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Su Y, Pan A, Wu Y, Zhu S, Zheng L, Xue A. The efficacy of posterior scleral contraction in controlling high myopia in young people. Am J Transl Res 2018; 10:3628-3634. [PMID: 30662614 PMCID: PMC6291706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 10/21/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To investigate the clinical effectiveness and safety of posterior scleral contraction (PSC) surgery in controlling high myopia in young people. METHODS Twenty patients with high myopia (30 eyes) were treated with PSC. The average age for the patients was 11.45 ± 5.17 years old (range 3-22). A genipin cross-linked sclera was implanted to the posterior sclera in PSC surgery. Axial length and myopia progression rates were measured at least two years before and after PSC surgery. RESULTS Prior to surgery, the mean AL progression was 0.73 ± 0.33 mm, compared to -0.08 ± 0.31 mm (P=0.00) post-surgery; the degree of myopia increased was -1.40 ± 0.95 D, compared to 0.18 ± 1.10 D post-surgery (P=0.00). The best corrected visual acuity (BCVA, in LogMAR) improved from 0.21 ± 0.16 preoperatively to 0.13 ± 0.13 two years after PSC (P=0.014). CONCLUSIONS PSC can restrict AL extension and safely control high myopia progression in young people.
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Affiliation(s)
- Yanfeng Su
- High Myopia Department, The Eye Hospital of Wenzhou Medical University, The Eye Hospital of Zhejiang Province Wenzhou, China
| | - Anpeng Pan
- High Myopia Department, The Eye Hospital of Wenzhou Medical University, The Eye Hospital of Zhejiang Province Wenzhou, China
| | - Yue Wu
- High Myopia Department, The Eye Hospital of Wenzhou Medical University, The Eye Hospital of Zhejiang Province Wenzhou, China
| | - Shuangqian Zhu
- High Myopia Department, The Eye Hospital of Wenzhou Medical University, The Eye Hospital of Zhejiang Province Wenzhou, China
| | - Linyan Zheng
- High Myopia Department, The Eye Hospital of Wenzhou Medical University, The Eye Hospital of Zhejiang Province Wenzhou, China
| | - Anquan Xue
- High Myopia Department, The Eye Hospital of Wenzhou Medical University, The Eye Hospital of Zhejiang Province Wenzhou, China
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152
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Craig JP, Lim J, Han A, Tien L, Xue AL, Wang MTM. Ethnic differences between the Asian and Caucasian ocular surface: A co-located adult migrant population cohort study. Ocul Surf 2018; 17:83-88. [PMID: 30253249 DOI: 10.1016/j.jtos.2018.09.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 09/16/2018] [Accepted: 09/21/2018] [Indexed: 12/31/2022]
Abstract
PURPOSE To investigate the ethnic differences in tear film quality, ocular surface parameters, and dry eye symptomology between co-located Asian and Caucasian populations. METHODS Two hundred and six participants (103 East Asian and 103 Caucasian) were recruited in an age and gender-matched cross-sectional study. Dry eye symptomology, ocular surface parameters, and tear film quality were evaluated for each participant within a single clinical session. RESULTS The mean ± SD age of the 206 participants (82 male, 124 female) was 45 ± 16 years. Overall, a greater proportion of Asian participants were symptomatic of dry eye and fulfilled the TFOS DEWS II dry eye diagnostic criteria than Caucasian participants (74% versus 51%, p = 0.002), with an odds ratio (95% CI) of 2.7 (1.5-4.8) times. Poorer OSDI scores, tear film stability, lipid layer quality, tear osmolarity, lid wiper epitheliopathy, meibomian gland dropout, and expressed meibum quality were observed in the Asian group (all p < 0.05). A significantly higher proportion of participants exhibited incomplete blinking in the Asian group than the Caucasian group (81% versus 45%, p < 0.001). CONCLUSIONS Asian participants exhibited more severe dry eye signs and symptoms than Caucasian participants. The poorer meibomian gland function and higher degree of incomplete blinking observed among Asian participants may potentially contribute towards the ethnic predisposition towards dry eye development.
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Affiliation(s)
- Jennifer P Craig
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand.
| | - Joevy Lim
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand
| | - Alicia Han
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand; School of Optometry and Vision Science, New Zealand National Eye Centre, The University of Auckland, New Zealand
| | - Leslie Tien
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand; School of Optometry and Vision Science, New Zealand National Eye Centre, The University of Auckland, New Zealand
| | - Ally L Xue
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand
| | - Michael T M Wang
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand
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153
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Kim JS, Wang MTM, Craig JP. Exploring the Asian ethnic predisposition to dry eye disease in a pediatric population. Ocul Surf 2018; 17:70-77. [PMID: 30219270 DOI: 10.1016/j.jtos.2018.09.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 07/20/2018] [Accepted: 09/12/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE To investigate the differences in ocular surface characteristics, tear film parameters, and dry eye symptomology between co-located pediatric populations of Asian and Caucasian ethnicity. METHODS Seventy New Zealand-born pediatric participants, aged between 5 and 18 years, were recruited in an age and environmentally controlled cross-sectional study. Participants were classified into three groups according to ethnicity and eyelid morphology: Asian single lid (ASL), Asian double lid (ADL), and Caucasian double lid (CDL). Ocular biometry, tear film parameters, ocular surface characteristics, and dry eye symptomology were evaluated in a single clinical session. RESULTS Overall, no significant intergroup differences were observed in tear film quality, dry eye symptomology, and meibomian gland dropout. A higher proportion of ASL and ADL participants exhibited incomplete blinking than the Caucasian group (both p < 0.001). Meibomian gland shortening was more frequently observed among the two Asian groups (both p < 0.05), while gland tortuosity was more common in the Caucasian group (both p < 0.001). ASL participants exhibited greater inferior lid wiper epitheliopathy grades than ADL participants (p = 0.01), and corneal astigmatism was more pronounced in the ASL than CDL group (p = 0.02). CONCLUSIONS Ethnic differences in meibomian gland morphological patterns were observed in the current pediatric cohort, although overall meibomian gland dropout did not differ between groups. Asian participants exhibited a higher degree of incomplete blinking, and more marked inferior lid wiper epitheliopathy and corneal astigmatism were observed in the ASL group. These findings would suggest that eyelid anatomy and tension may potentially be implicated in the development of ethnic differences in dry eye disease later in life.
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Affiliation(s)
- Ji Soo Kim
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand
| | - Michael T M Wang
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand
| | - Jennifer P Craig
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand.
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Ghorbani Mojarrad N, Williams C, Guggenheim JA. A genetic risk score and number of myopic parents independently predict myopia. Ophthalmic Physiol Opt 2018; 38:492-502. [PMID: 30182516 DOI: 10.1111/opo.12579] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 07/19/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE To investigate whether a genetic risk score (GRS) improved performance of predicting refractive error compared to knowing a child's number of myopic parents (NMP) alone. METHODS This was a retrospective analysis of data from the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort study. Refractive error was assessed longitudinally between age 7-15 using non-cycloplegic autorefraction. Genetic variants (n = 149) associated with refractive error from a Consortium for Refractive Error And Myopia (CREAM) genome-wide association study were used to calculate a GRS for each child. Using refractive error at ages 7 and 15 years as the outcome variable, coefficient of determination (R2 ) values were calculated via linear regression models for the predictors: NMP, GRS and a combined model. RESULTS Number of myopic parents was weakly predictive of refractive error in children aged 7 years, R2 = 3.0% (95% CI 1.8-4.1%, p < 0.0001) and aged 15 years, R2 = 4.8% (3.1-6.5%, p < 0.0001). The GRS was also weakly predictive; age 7 years, R2 = 1.1% (0.4-1.9%, p < 0.0001) and 15 years R2 = 2.6% (1.3-3.9%, p < 0.0001). Combining the 2 variables gave larger R2 values at age 7, R2 = 3.7% (2.5-5.0%, p < 0.0001) and 15, R2 = 7.0% (5.0-9.0%, p < 0.0001). The combined model improved performance at both ages (both p < 0.0001). CONCLUSION A GRS improved the ability to detect children at risk of myopia independently of knowing the NMP. We speculate this may be because NMP captures information concerning environmental risk factors for myopia. Nevertheless, further gains are required to make such predictive tests worthwhile in the clinical environment.
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Affiliation(s)
| | - Cathy Williams
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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155
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Ku PW, Steptoe A, Lai YJ, Hu HY, Chu D, Yen YF, Liao Y, Chen LJ. The Associations between Near Visual Activity and Incident Myopia in Children: A Nationwide 4-Year Follow-up Study. Ophthalmology 2018; 126:214-220. [PMID: 29934268 DOI: 10.1016/j.ophtha.2018.05.010] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 05/05/2018] [Accepted: 05/08/2018] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE This nationwide population-based study aimed to examine the prospective association between near visual activities and incident myopia in Taiwanese children 7 to 12 years old over a 4-year follow-up period. DESIGN Prospective cohort design. PARTICIPANTS There were 1958 children aged 7 to 12 years from the Taiwan 2009 National Health Interview Survey who were linked to the 2009 through 2013 claims data from the National Health Insurance system. METHODS Multivariable Cox proportional hazard models were used to estimate the associations between 3 types of near visual activities in sedentary posture, namely reading (< 0.5, 0.5-0.9, ≥1.0 hours per day [h/d]), use of computer, Internet, and games (<0.5, 0.5-0.9, ≥1.0 h/d), and "cram school" attendance (<0.5, 0.5-1.9, ≥2.0 h/d), and incident myopia. MAIN OUTCOME MEASURES Prevalent myopia was defined as those who had ≥2 ambulatory care claims (International Classification of Diseases code 367.1) in 2008-2009. Incident myopia was defined by those who had at least 2 ambulatory care claims (International Classification of Diseases code 367.1) during the 4-year follow-up period (2010-2013) after excluding prevalent cases. RESULTS Overall, 26.8% of children had myopia at baseline, and 27.7% of those without myopia at baseline developed incident myopia between 2010 and 2013. On average, they spent 0.68±0.86 h/d on computer/Internet use, 0.63±0.67 h/d on reading, and 2.78±3.53 h/d on cram school. The results showed that children attending cram schools ≥2 h/d (hazard ratio, 1.31; 95% confidence interval, 1.03-1.68) had a higher risk of incident myopia. The effects of these activities remained similar in sensitivity analyses. CONCLUSIONS Cram school attendance for ≥2 h/d may increase the risk of children's incident myopia. This effect may be due to increased near visual activity or reduced time outdoors.
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Affiliation(s)
- Po-Wen Ku
- Graduate Institute of Sports and Health, National Changhua University of Education, Taiwan; Department of Epidemiology and Public Health, University College London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, UK
| | - Yun-Ju Lai
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan; Department of Exercise Health Science, National Taiwan University of Sport, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hsiao-Yun Hu
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Dachen Chu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Neurosurgery, Taipei City Hospital, Taipei, Taiwan; Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Yung-Feng Yen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan; Section of Infectious Diseases, Taipei City Hospital, Taipei City Government, Taipei, Taiwan
| | - Yung Liao
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taichung, Taiwan.
| | - Li-Jung Chen
- Department of Epidemiology and Public Health, University College London, UK; Department of Exercise Health Science, National Taiwan University of Sport, Taiwan.
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156
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Melzer C, Ziemssen F, Eter N, Brinkmann C, Agostini H, Haeusser-Fruh G, Rose U, Schargus M, Lorenz K, Holz FG, Schmitz-Valckenberg S. Design and Baseline Characteristics of the HELP Study: An Extended and Long-Term Observation of Pathological Myopia in Caucasians. Ophthalmologica 2018; 240:167-178. [PMID: 29909408 DOI: 10.1159/000489180] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 04/11/2018] [Indexed: 11/19/2022]
Abstract
PURPOSE To assess the natural disease progression of high myopia in Caucasians considered at risk for the development of myopic choroidal neovascularization (mCNV). METHODS Subjects were recruited in 25 clinical sites between June 2014 and June 2016. Main inclusion criteria included axial length of ≥26 mm, best-corrected visual acuity ≥0.05 decimal equivalent and presence of at least one out of five predefined morphological disease risk criteria. These were (1) subfoveal choroidal thinning < 50 µm, (2) enhanced choroidal curvature length > 6,300 µm, (3) lacquer cracks, (4) patchy atrophy > 5 mm2 and (5) preexisting mCNV in the fellow eye (German Clinical Trial Register DRKS00007761). RESULTS A total of 150 participants (66% females) with a mean age of 57.2 (±12.7) years (range 21.9-86.2 years) were included. The disease criteria most frequently encountered were choroidal thinning (33.3%) and lacquer cracks (32.7%). Enhanced choroidal curvature length was detected in only 8 subjects and always occurred in combination with other disease criteria. Presence of patchy atrophy was found to be more common in older subjects (p = 0.0012) and also associated with a more severe disease manifestation. CONCLUSION The baseline data of this study indicate that enhanced choroidal curvature might be less common in Caucasians than in Asian populations. Further, disease severity in patients with high myopia is relatively high in the presence of patchy atrophy.
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Affiliation(s)
- Charlotte Melzer
- GRADE Reading Center, Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Focke Ziemssen
- Department of Ophthalmology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Nicole Eter
- Department of Ophthalmology, University of Münster, Münster, Germany
| | - Christian Brinkmann
- GRADE Reading Center, Department of Ophthalmology, University of Bonn, Bonn, Germany
| | | | | | - Uwe Rose
- Novartis Pharma Nuremberg, Nuremberg, Germany
| | - Marc Schargus
- Department of Ophthalmology, Heinrich Heine University, Düsseldorf, Germany.,Eye Hospital, Gerolzhofen, Germany
| | - Katrin Lorenz
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - Frank G Holz
- GRADE Reading Center, Department of Ophthalmology, University of Bonn, Bonn, Germany
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157
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Varadarajan AV, Poplin R, Blumer K, Angermueller C, Ledsam J, Chopra R, Keane PA, Corrado GS, Peng L, Webster DR. Deep Learning for Predicting Refractive Error From Retinal Fundus Images. ACTA ACUST UNITED AC 2018; 59:2861-2868. [DOI: 10.1167/iovs.18-23887] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
| | - Ryan Poplin
- Google Research, Google, Inc., Mountain View, California, United States
| | - Katy Blumer
- Google Research, Google, Inc., Mountain View, California, United States
| | | | - Joe Ledsam
- Google DeepMind, Google, Inc., London, United Kingdom
| | - Reena Chopra
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Pearse A. Keane
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Greg S. Corrado
- Google Research, Google, Inc., Mountain View, California, United States
| | - Lily Peng
- Google Research, Google, Inc., Mountain View, California, United States
| | - Dale R. Webster
- Google Research, Google, Inc., Mountain View, California, United States
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158
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Owen CG, Oken E, Rudnicka AR, Patel R, Thompson J, Rifas-Shiman SL, Vilchuck K, Bogdanovich N, Hameza M, Kramer MS, Martin RM. The Effect of Longer-Term and Exclusive Breastfeeding Promotion on Visual Outcome in Adolescence. Invest Ophthalmol Vis Sci 2018; 59:2670-2678. [PMID: 29860453 PMCID: PMC5983062 DOI: 10.1167/iovs.17-23211] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Purpose Breastfeeding may influence early visual development. We examined whether an intervention to promote increased duration and exclusivity of breastfeeding improves visual outcomes at 16 years of age. Methods Follow-up of a cluster-randomized trial in 31 Belarusian maternity hospitals/polyclinics randomized to receive a breastfeeding promotion intervention, or usual care, where 46% vs. 3% were exclusively breastfed at 3 months respectively. Low vision in either eye was defined as unaided logMAR vision of ≥0.3 or worse (equivalent to Snellen 20/40) and was used as the primary outcome. Open-field autorefraction in a subset (n = 963) suggested that 84% of those with low vision were myopic. Primary analysis was based on modified intention-to-treat, accounting for clustering within hospitals/clinics. Observational analyses also examined the effect of breastfeeding duration and exclusivity, as well as other sociodemographic and environmental determinants of low vision. Results A total of 13,392 of 17,046 (79%) participants were followed up at 16 years. Low vision prevalence was 19.6% (95% confidence interval [CI]: 17.5, 22.0%) in the experimental group versus 21.6% (19.5, 23.8%) in the control group. Cluster-adjusted odds ratio (OR) of low vision associated with the intervention was 0.92 (95% CI: 0.73, 1.16); 0.88 (95% CI: 0.74, 1.05) after adjustment for parental and early life factors. In observational analyses, breastfeeding duration and exclusivity had no significant effect on low vision. However, maternal age at birth (OR: 1.13, 95% CI: 1.07, 1.14/5-year increase) and urban versus rural residence were associated with increased risk of low vision. Lower parental education, number of older siblings was associated with a lower risk of low vision; boys had lower risk compared with girls (0.64, 95% CI: 0.59,0.70). Conclusions Exclusive breastfeeding promotion had no significant effect on visual outcomes in this study, but other environmental factors showed strong associations. (ClinicalTrials.gov number, NCT01561612.)
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Affiliation(s)
- Christopher G Owen
- Population Health Research Institute, St. George's, University of London, Cranmer Terrace, London, United Kingdom
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States
| | - Alicja R Rudnicka
- Population Health Research Institute, St. George's, University of London, Cranmer Terrace, London, United Kingdom
| | - Rita Patel
- Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Jennifer Thompson
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States
| | - Sheryl L Rifas-Shiman
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States
| | - Konstatin Vilchuck
- National Research and Applied Medicine Mother and Child Centre, Minsk, Republic of Belarus
| | - Natalia Bogdanovich
- National Research and Applied Medicine Mother and Child Centre, Minsk, Republic of Belarus
| | - Mikhail Hameza
- National Research and Applied Medicine Mother and Child Centre, Minsk, Republic of Belarus
| | - Michael S Kramer
- Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Montreal, Canada
| | - Richard M Martin
- Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom.,University Hospitals Bristol NHS Foundation Trust and University of Bristol National Institute for Health Research Bristol Biomedical Research Centre, Bristol, United Kingdom.,Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
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159
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Queirós A, Amorim-de-Sousa A, Lopes-Ferreira D, Villa-Collar C, Gutiérrez ÁR, González-Méijome JM. Relative peripheral refraction across 4 meridians after orthokeratology and LASIK surgery. EYE AND VISION 2018; 5:12. [PMID: 29796404 PMCID: PMC5960502 DOI: 10.1186/s40662-018-0106-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 05/05/2018] [Indexed: 12/19/2022]
Abstract
Background To characterize the axial and off-axis refraction across four meridians of the retina in myopic eyes before and after Orthokeratology (OK) and LASIK surgery. Methods Sixty right eyes with a spherical equivalent (M) between − 0.75 to − 5.25 D (cylinder <− 1.00 D) underwent LASIK (n = 26) or OK (n = 34) to treat myopia. Axial and off-axis refraction were measured with an open-field autorefractometer before and after stabilized treatments. Off-axis measurements were obtained for the horizontal (35° nasal and temporal retina) and vertical (15° superior and inferior retina) meridians, and for two oblique directions (45–225° and 135–315°) up to 20° of eccentricity. The refractive profile was addressed as relative peripheral refractive error (RPRE). Results OK and LASIK post-treatment results showed an increase of myopic relative refraction at several eccentric locations. At the four meridians evaluated, the M component of the pre-treatment RPRE values was not statistically different (p > 0.05) from the post-treatment RPRE within 30° and 20° of the central visual field after LASIK and OK, respectively. These results demonstrated that the treatment zone warrants an optimal central field of vision. Conclusions The present study gives an overview of RPRE after refractive corneal reshaping treatments (OK and LASIK) across vertical, horizontal and two oblique meridians together. This allows a 3D representation of RPRE at the retina and shows that the myopic shift induced by both treatments is more relevant in horizontal directions.
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Affiliation(s)
- António Queirós
- 1Clinical & Experimental Optometry Research Lab-CEORLab, Center of Physics (Optometry), University of Minho, Braga, Portugal
| | - Ana Amorim-de-Sousa
- 1Clinical & Experimental Optometry Research Lab-CEORLab, Center of Physics (Optometry), University of Minho, Braga, Portugal
| | - Daniela Lopes-Ferreira
- 1Clinical & Experimental Optometry Research Lab-CEORLab, Center of Physics (Optometry), University of Minho, Braga, Portugal
| | - César Villa-Collar
- 2Department of Optics and Optometry, European University of Madrid, Madrid, Spain
| | | | - José Manuel González-Méijome
- 1Clinical & Experimental Optometry Research Lab-CEORLab, Center of Physics (Optometry), University of Minho, Braga, Portugal
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160
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Modjtahedi BS, Ferris FL, Hunter DG, Fong DS. Public Health Burden and Potential Interventions for Myopia. Ophthalmology 2018; 125:628-630. [DOI: 10.1016/j.ophtha.2018.01.033] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 01/21/2018] [Accepted: 01/24/2018] [Indexed: 11/28/2022] Open
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161
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Joseph S, Krishnan T, Ravindran RD, Maraini G, Camparini M, Chakravarthy U, Ravilla TD, Hutchings A, Fletcher AE. Prevalence and risk factors for myopia and other refractive errors in an adult population in southern India. Ophthalmic Physiol Opt 2018; 38:346-358. [PMID: 29574882 PMCID: PMC6001660 DOI: 10.1111/opo.12447] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 02/02/2018] [Indexed: 12/17/2022]
Abstract
PURPOSE To investigate prevalence and risk factors for myopia, hyperopia and astigmatism in southern India. METHODS Randomly sampled villages were enumerated to identify people aged ≥40 years. Participants were interviewed for socioeconomic and lifestyle factors and attended a hospital-based ophthalmic examination including visual acuity measurement and objective and subjective measurement of refractive status. Myopia was defined as spherical equivalent (SE) worse than -0.75 dioptres (D), hyperopia as SE ≥+1D and astigmatism as cylinder <-0.5. RESULTS The age-standardised prevalences of myopia, hyperopia and astigmatism were 35.6% (95% CI: 34.7-36.6), 17.0% (95% CI: 16.3-17.8) and 32.6 (29.3-36.1), respectively. Of those with myopia (n = 1490), 70% had advanced cataract. Of these, 79% had presenting visual acuity (VA) less than 6/18 and after best correction, 44% of these improved to 6/12 or better and 27% remained with VA less than 6/18. In multivariable analyses (excluding patients with advanced cataract), increasing nuclear opacity score, current tobacco use, and increasing height were associated with higher odds of myopia. Higher levels of education were associated with increased odds of myopia in younger people and decreased odds in older people. Increasing time outdoors was associated with myopia only in older people. Increasing age and female gender were associated with hyperopia, and nuclear opacity score, increasing time outdoors, rural residence and current tobacco use with lower odds of hyperopia. After controlling for myopia, factors associated with higher odds of astigmatism were age, rural residence, and increasing nuclear opacity score and increasing education with lower odds. CONCLUSIONS In contrast to high-income settings and in agreement with studies from low-income settings, we found a rise in myopia with increasing age reflecting the high prevalence of advanced cataract.
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Affiliation(s)
- Sanil Joseph
- Lions Aravind Institute of Community OphthalmologyAravind Eye Care SystemMaduraiIndia
| | | | | | - Giovanni Maraini
- Sezione di OftalmologiaDipartimento di Scienze Otorino‐Odonto‐Oftalmologiche e Cervico FaccialiUniversità degli Studi di ParmaParmaItaly
| | - Monica Camparini
- Dipartimento di Scienze Biomediche, Biotecnologiche e Traslazionali‐S.Bi.Bi.TUniversità degli Studi di ParmaParmaItaly
| | - Usha Chakravarthy
- Centre for Vision & Vascular ScienceSchool of Medicine, Dentistry and Biomedical SciencesQueen's University BelfastBelfastUK
| | - Thulasiraj D. Ravilla
- Lions Aravind Institute of Community OphthalmologyAravind Eye Care SystemMaduraiIndia
| | - Andrew Hutchings
- Department of Health Services, Research and PolicyLondon School of Hygiene & Tropical MedicineLondonUK
| | - Astrid E. Fletcher
- Faculty of Epidemiology & Population HealthLondon School of Hygiene & Tropical MedicineLondonUK
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Dorr M, Elze T, Wang H, Lu ZL, Bex PJ, Lesmes LA. New Precision Metrics for Contrast Sensitivity Testing. IEEE J Biomed Health Inform 2018; 22:919-925. [PMID: 28650831 PMCID: PMC6706861 DOI: 10.1109/jbhi.2017.2708745] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Visual sensitivity is comprehensively described by the contrast sensitivity function (CSF), but current routine clinical care does not include its assessment because of the time-consuming need to estimate thresholds for a large number of spatial frequencies. The quick CSF method, however, dramatically reduces testing times by using a Bayesian information maximization rule. We evaluate the test-retest variability of a tablet-based quick CSF implementation in a study with 100 subjects who repeatedly assessed their vision with and without optical correction. We first discuss two commonly used measures of repeatability, intraclass correlation and the Bland-Altman Coefficient of Repeatability, and show that they are vulnerable to artifacts. Instead, we propose to formulate precision as an information retrieval task: from all repeat test scores, can we retrieve a certain individual based on their first test score? We then use rank-based analyses such as mean average precision as a better measure to compare different test metrics, and show that the highest test-retest precision is achieved using a summary statistic, the area under the log CSF (AULCSF). This demonstrates the benefit of assessment of the whole CSF compared to sensitivity at individual spatial frequencies only. AULCSF also yields best discrimination performance (99.2%) between measurements that were taken with and without glasses, respectively, even better than CSF Acuity. The tablet-based quick CSF thus enables the rapid and reliable home monitoring of visual function, which has the potential to improve early diagnosis and treatment of ophthalmic pathologies such as diabetic retinopathy or age-related macular degeneration.
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163
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Lake D. Medico-legal aspects of corneal refractive laser eye surgery. JOURNAL OF PATIENT SAFETY AND RISK MANAGEMENT 2018. [DOI: 10.1177/2516043518766775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
It is estimated that over 40 million people have had laser vision correction worldwide since 1991. Laser-assisted subepithelial keratomileusis is commonplace in the UK in high street chains and from more bespoke suppliers. The standards around this treatment have always been regulated by the General Medical Council (GMC), but litigation cases have been common. The recent GMC guidance for cosmetic procedures and subsequent guidelines by the Royal College of Ophthalmologists cover advertising, facility regulations, equipment, consent and surgeon training which should improve industry practices and deliver improved patient safety standards.
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Affiliation(s)
- Damian Lake
- The Queen Victoria Hospital & The Eye Bank, The Corneo Plastic Unit, East Grinstead, UK
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164
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Salchow DJ, Gehle P. Ocular manifestations of Marfan syndrome in children and adolescents. Eur J Ophthalmol 2018; 29:38-43. [PMID: 29587526 DOI: 10.1177/1120672118761333] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE: To study ocular manifestations of Marfan syndrome in children and adolescents. METHODS: Retrospective comparative cohort study on consecutive patients up to age 17 years, presenting to the interdisciplinary Marfan clinic of Charité-University Medicine Berlin over a period of 4 years. RESULTS: A total of 52 Marfan syndrome patients and 73 controls were enrolled. In Marfan syndrome eyes, the cornea was flatter (mean keratometry, 40.86 ± 2.13 vs 42.55 ± 1.55 diopters in control eyes, p < .001) and corneal astigmatism was greater (1.50 ± 1.22 vs 0.88 ± 0.49 diopters in control eyes, p < .001). The central cornea was thinner in Marfan syndrome eyes (537.35 ± 40.64 vs 552.95 ± 38.57 μm, p = 0.007) and Marfan syndrome eyes were more myopic than control eyes (spherical equivalent, -2.77 ± 4.77 vs -0.64 ± 1.92 diopters, p < .001). Visual acuity was reduced (logMAR 0.11 ± 0.17 vs 0.04 ± 0.26, p = 0.014) and intraocular pressure was lower in Marfan syndrome eyes. Iris transillumination defects were more common in Marfan syndrome eyes (19.6% vs 4.3% in control eyes, odds ratio for Marfan syndrome in the presence of iris transillumination defects = 7.2). Ectopia lentis was only found in Marfan syndrome eyes (25 Marfan syndrome patients, 49% with available data, bilateral in 68%). CONCLUSION: Iris transillumination defects and ectopia lentis are characteristic ocular findings in children and adolescents with Marfan syndrome. Myopia is more common and corneal curvature, central corneal thickness, and visual acuity are reduced in Marfan syndrome eyes. Children with Marfan syndrome need regular comprehensive eye examinations to identify potential complications.
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Affiliation(s)
- Daniel J Salchow
- 1 Department of Ophthalmology, Charité-University Medicine Berlin, Berlin, Germany
| | - Petra Gehle
- 2 Department of Cardiology, Charité-University Medicine Berlin, Berlin, Germany
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165
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Myopia Progression Risk: Seasonal and Lifestyle Variations in Axial Length Growth in Czech Children. J Ophthalmol 2018; 2018:5076454. [PMID: 29692929 PMCID: PMC5859838 DOI: 10.1155/2018/5076454] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 02/06/2018] [Indexed: 11/30/2022] Open
Abstract
The growth in the prevalence of myopia leads to the growth of socioeconomic stress in society. It is important to detect any potential risk factors leading to myopia onset and progression. Among the potential risk factors, the lack of natural daylight exposure and the lack of the physical activity together with excess of near-work activities in children are the most prevalent. In the study, the axial length growth depending on the season and the type of behaviour was measured. The assessment was performed in 12-year-old children, 398 eyes of whom were included and measured during the winter and summer period. The children were categorized by the amount of time spent on near-work, physical, and outdoor activity. Results. Statistically significantly higher (p < 0.0001) axial length growth was observed during the winter period. Statistically significantly (p < 0.0001) more frequently, the eyeball growth has been proved during the winter season. According to the way of spending leisure time, no statistically significant difference was reported within the individual subgroups in the development of the eyeball length during the observed period. However, statistically significant differences were ascertained in the eyeball initial length within various groups. Conclusion. The lack of daylight exposure may lead to myopia progression.
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166
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Hoover KC. Sensory Disruption in Modern Living and the Emergence of Sensory Inequities. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2018; 91:53-62. [PMID: 29599658 PMCID: PMC5872642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Modern lifestyles are disrupting the human senses-primarily sight, sound, and smell. Noise-induced hearing loss has been noted for centuries and increasing over time following the industrial era. From the mid-20th century, the numbers of individuals with myopia (the leading visual impairment) have been increasing globally. Historical evidence for olfactory dysfunction is not known but its etiological links to pollution suggest it increased following industrialization. Clinical interventions for sight and sound loss include preventative and corrective measures but none exist for olfactory dysfunction. Further, olfactory loss is linked to multiple negative health outcomes across physical, mental, and social domains. Due to the global rates of exposure to pollution, olfaction is a global health concern. The environmental injustice inherent in human society (locally and globally) results in inequitable risk for sensory loss by the most vulnerable populations and creates an even deeper gradient in health disparity. Situated within the environmental justice and health disparity literature, this paper introduces the term sensory inequity to describe variation in sensory environments based on socio-economic status (which is often entwined with race and education). A key challenge to risk management is awareness of sensory inequity experienced by vulnerable populations and incorporating that awareness into basic research and policy.
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Affiliation(s)
- Kara C. Hoover
- Department of Anthropology, University of Alaska, Fairbanks, AK
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167
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Tai ELM, Ling JL, Gan EH, Adil H, Wan-Hazabbah WH. Comparison of peripapillary retinal nerve fiber layer thickness between myopia severity groups and controls. Int J Ophthalmol 2018; 11:274-278. [PMID: 29487819 DOI: 10.18240/ijo.2018.02.16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 10/23/2017] [Indexed: 12/21/2022] Open
Abstract
AIM To compare the peripapillary retinal nerve fiber layer (RNFL) thickness measured via optical coherence tomography (OCT) between different groups of myopia severity and controls. METHODS This was a prospective cross-sectional study. All subjects underwent a full ophthalmic examination, refraction, visual field analysis and A-scan biometry. Myopic patients were classified as low myopia (LM) [spherical equivalent (SE) from greater than -0.5 D, up to -3.0 D], moderate myopia (MM; SE greater than -3.0 D, up to -6.0 D) and high myopia (HM; SE greater than -6.0 D). The control group consisted of emmetropic (EM) patients (SE from +0.5 D to -0.5 D). A Zeiss Cirrus HD-OCT machine was used to measure the peripapillary RNFL thickness of both eyes of each subject. The mean peripapillary RNFL thickness between groups was compared using both analysis of variance and analysis of covariance. RESULTS A total of 403 eyes of 403 subjects were included in this study. The mean age was 31.48±10.23y. There were 180 (44.7%) eyes with EM, 124 (30.8%) with LM, 73 (18.1%) with MM and 26 (6.5%) with HM. All groups of myopia severity had a thinner average RNFL than the EM group, but after controlling for gender, age, and axial eye length, only the HM group differed significantly from the EM group (P=0.017). Likewise, the superior, inferior and nasal RNFL was thinner in all myopia groups compared to controls, but after controlling for confounders, only the inferior quadrant RNFL was significantly thinner in the HM group, when compared to the EM group (P=0.017). CONCLUSION The average and inferior quadrant RNFL is thinner in highly myopic eyes compared to emmetropic eyes. Refractive status must be taken into consideration when interpreting the OCT of myopic patients, as RNFL thickness varies with the degree of myopia.
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Affiliation(s)
- Evelyn Li Min Tai
- Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.,Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Jiunn Loong Ling
- Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.,Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Eng Hui Gan
- Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.,Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Hussein Adil
- Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.,Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Wan-Hitam Wan-Hazabbah
- Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.,Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
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168
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Yamashita T, Terasaki H, Yoshihara N, Kii Y, Uchino E, Sakamoto T. Relationship between retinal artery trajectory and axial length in Japanese school students. Jpn J Ophthalmol 2018; 62:315-320. [PMID: 29442204 DOI: 10.1007/s10384-018-0572-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 12/17/2017] [Indexed: 01/18/2023]
Abstract
PURPOSE The trajectories of the supratemporal and infratemporal retinal arteries are associated with the position of the nerve fiber layer defects of glaucomatous eyes. However, no reports have thus far been published on changes in the retinal artery trajectory (RA trajectory) along with growth. Thus, the purpose of this study was to investigate the differences in the RA trajectories of elementary and junior high school students and the associations with axial length (AL). STUDY DESIGN Prospective cross-sectional observational study. METHODS In total, 122 right eyes of healthy elementary school students (61 boys, 61 girls) and 170 right eyes of healthy junior high school students (83 boys, 87 girls) were studied. The AL was measured and color fundus photographs were taken, and used for the analysis. The RA trajectory was plotted in the color fundus photographs and fitted to a second-degree polynomial equation, [Formula: see text], using ImageJ. The coefficient "a" represented the steepness of the trajectories. The differences in the RA trajectories and ALs of elementary and junior high school students were determined using the Mann-Whitney test. The association between the RA trajectory and AL was determined using the Spearman rank correlation. RESULTS The AL and the RA trajectory of the junior high school students were significantly greater than those of the elementary school students (P < 0.001). The RA trajectory was significantly associated with the AL in both elementary (r = 0.26, P = 0.005) and junior high (r = 0.32, P < 0.001) school students. CONCLUSIONS Junior high school students have a longer AL and narrower RA trajectory than do elementary school students. A longer AL is associated with a narrower RA trajectory in both elementary and junior high school students.
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Affiliation(s)
- Takehiro Yamashita
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, 890-0075, Japan
| | - Hiroto Terasaki
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, 890-0075, Japan
| | - Naoya Yoshihara
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, 890-0075, Japan
| | - Yuya Kii
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, 890-0075, Japan
| | - Eisuke Uchino
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, 890-0075, Japan
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, 890-0075, Japan.
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169
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Early Intervention and Nonpharmacological Therapy of Myopia in Young Adults. J Ophthalmol 2018; 2018:4680603. [PMID: 29576878 PMCID: PMC5822817 DOI: 10.1155/2018/4680603] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 12/13/2017] [Indexed: 02/08/2023] Open
Abstract
Myopia is a condition of the eye where parallel rays focus in front of, instead of on, the retina, which results in excessive refractive power of the cornea or the lens or eyeball elongation. Studies carried out in recent years show that the etiology of myopia is complex with genetic and environmental factors playing a role. Refraction defects decrease the quality of vision, while progressing myopia can lead to partial loss of vision, which can be particularly dramatic in young adults. Therefore, it is so crucial to take appropriate actions aimed at preventing myopia progression. This is a review of nonpharmacological therapeutic possibilities of refraction defect prevention in young adults, with special regard to myofascial therapy, osteopathy, and massage of acupuncture points surrounding the eye.
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170
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Ruiz-Pomeda A, Pérez-Sánchez B, Valls I, Prieto-Garrido FL, Gutiérrez-Ortega R, Villa-Collar C. MiSight Assessment Study Spain (MASS). A 2-year randomized clinical trial. Graefes Arch Clin Exp Ophthalmol 2018; 256:1011-1021. [PMID: 29396662 DOI: 10.1007/s00417-018-3906-z] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 12/05/2017] [Accepted: 01/10/2018] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To compare myopia progression in children randomized to MiSight contact lenses (CLs) versus children corrected with single-vision spectacles (SV) over a 2-year period. METHODS Subjects aged 8 to 12 with myopia (-0.75 to -4.00 D sphere) and astigmatism (< -1.00 D cylinder) were assigned to the lens study group (MiSight) or the control group (single vision). Measurements of visual acuity and subjective refraction were taken at 6-month intervals, and axial length, anterior chamber, corneal power, and cycloplegic autorefraction were measured at the baseline, 12-month, and 24-month visits. RESULTS Eighty-nine subjects were recruited. Forty-fix children were assigned to the MiSight group, and 33 to the single-vision spectacle group. In total, 74 children completed the clinical trial, with the following parameters at the beginning of the study: n = 41 in the MiSight group (age: 11.01 ± 1.23 years, spherical equivalent: -2.16 ± 0.94 D, gender: male: 21, female: 20) and n = 33 in the single-vision group (age: 10.12 ± 1.38 years, spherical equivalent: -1.75 ± 0.94 D, gender: male: 12, female: 21). After 2 years of follow-up, myopia progressed slowly in the MiSight group compared to the control group (0.45 D vs 0.74 D, p < 0.001) and there was less axial elongation in the MiSight group compared to the single-vision group (0.28 mm vs 0.44 mm, p < 0.001). Therefore, use of MiSight CLs produced lower myopia progression (39.32%) and lower axial growth of the eye (36.04%) at 2 years compared to spectacle use. CONCLUSIONS MiSight contact lens wear reduces axial elongation and myopia progression in comparison to distance single-vision spectacles in children. ClinicalTrials.gov Identifier: NCT01917110.
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Affiliation(s)
- Alicia Ruiz-Pomeda
- Department of Pharmacy, Biotechnology, Optics and Optometry, European University of Madrid, C/Tajo s/n, Villaviciosa de Odón, 28670, Madrid, Spain.
| | - Belén Pérez-Sánchez
- Department of Statistics, Mathematics and Informatics. Area of Languages and Computer Systems, Miguel Hernández University of Elche, Elche, Alicante, Spain
| | | | | | | | - César Villa-Collar
- Doctoral and Research School, European University of Madrid, Madrid, Spain
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171
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Nowak MS, Jurowski P, Grzybowski A, Smigielski J. Characteristics of Refractive Errors in a Population of Adults in the Central Region of Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15010090. [PMID: 29316688 PMCID: PMC5800189 DOI: 10.3390/ijerph15010090] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 12/19/2017] [Accepted: 01/06/2018] [Indexed: 01/30/2023]
Abstract
Background: To investigate the distribution of refractive errors and their characteristics in older adults from a Polish population. Methods: The study design was a cross-sectional study. A total of 1107 men and women were interviewed and underwent detailed ophthalmic examinations, 998 subjects underwent refraction. Myopia was defined as spherical equivalent (SER) refraction ≤−0.5 dioptres (D) and hyperopia was defined as SER ≥+0.5 dioptres (D). Results: Among those who were refracted the distribution of myopia and hyperopia was 24.1% (95% CI 21.4–26.7) and 37.5% (95% CI 34.5–40.5), respectively. Myopia decreased from 28.7% in subjects aged 35–59 years to 19.3% in those aged 60 years or older and hyperopia increased from 21.8% at 35–59 years of age to 53.3% in subjects aged ≥60 years. Multiple regression analysis showed decreasing age (OR 0.98, 95% CI 0.96–1.00), female gender (OR 1.87, 95% CI 1.18–2.95) and presence of cataract (OR 2.40, 95% CI 1.24–4.63) were independent risk factors associated with myopia. Conclusions: The distribution of refractive errors found in our study is similar to those reported in other Caucasian populations and differs from Asian populations. Myopia was positively associated with younger age, female gender and presence of cataract.
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Affiliation(s)
- Michal S Nowak
- Provisus Eye Clinic, 112 Redzinska str., 42-209 Czestochowa, Poland.
| | - Piotr Jurowski
- Department of Ophthalmology and Visual Rehabilitation, Medical University of Lodz, 113 Zeromskiego str., 90-549 Lodz, Poland.
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, 30 Warszawska str., 10-082 Olsztyn, Poland.
| | - Janusz Smigielski
- Department of Statistics, State University of Applied Science in Konin, 1 Przyjazni str., 65-510 Konin, Poland.
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172
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Moon TH, Choi DG, Bae SH, Choi MY. Comparison of Clinical Features among Children of Multicultural Families, Ethnic Koreans and Native Koreans. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.9.854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Tae Hwan Moon
- Department of Ophthalmology, Chungbuk National University College of Medicine, Cheongju, Korea
- Medical Research Institute, Chungbuk National University, Cheongju, Korea
| | - Dong Gyu Choi
- Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Seok Hyun Bae
- Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Mi Young Choi
- Department of Ophthalmology, Chungbuk National University College of Medicine, Cheongju, Korea
- Medical Research Institute, Chungbuk National University, Cheongju, Korea
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173
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Pan CW, Wu RK, Liu H, Li J, Zhong H. Types of Lamp for Homework and Myopia among Chinese School-Aged Children. Ophthalmic Epidemiol 2017; 25:250-256. [PMID: 29281362 DOI: 10.1080/09286586.2017.1420204] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE We aim to determine the association of the types of lamp for homework including incandescent lamp, fluorescent lamp, and light-emitting diode (LED) lamp with the prevalence of myopia in Chinese children. METHODS 2346 grade 7 students from ten middle schools (93.5% response rate) aged 13 to 14 years in Mojiang, a small county located in Southwestern China, participated in the study. Refractive error was measured with cycloplegia using an autorefractor by optometrists or trained technicians. An IOL Master was used to measure ocular biometric parameters including axial length (AL). Information regarding the types of lamp for homework af``ter schools was collected by questionnaires. RESULTS Of all the study participants, 693 (29.5%) were affected by myopia, with the prevalence estimates being higher in girls (36.8%; 95% confidence interval [CI]: 34.0, 39.6) than in boys (22.8%; 95% CI: 20.4, 25.1) (P < 0.001). After adjusting for potential confounders such as gender, height, parental history of myopia, time on computer use, time on watching TV, time outdoors, and time on reading and writing, participants using LED lamps for homework had a more myopic refractive error and a longer AL compared with those using incandescent or fluorescent lamps. There were no significant differences in myopia prevalence between children using incandescent and fluorescent lamps for homework. The population attributable risk percentage for myopia associated with using LED lamps for homework after schools was 11.2%. CONCLUSIONS Using LED lamps for homework after schools might contribute to the development of myopia among school-aged children.
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Affiliation(s)
- Chen-Wei Pan
- a School of Public Health , Medical College of Soochow University , Suzhou , China
| | - Rong-Kun Wu
- a School of Public Health , Medical College of Soochow University , Suzhou , China
| | - Hu Liu
- b Department of Ophthalmology , The First Affiliated Hospital with Nanjing Medical University , Nanjing , China
| | - Jun Li
- c Department of Ophthalmology , The Second People's Hospital of Yunnan Province , Kunming , China
| | - Hua Zhong
- d Department of Ophthalmology , The First Affiliated Hospital of Kunming Medical University , Kunming , China
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174
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Pan CW, Qiu QX, Qian DJ, Hu DN, Li J, Saw SM, Zhong H. Iris colour in relation to myopia among Chinese school-aged children. Ophthalmic Physiol Opt 2017; 38:48-55. [DOI: 10.1111/opo.12427] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 10/27/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Chen-Wei Pan
- School of Public Health; Medical College of Soochow University; Suzhou China
| | - Qin-Xiao Qiu
- School of Public Health; Medical College of Soochow University; Suzhou China
| | - Deng-Juan Qian
- School of Public Health; Medical College of Soochow University; Suzhou China
| | - Dan-Ning Hu
- New York Eye and Ear Infirmary at Mount Sinai; Icahn School of Medicine at Mount Sinai; New York USA
| | - Jun Li
- Department of Ophthalmology; the Second People's Hospital of Yunnan Province; Kunming China
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health; National University of Singapore; Singapore City Singapore
| | - Hua Zhong
- Department of Ophthalmology; the First Affiliated Hospital of Kunming Medical University; Kunming China
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175
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Campbell IC, Hannon BG, Read AT, Sherwood JM, Schwaner SA, Ethier CR. Quantification of the efficacy of collagen cross-linking agents to induce stiffening of rat sclera. J R Soc Interface 2017; 14:rsif.2017.0014. [PMID: 28381643 DOI: 10.1098/rsif.2017.0014] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 03/09/2017] [Indexed: 11/12/2022] Open
Abstract
The concept of scleral stiffening therapies has emerged as a novel theoretical approach for treating the ocular disorders glaucoma and myopia. Deformation of specific regions of the posterior eye is innately involved in the pathophysiology of these diseases, and thus targeted scleral stiffening could resist these changes and slow or prevent progression of these diseases. Here, we present the first systematic screen and direct comparison of the stiffening effect of small molecule collagen cross-linking agents in the posterior globe, namely using glyceraldehyde, genipin and methylglyoxal (also called pyruvaldehyde). To establish a dose-response relationship, we used inflation testing to simulate the effects of increasing intraocular pressure in freshly harvested rat eyes stiffened with multiple concentrations of each agent. We used digital image correlation to compute the mechanical strain in the tissue as a metric of stiffness, using a novel treatment paradigm for screening relative stiffening by incubating half of each eye in cross-linker and using the opposite half as an internal control. We identified the doses necessary to increase stiffness by approximately 100%, namely 30 mM for glyceraldehyde, 1 mM for genipin and 7 mM for methylglyoxal, and we also identified the range of stiffening it was possible to achieve with such agents. Such findings will inform development of in vivo studies of scleral stiffening to treat glaucoma and myopia.
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Affiliation(s)
- Ian C Campbell
- Center for Visual and Neurocognitive Rehabilitation, Rehabilitation Research and Development, Atlanta VA Medical Center, Decatur, GA 30033, USA.,Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30332, USA.,Exponent, Inc., Biomechanics Practice, Atlanta, GA 30326, USA
| | - Bailey G Hannon
- Center for Visual and Neurocognitive Rehabilitation, Rehabilitation Research and Development, Atlanta VA Medical Center, Decatur, GA 30033, USA.,George W. Woodruff Department of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - A Thomas Read
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30332, USA
| | - Joseph M Sherwood
- Department of Bioengineering, Faculty of Engineering, Imperial College London, London SW7 2AZ, UK
| | - Stephen A Schwaner
- George W. Woodruff Department of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - C Ross Ethier
- Center for Visual and Neurocognitive Rehabilitation, Rehabilitation Research and Development, Atlanta VA Medical Center, Decatur, GA 30033, USA .,Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30332, USA.,George W. Woodruff Department of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
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Evidence for the need for vision screening of school children in Turkey. BMC Ophthalmol 2017; 17:230. [PMID: 29197362 PMCID: PMC5712108 DOI: 10.1186/s12886-017-0618-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 11/20/2017] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND In many countries, access to general health and eye care is related to an individual's socioeconomic status (SES). We aimed to examine the prevalence of oculo-visual disorders in children in Istanbul Turkey, drawn from schools at SES extremes but geographically nearby. METHODS Three school-based vision screenings (presenting distance visual acuity, cover test, eye assessment history, colour vision, gross stereopsis and non-cycloplegic autorefraction) were conducted on 81% of a potential 1014 primary-school children aged 4-10 years from two private (high SES) schools and a nearby government (low SES) school in central Istanbul. Prevalence of refractive errors and school-based differences were analysed using parametric statistics (ANOVA). The remaining oculo-visual aspects were compared using non-parametric tests. RESULTS Of the 823 children with mean age 6.7 ± 2.2 years, approximately 10% were referred for a full eye examination (8.2% and 16.3% of private/government schools respectively). Vision had not been previously examined in nearly 22% of private school children and 65% of government school children. Of all children, 94.5% were able to accurately identify the 6/9.5 [LogMAR 0.2] line of letters/shapes with each eye and 86.6% the 6/6 line [LogMAR 0], while 7.9% presented wearing spectacles, 3.8% had impaired colour vision, 1.5% had grossly impaired stereo-vision, 1.5% exhibited strabismus, 1.8% were suspected to have amblyopia and 0.5% had reduced acuity of likely organic origin. Of the 804 without strabismus, amblyopia or organic conditions, 6.0% were myopic ≤ - 0.50DS, 0.6% hyperopic ≥ + 2.00DS, 7.7% astigmatic ≥1.00 DC and 6.2% anisometropic ≥1.00DS. CONCLUSIONS The results highlight the need for general vision screenings for all children prior to school entry given the varied and different pattern of visual problems associated with lifestyle differences in two populations raised in the same urban locale but drawn from different socioeconomic backgrounds.
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Zhou S, Yang L, Lu B, Wang H, Xu T, Du D, Wu S, Li X, Lu M. Association between parents' attitudes and behaviors toward children's visual care and myopia risk in school-aged children. Medicine (Baltimore) 2017; 96:e9270. [PMID: 29384911 PMCID: PMC6392714 DOI: 10.1097/md.0000000000009270] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The purpose of this survey was to determine the association of parents' attitudes and behaviors toward children's visual care with myopia risk in school-aged children.A total of 894 parents of school-aged children were investigated in primary and middle schools in the central and noncentral urban area in Wuhan through stratified cluster random sampling on July, 2015. We analyzed the association by the generalized linear mixed model.The results indicated that children with parents' high expectations of 1.5 or higher on their vision exhibited a decreased risk of myopia compared with 1.0 and 0.5 or lower (OR = 0.49, 95%CI = 0.36-0.67). Children whose parents only paid attention to their vision in junior and senior school and in primary school had an increased myopia risk than that in preschool (OR = 2.12, 95%CI = 1.01-4.45, and OR = 3.11, 95%CI = 1.28-7.58, respectively). Children whose parents ensured for their sufficient sleep had a decreased myopia risk (OR = 0.45, 95%CI = 0.24-0.85). Compared with children whose parents who never adjusted electronic devices' parameters, the odds ratio of sometimes was 0.49 (95%CI = 0.31-0.79), often 0.53 (95%CI = 0.33-0.85), and always 0.44 (95%CI = 0.26-0.75), respectively.Parents' attitudes and behaviors toward children's visual care are significantly associated with the myopia risk in school-aged children. Consequently, efforts should be made to educate parents on how they protect children's vision and reduce their risk of myopia.
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Affiliation(s)
- Shuang Zhou
- Department of Epidemiology and Statistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology
| | - Lihua Yang
- Wuhan Center for Adolescent Poor Vision Prevention & Control
- Wuhan Commission of Experts for the Prevention & Control of Adolescent Poor Vision, Wuhan
| | - Benlin Lu
- Wuhan Commission of Experts for the Prevention & Control of Adolescent Poor Vision, Wuhan
| | - Hexin Wang
- China Innovation and R&D Center, Carl Zeiss (Shanghai) Co., Ltd. ZEISS Group. Shanghai, China
| | - Ting Xu
- Wuhan Center for Adolescent Poor Vision Prevention & Control
| | - Dandan Du
- Department of Epidemiology and Statistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology
| | - Shiqing Wu
- Department of Epidemiology and Statistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology
| | - Xiuxiu Li
- Department of Epidemiology and Statistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology
| | - Meixia Lu
- Department of Epidemiology and Statistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology
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Quantification of Macular Vascular Density Using Optical Coherence Tomography Angiography and Its Relationship with Retinal Thickness in Myopic Eyes of Young Adults. J Ophthalmol 2017; 2017:1397179. [PMID: 29318037 PMCID: PMC5727759 DOI: 10.1155/2017/1397179] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 11/06/2017] [Indexed: 12/13/2022] Open
Abstract
Purpose To quantify macular vascular density using optical coherence tomography angiography (OCTA) and to investigate its relationship with retinal thickness in myopic eyes of young adults. Methods In this cross-sectional study, 268 myopic eyes without pathological changes were recruited and divided into three groups: mild myopia (n = 81), moderate myopia (n = 117), and high myopia (n = 70). Macular vascular density was quantified by OCTA and compared among three groups. Average retinal thickness, central subfield thickness, and macular ganglion cell complex (mGCC) thickness were also evaluated and compared. Correlations among these variables were analyzed. Results There was no statistical difference in superficial (62.3 ± 5.7% versus 62.7 ± 5.9% versus 63.8 ± 5.5%) and deep macular vascular densities (58.3 ± 9.6% versus 59.2 ± 9.3% versus 60.9 ± 7.9%) among mild-myopia, moderate-myopia, and high-myopia groups (both P > 0.05). Superficial and deep macular vascular densities both had correlations with mean arterial pressure. Furthermore, superficial macular vascular density was significantly correlated with mGCC thickness. Conclusions Varying degrees of myopia did not affect macular vascular density in young healthy adults. In addition, superficial macular vascular density, as an independent factor, was positively correlated with mGCC thickness.
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179
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Liu Y, Wang Y, Lv H, Jiang X, Zhang M, Li X. α-adrenergic agonist brimonidine control of experimentally induced myopia in guinea pigs: A pilot study. Mol Vis 2017; 23:785-798. [PMID: 29204068 PMCID: PMC5693025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 11/13/2017] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To investigate the efficacy of α-adrenergic agonist brimonidine either alone or combined with pirenzepine for inhibiting progressing myopia in guinea pig lens-myopia-induced models. METHODS Thirty-six guinea pigs were randomly divided into six groups: Group A received 2% pirenzepine, Group B received 0.2% brimonidine, Group C received 0.1% brimonidine, Group D received 2% pirenzepine + 0.2% brimonidine, Group E received 2% pirenzepine + 0.1% brimonidine, and Group F received the medium. Myopia was induced in the right eyes of all guinea pigs using polymethyl methacrylate (PMMA) lenses for 3 weeks. Eye drops were administered accordingly. Intraocular pressure was measured every day. Refractive error and axial length measurements were performed once a week. The enucleated eyeballs were removed for hematoxylin and eosin (H&E) and Van Gieson (VG) staining at the end of the study. RESULTS The lens-induced myopia model was established after 3 weeks. Treatment with 0.1% brimonidine alone and 0.2% brimonidine alone was capable of inhibiting progressing myopia, as shown by the better refractive error (p=0.024; p=0.006) and shorter axial length (p=0.005; p=0.0017). Treatment with 0.1% brimonidine and 0.2% brimonidine combined with 2% pirenzepine was also effective in suppressing progressing refractive error (p=0.016; p=0.0006) and axial length (p=0.017; p=0.0004). The thickness of the sclera was kept stable in all groups except group F; the sclera was much thinner in the lens-induced myopia eyes compared to the control eyes. CONCLUSIONS Treatment with 0.1% brimonidine alone and 0.2% brimonidine alone, as well as combined with 2% pirenzepine, was effective in inhibiting progressing myopia. The result indicates that intraocular pressure elevation is possibly a promising mechanism and potential treatment for progressing myopia.
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180
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Multiple deprivation, vision loss, and ophthalmic disease in adults: global perspectives. Surv Ophthalmol 2017; 63:406-436. [PMID: 29100897 DOI: 10.1016/j.survophthal.2017.10.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 10/19/2017] [Accepted: 10/19/2017] [Indexed: 12/19/2022]
Abstract
The association between socioeconomic position and morbidity and mortality has long been recognized. We evaluate the evidence for an association between multiple aspects of deprivation and ocular health in a global context. This is a systematic review of studies that evaluated deprivation in the adult population in the context of the major acquired causes of visual loss such as cataract, diabetic eye disease, glaucoma, age-related macular degeneration, and ocular trauma. The search strategy identified relevant studies reported between 1946 and August 2016, with randomized control trials, case-control, cohort, and cross-sectional study designs being selected for inclusion. The studies identified in this review from across the world demonstrate the extent to which the common themes such as low educational attainment and low income may be associated with increased incidence of various sight-threatening conditions and may adversely affect access to specialist assessment and delivery of treatment. Health inequality may always persist, but an increased recognition of the importance of the various impacts of deprivation may empower policy makers to target limited resources to the most vulnerable groups in order to deliver the greatest benefit.
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181
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Axial Length and Ocular Development of Premature Infants without ROP. J Ophthalmol 2017; 2017:6823965. [PMID: 29163989 PMCID: PMC5661099 DOI: 10.1155/2017/6823965] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 07/24/2017] [Accepted: 08/17/2017] [Indexed: 02/07/2023] Open
Abstract
Purpose To investigate the ocular parameters of premature infants without ROP at gestational age (GA) more than 28 weeks and their relationship with growth parameters. Methods 76 preterm infants without ROP and 65 term infants were involved to undergo portable slit lamp, RetCam3, ultrasonic A-scan biometry, and cycloplegic streak examination at their 40 weeks' postconceptional ages (PCA). Ocular parameters of infants' right eye and growth parameters were used for analysis. Results All the infants were examined at 40 weeks' PCA. No significant difference was found between male and female in axial length of preterm infants (p = 0.993) and term infants (p = 0.591). Significant differences were found in axial length (AL), anterior chamber depth (ACD), lens thickness (LT), and vitreous depth (VD) between preterm and term infants. No significant correlation was found between AL and spherical equivalent in preterm infants' group. In preterm group, AL was significantly correlated with gestational age (GA), birth weight (BW), and head circumference (HC). Conclusions Preterm infants had shorter AL, shallow ACD, thicker LT, and thinner VD compared to term infants. Refractive error in preterm infants at GA between 28 to 37 weeks was not related to axial length. Among all the growth parameters of preterm infants, GA, BW, and HC had effect on axial length.
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182
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Chang LC, Liao LL, Chen MI, Niu YZ, Hsieh PL. Strengthening teachers' abilities to implement a vision health program in Taiwanese schools. HEALTH EDUCATION RESEARCH 2017; 32:437-447. [PMID: 28931170 DOI: 10.1093/her/cyx057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 07/18/2017] [Indexed: 06/07/2023]
Abstract
We designed a school-based, nationwide program called the 'New Era in Eye Health' to strengthen teacher training and to examine whether the existence of a government vision care policy influenced teachers' vision care knowledge and students' behavior. Baseline data and 3-month follow-up data were compared. A random sample of teachers (n = 660) from school vision health clusters in 22 cities/counties in Taiwan were invited to participate in our study and 436 agreed to participate (response rate = 66.1%). The mean age of participant teachers was 41.2 years, while the length of service mean was 14.6 years. For monitoring teacher outcomes, five cities/counties were selected as the intensely monitored group based on certain criteria. Sunlight diaries (n = 5434) were distributed and 3342 (61.5%) were returned. Teachers showed significant improvements in knowledge and behavior on the school vision health questionnaire. At the 3-month follow-up, the number of recesses as recorded by students' 'sunlight diary' increased. When teachers had better knowledge and behavior, recesses also increased. This study provided valuable insights to guide dissemination efforts for school vision health interventions and to help teachers implement research into their school vision health activities.
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Affiliation(s)
- L C Chang
- School of Nursing, Chang Gung University of Science and Technology, No. 261, Wen-Hua 1 Road, Gui-Shan Town, Tao-Yuan City 33303, Taiwan, Republic of China
| | - L L Liao
- Department of Health Management, I-Shou University No. 8, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung, Taiwan, Republic of China
| | - M I Chen
- School of Nursing, Chang Gung University of Science and Technology, No. 261, Wen-Hua 1 Road, Gui-Shan Town, Tao-Yuan City 33303, Taiwan, Republic of China
| | - Y Z Niu
- Sanitary and Health Caring Center, National Chiao Tung University, No. 1001 University Road, Hsinchu, Taiwan 300, Republic of China
| | - P L Hsieh
- School of Nursing, Chang Gung University of Science and Technology, No. 261, Wen-Hua 1 Road, Gui-Shan Town, Tao-Yuan City 33303, Taiwan, Republic of China
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183
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Global and regional estimates of prevalence of refractive errors: Systematic review and meta-analysis. J Curr Ophthalmol 2017; 30:3-22. [PMID: 29564404 PMCID: PMC5859285 DOI: 10.1016/j.joco.2017.08.009] [Citation(s) in RCA: 216] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 08/01/2017] [Accepted: 08/24/2017] [Indexed: 11/22/2022] Open
Abstract
Purpose The aim of the study was a systematic review of refractive errors across the world according to the WHO regions. Methods To extract articles on the prevalence of refractive errors for this meta-analysis, international databases were searched from 1990 to 2016. The results of the retrieved studies were merged using a random effect model and reported as estimated pool prevalence (EPP) with 95% confidence interval (CI). Results In children, the EPP of myopia, hyperopia, and astigmatism was 11.7% (95% CI: 10.5–13.0), 4.6% (95% CI: 3.9–5.2), and 14.9% (95% CI: 12.7–17.1), respectively. The EPP of myopia ranged from 4.9% (95% CI: 1.6–8.1) in South–East Asia to 18.2% (95% CI: 10.9–25.5) in the Western Pacific region, the EPP of hyperopia ranged from 2.2% (95% CI: 1.2–3.3) in South-East Asia to 14.3% (95% CI: 13.4–15.2) in the Americas, and the EPP of astigmatism ranged from 9.8% in South-East Asia to 27.2% in the Americas. In adults, the EPP of myopia, hyperopia, and astigmatism was 26.5% (95% CI: 23.4–29.6), 30.9% (95% CI: 26.2–35.6), and 40.4% (95% CI: 34.3–46.6), respectively. The EPP of myopia ranged from 16.2% (95% CI: 15.6–16.8) in the Americas to 32.9% (95% CI: 25.1–40.7) in South-East Asia, the EPP of hyperopia ranged from 23.1% (95% CI: 6.1%–40.2%) in Europe to 38.6% (95% CI: 22.4–54.8) in Africa and 37.2% (95% CI: 25.3–49) in the Americas, and the EPP of astigmatism ranged from 11.4% (95% CI: 2.1–20.7) in Africa to 45.6% (95% CI: 44.1–47.1) in the Americas and 44.8% (95% CI: 36.6–53.1) in South-East Asia. The results of meta-regression showed that the prevalence of myopia increased from 1993 (10.4%) to 2016 (34.2%) (P = 0.097). Conclusion This report showed that astigmatism was the most common refractive errors in children and adults followed by hyperopia and myopia. The highest prevalence of myopia and astigmatism was seen in South-East Asian adults. The highest prevalence of hyperopia in children and adults was seen in the Americas.
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184
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Morgan IG, French AN, Ashby RS, Guo X, Ding X, He M, Rose KA. The epidemics of myopia: Aetiology and prevention. Prog Retin Eye Res 2017; 62:134-149. [PMID: 28951126 DOI: 10.1016/j.preteyeres.2017.09.004] [Citation(s) in RCA: 612] [Impact Index Per Article: 87.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 09/11/2017] [Accepted: 09/20/2017] [Indexed: 02/06/2023]
Abstract
There is an epidemic of myopia in East and Southeast Asia, with the prevalence of myopia in young adults around 80-90%, and an accompanying high prevalence of high myopia in young adults (10-20%). This may foreshadow an increase in low vision and blindness due to pathological myopia. These two epidemics are linked, since the increasingly early onset of myopia, combined with high progression rates, naturally generates an epidemic of high myopia, with high prevalences of "acquired" high myopia appearing around the age of 11-13. The major risk factors identified are intensive education, and limited time outdoors. The localization of the epidemic appears to be due to the high educational pressures and limited time outdoors in the region, rather than to genetically elevated sensitivity to these factors. Causality has been demonstrated in the case of time outdoors through randomized clinical trials in which increased time outdoors in schools has prevented the onset of myopia. In the case of educational pressures, evidence of causality comes from the high prevalence of myopia and high myopia in Jewish boys attending Orthodox schools in Israel compared to their sisters attending religious schools, and boys and girls attending secular schools. Combining increased time outdoors in schools, to slow the onset of myopia, with clinical methods for slowing myopic progression, should lead to the control of this epidemic, which would otherwise pose a major health challenge. Reforms to the organization of school systems to reduce intense early competition for accelerated learning pathways may also be important.
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Affiliation(s)
- Ian G Morgan
- Division of Biochemistry and Molecular Biology, Research School of Biology, Australian National University, Canberra, ACT, Australia; State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yatsen University, Guangzhou, China.
| | - Amanda N French
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Regan S Ashby
- Centre for Research in Therapeutic Solutions, Biomedical Sciences, Faulty of Education, Science, Technology and Mathematics, University of Canberra, Canberra, Australia
| | - Xinxing Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yatsen University, Guangzhou, China; Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Xiaohu Ding
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yatsen University, Guangzhou, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yatsen University, Guangzhou, China; Centre for Eye Research Australia, University of Melbourne, Parkville, VIC, Australia
| | - Kathryn A Rose
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia
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185
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Gehle P, Goergen B, Pilger D, Ruokonen P, Robinson PN, Salchow DJ. Biometric and structural ocular manifestations of Marfan syndrome. PLoS One 2017; 12:e0183370. [PMID: 28931008 PMCID: PMC5607136 DOI: 10.1371/journal.pone.0183370] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 07/23/2017] [Indexed: 11/29/2022] Open
Abstract
Background To study biometric and structural ocular manifestations of Marfan syndrome (MFS). Methods Observational, retrospective, comparative cohort study in a tertiary referral center on 285 MFS patients and 267 controls. Structural and biometric ocular characteristic were compared. Results MFS eyes were longer (axial length 24.25 ± 1.74 mm versus 23.89 ± 1.31 mm, p < 0.001) and had a flatter cornea than control eyes (mean keratometry 41.78 ± 1.80 diopters (D) versus 43.05 ± 1.51 D, p < 0.001). Corneal astigmatism was greater and the central cornea was thinner in MFS eyes (530.14 ± 41.31 μm versus 547.02 ± 39.18 μm, p < 0.001). MFS eyes were more myopic than control eyes (spherical equivalent -2.16 ± 3.75 D versus -1.17 ± 2.58 D, p < 0.001). Visual acuity was reduced (0.13 ± 0.25 logMAR versus 0.05 ± 0.18 logMAR, p < 0.001) and intraocular pressure was lower in MFS eyes (14.6 ± 3.4 mmHg versus 15.1 ± 3.2 mmHg, p = 0.01). Iris transillumination defects (ITD) were significantly more common in MFS eyes (odds ratio for MFS in the presence of ITD, 3.7). Ectopia lentis (EL) was only present in MFS eyes (33.4%). History of retinal detachment was significantly more common in MFS eyes. Glaucoma was equally common in both groups. Conclusions ITD and EL are most characteristic findings in MFS. ITD and corneal curvature should be studied as diagnostic criteria for MFS. Visual acuity is reduced in MFS. MFS patients need regular eye exams to identify serious ocular complications.
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Affiliation(s)
- Petra Gehle
- Department of Cardiology, Charité –University Medicine Berlin, Augustenburger Platz 1, Berlin, Germany
| | - Barbara Goergen
- Department of Ophthalmology, Charité –University Medicine Berlin, Augustenburger Platz 1, Berlin, Germany
| | - Daniel Pilger
- Department of Ophthalmology, Charité –University Medicine Berlin, Augustenburger Platz 1, Berlin, Germany
| | | | - Peter N. Robinson
- The Jackson Laboratory for Genomic Medicine, Farmington, United States of America
| | - Daniel J. Salchow
- Department of Ophthalmology, Charité –University Medicine Berlin, Augustenburger Platz 1, Berlin, Germany
- * E-mail:
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186
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Harrison WW, Putnam NM, Shukis C, Nguyen E, Reinard K, Hundelt E, Vardanyan G, Gabai C, Yevseyenkov V. The corneal nerve density in the sub-basal plexus decreases with increasing myopia: a pilot study. Ophthalmic Physiol Opt 2017; 37:482-488. [PMID: 28656670 DOI: 10.1111/opo.12366] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 02/01/2017] [Indexed: 12/14/2022]
Abstract
PURPOSE Myopia can cause many changes in the health of the eye. As it becomes more prevalent worldwide, more patients seek correction in the form of glasses, contact lenses and refractive surgery. In this study we explore the impact that high myopia has on central corneal nerve density by comparing sub basal nerve plexus density measured by confocal microscopy in a variety of refractive errors. METHODS Seventy healthy adult subjects between the ages of 21-50 years participated in this study. The study took place in two phases with no overlapping subjects (n = 30 phase 1 and n = 40 phase 2). In both phases an autorefraction, keratometry reading, corneal thickness measure and confocal corneal scan of the sub basal nerve plexus were performed for both eyes. There were 11 hyperopes (+0.50 to +3.50DS), six emmetropes (-0.25 to +0.50DS), 30 low myopes (-5.50 to -0.50DS), and 23 high myopes (-5.50DS and above). In the second phase of the study additional tests were performed including an axial length, additional corneal scans, and a questionnaire that asked about age of first refractive correction and contact lens wear. Corneal nerves were imaged over the central cornea with a Nidek CS4 confocal microscope (460 × 345 μm field). Nerves were evaluated using the NeuronJ program for density calculation. One eye was selected for inclusion based on image quality and higher refractive error (more myopic or hyperopic). RESULTS As myopia increased, nerve density decreased (t1 = 3.86, p < 0.001). We also note a decrease in data scatter above -7 D. The relationship between axial length values and nerve density was also significant and the slope was not as robust as refractive error (t1 = 2.4, p < 0.04). As expected there was a significant difference between the four groups in axial length (F3 = 19.9, p < 0.001) and age of first refractive correction of the myopic groups (14.9 vs 11.5 years; t46 = 2.99 p < 0.01). There was no difference in keratometry readings or corneal thickness between the groups (F3 = 0.6, p = 0.66 and F3 = 1.2, p = 0.33 respectively). CONCLUSION Corneal nerve density in the sub-basal plexus decreased with increasing myopia. This could have implications for corneal surgery and contact lens wear in this patient population.
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Affiliation(s)
- Wendy W Harrison
- Midwestern University Arizona College of Optometry, Glendale, Arizona, USA
| | - Nicole M Putnam
- Midwestern University Arizona College of Optometry, Glendale, Arizona, USA
| | - Christine Shukis
- Midwestern University Arizona College of Optometry, Glendale, Arizona, USA
| | - Evelyn Nguyen
- Midwestern University Arizona College of Optometry, Glendale, Arizona, USA
| | - Kristen Reinard
- Midwestern University Arizona College of Optometry, Glendale, Arizona, USA
| | - Elizabeth Hundelt
- Midwestern University Arizona College of Optometry, Glendale, Arizona, USA
| | - Galina Vardanyan
- Midwestern University Arizona College of Optometry, Glendale, Arizona, USA
| | - Celine Gabai
- Midwestern University Arizona College of Optometry, Glendale, Arizona, USA
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Prousali E, Mataftsi A, Ziakas N, Fontalis A, Brazitikos P, Haidich AB. Interventions to control myopia progression in children: protocol for an overview of systematic reviews and meta-analyses. Syst Rev 2017; 6:188. [PMID: 28893307 PMCID: PMC5594593 DOI: 10.1186/s13643-017-0580-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 09/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Myopia is a common visual disorder with increasing prevalence among developed countries of the world. Myopia constitutes a substantial risk factor for several ocular conditions that can lead to blindness. The purpose of this study is to conduct an overview of systematic reviews and meta-analyses in order to identify and appraise robust research evidence regarding the management of myopia progression in children and adolescents. METHODS A literature search will be conducted in MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effects (DARE), and Health Technology Assessment (HTA) Database via Centre for Reviews and Dissemination (CRD). We will search for systematic reviews or meta-analyses that examine optical or pharmaceutical modalities for myopia control. Two independent overview authors will screen the titles and abstracts against the eligibility criteria. Individual study's methodological quality and quality of evidence for each outcome of interest will be assessed by two independent authors using the ROBIS tool and GRADE rating, respectively. In cases of disagreement, consensus will be reached with the help of a third author. Our primary outcomes will be the mean change in refractive error, mean axial length change, and adverse events. A citation matrix will be generated, and the corrected covered area (CCA) will be estimated, in order to identify overlapping primary studies. Possible meta-biases and measures of heterogeneity will be described, and cases of dual co-authorship will be identified and discussed. If any recently published randomized controlled trials (RCTs) are detected, these will be appraised and their findings will be presented. An overall summary of outcomes will be provided using descriptive statistics and will be supplemented by narrative synthesis. DISCUSSION This overview will examine the high level of existing evidence for treatment of myopia progression. Efficient interventions will be identified, and side effects will be reported. The expected benefit is that all robust recent research evidence will be compiled in a single study. The results may inform future research in this area, which should provide insight into the appropriate regimes for the administration of these modalities and contribute to future guideline development. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017068204.
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Affiliation(s)
| | - Asimina Mataftsi
- IInd Department of Ophthalmology, Aristotle University of Thessaloniki, 56403, Thessaloniki, Greece
| | - Nikolaos Ziakas
- Ist Department of Ophthalmology, Aristotle University of Thessaloniki, 54621, Thessaloniki, Greece
| | | | - Periklis Brazitikos
- IInd Department of Ophthalmology, Aristotle University of Thessaloniki, 56403, Thessaloniki, Greece
| | - Anna-Bettina Haidich
- Department of Hygiene and Epidemiology, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
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188
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Iontophoresis-assisted accelerated riboflavin/ultraviolet A scleral cross-linking: A potential treatment for pathologic myopia. Exp Eye Res 2017; 162:37-47. [DOI: 10.1016/j.exer.2017.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 06/16/2017] [Accepted: 07/05/2017] [Indexed: 12/23/2022]
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189
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Terasaki H, Yamashita T, Yoshihara N, Kii Y, Sakamoto T. Association of lifestyle and body structure to ocular axial length in Japanese elementary school children. BMC Ophthalmol 2017; 17:123. [PMID: 28697750 PMCID: PMC5506696 DOI: 10.1186/s12886-017-0519-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 07/07/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The purpose of this study is to determine whether the lifestyle and body stature are significantly associated with the axial length (AL) of the eyes of Japanese third grade students. METHODS A prospective, cross sectional, observational study was performed on 122 third grade students consisting of 61 boys and 61 girls ages 8 to 9 years. The AL, body height, body weight, and body mass index (BMI) were measured. The lifestyle was determined by activities such as the daily duration of indoor studying, television viewing, use of computers and smart phones, outdoor activity time, bed time, Japanese or Western dietary habits, and parental myopia were investigated by a questionnaire with three or five grade levels. The relationship between AL and the questionnaire variables were analyzed by Spearman's correlation analyses. RESULTS Westernized dietary habits (r = -0.24, P = 0.01), duration of computer and smart phone use (r = 0.24, P = 0.008), parental myopia (r = 0.39, P < 0.001), body weight (r = 0.26, P = 0.005), and BMI (r = 0.23, P = 0.011) were significantly correlated with the AL. Multiple logistic regression analyses showed that the sex [r = -0.48; 95% confidence interval (CI) -0.80 to -0.17, P = 0.003], body weight (r = 0.04; 95% CI 0.02 to 0.07, P = 0.038), westernized dietary habits (r = -0.30; 95% CI -0.55 to -0.05, P = 0.021), and parental myopia (r = 0.40; 95% CI 0.20 to 0.61, P < 0.001) were significantly and independently correlated with the AL. CONCLUSIONS The body weight and parental myopia and westernized dietary habits are factors significantly associated with myopia. Changing from Japanese food style to westernized food style might increase the risk of progression of school myopia.
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Affiliation(s)
- Hiroto Terasaki
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takehiro Yamashita
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Naoya Yoshihara
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yuya Kii
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
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190
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Abstract
Refractive errors are very common and can lead to severe pathological changes in the eye. This article analyzes the epidemiology of refractive errors in the general population in Germany and worldwide and describes common definitions for refractive errors and clinical characteristics for pathologicaal changes. Refractive errors differ between age groups due to refractive changes during the life time and also due to generation-specific factors. Current research about the etiology of refractive errors has strengthened the influence of environmental factors, which led to new strategies for the prevention of refractive pathologies.
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191
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Shah RL, Huang Y, Guggenheim JA, Williams C. Time Outdoors at Specific Ages During Early Childhood and the Risk of Incident Myopia. Invest Ophthalmol Vis Sci 2017; 58:1158-1166. [PMID: 28245296 PMCID: PMC5341622 DOI: 10.1167/iovs.16-20894] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose Time outdoors during childhood is negatively associated with incident myopia. Consequently, additional time outdoors has been suggested as a public health intervention to reduce the prevalence of myopia. We investigated whether there were specific ages during early childhood when the time outdoors versus incident myopia association was strongest. Methods Children participating in the Avon Longitudinal Study of Parents and Children (ALSPAC) were studied from age 2 to 15 years. Parentally reported time outdoors and time spent reading were assessed longitudinally in early childhood (ages 2, 3, 4, 5, 7, and 9 years). Noncycloplegic autorefraction was carried out longitudinally in later childhood (ages 10, 11, 12, and 15 years). Information was available for 2833 participants. Cox proportional hazards regression was used to test for association between time outdoors and incident myopia. Results From 3 years of age onward, greater time outdoors was associated with a reduced risk of incident myopia. The hazard ratio for myopia changed progressively from 0.90 (95% CI 0.83–0.98, P = 0.012) at age 3 years, to 0.86 (95% CI 0.78–0.93, P = 0.001) at age 9 years, for each additional SD of time spent outdoors per day. These associations were independent of two major risk factors for myopia: time reading and number of myopic parents. Conclusions Additional time spent outdoors across the 3 to 9 years age range was associated with a reduced incidence of myopia between ages 10 and 15 years. There was a trend for the association to increase toward the older end of the 3 to 9 years range.
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Affiliation(s)
- Rupal L Shah
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom
| | - Yu Huang
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom 2School of Optometry, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Jeremy A Guggenheim
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom
| | - Cathy Williams
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
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192
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Feng L, Lin H, Chen Y, Wang J, Wang Y, Liao R, Zhou J, Hess RF. The effect of Lasik surgery on myopic anisometropes' sensory eye dominance. Sci Rep 2017; 7:3629. [PMID: 28620156 PMCID: PMC5472567 DOI: 10.1038/s41598-017-03553-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 05/02/2017] [Indexed: 11/09/2022] Open
Abstract
Lasik is a common surgery for treating anisometropia. In this study, we asked a specific question: what’s the effect of Lasik surgery on anisometropes’ sensory eye dominance? Fifteen myopic anisometropes (mean age: 23 ± 6.9 years old; 6 females) participated in our experiment. We quantitatively measured participants’ sensory eye dominance before and after the Lasik surgery using a binocular phase combination paradigm. We found no significant change of sensory eye dominance within 16 weeks (measured between 8 to 96 days, for one or two repetitions) after the surgery (t(14) = −1.44, p = 0.17). A further following on eight patients showed that patients’ two eyes were much more balanced at 16 weeks or more (measured one or two times between 112 to 408 days) after the surgery (t(7) = −3.79, p = 0.007). Our results suggest that the benefit of Lasik surgery on anisometropes’ sensory eye dominance is not immediate, a long-term ‘adaptation’ period (16 weeks or more) is necessary to enable the surgery to be truly effective.
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Affiliation(s)
- Lixia Feng
- Department of Ophthalmology, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, P.R. China.
| | - Huimin Lin
- Department of Ophthalmology, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, P.R. China
| | - Yao Chen
- Department of Ophthalmology, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, P.R. China
| | - Jiafeng Wang
- Department of Ophthalmology, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, P.R. China
| | - Yonghua Wang
- School of Ophthalmology and Optometry and Eye hospital, Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Rongfeng Liao
- Department of Ophthalmology, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, P.R. China
| | - Jiawei Zhou
- School of Ophthalmology and Optometry and Eye hospital, Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China. .,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China.
| | - Robert F Hess
- McGill Vision Research, Dept. Ophthalmology, McGill University, Montreal, PQ, Canada
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193
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Yang J, Reinach PS, Zhang S, Pan M, Sun W, Liu B, Li F, Li X, Zhao A, Chen T, Jia W, Qu J, Zhou X. Changes in retinal metabolic profiles associated with form deprivation myopia development in guinea pigs. Sci Rep 2017; 7:2777. [PMID: 28584257 PMCID: PMC5459838 DOI: 10.1038/s41598-017-03075-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 04/24/2017] [Indexed: 01/02/2023] Open
Abstract
Retinal metabolic changes have been suggested to be associated with myopia development. However, little is known about either their identity or time dependent behavior during this sight compromising process. To address these questions, gas chromatography time-of-flight mass spectrometry (GC-TOF/MS) was applied to compare guinea pig retinal metabolite levels in form deprivation (FD) eyes at 3 days and 2 weeks post FD with normal control (NC) eyes. Orthogonal partial least squares (OPLS) models discriminated between time dependent retinal metabolic profiles in the presence and absence of FD. Myopia severity was associated with more metabolic pattern differences in the FD than in the NC eyes. After 3 days of FD, 11 metabolite levels changed and after 2 weeks the number of differences increased to 16. Five metabolites continuously decreased during two weeks of FD. Two-way ANOVA of the changes identified by OPLS indicates that 15 out of the 22 metabolites differences were significant. Taken together, these results suggest that myopia progression is associated with an inverse relationship between increases in glucose accumulation and lipid level decreases in form-deprived guinea pig eyes. Such changes indicate that metabolomic studies are an informative approach to identify time dependent retinal metabolic alterations associated with this disease.
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Affiliation(s)
- Jinglei Yang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- State Key Laboratory Cultivation Base and Key Laboratory of Vision Science, Ministry of Health, China, and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
| | - Peter S Reinach
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- State Key Laboratory Cultivation Base and Key Laboratory of Vision Science, Ministry of Health, China, and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
| | - Sen Zhang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- State Key Laboratory Cultivation Base and Key Laboratory of Vision Science, Ministry of Health, China, and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
| | - Miaozhen Pan
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- State Key Laboratory Cultivation Base and Key Laboratory of Vision Science, Ministry of Health, China, and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
| | - Wenfeng Sun
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- State Key Laboratory Cultivation Base and Key Laboratory of Vision Science, Ministry of Health, China, and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
| | - Bo Liu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- State Key Laboratory Cultivation Base and Key Laboratory of Vision Science, Ministry of Health, China, and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
| | - Fen Li
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- State Key Laboratory Cultivation Base and Key Laboratory of Vision Science, Ministry of Health, China, and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
| | - Xiaoqing Li
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- State Key Laboratory Cultivation Base and Key Laboratory of Vision Science, Ministry of Health, China, and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
| | - Aihua Zhao
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Tianlu Chen
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Wei Jia
- Shanghai Key Laboratory of Diabetes Mellitus and Center for Translational Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Jia Qu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
- State Key Laboratory Cultivation Base and Key Laboratory of Vision Science, Ministry of Health, China, and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China.
| | - Xiangtian Zhou
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
- State Key Laboratory Cultivation Base and Key Laboratory of Vision Science, Ministry of Health, China, and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China.
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194
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Li Y, Zhang Y, Li P, Mi G, Tu J, Sun L, Webster TJ, Shen Y. Ion-paired pirenzepine-loaded micelles as an ophthalmic delivery system for the treatment of myopia. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2017; 13:2079-2089. [PMID: 28539273 DOI: 10.1016/j.nano.2017.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 04/20/2017] [Accepted: 05/01/2017] [Indexed: 10/19/2022]
Abstract
Myopia is one of the most common ocular disorders for which standard treatments, such as refractive surgery, often involve invasive procedures. Pirenzepine (PRZ), a muscarinic receptor antagonist, has been recognized as a promising candidate for the treatment of myopia, but possesses poor ocular bioavailability. The overall objective of this study was to prepare PRZ-sorbic acid complexes suitable to be encapsulated into micelles with high efficiency for optimal ophthalmic delivery. The results demonstrated that sorbic acid, used as the counter ion, had the most significant effects in increasing the octanol-water distribution coefficient of PRZ as well as improving its corneal permeability in vitro among various counter ions tested. In vivo absorption results showed that a 1.5 times higher bioavailability was achieved by the addition of sorbic acid at a 1:1 ratio. Cytotoxicity studies in vitro and biocompatibility studies in vivo indicated that the micelles did not cause significant toxicities to the eyes.
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Affiliation(s)
- Yanan Li
- State Key Laboratory of Natural Medicines, Department of Pharmaceutics, China Pharmaceutical University, Nanjing, China
| | - Yong Zhang
- Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Pengmei Li
- Department of Pharmacy, China-Japan Friendship Hospital, Beijing, China
| | - Gujie Mi
- Department of Chemical Engineering, Northeastern University, Boston, MA, United States
| | - Jiasheng Tu
- State Key Laboratory of Natural Medicines, Department of Pharmaceutics, China Pharmaceutical University, Nanjing, China
| | - Linlin Sun
- Department of Chemical Engineering, Northeastern University, Boston, MA, United States
| | - Thomas J Webster
- Department of Chemical Engineering, Northeastern University, Boston, MA, United States.
| | - Yan Shen
- State Key Laboratory of Natural Medicines, Department of Pharmaceutics, China Pharmaceutical University, Nanjing, China; Department of Chemical Engineering, Northeastern University, Boston, MA, United States.
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195
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Gomez-Salazar F, Campos-Romero A, Gomez-Campaña H, Cruz-Zamudio C, Chaidez-Felix M, Leon-Sicairos N, Velazquez-Roman J, Flores-Villaseñor H, Muro-Amador S, Guadron-Llanos AM, Martinez-Garcia JJ, Murillo-Llanes J, Sanchez-Cuen J, Llausas-Vargas A, Alapizco-Castro G, Irineo-Cabrales A, Graue-Hernandez E, Ramirez-Luquin T, Canizalez-Roman A. Refractive errors among children, adolescents and adults attending eye clinics in Mexico. Int J Ophthalmol 2017; 10:796-802. [PMID: 28546940 PMCID: PMC5437471 DOI: 10.18240/ijo.2017.05.23] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 01/13/2017] [Indexed: 11/23/2022] Open
Abstract
AIM To assess the proportion of refractive errors in the Mexican population that visited primary care optometry clinics in fourteen states of Mexico. METHODS Refractive data from 676 856 patients aged 6 to 90y were collected from optometry clinics in fourteen states of Mexico between 2014 and 2015. The refractive errors were classified by the spherical equivalent (SE), as follows: sphere+½ cylinder. Myopia (SE>-0.50 D), hyperopia (SE>+0.50 D), emmetropia (-0.50≤SE≤+0.50), and astigmatism alone (cylinder≥-0.25 D). A negative cylinder was selected as a notation. RESULTS The proportion (95% confidence interval) among all of the subjects was hyperopia 21.0% (20.9-21.0), emmetropia 40.7% (40.5-40.8), myopia 24.8% (24.7-24.9) and astigmatism alone 13.5% (13.4-13.5). Myopia was the most common refractive error and frequency seemed to increase among the young population (10 to 29 years old), however, hyperopia increased among the aging population (40 to 79 years old), and astigmatism alone showed a decreasing trend with age (6 to 90y; from 19.7% to 10.8%). There was a relationship between age and all refractive errors (approximately 60%, aged 50 and older). The proportion of any clinically important refractive error was higher in males (61.2%) than in females (58.3%; P<0.0001). From fourteen states that collected information, the proportion of refractive error showed variability in different geographical areas of Mexico. CONCLUSION Myopia is the most common refractive error in the population studied. This study provides the first data on refractive error in Mexico. Further programs and studies must be developed to address the refractive errors needs of the Mexican population.
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Affiliation(s)
| | | | | | | | | | - Nidia Leon-Sicairos
- CIASaP, School of Medicine, Autonomous University of Sinaloa, Culiacan Sinaloa 80246, Mexico
- Pediatric Hospital of Sinaloa, Culiacan Sinaloa 80200, Mexico
| | - Jorge Velazquez-Roman
- CIASaP, School of Medicine, Autonomous University of Sinaloa, Culiacan Sinaloa 80246, Mexico
| | | | - Secundino Muro-Amador
- CIASaP, School of Medicine, Autonomous University of Sinaloa, Culiacan Sinaloa 80246, Mexico
| | | | - Javier J. Martinez-Garcia
- CIASaP, School of Medicine, Autonomous University of Sinaloa, Culiacan Sinaloa 80246, Mexico
- Pediatric Hospital of Sinaloa, Culiacan Sinaloa 80200, Mexico
| | | | - Jaime Sanchez-Cuen
- CIASaP, School of Medicine, Autonomous University of Sinaloa, Culiacan Sinaloa 80246, Mexico
- Department of Gastroenterology, Regional Hospital, ISSSTE, Culiacán 80230, Sinaloa, Mexico
| | - Alejando Llausas-Vargas
- CIASaP, School of Medicine, Autonomous University of Sinaloa, Culiacan Sinaloa 80246, Mexico
| | - Gerardo Alapizco-Castro
- CIASaP, School of Medicine, Autonomous University of Sinaloa, Culiacan Sinaloa 80246, Mexico
- Education and Research Department, Regional general Hospital No. 1, IMSS, Culiacan Sinaloa 80220, Mexico
| | - Ana Irineo-Cabrales
- CIASaP, School of Medicine, Autonomous University of Sinaloa, Culiacan Sinaloa 80246, Mexico
- Department of Gastroenterology, Regional Hospital, ISSSTE, Culiacán 80230, Sinaloa, Mexico
| | - Enrique Graue-Hernandez
- Department of Cornea and Refractive Surgery, Institute of Ophthalmology “Conde de Valenciana”, Mexico City 06800, Mexico
| | - Tito Ramirez-Luquin
- Department of Cornea and Refractive Surgery, Institute of Ophthalmology “Conde de Valenciana”, Mexico City 06800, Mexico
| | - Adrian Canizalez-Roman
- CIASaP, School of Medicine, Autonomous University of Sinaloa, Culiacan Sinaloa 80246, Mexico
- The Women's Hospital, Secretariat of Health, Culiacan Sinaloa 80127, Mexico
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196
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Kandel H, Khadka J, Goggin M, Pesudovs K. Impact of refractive error on quality of life: a qualitative study. Clin Exp Ophthalmol 2017; 45:677-688. [PMID: 28370795 DOI: 10.1111/ceo.12954] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 02/27/2017] [Accepted: 03/24/2017] [Indexed: 11/28/2022]
Abstract
IMPORTANCE This study qualitatively explores the impact of refractive error on adults, particularly after correction. BACKGROUND The study aimed to explore the impact of refractive error on quality of life. DESIGN Cross-sectional; in-depth telephone and face-to-face semistructured interviews; qualitative study with inductive and deductive processes. PARTICIPANTS Forty-eight adults with refractive error (including presbyopia) were recruited from the Flinders Vision, the Ashford Advanced Eye Care and among Flinders University staff and students, in South Australia. METHODS The interviews were audio-recorded, transcribed verbatim, coded and analysed using thematic analysis. MAIN OUTCOME MEASURES Themes and categories RESULTS: The median age of the participants was 49 years (min: 22 years; max: 76 years). Most of them were female: (29; 59%). Most of them (36; 75.0%) had myopia followed by hyperopia (12; 25.0%). Twenty-two (45.8%) participants had astigmatism. Similarly, 23 (47.9%) of them were presbyopes. Most of the participants (39; 81.3%) wore glasses; 17 (35.4%) used contact lenses, and 17 (35.4%) had undergone refractive surgery. A total of 2367 comments were coded. Thematic analysis resulted into six themes that informed about quality of life issues in people with refractive error. Concerns about cosmetic appearance, personal health and safety, difficulties in day-to-day activities and inconveniences rendered in daily life were identified as the most important themes. CONCLUSIONS AND RELEVANCE The findings of this study enrich the understanding on the issues important in people with refractive error. The quality of life issues identified will be used to develop a refractive error-specific item bank.
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Affiliation(s)
- Himal Kandel
- NHMRC Centre for Clinical Eye Research, Flinders University of South Australia, Adelaide, South Australia, Australia
| | - Jyoti Khadka
- NHMRC Centre for Clinical Eye Research, Flinders University of South Australia, Adelaide, South Australia, Australia
| | - Michael Goggin
- University of Adelaide/South Australian Institute of Ophthalmology, Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Konrad Pesudovs
- NHMRC Centre for Clinical Eye Research, Flinders University of South Australia, Adelaide, South Australia, Australia
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197
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Li X, Friedman IB, Medow NB, Zhang C. Update on Orthokeratology in Managing Progressive Myopia in Children: Efficacy, Mechanisms, and Concerns. J Pediatr Ophthalmol Strabismus 2017; 54:142-148. [PMID: 28092397 DOI: 10.3928/01913913-20170106-01] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 10/19/2016] [Indexed: 02/06/2023]
Abstract
Myopia is an important public health issue, and high myopia may lead to severe complications if left untreated. Orthokeratology lenses, worn overnight to reshape the cornea, are one of many recent modalities used to slow down the progression of myopia in children. This treatment has been proven successful, as evidenced by decreased spherical refractive error and axial length relative to the control at interval follow-up ranging from 6 months to 5 years. In this systematic review, the authors collected published controlled studies that analyzed the efficacy of orthokeratology lens wear and calculated longitudinal relative changes in axial length, revealing a weighted average of -45.1% change in axial length at the 2-year follow-up. The exact mechanism by which orthokeratology lenses reduce myopia progression is unknown, but research shows that the corneal reshaping decreases peripheral hyperopic defocus and therefore increases peripheral myopic defocus to likely reduce stimuli for axial elongation and subsequent development of myopia. Use of orthokeratology lenses is generally safe, but cases of associated infectious keratitis may have a higher incidence of virulent organisms such as Pseudomonas, Acanthamoeba, and antibacterial-resistant strains of Staphylococcus, partially due to the required overnight use of these lenses. Orthokeratology is regarded as one of the most effective non-pharmacologic measures to slow progression of myopia in children and, with regular follow-up to ensure safety, continues to be one of the most effective treatments for myopia management around the world. [J Pediatr Ophthalmol Strabismus. 2017;54(3):142-148.].
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Wang L, Du M, Yi H, Duan S, Guo W, Qin P, Hao Z, Sun J. Prevalence of and Factors Associated with Myopia in Inner Mongolia Medical Students in China, a cross-sectional study. BMC Ophthalmol 2017; 17:52. [PMID: 28438126 PMCID: PMC5404280 DOI: 10.1186/s12886-017-0446-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 04/20/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND To further explore characteristics of myopia and changes in factors associated with myopia among students at Inner Mongolia Medical University. METHODS Two cross-sectional censuses were conducted in 2011 and 2013. Participants were medical students residing on campus in 2011 and 2013. Logistic regression analysis was performed to ascertain associations with basic information, genetic factors, environmental factors. The χ2 test was used to test for differences in prevalence between 2011 and 2013. Prevalence was calculated at various myopia occurrence times among different parental myopia statuses. RESULTS A total of 11,138 students enrolled from 2007 to 2012 completed the questionnaire. The prevalence of myopia in 2011 and 2013 was 70.50% and 69.21%, respectively, no statistically significant difference existed between the two censuses (p = 0.12). Both censuses were completed by 1015 students. There were no differences among the various year of study in 2011 or 2013. Myopic prevalence increased with an increased number of myopic parents: the prevalence if both parents were myopic was over 90%, nearly 80% if one parent was myopic, and less than 70% with non-myopic parents (p < 0.001). Myopic occurrence ranked from earliest to latest was in kindergarten and primary school when both parents were myopic, in middle school when one parent was myopic, and in university when no parent was myopic. Students staying up late, using a computer more than 3 h per day, not performing eye exercises, using eye drops, and rubbing the eyes at high risk for myopia. CONCLUSIONS Myopic status was stable during the university period. Genetic factors play a major role in myopia. Protective measures are useful for university students.
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Affiliation(s)
- Lan Wang
- Inner Mongolia Medical University, No. 5, Xinhua Street, Hohhot, Inner Mongolia Autonomous Region, 010110, China
| | - Maolin Du
- Inner Mongolia Medical University, No. 5, Xinhua Street, Hohhot, Inner Mongolia Autonomous Region, 010110, China
| | - He Yi
- Inner Mongolia Medical University, No. 5, Xinhua Street, Hohhot, Inner Mongolia Autonomous Region, 010110, China
| | - Shengyun Duan
- Inner Mongolia Medical University, No. 5, Xinhua Street, Hohhot, Inner Mongolia Autonomous Region, 010110, China
| | - Wenfang Guo
- Inner Mongolia Medical University, No. 5, Xinhua Street, Hohhot, Inner Mongolia Autonomous Region, 010110, China
| | - Peng Qin
- Hohhot University for Nationalities, Hohhot, Inner Mongolia, China
| | - Zhihui Hao
- Inner Mongolia People's Hospital, Hohhot, Inner Mongolia, China
| | - Juan Sun
- Inner Mongolia Medical University, No. 5, Xinhua Street, Hohhot, Inner Mongolia Autonomous Region, 010110, China.
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199
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Fan H, Chen HY, Ma HJ, Chang Z, Yin HQ, Ng DSC, Cheung CY, Hu S, Xiang X, Tang SB, Li SN. Reduced Macular Vascular Density in Myopic Eyes. Chin Med J (Engl) 2017; 130:445-451. [PMID: 28218219 PMCID: PMC5324382 DOI: 10.4103/0366-6999.199844] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Morphological changes of the vasculature system in patients with myopia have been observed by Doppler ultrasound and fundus fluorescein angiography (FFA); however, these studies have limitations. Doppler ultrasound provides low-resolution images which are mainly obtained from visualized large vessels, and FFA is an invasive examination. Optic coherence tomography (OCT) angiography is a noninvasive, high-resolution measurement for vascular density. The purpose of this study was to investigate the change of vascular density in myopic eyes using OCT angiography. METHODS This cross-sectional study includes a total of 91 eyes from 47 participants including control, moderate, and high myopia that were evaluated by OCT angiography. Patients with myopia were recruited from the Refractive Department, Shenzhen Aier Eye Hospital, from August 5, 2015 to April 1, 2016. Emmetropic eyes were from healthy volunteers. The vascular density at macula and optic disc regions, ganglion cell complex (GCC) thickness, and retinal nerve fiber layer (RNFL) thickness were measured. Their relationships with axial length (AL) and refractive error were analyzed. One-way analysis of variance (ANOVA), Pearson's correlation, and generalized estimating equation were used for statistical analysis. RESULTS Both superficial and deep macular vascular density were highest in control (25.64% ± 3.76% and 37.12% ± 3.66%, respectively), then in moderate myopia (21.15% ± 5.33% and 35.35% ± 5.50%, respectively), and lowest in high myopia group (19.64% ± 3.87% and 32.81% ± 6.29%, respectively) (F = 13.74 and 4.57, respectively; both P < 0.001). Both superficial (β = -0.850 and 0.460, respectively) and deep (β = -0.766 and 0.396, respectively) macular vascular density were associated with AL and spherical equivalent (all P < 0.001). Superficial macular vascular density was associated with GCC thickness (β = 0.244, P = 0.040), independent of spherical equivalent. The vascular density in optic disc region had no difference among the three groups, and it was not associated with AL, spherical equivalent, or RNFL thickness. CONCLUSION Our results suggested that with the increase of myopia, the vascular density decreased in macular region, but not in optic disc region.
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Affiliation(s)
- Hua Fan
- Aier School of Ophthalmology, Central South University, Changsha, Hunan 410015, China
| | - Hao-Yu Chen
- Joint Shantou International Eye Center, Shantou, Guangdong 515000, China
| | - Hong-Jie Ma
- Shenzhen Aier Eye Hospital, Shenzhen, Guangdong 518000, China
| | - Zheng Chang
- Shenzhen Aier Eye Hospital, Shenzhen, Guangdong 518000, China
| | - Hai-Quan Yin
- Shenzhen Aier Eye Hospital, Shenzhen, Guangdong 518000, China
| | - Danny Siu-Chun Ng
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Shan Hu
- Aier School of Ophthalmology, Central South University, Changsha, Hunan 410015, China
| | - Xiang Xiang
- Aier School of Ophthalmology, Central South University, Changsha, Hunan 410015, China
| | - Shi-Bo Tang
- Aier School of Ophthalmology, Central South University, Changsha, Hunan 410015, China
| | - Shuang-Nong Li
- Shenzhen Aier Eye Hospital, Shenzhen, Guangdong 518000, China
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200
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Hsu CC, Huang N, Lin PY, Fang SY, Tsai DC, Chen SY, Tsai CY, Woung LC, Chiou SH, Liu CJL. Risk factors for myopia progression in second-grade primary school children in Taipei: a population-based cohort study. Br J Ophthalmol 2017; 101:1611-1617. [PMID: 28315834 DOI: 10.1136/bjophthalmol-2016-309299] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 02/28/2017] [Accepted: 03/08/2017] [Indexed: 11/03/2022]
Abstract
PURPOSE To evaluate the 1-year progression of myopia and associated risk factors in second-grade primary school children. METHODS The myopia investigation study in Taipei provided semiannual visual acuity testing and cycloplegic refraction for all second-grade primary school children (mean age: 7.49 years) in Taipei who provided parental consent. A questionnaire was distributed to the participants' parents before the first and third examinations. We evaluated 1-year follow-up data for children noted to have myopia on the first examination. Multinomial logistic regression models were applied to assess risk factors associated with myopia progression. Myopia progression was categorised, based on the change in spherical equivalent (ΔSE) over 1 year, as slow (ΔSE>-0.5 dioptres (D)), moderate (-1.0 D<ΔSE≤-0.5 D) or fast (ΔSE≤-1.0 D). Of the 4214 myopic children, data were analysed for 3256 (77.3%) who completed the 1-year follow-up evaluation. RESULTS The baseline SE was -1.43±1.1 D. The average ΔSE was -0.42±0.85 D, with 46.96%, 28.50% and 24.54% of the study subjects showing slow, moderate and fast myopia progression, respectively. When compared with slow myopia progression, fast myopia progression was associated with a greater myopic SE at baseline (OR: 0.67, 95% CI: 0.61 to 0.72) and a shorter eye-object distance when doing near work (OR: 1.45, 95% CI: 1.18 to 1.78). More outdoor activity time and self-reported cycloplegic treatment were not associated with slow myopia progression. CONCLUSIONS Children with fast annual myopia progression were more myopic at baseline and had a shorter reading distance. Our study results highlight the importance of having children keep a proper reading distance.
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Affiliation(s)
- Chih-Chien Hsu
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Nicole Huang
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Yu Lin
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Shao-You Fang
- Institution of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Der-Chong Tsai
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Ophthalmology, National Yang-Ming University Hospital, I-Lan, Taiwan
| | - Shing-Yi Chen
- Department of Health, Taipei City Government, Taipei, Taiwan
| | - Ching-Yao Tsai
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan
| | - Lin-Chung Woung
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan
| | - Shih-Hwa Chiou
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan
| | - Catherine Jui-Ling Liu
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
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