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Yu H, Guo X, Wu J, Wu H, Zhao H. Analyzing the effect of blue-blocking lenses on color vision tests using the chromaticity coordinate method. Heliyon 2024; 10:e32938. [PMID: 38994067 PMCID: PMC11238008 DOI: 10.1016/j.heliyon.2024.e32938] [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: 08/29/2023] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 07/13/2024] Open
Abstract
Significance Blue light with wavelengths of 380-445 nm can harm the retina, leading to the development of blue-blocking lenses (BBLs). Understanding whether BBLs affect color vision test outcomes and color discrimination ability is crucial for people in color-associated jobs. Aim This study aimed to evaluate the effect of BBLs on color vision tests and analyze color discrimination using mathematical models of color spaces. Approach Six pseudoisochromatic (PIC) tests and two Farnsworth-Munsell (FM) tests were conducted to assess participants' color vision. Friedman signed rank test was used to compare the outcomes of the Farnsworth-Munsell 100-Hue Tests (FM 100-Hue Tests) between the BBLs and ordinary lenses groups. The CIE color difference formula and a spectral illuminometer were employed to evaluate the color differences with and without BBLs. Results All subjects showed normal outcomes in all PIC tests and Farnsworth-Munsell Dichotomous D-15 Tests (FM D-15 Tests). There were no significant differences between ordinary lenses group and BBLs groups in FM 100-Hue Tests. In the color space, the effect of BBLs on each color light was equivalent to a translation on the CIE 1931 chromaticity diagram with minor distortion. Since BBLs do not disrupt the continuity of the chromaticity diagram, or cause different colors to appear the same, they do not lead to color confusion. However, colors with short wavelengths exhibited more changes in color difference when wearing BBLs. Conclusions BBLs do not impair the wearer's ability to discriminate colors or perform color vision tests accurately. However, BBLs can cause color differences especially in the recognition of blue hues.
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Affiliation(s)
- Huiyao Yu
- College of science, Zhejiang University of Technology, Hangzhou, 310023, China
| | - Xinwei Guo
- Hospital of Stomatology, Jilin University, Changchun, 130012, China
- Hospital of Stomatology, Peking University, Beijing, 100191, China
| | - Jian Wu
- Hospital of Stomatology, Jilin University, Changchun, 130012, China
| | - Huang Wu
- Department of Optometry, the Second Hospital of Jilin University, Changchun, 130041, China
| | - Hongyan Zhao
- Hospital of Stomatology, Jilin University, Changchun, 130012, China
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2
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Castro-Torres JJ, Casares-López M, Ortiz-Peregrina S, Martino F, Gómez-Robledo L, Jiménez JR. Effect of the chromaticity of stimuli on night vision disturbances. Sci Rep 2024; 14:10183. [PMID: 38702452 PMCID: PMC11068904 DOI: 10.1038/s41598-024-61069-4] [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: 10/17/2023] [Accepted: 04/30/2024] [Indexed: 05/06/2024] Open
Abstract
The perception of halos and other night vision disturbances is a common complaint in clinical practice. Such visual disturbances must be assessed in order to fully characterize each patient's visual performance, which is particularly relevant when carrying out a range of daily tasks. Visual problems are usually assessed using achromatic stimuli, yet the stimuli encountered in daily life have very different chromaticities. Hence, it is important to assess the effect of the chromaticity of visual stimuli on night vision disturbances. The aim of this work is to study the influence of the chromaticity of different visual stimuli on night vision disturbances by analyzing straylight and visual discrimination under low-light conditions. For that, we assessed the monocular and binocular visual discrimination of 27 subjects under low illumination using the Halo test. The subjects' visual discrimination was assessed after exposure to different visual stimuli: achromatic, red, green, and blue, both at the monitor's maximum luminance and maintaining the same luminance value for the different visual stimuli. Monocular straylight was also measured for an achromatic, red, green, and blue stimuli. The blue stimulus had the greatest effect on halos in both monocular and binocular conditions. Visual discrimination was similar for the red, green, and achromatic stimuli, but worsened at lower luminance. The greatest influence of straylight was observed for the blue stimulus. In addition, visual discrimination correlated with straylight measurements for achromatic stimuli, wherein greater straylight values correlated with an increased perception of halos and other visual disturbances.
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Affiliation(s)
- José J Castro-Torres
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071, Granada, Spain.
| | - Miriam Casares-López
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071, Granada, Spain
| | - Sonia Ortiz-Peregrina
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071, Granada, Spain
| | - Francesco Martino
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071, Granada, Spain
| | - Luis Gómez-Robledo
- Basic and Applied Colorimetry Lab, Department of Optics, University of Granada, 18071, Granada, Spain
| | - José R Jiménez
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071, Granada, Spain
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Ballae Ganeshrao S, Theruveethi N, Srinivasan K. Knowledge, perception and practice towards blue-blocking lenses among optometrists. Clin Exp Optom 2024; 107:332-340. [PMID: 37257458 DOI: 10.1080/08164622.2023.2215380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 12/22/2022] [Accepted: 05/09/2023] [Indexed: 06/02/2023] Open
Abstract
CLINICAL RELEVANCE There is a lack of clinical guidelines in India for the prescription of blue-blocking lenses. Therefore, the practice trends will depend on practitioners' knowledge, attitude, and perception. BACKGROUND Exposure to blue light with increased use of light-emitting diode (LED) lights and digital devices along with the commercial availability of blue blocking lenses has warranted the need to understand the factors that influence the prescription of blue blocking lenses among eye care practitioners. Hence, we aim to assess knowledge, perception, and practice pattern of blue blocking lenses among Indian optometrists. METHODS This cross-sectional online survey was conducted among Indian Optometrists. The survey was distributed through various social groups of optometrists and state associations. The questionnaire had four main domains with 29 items in total. The four major domains were knowledge, practice, perception and demographic details on education. Descriptive analysis and logistic regression were performed to study the impact of these domains on the prescription of blue block lenses. RESULTS Out of 341 responses, 247 were included for analysis as per study criteria. About 50% (n = 123) of the participants had appropriate knowledge about blue light. Blue-blocking lenses were prescribed always or most of the time by 52% (n = 130) of the participants. The odds of prescribing blue blocking lenses were higher among practitioners who considered blue light as an important factor in causing computer vision syndrome (OR 3.77, 95% CI: 1.33-10.69, P = 0.01) or if they considered there is adequate published evidence (OR 3.95, 95% CI: 1.58-9.87, P = 0.003). CONCLUSIONS The source of evidence for prescribing blue-blocking lenses for our participants was mainly from advertisements rather than from scientific studies. Factors such as awareness, knowledge, education, and nature of practice did not play a significant role in prescribing blue-blocking lenses. This raises the need for evidence-based practice and the development of practice guidelines for prescribing blue-blocking lenses.
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Affiliation(s)
- Shonraj Ballae Ganeshrao
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Nagarajan Theruveethi
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Krithica Srinivasan
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
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Kitnarong N, Udomwech L, Chongthurakit N, Phongsuphan T, Petchyim S. Effects of blue-light-filtering intraocular lenses on contrast sensitivity in patients with glaucoma. Medicine (Baltimore) 2023; 102:e36821. [PMID: 38206685 PMCID: PMC10754553 DOI: 10.1097/md.0000000000036821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/08/2023] [Indexed: 01/13/2024] Open
Abstract
To compare the effects of blue-light-filtering intraocular lenses (BF-IOLs) and conventional ultraviolet-blocking intraocular lenses (UVB-IOLs) on contrast sensitivity in patients with concurrent cataracts and glaucoma. This prospective randomized comparative interventional study enrolled glaucomatous patients with concurrent cataracts scheduled for cataract surgery with IOL implantation at Siriraj Hospital, Bangkok, Thailand, between October 2016 and March 2018. The patients were randomly assigned to receive BF-IOLs or UVB-IOLs. A functional vision analyzer measured contrast sensitivity at spatial frequencies of 1.5, 3.0, 6.0, 12.0, and 18.0 cycles per degree (CPD). The contrast sensitivity values of the 2 patient groups were compared at 2 months postoperatively. The study enrolled 42 eyes (21 with primary angle-closure glaucoma and 21 with primary open-angle glaucoma) of 32 patients. Twenty eyes received BF-IOLs, and 22 received UVB-IOLs. Postoperative logarithmic contrast sensitivity (log contrast sensitivity) significantly improved at each spatial frequency in both groups, except for 1.5 CPD. The median postoperative log contrast sensitivity values for the spatial frequencies of 1.5, 3.0, 6.0, 12.0, and 18.0 CPD for the BF-IOL group were 1.6, 1.9, 1.8, 1.4, and 0.6, respectively, compared to 1.4, 1.8, 1.7, 1.2, and 0.8 for the UVB-IOL group. However, the 2 groups had no significant differences in log contrast sensitivity values at each spatial frequency (P = .20, .37, .30, .28, and .68, respectively). Cataract surgery with IOL implantation improved contrast sensitivity in glaucomatous patients. The BF-IOLs and UVB-IOLs showed no statistically significant difference in the postoperative contrast sensitivity achieved at each spatial frequency.
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Affiliation(s)
- Naris Kitnarong
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok Noi, Thailand
| | - Lunla Udomwech
- Department of Clinical Science, Walailak University, Nakhon Si Thammarat, Thailand
| | - Nisarate Chongthurakit
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok Noi, Thailand
| | - Theerajate Phongsuphan
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok Noi, Thailand
| | - Sakaorat Petchyim
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok Noi, Thailand
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Chang DH, Thompson VM, Christie WC, Chu YR, Vida RS. Clinical Evaluation of a Modified Light Transmission Short-Wavelength Filtering Intraocular Lens Compared to a Colorless Control. Ophthalmol Ther 2023; 12:1775-1785. [PMID: 37071325 PMCID: PMC10164208 DOI: 10.1007/s40123-023-00709-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/30/2023] [Indexed: 04/19/2023] Open
Abstract
INTRODUCTION The aim of this study was to evaluate the safety and efficacy of a violet-light filtering intraocular lens (IOL) compared to a colorless IOL control. METHODS This was a prospective, bilateral, randomized, comparative, patient/evaluator-masked multi-center clinical trial at 12 sites in the USA. Patients underwent standard small-incision phacoemulsification cataract extraction. Visual acuity, contrast sensitivity, and color vision were tested 12 months postoperatively. Patient satisfaction and vision-related quality of life were evaluated based on directed patient responses obtained from a binocular subjective questionnaire. RESULTS A total of 250 subjects were bilaterally implanted with the violet-light filtering TECNIS monofocal ZV9003 (n = 126) and colorless TECNIS monofocal ZA9003 (n = 124). Mean uncorrected distance visual acuity (UDVA) was 0.123 LogMAR for ZV9003 and 0.116 LogMAR for the ZA9003 group. Mean corrected distance visual acuity (CDVA) was 0.00 LogMAR for both groups. No significant difference was found between the groups for 22/25 questionnaire categories, including color perception. A significant difference was found in favor of the ZV9003 group for day driving, night driving, and frustration with vision. Contrast sensitivity mean difference was < 0.05 log units across all lighting conditions and spatial frequencies. CONCLUSION No difference was found between groups for visual acuity, contrast sensitivity, color testing, and adverse events as well as with the majority of optical/visual symptoms. A statistical difference was noted in driving and frustration with eyesight that may be related to benefits of using a violet-light filtering chromophore. Overall, the violet-light filtering ZV9003 showed excellent visual acuity and contrast sensitivity results with a low incidence of optical/visual symptoms.
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Affiliation(s)
| | | | | | | | - Ryan S Vida
- Johnson & Johnson Surgical Vision, Irvine, CA, USA.
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Vacalebre M, Frison R, Corsaro C, Neri F, Santoro A, Conoci S, Anastasi E, Curatolo MC, Fazio E. Current State of the Art and Next Generation of Materials for a Customized IntraOcular Lens according to a Patient-Specific Eye Power. Polymers (Basel) 2023; 15:polym15061590. [PMID: 36987370 PMCID: PMC10054364 DOI: 10.3390/polym15061590] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/19/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Intraocular lenses (IOLs) are commonly implanted after surgical removal of a cataractous lens. A variety of IOL materials are currently available, including collamer, hydrophobic acrylic, hydrophilic acrylic, PHEMA copolymer, polymethylmethacrylate (PMMA), and silicone. High-quality polymers with distinct physical and optical properties for IOL manufacturing and in line with the highest quality standards on the market have evolved to encompass medical needs. Each of them and their packaging show unique advantages and disadvantages. Here, we highlight the evolution of polymeric materials and mainly the current state of the art of the unique properties of some polymeric systems used for IOL design, identifying current limitations for future improvements. We investigate the characteristics of the next generation of IOL materials, which must satisfy biocompatibility requirements and have tuneable refractive index to create patient-specific eye power, preventing formation of posterior capsular opacification.
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Affiliation(s)
- Martina Vacalebre
- Dipartimento di Scienze Matematiche ed Informatiche, Scienze Fisiche e Scienze della Terra (MIFT), Università di Messina, V.le Ferdinando Stagno d'Alcontres 31, 98166 Messina, Italy
| | - Renato Frison
- Optical Consultant SIFI SpA, 95025 Aci Sant'Antonio (CT), Italy
| | - Carmelo Corsaro
- Dipartimento di Scienze Matematiche ed Informatiche, Scienze Fisiche e Scienze della Terra (MIFT), Università di Messina, V.le Ferdinando Stagno d'Alcontres 31, 98166 Messina, Italy
| | - Fortunato Neri
- Dipartimento di Scienze Matematiche ed Informatiche, Scienze Fisiche e Scienze della Terra (MIFT), Università di Messina, V.le Ferdinando Stagno d'Alcontres 31, 98166 Messina, Italy
| | - Antonio Santoro
- Dipartimento di Scienze Chimiche, Biologiche, Farmacologiche ed Ambientali (CHIBIOFARAM), Università di Messina, V.le Ferdinando Stagno d'Alcontres 31, 98166 Messina, Italy
| | - Sabrina Conoci
- Dipartimento di Scienze Chimiche, Biologiche, Farmacologiche ed Ambientali (CHIBIOFARAM), Università di Messina, V.le Ferdinando Stagno d'Alcontres 31, 98166 Messina, Italy
| | - Elena Anastasi
- Innovation and Medical Science, SIFI SpA, 95025 Aci Sant'Antonio (CT), Italy
| | | | - Enza Fazio
- Dipartimento di Scienze Matematiche ed Informatiche, Scienze Fisiche e Scienze della Terra (MIFT), Università di Messina, V.le Ferdinando Stagno d'Alcontres 31, 98166 Messina, Italy
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Wong NA, Bahmani H. A review of the current state of research on artificial blue light safety as it applies to digital devices. Heliyon 2022; 8:e10282. [PMID: 36042717 PMCID: PMC9420367 DOI: 10.1016/j.heliyon.2022.e10282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 05/13/2022] [Accepted: 08/09/2022] [Indexed: 12/24/2022] Open
Abstract
Light is necessary for human health and well-being. As we spend more time indoors, we are being increasingly exposed to artificial light. The development of artificial lighting has allowed us to control the brightness, colour, and timing of our light exposure. Yet, the widespread use of artificial light has raised concerns about the impact of altering our light environment on our health. The widespread adoption of personal digital devices over the past decade has exposed us to yet another source of artificial light. We spend a significant amount of time using digital devices with light-emitting screens, including smartphones and tablets, at close range. The light emitted from these devices, while appearing white, has an emission spectrum with a peak in the blue range. Blue light is often characterised as hazardous as its photon energy is higher than that of other wavelengths of visible light. Under certain conditions, visible blue light can cause harm to the retina and other ocular structures. Blue light can also influence the circadian rhythm and processes mediated by melanopsin-expressing intrinsically photosensitive retinal ganglion cells. While the blue component of sunlight is necessary for various physiological processes, whether the low-illuminance artificial blue light emitted from digital devices presents a risk to our health remains an ongoing area of debate. As technological advancements continue, it is relevant to understand how new devices may influence our well-being. This review examines the existing research on artificial blue light safety and the eye, visual performance, and circadian functions.
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Affiliation(s)
| | - Hamed Bahmani
- Dopavision GmbH, Berlin, Germany.,Department of Physiology of Cognitive Processes, Max Planck Institute for Biological Cybernetics, Tuebingen, Germany
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See LC, Li PR, Lin KK, Hou CH, Lee JS. Effect of Blue Light-Filtering Intraocular Lenses on Insomnia After Cataract Surgery: A Nationwide Cohort Study With 10-Year Follow-up. Am J Ophthalmol 2022; 239:26-36. [PMID: 35123954 DOI: 10.1016/j.ajo.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE To compare the incidence of clinically diagnosed insomnia after cataract surgery in pseudophakic eyes with blue light-filtering intraocular lenses (BF-IOLs) and non-BF-IOLs. DESIGN Nationwide cohort study using the Taiwan National Health Insurance Research Database. METHODS We enrolled 171,415 patients who underwent cataract surgery in both eyes between 2008 and 2013 and followed them till 2018. Propensity score matching (PSM) was used to balance the baseline characteristics between the 2 IOL groups. The Cox model and cause-specific hazard model were used to estimate the hazard ratios (HRs) and subdistribution hazard ratio (SHR). RESULTS Overall, 19,604 (11.4%) and 151,811 (88.6%) patients had BF-IOL and non-BF-IOL implants, respectively. The BF-IOL group tended to be younger and had fewer chronic diseases. Within a mean follow-up period of 6.2 years, the incidence rates of insomnia (per 100 person-years) in the BF-IOL and non-BF-IOL groups were 2.97 and 3.21, respectively. There was no significant difference in the incidence rate of insomnia between the 2 IOL groups after treating all-cause mortality as a competing risk (SHR 0.98, 95% CI 0.95-1.01) and after PSM (HR 0.97, 95% CI 0.92-1.01), respectively. Subgroup analysis revealed no significant difference in the insomnia rate between the 2 IOL groups for various age groups, 2 sex groups, and men with and without benign prostatic hyperplasia. CONCLUSION In Taiwan, the use of a BF-IOL for up to 10 years had no apparent disadvantage over non-BF-IOLs with respect to insomnia.
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Association between Cataract Surgery and Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis. J Ophthalmol 2022; 2022:6780901. [PMID: 35573811 PMCID: PMC9098349 DOI: 10.1155/2022/6780901] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 01/24/2022] [Accepted: 04/01/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose We performed a systematic review and meta-analysis to evaluate the association between cataract surgery and the development and progression of AMD. Methods This meta-analysis was registered at PROSPERO (CRD42017077962). We conducted a systematic literature search in August 2020 in Embase and PubMed and included cohort studies, case-control studies, or randomized controlled trials (RCTs) if they examined the association between cataract surgery and AMD. Odds ratio (OR) was used as a measure of the association with a random effect model. The analysis was further stratified by factors that could affect the outcomes. Results 15 studies were included in this study. In the overall analysis, cataract surgery was significantly associated with the incidence of late AMD (OR, 1.80; 95% CI, 1.26–2.56; P = 0.001), particularly geographic atrophy (OR, 3.20; 95% CI, 1.90–5.39; P ≤ 0.001). No significant associations were observed between cataract surgery and the incidence of early AMD. Subgroup analysis showed that the OR for incidence of early and late AMD was significantly higher for cataract surgery performed more than 5 years compared with less than 5 years. We also found an increased risk of progression of AMD after cataract surgery performed more than 5 years (OR, 1.97; 95% CI, 1.29–3.01; P = 0.002). Conclusions Our results suggest that cataract surgery may be associated with an increased risk of late AMD development and AMD progression. In addition, increasing the follow-up time since cataract surgery may further increase the risk for the development and progression of AMD. In the future, prospective multicenter studies with well-designed RCTs are required to confirm our findings.
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Fernández-Vega Cueto A, Del Olmo-Aguado S, García-Pérez E, Rodriguez-Uña I, Fernández-Vega Cueto L, Suárez-Barrio C, Alfonso JF, Fernández-Vega L, Merayo-Lloves J. Protector role of intraocular lenses under artificial light conditions. Ophthalmic Res 2021; 65:276-286. [PMID: 34883496 DOI: 10.1159/000521306] [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: 08/13/2021] [Accepted: 12/02/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of this work is to analyse, in an in vitro model, the possible protective effects of ultraviolet- (UV-) or UV/ blue-filtering intraocular lens (IOLs) under LED lighting conditions. METHODS 10 models of IOLs were evaluated. Light transmission spectrum was recorded from 300 to 800 nm, in steps of 1 nm. Photodamage in vitro model was induced in ARPE-19 cells by blue LED light (465-475 nm). Changes in cell viability and oxidative stress variables were studied to assess the protective effect of IOLs. RESULTS UV/blue-filtering IOLs models block blue light spectrum in different proportion and UV-filtering IOLs blocking wavelength below 400 nm. However, in vitro study under blue LED light exposure does not show protective effects related with mitochondrial dysfunction and oxidative stress of UV/blue-filtering IOLs. CONCLUSIONS The current in vitro study suggest that UV/blue filtering IOLs are not useful in terms of photoprotection in artificial light conditions. The results obtained indicate that it is needed to give attention to other IOLs parameters besides the type of filter, as it seems they could have influence also protective role.
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Affiliation(s)
- Andrés Fernández-Vega Cueto
- University Institute Fernández Vega, Ophthalmologic Research Foundation, University of Oviedo, Oviedo, Spain
- Fernández-Vega Ophthalmological Institute, Oviedo, Spain
| | - Susana Del Olmo-Aguado
- University Institute Fernández Vega, Ophthalmologic Research Foundation, University of Oviedo, Oviedo, Spain
- Health Research Institute of Asturias (ISPA), Oviedo, Spain
| | | | | | - Luis Fernández-Vega Cueto
- University Institute Fernández Vega, Ophthalmologic Research Foundation, University of Oviedo, Oviedo, Spain
- Fernández-Vega Ophthalmological Institute, Oviedo, Spain
- Health Research Institute of Asturias (ISPA), Oviedo, Spain
| | - Carlota Suárez-Barrio
- University Institute Fernández Vega, Ophthalmologic Research Foundation, University of Oviedo, Oviedo, Spain
- Health Research Institute of Asturias (ISPA), Oviedo, Spain
| | - José F Alfonso
- Fernández-Vega Ophthalmological Institute, Oviedo, Spain
- Health Research Institute of Asturias (ISPA), Oviedo, Spain
| | - Luis Fernández-Vega
- University Institute Fernández Vega, Ophthalmologic Research Foundation, University of Oviedo, Oviedo, Spain
- Fernández-Vega Ophthalmological Institute, Oviedo, Spain
- Health Research Institute of Asturias (ISPA), Oviedo, Spain
| | - Jesús Merayo-Lloves
- University Institute Fernández Vega, Ophthalmologic Research Foundation, University of Oviedo, Oviedo, Spain
- Health Research Institute of Asturias (ISPA), Oviedo, Spain
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11
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Baldasso M, Roy M, Boon MY, Dain SJ. Effect of blue-blocking lenses on colour discrimination. Clin Exp Optom 2021; 104:56-61. [PMID: 33090580 DOI: 10.1111/cxo.13139] [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] [Indexed: 01/10/2023] Open
Abstract
CLINICAL RELEVANCE Tinted lenses may adversely affect colour discrimination. Before recommending tinted lenses to patients, practitioners should bear in mind any effects on colour discrimination. The effects of 'blue-blocking' spectacle lenses with high luminous transmittance on colour vision is not a concern. BACKGROUND Blue-blocking lenses have been widely promoted by manufacturers and practitioners. The more blue-blocking lenses are known to affect colour vision significantly but there has been no study of the effects of 'blue-blocking' spectacle lenses. METHODS The transmittances of commercially available lenses were measured and the three lenses with the lowest blue light transmittance were selected. Subjects undertook the following computer-based colour vision tests: Colour Assessment and Diagnosis; the Cambridge Colour Test; and the Farnsworth-Munsell 100 Hue Test. RESULTS Blue and luminous transmittances of lenses were documented. The reduction in blue transmittance varied from 12 to 40 per cent (two to 30 per cent compared with an untinted lens). The lenses were found to have no significant, statistical or possibly practical, effect on the results of the three colour vision tests (t-test, analysis of variance, Mann-Whitney, Kruskal-Wallis). CONCLUSION The modest blue light transmittance reduction of the 'blue-blocking' spectacle lenses examined was not sufficient to have a statistically significant effect on colour vision.
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Affiliation(s)
- Manon Baldasso
- School of Optometry and Vision Science, The University of New South Wales , Sydney, Australia
| | - Maitreyee Roy
- School of Optometry and Vision Science, The University of New South Wales , Sydney, Australia
| | - Mei-Ying Boon
- School of Optometry and Vision Science, The University of New South Wales , Sydney, Australia
| | - Stephen J Dain
- School of Optometry and Vision Science, The University of New South Wales , Sydney, Australia
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Xiang Y, Zou M, Zhang Y, Jin R, Nie Y. Drug-loaded and Blue-ray Filtered Hydrogel as a Potential Intraocular Lens for Cataract Treatment. Pharm Nanotechnol 2020; 8:302-312. [PMID: 32167435 DOI: 10.2174/2211738508666200313144112] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 01/21/2020] [Accepted: 02/25/2020] [Indexed: 02/08/2023]
Abstract
Background:
Indomethacin (IND) is a class of non-steroidal, anti-inflammatory
drugs, which is used to treat various kinds of ocular inflammation, and has been reported to
prevent posterior capsule opacification (PCO) by inhibiting the mitosis and collagen synthesis
of human lens epithelial cells (LECs). In addition, the specific absorption spectrum of indomethacin
shows the effect of absorbing short-wavelength blue-violet light.
Objective:
We prepared an indomethacin-loaded hydrogel as a potential intraocular lens (IOLs)
material to prevent endophthalmitis, PCO and filter harmful blue light.
Methods:
Indomethacin prodrugs (HEMA-IND) (HI) were prepared by esterification of indomethacin
and 2-hydroxyethyl methacrylate (HEMA), and poly (HEMA-co-MAA-co-MMA-co-
HI) (HAMI) hydrogels were prepared by free-radical polymerization of 2-hydroxyethyl methacrylate
(HEMA), methyl methacrylate (MMA), methacrylic acid (MAA) and HI. The physical
and chemical properties of obtained hydrogel were detected, including optical, morphology,
thermomechanical and surface properties, equilibrium water content, drug release behaviors and
cytotoxicity.
Results:
HAMI hydrogels can filter harmful short-wavelength blue light and show other necessary
properties like visible light transparency, glass transition temperatures, mechanical
strength, and biocompatibility for making intraocular lenses. Meanwhile, MAA increases the
hydrophilicity of the hydrogels, resulting in a lower water contact angle and controllable drug
release from the hydrogels.
Conclusion:
In summary, HAMI hydrogels show a great potential as IOL biomaterials that can
maintain the sustained release of indomethacin and filter harmful blue light after cataract surgery.
Lay Summary:
People with cataract surgery can be at high risk of postoperative complications,
such as PCO and postoperative endophthalmitis. Moreover, early IOLs allowed all ultraviolet
(UV) and visible light to pass through retina without restriction, thus to damage the retina and
the retinal pigment epithelium, which may lead to retinopathy and age-related macular degeneration
(AMD). Herein, we sought to design and prepare a kind of IOLs loaded with indomethacin
to mitigate those postoperative complications and filter harmful blue light to improve the
treatment prognosis.
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Affiliation(s)
- Yang Xiang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
| | - Mengwei Zou
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
| | - Ying Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Rongrong Jin
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
| | - Yu Nie
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
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13
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Tzamalis A, Kynigopoulos M, Pallas G, Tsinopoulos I, Ziakas N. Influence of Intraocular Lens Asphericity and Blue Light Filtering on Visual Outcome, Contrast Sensitivity, and Aberrometry after Uneventful Cataract Extraction. J Ophthalmic Vis Res 2020; 15:308-317. [PMID: 32864061 PMCID: PMC7431729 DOI: 10.18502/jovr.v15i3.7449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 12/31/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the effect of asphericity and blue light filter (BLF) of three different intraocular lenses (IOLs) on the visual performance, second- and third-order aberrations (defocus, coma, trefoil), and contrast sensitivity after uneventful cataract surgery. Methods One hundred and twenty eyes of 60 patients with clinically significant cataract were randomly assigned to receive one of the three IOL types: Bioline Yellow Accurate (aspheric, with BLF, i-medical, Germany), BioAcryl 60125 (spherical, without BLF, Biotech, France), and H65C/N (aspheric, without BLF, PhysIOL, Belgium). Each IOL was implanted in 40 eyes. Complete ophthalmologic examination, functional acuity contrast testing and wavefront analysis were performed 60 days postoperatively. Results The mean postoperative best-corrected visual acuity (BCVA) was 0.95 ± 0.08, not differing statistically among the IOL groups (P = 0.83). Mean defocus and coma values did not yield any statistically significant difference through the IOL groups varying from –0.784 to –0.614 μm and 0.129 to 0.198 μm (P = 0.79 and 0.34, respectively). Bioline Yellow Accurate IOL presented less trefoil aberrations, 0.108 ± 0.05 μm, compared to the other two IOL types (BioAcryl [0.206 ± 0.19 μm] and Physiol [0.193 ± 0.17 μm], P< 0.05). Contrast sensitivity values did not differ among the groups under all lighting conditions. Bioline Yellow IOL showed a statistically higher loss of contrast sensitivity (between mesopic and mesopic with glare conditions) compared to the BioAcryl and PhysIOL in 12 and 3 cpd spatial frequencies, respectively (P< 0.05). Conclusion Bioline Yellow IOL indicated lower contrast sensitivity under mesopic conditions when glare was applied but resulted in less trefoil aberrations after uneventful cataract surgery. No further differences were noted in postoperative visual performance among three IOL groups.
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Affiliation(s)
- Argyrios Tzamalis
- 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.,Department of Ophthalmology, Clinic Pallas, Olten, Switzerland
| | | | - Grigoris Pallas
- Department of Ophthalmology, Clinic Pallas, Olten, Switzerland
| | - Ioannis Tsinopoulos
- 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Nikolaos Ziakas
- 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
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14
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Hammond BR, Sreenivasan V, Suryakumar R. The Effects of Blue Light-Filtering Intraocular Lenses on the Protection and Function of the Visual System. Clin Ophthalmol 2019; 13:2427-2438. [PMID: 31824137 PMCID: PMC6901063 DOI: 10.2147/opth.s213280] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 10/04/2019] [Indexed: 12/20/2022] Open
Abstract
Filtration of high-energy short-wave visible light (blue light) to improve vision and protect against damage has evolved both in aquatic animals and terrestrial species. In humans, pigments in the inner layer of the macula absorb wavelengths between 400 and 520 nm and function to improve visual performance. In patients who undergo cataract surgery, replacing cataractous lenses with artificial intraocular lenses (IOLs) that do not mimic normal healthy adult lenses could result in preventable negative visual effects, including glare disability. Blue light-filtering (BLF) IOLs were designed to filter short-wave light in addition to ultraviolet light and mimic the natural crystalline lens. Current studies indicate that BLF IOLs may provide protection from blue light-induced retinal damage and slow the development and progression of age-related macular degeneration. Additionally, BLF IOLs have been shown to improve chromatic contrast, reduce photostress recovery time, reduce glare disability and discomfort, and generally improve visual performance under glare conditions. Although a number of concerns have been raised about the relative risks versus the benefits of BLF IOLs, recent studies reported no adverse effects on visual function or contrast under photopic conditions, no long-term effects on color vision, and no detrimental effects on circadian rhythms with BLF IOLs. Based on the current understanding of the field, evidence suggests that BLF IOLs would be returning the eye to a more natural state compared with non-BLF lenses.
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Affiliation(s)
- Billy R Hammond
- Department of Psychology, Vision Sciences Laboratory, University of Georgia, Athens, GA, USA
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15
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Waugh N, Loveman E, Colquitt J, Royle P, Yeong JL, Hoad G, Lois N. Treatments for dry age-related macular degeneration and Stargardt disease: a systematic review. Health Technol Assess 2019; 22:1-168. [PMID: 29846169 DOI: 10.3310/hta22270] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Age-related macular degeneration (AMD) is the leading cause of visual loss in older people. Advanced AMD takes two forms, neovascular (wet) and atrophic (dry). Stargardt disease (STGD) is the commonest form of inherited macular dystrophy. OBJECTIVE To carry out a systematic review of treatments for dry AMD and STGD, and to identify emerging treatments where future NIHR research might be commissioned. DESIGN Systematic review. METHODS We searched MEDLINE, EMBASE, Web of Science and The Cochrane Library from 2005 to 13 July 2017 for reviews, journal articles and meeting abstracts. We looked for studies of interventions that aim to preserve or restore vision in people with dry AMD or STGD. The most important outcomes are those that matter to patients: visual acuity (VA), contrast sensitivity, reading speed, ability to drive, adverse effects of treatment, quality of life, progression of disease and patient preference. However, visual loss is a late event and intermediate predictors of future decline were accepted if there was good evidence that they are strong predictors of subsequent visual outcomes. These include changes detectable by investigation, but not necessarily noticed by people with AMD or STGD. ClinicalTrials.gov, the World Health Organization search portal and the UK Clinical Trials gateway were searched for ongoing and recently completed clinical trials. RESULTS The titles and abstracts of 7948 articles were screened for inclusion. The full text of 398 articles were obtained for further screening and checking of references and 112 articles were included in the final report. Overall, there were disappointingly few good-quality studies (including of sufficient size and duration) reporting useful outcomes, particularly in STGD. However we did identify a number of promising research topics, including drug treatments, stem cells, new forms of laser treatment, and implantable intraocular lens telescopes. In many cases, research is already under way, funded by industry or governments. LIMITATIONS In AMD, the main limitation came from the poor quality of much of the evidence. Many studies used VA as their main outcome despite not having sufficient duration to observe changes. The evidence on treatments for STGD is sparse. Most studies tested interventions with no comparison group, were far too short term, and the quality of some studies was poor. FUTURE WORK We think that the topics on which the Health Technology Assessment (HTA) and Efficacy Mechanism and Evaluation (EME) programmes might consider commissioning primary research are in STGD, a HTA trial of fenretinide (ReVision Therapeutics, San Diego, CA, USA), a visual cycle inhibitor, and EME research into the value of lutein and zeaxanthin supplements, using short-term measures of retinal function. In AMD, we suggest trials of fenretinide and of a potent statin. There is epidemiological evidence from the USA that the drug, levodopa, used for treating Parkinson's disease, may reduce the incidence of AMD. We suggest that similar research should be carried out using the large general practice databases in the UK. Ideally, future research should be at earlier stages in both diseases, before vision is impaired, using sensitive measures of macular function. This may require early detection of AMD by screening. STUDY REGISTRATION This study is registered as PROSPERO CRD42016038708. FUNDING The National Institute for Health Research HTA programme.
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Affiliation(s)
- Norman Waugh
- Division of Health Sciences, University of Warwick, Coventry, UK
| | | | | | - Pamela Royle
- Division of Health Sciences, University of Warwick, Coventry, UK
| | | | | | - Noemi Lois
- Ophthalmology, Royal Victoria Hospital, Belfast, UK.,Wellcome-Wolfson Centre for Experimental Medicine, Queens University, Belfast, UK
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16
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Singh S, Anderson AJ, Downie LE. Insights into Australian optometrists’ knowledge and attitude towards prescribing blue light‐blocking ophthalmic devices. Ophthalmic Physiol Opt 2019; 39:194-204. [DOI: 10.1111/opo.12615] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 03/19/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Sumeer Singh
- Department of Optometry and Vision Sciences The University of Melbourne Parkville Australia
| | - Andrew J Anderson
- Department of Optometry and Vision Sciences The University of Melbourne Parkville Australia
| | - Laura E Downie
- Department of Optometry and Vision Sciences The University of Melbourne Parkville Australia
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17
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Abstract
Objective: This paper aimed to review the current literature on the surface modification of intraocular lenses (IOLs). Data Sources: All articles about surface modification of IOLs published up to 2015 were identified through a literature search on both PubMed and ScienceDirect. Study Selection: The articles on the surface modification of IOLs were included, but those on design modification and surface coating were excluded. Results: Technology of surface modification included plasma, ion beam, layer-by-layer self-assembly, ultraviolet radiation, and ozone. The main molecules introduced into IOLs surface were poly (ethylene glycol), polyhedral oligomeric silsesquioxane, 2-methacryloyloxyethyl phosphorylcholine, TiO2, heparin, F-heparin, titanium, titanium nitride, vinyl pyrrolidone, and inhibitors of cytokines. The surface modification either resulted in a more hydrophobic lens, a more hydrophilic lens, or a lens with a hydrophilic anterior and hydrophobic posterior surface. Advances in research regarding surface modification of IOLs had led to a better biocompatibility in both in vitro and animal experiments. Conclusion: The surface modification is an efficient, convenient, economic and promising method to improve the biocompatibility of IOLs.
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Affiliation(s)
| | | | | | - Gui-Qin Wang
- Department of Ophthalmology, Navy General Hospital of PLA, Beijing 100048; Department of Ophthalmilogy, Third Clinical Medical College of Southern Medical University, Guangzhou, Guangdong 510515, China
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18
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Li X, Kelly D, Nolan JM, Dennison JL, Beatty S. The evidence informing the surgeon's selection of intraocular lens on the basis of light transmittance properties. Eye (Lond) 2016; 31:258-272. [PMID: 27935597 PMCID: PMC5306461 DOI: 10.1038/eye.2016.266] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 09/27/2016] [Indexed: 01/01/2023] Open
Abstract
In recent years, manufacturers and distributors have promoted commercially available intraocular lenses (IOLs) with transmittance properties that filter visible short-wavelength (blue) light on the basis of a putative photoprotective effect. Systematic literature review. Out of 21 studies reporting on outcomes following implantation of blue-light-filtering IOLs (involving 8914 patients and 12 919 study eyes undergoing cataract surgery), the primary outcome was vision, sleep pattern, and photoprotection in 9 (42.9%), 9 (42.9%), and 3 (14.2%) respectively, and, of these, only 7 (33.3%) can be classed as high as level 2b (individual cohort study/low-quality randomized controlled trials), all other studies being classed as level 3b or lower. Of the level 2b studies, only one (14.3%) found in favor of blue-light-filtering IOLs vs ultraviolet (UV)-only filtering IOLs on the basis of an association between better post-operative contrast sensitivity (CS) at select frequencies with the former; however, that study did not measure or report CS preoperatively in either group, and the finding may simply reflect better preoperative CS in the eyes scheduled to be implanted with the blue-light-filtering IOL; moreover, that study failed to measure macular pigment, a natural preceptoral filter of blue-light, augmentation of which is now known to improve CS. In terms of photoprotection, there is no level 2b (or higher) evidence in support of blue filtering IOLs vs UV-only filtering IOLs. On the basis of currently available evidence, one cannot advocate for the use of blue-light-filtering IOLs over UV-only filtering IOLs.
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Affiliation(s)
- X Li
- Pharmaceutical & Molecular Biotechnology Research Centre, Department of Chemical & Life Sciences, Waterford Institute of Technology, Waterford, Ireland
| | - D Kelly
- Nutrition Research Centre Ireland, Macular Pigment Research Group, School of Health Science, Waterford Institute of Technology, Waterford, Ireland
| | - J M Nolan
- Nutrition Research Centre Ireland, Macular Pigment Research Group, School of Health Science, Waterford Institute of Technology, Waterford, Ireland
| | - J L Dennison
- Nutrition Research Centre Ireland, Macular Pigment Research Group, School of Health Science, Waterford Institute of Technology, Waterford, Ireland
| | - S Beatty
- Nutrition Research Centre Ireland, Macular Pigment Research Group, School of Health Science, Waterford Institute of Technology, Waterford, Ireland.,Institute of Vision Research, Whitfield Clinic, Waterford, Ireland
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19
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Yan SS, Wang W. The effect of lens aging and cataract surgery on circadian rhythm. Int J Ophthalmol 2016; 9:1066-74. [PMID: 27500118 DOI: 10.18240/ijo.2016.07.21] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 02/14/2016] [Indexed: 12/31/2022] Open
Abstract
Many organisms have evolved an approximately 24-hour circadian rhythm that allows them to achieve internal physiological homeostasis with external environment. Suprachiasmatic nucleus (SCN) is the central pacemaker of circadian rhythm, and its activity is entrained to the external light-dark cycle. The SCN controls circadian rhythm through regulating the synthesis of melatonin by pineal gland via a multisynaptic pathway. Light, especially short-wavelength blue light, is the most potent environmental time cue in circadian photoentrainment. Recently, the discovery of a novel type of retinal photoreceptors, intrinsically photosensitive retinal ganglion cells, sheds light on the mechanism of circadian photoentrainment and raises concerns about the effect of ocular diseases on circadian system. With age, light transmittance is significantly decreased due to the aging of crystalline lens, thus possibly resulting in progressive loss of circadian photoreception. In the current review, we summarize the circadian physiology, highlight the important role of light in circadian rhythm regulation, discuss about the correlation between age-related cataract and sleep disorders, and compare the effect of blue light- filtering intraocular lenses (IOLs) and ultraviolet only filtering IOLs on circadian rhythm.
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Affiliation(s)
- Shen-Shen Yan
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
| | - Wei Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
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20
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Ultraviolet or blue-filtering intraocular lenses: what is the evidence? Eye (Lond) 2016; 30:215-21. [PMID: 26742866 DOI: 10.1038/eye.2015.267] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 11/25/2015] [Indexed: 11/08/2022] Open
Abstract
Cataract surgery was revolutionised by the introduction of modern intraocular lenses in the late 1940's. By the late 1960's to 1970's evidence had emerged that short-wavelength light caused phototoxicity at the retina and retinal pigment epithelium. By the early 1980's ultraviolet filters had been incorporated into intraocular lenses. This caused intense controversy, as there was concern that the UV-filtering chromophore might leach out into the eye causing toxicity. With the arrival of blue-filtering intraocular lenses (BFIOLs) in 1990's, a further debate was ignited as to their safety and potential disadvantages. Selecting the optimal performing intraocular lens to obtain the best visual performance with the fewest potential drawbacks has become complex and challenging for cataract surgeons and their patients with the wide choice of lenses available. Choosing a personalised lens to address astigmatism, presbyopia, spherical aberration, chromatic aberration, and potentially to shield the retina from short-wavelength light is now possible. The potential benefits and possible side effects of these different innovations emphasise the importance of assessing the evidence for their clinical utility, allowing the surgeon and the patient to weigh-up the risk benefit ratio and make an informed decision. The BFIOLs were developed to reduce cyanopsia, address chromatic aberration, and improve contrast sensitivity in different lighting conditions, as well as to prevent short-wavelength light reaching the retina thus potentially reducing the risk of developing age-related macular degeneration. Further design development of the BFIOLs was to mimic the natural crystalline lens absorption and transmittance properties in adulthood. Multiple publications have reported on the potential benefits and pitfalls of implanting a blue-filtering lens. The potential disadvantages raised in the literature over the last 25 years since their introduction, regarding compromise of visual function and disruption of the circadian system, have been largely dispelled. The clear benefits of protecting the retina from short-wavelength light make a BFIOLs a sensible choice. The purpose of this article presented at the Cambridge symposium 2015 is to review the literature on this subject.
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21
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Ayaki M, Negishi K, Tsubota K. Rejuvenation effects of cataract surgery with ultraviolet blocking intra-ocular lens on circadian rhythm and gait speed. Rejuvenation Res 2015; 17:359-65. [PMID: 24701992 DOI: 10.1089/rej.2014.1550] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Previously, we reported improvements in sleep quality and gait speed after implantation of a yellow-colored, blue light-blocking intra-ocular lens (IOL). This study evaluated systemic health parameters for 7 months after cataract surgery with implantation of a clear, ultraviolet (UV)-blocking IOL. METHODS A total of consecutive 71 patients (average age 74.1 years) underwent cataract surgery with the implantation of a clear, UV-blocking IOL. Participants were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the National Eye Institute Visual Function Questionnaire (VFQ-25) before and at 2 and 7 months after surgery. Four-meter gait speed was also determined. The metabolic parameters of serum glycated hemoglobin (HbA1c), triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were tested. RESULTS The pre-operative and post-operative (2 and 7 months after surgery) results were 66.4±16.5, 79.5±12.6, and 81.0±13.0 for VFQ-25 score, 5.7±3.5, 5.1±3.1, and 4.8±2.9 for PSQI, and 0.90±0.22, 0.91±0.22, and 0.92±0.22 meters/sec for gait speed. Significant improvements following surgery were noted in the VFQ-25 score for all cases and in the PSQI for poor sleepers (preoperative PSQI >5.5) (P<0.05, paired t-test). The gait speed and metabolic parameters showed no significant changes. CONCLUSIONS Cataract surgery with implantation of an UV-blocking clear IOL has the potential for improving circadian rhythm and systemic health parameters.
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Affiliation(s)
- Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine , Tokyo, Japan
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22
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Evidence for the Role of Blue Light in the Development of Uveal Melanoma. J Ophthalmol 2015; 2015:386986. [PMID: 26075084 PMCID: PMC4449937 DOI: 10.1155/2015/386986] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/28/2015] [Indexed: 12/26/2022] Open
Abstract
Uveal melanoma is the most common malignancy of the adult eye. Although it is a relatively infrequent tumor, clinical prognosis is often poor owing to a high incidence of aggressive metastatic disease, for which there are limited treatment options. Little is known about the etiology of this condition, although several risk factors have been identified. Unlike cutaneous melanoma, however, ultraviolet radiation does not figure prominently among these risk factors. In this review, we focus on an associated form of visible electromagnetic radiation, high-energy short-wave (blue) light, a causative agent in various forms of age-related retina damage, as a previously overlooked risk factor in uveal melanoma development and progression. Finally, we discuss the impact of these data on contemporary ocular therapy, particularly the debate surrounding the filtering capabilities of intraocular lenses used to replace dysfunctional crystalline lenses during cataract surgery.
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23
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Abstract
Age-related macular degeneration (AMD) and cataract are two leading causes of visual impairment worldwide which often occur concurrently in the same patient. With more than 1.6 million cataract operations performed per year in the United States, many of which occur in the nearly 1.75 million individuals diagnosed with AMD, there is ample incentive to further explore the interaction between these two conditions. Notably, the role of cataract surgery on AMD development and progression is of particular interest. This review summarizes the major findings from literature focusing on the effect of cataract surgery on AMD.
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Affiliation(s)
- Cynthia X Qian
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School , Boston, Massachusetts , USA
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24
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Ayaki M, Negishi K, Suzukamo Y, Tsubota K. Color of intra-ocular lens and cataract type are prognostic determinants of health indices after visual and photoreceptive restoration by surgery. Rejuvenation Res 2015; 18:145-52. [PMID: 25526429 PMCID: PMC4403229 DOI: 10.1089/rej.2014.1613] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: This study compared post-operative quality of life and sleep according to the type of cataract opacity and color of the implanted intra-ocular lens (IOL). Methods: This is a cohort study and participants were 206 patients (average age 74.1 years) undergoing cataract surgery with the implantation of a clear ultra-violet (UV)-blocking IOL (C) or a yellow blue-light-blocking IOL (Y). Participants were evaluated using the National Eye Institute Visual Function Questionnaire (VFQ-25) and Pittsburgh Sleep Quality Index (PSQI) before surgery and 2 and 7 months after surgery. Changes in sub-scale scores of VFQ-25 and PSQI were compared. Results: Sub-scale analyses for improvement after surgery revealed significant differences in ocular pain scores on the VFQ-25 (Y>C; the higher the score, the better the outcome). Furthermore, there were significant differences between the two IOLs in terms of the sleep latency score (C>Y) and sleep disturbances score (C>Y). A posterior sub-capsular cataract was significantly correlated with improvements in ocular pain and sleep latency scores. These effects were successfully represented by the change in scores rather than absolute post-operative scores because individual standard of response may often change after intervention, recognized as a response shift phenomenon in patient-reported outcome study. Regarding seasonal differences, patients who had surgery in summer exhibited relatively better sleep quality than those who had surgery in winter. Conclusions: Analysis of sub-scales of health indices demonstrated characteristic prognoses for each IOL and cataract type. Cataract surgery may potentially contribute to systemic health in older adults.
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Affiliation(s)
- Masahiko Ayaki
- 1 Department of Ophthalmology, Keio University School of Medicine , Tokyo, Japan
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25
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Osborne NN, Núñez-Álvarez C, del Olmo-Aguado S. The effect of visual blue light on mitochondrial function associated with retinal ganglions cells. Exp Eye Res 2014; 128:8-14. [DOI: 10.1016/j.exer.2014.08.012] [Citation(s) in RCA: 305] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 08/18/2014] [Accepted: 08/20/2014] [Indexed: 11/16/2022]
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26
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Hammond BR, Johnson BA, George ER. Oxidative photodegradation of ocular tissues: beneficial effects of filtering and exogenous antioxidants. Exp Eye Res 2014; 129:135-50. [PMID: 25236792 DOI: 10.1016/j.exer.2014.09.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 09/11/2014] [Accepted: 09/13/2014] [Indexed: 01/17/2023]
Abstract
The fact that light is necessary for life is generally accepted as an axiom. The extent to which light interacts and influences human biology, however, is often not fully appreciated. Exposure to sunlight, for instance, can both promote and degrade human health. There is now general scientific consensus that, although the eye evolved to respond to light, it is also damaged by excessive exposure. Light-mediated ocular damage is involved in the pathophysiology of many common forms of blindness. The type of ocular tissue damage induced by light exposure depends on the extent of exposure and wavelength. The tissues of the lens, cornea, and retina contain specific chemical moieties that have been proven to exhibit light-mediated oxidative degradation. Proteins and lipids present in the cornea, lens, and retina, meet all of the physical requirements known to initiate the process of oxidative photodegradation upon exposure to solar radiation. As such, different mechanisms have evolved in the lens, cornea, and retina to ameliorate such light-mediated oxidative damage. It appears, however, that such mechanisms are ill-matched to handle modern conditions: namely, poor diet and longer life-spans (and the degenerative diseases that accompany them). Hence, steps must be taken to protect the eye from the damaging effects of light. Preventative measures include minimizing actinic light exposure, providing exogenous filtering (e.g., through the use of protective lenses), and enhancing antioxidant defenses (e.g., through increased dietary intake of antioxidants). These strategies may yield long-term benefits in terms of reducing oxidative photodegradation of the ocular tissues.
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Affiliation(s)
- Billy R Hammond
- Vision Sciences Laboratory, University of Georgia, Athens, GA 30602-3013, USA.
| | - Bart A Johnson
- Johnson & Johnson Vision Care, Inc., 7500 Centurion Parkway, R&D 3rd Floor W3A, Jacksonville, FL 33256, USA
| | - Eric R George
- Johnson & Johnson Vision Care, Inc., 7500 Centurion Parkway, R&D 3rd Floor W3A, Jacksonville, FL 33256, USA.
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27
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Leruez S, Annweiler C, Gohier B, Beauchet O, Ebran JM, Gohier P, Milea D. Blue light-filtering intraocular lenses and post-operative mood: a pilot clinical study. Int Ophthalmol 2014; 35:249-56. [PMID: 24756476 DOI: 10.1007/s10792-014-9944-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 03/31/2014] [Indexed: 11/29/2022]
Abstract
The purpose of the study was to determine if implantation of blue-filtering intraocular lenses (IOLs) affects post-operative mood, inducing more depression, compared to patients undergoing implantation with conventional IOLs. The study was conducted at the Angers University Hospital, France. This was a prospective with a lowercase pilot study, including consecutive patients planned to undergo cataract surgery in both eyes within 1 week. The same type of IOL was used in both eyes of each patient. The choice of IOL was not randomized but driven by the habits and experience of each participating surgeon. Cognitively healthy patients (an MMSE score higher than 25) were assessed before and after surgery, using the 30-item geriatric depression scale (GDS) to seek symptoms of depression. Univariate and multiple logistic regressions were used to examine the association between the type of IOL and the 30-item GDS score improvement during the 3 months after lens implantation, while adjusting for participants' characteristics (age, visual acuity). Blue-filtering IOLs were used in 16 patients (mean ± standard deviation, 75.6 ± 7.5 years; 75 % female), and untinted IOLs in 18 patients (77.3 ± 6.9 years; 77.8 %female). Pre-operatively visual acuity and GDS scores were comparable in the two groups. The post-operative GDS score was improved by 1.91 ± 3.10 points in the whole sample (P = 0.002), as well as in each subgroup of patients. Three months after surgery, the mean change in GDS score did not differ between groups (P = 0.365), nor did the mean visual acuity (P = 0.198).
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Affiliation(s)
- Stephanie Leruez
- Department of Neuroscience, Division of Ophthalmology, Angers University Hospital, 4 rue Larrey, 49933, Angers cedex 9, France,
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Changes in blood pressure and sleep duration in patients with blue light-blocking/yellow-tinted intraocular lens (CHUKYO study). Hypertens Res 2014; 37:659-64. [DOI: 10.1038/hr.2014.50] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 11/15/2013] [Accepted: 11/18/2013] [Indexed: 11/08/2022]
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Chamorro E, Bonnin-Arias C, Pérez-Carrasco MJ, Alvarez-Rementería L, Villa-Collar C, Armadá-Maresca F, Sánchez-Ramos C. [Macular thickness measured by optical coherence tomography in pseudoaphakic eyes with clear vs yellow implant]. ACTA ACUST UNITED AC 2014; 89:136-42. [PMID: 24548791 DOI: 10.1016/j.oftal.2013.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Revised: 11/25/2013] [Accepted: 12/16/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To study the use of optical coherence tomography (OCT), for measuring the macular thickness variations produced over time in elderly pseudophakic subjects implanted with a clear intraocular lens (IOL) in one eye, and a yellow IOL in the other eye. METHODS Macular thickness measurements were obtained in the 36 eyes of 18 subjects over 65 years, with cataracts surgically removed from both eyes and implanted with different absorbance (clear and yellow) IOLs in 2 separate surgeries. Stratus-OCT was used to determine the macular thickness in 2 sessions with 5 years of difference. RESULTS After 5 years of follow-up, the eyes implanted with clear IOLs revealed a significant decrease in macular thickness. However, in eyes implanted with yellow IOLs the macular thickness remained stable. The mean overall decrease in macular thickness in eyes implanted with clear IOLs was 5 ± 8 μm (P=.02), and foveal thickness reduction was 10 ± 17 μm (P=.02). CONCLUSIONS The macular thickness changes produced in eyes implanted with a yellow IOL differ from those with a clear IOL. These observation point to a possible protective effect of yellow IOL against the harmful effects of light in elderly pseudophakic subjects. However, studies with a longer follow-up are still needed to confirm that the protection provided by this IOL model is clinically significant.
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Affiliation(s)
- E Chamorro
- Grupo de Neurocomputación y Neurorrobótica, Universidad Complutense, Madrid, España.
| | - C Bonnin-Arias
- Grupo de Neurocomputación y Neurorrobótica, Universidad Complutense, Madrid, España
| | - M J Pérez-Carrasco
- Grupo de Neurocomputación y Neurorrobótica, Universidad Complutense, Madrid, España
| | | | - C Villa-Collar
- Departamento Óptica y Optometría, Universidad Europea, Madrid, España
| | - F Armadá-Maresca
- Departamento Oftalmología, Hospital Universitario La Paz, Madrid, España
| | - C Sánchez-Ramos
- Grupo de Neurocomputación y Neurorrobótica, Universidad Complutense, Madrid, España
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Schmoll C, Khan A, Aspinall P, Goudie C, Koay P, Tendo C, Cameron J, Roe J, Deary I, Dhillon B. New light for old eyes: comparing melanopsin-mediated non-visual benefits of blue-light and UV-blocking intraocular lenses. Br J Ophthalmol 2013; 98:124-8. [PMID: 24158845 DOI: 10.1136/bjophthalmol-2013-304024] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS Melanopsin-expressing photosensitive retinal ganglion cells form a blue-light-sensitive non-visual system mediating diverse physiological effects including circadian entrainment and cognitive alertness. Reduced blue wavelength retinal illumination through cataract formation is thought to blunt these responses while cataract surgery and intraocular lens (IOL) implantation have been shown to have beneficial effects on sleep and cognition. We aimed to use the reaction time (RT) task and the Epworth Sleepiness Score (ESS) as a validated objective platform to compare non-visual benefits of UV- and blue-blocking IOLs. METHODS Patients were prospectively randomised to receive either a UV- or blue-blocking IOL, performing an RT test and ESS questionnaire before and after surgery. Optical blurring at the second test controlled for visual improvement. Non-operative age-matched controls were recruited for comparison. RESULTS 80 participants completed the study. Those undergoing first-eye phacoemulsification demonstrated significant improvements in RT over control (p=0.001) and second-eye surgery patients (p=0.03). Moreover, reduced daytime sleepiness was measured by ESS for the first-eye surgery group (p=0.008) but not for the second-eye group (p=0.09). Choice of UV- or blue-blocking IOL made no significant difference to magnitude of cognitive improvement (p=0.272). CONCLUSIONS Phacoemulsification, particularly first-eye surgery, has a strong positive effect on cognition and daytime alertness, regardless of IOL type.
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Brøndsted AE, Lundeman JH, Kessel L. Short wavelength light filtering by the natural human lens and IOLs -- implications for entrainment of circadian rhythm. Acta Ophthalmol 2013; 91:52-7. [PMID: 22136468 DOI: 10.1111/j.1755-3768.2011.02291.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE Photoentrainment of circadian rhythm begins with the stimulation of melanopsin containing retinal ganglion cells that respond directly to blue light. With age, the human lens becomes a strong colour filter attenuating transmission of short wavelengths. The purpose of the study was to examine the effect the ageing human lens may have for the photoentrainment of circadian rhythm and to compare with intraocular implant lenses (IOLs) designed to block UV radiation, violet or blue light. METHODS The potential for photoentrainment of circadian rhythm was computed for 29 human donor lenses (18-76 years) and five IOLs (one UV, two violet and two blue light blocking) based on the transmission properties of the lenses and the spectral characteristics of melanopsin activation and two of it's physiological outcomes; melanopsin-driven pupillary light reponse and light-induced melatonin suppression. RESULTS The potential for melanopsin stimulation and melatonin suppression was reduced by 0.6-0.7 percentage point per year of life because of yellowing of the natural lens. The computed effects were small for the IOLs and did not exceed that of a 22.2-year-old natural lens for the blue-blocking IOLs. CONCLUSION The results show that photoentrainment of circadian rhythm may be significantly impaired in older subjects because of the colour filtering characteristics of the human lens, whereas the effects were small for all three types of IOLs studied. Consequently, the ageing process of the natural lens is expected to influence the photoentrainment of circadian rhythm, whereas IOLs are not expected to be detrimental to circadian rhythm.
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Affiliation(s)
- Adam Elias Brøndsted
- Department of Ophthalmology, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark
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Grandner MA, Kripke DF, Elliott J, Cole R. Short wavelength light administered just prior to waking: a pilot study. BIOL RHYTHM RES 2013; 44:13-32. [PMID: 23275686 DOI: 10.1080/09291016.2011.632578] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Bright light in the blue-green range, administered in the early morning hours (prior to waking) may be particularly effective in shifting circadian rhythms and may increase gonadotropin production. Accordingly, we tested the feasibility and utility of a mask that emits bright blue/green light (compared to a similar mask that emitted a dim red light) towards the end of sleep in a randomized, placebo-controlled pilot study. The study included a 3-day baseline period, immediately followed by a 12-day intervention period. Subjects were 30 healthy young men with minimal-mild depression. The bright light masks were well-tolerated and demonstrated adequate safety and feasibility. Following the intervention, those who wore the bright light mask demonstrated altered sleep timing suggestive of an earlier sleep period, and excreted a slight increase in follicle-stimulating hormone. Overall, light masks may prove useful in future studies of bright light therapy.
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Affiliation(s)
- Michael A Grandner
- Center for Sleep and Circadian Neurobiology, Division of Sleep Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Kim YJ, Cheon MH, Ko DA, Kim JY, Kim MJ, Tchah HW. Clinical Outcome of in-the-Bag Single-Piece Aspheric Intraocular Lens Implantation after Microincision Cataract Surgery. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.4.595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yoon Jeon Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mi Hyun Cheon
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Ah Ko
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Yong Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Myoung Joon Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hung Won Tchah
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Surface localisation of photosensitisers on intraocular lens biomaterials for prevention of infectious endophthalmitis and retinal protection. Biomaterials 2012; 33:7952-8. [DOI: 10.1016/j.biomaterials.2012.07.052] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 07/24/2012] [Indexed: 11/22/2022]
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Schmack I, Schimpf M, Stolzenberg A, Conrad-Hengerer I, Hengerer FH, Dick BH. Visual quality assessment in patients with orange-tinted blue light–filtering and clear ultraviolet light–filtering intraocular lenses. J Cataract Refract Surg 2012; 38:823-32. [DOI: 10.1016/j.jcrs.2011.12.028] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Revised: 11/30/2011] [Accepted: 12/01/2011] [Indexed: 11/15/2022]
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Sakanishi Y, Awano M, Mizota A, Tanaka M, Murakami A, Ohnuma K. Age-related changes in spectral transmittance of the human crystalline lens in situ. ACTA ACUST UNITED AC 2012; 228:174-80. [PMID: 22487898 DOI: 10.1159/000336721] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Accepted: 12/28/2011] [Indexed: 11/19/2022]
Abstract
AIMS It was the aim of this study to measure spectral transmission of the human crystalline lens in situ. METHOD The crystalline lens was illuminated by one of four light-emitting diodes of different colors. The relative spectral transmittance of the human crystalline lens was measured with the Purkinje-Sanson mirror images over a wide range of ages. RESULT The study evaluated 36 crystalline lenses of 28 subjects aged 21-76 years. There was a significant correlation between the age and spectral transmittance for blue light. CONCLUSION Spectral transmittance of the crystalline lens in situ could be measured with Purkinje-Sanson mirror images.
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Affiliation(s)
- Yoshihito Sakanishi
- Department of Ophthalmology, Juntendo University, Urayasu Hospital, Urayasu, Japan.
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Hunter JJ, Morgan JIW, Merigan WH, Sliney DH, Sparrow JR, Williams DR. The susceptibility of the retina to photochemical damage from visible light. Prog Retin Eye Res 2012; 31:28-42. [PMID: 22085795 PMCID: PMC3242847 DOI: 10.1016/j.preteyeres.2011.11.001] [Citation(s) in RCA: 219] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 10/28/2011] [Accepted: 11/01/2011] [Indexed: 02/08/2023]
Abstract
The photoreceptor/RPE complex must maintain a delicate balance between maximizing the absorption of photons for vision and retinal image quality while simultaneously minimizing the risk of photodamage when exposed to bright light. We review the recent discovery of two new effects of light exposure on the photoreceptor/RPE complex in the context of current thinking about the causes of retinal phototoxicity. These effects are autofluorescence photobleaching in which exposure to bright light reduces lipofuscin autofluorescence and, at higher light levels, RPE disruption in which the pattern of autofluorescence is permanently altered following light exposure. Both effects occur following exposure to visible light at irradiances that were previously thought to be safe. Photopigment, retinoids involved in the visual cycle, and bisretinoids in lipofuscin have been implicated as possible photosensitizers for photochemical damage. The mechanism of RPE disruption may follow either of these paths. On the other hand, autofluorescence photobleaching is likely an indicator of photooxidation of lipofuscin. The permanent changes inherent in RPE disruption might require modification of the light safety standards. AF photobleaching recovers after several hours although the mechanisms by which this occurs are not yet clear. Understanding the mechanisms of phototoxicity is all the more important given the potential for increased susceptibility in the presence of ocular diseases that affect either the visual cycle and/or lipofuscin accumulation. In addition, knowledge of photochemical mechanisms can improve our understanding of some disease processes that may be influenced by light exposure, such as some forms of Leber's congenital amaurosis, and aid in the development of new therapies. Such treatment prior to intentional light exposures, as in ophthalmic examinations or surgeries, could provide an effective preventative strategy.
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Affiliation(s)
- Jennifer J Hunter
- Flaum Eye Institute, University of Rochester, Box 314, 601Elmwood Ave, Rochester, NY 14642, USA.
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Kara-Junior N, Espindola RF, Gomes BA, Ventura B, Smadja D, Santhiago MR. Effects of blue light–filtering intraocular lenses on the macula, contrast sensitivity, and color vision after a long-term follow-up. J Cataract Refract Surg 2011; 37:2115-9. [DOI: 10.1016/j.jcrs.2011.06.024] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2011] [Revised: 05/31/2011] [Accepted: 06/04/2011] [Indexed: 11/25/2022]
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Khokhar SK, Jindal A, Agarwal T, Panda A. Comparison of color perception after tinted blue light–filtering and clear ultraviolet-filtering intraocular lens implantation. J Cataract Refract Surg 2011; 37:1598-604. [DOI: 10.1016/j.jcrs.2011.03.044] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Revised: 03/05/2011] [Accepted: 03/08/2011] [Indexed: 11/27/2022]
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Recent studies provide an updated clinical perspective on blue light-filtering IOLs. Graefes Arch Clin Exp Ophthalmol 2011; 249:957-68. [PMID: 21584764 PMCID: PMC3124647 DOI: 10.1007/s00417-011-1697-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 04/07/2011] [Accepted: 04/08/2011] [Indexed: 11/10/2022] Open
Abstract
Background Recent reviews of blue light-filtering intraocular lenses (IOLs) have stated their potential risks for scotopic vision and circadian photoentrainment. Some authors have challenged the rationale for retinal photoprotection that these IOLs might provide. Our objective is to address these issues by providing an updated clinical perspective based on the results of the most recent studies. Methods This article evaluates the currently available published papers assessing the potential risks and benefits of blue light-filtering IOLs. It summarizes the results of seven clinical and two computational studies on photoreception, and several studies related to retinal photoprotection, all of which were not available in the previous reviews. These results provide a clinical risk/benefit analysis for an updated review for these IOLs. Results Most clinical studies comparing IOLs with and without the blue light-filtering feature have found no difference in clinical performance for; visual acuity, contrast sensitivity, color vision, or glare. For blue light-filtering IOLs, three comparative clinical studies have shown improved contrast sensitivity and glare reduction; but one study, while it showed satisfactory overall color perception, demonstrated some compromise in mesopic comparative blue color discrimination. Comparative results of two recent clinical studies have also shown improved performance for simulated driving under glare conditions and reduced glare disability, better heterochromatic contrast threshold, and faster recovery from photostress for blue light-filtering IOLs. Two computational and five clinical studies found no difference in performance between IOLs with or without blue light-filtration for scotopic vision performance and photo entrainment of the circadian rhythm. The rationale for protection of the pseudophakic retina against phototoxicity is discussed with supporting results of the most recent computational, in-vitro, animal, clinical, and epidemiological investigations. Conclusions This analysis provides an updated clinical perspective which suggests the selection of blue light-filtering IOLs for patients of any age, but especially for pediatric and presbyopic lens exchange patients with a longer pseudophakic life. Without clinically substantiated potential risks, these patients should experience the benefit of overall better quality of vision, reduced glare disability at least in some conditions, and better protection against retinal phototoxicity and its associated potential risk for AMD. Electronic supplementary material The online version of this article (doi:10.1007/s00417-011-1697-6) contains supplementary material, which is available to authorized users.
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Paletta Guedes RA, Paletta Guedes VM, Aptel F. [Multifocal, toric, and aspheric intraocular lenses for glaucoma patients]. J Fr Ophtalmol 2011; 34:387-91. [PMID: 21507514 DOI: 10.1016/j.jfo.2011.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2011] [Accepted: 02/14/2011] [Indexed: 11/20/2022]
Abstract
Cataract surgery has greatly developed over recent years, mainly due to the introduction and availability of newer intraocular lenses (IOLs) with modern platforms and better visual outcomes. Aspheric, multifocal, and toric lenses are among these new lenses. Glaucomatous eyes have a number of particularities that can influence the way these implants are indicated and used. Contrast sensitivity is usually reduced in eyes with glaucoma and, sometimes, a poor IOL choice can aggravate the disease. Small pupils and zonular weakness are frequently associated with certain types of glaucoma (e.g. pseudoexfoliative glaucoma) and can limit the indication of some of the newer IOLs. Lastly, in some cases of combined surgery, the postoperative axial length and anterior chamber depth can change after surgery, requiring adjustments in the IOL power calculation. The purpose of this article is to quickly review some of the specific features of cataract surgery in the glaucomatous eye, some of the IOL choices, and the necessary precautions for these eyes.
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Affiliation(s)
- R-A Paletta Guedes
- Centre ophtalmologique Paletta-Guedes, université fédéral de Juiz-de-Fora, avenue Rio-Branco 2337, sl. 801/807/808 Centre, 36010-905 Juiz-de-Fora, Brésil.
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