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Saad A, Steinberg J, Frings A. Repeatability of pupil diameter measurements using three different topography devices. PLoS One 2023; 18:e0290417. [PMID: 37594948 PMCID: PMC10437858 DOI: 10.1371/journal.pone.0290417] [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: 04/16/2023] [Accepted: 08/07/2023] [Indexed: 08/20/2023] Open
Abstract
PURPOSE To evaluate the intra- and inter-device repeatability of pupil diameter measurements using three different devices in patients prior to corneal refractive surgery. METHODS We examined preoperative measurements from a total of 204 eyes (102 patients) scheduled for corneal refractive surgery at two private centers between July and December 2021. Three consecutive scans were performed with three different devices (Sirius anterior segment analyzer, Pentacam HR, IOLMaster 500) in the same session by the same examiner under standardized conditions. To assess the intra- and inter-device repeatability, we calculated the Intraclass Correlation Coefficient (ICC) and demonstrated results using Bland-Altman plots. RESULTS The measurement accuracy (intra-device repeatability) of Sirius and IOLMaster was comparable (ICC = 0.64 and 0.61, respectively), with almost no statistically significant differences. Sirius showed the highest measurement accuracy among the three devices. Pentacam measurements resulted in lower precision, with an ICC of 0.09. The agreement between the pairs of devices (inter-device repeatability) was low (wide LoA ranges, Table 5). CONCLUSION In this study, the intra-device repeatability of Sirius and IOLMaster was higher than that of the Pentacam, although it did not achieve an optimal level across all three devices. The three devices examined cannot be used interchangeably.
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Affiliation(s)
- Amr Saad
- Department of Ophthalmology, University Hospital of Duesseldorf, Duesseldorf, Germany
| | - Johannes Steinberg
- Department of Ophthalmology, University Medical Center, Hamburg, Germany
- Zentrum Sehstärke, Hamburg, Germany
| | - Andreas Frings
- Department of Ophthalmology, University Hospital of Duesseldorf, Duesseldorf, Germany
- Augenheilkunde & Augenlaser Zentrum PD Dr. med. A. Frings, Nuremberg, Germany
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Zhao W, Zhao J, Han T, Wang J, Zhang Z, Zhou X. A Comprehensive Investigation of Contrast Sensitivity and Disk Halo in High Myopia Treated With SMILE and EVO Implantable Collamer Lens Implantation. Transl Vis Sci Technol 2022; 11:23. [PMID: 35452094 PMCID: PMC9055559 DOI: 10.1167/tvst.11.4.23] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate the clinical outcomes in small incision lenticule extraction (SMILE) and EVO implantable Collamer lens (ICL)–treated high myopia. Methods Thirty-three SMILE-treated and 32 EVO ICL-treated patients were included and followed up for 6 months. Subjective refraction, contrast sensitivity, and disk halo size were measured preoperatively and postoperatively. Patient-reported outcomes (PROs) were obtained at the final visit. Results Significant differences in efficacy and safety indices were observed between the SMILE and EVO ICL groups at 6 months postoperatively (P < 0.05). In the SMILE group, the mesopic contrast sensitivity at 2.2 cycles per degree (cpd) and photopic contrast sensitivity at 0.5, 3.4, and 7.1 cpd were significantly improved. In the EVO ICL group, the mesopic contrast sensitivity at 7.1 cpd and photopic contrast sensitivity at 0.5, 7.1, and 14.6 cpd were significantly improved. The halo radii after SMILE were significantly increased at 1 week, showed a decreasing trend at 1 month, returned to baseline at 3 months, and progressed stably at 6 months. However, it was unchanged in the EVO ICL group. Regarding subjective experience, haloes were the most common disturbance with mild and little bothersomeness after EVO ICL in contrast to starbursts after SMILE. Conclusions EVO ICL implantation yielded better visual outcomes, improved contrast sensitivity particularly at high spatial frequencies, had a stabler disk halo size, and increased incidence of haloes, with less influence than that of SMILE. Translational Relevance The disk halo and PRO findings will be of benefit for consultations and evaluations in visual performance and disturbances.
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Affiliation(s)
- Wuxiao Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Jing Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Tian Han
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Jifang Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Zhe Zhang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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Zhao W, Zhao J, Han T, Li M, Wang J, Zhou X. Evaluation of Disk Halo Size and Identification of Correlated Factors in Myopic Adults. Front Med (Lausanne) 2022; 9:743543. [PMID: 35155490 PMCID: PMC8831374 DOI: 10.3389/fmed.2022.743543] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 01/05/2022] [Indexed: 11/15/2022] Open
Abstract
This study aimed to evaluate glare source-induced disk halo size and assess its correlation with higher-order aberrations (HOAs), pupillometry findings, and contrast sensitivity in myopic adults (aged 23.8 ± 4.4 years). In this cross-sectional study, 150 eyes of 150 patients were assessed. All patients underwent routine ophthalmic examinations, wavefront aberrometry, halo size measurement, dynamic pupillometry, and contrast sensitivity tests. Spearman's correlation analysis and independent sample t-tests were performed for data analysis. The mean halo radius was 82.5 ± 21.8 and 236.7 ± 52.2 arc min at 5 and 1 cd/m2 luminance levels, respectively. The values were inversely correlated with internal spherical aberration (SA) (r = −0.175, p = 0.032 and r = −0.241, p = 0.003, respectively), but not correlated with spherical equivalent (SE, both p > 0.05). Positive correlations were observed between halo radius and pupil size, contraction amplitude, and dilation speed during pupillary light reflex. Halo radii at 5 and 1 cd/m2 luminance levels were not significantly correlated with the area under the log contrast sensitivity function (r = −0.093, p = 0.258 and r = −0.149, p = 0.069, respectively). The mean halo radius was not clinically different between myopic and healthy eyes at 5 cd/m2 luminance level and did not differ significantly between the high and low-to-moderate myopia at 5 and 1 cd/m2 luminance levels (all p > 0.05). According to a stepwise linear regression model, the internal SA had a negative effect on the halo radius under low photpic condition; the average pupil diameter, internal SA and corneal HOAs played a large role in determining the halo radius under mesopic condition.
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Affiliation(s)
- Wuxiao Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Jing Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Tian Han
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Meng Li
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Jifang Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
- *Correspondence: Xingtao Zhou
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Gonzalez-Lopez F, Bouza-Miguens C, Tejerina V, Druchkiv V, Mompean B, Ortega-Usobiaga J, Bilbao-Calabuig R. Dynamic assessment of variations in pupil diameter using swept-source anterior segment optical coherence tomography after phakic collamer lens implantation. EYE AND VISION 2021; 8:39. [PMID: 34688308 PMCID: PMC8542318 DOI: 10.1186/s40662-021-00262-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/04/2021] [Indexed: 11/29/2022]
Abstract
Purpose To dynamically assess variations in pupil diameter induced by changes in brightness in myopic eyes implanted with an implantable collamer lens (ICL, STAAR Surgical) with a central port.
Methods This prospective, observational single-center case series study comprised 65 eyes from 65 consecutive patients undergoing ICL implant. A modified commercially available swept-source Fourier-domain anterior segment optical coherence tomography (AS-OCT) device was used for imaging and performing dynamic pupillometry under changing light conditions before and after a mean follow-up interval of four months after surgery. Results Preoperative mean pupil size under photopic conditions was 3.38 ± 0.64 mm; after surgery, this increased to 3.48 ± 0.61 mm. Mean pupil size under scotopic light conditions was 5.72 ± 0.79 mm before surgery and 5.84 ± 0.77 mm postoperatively. The differences between preoperative and postoperative pupil diameter in miosis and mydriasis were 0.10 ± 0.44 mm (P = 0.078) and 0.12 ± 0.58 mm (P = 0.098), respectively. The scotopic pupil exceeded the optic zone of the implanted lens in 39 eyes (60%). The mean central vault value was 412 ± 177 μm under maximum miosis and 506 ± 190 μm under maximum mydriasis. We found a positive correlation between vault and differences in pupil diameter under all light conditions (P < 0.05). Conclusion Dynamic AS-OCT enables a very precise determination of the pupillary diameter in the iris plane. The changes in the pupil diameter under different light conditions after the implantation of an ICL are related to the postoperative vault. Supplementary Information The online version contains supplementary material available at 10.1186/s40662-021-00262-2.
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Affiliation(s)
- Felix Gonzalez-Lopez
- Department of Refractive Surgery, Clinica Baviera, Melchor Fernández Almagro, 9, 28029, Madrid, Spain.
| | - Carmen Bouza-Miguens
- Department of Refractive Surgery, Clinica Baviera, Melchor Fernández Almagro, 9, 28029, Madrid, Spain
| | - Victor Tejerina
- Department of Refractive Surgery, Clinica Baviera, Melchor Fernández Almagro, 9, 28029, Madrid, Spain
| | - Vasyl Druchkiv
- Department of Research and Development, Clinica Baviera, Valencia, Spain
| | - Blas Mompean
- Department of Refractive Surgery, Clinica Baviera, Melchor Fernández Almagro, 9, 28029, Madrid, Spain
| | - Julio Ortega-Usobiaga
- Department of Refractive Surgery, Clinica Baviera, Melchor Fernández Almagro, 9, 28029, Madrid, Spain
| | - Rafael Bilbao-Calabuig
- Department of Refractive Surgery, Clinica Baviera, Melchor Fernández Almagro, 9, 28029, Madrid, Spain
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Kılınç Hekimsoy H, Şekeroğlu MA, Yeşilyaprak N, Doğuizi S, Yılmazbaş P. The pupillary dynamics of patients with physiological anisocoria. Eye (Lond) 2021; 36:1578-1582. [PMID: 34290440 PMCID: PMC9307830 DOI: 10.1038/s41433-021-01696-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 06/26/2021] [Accepted: 07/09/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND To evaluate static pupillometric measurements and making inter-ocular comparative analysis in healthy subjects for demonstrating the prevalance of physiological anisocoria in various lighting conditions and to compare the variations of the dynamic pupillometric measurements of the patients with physiological anisocoria. METHODS Automatic quantitative pupillometry system was used to measure pupillary diameters in low mesopic (0.1 cd/m2), high mesopic (1 cd/m2), low photopic (10 cd/m2) and high photopic (100 cd/m2) conditions. After inter-ocular comparison of these data, the prevalance of physiological anisocoria was detected in four different lighting conditions. The inter-ocular dynamic pupillometric parameters (amplitude, latency, duration and velocity of pupil contraction; latency, duration and velocity of pupil dilation) of these patients were further analysed. RESULTS After inter-ocular comparison of pupillary diameters of 195 participants [96 females (49.2%) and 99 males (50.8%)] with a mean age of 38.4 ± 18.9 years (range 7-78 years), six (3.1%) participants under high photopic; 11 (5.6%) participants under low photopic; 25 (12.8%) participants under high mesopic, and 34 (17.4%) participants under low mesopic illumination levels exhibited physiological anisocoria. The mean relative amplitude of anisocoric small pupils' contraction was lower than the mean relative amplitudes of pupil contraction of both isocoric and anisocoric large pupils (p = 0.021, p = 0.035, respectively). The mean velocity of anisocoric small pupils' contraction was lower than the mean velocity of anisocoric large pupils' contraction (p = 0.013). CONCLUSIONS The mean contraction amplitude and contraction velocity of smaller pupils was lower when compared to fellow larger pupils of anisocoric patients.
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Affiliation(s)
| | | | | | - Sibel Doğuizi
- Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Pelin Yılmazbaş
- Ankara Kudret Eye Hospital, Ophthalmology Clinic, Ankara, Turkey
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Pupillary and Anterior Chamber Changes Following Upper Eyelid Blepharoplasty. Ophthalmic Plast Reconstr Surg 2020; 37:465-469. [PMID: 33315845 DOI: 10.1097/iop.0000000000001917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study investigated the preoperative and postoperative pupillary and anterior chamber (AC) characteristics of patients undergoing upper eyelid blepharoplasty. METHODS This prospective, cross-sectional study examined 32 eyes from 20 dermatochalasis patients. Following a detailed ophthalmological examination, quantitative pupillometry and Scheimpflug corneal topography were used to evaluate the pupil and AC characteristics of eyes on the day of operation and postoperative days 1 and 7. Static and dynamic pupillometry characteristics, including scotopic, mesopic, low photopic, and high photopic pupil diameter (PD), resting diameter, amplitude, latency, duration, and velocity of pupil contraction, and latency, duration, and velocity of pupil dilation, were measured. Additionally, AC volume, depth, and angle parameters were analyzed. RESULTS There were significant differences between scotopic, mesopic, and resting PD and the amplitude of pupil contraction. Pairwise comparisons showed that postoperative day 1 scotopic, mesopic, and resting PD and amplitude of pupil contraction measurements were significantly higher than preoperative measurements (p = 0.008, p < 0.001, p = 0.006, and p = 0.033, respectively). Additionally, scotopic and resting PD were significantly lower on postoperative day 7 compared with postoperative day 1 (p = 0.001 and p = 0.041, respectively). However, there were no significant differences in AC parameters. CONCLUSIONS This study revealed that static and dynamic pupil measurements changed following blepharoplasty, with postoperative increased PD occurring particularly under low-light conditions. Therefore, low-light environments should be avoided following blepharoplasty, and patients with angle-closure risk factors should be closely monitored in the early postoperative period.
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