Berthold Seitz
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes UKS, Homburg/Saar, Deutschland
| | - Hartmut Schwahn
- Internationale Innovative Ophthalmochirurgie GbR, Theo-Champion-Str. 1, 40549, Düsseldorf, Deutschland
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165
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Romashchenko D, Papadogiannis P, Unsbo P, Lundström L. Simultaneous measurements of foveal and peripheral aberrations with accommodation in myopic and emmetropic eyes. BIOMEDICAL OPTICS EXPRESS 2021; 12:7422-7433. [PMID: 35003843 PMCID: PMC8713693 DOI: 10.1364/boe.438400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 06/14/2023]
Abstract
The difference in peripheral retinal image quality between myopic and emmetropic eyes plays a major role in the design of the optical myopia interventions. Knowing this difference under accommodation can help to understand the limitations of the currently available optical solutions for myopia control. A newly developed dual-angle open-field sensor was used to assess the simultaneous foveal and peripheral ( 20 ∘ nasal visual field) wavefront aberrations for five target vergences from -0.31 D to -4.0 D in six myopic and five emmetropic participants. With accommodation, the myopic eyes showed myopic shifts, and the emmetropic eyes showed no change in RPR. Furthermore, RPR calculated from simultaneous measurements showed lower intra-subject variability compared to the RPR calculated from peripheral measurements and target vergence. Other aberrations, as well as modulation transfer functions for natural pupils, were similar between the groups and the accommodation levels, foveally and peripherally. Results from viewing the same nearby target with and without spectacles by myopic participants suggest that the accommodative response is not the leading factor controlling the amplitude of accommodation microfluctuations.
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Affiliation(s)
- Dmitry Romashchenko
- Department of Applied Physics, Royal Institute of Technology, Stockholm, 11421, Sweden
- Current address: R&D, Johnson & Johnson Vision, Groningen, 9728 NX, The Netherlands
| | - Petros Papadogiannis
- Department of Applied Physics, Royal Institute of Technology, Stockholm, 11421, Sweden
| | - Peter Unsbo
- Department of Applied Physics, Royal Institute of Technology, Stockholm, 11421, Sweden
| | - Linda Lundström
- Department of Applied Physics, Royal Institute of Technology, Stockholm, 11421, Sweden
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166
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Lipson MJ, Boland B, McAlinden C. Vision-related quality of life with myopia management: A review. Cont Lens Anterior Eye 2021; 45:101538. [PMID: 34802915 DOI: 10.1016/j.clae.2021.101538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 11/03/2022]
Abstract
The disease of myopia has come into focus as a worldwide public health concern. Myopia has shown increasing prevalence, incidence at earlier age and progression to a higher degree. Progressive increase in degree of myopia is strongly associated with increase in axial length of the eye. Various interventions have been shown to slow axial elongation in children. These interventions have been studied to assess efficacy in slowing axial elongation and correction of vision. In addition, research into quality of vision, risk of adverse events, overall safety and impact on vision-related quality (VR-QoL) of life has been pursued. In contrast, studies have been published to demonstrate the risks of myopia, high myopia and increased axial length. This review will discuss VR-QoL assessment on the most effective and most commonly prescribed interventions to slow axial elongation and myopia progression. The patient attributes considered are VR-QoL scores from validated instruments. The development and use of validated survey instruments to assess the patient-reported outcomes is discussed. The review demonstrates that there are numerous factors that may impact VR-QoL to evaluate in the decision-making process when eye care providers consider when, how and if to prescribe myopia management (MM) for children with myopia.
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Affiliation(s)
- Michael J Lipson
- Department of Ophthalmology and Visual Sciences, University of Michigan, Kellogg Eye Center (Retired), Independent Consultant, United States.
| | - Brittany Boland
- Department of Ophthalmology and Visual Sciences, University of Michigan, Kellogg Eye Center, United States
| | - Colm McAlinden
- Department of Ophthalmology, Singleton Hospital, Swansea University Health Board, Swansea, UK; Department of Ophthalmology, Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, UK; Wenzhou Medical University, Wenzhou, China; Eye & ENT Hospital of Fudan University, Shanghai, China
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167
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Gupta SK, Chakraborty R, Verkicharla PK. Electroretinogram responses in myopia: a review. Doc Ophthalmol 2021; 145:77-95. [PMID: 34787722 PMCID: PMC9470726 DOI: 10.1007/s10633-021-09857-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/11/2021] [Indexed: 11/02/2022]
Abstract
The stretching of a myopic eye is associated with several structural and functional changes in the retina and posterior segment of the eye. Recent research highlights the role of retinal signaling in ocular growth. Evidence from studies conducted on animal models and humans suggests that visual mechanisms regulating refractive development are primarily localized at the retina and that the visual signals from the retinal periphery are also critical for visually guided eye growth. Therefore, it is important to study the structural and functional changes in the retina in relation to refractive errors. This review will specifically focus on electroretinogram (ERG) changes in myopia and their implications in understanding the nature of retinal functioning in myopic eyes. Based on the available literature, we will discuss the fundamentals of retinal neurophysiology in the regulation of vision-dependent ocular growth, findings from various studies that investigated global and localized retinal functions in myopia using various types of ERGs.
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Affiliation(s)
- Satish Kumar Gupta
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, India
| | - Ranjay Chakraborty
- Caring Futures Institute, College of Nursing and Health Sciences, Optometry and Vision Science, Flinders University, Adelaide, South Australia, Australia
| | - Pavan Kumar Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, India.
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168
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Cui C, Li X, Lyu Y, Wei L, Zhao B, Yu S, Rong J, Bai Y, Fu A. Safety and efficacy of 0.02% and 0.01% atropine on controlling myopia progression: a 2-year clinical trial. Sci Rep 2021; 11:22267. [PMID: 34782708 PMCID: PMC8592985 DOI: 10.1038/s41598-021-01708-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 10/27/2021] [Indexed: 11/09/2022] Open
Abstract
Four hundred myopic children randomly received atropine 0.02% (n = 138) or 0.01% (n = 142) in both eyes once-nightly or only wore single-vision spectacles (control group) (n = 120) for 2 years. Spherical equivalent refractive error (SER), axial length (AL), pupil diameter (PD), and amplitude of accommodation (AMP) were measured every 4 months. After 2 years, the SER changes were - 0.80 (0.52) D, - 0.93 (0.59) D and - 1.33 (0.72) D and the AL changes were 0.62 (0.29) mm, 0.72 (0.31) mm and 0.88 (0.35) mm in the 0.02% and 0.01% atropine groups and control group, respectively. There were significant differences between changes in SER and AL in the three groups (all P < 0.001). The changes in SER and AL in the 2nd year were similar to the changes in the 1st year in the three groups (all P > 0.05). From baseline to 2 years, the overall decrease in AMP and increase in PD were not significantly different in the two atropine groups, whereas the AMP and PD in the control group remained stable (all P > 0.05). 0.02% atropine had a better effect on myopia control than 0.01% atropine, and its effects on PD and AMP were similar to 0.01% atropine. 0.02% or 0.01% atropine controlled myopia progression and AL elongation synchronously and had similar effects on myopia control each year.
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Affiliation(s)
- Can Cui
- The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhengzhou, 450000, China
| | - Xiujuan Li
- The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhengzhou, 450000, China
| | - Yong Lyu
- The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhengzhou, 450000, China
| | - Li Wei
- The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhengzhou, 450000, China
| | - Bingxin Zhao
- The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhengzhou, 450000, China
| | - Shiao Yu
- The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhengzhou, 450000, China
| | - Junbo Rong
- The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhengzhou, 450000, China
| | - Yanhui Bai
- The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhengzhou, 450000, China
| | - Aicun Fu
- The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe Road, Zhengzhou, 450000, China.
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169
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Stable Atropine Loaded Film As a Potential Ocular Delivery System For Treatment Of Myopia. Pharm Res 2021; 38:1931-1946. [PMID: 34773183 DOI: 10.1007/s11095-021-03135-4] [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: 07/26/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The objective of the present study was to prepare stable and high bioavailability ocular atropine loaded films (ATR-films) as potential ocular drug delivery systems for the treatment of myopia. METHODS ATR-films were prepared by the solvent casting method and the physical properties of films were evaluated including thickness, water content, light transparency, disintegration time, and mechanical properties. FT-IR, DSC, XRD, TGA, AFM, and Raman spectroscopy were performed to characterize the film. The stability test was conducted under different conditions, such as high humidity, high temperature, and strong light. The pharmacokinetic study and irritation assessment were conducted in rabbits. The efficacy of ATR-films was evaluated by refraction and ocular biometry in myopia guinea pigs. RESULT After optimizing the formulation, the resulting ATR-film was flexible and transparent with lower water content (8.43% ± 1.25). As expected, the ATR-film was stable and hydrolysate was not detected, while the content of hydrolysate in ATR eye drops can reach up to 8.1867% (limit: < 0.2%) in the stability study. The safety assessment both in vitro and in vivo confirmed that the ATR-film was biocompatible. Moreover, the bioavailability (conjunctiva 3.21-fold, cornea 2.87-fold, retina 1.35-fold, sclera 2.05-fold) was greatly improved compared with the ATR eye drops in vivo pharmacokinetic study. The pharmacodynamic study results showed that the ATR-film can slow the progress of form-deprivation myopia (~ 100 ± 0.81D), indicating that it has a certain therapeutic effect on form-deprivation myopia. CONCLUSION The ATR-film with good stability and high bioavailability will have great potential for the treatment of myopia.
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170
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Zhu Y, Zhang Y, Jiang R, Zhao K, Zhou J. MicroRNA-29a May Influence Myopia Development by Regulating Collagen I. Curr Eye Res 2021; 47:468-476. [PMID: 34766525 DOI: 10.1080/02713683.2021.1998542] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of this study was to characterize the regulatory role of microRNA-29a (miR-29a) in myopia, providing support for potential biomarkers and new therapeutic targets of myopia in humans. METHODS The miR-29a expression level was detected in the aqueous humor and peripheral blood plasma of 21 high myopic patients and eight cataract control patients using quantitative polymerase chain reaction. iTRAQ analysis of proteomes was conducted to show the regulatory effect of miR-29a on human scleral fibroblasts (SFs) cultured in vitro. We also assessed proliferation, migration, and collagen I synthesis in SF cells, mediated by miR-29a. RESULTS MiR-29a expression was significantly higher in the aqueous humor of highly myopic patients than in the cataract control patients (fold change: 4.861, p = 0.001). miR-29a inhibited the synthesis of type I collagen in human SF cells and enhanced cell migration, but had no significant effect on cell proliferation. CONCLUSION MiR-29a was highly expressed in aqueous humor of myopia patients and inhibited the synthesis of type I collagen in human SF cells in vivo, thereby it may play an important role in myopia development.
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Affiliation(s)
- Yi Zhu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Yingjie Zhang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Run Jiang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Keke Zhao
- Department of Ophthalmology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jibo Zhou
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
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Wang Z, Meng Y, Wang Z, Hao L, Rashidi V, Sun H, Zhang J, Liu X, Duan X, Jiao Z, Qie S, Yan Z. Crystalline lens thickness change is associated with axial length elongation and myopia progression in orthokeratology. Cont Lens Anterior Eye 2021; 45:101534. [PMID: 34772627 DOI: 10.1016/j.clae.2021.101534] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 10/23/2021] [Accepted: 11/01/2021] [Indexed: 11/03/2022]
Abstract
AIMS Considering individual variability in regards to the effects of orthokeratology (ortho-k) on myopia progression and controversies regarding the precise underlying mechanism, the aim of this study was to investigate several ocular measurements associated with axial length (AL) growth in children wearing ortho-k lenses. METHODS In this retrospective chart review, medical records of 53 Chinese children who wore ortho-k lenses over the course of 12 months were reviewed. Baseline variables included age at initiation of ortho-k wear, refractive error (spherical equivalent, SE), central corneal thickness (CCT), and flat and steep keratometry of corneal principal meridians. The change of anterior chamber depth (ACD) and the change of crystalline lens thickness (CLT) between baseline and the 12-month follow-up were also analyzed. The contributions of all analyzed variables to AL change were assessed using univariate and multivariate regression analyses. RESULTS Initially, the results of paired t-test showed that CLT and AL were significantly increased after 12 months of ortho-k wear compared with that at baseline (P = 0.001 and < 0.001). The ACD did not change significantly after 12 months compared with that at baseline (P = 0.491). Subsequently, univariate analyses showed that a reduced rate of AL elongation was found in children who were older age at initiation of ortho-k wear (P = 0.028), had greater SE (higher degree of myopia) at baseline (p = 0.006), had thicker CCT at baseline (P = 0.04), and had greater increase of CLT (P = 0.001) in 12 months. At last, only greater SE (higher degree of myopia) and greater increase of CLT were associated with smaller increases of AL in multivariable analyses, (P = 0.003 and 0.001). CONCLUSIONS Both CLT and AL were significantly increased in children with overnight ortho-k wear after 12 months of follow-up. Greater baseline SE and greater increase of CLT were associated with less increase in AL during ortho-k wear in children with myopia.
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Affiliation(s)
- Zengying Wang
- The Department of Ophthalmology, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, Hebei Province 050000, China
| | - Yifei Meng
- The Department of Ophthalmology, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, Hebei Province 050000, China
| | - Zuocheng Wang
- The Architecture of Hebei University, 13 Chaoyang West Street, Zhangjiagkou, Hebei Province, China
| | - Lili Hao
- The Fourth Hospital of Zhangjiakou, Hebei Province, China
| | - Vania Rashidi
- University of South Florida Morsani College of Medicine, Tampa, FL 33612, USA
| | - Haiyan Sun
- The Department of Ophthalmology, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, Hebei Province 050000, China
| | - Jun Zhang
- The Department of Ophthalmology, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, Hebei Province 050000, China
| | - Xiaokun Liu
- The Department of Ophthalmology, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, Hebei Province 050000, China
| | - Xuemin Duan
- The Department of Ophthalmology, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, Hebei Province 050000, China
| | - Zhaocai Jiao
- The Department of Ophthalmology, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, Hebei Province 050000, China
| | - Sufang Qie
- The Department of Ophthalmology, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, Hebei Province 050000, China
| | - Zhipeng Yan
- The Department of Ophthalmology, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, Hebei Province 050000, China.
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172
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Liu Y, Wang L, Xu Y, Pang Z, Mu G. The influence of the choroid on the onset and development of myopia: from perspectives of choroidal thickness and blood flow. Acta Ophthalmol 2021; 99:730-738. [PMID: 33550704 DOI: 10.1111/aos.14773] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 01/12/2021] [Indexed: 12/11/2022]
Abstract
Myopia is the most common type of refractive errors characterized by excessive elongation of the ocular globe. With the increasing prevalence of myopia, improved knowledge of factors involved in myopia development is of particular importance. There are growing evidence suggesting that the choroid plays an important role in the regulation of eye growth and the development of myopia. Studies have demonstrated that thinning choroid is a structural feature of myopia, with a negative correlation between choroidal thickness and axial length, suggesting that the change in choroidal thickness may be a predictive biomarker for long-term changes in ocular elongation. Given the fact that the choroid is primarily a vascular structure capable of rapidly changing blood flow, variations of choroidal thickness might be primarily caused by changes in choroidal blood flow. Considering that hypoxia is associated with myopia and choroidal blood flow is the main source of oxygen and nourishment supply, apart from the effect on myopia possibly by changing choroidal thickness, decreasing choroidal blood flow may contribute to scleral ischaemia and hypoxia, resulting in alterations in the scleral structure and thus leading to myopia. This review aims to provide an overview of recent work exploring the influence of the choroid on myopia from perspectives of choroidal thickness and blood flow, which may present new predictive indicators for the onset of myopia and new targets for the development of novel therapeutic approaches for myopia.
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Affiliation(s)
- Yilin Liu
- Department of Ophthalmology Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University Jinan China
| | - Lijun Wang
- Department of Ophthalmology Binzhou Medical University Hospital Binzhou China
| | - Yanyun Xu
- Department of Ophthalmology Shandong Second Provincial General Hospital, Shandong Provincial ENT Hospital Jinan China
| | - Zuoxiang Pang
- Department of Ophthalmology Weifang People's Hospital Weifang China
| | - Guoying Mu
- Department of Ophthalmology Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University Jinan China
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173
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Choi KY, Chan HHL. Extrinsic and Intrinsic Factors Regulating Juvenile Refractive Development and Eye Growth. Invest Ophthalmol Vis Sci 2021; 62:21. [PMID: 34797905 PMCID: PMC8606828 DOI: 10.1167/iovs.62.14.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Peripheral refraction and accommodation are intrinsic factors that were once hypothesized to trigger myopia but are now controversial. Previously, home nearwork environment (i.e., extrinsic factor) was reported to be associated with myopia progression. In this study, we aimed to evaluate the potential interaction between extrinsic and intrinsic factors with juvenile refractive development. Methods Nearwork environmental parameters were measured for 50 children (aged 9.3 ± 1.2 years), including net amount and dispersion of defocus. Refraction was measured at near distances and in central field (±30° horizontal) at 3m. The relative peripheral refraction (RPRE) was obtained and presented in a vectoral approach. The linear regression coefficient was extracted (mAcc) from the accommodative stimulus-response curve. RPRE was quadratically regressed against field eccentricity, and the first coefficients (aM, aJ0, aP90, and aP180) were extracted. Relationships between RPRE, baseline accommodation, and 1-year myopia progression (∆M), controlled for the nearwork environment, were evaluated. Results Coefficients of RPRE were independent of ∆M. However, additional nearwork environmental parameters significantly improved the variance in ∆M explained by aM and aP180 (P < 0.03). The relationship between intrinsic factor and ∆M was stronger when the extrinsic risk was low (P ≤ 0.01), whereas the relationship was abolished when extrinsic risk was high. For mAcc, it also significantly improved the variance in ∆M explained by nearwork environmental parameters. Conclusions The interaction between extrinsic (environment) and intrinsic (RPRE and accommodation) factors is speculated to contribute to juvenile myopia progression. Our findings may also explain the inconsistencies of such intrinsic factors in the literature.
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Affiliation(s)
- Kai Yip Choi
- The Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Henry Ho-Lung Chan
- The Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong.,Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong.,Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Hong Kong
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174
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Choi KY, Chan SSH, Chan HHL. The effect of spatially-related environmental risk factors in visual scenes on myopia. Clin Exp Optom 2021; 105:353-361. [PMID: 34612803 DOI: 10.1080/08164622.2021.1983400] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Myopia, the most common refractive error, is estimated to affect over two billion people worldwide, especially children from East Asian regions. Children with early onset myopia have an increased risk of developing sight threatening complications in later life. In addition to the contribution of genetic factors, of which expression is controversially suggested to be subject to environmental regulation, various environmental factors, such as near-work, outdoor, and living environment, have also been determined to play significant roles in the development of refractive error, especially juvenile myopia. Cues from daily visual scenes, including lighting, spatial frequency, and optical defocus over the field of visual stimuli, are suggested to influence emmetropisation, thereby affecting myopia development and progression. These risk factors in visual scenes of the everyday life may explain the relationship between urbanicity and myopia prevalence. This review first summarises the previously reported associations between myopia development and everyday-life environments, including schooling, urban settings, and outdoors. Then, there is a discussion of the mechanisms hypothesised in the literature about the cues from different visual scenes of urbanicity in relation to myopia development.
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Affiliation(s)
- Kai Yip Choi
- The Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Sonia Seen-Hang Chan
- The Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Henry Ho-Lung Chan
- The Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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175
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Peng BA, Naduvilath TJ, Flitcroft DI, Jong M. Is myopia prevalence related to outdoor green space? Ophthalmic Physiol Opt 2021; 41:1371-1381. [PMID: 34609002 DOI: 10.1111/opo.12896] [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] [Received: 06/17/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Rapid urbanisation and lifestyle changes have been associated with a huge increase in myopia across many parts of the world. There is strong evidence that environmental factors including time outdoors and urbanisation can influence the development of myopia, particularly in school-aged children. The aim of this study is to determine whether there is a relationship between the prevalence of myopia and the amount of vegetation/green spaces across different regions of the world, as a risk factor for myopia development. METHODS The prevalence of myopia in the 15 to 19-year age group in Australia, Brazil, China, Finland, India, Iran, Japan, Oman, Singapore, South Africa and the UK was obtained from a meta-analysis by Holden et al. Normalised Difference Vegetation Index (NDVI) was used to quantify green space exposure based on Landsat 7 Enhanced Thematic Mapper Plus (ETM+) satellite data. Green space was measured in locations specific to 15 studies that reported myopia prevalence. Simple linear regression was used to analyse yearly data, and a mixed effects model was applied to assess the significance of green space when study was a random effect. RESULTS Myopia prevalence increases significantly when green space was <-0.2, but the effect was less apparent for values >-0.1. When a mixed effects model was used, the effect of green space was found to be significantly associated with myopia prevalence (p = 0.05). CONCLUSIONS There was evidence of a weak but significant non-linear relationship between myopia and green space, with the effect most apparent at low levels of green space. A larger data sample, along with further investigations into the utilisation of green spaces, are required to understand whether increasing the amount of green space can reduce myopia incidence and progression impact.
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Affiliation(s)
- Brian An Peng
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Daniel Ian Flitcroft
- Department of Ophthalmology, Children's University Hospital, Dublin, Republic of Ireland
| | - Monica Jong
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia.,Brien Holden Vision Institute, Sydney, New South Wales, Australia.,Discipline of Optometry and Vision Science, University of Canberra, Canberra, Australian Capital Territory, Australia
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176
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Mccrann S, Loughman J, Butler JS, Paudel N, Flitcroft DI. Smartphone use as a possible risk factor for myopia. Clin Exp Optom 2021; 104:35-41. [PMID: 32452059 DOI: 10.1111/cxo.13092] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
CLINICAL RELEVANCE This study demonstrates an association between myopia and smartphone data usage. Youths now spend more time participating in near tasks as a result of smartphone usage. This poses an additional risk factor for myopia development/progression and is an important research question in relation to potential myopia management strategies. BACKGROUND Children are now exposed to another possible environmental risk factor for myopia - smartphones. This study investigates the amount of time students spend on their smartphones and their patterns of smartphone usage from a myopia perspective. METHODS Primary, secondary and tertiary level students completed a questionnaire exploring patterns of smartphone usage and assessing their attitudes toward potential myopia risk factors. Device-recorded data usage over an extended period was quantified as the primary and objective indicator of phone use. Average daily time spent using a smartphone was also quantified by self-reported estimates. Refractive status was verified by an optometrist. RESULTS Smartphone ownership among the 418 students invited to participate was over 99-per cent. Average daily smartphone data and time usage was 800.37 ± 1,299.88-MB and 265.16 ± 168.02-minutes respectively. Myopic students used almost double the amount of smartphone data at 1,130.71 ± 1,748.14-MB per day compared to non-myopes at 613.63 ± 902.15-MB (p = 0.001). Smartphone time usage was not significantly different (p = 0.09, 12-per cent higher among myopes). Multinomial logistic regression revealed that myopic refractive error was statistically significantly associated with increasing daily smartphone data usage (odds ratio 1.08, 95% CI 1.03-1.14) as well as increasing age (odds ratio 1.09, 95% CI 1.02-1.17) and number of myopic parents (odds ratio 1.55, 95% CI 1.06-2.3). Seventy-three per cent of students believed that digital technology may adversely affect their eyes. CONCLUSION This study demonstrates an association between myopia and smartphone data usage. Given the serious nature of the ocular health risks associated with myopia, our findings indicate that this relationship merits more detailed investigation.
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Affiliation(s)
- Saoirse Mccrann
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, Technological University Dublin , Dublin, Ireland
| | - James Loughman
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, Technological University Dublin , Dublin, Ireland.,Department of Optometry, African Vision Research Institute, University of KwaZulu Natal , Durban, South Africa
| | - John S Butler
- School of Mathematical Sciences, Technological University Dublin , Dublin, Ireland
| | - Nabin Paudel
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, Technological University Dublin , Dublin, Ireland
| | - Daniel Ian Flitcroft
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, Technological University Dublin , Dublin, Ireland.,Department of Ophthalmology, Children's University Hospital , Dublin, Ireland
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177
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Damani JM, Annasagaram M, Kumar P, Verkicharla PK. Alterations in peripheral refraction with spectacles, soft contact lenses and orthokeratology during near viewing: implications for myopia control. Clin Exp Optom 2021; 105:761-770. [PMID: 34538199 DOI: 10.1080/08164622.2021.1970480] [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] [Indexed: 10/20/2022] Open
Abstract
CLINICAL RELEVANCE The peripheral refraction profile in myopes with different corrective modalities varies significantly for both distance and near viewing and will have implications in managing myopia. BACKGROUND This study investigated how the magnitude of peripheral myopic defocus induced by Ortho-K varies with and without accommodation, and how this compares to single vision spectacles and soft-contact-lenses (SCL). METHODS Relative peripheral refraction (RPR) of 18 young adults (spherical equivalent -1.00 D to -4.50 D) was determined along the horizontal meridian (±10°, ±20°, ±25°) during distance (3-metres) and near viewing (0.2-metres), and along vertical meridian (±10°, ±15°) for distance viewing alone. Measurements were obtained in an uncorrected state and with single vision spectacles, soft contact lens and Ortho-K. Changes in RPR and astigmatic components were compared between distance and near viewing with all different modalities. RESULTS A significant interaction (p = 0.02) between relative peripheral refraction and the target distance (distance and near viewing) was found among different refractive modalities. Single overnight Ortho-K lens wear alone led to relative peripheral myopia for both distance (mean RPR ± SE: -0.92 ± 0.21D and -1.04 ± 0.22D) and near viewing (-0.71 ± 0.17D and -0.76 ± 0.20D). Comparisons of relative peripheral refraction between different corrective modalities at each eccentricity indicated statistical significance of RPR at extreme locations along both temporal and nasal meridian (±20 and ±25°, p < 0.05). RPR with soft contact lenses and spectacles were similar for both distance and near viewing (p > 0.05). CONCLUSION Single overnight Ortho-K lens wear alone shifted the RPR in the myopic direction for both distance and near viewing in comparison with single vision spectacles and soft contact lenses. The Ortho-K lens designs that offer a large amount of mid-peripheral corneal steeping, in-turn leading to high relative peripheral myopia for both distance and near viewing and might offer beneficial effects on myopia control.
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Affiliation(s)
- Jyoti M Damani
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Madhuri Annasagaram
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Preetam Kumar
- Bausch & Lomb Contact Lens Center, L V Prasad Eye Institute, Hyderabad, India
| | - Pavan Kumar Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India.,Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
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178
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Son S, Moon J, Kang H, Kim Y, Lee J. Induced astigmatism biases the orientation information represented in multivariate electroencephalogram activities. Hum Brain Mapp 2021; 42:4336-4347. [PMID: 34060695 PMCID: PMC8357008 DOI: 10.1002/hbm.25550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/20/2021] [Accepted: 05/23/2021] [Indexed: 01/23/2023] Open
Abstract
A small physical change in the eye influences the entire neural information process along the visual pathway, causing perceptual errors and behavioral changes. Astigmatism, a refractive error in which visual images do not evenly focus on the retina, modulates visual perception, and the accompanying neural processes in the brain. However, studies on the neural representation of visual stimuli in astigmatism are scarce. We investigated the relationship between retinal input distortions and neural bias in astigmatism and how modulated neural information causes a perceptual error. We induced astigmatism by placing a cylindrical lens on the dominant eye of human participants, while they reported the orientations of the presented Gabor patches. The simultaneously recorded electroencephalogram activity revealed that stimulus orientation information estimated from the multivariate electroencephalogram activity was biased away from the neural representation of the astigmatic axis and predictive of behavioral bias. The representational neural dynamics underlying the perceptual error revealed the temporal state transition; it was transiently dynamic and unstable (approximately 350 ms from stimulus onset) that soon stabilized. The biased stimulus orientation information represented by the spatially distributed electroencephalogram activity mediated the distorted retinal images and biased orientation perception in induced astigmatism.
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Affiliation(s)
- Sangkyu Son
- Center for Neuroscience Imaging ResearchInstitute for Basic Science (IBS)SuwonRepublic of Korea
- Department of Biomedical EngineeringSungkyunkwan UniversitySuwonRepublic of Korea
| | - Joonsik Moon
- Center for Neuroscience Imaging ResearchInstitute for Basic Science (IBS)SuwonRepublic of Korea
| | - Hyungoo Kang
- Department of OptometryCatholic Kwandong UniversityGangneungRepublic of Korea
| | - Yee‐Joon Kim
- Center for Cognition and SocialityInstitute for Basic Science (IBS)DaejeonRepublic of Korea
| | - Joonyeol Lee
- Center for Neuroscience Imaging ResearchInstitute for Basic Science (IBS)SuwonRepublic of Korea
- Department of Biomedical EngineeringSungkyunkwan UniversitySuwonRepublic of Korea
- Department of Intelligent Precision Healthcare ConvergenceSungkyunkwan UniversitySuwonRepublic of Korea
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179
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Efron N, Morgan PB, Jones LW, Nichols JJ. Topical Review: Bibliometric Analysis of the Emerging Field of Myopia Management. Optom Vis Sci 2021; 98:1039-1044. [PMID: 34469928 DOI: 10.1097/opx.0000000000001766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
SIGNIFICANCE Identification of the most impactful articles, authors, institutions, countries, and journals in myopia management provides a useful baseline reference for clinicians, researchers, and funding agencies in respect of this emerging field.This work aims to assemble publication metrics for myopia management to identify the most impactful articles, authors, institutions, countries, and journals in this emerging field of research. A search of the titles of articles was undertaken on the Scopus database to identify myopia management-related articles. The 25 most highly cited articles were determined from the total list of 1064 articles found. Rank-order lists by count were assembled for the top 25 in each of four categories: authors, institutions, countries, and journals. A subject-specific myopia management-related h-index (hMM-index) was derived for the entire field, in addition to each of the four categories, to serve as measures of impact in the field. Top 15 lists were generated for each category ranked by hMM-index and tabulated for consideration. An article by Christine Wildsoet and colleagues, describing choroidal and scleral mechanisms of compensation for spectacle lenses in chicks, has generated the most citations (412); Earl Smith is the most impactful author (hMM = 19); the University of Houston produces the most impactful articles (hMM = 31); the United States is the most highly ranked country (hMM = 60); and Optometry and Vision Science is the most impactful journal. Although still in its infancy, myopia management is a topic of emerging interest in the clinical and scientific ophthalmic literature. Impactful authors, institutions, countries, and journals are identified. Optometry is revealed as the leading profession in relation to the publication of myopia management-related articles.
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Affiliation(s)
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, Manchester, United Kingdom
| | | | - Jason J Nichols
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama
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180
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Tran HDM, Sankaridurg P, Naduvilath T, Ha TTX, Tran TD, Jong M, Coroneo M, Tran YH. A Meta-Analysis Assessing Change in Pupillary Diameter, Accommodative Amplitude, and Efficacy of Atropine for Myopia Control. Asia Pac J Ophthalmol (Phila) 2021; 10:450-460. [PMID: 34456234 DOI: 10.1097/apo.0000000000000414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To determine the effect of atropine on pupillary diameter, accommodative amplitude as well as myopia progression. METHODS Medical databases and Cochrane Library were systematically searched for studies from 1980 until June 2020. The primary and secondary outcomes were: a) change in pupillary diameter (PD) and accommodative amplitude (AA) and b) annualized mean change in spherical equivalent and axial length with various concentrations of atropine compared to control. RESULTS Thirteen trials (6 RCTs, 7 observational studies) that studied 9 atropine concentrations (0.01-1.0%) were included. The relation between atropine and change in PD and AA was nonlinear; at < 0.10% atropine, the slope of the curve was steep but the change in PD (+0.7 mm; 95% CI: +0.1 to +1.4) and AA (-1.6D; 95% CI: -3.9 to +0.7) was smaller whereas at ≥0.10% atropine, the slope plateaued but change in PD (+3.2 mm, 95% CI: +2.8 to +3.5) and AA (-10.7D; 95% CI: -12.2 to -9.2) was high.Reduction in myopia progression with atropine at <0.10% and ≥0.10% as compared to controls was 0.37D (95% CI: 0.16 to 0.58) versus 0.75D (95% CI: 0.17 to 1.33) for spherical equivalent and -0.10 mm (95% CI: -0.24 to 0.05) versus -0.23 mm (95% CI: -0.34 to -0.13) for axial length. CONCLUSIONS A nonlinear dose-response relationship exists between atropine and PD and AA. Further work is warranted to determine the concentration that provides maximal efficacy with tolerable side effects.
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Affiliation(s)
- Huy D M Tran
- Brien Holden Vision Institute, Sydney, Australia
- Hai Yen Vision Institute, Ho Chi Minh City, Vietnam
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute, Sydney, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Thomas Naduvilath
- Brien Holden Vision Institute, Sydney, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Thao T X Ha
- Hai Yen Vision Institute, Ho Chi Minh City, Vietnam
| | - Tuan D Tran
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Monica Jong
- Brien Holden Vision Institute, Sydney, Australia
- Discipline of Optometry and Vision Science, University of Canberra, Australia
| | - Minas Coroneo
- Department of Ophthalmology, University of New South Wales, Sydney, Australia
| | - Yen H Tran
- Hai Yen Vision Institute, Ho Chi Minh City, Vietnam
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181
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Karouta C, Kucharski R, Hardy K, Thomson K, Maleszka R, Morgan I, Ashby R. Transcriptome-based insights into gene networks controlling myopia prevention. FASEB J 2021; 35:e21846. [PMID: 34405458 DOI: 10.1096/fj.202100350rr] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 11/11/2022]
Abstract
Myopia (short-sightedness), usually caused by excessive elongation of the eye during development, has reached epidemic proportions worldwide. In animal systems including the chicken model, several treatments have been shown to inhibit ocular elongation and experimental myopia. Although diverse in their apparent mechanism of action, each one leads to a reduction in the rate of ocular growth. We hypothesize that a defined set of retinal molecular changes may underlie growth inhibition, irrespective of the treatment agent used. Accordingly, across five well-established but diverse methods of inhibiting myopia, significant overlap is seen in the retinal transcriptome profile (transcript levels and alternative splicing events) in chicks when analyzed by RNA-seq. Within the two major pathway networks enriched during growth inhibition, that of cell signaling and circadian entrainment, transcription factors form the largest functional grouping. Importantly, a large percentage of those genes forming the defined retinal response are downstream targets of the transcription factor EGR1 which itself shows a universal response to all five growth-inhibitory treatments. This supports EGR1's previously implicated role in ocular growth regulation. Finally, by contrasting our data with human linkage and GWAS studies on refractive error, we confirm the applicability of our study to the human condition. Together, these findings suggest that a universal set of transcriptome changes, which sit within a well-defined retinal network that cannot be bypassed, is fundamental to growth regulation, thus paving a way for designing novel targets for myopia therapies.
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Affiliation(s)
- Cindy Karouta
- Centre for Research in Therapeutic Solutions, Biomedical Sciences, Faculty of Science and Technology, University of Canberra, Canberra, ACT, Australia
| | - Robert Kucharski
- Centre for Research in Therapeutic Solutions, Biomedical Sciences, Faculty of Science and Technology, University of Canberra, Canberra, ACT, Australia.,Research School of Biology, Australian National University, Canberra, ACT, Australia
| | - Kristine Hardy
- Centre for Research in Therapeutic Solutions, Biomedical Sciences, Faculty of Science and Technology, University of Canberra, Canberra, ACT, Australia
| | - Kate Thomson
- Centre for Research in Therapeutic Solutions, Biomedical Sciences, Faculty of Science and Technology, University of Canberra, Canberra, ACT, Australia
| | - Ryszard Maleszka
- Research School of Biology, Australian National University, Canberra, ACT, Australia
| | - Ian Morgan
- Research School of Biology, Australian National University, Canberra, ACT, Australia
| | - Regan Ashby
- Centre for Research in Therapeutic Solutions, Biomedical Sciences, Faculty of Science and Technology, University of Canberra, Canberra, ACT, Australia.,Research School of Biology, Australian National University, Canberra, ACT, Australia
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182
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Xu L, Zhuang Y, Zhang G, Ma Y, Yuan J, Tu C, Li M, Wang W, Zhang Y, Lu X, Li J, Liu X, Xue Z, Zhou M, Sun J, Bao J, Li M, Lu F, Wang H, Su J, Qu J. Design, methodology, and baseline of whole city-million scale children and adolescents myopia survey (CAMS) in Wenzhou, China. EYE AND VISION 2021; 8:31. [PMID: 34407890 PMCID: PMC8373605 DOI: 10.1186/s40662-021-00255-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 07/30/2021] [Indexed: 01/19/2023]
Abstract
Background Myopia is the most common visual impairment in children and adolescents worldwide. This study described an economical and effective population-based screening pipeline and performed the project of a million scale children and adolescents myopia survey (CAMS), which will shed light on the further study of myopia from the level of epidemiology and precision medicine. Methods We developed a novel population-based screening pattern, an intelligent screening process and internet-based information transmission and analysis system to carry out the survey consisting of school children in Wenzhou, China. The examination items include unaided distance visual acuity, presenting distance visual acuity, and non-cycloplegic autorefraction. Myopia and high myopia were defined as spherical equivalent (SE) ≤ − 1.00 diopters (D) and SE ≤ − 6.00 D, respectively. Next, the reports of the vision checking were automatically sent to parents and the related departments. The CAMS project will be done two to four times annually with the support of the government. An online eyesight status information management system (OESIMS) was developed to construct comprehensive and efficient electronic vision health records (EVHRs) for myopia information inquiry, risk pre-warning, and further study. Results The CAMS completed the first-round of screening within 30 days for 99.41% of Wenzhou students from districts and counties, in June 2019. A total of 1,060,925 participants were eligible for CAMS and 1,054,251 (99.37% participation rate) were selected through data quality control, which comprised 1305 schools, and 580,609, 251,050 and 170,967 elementary, middle, and high school students. The mean age of participants was 12.21 ± 3.32 years (6–20 years), the female-to-male ratio was 0.82. The prevalence of myopia in elementary, middle, and high school students was 38.16%, 77.52%, and 84.00%, respectively, and the high myopia incidence was 0.95%, 6.90%, and 12.98%. Conclusions The CAMS standardized myopia screening model involves automating large-scale information collection, data transmission, data analysis and early warning, thereby supporting myopia prevention and control. The entire survey reduced 90% of staff, cost, and time consumption compared with previous surveys. This will provide new insights for decision support for public health intervention. Supplementary Information The online version contains supplementary material available at 10.1186/s40662-021-00255-1.
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Affiliation(s)
- Liangde Xu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.,State Key Laboratory of Ophthalmology, Optometry and Visual Science, Wenzhou, 325027, China.,Institute of Biomedical Big Data, Wenzhou Medical University, Wenzhou, 325027, China
| | - Youyuan Zhuang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.,Institute of Biomedical Big Data, Wenzhou Medical University, Wenzhou, 325027, China
| | - Guosi Zhang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.,Institute of Biomedical Big Data, Wenzhou Medical University, Wenzhou, 325027, China
| | - Yunlong Ma
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.,Institute of Biomedical Big Data, Wenzhou Medical University, Wenzhou, 325027, China
| | - Jian Yuan
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.,Institute of Biomedical Big Data, Wenzhou Medical University, Wenzhou, 325027, China
| | - Changseng Tu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.,National Clinical Research Center for Ocular Disease, Wenzhou, 325027, China
| | - MiaoMiao Li
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.,National Clinical Research Center for Ocular Disease, Wenzhou, 325027, China
| | - Wencan Wang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.,Institute of Biomedical Big Data, Wenzhou Medical University, Wenzhou, 325027, China
| | - Yaru Zhang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.,Institute of Biomedical Big Data, Wenzhou Medical University, Wenzhou, 325027, China
| | - Xiaoyan Lu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.,Institute of Biomedical Big Data, Wenzhou Medical University, Wenzhou, 325027, China
| | - Jing Li
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.,College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, 150081, People's Republic of China
| | - Xinting Liu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.,State Key Laboratory of Ophthalmology, Optometry and Visual Science, Wenzhou, 325027, China
| | - Zhengbo Xue
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.,State Key Laboratory of Ophthalmology, Optometry and Visual Science, Wenzhou, 325027, China
| | - Meng Zhou
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.,Institute of Biomedical Big Data, Wenzhou Medical University, Wenzhou, 325027, China
| | - Jie Sun
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.,Institute of Biomedical Big Data, Wenzhou Medical University, Wenzhou, 325027, China
| | - Jinhua Bao
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.,State Key Laboratory of Ophthalmology, Optometry and Visual Science, Wenzhou, 325027, China.,National Clinical Research Center for Ocular Disease, Wenzhou, 325027, China
| | - Ming Li
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.,State Key Laboratory of Ophthalmology, Optometry and Visual Science, Wenzhou, 325027, China.,National Clinical Research Center for Ocular Disease, Wenzhou, 325027, China
| | - Fan Lu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China. .,State Key Laboratory of Ophthalmology, Optometry and Visual Science, Wenzhou, 325027, China. .,National Clinical Research Center for Ocular Disease, Wenzhou, 325027, China.
| | - Hong Wang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China. .,Institute of Biomedical Big Data, Wenzhou Medical University, Wenzhou, 325027, China.
| | - Jianzhong Su
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China. .,State Key Laboratory of Ophthalmology, Optometry and Visual Science, Wenzhou, 325027, China. .,Institute of Biomedical Big Data, Wenzhou Medical University, Wenzhou, 325027, China.
| | - Jia Qu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China. .,State Key Laboratory of Ophthalmology, Optometry and Visual Science, Wenzhou, 325027, China. .,National Clinical Research Center for Ocular Disease, Wenzhou, 325027, China.
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183
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Khanal S, Norton TT, Gawne TJ. Amber light treatment produces hyperopia in tree shrews. Ophthalmic Physiol Opt 2021; 41:1076-1086. [PMID: 34382245 DOI: 10.1111/opo.12853] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Exposure to narrow-band red light, which stimulates only the long-wavelength sensitive (LWS) cones, slows axial eye growth and produces hyperopia in tree shrews and macaque monkeys. We asked whether exposure to amber light, which also stimulates only the LWS cones but with a greater effective illuminance than red light, has a similar hyperopia-inducing effect in tree shrews. METHODS Starting at 24 ± 1 days of visual experience, 15 tree shrews (dichromatic mammals closely related to primates) received light treatment through amber filters (BPI 500/550 dyed acrylic) either atop the cage (Filter group, n = 8, 300-400 human lux) or fitted into goggles in front of both eyes (Goggle group, n = 7). Non-cycloplegic refractive error and axial ocular dimensions were measured daily. Treatment groups were compared with age-matched animals (Colony group, n = 7) raised in standard colony fluorescent lighting (100-300 lux). RESULTS At the start of treatment, mean refractive errors were well-matched across the three groups (p = 0.35). During treatment, the Filter group became progressively more hyperopic with age (p < 0.001). By contrast, the Goggle and Colony groups showed continued normal emmetropization. When the treatment ended, the Filter group exhibited significantly greater hyperopia (mean [SE] = 3.5 [0.6] D) compared with the Goggle (0.2 [0.8] D, p = 0.01) and Colony groups (1.0 [0.2] D, p = 0.01). However, the refractive error in the Goggle group was not different from that in the Colony group (p = 0.35). Changes in the vitreous chamber were consistent with the refractive error changes. CONCLUSIONS Exposure to ambient amber light produced substantial hyperopia in the Filter group but had no effect on refractive error in the Goggle group. The lack of effect in the Goggle group could be due to the simultaneous activation of the short-wavelength sensitive (SWS) and LWS cones caused by the scattering of the broad-band light from the periphery of the goggles.
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Affiliation(s)
- Safal Khanal
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Thomas T Norton
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Timothy J Gawne
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama, USA
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184
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Howell CM, McCullough SJ, Doyle L, Murphy MH, Saunders KJ. Reliability and validity of the Actiwatch and Clouclip for measuring illumination in real-world conditions. Ophthalmic Physiol Opt 2021; 41:1048-1059. [PMID: 34387902 DOI: 10.1111/opo.12860] [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] [Received: 12/09/2020] [Revised: 06/09/2021] [Accepted: 06/09/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE To compare real-world measures of illumination obtained with the Actiwatch-2 and Clouclip-M2 with 'gold standard' photometry measures and to evaluate the ability of Actiwatch-2 to correctly identify photometer-defined conditions: scotopic (≤0.01 lux), mesopic (0.02-3 lux), indoor photopic (>3-1,000 lux) and outdoor photopic (>1,000 lux); and Clouclip to correctly identify photometer-defined conditions within its operating range (>1 lux). Inter-device reliability of Clouclip for illumination and viewing distance measures was also investigated. METHODS A Hagner-S2 photometer was used as reference. Measures of illumination were obtained from a range of real-world conditions. To investigate inter-device reliability, five Clouclips were simultaneously exposed to varied light conditions and object distances. RESULTS Strong correlations existed between illumination measured with the photometer and both Actiwatch-2 (ρ = 0.99, p < 0.0001) and Clouclip (ρ = 0.99, p < 0.0001). However, both devices underestimated illumination compared to the photometer; disparity increased with increasing illumination and was greater for Actiwatch-2 than Clouclip measures. Actiwatch-2 successfully categorised illumination level (scotopic, mesopic, indoor and outdoor photopic) in 71.2% of cases. Clouclip successfully categorised illumination levels as scotopic/mesopic (≤3 lux) and indoor and outdoor photopic in 100% of cases. Mean differences and limits of agreement (LOA) were 430.92 ± 1,828.74 and 79.35 ± 407.33 lux, between the photometer and Actiwatch-2 and photometer and Clouclip, respectively. The Intra-class Correlation Coefficients for illumination and viewing distance measured with five Clouclips were 0.85 and 0.96, respectively. CONCLUSION These data illustrate that different Clouclip devices produce comparable measures of viewing distance and illumination in real-world settings. Both Actiwatch-2 and Clouclip underestimate illumination in the field compared to gold standard photometer measures. The disparity increases at higher levels of illumination and the discrepancy was greater for Actiwatch-2 measures. For researchers interested in categorising light exposure, Clouclip classifies illumination levels >2 lux more accurately than Actiwatch-2 but cannot discriminate between scotopic and low mesopic light.
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Affiliation(s)
- Colleen M Howell
- Optometry and Vision Science Research Group, School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Sara J McCullough
- Optometry and Vision Science Research Group, School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Lesley Doyle
- Optometry and Vision Science Research Group, School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Marie H Murphy
- Sport and Exercise Sciences Research Institute, School of Sport, Ulster University, Jordanstown, UK
| | - Kathryn J Saunders
- Optometry and Vision Science Research Group, School of Biomedical Sciences, Ulster University, Coleraine, UK
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185
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Xu S, Hu Y, Cui D, Zhao F, Jiang J, Feng Z, Li C, Li Z, Yang X. Association between the posterior ocular contour pattern and progression of myopia in children: A prospective study based on OCT imaging. Ophthalmic Physiol Opt 2021; 41:1087-1096. [PMID: 34382246 DOI: 10.1111/opo.12850] [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] [Received: 01/31/2021] [Revised: 05/09/2021] [Accepted: 05/10/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE This study aims to reveal the relationship between the posterior ocular contour and the subsequent progression of myopia in children. METHODS Children aged 8-12 years with myopia received baseline measurements and were instructed to wear their glasses every day and return for a follow-up visit after one year. Axial length and other ocular parameters were measured using a noncontact biometer. The contour of the posterior eye was calculated and analysed based on images from spectral domain optical coherence tomography (SD-OCT). Univariate and multivariate linear regression models were created to analyse the relationship between the contour of the posterior eye and the progression of myopia. RESULTS Baseline posterior ocular contour measurements correlated with baseline axial length and spherical equivalent refraction (SER) (all p < 0.05). Eyes that were more myopic tended to have a more prolate posterior ocular contour. Although the baseline contour of the retinal pigment epithelium (RPE) and chorioscleral interface (CSI) showed no significant relationship with the progression of myopia (all p > 0.05), interestingly, when the baseline contour of the RPE was more prolate than that of the CSI, the axial length increased during the following year (R2 = 0.62; p < 0.01). The multivariate model, when adjusted for other variables, further validated the independent role of this variable. CONCLUSIONS The difference between the RPE and CSI contours correlated with the subsequent progression of myopia in children. This finding can help inform clinicians regarding the management of children at the onset of myopia and potentially provide an avenue for experimental research on the mechanism of myopia development.
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Affiliation(s)
- Shengsong Xu
- State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Yin Hu
- State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Dongmei Cui
- State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Feng Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Jinyun Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Zhibin Feng
- State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Cong Li
- State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Zhouyue Li
- State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Xiao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China
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186
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Hair LA, Steffensen EM, Berntsen DA. The Effects of Center-near and Center-distance Multifocal Contact Lenses on Peripheral Defocus and Visual Acuity. Optom Vis Sci 2021; 98:983-994. [PMID: 34393205 PMCID: PMC8405543 DOI: 10.1097/opx.0000000000001753] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Multifocal contact lenses (MFCLs) are being used clinically for myopia control. Center-distance designs caused myopic changes in defocus across the retina that varied by lens design, whereas the center-near design caused peripheral hyperopic changes. Multifocal lenses caused reductions in low-contrast vision that varied by lens design, affecting visual performance. PURPOSE The purpose of this study was to compare changes in defocus with four MFCLs, three center-distance and one center-near. METHODS Two cohorts of 25 nonpresbyopic myopic adults were enrolled. The first cohort was fitted with Proclear D and Biofinity D MFCL (center-distance, +2.50 D add), and the second cohort was fitted with NaturalVue MFCL (center-distance) and Clariti 1-Day MFCL (center-near, high add), both in random order. Overrefraction was performed to maximize visual acuity. Cycloplegic autorefraction was performed with each lens and without a lens along the line of sight and at nasal and temporal retinal locations out to 40°. Data were analyzed with repeated-measures ANOVAs with post hoc t tests, when indicated. RESULTS Changes in defocus at each location differed between MFCL designs (lens by location; both, P < .001). Clariti 1-Day caused peripheral hyperopic retinal changes (40 and 30° nasal, and 20, 30, and 40° temporal; all, P < .05). NaturalVue MFCL caused myopic changes centrally and hyperopic changes at 40° nasal and 30° temporal (all, P < .05). The remaining center-distance designs caused myopic changes at multiple locations (all, P < .05). CONCLUSIONS After overrefraction, the center-near MFCL design caused hyperopic defocus at multiple peripheral locations, which is not hypothesized to slow myopia progression. NaturalVue MFCL caused myopic changes in defocus centrally but hyperopic changes in the far periphery. Biofinity D and Proclear D caused myopic changes in retinal defocus. Further work is warranted to determine whether defocus profile differences between the center-distance designs influence any slowing of myopia progression.
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Affiliation(s)
- Lea A Hair
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, Texas
| | - Elaine M Steffensen
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, Texas
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187
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Neitz M, Neitz J. Intermixing the OPN1LW and OPN1MW Genes Disrupts the Exonic Splicing Code Causing an Array of Vision Disorders. Genes (Basel) 2021; 12:genes12081180. [PMID: 34440353 PMCID: PMC8391646 DOI: 10.3390/genes12081180] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/27/2021] [Accepted: 07/29/2021] [Indexed: 02/07/2023] Open
Abstract
Light absorption by photopigment molecules expressed in the photoreceptors in the retina is the first step in seeing. Two types of photoreceptors in the human retina are responsible for image formation: rods, and cones. Except at very low light levels when rods are active, all vision is based on cones. Cones mediate high acuity vision and color vision. Furthermore, they are critically important in the visual feedback mechanism that regulates refractive development of the eye during childhood. The human retina contains a mosaic of three cone types, short-wavelength (S), long-wavelength (L), and middle-wavelength (M) sensitive; however, the vast majority (~94%) are L and M cones. The OPN1LW and OPN1MW genes, located on the X-chromosome at Xq28, encode the protein component of the light-sensitive photopigments expressed in the L and M cones. Diverse haplotypes of exon 3 of the OPN1LW and OPN1MW genes arose thru unequal recombination mechanisms that have intermixed the genes. A subset of the haplotypes causes exon 3- skipping during pre-messenger RNA splicing and are associated with vision disorders. Here, we review the mechanism by which splicing defects in these genes cause vision disorders.
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188
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Wu H, Xie Z, Wang P, Liu M, Wang Y, Zhu J, Chen X, Xu Z, Mao X, Zhou X. Differences in Retinal and Choroidal Vasculature and Perfusion Related to Axial Length in Pediatric Anisomyopes. Invest Ophthalmol Vis Sci 2021; 62:40. [PMID: 34319397 PMCID: PMC8322721 DOI: 10.1167/iovs.62.9.40] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Purpose The purpose of this study was to evaluate the interocular differences in choroidal vasculature, choriocapillaris perfusion, and retinal microvascular network, and to explore their associations with interocular asymmetry in axial lengths (ALs) in children with anisomyopia. Methods Refractive error, AL, and other biometric parameters were measured in 70 children with anisomyopia. Using optical coherence tomography (OCT) and OCT-angiography, we measured the submacular choroidal thickness (ChT), total choroidal area (TCA), luminal area (LA), stromal area (SA), choroidal vascularity index (CVI), choriocapillaris flow deficit (CcFD), retinal vessel density (VD), and foveal avascular zone (FAZ) area. Results The mean interocular differences in spherical equivalent refraction and AL were −2.26 ± 0.94 diopters and 0.95 ± 0.46 mm, respectively. Submacular ChT, TCA, LA, SA, and CVI were all significantly lower in the more myopic (longer AL) eyes than in the less myopic (shorter AL) fellow eyes. In eyes with longer ALs, both the CcFD and FAZ areas were significantly greater, whereas the superficial and deep retinal VDs were significantly less. After adjusting for corneal power and intraocular pressure, interocular differences in LA (β = −0.774), SA (β = −0.991), and CcFD (β = 0.040) were significantly associated with interocular asymmetry in AL (all P < 0.05). Conclusions In pediatric anisomyopes, eyes with longer ALs tended to have lower choroidal vascularity and choriocapillaris perfusion than the contralateral eyes with shorter ALs. Longitudinal investigations would be useful follow-ups to test for a causal role of choroidal circulation in human myopia.
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Affiliation(s)
- Hao Wu
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Zhu Xie
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Pengqi Wang
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Mengqi Liu
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Yuanyuan Wang
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Jiadi Zhu
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Xiangqin Chen
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Zhiqiang Xu
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Xinjie Mao
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Xiangtian Zhou
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China.,Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, Zhejiang, China
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189
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Thomson K, Kelly T, Karouta C, Morgan I, Ashby R. Insights into the mechanism of atropine's anti-myopia effects: evidence against cholinergic hyperactivity and modulation of dopamine release. Br J Pharmacol 2021; 178:4501-4517. [PMID: 34302355 PMCID: PMC9293064 DOI: 10.1111/bph.15629] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 04/29/2021] [Accepted: 06/25/2021] [Indexed: 11/27/2022] Open
Abstract
Background and Purpose The ability of the muscarinic cholinergic antagonist atropine to inhibit myopia development in humans and animal models would suggest that cholinergic hyperactivity may underlie myopic growth. To test this, we investigated whether cholinergic agonists accelerate ocular growth rates in chickens. Furthermore, we investigated whether atropine alters ocular growth by downstream modulation of dopamine levels, a mechanism postulated to underlie its antimyopic effects. Experimental Approach Muscarinic (muscarine and pilocarpine), nicotinic (nicotine) and non‐specific (oxotremorine and carbachol) cholinergic agonists were administered to chicks developing form‐deprivation myopia (FDM) or chicks that were otherwise untreated. Vitreal levels of dopamine and its primary metabolite 3,4‐dihydroxyphenylacetic acid (DOPAC) were examined using mass spectrometry MS in form‐deprived chicks treated with atropine (360, 15 or 0.15 nmol). Further, we investigated whether dopamine antagonists block atropine's antimyopic effects. Key Results Unexpectedly, administration of each cholinergic agonist inhibited FDM but did not affect normal ocular development. Atropine only affected dopamine and DOPAC levels at its highest dose. Dopamine antagonists did not alter the antimyopia effects of atropine. Conclusion and Implications Muscarinic, nicotinic and non‐specific cholinergic agonists inhibited FDM development. This indicates that cholinergic hyperactivity does not underlie myopic growth and questions whether atropine inhibits myopia via cholinergic antagonism. This study also demonstrates that changes in retinal dopamine release are not required for atropine's antimyopic effects. Finally, nicotinic agonists may represent a novel and more targeted approach for the cholinergic control of myopia as they are unlikely to cause the anterior segment side effects associated with muscarinic treatment.
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Affiliation(s)
- Kate Thomson
- Centre for Research in Therapeutic Solutions, Faculty of Science and Technology, University of Canberra, Australia
| | - Tamsin Kelly
- National Centre for Forensic Studies, Faculty of Science and Technology, University of Canberra, Australia
| | - Cindy Karouta
- Centre for Research in Therapeutic Solutions, Faculty of Science and Technology, University of Canberra, Australia
| | - Ian Morgan
- Research School of Biology, Australian National University, Australia
| | - Regan Ashby
- Centre for Research in Therapeutic Solutions, Faculty of Science and Technology, University of Canberra, Australia.,Research School of Biology, Australian National University, Australia
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190
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Summers JA, Schaeffel F, Marcos S, Wu H, Tkatchenko AV. Functional integration of eye tissues and refractive eye development: Mechanisms and pathways. Exp Eye Res 2021; 209:108693. [PMID: 34228967 DOI: 10.1016/j.exer.2021.108693] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 12/16/2022]
Abstract
Refractive eye development is a tightly coordinated developmental process. The general layout of the eye and its various components are established during embryonic development, which involves a complex cross-tissue signaling. The eye then undergoes a refinement process during the postnatal emmetropization process, which relies heavily on the integration of environmental and genetic factors and is controlled by an elaborate genetic network. This genetic network encodes a multilayered signaling cascade, which converts visual stimuli into molecular signals that guide the postnatal growth of the eye. The signaling cascade underlying refractive eye development spans across all ocular tissues and comprises multiple signaling pathways. Notably, tissue-tissue interaction plays a key role in both embryonic eye development and postnatal eye emmetropization. Recent advances in eye biometry, physiological optics and systems genetics of refractive error have significantly advanced our understanding of the biological processes involved in refractive eye development and provided a framework for the development of new treatment options for myopia. In this review, we summarize the recent data on the mechanisms and signaling pathways underlying refractive eye development and discuss new evidence suggesting a wide-spread signal integration across different tissues and ocular components involved in visually guided eye growth.
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Affiliation(s)
- Jody A Summers
- Department of Cell Biology, University of Oklahoma Health Science Center, Oklahoma City, OK, USA
| | - Frank Schaeffel
- Section of Neurobiology of the Eye, Ophthalmic Research Institute, University of Tuebingen, Tuebingen, Germany; Myopia Research Group, Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland
| | - Susana Marcos
- Instituto de Óptica "Daza de Valdés", Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - Hao Wu
- Department of Ophthalmology, Columbia University, New York, USA
| | - Andrei V Tkatchenko
- Department of Ophthalmology, Columbia University, New York, USA; Department of Pathology and Cell Biology, Columbia University, New York, USA.
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191
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Tomiyama ES, Hu C, Marsack JD, Richdale K. Greater higher order aberrations induced by toric orthokeratology versus soft toric multifocal contact lens wear. Ophthalmic Physiol Opt 2021; 41:726-735. [PMID: 34076904 PMCID: PMC8217292 DOI: 10.1111/opo.12839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/16/2021] [Indexed: 01/15/2023]
Abstract
PURPOSE Spherical orthokeratology and soft multifocal contact lenses are commonly used for myopia control and correction, but have been shown to increase spherical aberration, coma and total higher order root mean square (HORMS) aberrations. There are limited myopia control contact lens options for patients with moderate to high astigmatism. The purpose of this study was to quantify changes in higher order aberrations (HOA) in myopic astigmatic eyes fitted with toric orthokeratology (TOK) and soft toric multifocal (STM) contact lenses. METHODS Ocular wavefront aberrations were measured in both eyes of 30 adult subjects and are reported through the 6th radial order over a 5 mm, dilated pupil. All eyes met refractive criteria of myopia (-5.00 D to plano) and cylinder (-3.50 to -1.25 D). Three measurements were taken at baseline and after 10 ± 2 days of lens wear (TOK, STM). Sixteen subjects achieved logMAR high contrast visual acuity of 0.30 or better in both eyes and were included in this analysis. Repeated measures analysis of variance and post-hoc paired t-tests were used, as appropriate, with Benjamini-Hochberg correction. RESULTS Higher order root mean square, spherical aberration (C12), and coma RMS (C7, C8) increased with TOK (0.641 [0.222], 0.409 [0.157], 0.426 [0.187] µm, respectively) and STM (0.481 [0.107], 0.223 [0.139], 0.320 [0.130] µm, respectively) from baseline (all p < 0.001). TOK was elevated compared to STM for HORMS (p = 0.03), spherical aberration (p = 0.001) and coma RMS (p = 0.04). CONCLUSIONS Toric orthokeratology induced more HORMS, spherical aberration and coma RMS than STM in myopic astigmats; however, both lens types showed an increase in HOA compared to baseline, which placed patients outside the age and pupil size matched normative ranges. While the optical changes that accompany these modalities are helpful for myopia management, the induction of HOAs may have unintended consequences on visual performance.
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Affiliation(s)
- Erin S Tomiyama
- University of Houston College of Optometry, Houston, Texas, USA
| | - Chuan Hu
- University of Houston College of Optometry, Houston, Texas, USA
| | - Jason D Marsack
- University of Houston College of Optometry, Houston, Texas, USA
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192
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Early Age of the First Myopic Spectacle Prescription, as an Indicator of Early Onset of Myopia, Is a Risk Factor for High Myopia in Adulthood. J Ophthalmol 2021; 2021:6612116. [PMID: 34258048 PMCID: PMC8260292 DOI: 10.1155/2021/6612116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 06/02/2021] [Accepted: 06/12/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose The present study investigated the risk factors for high myopia in adulthood, with a focus on the age at which children wore their first spectacles. Methods Adults aged between 20 and 45 years were invited to complete a questionnaire about age, sex, current refractive error, high myopia in parents, early onset of myopia presented by the age of the first myopic spectacle prescription, refractive power of the first spectacles, and life habits at different educational stages. The associations between these factors and high myopia in adulthood were then evaluated and analyzed. Results In total, 331 participants were enrolled. Their average refractive error was −4.03 diopters, and high myopia was noted in 27.5% of the study participants. Only 3.3% of participants had fathers with high myopia, while 6.0% had mothers with high myopia. The participants received their first myopic spectacle prescription at a mean age of 13.35 years, with a mean refractive error of −1.63 diopters. The significant risk factors for developing high myopia in adult life were earlier age of the first spectacles prescribed (p < 0.001), higher refractive power of the first spectacles (p < 0.001), mother with high myopia (p=0.015), and after-school class attendance in senior high school (p=0.018). Those who wore their first spectacles at <9 years of age were more predisposed to high myopia than those who did so at ≧13 years, with an odds ratio of 24.9. Conclusion The present study shows that earlier onset of myopia, which is presented by the age of the first myopic spectacle prescription, higher myopic refraction of the first spectacles, mothers with high myopia, and after-school class attendance in senior high school are risk factors for high myopia in adulthood. It suggests that delaying the onset of myopia in children is important for the prevention of high myopia in later life.
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193
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Kaymak H, Graff B, Schaeffel F, Langenbucher A, Seitz B, Schwahn H. A retrospective analysis of the therapeutic effects of 0.01% atropine on axial length growth in children in a real-life clinical setting. Graefes Arch Clin Exp Ophthalmol 2021; 259:3083-3092. [PMID: 34142186 PMCID: PMC8478763 DOI: 10.1007/s00417-021-05254-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/06/2021] [Accepted: 05/22/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Several randomized controlled studies have demonstrated the beneficial effects of 0.01% atropine eye drops on myopia progression in children. However, treatment effects may be different in a routine clinical setting. We performed a retrospective analysis of our clinical data from children to investigate the effect of 0.01% atropine eye drops on myopia progression in a routine clinical setting. METHODS Atropine-treated children were asked to instill one drop of 0.01% atropine in each eye every evening at 5 days a week. Myopic children who did not undergo atropine treatment served as controls. Objective refraction and ocular biometry of 80 atropine-treated and 103 untreated children at initial visit and 1 year later were retrospectively analyzed. RESULTS Myopic refractions in the treated and untreated children at initial visit ranged from -0.625 to -15.25 D (-4.21 ± 2.90 D) and from -0.125 to -9.375 D (-2.92 ± 1.77 D), respectively. Ages at initial visit ranged from 3.2 to 15.5 years (10.1 ± 2.7 years) in the treated and from 3.4 to 15.5 years (11.2 ± 3.0 years) in untreated children. Two-factor ANOVA for age and atropine effects on axial length growth confirmed that axial length growth rates declined with age (p<0.0001) and revealed a significant inhibitory effect of atropine on axial length growth (p<0.0015). The atropine effect on axial length growth averaged to 0.08 mm (28%) inhibition per year. Effects on refraction were not statistically significant. CONCLUSION The observed atropine effects were not very distinctive: Statistical analysis confirmed that atropine reduced axial length growth, but to an extent of minor clinical relevance. It was also shown that beneficial effects of 0.01% atropine may not be obvious in each single case, which should be communicated with parents and resident ophthalmologists.
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Affiliation(s)
- Hakan Kaymak
- Internationale Innovative Ophthalmochirurgie GbR c/o Breyer Kaymak and Klabe Augenchirurgie, Duesseldorf, Germany. .,Institute of Experimental Ophthalmology, Saarland University, Homburg, Germany.
| | - Birte Graff
- Internationale Innovative Ophthalmochirurgie GbR c/o Breyer Kaymak and Klabe Augenchirurgie, Duesseldorf, Germany.,Institute of Experimental Ophthalmology, Saarland University, Homburg, Germany
| | - Frank Schaeffel
- Section of Neurobiology of the Eye, Ophthalmic Research Institute, University of Tuebingen, Tuebingen, Germany
| | - Achim Langenbucher
- Institute of Experimental Ophthalmology, Saarland University, Homburg, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center UKS, Homburg, Germany
| | - Hartmut Schwahn
- Internationale Innovative Ophthalmochirurgie GbR c/o Breyer Kaymak and Klabe Augenchirurgie, Duesseldorf, Germany
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194
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Wu H, Zhang G, Shen M, Xu R, Wang P, Guan Z, Xie Z, Jin Z, Chen S, Mao X, Qu J, Zhou X. Assessment of Choroidal Vascularity and Choriocapillaris Blood Perfusion in Anisomyopic Adults by SS-OCT/OCTA. Invest Ophthalmol Vis Sci 2021; 62:8. [PMID: 33393974 PMCID: PMC7797932 DOI: 10.1167/iovs.62.1.8] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose To explore the association of choroidal vascularity and choriocapillaris blood perfusion with myopic severity in anisomyopes. Methods Refractive error, axial length (AL), and other biometric parameters were measured in 34 anisomyopic young adults. Macular choroidal thickness (ChT) and choroidal vascularity, including total choroidal area (TCA), luminal area (LA), stromal area (SA), and choroidal vascularity index (CVI), were determined from swept-source optical coherence tomography (SS-OCT) vertical and horizontal B-scans. The percentage of choriocapillaris flow voids (FV%) was obtained from en face SS-OCT-angiography. Results The spherical equivalent refraction (SER) was –3.35 ± 1.25 diopters in the more myopic eyes and –1.25 ± 1.17 diopters in the less myopic eyes (P < 0.001). The interocular difference in SER was highly correlated with that in AL (P < 0.001). The macular ChT, TCA, LA, and SA were smaller in the more myopic eyes than in the less myopic eyes in both vertical and horizontal scans (all P < 0.001). Importantly, the CVIs in vertical and horizontal scans were smaller and the FV% was greater in the more myopic eyes (P < 0.05). In vertical scans, the interocular difference in CVIs was correlated with that in the SER, AL, and ChT (all P < 0.05). The interocular difference in FV% was correlated with that in SER, AL, and vertical and horizontal ChTs (all P < 0.05). Conclusions Choroidal vascularity and choriocapillaris blood perfusion were lower in the more myopic eyes of anisomyopic adults. These changes were correlated with the severity of myopia and choroidal thinning, indicating that choroidal blood flow is disturbed in human myopia.
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Affiliation(s)
- Hao Wu
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Guoyun Zhang
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Meixiao Shen
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Renchang Xu
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Pengqi Wang
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Zhenqi Guan
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Zhu Xie
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Zi Jin
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Sisi Chen
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Xinjie Mao
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Jia Qu
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China.,Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Science, Wenzhou, Zhejiang, China
| | - Xiangtian Zhou
- Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China.,Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Science, Wenzhou, Zhejiang, China
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195
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Jiang F, Huang X, Xia H, Wang B, Lu F, Zhang B, Jiang J. The Spatial Distribution of Relative Corneal Refractive Power Shift and Axial Growth in Myopic Children: Orthokeratology Versus Multifocal Contact Lens. Front Neurosci 2021; 15:686932. [PMID: 34177459 PMCID: PMC8219929 DOI: 10.3389/fnins.2021.686932] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 05/17/2021] [Indexed: 01/29/2023] Open
Abstract
Purpose To determine if the spatial distribution of the relative corneal refractive power shift (RCRPS) explains the retardation of axial length (AL) elongation after treatment by either orthokeratology (OK) or multifocal soft contact lenses (MFCLs). Methods Children (8–14 years) were enrolled in the OK (n = 35) or MFCL (n = 36) groups. RCRPS maps were derived by computing the difference between baseline and 12-month corneal topography maps and then subtracting the apex values. Values at the same radius were averaged to obtain the RCRPS profile, from which four parameters were extracted: (1) Half_x and (2) Half_y, i.e., the x- and y-coordinates where each profile first reached the half peak; (3) Sum4 and (4) Sum7, i.e., the summation of powers within a corneal area of 4- and 7-mm diameters. Correlations between AL elongation and these parameters were analyzed by multiple linear regression. Results AL elongation in the OK group was significantly smaller than that in the MFCL group (p = 0.040). Half_x and Half_y were also smaller in the OK group than the MFCL group (p < 0.001 each). Half_x was correlated with AL elongation in the OK group (p = 0.005), but not in the MFCL group (p = 0.600). In an analysis that combined eyes of both groups, Half_x was correlated with AL elongation (β = 0.161, p < 0.001). Conclusions The OK-induced AL elongation and associated RCRPS Half_x were smaller than for the MFCL. Contact lenses that induce RCRPS closer to the corneal center may exert better myopia control.
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Affiliation(s)
- Fan Jiang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Xiaopeng Huang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Houxue Xia
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Bingqi Wang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Fan Lu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Bin Zhang
- College of Optometry, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Jun Jiang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,Eye Hospital, Wenzhou Medical University, Wenzhou, China
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196
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Quint WH, Tadema KCD, de Vrieze E, Lukowicz RM, Broekman S, Winkelman BHJ, Hoevenaars M, de Gruiter HM, van Wijk E, Schaeffel F, Meester-Smoor M, Miller AC, Willemsen R, Klaver CCW, Iglesias AI. Loss of Gap Junction Delta-2 (GJD2) gene orthologs leads to refractive error in zebrafish. Commun Biol 2021; 4:676. [PMID: 34083742 PMCID: PMC8175550 DOI: 10.1038/s42003-021-02185-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 05/04/2021] [Indexed: 12/20/2022] Open
Abstract
Myopia is the most common developmental disorder of juvenile eyes, and it has become an increasing cause of severe visual impairment. The GJD2 locus has been consistently associated with myopia in multiple independent genome-wide association studies. However, despite the strong genetic evidence, little is known about the functional role of GJD2 in refractive error development. Here, we find that depletion of gjd2a (Cx35.5) or gjd2b (Cx35.1) orthologs in zebrafish, cause changes in the biometry and refractive status of the eye. Our immunohistological and scRNA sequencing studies show that Cx35.5 (gjd2a) is a retinal connexin and its depletion leads to hyperopia and electrophysiological changes in the retina. These findings support a role for Cx35.5 (gjd2a) in the regulation of ocular biometry. Cx35.1 (gjd2b) has previously been identified in the retina, however, we found an additional lenticular role. Lack of Cx35.1 (gjd2b) led to a nuclear cataract that triggered axial elongation. Our results provide functional evidence of a link between gjd2 and refractive error. Quint et al. use zebrafish lines deficient in one of two orthologs of the Gap Junction Delta-2 (GJD2) gene, which is associated with myopia by genome-wide association studies. They link gjd2 with refractive error and report evidence to suggest that gjd2a plays a role in ocular biometry whilst gjd2b, previously found in the retina, possesses an additional lenticular role.
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Affiliation(s)
- Wim H Quint
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands. .,Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands.
| | - Kirke C D Tadema
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Erik de Vrieze
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Rachel M Lukowicz
- Institute of Neuroscience, University of Oregon, Eugene, United States
| | - Sanne Broekman
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Beerend H J Winkelman
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Cerebellar Coordination and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
| | - Melanie Hoevenaars
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Erwin van Wijk
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - Frank Schaeffel
- Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany.,Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
| | - Magda Meester-Smoor
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Adam C Miller
- Institute of Neuroscience, University of Oregon, Eugene, United States
| | - Rob Willemsen
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland.,Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Adriana I Iglesias
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands. .,Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands.
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197
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Tideman JWL, Pärssinen O, Haarman AEG, Khawaja AP, Wedenoja J, Williams KM, Biino G, Ding X, Kähönen M, Lehtimäki T, Raitakari OT, Cheng CY, Jonas JB, Young TL, Bailey-Wilson JE, Rahi J, Williams C, He M, Mackey DA, Guggenheim JA. Evaluation of Shared Genetic Susceptibility to High and Low Myopia and Hyperopia. JAMA Ophthalmol 2021; 139:601-609. [PMID: 33830181 DOI: 10.1001/jamaophthalmol.2021.0497] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Importance Uncertainty currently exists about whether the same genetic variants are associated with susceptibility to low myopia (LM) and high myopia (HM) and to myopia and hyperopia. Addressing this question is fundamental to understanding the genetics of refractive error and has clinical relevance for genotype-based prediction of children at risk for HM and for identification of new therapeutic targets. Objective To assess whether a common set of genetic variants are associated with susceptibility to HM, LM, and hyperopia. Design, Setting, and Participants This genetic association study assessed unrelated UK Biobank participants 40 to 69 years of age of European and Asian ancestry. Participants 40 to 69 years of age living in the United Kingdom were recruited from January 1, 2006, to October 31, 2010. Of the total sample of 502 682 participants, 117 279 (23.3%) underwent an ophthalmic assessment. Data analysis was performed from December 12, 2019, to June 23, 2020. Exposures Four refractive error groups were defined: HM, -6.00 diopters (D) or less; LM, -3.00 to -1.00 D; hyperopia, +2.00 D or greater; and emmetropia, 0.00 to +1.00 D. Four genome-wide association study (GWAS) analyses were performed in participants of European ancestry: (1) HM vs emmetropia, (2) LM vs emmetropia, (3) hyperopia vs emmetropia, and (4) LM vs hyperopia. Polygenic risk scores were generated from GWAS summary statistics, yielding 4 sets of polygenic risk scores. Performance was assessed in independent replication samples of European and Asian ancestry. Main Outcomes and Measures Odds ratios (ORs) of polygenic risk scores in replication samples. Results A total of 51 841 unrelated individuals of European ancestry and 2165 unrelated individuals of Asian ancestry were assigned to a specific refractive error group and included in our analyses. Polygenic risk scores derived from all 4 GWAS analyses were predictive of all categories of refractive error in both European and Asian replication samples. For example, the polygenic risk score derived from the HM vs emmetropia GWAS was predictive in the European sample of HM vs emmetropia (OR, 1.58; 95% CI, 1.41-1.77; P = 1.54 × 10-15) as well as LM vs emmetropia (OR, 1.15; 95% CI, 1.07-1.23; P = 8.14 × 10-5), hyperopia vs emmetropia (OR, 0.83; 95% CI, 0.77-0.89; P = 4.18 × 10-7), and LM vs hyperopia (OR, 1.45; 95% CI, 1.33-1.59; P = 1.43 × 10-16). Conclusions and Relevance Genetic risk variants were shared across HM, LM, and hyperopia and across European and Asian samples. Individuals with HM inherited a higher number of variants from among the same set of myopia-predisposing alleles and not different risk alleles compared with individuals with LM. These findings suggest that treatment interventions targeting common genetic risk variants associated with refractive error could be effective against both LM and HM.
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Affiliation(s)
- J Willem L Tideman
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands.,Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Olavi Pärssinen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Ophthalmology, Central Hospital of Central Finland, Jyväskylä, Finland
| | - Annechien E G Haarman
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands.,Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital National Health Service (NHS) Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Juho Wedenoja
- Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Katie M Williams
- Section of Academic Ophthalmology, Faculty of Life Sciences and Medicine, King's College London School of Life Course Sciences, London, United Kingdom.,Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Ginevra Biino
- Institute of Molecular Genetics, National Research Council of Italy, Pavia, Italy
| | - Xiaohu Ding
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Mika Kähönen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland
| | - Terho Lehtimäki
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland.,Department of Clinical Chemistry, Finnish Cardiovascular Research Center, Tampere, Finland
| | - Olli T Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, Finland.,Research Centre of Applied and Preventive Medicine, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Ching-Yu Cheng
- Duke-NUS Medical School, Singapore, Singapore.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Terri L Young
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison
| | - Joan E Bailey-Wilson
- Computational and Statistical Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Baltimore, Maryland
| | - Jugnoo Rahi
- UCL Great Ormond Street Institute of Child Health and Institute of Ophthalmology, University College London, London, United Kingdom
| | - Cathy Williams
- Centre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Centre for Eye Research Australia; Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia
| | - Jeremy A Guggenheim
- Cardiff University School of Optometry and Vision Sciences, Cardiff, United Kingdom
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198
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Riddell N, Murphy MJ, Crewther SG. Electroretinography and Gene Expression Measures Implicate Phototransduction and Metabolic Shifts in Chick Myopia and Hyperopia Models. Life (Basel) 2021; 11:life11060501. [PMID: 34072440 PMCID: PMC8228081 DOI: 10.3390/life11060501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/23/2021] [Accepted: 05/25/2021] [Indexed: 12/26/2022] Open
Abstract
The Retinal Ion-Driven Fluid Efflux (RIDE) model theorizes that phototransduction-driven changes in trans-retinal ion and fluid transport underlie the development of myopia (short-sightedness). In support of this model, previous functional studies have identified the attenuation of outer retinal contributions to the global flash electroretinogram (gfERG) following weeks of myopia induction in chicks, while discovery-driven transcriptome studies have identified changes to the expression of ATP-driven ion transport and mitochondrial metabolism genes in the retina/RPE/choroid at the mid- to late-induction time-points. Less is known about the early time-points despite biometric analyses demonstrating changes in eye growth by 3 h in the chick lens defocus model. Thus, the present study compared gfERG and transcriptome profiles between 3 h and 3 days of negative lens-induced myopia and positive lens-induced hyperopia in chicks. Photoreceptor (a-wave and d-wave) and bipolar (b-wave and late-stage d-wave) cell responses were suppressed following negative lens-wear, particularly at the 3–4 h and 3-day time-points when active shifts in the rate of ocular growth were expected. Transcriptome measures revealed the up-regulation of oxidative phosphorylation genes following 6 h of negative lens-wear, concordant with previous reports at 2 days in this model. Signal transduction pathways, with core genes involved in glutamate and G-protein coupled receptor signalling, were down-regulated at 6 h. These findings contribute to a growing body of evidence for the dysregulation of phototransduction and mitochondrial metabolism in animal models of myopia.
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199
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Intraocular epidermal growth factor concentration, axial length, and high axial myopia. Graefes Arch Clin Exp Ophthalmol 2021; 259:3229-3234. [PMID: 34050811 PMCID: PMC8523420 DOI: 10.1007/s00417-021-05200-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 03/12/2021] [Accepted: 04/11/2021] [Indexed: 11/05/2022] Open
Abstract
Purpose Various molecules such as dopamine have been found to be associated with axial elongation in experimental studies. Here, we examined whether intraocular EGF is associated with axial length in myopic patients. Methods The hospital-based investigation included patients of European descent without optic nerve, retinal, or macular diseases except for myopic maculopathy. Using aqueous humor samples collected during surgery, the EGF concentration was examined applying a cytometric bead array. High myopia was defined by an axial length of ≥ 27.0 mm. Results The study included a non-highly myopic group of 11 patients (mean age, 72.9 ± 10.8 years; mean axial length, 24.3 ± 1.1 mm) and a highly myopic group of three patients (age, 81.11 ± 12.3 years; axial length, 29.5 ± 1.3 mm), with one of them having pathologic myopic maculopathy. In multivariable linear regression analysis, higher EGF concentration was correlated with the highly myopic versus non-highly myopic group (beta, 1.24; non-standardized correlation coefficient B, 6.24; 95% confidence interval (CI), 0.10,12.4;P = 0.047) after adjusting for axial length. The amount of intraocular EGF was significantly higher in the highly myopic group than in the non-highly myopic group (89.1 ± 40.8 pg versus 34.1 ± 13.2 pg; P = 0.005), and it was highest in the eye with myopic maculopathy (135 pg). Conclusions The intraocular amount of EGF is higher in highly myopic versus non-highly myopic eyes.
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Flitcroft's model of refractive development in childhood and the possible identification of children at risk of developing significant myopia. Cont Lens Anterior Eye 2021; 45:101451. [PMID: 33975784 DOI: 10.1016/j.clae.2021.101451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/23/2021] [Accepted: 04/25/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE To better understand juvenile myopia in the context of overall refractive development during childhood and to suggest more informative ways of analysing relevant data, particularly in relation to early identification of those children who are likely to become markedly myopic and would therefore benefit from myopia control. METHODS Examples of the frequency distributions of childhood mean spherical refractive errors (MSEs) at different ages, taken from previously-published longitudinal and cross-sectional studies, are analysed in terms of Flitcroft's model of a linear combination of two Gaussian distributions with different means and standard deviations. Flitcroft hypothesises that one, relatively-narrow, Gaussian (Mode 1) represents a "regulated" population which maintains normal emmetropisation and the other, broader, Gaussian (Mode 2) a "dysregulated" population. RESULTS Analysis confirms that Flitcroft's model successfully describes the major features of the frequency distribution of MSEs in randomly-selected populations of children of the same age. The narrow "regulated" Gaussian typically changes only slightly between the ages of about 6 and 15, whereas the mean of the broader "dysregulated" Gaussian changes with age more rapidly in the myopic direction and its standard deviation increases. These effects vary with the ethnicity, environment and other characteristics of the population involved. At all ages there is considerable overlap between the two Gaussians. This limits the utility of simple refractive cut-off values to identify those children likely to show marked myopic progression. CONCLUSIONS Analysing the frequency distributions for individual MSEs in terms of bi-Gaussian models can provide useful insights into childhood refractive change. A wider exploration of the methodology and its extension to include individual progression rates is warranted, using a range of populations of children exposed to different ethnic, environmental and other factors.
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