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Xiang A, He H, Li A, Meng X, Luo Y, Luo Y, Wang X, Yang J, Chen X, Zhong X. Changes in choroidal thickness and blood flow in response to form deprivation-induced myopia and repeated low-level red-light therapy in Guinea pigs. Ophthalmic Physiol Opt 2024. [PMID: 39367704 DOI: 10.1111/opo.13404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 09/16/2024] [Accepted: 09/19/2024] [Indexed: 10/06/2024]
Abstract
PURPOSE To evaluate ocular refractive development, choroidal thickness (ChT) and changes in choroidal blood flow in form-deprived myopia (FDM) Guinea pigs treated with repeated low-level red-light (RLRL) therapy. METHODS Twenty-eight 3-week-old male tricolour Guinea pigs were randomised into three groups: normal controls (NC, n = 10), form-deprived (FD, n = 10) and red light treated with form-deprivation (RLFD, n = 8). Interocular refraction and axial length (AL) changes were monitored. Optical coherence tomography angiography (OCTA) measured choroidal thickness, vessel area density, vessel skeleton density and blood flow signal intensity (flux) in the choriocapillaris and medium-large vessel layers. The experimental intervention lasted 3 weeks. RESULTS At week 3, the FD group had higher myopia and longer axial length than the NC group (all p < 0.001). The RLFD group had higher hyperopia and shorter axial length than the FD group (all p < 0.001). At week 1, the NC group had a thicker choroidal thickness than the FD group (p < 0.05). At weeks 2 and 3, the RLFD group had a thicker choroidal thickness than the FD group (p = 0.002, p < 0.001, respectively). Additionally, the NC group had higher vessel area density, vessel skeleton density and flux in the choriocapillaris layer than the FD group at the three follow-up time points (all p < 0.05). At week 3, the vessel skeleton density and flux were higher in the RLFD group than in the FD group (all p < 0.05). Correlation analysis results showed that weekly changes in refraction and choroidal thickness were negatively correlated with changes in axial length (all p < 0.05). Choroidal thickness changes were positively correlated with alterations in the vessel area density, vessel skeleton density and flux in the choriocapillaris layer, as well as vessel skeleton density and flux changes in the medium-large vessel layers (all p < 0.05). CONCLUSIONS Repeated low-level red-light (RLRL) therapy retards FDM progression in Guinea pigs, potentially through increased choroidal blood flow in the choriocapillaris layer.
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Affiliation(s)
- Aiqun Xiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, China
| | - Hong He
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Haikou, China
| | - Anzhen Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, China
| | - Xuyun Meng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, China
| | - Yanting Luo
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Haikou, China
| | - Yuhan Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, China
| | - Xingxing Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, China
| | - Junming Yang
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Haikou, China
| | - Xiaolian Chen
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Haikou, China
| | - Xingwu Zhong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Sun Yat-sen University, Guangzhou, China
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Haikou, China
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Zhang Y, Liu Y, An M. Analysis and validation of potential ICD-related biomarkers in development of myopia using machine learning. Int Ophthalmol 2024; 44:116. [PMID: 38411755 DOI: 10.1007/s10792-024-02986-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 10/19/2023] [Indexed: 02/28/2024]
Abstract
PURPOSE We aimed to identify and verify potential biomarkers in the development of myopia associated with immunogenic cell death (ICD). METHODS We download high myopia (HM) dataset GSE136701 from Gene Expression Omnibus. Differentially expressed genes in HM were identified to overlapped with ICD-related genes. Least absolute shrinkage and selection operator were used to select the Hub genes. Furthermore, the correlation between the hub genes and immune infiltration, immune response activities, and hub genes Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways analysis was investigated using Spearman's rank correlation. Prediction of the miRNAs upstream of the Hub genes was based on the TargetScan database. We used guinea pig lens-induced myopia model's scleral tissues performed quantitative real-time polymerase chain reaction. RESULTS We identified overlapped with ICD-related genes (LY96, IL1A, IL33, and AGER) and two genes (LY96 and AGER) as hub genes. Single sample gene set enrichment analysis and Spearman's rank correlation revealed that hub gene expression levels in HM were significantly correlated with the infiltration percentages of CD56dim natural killer cells, macrophages, immature B cells, and the immune response activities of APC co-stimulation and Kyoto Encyclopedia of Genes and Genomes pathways, such as terpenoid backbone biosynthesis, aminoacyl-trna biosynthesis, Huntington's disease, oxidative phosphorylation; there were a few additional signaling pathways compared to normal samples. Additionally, several miRNA were predicted as upstream regulators of LY96 and AGER. LY96 was identified as a significantly differentially expressed biomarker in myopia guinea pig's scleral tissues, as verified by qPCR. CONCLUSION LY96 was identified and verified as a ICD-related potential myopia biomarker. Molecular mechanisms or pathways involved in myopia development by LY96 requires further research.
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Affiliation(s)
- Yun Zhang
- Department of Ophthalmology, The Third Affiliated Hospital of Southern Medical University, Number 183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, People's Republic of China
- Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, 510630, Guangdong, People's Republic of China
| | - Yanli Liu
- Department of Ophthalmology, The Third Affiliated Hospital of Southern Medical University, Number 183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, People's Republic of China
- Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, 510630, Guangdong, People's Republic of China
| | - Meixia An
- Department of Ophthalmology, The Third Affiliated Hospital of Southern Medical University, Number 183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, People's Republic of China.
- Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, 510630, Guangdong, People's Republic of China.
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Gawne TJ, Samal AV, She Z. The effects of intensity, spectral purity and duty cycle on red light-induced hyperopia in tree shrews. Ophthalmic Physiol Opt 2023; 43:1419-1426. [PMID: 37431102 PMCID: PMC10592436 DOI: 10.1111/opo.13201] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 06/24/2023] [Accepted: 06/26/2023] [Indexed: 07/12/2023]
Abstract
INTRODUCTION There have recently been several clinical studies suggesting that brief periods of exposure to red light (repeated low-level red light, 'RLRL') may produce a dramatic anti-myopia effect, calling for further investigations into its therapeutic parameters. Unfortunately, many experimental species used in refractive studies develop myopia in response to this wavelength. Tree shrews are the only animal model other than rhesus monkeys that consistently exhibit hyperopic responses to ambient red light. Here, tree shrews were used to study the influence of the spectral purity, duty cycle and intensity of red light on its anti-myopic effect. METHODS Juvenile tree shrews (Tupaia belangeri) were raised from 24 to 35 days after eye opening under ambient lighting that was: standard white colony fluorescent light; pure narrow band red light of either 600, 50-100 or 5 lux; red light that was diluted with 10% white light (by lux) or 50% white and 2 s of pure red light that alternated with 2 s of pure white light (50% duty cycle). Refractive measures were taken with a NIDEK ARK-700 autorefractor and axial dimensions with a LenStar LS-900 Axial Biometer. RESULTS The pro-hyperopia effect of ambient red light was greatly reduced by even small amounts of concurrent white light 'contamination', but remained robust if 2-s periods of pure white light alternated with 2 s of red. Finally, the hyperopic effect of red light was maintained at reduced luminance levels in the 50-100 lux range and only failed at 5 lux. CONCLUSIONS These results have implications for understanding the mechanisms by which ambient red light affects refractive development, and possibly also for clinical therapies using RLRL. Nevertheless, it remains to be determined if the mechanism of the current clinical RLRL therapy is the same as that operating on tree shrews in ambient red light.
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Affiliation(s)
- Timothy J. Gawne
- Department of Optometry and Vision Science, University of Alabama at Birmingham (UAB). USA
| | - Alena V. Samal
- Department of Optometry and Vision Science, University of Alabama at Birmingham (UAB). USA
- Current Location: MyEyeDr., Birmingham, Alabama. USA
| | - Zhihui She
- Department of Optometry and Vision Science, University of Alabama at Birmingham (UAB). USA
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Huang Y, Wang Y, Shen Y, Chen Z, Peng X, Zhang L, Han T, Zhou X. Defocus-induced spatial changes in choroidal thickness of chicks observed by wide-field swept-source OCT. Exp Eye Res 2023:109564. [PMID: 37419380 DOI: 10.1016/j.exer.2023.109564] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 02/07/2023] [Accepted: 06/29/2023] [Indexed: 07/09/2023]
Abstract
Choroid has been claimed to be of importance during ocular development. However, how the choroid responds spatially to different visual cues has not been fully understood. The aim of this study was to investigate defocus-induced spatial changes in choroidal thickness (ChT) in chicks. Eight 10-day-old chicks were fitted monocularly with -10 D or +10 D lenses (day 0), which were removed seven days later (day 7). The ChT was measured on days 0, 7, 14, and 21 using wide-field swept-source optical coherence tomography (SS-OCT) and analyzed with custom-made software. Comparisons of the ChT in the central (1 mm), paracentral (1-3 mm), and peripheral (3-6 mm) ring areas and the ChT in the superior, inferior, nasal, and temporal regions were conducted. Axial lengths and refractions were also evaluated. In the negative lens group, the global ChT of the treated eyes was significantly less than that of the fellow eyes on day 7 (interocular difference: 179.28 ± 25.94 μm, P = 0.001), but thicker on day 21 (interocular difference: 241.80 ± 57.13 μm, P = 0.024). These changes were more pronounced in the central choroid. The superior-temporal choroid changed more during induction but less during recovery. In the positive lens group, the ChT of both eyes increased on day 7 and decreased on day 21, with most changes occurring in the central region, too. The inferior-nasal choroid of the treated eyes changed more during induction but less during recovery. These results provide evidence for regionally asymmetric characteristics of the choroidal response to visual cues and insights into the underlying mechanisms of emmetropization.
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Affiliation(s)
- Yangyi Huang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Research Center of Ophthalmology and Optometry, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, China
| | - Yuliang Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Research Center of Ophthalmology and Optometry, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, China
| | - Yang Shen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Research Center of Ophthalmology and Optometry, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, China
| | - Zhi Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Research Center of Ophthalmology and Optometry, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, China
| | - Xiaoliao Peng
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Research Center of Ophthalmology and Optometry, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, China
| | - Luoli Zhang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Research Center of Ophthalmology and Optometry, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, China
| | - Tian Han
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Research Center of Ophthalmology and Optometry, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, China.
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Research Center of Ophthalmology and Optometry, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, China.
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Liu H, Schaeffel F, Yang Z, Feldkaemper MP. GABAB Receptor Activation Affects Eye Growth in Chickens with Visually Induced Refractive Errors. Biomolecules 2023; 13:biom13030434. [PMID: 36979369 PMCID: PMC10046083 DOI: 10.3390/biom13030434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 03/02/2023] Open
Abstract
This study aims to explore the role of GABAB receptors in the development of deprivation myopia (DM), lens-induced myopia (LIM) and lens-induced hyperopia (LIH). Chicks were intravitreally injected with 25 µg baclofen (GABABR agonist) in one eye and saline into the fellow eye. Choroidal thickness (ChT) was measured via OCT before and 2, 4, 6, 8, 24 h after injection. ChT decreased strongly at 6 and 8 h after baclofen injection and returned back to baseline level after 24 h. Moreover, chicks were monocularly treated with translucent diffusers, −7D or +7D lenses and randomly assigned to baclofen or saline treatment. DM chicks were injected daily into both eyes, while LIM and LIH chicks were monocularly injected into the lens-wearing eyes, for 4 days. Refractive error, axial length and ChT were measured before and after treatment. Dopamine and its metabolites were analyzed via HPLC. Baclofen significantly reduced the myopic shift and eye growth in DM and LIM eyes. However, it did not change ChT compared to respective saline-injected eyes. On the other hand, baclofen inhibited the hyperopic shift and choroidal thickening in LIH eyes. All the baclofen-injected eyes showed significantly lower vitreal DOPAC content. Since GABA is an inhibitory ubiquitous neurotransmitter, interfering with its signaling affects spatial retinal processing and therefore refractive error development with both diffusers and lenses.
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Affiliation(s)
- Hong Liu
- Section of Neurobiology of the Eye, Ophthalmic Research Institute, University of Tuebingen, 72076 Tuebingen, Germany
- Aier Institute of Optometry and Vision Science, Aier Eye Hospital Group, Changsha 410000, China
| | - Frank Schaeffel
- Section of Neurobiology of the Eye, Ophthalmic Research Institute, University of Tuebingen, 72076 Tuebingen, Germany
- Myopia Research Group, Institute of Molecular and Clinical Ophthalmology Basel (IOB), 4031 Basel, Switzerland
| | - Zhikuan Yang
- Aier Institute of Optometry and Vision Science, Aier Eye Hospital Group, Changsha 410000, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha 410000, China
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha 410000, China
- Correspondence: (Z.Y.); (M.P.F.)
| | - Marita Pauline Feldkaemper
- Section of Neurobiology of the Eye, Ophthalmic Research Institute, University of Tuebingen, 72076 Tuebingen, Germany
- Correspondence: (Z.Y.); (M.P.F.)
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Rozema J, Dankert S, Iribarren R. Emmetropization and nonmyopic eye growth. Surv Ophthalmol 2023:S0039-6257(23)00037-1. [PMID: 36796457 DOI: 10.1016/j.survophthal.2023.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 02/16/2023]
Abstract
Most eyes start with a hypermetropic refractive error at birth, but the growth rates of the ocular components, guided by visual cues, will slow in such a way that this refractive error decreases during the first 2 years of life. Once reaching its target, the eye enters a period of stable refractive error as it continues to grow by balancing the loss in corneal and lens power with the axial elongation. Although these basic ideas were first proposed over a century ago by Straub, the exact details on the controlling mechanism and the growth process remained elusive. Thanks to the observations collected in the last 40 years in both animals and humans, we are now beginning to get an understanding how environmental and behavioral factors stabilize or disrupt ocular growth. We survey these efforts to present what is currently known regarding the regulation of ocular growth rates.
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Affiliation(s)
- Jos Rozema
- Visual Optics Lab Antwerp (VOLANTIS), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium; Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany.
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Pucker AD, Gawne TJ. Fighting Myopia with Intermittent Nearwork Breaks: 20 Seconds Every 20 Minutes Might Not Be Enough Time. Optom Vis Sci 2023; 100:31-32. [PMID: 36705713 DOI: 10.1097/opx.0000000000001965] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
SIGNIFICANCE Practitioners commonly prescribe the 20/20/20 rule with hopes that, if patients follow it, they will reduce their myopic progression. This clinical perspective provides evidence that 20-second break from nearwork every 20 minutes are not enough time to impact ocular growth.The ongoing myopia epidemic is a major public health crisis. Although the correlation between nearwork tasks such as reading, computers, and smartphones and myopia development is controversial, multiple lines of research suggest that sustained nearwork contributes to myopia development. Clinicians have proposed that children should take short breaks from nearwork with a 20-second break every 20 minutes being a common suggestion. Animal model data do strongly support the idea that multiple short breaks across time can cancel out the effects of longer periods of myopia-promoting activities. However, the animal model data also suggest that repeated episodes of 20 seconds are ineffective at reducing myopia development and instead indicate that sustained breaks of 5 minutes or more every hour are needed to negate myopiagenic effects.
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Gawne TJ, She Z, Norton TT. Chromatically simulated myopic blur counteracts a myopiagenic environment. Exp Eye Res 2022; 222:109187. [PMID: 35843288 DOI: 10.1016/j.exer.2022.109187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 06/03/2022] [Accepted: 07/05/2022] [Indexed: 02/09/2023]
Abstract
There is a world-wide epidemic of myopia (nearsightedness), produced largely by human-made environmental visual cues that disrupt the emmetropization feedback mechanism that normally uses defocus cues to produce and maintain eyes in good focus. Previous studies have shown that the wavelength of light affects this process and that myopic defocus can slow the progression of myopia in children. We first asked if continuous exposure to a small cage with restricted viewing distance would produce an environmentally-induced myopia in tree shrews, small diurnal mammals closely related to primates. A group (n = 7) spent 11 days in a small cage with restricted viewing distance; one wall was a video display covered with Maltese crosses that included low-to-high spatial frequencies in the range visible to tree shrews. This group developed myopia (-1.2 ± 0.4 [stderr] D) that was significant relative to a colony group of seven animals (+1.0 ± 0.2 D) raised in mesh cages allowing more distant viewing. We then asked if chromatically-simulated myopic defocus, produced by blurring just the blue channel of the video display, would counteract this environmentally-induced myopia in a group of eight tree shrews. This group instead became significantly hyperopic (+4.0 ± 0.4 D) due to slowed axial elongation. These results demonstrate the high potency of chromatic cues in refractive regulation and may provide the basis for an anti-myopia treatment in humans.
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Affiliation(s)
- Timothy J Gawne
- Department of Optometry and Vision Science, University of Alabama at Birmingham (UAB), USA.
| | - Zhihui She
- Department of Optometry and Vision Science, University of Alabama at Birmingham (UAB), USA
| | - Thomas T Norton
- Department of Optometry and Vision Science, University of Alabama at Birmingham (UAB), USA
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Hsia NY, Wen LY, Chou CY, Lin CL, Wan L, Lin HJ. Increased Risk of Refractive Errors and Amblyopia among Children with Ptosis: A Nationwide Population-Based Study. J Clin Med 2022; 11:jcm11092334. [PMID: 35566461 PMCID: PMC9100637 DOI: 10.3390/jcm11092334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 11/16/2022] Open
Abstract
Background: This study aimed to investigate the risk of refractive errors (astigmatism, myopia, and hyperopia) and amblyopia in children with ptosis and association between age at diagnosis of ptosis and subsequent risks of vision problems. Methods: Retrospective claims data from the Taiwan National Health Insurance Research Database (NHIRD) were analyzed. We identified 1799 children aged 0−18 years who were newly diagnosed with ptosis between 2000 and 2012 and 7187 individuals without the disease. Both cohorts were followed up until 2013 to estimate the incidence of refractive errors and amblyopia. Results: Children with ptosis had 5.93-fold, 3.46-fold, 7.60-fold, and 13.45-fold increases in the risk of developing astigmatism, myopia, hyperopia, and amblyopia, respectively, compared with the control cohort (astigmatism: adjusted hazard ratio, aHR = 5.93, 95% confidence interval, CI = 5.16−6.82; myopia: aHR = 3.46, 95% CI = 3.13−3.83; hyperopia: aHR = 7.60, 95% CI = 5.99−9.63; amblyopia: aHR = 13.45, 95% CI = 10.60−17.05). Children diagnosed with ptosis at an age older than 3 years old had a higher risk of myopia than patients diagnosed with ptosis before age 3. There was no significant difference of the risk of astigmatism, amblyopia, and hyperopia between age groups. Conclusions: Children with ptosis may exhibit a higher risk of astigmatism, myopia, hyperopia, and amblyopia than children without ptosis. The risk of myopia is higher in children with ptosis diagnosed at >3 years than those diagnosed at ≤3 years.
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Affiliation(s)
- Ning-Yi Hsia
- Department of Ophthalmology, China Medical University Hospital, Taichung 40402, Taiwan;
- School of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Li-Yen Wen
- School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan; (L.-Y.W.); (C.-Y.C.)
| | - Ching-Ying Chou
- School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan; (L.-Y.W.); (C.-Y.C.)
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung 40402, Taiwan;
| | - Lei Wan
- School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan; (L.-Y.W.); (C.-Y.C.)
- Department of Medical Laboratory Science and Biotechnology, Asia University, Taichung 41354, Taiwan
- Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung 40402, Taiwan
- Correspondence: (L.W.); (H.-J.L.)
| | - Hui-Ju Lin
- Department of Ophthalmology, China Medical University Hospital, Taichung 40402, Taiwan;
- School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan; (L.-Y.W.); (C.-Y.C.)
- Correspondence: (L.W.); (H.-J.L.)
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Wu T, Wang Y, Wei S, Guo Y, Li X. Developing dynamic defocus curve for evaluating dynamic vision accommodative function. BMC Ophthalmol 2022; 22:106. [PMID: 35248018 PMCID: PMC8898511 DOI: 10.1186/s12886-022-02335-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 03/03/2022] [Indexed: 11/16/2022] Open
Abstract
Background To assess dynamic visual acuity (DVA) under different defocus statuses and explore the assessment of dynamic vision accommodation. Methods Twenty subjects (6 males and 14 females) aged 18 to 35 were recruited. Nonmydriatic subjective refraction (sphere and cylinder) and accommodative tests including negative relative accommodation (NRA), positive relative accommodation (PRA), binocular cross cylinder (BCC) and accommodative facility using a flipper were performed. Binocular static visual acuity (SVA) and DVA at 40 degrees per second (dps) were measured under different defocus statuses (+1.5D to -4D in -0.5D steps) based on the refractive error fully corrected. Static and dynamic defocus curves were plotted. The area under the curve (AUC) and corrected dynamic vision accommodation (CDVAc) were calculated. Results The study showed that the dynamic defocus curve fitted the cubic curve properly (p<0.001). DVA was significantly worse than SVA at all defocused statuses (p<0.001), and the difference was more significant at greater defocus diopters. Single factor analysis indicated that CDVAc was significantly correlated with NRA-PRA (p=0.012) and AUCdynamic (p<0.001). Significant associations were observed between AUCdynamic and PRA (p=0.013) as well as NRA-PRA (p=0.021). Meanwhile, DVA was positively correlated with PRA at 0D, -1.0D, -1.5D, -2.5D and -3.0D (p<0.05) and with NRA-PRA at 0D, -1.0D, -1.5D, -2.0D and -2.5D (p<0.05). Multiple factor regression analysis indicated that CDVAc (0D ~ -3.5D) and SVA (+1.5D ~ +1.0D & -2.5D ~ -4.0D) were significant influential factors for defocused DVA (p<0.05). Conclusions Our study demonstrated that DVA had a defocus curve similar to that of SVA. CDVAc was feasible for the assessment of dynamic vision accommodative function. The dynamic defocus curve test could efficiently be applied in the evaluation of dynamic visual performance under different defocus statuses.
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Zhu X, Kang P, Troilo D, Benavente-Perez A. Temporal properties of positive and negative defocus on emmetropization. Sci Rep 2022; 12:3582. [PMID: 35246571 PMCID: PMC8897502 DOI: 10.1038/s41598-022-07621-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/21/2022] [Indexed: 11/09/2022] Open
Abstract
Studying the temporal integration of visual signals is crucial to understand how time spent on different visual tasks can affect emmetropization and refractive error development. In this study we assessed the effect of interrupting positive and negative lens-imposed defocus with brief periods of unrestricted vision or darkness. A total of forty-six marmosets were treated monocularly with soft contact lenses for 4 weeks from 10 weeks of age (OD: + 5D or − 5D; OS: plano). Two control groups wore + 5D (n = 5) or − 5D (n = 13) lenses continuously for 9 h/day. Two experimental groups had lens-wear interrupted for 30 min twice/day at noon and mid-afternoon by removing lenses and monitoring vision while marmosets sat at the center of a viewing cylinder (normal vision interruption, + 5D: n = 7; − 5D: n = 8) or while they were in the dark (dark interruption, + 5D: n = 7; − 5D: n = 6). The interruption period (30 min/day) represented approx. 10% of the total stimulation time (9 h/day). On-axis refractive error (RE) and vitreous chamber depth (VCD) were measured using an autorefractor and high frequency A-scan ultrasound at baseline and after treatment. Wearing + 5D lenses continuously 9 h/day for 4 weeks induced slowed eye growth and hyperopic shifts in RE in treated relative to contralateral control eyes (relative change, VCD: − 25 ± 11 μm, p > 0.05; RE: + 1.24 ± 0.58 D, p > 0.05), whereas − 5D lens wear resulted in larger and myopic eyes (relative change, VCD: + 109 ± 24 μm, p < 0.001; RE: − 2.03 ± 0.56 D, p < 0.05), significantly different from those in the + 5D lens-treated animals (p < 0.01 for both). Interrupting lens induced defocus with periods of normal vision or darkness for approx. 10% of the treatment time affected the resulting compensation differently for myopic and hyperopic defocus. Interrupting defocus with unrestricted vision reduced − 5D defocus compensation but enhanced + 5D defocus compensation (− 5D, VCD: + 18 ± 33 μm; RE: − 0.93 ± 0.50 D, both p > 0.05; + 5D, VCD: − 86 ± 30 μm; RE: + 1.93 ± 0.50 D, both p < 0.05). Interrupting defocus with darkness also decreased − 5D defocus compensation, but had little effect on + 5D defocus compensation (− 5D, VCD: + 73 ± 34 μm, RE: − 1.13 ± 0.77 D, p > 0.05 for both; + 5D, VCD: − 10 ± 28 μm, RE: + 1.22 ± 0.50 D, p > 0.05 for both). These findings in a non-human primate model of emmetropization are similar to those described in other species and confirm a non-linear model of visual signal integration over time. This suggests a mechanism that is conserved across species and may have clinical implications for myopia management in school-aged children.
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Affiliation(s)
- Xiaoying Zhu
- College of Optometry, State University of New York, 33 West 42nd Street, New York, NY, 10036, USA
| | - Pauline Kang
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, 2052, Australia
| | - David Troilo
- College of Optometry, State University of New York, 33 West 42nd Street, New York, NY, 10036, USA
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12
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Liu S, Chen H, Ma W, Zhong Y, Liang Y, Gu L, Lu X, Li J. Non-coding RNAs and related molecules associated with form-deprivation myopia in mice. J Cell Mol Med 2021; 26:186-194. [PMID: 34841657 PMCID: PMC8742199 DOI: 10.1111/jcmm.17071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/01/2021] [Accepted: 11/15/2021] [Indexed: 01/18/2023] Open
Abstract
The role of miRNAs and its regulatory mechanism in myopia are indeterminate. Our study aimed to investigate potential myopia‐associated non‐coding RNAs and related molecules by performing a comprehensive bioinformatic analysis of miRNA expression profile of mice with form‐deprivation myopia (FDM). Differentially expressed miRNAs in two raw microarray data sets (GSE58124 and GSE84220) from Gene Expression Omnibus (GEO) database were comprehensively analysed using GEO2R. Target genes were predicted using miRDB and enriched with Metascape online tool. Protein‐protein interaction (PPI) networks were constructed utilizing STRING and Cytoscape. Significant differentially expressed miRNAs were validated by real‐time polymerase chain reaction (qRT‐PCR) using RNA extracted from monocular FDM ocular tissues. As result, we identified three upregulated miRNAs (mmu‐miR‐1936, mmu‐miR‐338‐5p, and mmu‐miR‐673‐3p) significantly associated with myopia in the two microarray data sets (p < 0.05 and |Log (Fold Change) |>1). GO functional analysis suggested these three miRNAs were targeted in genes mostly enriched in morphogenesis and developmental growth of retinal tissues. Enrichment analysis revealed top eight transcription factors, including PAX6 and Smad3, related to myopia. Ten hub genes, including Rbx1, Fbxl3, Fbxo27, Fbxl7, Fbxo4, Cul3, Cul2, Klhl5, Fbxl16 and Klhl42, associated with ubiquitin conjugation were identified. qRT‐PCR confirmed the increased expression of mmu‐miR‐1936 and mmu‐miR‐338‐5p (p < 0.05), but no statistical difference was observed in mmu‐miR‐673‐3p expression in myopic retinas. Our findings indicated mmu‐miR‐1936, mmu‐miR‐338‐5p and mmu‐miR‐673‐3p upregulation may be associated with myopia development via post‐transcriptional gene regulation, and identified potential molecules that could be further explored in future studies of the mechanism in myopia.
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Affiliation(s)
- Shanshan Liu
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Huijie Chen
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Wenbei Ma
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yanyan Zhong
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yingying Liang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Lishan Gu
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaohe Lu
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jiali Li
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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13
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Khanal S, Norton TT, Gawne TJ. Amber light treatment produces hyperopia in tree shrews. Ophthalmic Physiol Opt 2021; 41:1076-1086. [PMID: 34382245 DOI: 10.1111/opo.12853] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Exposure to narrow-band red light, which stimulates only the long-wavelength sensitive (LWS) cones, slows axial eye growth and produces hyperopia in tree shrews and macaque monkeys. We asked whether exposure to amber light, which also stimulates only the LWS cones but with a greater effective illuminance than red light, has a similar hyperopia-inducing effect in tree shrews. METHODS Starting at 24 ± 1 days of visual experience, 15 tree shrews (dichromatic mammals closely related to primates) received light treatment through amber filters (BPI 500/550 dyed acrylic) either atop the cage (Filter group, n = 8, 300-400 human lux) or fitted into goggles in front of both eyes (Goggle group, n = 7). Non-cycloplegic refractive error and axial ocular dimensions were measured daily. Treatment groups were compared with age-matched animals (Colony group, n = 7) raised in standard colony fluorescent lighting (100-300 lux). RESULTS At the start of treatment, mean refractive errors were well-matched across the three groups (p = 0.35). During treatment, the Filter group became progressively more hyperopic with age (p < 0.001). By contrast, the Goggle and Colony groups showed continued normal emmetropization. When the treatment ended, the Filter group exhibited significantly greater hyperopia (mean [SE] = 3.5 [0.6] D) compared with the Goggle (0.2 [0.8] D, p = 0.01) and Colony groups (1.0 [0.2] D, p = 0.01). However, the refractive error in the Goggle group was not different from that in the Colony group (p = 0.35). Changes in the vitreous chamber were consistent with the refractive error changes. CONCLUSIONS Exposure to ambient amber light produced substantial hyperopia in the Filter group but had no effect on refractive error in the Goggle group. The lack of effect in the Goggle group could be due to the simultaneous activation of the short-wavelength sensitive (SWS) and LWS cones caused by the scattering of the broad-band light from the periphery of the goggles.
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Affiliation(s)
- Safal Khanal
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Thomas T Norton
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Timothy J Gawne
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama, USA
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14
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Abstract
Myopia, also known as short-sightedness or near-sightedness, is a very common condition that typically starts in childhood. Severe forms of myopia (pathologic myopia) are associated with a risk of other associated ophthalmic problems. This disorder affects all populations and is reaching epidemic proportions in East Asia, although there are differences in prevalence between countries. Myopia is caused by both environmental and genetic risk factors. A range of myopia management and control strategies are available that can treat this condition, but it is clear that understanding the factors involved in delaying myopia onset and slowing its progression will be key to reducing the rapid rise in its global prevalence. To achieve this goal, improved data collection using wearable technology, in combination with collection and assessment of data on demographic, genetic and environmental risk factors and with artificial intelligence are needed. Improved public health strategies focusing on early detection or prevention combined with additional effective therapeutic interventions to limit myopia progression are also needed.
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15
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Delshad S, Collins MJ, Read SA, Vincent SJ. The human axial length and choroidal thickness responses to continuous and alternating episodes of myopic and hyperopic blur. PLoS One 2020; 15:e0243076. [PMID: 33264356 PMCID: PMC7710071 DOI: 10.1371/journal.pone.0243076] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 11/14/2020] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To investigate the change in axial length (AxL) and choroidal thickness (ChT) in response to continuous and alternating episodes of monocular myopic and hyperopic defocus. METHODS The right eye of sixteen young adults was exposed to 60 minute episodes of either continuous or alternating myopic and hyperopic defocus (+3 DS & -3 DS) over six separate days, with the left eye optimally corrected for distance. During alternating defocus conditions, the eye was exposed to either 30 or 15 minute cycles of myopic and hyperopic defocus, with the order of defocus reversed in separate sessions. The AxL and ChT of the right eye were measured before, during and after each defocus condition. RESULTS Significant changes in AxL were observed over time, dependent upon the defocus condition (p < 0.0001). In general, AxL exhibited a greater magnitude of change during continuous than alternating defocus conditions. The maximum AxL elongation was +7 ± 7 μm (p = 0.010) in response to continuous hyperopic defocus and the maximum AxL reduction was -8 ± 10 μm of (p = 0.046) in response to continuous myopic defocus. During both 30 and 15 minute cycles of alternating myopic and hyperopic defocus of equal duration, the effect of opposing blur sessions cancelled each other and the AxL was near baseline levels following the final defocus session (mean change from baseline across all alternating defocus conditions was +2 ± 10 μm, p > 0.05). Similar, but smaller magnitude, changes were observed for ChT. CONCLUSIONS The human eye appears capable of temporal averaging of visual cues from alternating myopic and hyperopic defocus. In the short term, this integration appears to be a cancellation of the effects of the preceding defocus condition of opposite sign.
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Affiliation(s)
- Samaneh Delshad
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Kelvin Grove, Queensland, Australia
- * E-mail:
| | - Michael John Collins
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Kelvin Grove, Queensland, Australia
| | - Scott Andrew Read
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Kelvin Grove, Queensland, Australia
| | - Stephen James Vincent
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Kelvin Grove, Queensland, Australia
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16
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Gawne TJ, Norton TT. An opponent dual-detector spectral drive model of emmetropization. Vision Res 2020; 173:7-20. [PMID: 32445984 DOI: 10.1016/j.visres.2020.03.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 03/21/2020] [Accepted: 03/25/2020] [Indexed: 02/03/2023]
Abstract
In post-natal developing eyes a feedback mechanism uses optical cues to regulate axial growth so as to achieve good focus, a process termed emmetropization. However, the optical cues that the feedback mechanism uses have remained unclear. Here we present evidence that a primary visual cue may be the detection of different image statistics by the short-wavelength sensitive (SWS) and long-wavelength sensitive (LWS) cone photoreceptors, caused by longitudinal chromatic aberration (LCA). We use as a model system the northern tree shrew Tupaia belangeri, diurnal cone-dominated dichromatic mammals closely related to primates. We present an optical model in which the SWS and LWS photoreceptors each represent an image at different levels of defocus. The model posits that an imbalance between SWS and LWS image statistics directs eye growth towards the point at which these image statistics are in balance. Under spectrally broadband ("white") lighting, the focus of the eye is driven to a target point approximately in the middle of the visible spectrum, which is emmetropia. Calculations suggest that the SWS cone array, despite the sparse number of SWS cones, can plausibly detect the wavelength-dependent differences in defocus and guide refractive development. The model is consistent with the effects of various narrow-band illuminants on emmetropization in tree shrews. Simulations suggest that common artificial light spectra do not interfere with emmetropization. Simulations also suggest that multi-spectral multi-focal lenses, where the different optical zones of a multifocal lens have different spectral filtering properties, could be an anti-myopia intervention.
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Affiliation(s)
- Timothy J Gawne
- Dept. of Optometry and Vision Science, University of Alabama at Birmingham (UAB), Birmingham, AL, United States.
| | - Thomas T Norton
- Dept. of Optometry and Vision Science, University of Alabama at Birmingham (UAB), Birmingham, AL, United States
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17
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Chakraborty R, Ostrin LA, Benavente-Perez A, Verkicharla PK. Optical mechanisms regulating emmetropisation and refractive errors: evidence from animal models. Clin Exp Optom 2019; 103:55-67. [PMID: 31742789 DOI: 10.1111/cxo.12991] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/24/2019] [Accepted: 09/25/2019] [Indexed: 12/22/2022] Open
Abstract
Our current understanding of emmetropisation and myopia development has evolved from decades of work in various animal models, including chicks, non-human primates, tree shrews, guinea pigs, and mice. Extensive research on optical, biochemical, and environmental mechanisms contributing to refractive error development in animal models has provided insights into eye growth in humans. Importantly, animal models have taught us that eye growth is locally controlled within the eye, and can be influenced by the visual environment. This review will focus on information gained from animal studies regarding the role of optical mechanisms in guiding eye growth, and how these investigations have inspired studies in humans. We will first discuss how researchers came to understand that emmetropisation is guided by visual feedback, and how this can be manipulated by form-deprivation and lens-induced defocus to induce refractive errors in animal models. We will then discuss various aspects of accommodation that have been implicated in refractive error development, including accommodative microfluctuations and accommodative lag. Next, the impact of higher order aberrations and peripheral defocus will be discussed. Lastly, recent evidence suggesting that the spectral and temporal properties of light influence eye growth, and how this might be leveraged to treat myopia in children, will be presented. Taken together, these findings from animal models have significantly advanced our knowledge about the optical mechanisms contributing to eye growth in humans, and will continue to contribute to the development of novel and effective treatment options for slowing myopia progression in children.
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Affiliation(s)
- Ranjay Chakraborty
- College of Nursing and Health Sciences, Optometry and Vision Science, Flinders University, Adelaide, Australia
| | - Lisa A Ostrin
- University of Houston College of Optometry, Houston, Texas, USA
| | | | - Pavan Kumar Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, LV Prasad Eye Institute, Hyderabad, India
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18
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Wen L, Cheng Q, Lan W, Cao Y, Li X, Lu Y, Lin Z, Pan L, Zhu H, Yang Z. An Objective Comparison of Light Intensity and Near-Visual Tasks Between Rural and Urban School Children in China by a Wearable Device Clouclip. Transl Vis Sci Technol 2019; 8:15. [PMID: 31772826 PMCID: PMC6859833 DOI: 10.1167/tvst.8.6.15] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 09/22/2019] [Indexed: 12/19/2022] Open
Abstract
Purpose To compare light intensity and near-visual tasks objectively between rural and urban children. Methods Clouclip, a wearable device, was applied to assess metrics of these two factors in 78 fifth-grade students from an urban and from a rural school. Results The light intensity experienced by urban students was found significantly lower both in the school period (614.05 ± 178.77 vs. 918.41 ± 257.81 lux, P < 0.001) and on the weekend (444.53 ± 216.65 vs. 882.21 ± 536.67 lux, P < 0.001). The duration of exposure to bright light (>1000 lux) was also substantially shorter for urban students. Although no significant difference was found in near work–related behaviors during the school period and the weekend, for the after-school period the urban students had a shorter average viewing distance (30.94 ± 4.14 vs. 34.81 ± 3.93 cm, P < 0.001), a longer accumulated duration of near work (2.25 ± 0.53 vs. 1.95 ± 0.46 hours, P = 0.010), a greater time ratio of near work (56% ± 14% vs. 49% ± 14%, P = 0.045), and a greater time ratio of excessively close near work (49% ± 13% vs. 40% ± 12%, P = 0.001). Conclusions Our data indicate there were substantial differences in light exposure and near-work metrics between the two regions. The correlation between these differences and the discrepancy in regional myopia prevalence needs further investigation. Translational Relevance The objective quantification of these metrics might help explain the varied myopia prevalence among regions.
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Affiliation(s)
- Longbo Wen
- Aier School of Ophthalmology, Central South University, Hunan, China
| | - Qian Cheng
- State Key Laboratory of Software Development Environment, Beihang University, Beijing, China
| | - Weizhong Lan
- Aier School of Ophthalmology, Central South University, Hunan, China.,Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Hubei, China
| | - Yingpin Cao
- Aier School of Ophthalmology, Central South University, Hunan, China
| | - Xiaoning Li
- Aier School of Ophthalmology, Central South University, Hunan, China.,Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Hubei, China
| | - Yiqiu Lu
- Aier School of Ophthalmology, Central South University, Hunan, China
| | - Zhenghua Lin
- Aier School of Ophthalmology, Central South University, Hunan, China
| | - Lun Pan
- Aier School of Ophthalmology, Central South University, Hunan, China.,Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Hubei, China
| | - Haogang Zhu
- State Key Laboratory of Software Development Environment, Beihang University, Beijing, China
| | - Zhikuan Yang
- Aier School of Ophthalmology, Central South University, Hunan, China.,Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Hubei, China
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19
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Daniel MC, Dubis AM, MacPhee B, Ibanez P, Adams G, Brookes J, Papadopoulos M, Khaw PT, Theodorou M, Dahlmann-Noor AH. Optical Coherence Tomography Findings After Childhood Lensectomy. Invest Ophthalmol Vis Sci 2019; 60:4388-4396. [PMID: 31634396 PMCID: PMC6798320 DOI: 10.1167/iovs.19-26806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To explore the impact of childhood lensectomy on posterior segment development. Methods Cross-sectional observational study at children's eye clinics at a tertiary referral center in London, UK. We included 45 children age 4 to 16 years with healthy eyes and 38 who had undergone lensectomy. We acquired posterior segment optical coherence tomography scans of both eyes. We used parametric and nonparametric tests in SPSS24 for the comparison of parameters between groups and within individuals; a P value less than 0.05 was considered significant. The main outcome measures were foveal pit depth and subfoveal choroidal thickness (CT). Secondary outcomes were inner and outer ring CT and photoreceptor layer parameters, macular and peripapillary retinal nerve fiber layer thickness. Results Foveal pit depth and subfoveal CT are significantly reduced in eyes that have undergone lensectomy compared with nonoperated eyes. Inner ring CT and outer ring CT are reduced. Foveal inner retinal layer thickness is increased. Mean inner retinal and outer nuclear layer thickness are not affected. Conclusions Childhood lensectomy is associated with a reduction in developmental foveal pit deepening and lack of developmental thickening of the posterior choroid. Mechanical and optical disruption of foveal and subfoveal choroidal development may affect structural foveal development after childhood lensectomy.
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Affiliation(s)
- Moritz C Daniel
- National Institute of Health Research Moorfields Biomedical Research Centre, London, United Kingdom.,Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Adam M Dubis
- National Institute of Health Research Moorfields Biomedical Research Centre, London, United Kingdom
| | - Becky MacPhee
- National Institute of Health Research Moorfields Biomedical Research Centre, London, United Kingdom
| | - Patricia Ibanez
- National Institute of Health Research Moorfields Biomedical Research Centre, London, United Kingdom
| | - Gillian Adams
- Paediatric Service, Moorfields Eye Hospital, London, United Kingdom
| | - John Brookes
- Glaucoma Service, Moorfields Eye Hospital, London, United Kingdom
| | | | - Peng T Khaw
- National Institute of Health Research Moorfields Biomedical Research Centre, London, United Kingdom.,Glaucoma Service, Moorfields Eye Hospital, London, United Kingdom
| | - Maria Theodorou
- National Institute of Health Research Moorfields Biomedical Research Centre, London, United Kingdom.,Paediatric Service, Moorfields Eye Hospital, London, United Kingdom
| | - Annegret H Dahlmann-Noor
- National Institute of Health Research Moorfields Biomedical Research Centre, London, United Kingdom.,Paediatric Service, Moorfields Eye Hospital, London, United Kingdom
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20
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Short Interruptions of Imposed Hyperopic Defocus Earlier in Treatment are More Effective at Preventing Myopia Development. Sci Rep 2019; 9:11459. [PMID: 31391523 PMCID: PMC6685965 DOI: 10.1038/s41598-019-48009-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 07/29/2019] [Indexed: 12/21/2022] Open
Abstract
The purpose of this study was to evaluate the effect of interrupting negative lens wear for short periods early or late during the development of lens-induced myopia in marmosets. Sixteen marmosets were reared with a −5D contact lens on their right eye (plano on contralateral eye) for 8 weeks. Eight marmosets had lenses removed for 30 mins twice/day during the first four weeks (early interruption) and eight during the last four weeks (late interruption). Data were compared to treated controls that wore lenses continuously (N = 12) and untreated controls (N = 10). Interocular differences (IOD) in vitreous chamber (VC) depth and central and peripheral mean spherical refractive error (MSE) were measured at baseline and after four (T4) and eight (T8) weeks of treatment. Visual experience during the interruptions was monitored by measuring refraction while marmosets were seated at the center of a 1 m radius viewing cylinder. At T4 the eyes that were interrupted early were not different from untreated controls (p = 0.10) and at T8 had grown less and were less myopic than those interrupted later (IOD change from baseline, VC: +0.07 ± 0.04 mm vs +0.20 ± 0.03 mm, p < 0.05; MSE: −1.59 ± 0.26D vs −2.63 ± 0.60D, p = 0.13). Eyes interrupted later were not different from treated controls (MSE, p = 0.99; VC, p = 0.60) and grew at the same rate as during the first four weeks of uninterrupted lens wear (T4 − T0: 3.67 ± 1.1 µm/day, T8 − T4: 3.56 ± 1.3 µm/day p = 0.96). Peripheral refraction was a predictive factor for the amount of myopia developed only when the interruption was not effective. In summary, interrupting hyperopic defocus with short periods of myopic defocus before compensation occurs prevents axial myopia from developing. After myopia develops, interruption is less effective.
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21
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Moderiano D, Do M, Hobbs S, Lam V, Sarin S, Alonso-Caneiro D, Chakraborty R. Influence of the time of day on axial length and choroidal thickness changes to hyperopic and myopic defocus in human eyes. Exp Eye Res 2019; 182:125-136. [DOI: 10.1016/j.exer.2019.03.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 03/15/2019] [Accepted: 03/23/2019] [Indexed: 12/31/2022]
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22
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Troilo D, Smith EL, Nickla DL, Ashby R, Tkatchenko AV, Ostrin LA, Gawne TJ, Pardue MT, Summers JA, Kee CS, Schroedl F, Wahl S, Jones L. IMI - Report on Experimental Models of Emmetropization and Myopia. Invest Ophthalmol Vis Sci 2019; 60:M31-M88. [PMID: 30817827 PMCID: PMC6738517 DOI: 10.1167/iovs.18-25967] [Citation(s) in RCA: 231] [Impact Index Per Article: 46.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 10/20/2018] [Indexed: 11/24/2022] Open
Abstract
The results of many studies in a variety of species have significantly advanced our understanding of the role of visual experience and the mechanisms of postnatal eye growth, and the development of myopia. This paper surveys and reviews the major contributions that experimental studies using animal models have made to our thinking about emmetropization and development of myopia. These studies established important concepts informing our knowledge of the visual regulation of eye growth and refractive development and have transformed treatment strategies for myopia. Several major findings have come from studies of experimental animal models. These include the eye's ability to detect the sign of retinal defocus and undergo compensatory growth, the local retinal control of eye growth, regulatory changes in choroidal thickness, and the identification of components in the biochemistry of eye growth leading to the characterization of signal cascades regulating eye growth and refractive state. Several of these findings provided the proofs of concepts that form the scientific basis of new and effective clinical treatments for controlling myopia progression in humans. Experimental animal models continue to provide new insights into the cellular and molecular mechanisms of eye growth control, including the identification of potential new targets for drug development and future treatments needed to stem the increasing prevalence of myopia and the vision-threatening conditions associated with this disease.
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Affiliation(s)
- David Troilo
- SUNY College of Optometry, State University of New York, New York, New York, United States
| | - Earl L. Smith
- College of Optometry, University of Houston, Houston, Texas, United States
| | - Debora L. Nickla
- Biomedical Sciences and Disease, New England College of Optometry, Boston, Massachusetts, United States
| | - Regan Ashby
- Health Research Institute, University of Canberra, Canberra, Australia
| | - Andrei V. Tkatchenko
- Department of Ophthalmology, Department of Pathology and Cell Biology, Columbia University, New York, New York, United States
| | - Lisa A. Ostrin
- College of Optometry, University of Houston, Houston, Texas, United States
| | - Timothy J. Gawne
- School of Optometry, University of Alabama Birmingham, Birmingham, Alabama, United States
| | - Machelle T. Pardue
- Biomedical Engineering, Georgia Tech College of Engineering, Atlanta, Georgia, United States31
| | - Jody A. Summers
- College of Medicine, University of Oklahoma, Oklahoma City, Oklahoma, United States
| | - Chea-su Kee
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Falk Schroedl
- Departments of Ophthalmology and Anatomy, Paracelsus Medical University, Salzburg, Austria
| | - Siegfried Wahl
- Institute for Ophthalmic Research, University of Tuebingen, Zeiss Vision Science Laboratory, Tuebingen, Germany
| | - Lyndon Jones
- CORE, School of Optometry and Vision Science, University of Waterloo, Ontario, Canada
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Rucker F, Henriksen M, Yanase T, Taylor C. The role of temporal contrast and blue light in emmetropization. Vision Res 2018; 151:78-87. [PMID: 28734871 PMCID: PMC5794642 DOI: 10.1016/j.visres.2017.07.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 05/26/2017] [Accepted: 07/05/2017] [Indexed: 10/19/2022]
Abstract
A previous experiment showed that blue light (as a component of white light) protected against low temporal frequency dependent eye growth. This experiment investigated the role of temporal contrast. White leghorn chicks were exposed to white (with blue) or yellow (without blue) LED lighting modulated at either low (0.2Hz) or high (10Hz) temporal frequencies. Four cone contrast conditions were used: low (16%), medium (32%), medium-high (60%) and very-high (80%). Chicks were exposed to the lighting condition for 3days (mean 680lux). Exposure to high temporal frequencies, with very high temporal contrast, reduced eye growth, regardless of spectral content. However, at low temporal frequencies, eye growth was dependent on the illuminant. At lower temporal contrast levels, growth increased regardless of temporal or spectral characteristics. To conclude, very high temporal contrast, white light, provides a "stop" signal for eye growth that overrides temporal cues for growth that manifest in yellow light.
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Affiliation(s)
- Frances Rucker
- New England College of Optometry, Dept. of Biomedical Science, 424 Beacon St., Boston, MA 02115, United States.
| | - Mark Henriksen
- Illinois College of Optometry, 3241 South Michigan Ave., Chicago, IL 60616, United States
| | - Tiffany Yanase
- Marshall B. Ketchum University, 2575 Yorba Linda Blvd, Fullerton, CA 92831, United States
| | - Christopher Taylor
- New England College of Optometry, Dept. of Biomedical Science, 424 Beacon St., Boston, MA 02115, United States
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Ward AH, Norton TT, Huisingh CE, Gawne TJ. The hyperopic effect of narrow-band long-wavelength light in tree shrews increases non-linearly with duration. Vision Res 2018; 146-147:9-17. [PMID: 29655781 DOI: 10.1016/j.visres.2018.03.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 02/28/2018] [Accepted: 03/05/2018] [Indexed: 10/17/2022]
Abstract
During postnatal refractive development, an emmetropization mechanism uses refractive error to modulate the growth rate of the eye. Hyperopia (image focused behind the retina) produces what has been described as "GO" signaling that increases growth. Myopia (image focused in front of the retina) produces "STOP" signaling that slows growth. The interaction between GO and STOP conditions is non-linear; brief daily exposure to STOP counteracts long periods of GO. In young tree shrews, long-wavelength (red) light, presented 14 h per day, also appears to produce STOP signals. We asked if red light also shows temporal non-linearity; does brief exposure slow the normal decrease in hyperopia in infant animals? At 11 days after eye opening (DVE), infant tree shrews (n = 5/group) began 13 days of daily treatment (red LEDs, 624 ± 10 or 636 ± 10 nm half peak intensity bandwidth) at durations of 0 h (normal animals, n = 7) or 1, 2, 4, or 7 h. Following each daily red period, colony lighting resumed. A 14 h red group had no colony lights. Refractive state was measured daily; ocular component dimensions at the end of the 13-day red-light period. Even 1 h of red light exposure produced some hyperopia. The average hyperopic shift from normal rose exponentially with duration (time constant 2.5 h). Vitreous chamber depth decreased non-linearly with duration (time constant, 3.3 h). After red treatment was discontinued, refractions in colony lighting recovered toward normal; the initial rate was linearly related to the amount of hyperopia. The red light may produce STOP signaling similar to myopic refractive error.
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Affiliation(s)
- Alexander H Ward
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, AL 35294, United States
| | - Thomas T Norton
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, AL 35294, United States
| | - Carrie E Huisingh
- Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, AL 35294, United States
| | - Timothy J Gawne
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, AL 35294, United States.
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25
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Abstract
PURPOSE To compare peripheral refraction along both the horizontal and vertical retinal meridians before and after orthokeratology (OK) lens wear. METHODS Nineteen young adult myopic subjects (mean age, 28 ± 7 years) were fitted with OK lenses in both eyes. Central and peripheral refraction and corneal topography measurements were taken before and after 14 nights of OK. All measurements were taken with no correction or OK lens in place. RESULTS At baseline before OK, peripheral spherical equivalent refraction (M) across the horizontal meridian did not vary significantly from center. M across the vertical meridian was more myopic than the center (p < 0.05). After OK, there was a significant hyperopic shift in M (p < 0.001); both meridians now experienced myopic peripheral refraction. At baseline, J180 across the horizontal meridian was more negative than the center, and along the vertical meridian, it was more positive than the center (all p < 0.05). At baseline, J45 was more positive than center with increased eccentricity in the temporal and inferior retina and more negative than center with increased eccentricity in the nasal and superior retina. Orthokeratology caused greater rate of change of peripheral J180 across both retinal meridians (p < 0.001). Furthermore, compared with baseline, J45 became more positive in the nasal and superior retina and more negative in the temporal and inferior retina (all p < 0.05). CONCLUSIONS Orthokeratology lenses induced significant changes in peripheral refraction along the horizontal and vertical meridians. As peripheral myopia was measured at baseline along the vertical meridian, the results of our study suggest that inducing greater degrees of myopic defocus on to the peripheral retina, more than habitually experienced, may be required for effective myopia control. Further investigation into the critical threshold of retinal area receiving myopic defocus and the impact of duration of exposure is necessary to improve the efficacy of current myopia control treatments.
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Changes in Peripheral Refraction, Higher-Order Aberrations, and Accommodative Lag With a Radial Refractive Gradient Contact Lens in Young Myopes. Eye Contact Lens 2017; 42:380-387. [PMID: 26808699 DOI: 10.1097/icl.0000000000000222] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE To evaluate changes in the peripheral refraction (PR), visual quality, and accommodative lag with a novel soft radial refractive gradient (SRRG) experimental contact lens that produces peripheral myopic defocus. METHODS 59 myopic right eyes were fitted with the lens. The PR was measured up to 30° in the nasal and temporal horizontal visual fields and compared with values obtained without the lens. The accommodative lag was measured monocularly using the distance-induced condition method at 40 cm, and the higher-order aberrations (HOAs) of the entire eye were obtained for 3- and 5-mm pupils by aberrometry. Visual performance was assessed through contrast sensitivity function (CSF). RESULTS With the lens, the relative PR became significantly less hyperopic from 30° to 15° temporally and 30° nasally in the M and J0 refractive components (P<0.05). Cylinder foci showed significant myopization from 30° to 15° temporally and 30° to 25° nasally (P<0.05). The HOAs increased significantly, the CSF decreased slightly but reached statistical significance for 6 and 12 cycles per degree (P<0.05), and the accommodative lag decreased significantly with the SRRG lens (P=0.0001). There was a moderate correlation between HOAs and CSF at medium and high spatial frequencies. CONCLUSION The SRRG lens induced a significant change in PR, particularly in the temporal retina. Tangential and sagittal foci changed significantly in the peripheral nasal and temporal retina. The decreased accommodative lag and increased HOAs particularly in coma-like aberration may positively affect myopia control. A longitudinal study is needed to confirm this potential.
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27
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Chiang STH, Phillips JR, Backhouse S. Effect of retinal image defocus on the thickness of the human choroid. Ophthalmic Physiol Opt 2015; 35:405-13. [PMID: 26010292 DOI: 10.1111/opo.12218] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 05/02/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE To describe the time-course and amplitude of changes to sub-foveal choroidal thickness (SFCT) induced by imposed hyperopic and myopic retinal defocus and to compare the responses in emmetropic and myopic subjects. METHODS Twelve East Asian subjects (age: 18-34 years; six were emmetropic and six had myopia between -2.00 and -5.00 dioptres (D)) viewed a distant target (video movie at 6 m) for 60 min on two separate occasions while optical coherence tomography (OCT) images of the choroid were taken in both eyes every 5 min to monitor SFCT. On each occasion, one eye was optimally corrected for distance with a contact lens while the other eye wore a contact lens imposing either 2.00 D hyperopic or 2.00 D myopic retinal defocus. RESULTS Baseline SFCT in myopic eyes (mean ± S.D.): 256 ± 42 μm was significantly less than in emmetropic eyes (423 ± 62 μm; p < 0.01) and was correlated with magnitude of myopia (-39 μm per dioptre of myopia, R(2) = 0.67: p < 0.01). Repeated measures anova (General Linear Model) analysis revealed that in both subject groups, 2.00 D of myopic defocus caused a rapid increase in SFCT in the defocussed eye (significant by 10 min, increasing to approximately 20 μm within 60 min: p < 0.01), with little change in the control eye. In contrast, 2.00 D of hyperopic defocus caused a decrease in SFCT in the experimental eye (significant by 20-35 min. SFCT decreased by approximately 20 μm within 60 min: p < 0.01) with little change in the control eye. CONCLUSIONS Small but significant changes in SFCT (5-8%) were caused by retinal defocus. SFCT increased within 10 min of exposure to 2.00 D of monocular myopic defocus, but decreased more slowly in response to 2.00 D of monocular hyperopic defocus. In our relatively small sample we could detect no difference in the magnitude of changes to SFCT caused by defocus in myopic eyes compared to emmetropic eyes.
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Affiliation(s)
- Samuel T-H Chiang
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - John R Phillips
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
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Oxidative stress in myopia. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2015; 2015:750637. [PMID: 25922643 PMCID: PMC4397465 DOI: 10.1155/2015/750637] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 03/10/2015] [Accepted: 03/17/2015] [Indexed: 12/25/2022]
Abstract
Myopia affected approximately 1.6 billion people worldwide in 2000, and it is expected to increase to 2.5 billion by 2020. Although optical problems can be corrected by optics or surgical procedures, normal myopia and high myopia are still an unsolved medical problem. They frequently predispose people who have them to suffer from other eye pathologies: retinal detachment, glaucoma, macular hemorrhage, cataracts, and so on being one of the main causes of visual deterioration and blindness. Genetic and environmental factors have been associated with myopia. Nevertheless, lack of knowledge in the underlying physiopathological molecular mechanisms has not permitted an adequate diagnosis, prevention, or treatment to be found. Nowadays several pieces of evidence indicate that oxidative stress may help explain the altered regulatory pathways in myopia and the appearance of associated eye diseases. On the one hand, oxidative damage associated with hypoxia myopic can alter the neuromodulation that nitric oxide and dopamine have in eye growth. On the other hand, radical superoxide or peroxynitrite production damage retina, vitreous, lens, and so on contributing to the appearance of retinopathies, retinal detachment, cataracts and so on. The objective of this review is to suggest that oxidative stress is one of the key pieces that can help solve this complex eye problem.
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Efficacy of Chinese eye exercises on reducing accommodative lag in school-aged children: a randomized controlled trial. PLoS One 2015; 10:e0117552. [PMID: 25742161 PMCID: PMC4350838 DOI: 10.1371/journal.pone.0117552] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 12/24/2014] [Indexed: 02/05/2023] Open
Abstract
Purpose To evaluate the efficacy of Chinese eye exercises on reducing accommodative lag in children by a randomized, double-blinded controlled trial. Methods A total of 190 children aged 10 to 14 years with emmetropia to moderate myopia were included. They were randomly allocated to three groups: standard Chinese eye exercises group (trained for eye exercises by doctors of traditional Chinese medicine); sham point eye exercises group (instructed to massage on non-acupoints); and eyes closed group (asked to close their eyes without massage). Primary outcome was change in accommodative lag immediately after intervention. Secondary outcomes included changes in corrected near and distant visual acuity, and visual discomfort score. Results Children in the standard Chinese eye exercises group had significantly greater alleviation of accommodative lag (-0.10D) than those in sham point eye exercises group (-0.03D) and eyes closed group (0.07D) (P = 0.04). The proportion of children with alleviation of accommodative lag was significantly higher in the standard Chinese eye exercises group (54.0%) than in the sham point eye exercises group (32.8%) and the eyes closed group (34.9%) (P = 0.03). No significant differences were found in secondary outcomes. Conclusion Chinese eye exercises as performed daily in primary and middle schools in China have statistically but probably clinically insignificant effect in reducing accommodative lag of school-aged children in the short-term. Considering the higher amounts of near work load of Chinese children, the efficacy of eye exercises may be insufficient in preventing myopia progression in the long-term. Trial Registration ClinicalTrials.gov NCT01756287
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Benavente-Pérez A, Nour A, Troilo D. Axial eye growth and refractive error development can be modified by exposing the peripheral retina to relative myopic or hyperopic defocus. Invest Ophthalmol Vis Sci 2014; 55:6765-73. [PMID: 25190657 PMCID: PMC4209715 DOI: 10.1167/iovs.14-14524] [Citation(s) in RCA: 143] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 08/25/2014] [Indexed: 01/09/2023] Open
Abstract
PURPOSE Bifocal contact lenses were used to impose hyperopic and myopic defocus on the peripheral retina of marmosets. Eye growth and refractive state were compared with untreated animals and those treated with single-vision or multizone contact lenses from earlier studies. METHODS Thirty juvenile marmosets wore one of three experimental annular bifocal contact lens designs on their right eyes and a plano contact lens on the left eye as a control for 10 weeks from 70 days of age (10 marmosets/group). The experimental designs had plano center zones (1.5 or 3 mm) and +5 diopters [D] or -5 D in the periphery (referred to as +5 D/1.5 mm, +5 D/3 mm and -5 D/3 mm). We measured the central and peripheral mean spherical refractive error (MSE), vitreous chamber depth (VC), pupil diameter (PD), calculated eye growth, and myopia progression rates prior to and during treatment. The results were compared with age-matched untreated (N=25), single-vision positive (N=19), negative (N=16), and +5/-5 D multizone lens-reared marmosets (N=10). RESULTS At the end of treatment, animals in the -5 D/3 mm group had larger (P<0.01) and more myopic eyes (P<0.05) than animals in the +5 D/1.5 mm group. There was a dose-dependent relationship between the peripheral treatment zone area and the treatment-induced changes in eye growth and refractive state. Pretreatment ocular growth rates and baseline peripheral refraction accounted for 40% of the induced refraction and axial growth rate changes. CONCLUSIONS Eye growth and refractive state can be manipulated by altering peripheral retinal defocus. Imposing peripheral hyperopic defocus produces axial myopia, whereas peripheral myopic defocus produces axial hyperopia. The effects are smaller than using single-vision contact lenses that impose full-field defocus, but support the use of bifocal or multifocal contact lenses as an effective treatment for myopia control.
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Affiliation(s)
| | - Ann Nour
- SUNY College of Optometry, New York, New York, United States
| | - David Troilo
- SUNY College of Optometry, New York, New York, United States
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