Monochromatic aberrations of the human eye in a large population

Estimating the eye aberration coefficients in resized pupils: is it better to refit or to rescale?

In order to work in a consistent way with Zernike aberration coefficients estimated in different pupils, it is necessary to refer them to a common pupil size. Two standard approaches can be used to that end: to rescale algebraically the coefficients estimated in the original pupil or to refit them anew using the wavefront slope measurements available within the new one. These procedures are not equivalent; they are affected by different estimation errors that we address in this work. Our results for normal eye populations show that in case of reducing the pupil size it is better to rescale the original coefficients than to refit them using the measurements contained within the smaller pupil. In case of enlarging the pupil size, as it can a priori be expected, the opposite holds true. We provide explicit expressions to quantify the errors arising in both cases, including the expected error incurred when extrapolating the Zernike estimation beyond the radius where the measurements were made.

Validation of metrics for the detection of subclinical keratoconus in a new patient collective

PURPOSE

To validate the discriminative ability of wavefront- and pachymetry-based corneal topographic metrics to detect subclinical keratoconus in a new patient collective.

SETTING

Department of Ophthalmology, Goethe-University, Frankfurt am Main, Germany.

DESIGN

Retrospective cross-sectional study.

METHODS

Normal fellow eyes with early keratoconus and preoperative eyes with an uneventful follow-up without signs of iatrogenic keratectasia 12 months after laser in situ keratoconus were included. Zernike coefficients from the anterior and posterior surfaces and corneal thickness spatial profiles and corresponding discriminant functions were assessed for their usefulness to discriminate between eyes with subclinical keratoconus and normal eyes using receiver-operating-characteristic (ROC) curve analysis. Discriminant functions were obtained from a previous study and constructed de novo from the present collective.

RESULTS

The anterior C(1,-1) and C(3,-1) coefficients had the highest area under the ROC curve (both 0.87). The anterior 5th-order root mean square (RMS) was the RMS value with the maximum area under the ROC curve (0.90). The discriminant function with input from anterior and posterior Zernike coefficients (DAP) and DAP including pachymetry data (DAPT) performed best (area under ROC curve 0.864 and 0.857, respectively). Applying cutoff values from a previous study resulted in a minimal drop in accuracy (0.0% to 1.3%). The construction of discriminant functions from the present dataset resulted in a gain in accuracy of between 3.5% and 9.6%, with DAPT reaching the maximum area under the ROC curve of 0.956.

CONCLUSION

Validation in a new and larger patient collective proved the usefulness of metrics based on corneal wavefront and pachymetry for the detection of subclinical keratoconus.

FINANCIAL DISCLOSURE

No author has a financial or proprietary interest in any material or method mentioned.

Preoperative topographic characteristics of eyes that developed postoperative LASIK keratectasia

PURPOSE

To assess the suitability of corneal anterior and posterior surface aberrations and pachymetry profile data to discriminate between eyes that later developed postoperative LASIK iatrogenic keratectasia and eyes that remained stable.

METHODS

Ten eyes of five patients that later developed iatrogenic keratectasia and 245 control eyes of 245 patients with a stable postoperative LASIK follow-up of 12 months or more were included. Zernike coefficients from anterior and posterior cornea, data from corneal pachymetry profiles, and output values of discriminant functions (input from Zernike coefficients, pachymetry data, and age) were assessed for their usefulness to discriminate between preoperative eyes with iatrogenic keratectasia eyes and controls using receiver operator characteristic (ROC) curve analysis. Furthermore, Randleman Ectasia Risk Scores were calculated for each eye.

RESULTS

Anterior horizontal coma (C3(1)) was the coefficient with highest discriminative ability (area under the ROC curve [AZROC] = 0.819). For posterior coefficients and pachymetry data, AZROC values were lower. Constructing discriminant functions increased AZROC values. The function containing anterior and posterior Zernike coefficients, pachymetry data, and age reached an AZROC of 0.991. The other functions ranged from 0.858 (pachymetry) to 0.981 (anterior and posterior Zernike coefficients and age). With the Randleman Ectasia Risk Scores, 80.4% were classified correctly if eyes with 4 points or more were excluded from treatment (87.1% for 3 points or more).

CONCLUSIONS

Preoperative corneal topographic characteristics of eyes that developed iatrogenic keratectasia were different than those of eyes that remained stable. However, topography patterns were not identical with those found in eyes with subclinical keratoconus in previous studies. Discriminant functions from Zernike coefficients and pachymetry data were useful to discriminate between normal eyes and eyes with preoperative iatrogenic keratectasia.

Diurnal variations in ocular aberrations of human eyes

PURPOSE

To investigate the diurnal variations in ocular wavefront aberrations over two consecutive days in young adult subjects.

MATERIALS AND METHODS

Measurements of both lower-order (sphero-cylindrical refractive powers) and higher-order (third and fourth-order aberration terms) ocular aberrations were collected for 30 young adult subjects at 10 different times over two consecutive days using a Hartmann-Shack aberrometer. Seventeen subjects were myopic and 13 were emmetropic. Five sets of measurements were collected each day at approximately 3 hourly intervals, with the first measurement taken at ∼9 am and the final measurement at ∼9 pm.

RESULTS

Spherical equivalent refraction (p = 0.029) and spherical aberration (p = 0.043) were both found to undergo significant diurnal variation over the two measurement days. The spherical equivalent was typically found to be at a maximum (i.e. most hyperopic) at the morning measurement, with a small myopic shift of 0.37 ± 0.15 D observed over the course of the day. The mean spherical aberration of all subjects (0.038 ± 0.048 μm) was found to be positive during the day and gradually became more negative into the evening, with a mean amplitude of change of 0.036 ± 0.02 μm. None of the other considered sphero-cylindrical refractive power components or higher-order aberrations exhibited significant diurnal variation over the two days of the experiment (p > 0.05). Except for the lower-order astigmatism at 90/180 degree (p = 0.040), there were no significant differences between myopes and emmetropes in the magnitude and timing of the observed diurnal variations (p > 0.05).

CONCLUSIONS

Significant diurnal variations in spherical equivalent and spherical aberration were consistently observed over two consecutive days of measurement. Research and clinical applications requiring precise refractive error and wavefront measurements should take these diurnal changes into account when interpreting wavefront data.

Template-based correction of high-order aberration in keratoconus

PURPOSE

The common change in corneal morphology that is seen in keratoconus (KC) suggests the presence of common high-order aberration (HOA) structures and the potential for HOA corrections that apply to more than one eye. The purpose of this investigation is to classify a sample of KC eyes into subgroups based on similar HOA characteristics and simulate optical performance of common HOA corrections on members of each subgroup.

METHODS

High-order aberrations were recorded over a 5-mm pupil on 111 KC eyes. The eyes were divided into five subgroups based on observed commonality in HOA structure. From each subgroup, two eyes were removed for later evaluation of corrections. Principal components analysis was performed on the remaining eyes of each subgroup. The first principal component was scaled to form a set of corrections. Simulated optical correction of the test eyes was performed by identifying the magnitude of the inner-group correction providing the lowest level of residual higher order root mean square wavefront error (HORMS). Residual uncorrected HORMS was compared with levels found in uncorrected normal eyes and KC eyes wearing rigid gas-permeable corrections.

RESULTS

Ninety (81%) of the 111 eyes were included in one of the five subgroups. All 10 test eyes experienced a reduction in HORMS with a template correction compared with their uncorrected levels. Median HORMS reduced from uncorrected levels of 2.14 to 0.97 μm. On average, the 10 subjects experienced a 51% reduction in HORMS (minimum, 16%; maximum, 81%; p < 0.01). When scaled to a 4-mm pupil, five of the 10 eyes experienced residual uncorrected HORMS within limits associated with gas-permeable wear.

CONCLUSIONS

Overlap exists across these templates because of the dominance of vertical coma in the HOA structure. All eyes evaluated received reduced HORMS with a template-based correction.

Wavefront-guided scleral lens prosthetic device for keratoconus

PURPOSE

To investigate the feasibility of correcting ocular higher order aberrations (HOAs) in keratoconus (KC) using wavefront-guided optics in a scleral lens prosthetic device (SLPD).

METHODS

Six advanced KC patients (11 eyes) were fitted with an SLPD with conventional spherical optics. A custom-made Shack-Hartmann wavefront sensor was used to measure aberrations through a dilated pupil wearing the SLPD. The position of SLPD, that is, horizontal and vertical decentration relative to the pupil and rotation were measured and incorporated into the design of the wavefront-guided optics for the customized SLPD. A submicron-precision lathe created the designed irregular profile on the front surface of the device. The residual aberrations of the same eyes wearing the SLPD with wavefront-guided optics were subsequently measured. Visual performance with natural mesopic pupil was compared between SLPDs having conventional spherical and wavefront-guided optics by measuring best-corrected high-contrast visual acuity and contrast sensitivity.

RESULTS

Root mean square of HOA in the 11 eyes wearing conventional SLPD with spherical optics was 1.17 ± 0.57 μm for a 6-mm pupil. Higher order aberrations were effectively corrected by the customized SLPD with wavefront-guided optics, and root mean square was reduced 3.1 times on average to 0.37 ± 0.19 μm for the same pupil. This correction resulted in significant improvement of 1.9 lines in mean visual acuity (p < 0.05). Contrast sensitivity was also significantly improved by factors of 2.4, 1.8, and 1.4 on average for 4, 8, and 12 cycles/degree, respectively (p < 0.05 for all frequencies). Although the residual aberration was comparable to that of normal eyes, the average visual acuity in logMAR with the customized SLPD was 0.21, substantially worse than normal acuity.

CONCLUSIONS

The customized SLPD with wavefront-guided optics corrected the HOA of advanced KC patients to normal levels and improved their vision significantly.

Changes in higher-order aberrations after iris-fixated phakic intraocular lens implantation

PURPOSE

To evaluate surgically induced changes in corneal, internal, and ocular higher-order aberrations (HOAs) after phakic intraocular lens (PIOL) implantation and compare them between two PIOLs with different pupillary diameters.

METHODS

Twenty-three eyes with an Artisan PIOL (Ophtec BV, Groningen, The Netherlands) (Artisan group) and 30 eyes with an Artiflex PIOL (Ophtec BV) (Artiflex group) were retrospectively evaluated. The corneal, internal, and ocular HOAs and refractive data were recorded preoperatively and 6 months postoperatively. The root mean squares (RMSs) of the total HOAs from the third- to sixth-order Zernike coefficients were calculated. The RMSs of the third- and fourth-order coefficients represented coma-like aberrations (S3) and spherical-like aberrations (S4), respectively. The main outcome measures were the differences in the parameters among the groups with different pupillary diameters.

RESULTS

The mean postoperative spherical equivalents decreased from -11.84 ± 4.90 to -0.16 ± 0.40 diopters and -9.78 ± 3.20 to -0.09 ± 0.26 diopters in the Artisan and Artiflex groups, respectively. With the 4- and 5-mm pupillary diameters, the postoperative internal and ocular spherical aberrations (Z4(0)) were significantly lower in the Artiflex group than in the Artisan group (4 mm, P = .002, .024; 5 mm, P = .004, .022, respectively). With the 6-mm pupillary diameter, there were no significant postoperative differences in any parameter measured between groups; both groups had positive spherical aberration values.

CONCLUSIONS

The postoperative ocular spherical aberrations were positive after Artisan and Artiflex implantation. The postoperative ocular spherical aberration was greater in the Artisan group, possibly due to differences in the SAs of both PIOLs.

Visian implantable contact lens versus AcrySof Cachet phakic intraocular lenses: comparison of aberrmetric profiles

Purpose

To evaluate the in vivo aberrometric performance of two phakic intraocular lenses (PIOLs); the Visian implantable contact lens (ICL) and the AcrySof Cachet PIOL.

Methods

Thirty eight eyes from 29 patients with an age range of 23–32 years and more than 9 D of myopia were divided into two groups; one group of 20 eyes received a Visian ICL model V4c, another group of 18 eyes received an AcrySof Cachet PIOL. Total higher order aberrations (HOAs) root mean square, total coma, and total spherical aberrations were recorded pre and 6 weeks postoperatively to evaluate and compare the aberrometric performance of the Visian ICL and the AcrySof Cachet PIOL implanted in highly myopic patients.

Results

Preoperatively, there were no significant differences in any studied parameters, except for preoperative spherical equivalent. Postoperatively, there were no statistically significant differences in the induction of HOAs between both PIOLs. The reduction in spherical aberrations was statistically significant in each group as well as in all study patients.

Conclusion

Both AcrySof Cachet PIOL and ICLs are effective phakic implants to correct high refractive errors. They both induce small amounts of negative spherical aberration that do not affect the total HOAs, yet reduce the positive ocular spherical aberration. This result is expected to improve the quality of vision in such patients.

Changes in functional visual acuity and ocular wavefront aberration after administration of eye ointment

PURPOSE

To investigate the influence of an eye ointment on functional visual acuity (FVA) and ocular wavefront aberration.

METHODS

In 11 healthy volunteers (6 men and 5 women), visual function parameters, such as FVA, visual maintenance ratios (VMR), and minimal visual acuity (minVA), were assessed by the FVA measurement system before and 2, 5, 10, 20, 30, 40, 50, 60, 90, 120, 180, and 240 min after administration of ofloxacin eye ointment. Ocular aberration was also measured, and the root mean square (RMS) of second-, third-, fourth-, and total higher-order aberrations was determined. The time course of changes in each parameter was statistically analyzed by using repeated-measures analysis of variance and the Dunnett post hoc test, and relationships between visual function and ocular aberration parameters were also analyzed by the Pearson correlation test.

RESULTS

FVA, VMR, and minVA showed significant deteriorations at 2-, 5-, 10-, and 20 min after administration of eye ointment compared with the baseline values (P<0.05). All components of ocular wavefront aberration such as second-, third-, fourth-, and total higher-order RMS significantly increased at 2- and 5 min after the administration of eye ointment compared with the baseline values (P<0.05). In addition, deteriorations of these visual function parameters were significantly correlated with reduced blink numbers (Pearson's correlation coefficient; r=- 0.76, P=0.017 for FVA, r=0.79, P=0.013 for VMR, and r=-0.62, P=0.040 for minVA), and VMR was significantly related with changes in second-order RMS (r=-0.60, P=0.049).

CONCLUSIONS

Eye ointment significantly reduced visual function for at least 20 min. Especially, minVA was worse than 0.155 logMAR, which is legally required for driving, for 3 h after the administration. In addition, increases in lower-order aberration and low blink rates were associated with the degradation of visual function.

Population spherical aberration: associations with ametropia, age, corneal curvature, and image quality

PURPOSE

The aim of this analysis was to determine the total ocular wavefront aberration values of a large phakic population of physiologically normal, ametropic eyes, gathered under the same clinical protocol using the same diagnostic wavefront sensor.

MATERIALS AND METHODS

Studies were conducted at multiple sites in Asia, North America, Europe, and Australia. A Bausch + Lomb Zywave II Wavefront Aberrometer (Rochester, NY, USA) was used to measure the lower and higher order aberrations of each eye. Data analysis was conducted using linear regression analysis to determine the relationship between total spherical aberration, ametropia, age, corneal curvature, and image quality.

RESULTS

Linear regression analysis showed no correlation (r = 0.0207, P = 0.4874) between degree of ametropia and the amount of spherical aberration. There was also no correlation when the population was stratified into myopic and hyperopic refractive groups (r m = 0.0529, P m = 0.0804 and r h = 0.1572, P h = 0.2754). There was a statistically significant and weak positive correlation (r = 0.1962, P < 0.001) between age and the amount of spherical aberration measured in the eye; spherical aberration became more positive with increasing age. Also, there was a statistically significant and moderately positive correlation (r = 0.3611, P < 0.001) with steepness of corneal curvature; spherical aberration became more positive with increasing power of the anterior corneal surface. Assessment of image quality using optical design software (Zemax™, Bellevue, WA < USA) showed that there was an overall benefit in correcting the average spherical aberration of this population.

CONCLUSION

Analysis of this dataset provides insights into the inherent spherical aberration of a typical phakic, pre-presbyopic, population and provides the ability to determine what drives the spherical aberration of the eye, as well as what potential benefit a person could gain by compensating for that average spherical aberration.

Uncorrected binocular performance after biaspheric ablation profile for presbyopic corneal treatment using AMARIS with the PresbyMAX module

PURPOSE

To analyze the uncorrected binocular performance after biaspheric multifocal central presbyopic laser in situ keratomileusis treatments.

DESIGN

Retrospective, interventional case series.

METHODS

setting. Private clinical practice. patient or study population. Three hundred fifty-eight presbyopic patients (43% males, 82 myopic), bilaterally treated, suitable for laser in situ keratomileusis, with monocular corrected distance visual acuity of 20/32 or better. intervention or observation procedure(s). PresbyMAX (Schwind Eye-Tech-Solutions GmbH and Co) biaspheric multifocal ablation. main outcome measures. Binocular uncorrected distance visual acuity (UDVA) and near visual acuity (UNVA) after surgery and their changes compared with corrected distance visual acuity and corrected near visual acuity before surgery.

RESULTS

At 6 months, 76% of patients achieved a UDVA of 0.1 logarithm of the minimal angle of resolution (logMAR; Snellen equivalent, 20/25) or better, 91% of patients obtained a UNVA of 0.1 logarithmic of the reading acuity determination (logRAD) (p3) or better, and 99% of patients were within 1 diopter of defocus. Postoperative mean spherical equivalent was -0.17 ± 0.34 diopter. Ninety-six percent of patients achieved a UDVA of 0.2 logMAR (Snellen equivalent, 20/32) or better and a UNVA of 0.2 logRAD (p4) or better. Mean binocular corrected distance visual acuity degraded from 0.00 ± 0.01 logMAR (Snellen equivalent, 20/20) to a UDVA of 0.09 ± 0.07 logMAR (Snellen equivalent, 20/25). Mean binocular corrected near visual acuity degraded from 0.02 ± 0.01 logRAD (p2) to a UNVA of 0.07 ± 0.07 logRAD (p2).

CONCLUSIONS

Although optically the results are predictable, approximately 17% of the patients did not obtain objectively successful outcomes. In presbyopic patients without symptomatic cataracts, but with refractive errors, the PresbyMAX will decrease the presbyopic symptoms and correct far distance refraction in the same treatment, offering spectacle-free vision in daily life in most of the patients. Further investigation is necessary to evaluate the overall benefit of this procedure.

Modelling the impact of spherical aberration on accommodation

PURPOSE

To understand how primary and secondary spherical aberrations affect focusing of the retinal image and the measurement of refractive state in the accommodating eye.

METHODS

A computational eye model was constructed from published anatomical dimensions of the eye's refractive elements for a range of accommodative states. Two strategies for controlling accommodation were implemented, one in which paraxial rays are always perfectly focused and the other in which paraxial accommodative lag grew larger as target vergence increased. Multiple configurations of the model were achieved by selecting various combinations of pupil size and aberration structure. Refractive state was defined as optimum target vergence for maximizing retinal image quality according to several scalar metrics.

RESULTS

When accommodation optimally focuses paraxial rays, retinal image quality is sub-optimal for metrics of image quality sensitive to non-paraxial rays. This loss of image quality can be recovered by optimizing target vergence computationally, which indicates the presence of real accommodative error according to the non-paraxial metric even though the eye is accurately focused paraxially. However, such errors are spurious if non-paraxial refractive state is misinterpreted as paraxial refractive state. Accommodative errors may indicate lag or lead, but in general the slope of the stimulus-response function is less than 1 for non-paraxial measures of image quality. These results depend strongly on pupil size and its variation due to accommodative miosis.

CONCLUSIONS

spurious accommodative errors can appear when the eye focuses the retinal image optimally according to one metric of image quality (e.g. paraxial) while ocular refractive state is measured by another (e.g. non-paraxial). Spurious errors are small compared to real accommodative lag for small, photopic pupils but can be of the same order of magnitude as real lag for large, mesopic pupils.

Improving retinal imaging by corneal refractive index matching

Imaging the retina at high resolution requires a dilated pupil, which in turn exposes more corneal irregularities. We diminish the optical errors of the cornea by refractive index matching. Lens-fitted goggles were used for corneal immersion, to reduce its aberrations, while keeping the ocular power. An additional aspheric plate reduced the residual ocular spherical aberration. A comparison of the index-matching-based retinal images with those acquired directly shows resolution improvement for subjects with normal extent of ocular aberrations. A simulation of the point spread function, obtained from an averaged ocular and corneal wavefront error, also reveals substantial improvement when using corneal index matching. The demonstrated improvement using index matching may enable further improvement of current retinal imaging techniques or relaxing requirements for active ocular aberration correction.

Adaptive optics technology for high-resolution retinal imaging

Adaptive optics (AO) is a technology used to improve the performance of optical systems by reducing the effects of optical aberrations. The direct visualization of the photoreceptor cells, capillaries and nerve fiber bundles represents the major benefit of adding AO to retinal imaging. Adaptive optics is opening a new frontier for clinical research in ophthalmology, providing new information on the early pathological changes of the retinal microstructures in various retinal diseases. We have reviewed AO technology for retinal imaging, providing information on the core components of an AO retinal camera. The most commonly used wavefront sensing and correcting elements are discussed. Furthermore, we discuss current applications of AO imaging to a population of healthy adults and to the most frequent causes of blindness, including diabetic retinopathy, age-related macular degeneration and glaucoma. We conclude our work with a discussion on future clinical prospects for AO retinal imaging.

Adaptive Optics for Visual Simulation

A revision of the current state-of-the-art adaptive optics technology for visual sciences is provided. The human eye, as an optical system able to generate images onto the retina, exhibits optical aberrations. Those are continuously changing with time, and they are different for every subject. Adaptive optics is the technology permitting the manipulation of the aberrations, and eventually their correction. Across the different applications of adaptive optics, the current paper focuses on visual simulation. These systems are capable of manipulating the ocular aberrations and simultaneous visual testing though the modified aberrations on real eyes. Some applications of the visual simulators presented in this work are the study of the neural adaptation to the aberrations, the influence of aberrations on accommodation, and the recent development of binocular adaptive optics visual simulators allowing the study of stereopsis.

Tool to estimate optical metrics from summary wave-front analysis data in the human eye

PURPOSE

Studies in the field of cataract and refractive surgery often report only summary wave-front analysis data--data that are too condensed to allow for a retrospective calculation of metrics relevant to visual perception. The aim of this study was to develop a tool that can be used to estimate these metrics from summary wave-front analysis data.

METHODS

The core of the tool is a two-parameter (primary spherical aberration and an overall measure of all other higher-order aberrations) model for the statistical description of the optical aberrations of the human eye. Modulation transfer through-focus curves were calculated for realistic ranges of spherical aberration, other higher-order aberrations and pupil diameters, for both white and monochromatic light. A series of commonly used metrics (modulation transfer, Strehl ratio, visual Strehl ratio and width of line spread function) was derived from these through-focus curves, with corresponding location of optimal focus and depth-of-focus.

RESULTS

Published wave-front analysis data from healthy subjects served as input for the tool. The output was compared to published measurements of the included metrics, performed in the same or in comparable samples. Agreement between output of the tool and measurements was within the accuracy of the data.

CONCLUSIONS

The tool is able to relate accurately summary wave-front analysis data from groups of patients to metrics relevant to visual perception and can thus be used to estimate these metrics in situations where their calculation from raw wave-front analysis data is not possible.

Repeatability of internal aberrometry with a new simultaneous capture aberrometer/corneal topographer

PURPOSE

To compare repeatability of internal eye aberrations derived from aberrometry and corneal topography (CT) measured simultaneously by the Innovative Visual Systems Discovery, against time displaced but same instrument measurement (Nidek OPD-Scan 3), and time displaced different instrument measurement (Medmont E300 and Imagine Eyes irx3).

METHODS

Three aberrometry and CT measurements were captured with each instrument, except for the OPD-Scan 3 where three aberrometry scans were followed by a single CT. Measurements were repeated across 2 days. Corneal surface Zernike coefficients were derived from CT and subtracted from aberrometry to establish internal aberration coefficients. For the OPD-Scan 3, internal Zernike coefficients were derived by the instrument's software. Repeatability for second-order root mean square (RMS), spherical aberration, coma RMS, trefoil RMS, and the refraction components M, J0, and J45 were assessed using intraclass correlation coefficient (ICC).

RESULTS

Intrasession repeatability was similar between the Discovery and E300/irx3, with the E300/irx3 slightly more repeatable for second-order RMS. Across days, the Discovery was most repeatable for second-order RMS (ICC 0.98) followed by the E300/irx3 (ICC 0.96) and OPD-Scan 3 (ICC 0.88). All instruments were less repeatable for higher order aberrations with only the Discovery moderately repeatable for spherical aberration and trefoil RMS (both ICC ≥ 0.75). The Discovery was highly repeatable for all derived refractive components (ICC ≥ 0.96). The E300/irx3 was highly repeatable for M (ICC 0.98) and moderately repeatable for J0 (ICC 0.89). The OPD-Scan 3 was highly repeatable for the M component (ICC 0.98) but not repeatable for the cylindrical components.

CONCLUSIONS

The Discovery was highly repeatable for second-order RMS and derived refractive components. The lower repeatability for internal higher order aberrations measured with all instruments suggests caution in their use until further work is carried out to investigate sources of error and to develop methods to improve repeatability.

Through-focus performance with multifocal contact lenses: effect of binocularity, pupil diameter and inherent ocular aberrations

PURPOSE

To evaluate the effects of the wearer's pupil size and spherical aberration on visual performance with centre-near, aspheric multifocal contact lenses (MFCLs). The advantage of binocular over monocular vision was also investigated.

METHODS

Twelve young volunteers, with an average age of 27 ± 5 years, participated in the study. LogMAR Visual Acuity (VA) was measured under cycloplegia for a range of defocus levels (from +3.0 to -3.0 D, in 0.5 D steps) with no correction and with three aspheric MFCLs (Air Optix Aqua Multifocal) with a centre-near design, providing correction for 'Low', 'Med' and 'High' near demands. Measurements were performed for all combinations of the following conditions: (1) artificial pupils of 6 and 3 mm diameter, (2) binocular and monocular (dominant eye) vision. Depth-of-focus (DOF) was calculated from the VA vs defocus curves. Ocular aberrations under cycloplegia were measured using iTrace.

RESULTS

VA at -3.0 D defocus (simulating near performance) was statistically higher for the 3 mm than for the 6 mm pupil (p = 0.006), and for binocular rather than for monocular vision (p < 0.001). Similarly, DOF was better for the 3 mm pupil (p = 0.002) and for binocular viewing conditions (p < 0.001). Both VA at -3.0 D defocus and DOF increased as the 'addition' of the MFCL correction increased. Finally, with the centre-near MFCLs a linear correlation was found between VA at -3.0 D defocus and the wearer's ocular spherical aberration (R(2) = 0.20 p < 0.001 for 6 mm data), with the eyes exhibiting the higher positive spherical aberration experiencing worse VAs. By contrast, no correlation was found between VA and spherical aberration at 0.00 D defocus (distance vision).

CONCLUSIONS

Both near VA and depth-of-focus improve with these MFCLs, with the effects being more pronounced for small pupils and for binocular rather than monocular vision. Coupling of the wearer's ocular spherical aberration with the aberration profiles provided by MFCLs affects their functionality.

Comparison of spherical aberration and small-pupil profiles in improving depth of focus for presbyopic corrections

PURPOSE

To compare the validity and effectiveness of 2 methods for expanding depth of focus to correct for presbyopia; that is, induction of spherical aberration and small-pupil apertures.

SETTING

University of California, Berkeley, California, USA.

DESIGN

Comparative case series.

METHODS

A random 4-alternative forced-choice acuity task was performed on 13 subjects. Visual performance and depth of focus were compared using adaptive optics-corrected distance visual acuity (CDVA) values and mean visual acuity over a 3.0 diopter (D) range of defocus using the following 3 adaptive optics-corrected profiles: 2.0 mm pupil, 5.0 mm pupil, and 5.0 mm pupil with -0.274 μm of spherical aberration.

RESULTS

The 5.0 mm pupil profile had a CDVA of -0.218 logMAR and a mean visual acuity through focus of 0.156 logMAR. The 2.0 mm pupil profile had a worse CDVA (0.012 logMAR) but an improved mean visual acuity (0.061 logMAR). The 5.0 mm pupil profile with -0.274 μm of spherical aberration measured a CDVA of -0.082 logMAR and a mean visual acuity of 0.103 logMAR.

CONCLUSIONS

The spherical aberration and small-pupil profiles improved the mean visual acuity across a 3.0 D range of defocus but resulted in decreased CDVA at the plane of best focus in comparison to an adaptive optics-corrected 5.0 mm pupil. Small-pupil profiles are a better choice than spherical aberration profiles for presbyopic corrections due to expected accuracy, predictability, and patient satisfaction.

FINANCIAL DISCLOSURE

No author has a financial or proprietary interest in any material or method mentioned.

Statistical virtual eye model based on wavefront aberration

Wavefront aberration affects the quality of retinal image directly. This paper reviews the representation and reconstruction of wavefront aberration, as well as the construction of virtual eye model based on Zernike polynomial coefficients. In addition, the promising prospect of virtual eye model is emphasized.

Variations in image optical quality of the eye and the sampling limit of resolution of the cone mosaic with axial length in young adults

PURPOSE

To evaluate the variation in higher-order ocular wavefront aberrations and the Nyquist limit of resolution of the cone mosaic (N(c)) in a population of young healthy subjects and the relation to axial length (AL).

SETTING

Fondazione G.B. Bietti IRCCS, Rome, Italy.

DESIGN

Case series.

METHODS

An adaptive optics retinal camera prototype (rtx1) was used to image the cone mosaic. Cone density and N(c) were calculated at fixed eccentricity between 260 μm and 600 μm from the foveal center. Ocular higher-order wavefront aberrations were measured using the OPD Scan II device. The coefficient of variation (CoV) was used to analyze the variation in optical and retinal parameters. The correlation of optical and retinal parameters with AL was performed using Pearson analysis.

RESULTS

Twelve subjects (age 24 to 38 years; AL 22.61 to 26.63 mm) were evaluated. A high interindividual variation in the higher-order wavefront aberrations was found, ranging from 26% for corneal higher-order aberrations (HOAs) to 41% for intraocular HOAs. The CoV of cone density and N(c) were 16% and 5%, respectively. The decline in cone density and N(c) with AL was statistically significant at all retinal eccentricities (R(2) > 0.44, P<.001).

CONCLUSIONS

Although there appeared to be random variation in the eye's optical wavefront aberration from subject to subject, the cone-packing density and N(c) were highly correlated with AL. Although the eye's overall image optical quality in the emmetropic group and the myopic group was comparable, the spatial sampling of the cone mosaic decreased with increasing AL.

FINANCIAL DISCLOSURE

No author has a financial or proprietary interest in any material or method mentioned.

Change in visual acuity is highly correlated with change in six image quality metrics independent of wavefront error and/or pupil diameter

It is well known that the wavefront error (WFE) of the eye varies from individual to individual with pupil diameter (PD) and age. Numerous studies have been proposed evaluating the relationship between visual acuity and WFE, but all these studies were performed with either a fixed or natural PD. It is still not clear if metrics of image quality correlate well with visual acuity independent of PD. Here we investigate the correlation between the change in visual acuity and the change in 30 image quality metrics for a range of optical quality typically established in normal eyes that varies both with age and PD. Visual acuity was recorded for 4 normal subjects using simulated blurred logMAR acuity charts generated from the point spread functions of different scaled WFEs for 6 different PDs (2-7 mm in 1 mm steps). Six image quality metrics (log neural sharpness, log visual Strehl [spatial domain], log visual Strehl [MTF method], log pupil fraction [tessellated], log pupil fraction [concentric area], and log root mean square of WFE slope) accounted for over 80% of variance in change in acuity across all WFEs and all PDs. Multiple regression analysis did not significantly increase the R(2). Simple metrics derived from WFE could potentially act as an objective surrogate to visual acuity without the need for complex models.

Visual and aberrometric outcomes in eyes with an angle-supported phakic intraocular lens

PURPOSE

To evaluate the postoperative changes in spherical aberration and the point-spread function (PSF) induced by the implantation of a new angle-supported phakic intraocular lens (pIOL).

SETTING

Department of Ophthalmology, St. Bassiano Hospital, Bassano del Grappa, Italy.

DESIGN

Prospective nonrandomized cohort study.

METHODS

Eyes with high myopia had implantation of an Acrysof Cachet angle-supported pIOL. Preoperative and postoperative total spherical aberration and PSF were measured using a Luneau 80 Wave+ wavefront aberrometer (high-resolution Hartmann-Shack technology) at a fixed entrance pupil scan size of 5.0 mm under pharmacologic mydriasis. Preoperative and postoperative data were analyzed and compared using the Student t test.

RESULTS

Thirty-five eyes of 18 patients were included in the statistical analysis. The Student t test for paired data (95% confidence interval) showed a statistically significant difference between preoperative data and postoperative data. The mean preoperative total spherical aberration Z(4,0) was -0.001 μm ± 0.076 (SD) preoperatively and -0.13 ± 0.11 μm postoperatively (P≤.05). The mean PSF was 0.28 ± 0.15 preoperatively and 0.34 ± 0.16 postoperatively (P<.05).

CONCLUSION

Implantation of the angle-supported pIOL in eyes with high myopia improved the quality of vision, inducing negative spherical aberration and increasing the PSF under mesopic conditions.

Role of the human lens gradient-index profile in the compensation of third-order ocular aberrations

The open question regarding the compensation of the ocular aberrations between the cornea and the lens is currently being investigated. We report additional insights considering the role of the lens gradient-index (GRIN) profile in third-order ocular aberrations, since this profile changes through life. Thus, we have calculated the contribution of that profile to the ocular aberrations with aging by applying the Seidel third-order theory of tilted and decentered elements, and by using a schematic-eye model. The results show the GRIN profile is needed to account for the decoupling of the aberrations between the cornea and the lens because the geometrical changes of the ocular surfaces with aging are not enough. Therefore, the current developments of aging human-eye models, as well as the experimental studies, cannot neglect the changes of the lens GRIN structure through life when modelling mechanisms of the compensation of ocular aberrations.

Theoretical analysis for spherical aberration induction with low-order correction in refractive surgery

A theoretical foundation for the analysis of ocular aberration correction is developed. It enables a comparative study for two different refractive surgical approaches, namely, the conventional and the Q-preserved treatment modalities. A refractive surgical factor is identified that leads to a simple cubic function for the postoperative asphericity factor for the conventional treatment. A formulation is developed that paves the way for the calculation of the induction of spherical aberration for low-order aberration correction in refractive surgery. Opposite to the general belief, the Munnerlyn shape makes myopic LASIK more prolate, not oblate. A Monte Carlo simulation was conducted for 1000 eyes for these two refractive surgical modalities. It was found that, although the postoperative spherical aberration is similar for these surgical modalities, for the induction of spherical aberration from the ablation target shape, the conventional modality appears to be slightly more predictable.

Signal-to-noise ratio and aberration statistics in ocular aberrometry

We define a signal-to-noise ratio (SNR) for eye aberrometry in terms of the sensor geometry, measurement noise, and population statistics. The overall estimation error is composed of three main contributions: the bias in the estimated modes, the truncation error, and the error due to the noise propagation. This last term can be easily parametrized by the proposed SNR. We compute the overall error as well as the magnitude of its three components for a typical sensor configuration, population statistics, and different SNR. We show that there are an optimum number of Zernike aberration modes to be retrieved in each case.

Estimation of the ocular point spread function by retina modeling

Retinal imaging often suffers from blurring aberrations. With knowledge of the blurring point spread function (PSF), better images can be reconstructed by deconvolution techniques. We demonstrate a method to enhance the contrast of retinal cells by estimating the ocular PSF. This is done by finding the cells' positions and their intensity distributions and using these as a model for the image. The feasibility of this method is demonstrated by Wiener deconvolution both for adaptively and nonadaptively corrected images.

Ocular higher-order aberrations and mesopic pupil size in individuals screened for refractive surgery

AIM

To study the distribution of ocular higher-order aberrations(HOAs) and mesopic pupil size in individuals screened for refractive surgery.

METHODS

Ocular HOAs and mesopic pupil size were studied in 2 458 eyes of 1 240 patients with myopia, myopic astigmatism and compound myopic astigmatism and 215 eyes of 110 patients with hyperopia, hyperopic astigmatism and compound hyperopic astigmatism using the Zywave aberrometer (Busch& Lomb). All patients had correctable refractive errors without a history of refractive surgery or underlying diseases. Root-mean-square values of HOAs, total spherical aberration, total coma and mesopic pupil size were analyzed. Ocular HOAs were measured across a ≥ 6.0 mm pupil, and pupil size measurements were performed under the mesopic condition.

RESULTS

The mean values of HOAs, total spherical aberration and total coma in the myopic group were 0.369µm, ±0.233, 0.133± 0.112µm and 0.330±0.188µm, respectively. In the hyperopic group the mean values of HOAs, total spherical aberration and total coma were 0.418µm ±0.214, 0.202±0.209µm and 0.343±0.201µm, respectively. Hyperopes showed greater total HOAs (P<0.01) and total spherical aberration (P<0.01) compared to myopes. In age-matched analysis, only the amount of total spherical aberration was higher in the hyperopic group (P=0.05). Mesopic pupil size in the myopic group was larger (P≤0.05).

CONCLUSION

The results suggested that significant levels of HOAs were found in both groups which are important for planning refractive surgeries on Iranians. There were significantly higher levels of total spherical aberration in hyperopes compared to myopes. Mesopic pupil size was larger in myopic group.

The eye limits the brain's learning potential

The concept of a critical period for visual development early in life during which sensory experience is essential to normal neural development is now well established. However recent evidence suggests that a limited degree of plasticity remains after this period and well into adulthood. Here, we ask the question, "what limits the degree of plasticity in adulthood?" Although this limit has been assumed to be due to neural factors, we show that the optical quality of the retinal image ultimately limits the brain potential for change. We correct the high-order aberrations (HOAs) normally present in the eye's optics using adaptive optics, and reveal a greater degree of neuronal plasticity than previously appreciated.

Testing of Lagrange multiplier damped least-squares control algorithm for woofer-tweeter adaptive optics

A Lagrange multiplier-based damped least-squares control algorithm for woofer-tweeter (W-T) dual deformable-mirror (DM) adaptive optics (AO) is tested with a breadboard system. We show that the algorithm can complementarily command the two DMs to correct wavefront aberrations within a single optimization process: the woofer DM correcting the high-stroke, low-order aberrations, and the tweeter DM correcting the low-stroke, high-order aberrations. The optimal damping factor for a DM is found to be the median of the eigenvalue spectrum of the influence matrix of that DM. Wavefront control accuracy is maximized with the optimized control parameters. For the breadboard system, the residual wavefront error can be controlled to the precision of 0.03 μm in root mean square. The W-T dual-DM AO has applications in both ophthalmology and astronomy.

Effect of interaction of macroaberrations and scattered light on objective quality of vision in pseudophakic eyes with aspheric monofocal intraocular lenses

PURPOSE

To assess the impact of wavefront ocular aberrations on objective vision quality and depth of focus in pseudophakic patients.

SETTING

University Hospital Bretonneau of Tours, Francois Rabelais Medicine Faculty of Tours, France.

DESIGN

Cohort study.

METHODS

Consecutive eyes having implantation of an aspheric monofocal intraocular lens (IOL) (Acri.Smart) were studied. Aberrometry measurements were performed under mesopic conditions with a 6.0 mm pupil using a Wavescan aberrometer. Objective evaluation of optical vision quality was performed using the Optical Quality Analysis System II. The 3 measurements were the modulation transfer function values (MTF cutoff); objective depth of focus, which was computed as the focus range at which Strehl ratio did not fall below 50% of the maximum; and the objective scatter index.

RESULTS

Fifty-four eyes (30 patients) were enrolled. Six months postoperatively, MTF cutoff values were increased with decreasing total ocular spherical aberration, ocular trefoil, and 2nd-order astigmatism (P<.05). Objective depth of focus was positively correlated with 2nd-order astigmatism (r(2) = 0.171, P<.001) and total spherical aberration (r(2) = 0.091, P=.028). Objective scatter was more beneficial for depth of focus, with a significantly positive correlation with this parameter (r(2) = 0.28, P=.002), than compromising of optical quality (no significant correlation with MTF measurements in same multiple regression analysis).

CONCLUSION

Three ocular aberrations (2nd-order astigmatism, trefoil, spherical aberration) seemed to interact with objective contrast sensitivity and depth of focus, whereas residual spherical aberration exerted opposite effects on image quality in individual patients.

Investigation of the isoplanatic patch and wavefront aberration along the pupillary axis compared to the line of sight in the eye

Conventional optical systems usually provide best image quality on axis, while showing unavoidable gradual decrease in image quality towards the periphery of the field. The optical system of the human eye is not an exception. Within a limiting boundary the image quality can be considered invariant with field angle, and this region is known as the isoplanatic patch. We investigate the isoplanatic patch of eight healthy eyes and measure the wavefront aberration along the pupillary axis compared to the line of sight. The results are used to discuss methods of ocular aberration correction in wide-field retinal imaging with particular application to multi-conjugate adaptive optics systems.

Peripheral aberrations and image quality for contact lens correction

PURPOSE

Contact lenses (CLs) reduced the degree of hyperopic field curvature present in myopic eyes and rigid CLs reduced spherocylindrical image blur on the peripheral retina, but their effect on higher order aberrations and overall optical quality of the eye in the peripheral visual field is still unknown. The purpose of our study was to evaluate peripheral wavefront aberrations and image quality across the visual field before and after CL correction.

METHODS

A commercial Hartmann-Shack aberrometer was used to measure ocular wavefront errors in 5° steps out to 30° of eccentricity along the horizontal meridian in uncorrected eyes and when the same eyes are corrected with soft or rigid CLs. Wavefront aberrations and image quality were determined for the full elliptical pupil encountered in off-axis measurements.

RESULTS

Ocular higher order aberrations (HOA) increase away from fovea in the uncorrected eye. Third-order aberrations are larger and increase faster with eccentricity compared with the other HOA. CLs increase all HOA except third-order Zernike terms. Nevertheless, a net increase in image quality across the horizontal visual field for objects located at the foveal far point is achieved with rigid lenses, whereas soft CLs reduce image quality.

CONCLUSIONS

Second-order aberrations limit image quality more than HOA in the periphery. Although second-order aberrations are reduced by CLs, the resulting gain in image quality is partially offset by increased amounts of HOA. To fully realize the benefits of correcting HOA in the peripheral field requires improved correction of second-order aberrations as well.

Influence of age on peripheral ocular aberrations

PURPOSE

To compare peripheral lower and higher order aberrations across the horizontal (±40°) and inferior (-20°) visual fields in healthy groups of young and old emmetropes.

METHODS

We have measured off-axis aberrations in the groups of 30 younger (24 ± 3 years) and 30 older (58 ± 5 years) emmetropes. The aberrations of OD were measured using the COAS-HD VR Shack-Hartmann aberrometer in 10° steps to ±40° horizontally and -20° inferiorly in the visual field. The aberrations were quantified with Zernike polynomials for a 4 mm pupil diameter. The second-order aberration coefficients were converted to their respective refraction components (M, J45, and J180). Mixed between-within subjects, analysis of variance were used to determine whether there were significant differences in the refraction and aberration components for the between-subjects variable age and the within-subjects variable eccentricity.

RESULTS

Peripheral refraction components were similar in both age groups. Among the higher order coefficients, horizontal coma (C3) and spherical aberration (C4) varied mostly between the groups. Coma increased linearly with eccentricity, at a more rapid rate in the older group than in the younger group. Spherical aberration was more positive in the older group compared with the younger group. Higher order root mean square increased more rapidly with eccentricity in the older group.

CONCLUSIONS

Like the axial higher order aberrations, the peripheral higher order aberrations of emmetropes increase with age, particularly coma and spherical aberration.

Effects on vision with glare after correction of monochromatic wavefront aberrations

PURPOSE

To investigate effects of optical aberration correction on vision with glare.

METHODS

Correction of aberrations up to the 6th Zernike order (closed-loop correction) was compared with conventional spectacle correction in 42 healthy eyes. To create these corrections, an adaptive optics system including a thin-film transistor (TFT) monitor for displaying optotypes with additional glare sources was used. Employing both corrections, visual acuity and contrast sensitivity (CS) were tested alternately with and without glare. Disability glare was computed as the difference between log CS without and with glare. Individuals were also asked to rate subjectively the quality of three images displayed on the TFT monitor.

RESULTS

Significant improvements of CS without and with glare were found with the closed-loop correction (0.147 and 0.198 log CS, respectively), whereas no significant difference in visual acuity was found in either correction. Correlations were determined between reduction of total root-mean-square error and increase of CS with glare (Pearson correlation coefficient r=0.42) and decrease of disability glare (r=-0.33). Visual acuity was correlated with the visual Strehl ratio based on the optical transfer function (r=0.46). Subjective comparison of the images showed improvements more clearly. Depending on the image, in 57% to 78% of the eyes, closed-loop correction was rated better than spectacle correction. The subjective glare effect was reduced as well.

CONCLUSIONS

Investigation of vision with glare seems to be a reasonable additional test to evaluate the visual outcome of a customized correction.

Validity of scaling zernike coefficients to a larger diameter for refractive surgery

PURPOSE

To investigate the validity of a Zernike rescaling algorithm to a larger wavefront diameter.

METHODS

Using 4256 preoperative wavefront examinations, the variability of inter-examination wavefront root-mean-square (RMS) was compared to the error induced due to scaling Zernike coefficients to a larger diameter. The validity of scaling Zernike coefficients was set when the error due to the scaling was the same as the variability of the inter-examination wavefronts. The inter-examination variability was calculated from eyes having at least 3 same-day, preoperative examinations over the same diameters. Error from scaling Zernike coefficients to a larger diameter was calculated by comparing the wavefront for a (scaled-up) set of Zernike coefficients to the wavefront of the average of Zernike coefficient sets at a larger diameter for the same eye. Wavefront diameters of 5, 5.5, 6, 6.5, and 7 mm were considered.

RESULTS

No significant difference was found for the variability for different pupil sizes. The error due to scaling Zernike coefficients to a larger pupil size was generally smaller than the inter-examination variability when the new diameter was 0.25 mm larger than the original diameter. The error was comparable to the inter-examination variability when the new diameter was 0.5 mm larger. The error became larger when the new diameter was >0.75 mm larger than the original diameter.

CONCLUSIONS

Rescaling Zernike coefficients from a smaller diameter to a larger one has practical applications in optical zone extension for wavefront-guided refractive surgery.

Double drive modes unimorph deformable mirror for low-cost adaptive optics

This paper reports the development and characterization of a low-cost thin unimorph deformable mirror (DM) driven by positive voltage. The developed DM consists of both an inner actuator array and an outer ring actuator, which works two drive modes: the inner actuator array is used for aberration correction, while the outer ring actuator is used to generate an overall defocus bias. An analytical model based on the theory of plates and shells is studied for predicting the behavior of the developed DM. Measurement results indicate that dual direction maximum defocus deformations of the developed DM are -14.3 and 14.9 μm, respectively, and the resonant frequency is 1.8 kHz. The root-mean-square deformation of the mirror surface after correction is better than λ/20 for λ=633 nm. The replication of Zernike mode shapes up to the fifth order demonstrates that this developed DM is satisfactory for low-order aberration correction.

Optimal defocus estimation in individual natural images

Defocus blur is nearly always present in natural images: Objects at only one distance can be perfectly focused. Images of objects at other distances are blurred by an amount depending on pupil diameter and lens properties. Despite the fact that defocus is of great behavioral, perceptual, and biological importance, it is unknown how biological systems estimate defocus. Given a set of natural scenes and the properties of the vision system, we show from first principles how to optimally estimate defocus at each location in any individual image. We show for the human visual system that high-precision, unbiased estimates are obtainable under natural viewing conditions for patches with detectable contrast. The high quality of the estimates is surprising given the heterogeneity of natural images. Additionally, we quantify the degree to which the sign ambiguity often attributed to defocus is resolved by monochromatic aberrations (other than defocus) and chromatic aberrations; chromatic aberrations fully resolve the sign ambiguity. Finally, we show that simple spatial and spatio-chromatic receptive fields extract the information optimally. The approach can be tailored to any environment-vision system pairing: natural or man-made, animal or machine. Thus, it provides a principled general framework for analyzing the psychophysics and neurophysiology of defocus estimation in species across the animal kingdom and for developing optimal image-based defocus and depth estimation algorithms for computational vision systems.

Chromatic and wavefront aberrations: L-, M- and S-cone stimulation with typical and extreme retinal image quality

The first physiological process influencing visual perception is the optics of the eye. The retinal image is affected by diffraction at the pupil and several kinds of optical imperfections. A model of the eye (Thibos & Bradley, 1999), which takes account of pupil aperture, chromatic aberration and wavefront aberrations, was used to determine wavelength-dependent point-spread functions, which can be convolved with any stimulus specified by its spectral distribution of light at each point. The resulting retinal spectral distribution of light was used to determine the spatial distribution of stimulation for each cone type (S, M and L). In addition, individual differences in retinal-image quality were assessed using a statistical model (Thibos, Bradley, & Hong, 2002) for population values of Zernike coefficients, which characterize imperfections of the eye's optics. The median and relatively extreme (5th and 95th percentile) modulation transfer functions (MTFs) for the S, M and L cones were determined for equal-energy-spectrum (EES) 'white' light. The typical MTF for S cones was more similar to the MTF for L and M cones after taking wavefront aberrations into account but even with aberrations the S-cone MTF typically was below the M- or L-cone MTF by a factor of at least 10 (one log unit). More generally, the model presented here provides a technique for estimating retinal image quality for the S, M and L cones for any stimulus presented to the eye. The model is applied to some informative examples.

Risk factors for astigmatism in preschool children: the multi-ethnic pediatric eye disease and Baltimore pediatric eye disease studies

OBJECTIVE

To evaluate risk factors for astigmatism in a population-based sample of preschool children.

DESIGN

Population-based cross-sectional study.

PARTICIPANTS

Population-based samples of 9970 children ages 6 to 72 months from Los Angeles County, California, and Baltimore, Maryland.

METHODS

A cross-sectional study of children participating in the Multiethnic Pediatric Eye Disease Study and the Baltimore Eye Disease Study was completed. Data were obtained by clinical examination or by in-person interview. Odds ratios and 95% confidence intervals (CI) were calculated to evaluate potential associations between clinical, behavioral, or demographic factors and astigmatism.

MAIN OUTCOME MEASURES

Odds ratios (ORs) for various risk factors associated with astigmatism.

RESULTS

Participants with myopia (≤-1.0 diopters) were 4.6 times as likely to have astigmatism (95% CI, 3.56-5.96) than those without refractive error, whereas participants with hyperopia (≥+2.00 diopters) were 1.6 times as likely (95% CI, 1.39-1.94). Children 6 to <12 months of age were approximately 3 times as likely to have astigmatism than children 5 to 6 years of age (95% CI, 2.28-3.73). Both Hispanic (OR, 2.38) and African-American (OR, 1.47) children were as likely to have astigmatism than non-Hispanic white children. Furthermore, children whose mothers smoked during pregnancy were 1.46 times (95% CI, 1.14-1.87) as likely to have astigmatism than children whose mothers did not smoke.

CONCLUSIONS

In addition to infancy, Hispanic and African-American race/ethnicity and correctable/modifiable risk factors such as myopia, hyperopia, and maternal smoking during pregnancy are associated with a higher risk of having astigmatism. Although the prevalence of smoking during pregnancy is typically low, this association may suggest etiologic pathways for future investigation.

FINANCIAL DISCLOSURE(S)

The authors have no proprietary or commercial interest in any of the materials discussed in this article.

Optical and biometric characteristics of anisomyopia in human adults

PURPOSE

To investigate the role of higher order optical aberrations and thus retinal image degradation in the development of myopia, through the characterization of anisomyopia in human adults in terms of their optical and biometric characteristics.

METHODS

The following data were collected from both eyes of 15 young adult anisometropic myopes and 16 isometropic myopes: subjective and objective refractive errors, corneal power and shape, monochromatic optical aberrations, anterior chamber depth, lens thickness, vitreous chamber depth, and best corrected visual acuity. Monochromatic aberrations were analyzed in terms of their higher order components, and further analyzed in terms of 31 optical quality metrics. Interocular differences for the two groups (anisomyopes vs isomyopes) were compared and the relationship between measured ocular parameters and refractive errors also analyzed across all eyes.

RESULTS

As expected, anisomyopes and isomyopes differed significantly in terms of interocular differences in vitreous chamber depth, axial length and refractive error. However, interocular differences in other optical properties showed no significant intergroup differences. Overall, higher myopia was associated with deeper anterior and vitreous chambers, higher astigmatism, more prolate corneas, and more positive spherical aberration. Other measured optical and biometric parameters were not significantly correlated with spherical refractive error, although some optical quality metrics and corneal astigmatism were significantly correlated with refractive astigmatism.

CONCLUSIONS

An optical cause for anisomyopia related to increased higher order aberrations is not supported by our data. Corneal shape changes and increased astigmatism in more myopic eyes may be a by-product of the increased anterior chamber growth in these eyes; likewise, the increased positive spherical aberration in more myopic eyes may be a product of myopic eye growth.