Profile of off-axis higher order aberrations and its variation with time among various refractive error groups

The visual impact of higher-order aberrations in patients with pediatric blepharokeratoconjunctivitis

PURPOSE

To analyze higher-order aberrations (HOAs) and their visual impact in a pediatric blepharokeratoconjunctivitis (PBKC) cohort compared with healthy controls.

METHODS

Prospective case-control study of pediatric patients (≤ 16 years old). Subjects underwent wavefront aberrometry analysis to compare HOAs and their impact on visual quality.

RESULTS

A total of 150 eyes from 76 patients were included in the analysis. The PBKC group consisted of 50 eyes and the control group of 100 healthy eyes. Mean age was 10.39 ± 3.81 years for the PBKC group and 10.80 ± 3.61 years for the controls. Mean corrected-distance visual acuity (CDVA) was 0.24 ± 0.21 logMAR in the PBKC group and 0.07 ± 0.1 in the controls (P < 0.001). Mean astigmatism was 1.6 ± 1.98D in the PBKC group vs. 0.67 ± 0.76D in the control group (P = 0.01). Mean RMS of HOAs was 1.05 ± 1.7mm in the PBKC group and 0.41 ± 0.18mm in the controls (P < 0.001). The mean modulation transfer function (MTF) in the PBKC group was significantly lower (16.37 ± 16.32) than controls (30.3 ± 23.57) (P < 0.001). Corneal leukomas, stromal vascularization, peripheral nummular subepithelial scars, and pannus formation are associated with increased HOAs.

CONCLUSIONS

There was a significant increase in total HOAs of eyes with PBKC compared to healthy controls. Corneal opacity, vascularization, and scarring are associated with increased HOAs. The PBKC eye aberration profile: coma, secondary astigmatism, quadrafoil, and pentafoil, were associated with decreased CDVA and visual quality (PSF and MTF).

Central and Peripheral Ocular High-Order Aberrations and Their Relationship with Accommodation and Refractive Error: A Review

High-order aberrations (HOAs) are optical defects that degrade the image quality. They change with factors such as pupil diameter, age, and accommodation. The changes in optical aberrations during accommodation are mainly due to lens shape and position changes. Primary spherical aberration (Z(4.0)) is closely related to accommodation and some studies suggested that it plays an important role in the control of accommodation. Furthermore, central and peripheral HOAs vary with refractive error and seem to influence eye growth and the onset and progression of myopia. The variations of central and peripheral HOAs during accommodation also appear to be different depending on the refractive error. Central and peripheral high-order aberrations are closely related to accommodation and influence the accuracy of the accommodative response and the progression of refractive errors, especially myopia.

Prevalence and Associations of Vitreomacular Traction: The Beijing Eye Study

Purpose

To explore the prevalence and associations of vitreous macular traction (VMT) in Chinese population.

Methods

A population-based cross-sectional study with 3468 individuals (mean age of 64.6 ± 9.8 years) based on Beijing Eye Study 2011. Participants underwent detailed ophthalmic examinations, including spectral domain optical coherence tomography (SD-OCT). VMT was defined as abnormal posterior vitreous detachment with anatomical deformation of the fovea, which may include pseudocyst, macular schisis, cystoid macular edema, and subretinal fluid.

Main Outcome Measure

Prevalence of VMT.

Results

A VMT was detected in 151 (2.3%) eyes (prevalence rate (mean ± SE): 2.3± 0.2%; 95% CI: 1.9%, 2.7%) of 80 (2.4%) subjects (prevalence rate: 2.4± 0.3%; 95% CI: 1.9%, 2.9%). Mean age of all subjects with VMT was 70.1± 8.7 years (median, 70.0 years; range, 50–90 years), mean refractive error was −0.22 ± 2.38D (median, 0.25 D; range, −15.00 to 5.25D). In multivariate analysis, prevalence of VMT was associated with elder age (P=0.001, OR 1.06), female gender (P = 0.036, OR 1.77), subfoveal retinal thickness (P = 0.005, OR 1.01), and subfoveal choroidal thickness (P = 0.026, OR 0.10).

Conclusion

In adult Chinese in Greater Beijing, the prevalence of VMT was 2.3% for eyes or 2.4% for subjects. While it was associated with elder age, female gender, thicker subfoveal retinal thickness and thinner subfoveal choroidal thickness.

Effect of misalignment at different orientations associated with angle κ on optical performance of aspheric intraocular lenses with different surface designs

Intraocular lens (IOL) misalignment and angle κ have had significant negative impact on post-operative quality of vision. ZEMAX software has been used to imitate the optical performance of pseudophakic eyes with different IOL surface designs at different orientations of IOL misalignment (decentration of 0.4 mm and tilt of 7°, and with the existence of 0.5 mm angle κ). We found that an aspheric balanced curve optic surface maintained better optical performance via inducing less coma aberration. Coma aberration played an unexpectedly important role in the optical performance. With angle κ, the impact of IOL misalignment on visual quality was associated with the orientation of decentration and tilt, indicating that the coma compensation also took effect in pseudophakic eyes. Due to the high incidence of post-operative IOL misalignment, our results provide evidence of the importance of considering personalized angle κ before cataract surgery for patients.

Higher order aberrations, refractive error development and myopia control: a review

Evidence from animal and human studies suggests that ocular growth is influenced by visual experience. Reduced retinal image quality and imposed optical defocus result in predictable changes in axial eye growth. Higher order aberrations are optical imperfections of the eye that alter retinal image quality despite optimal correction of spherical defocus and astigmatism. Since higher order aberrations reduce retinal image quality and produce variations in optical vergence across the entrance pupil of the eye, they may provide optical signals that contribute to the regulation and modulation of eye growth and refractive error development. The magnitude and type of higher order aberrations vary with age, refractive error, and during near work and accommodation. Furthermore, distinctive changes in higher order aberrations occur with various myopia control treatments, including atropine, near addition spectacle lenses, orthokeratology and soft multifocal and dual-focus contact lenses. Several plausible mechanisms have been proposed by which higher order aberrations may influence axial eye growth, the development of refractive error, and the treatment effect of myopia control interventions. Future studies of higher order aberrations, particularly during childhood, accommodation, and treatment with myopia control interventions are required to further our understanding of their potential role in refractive error development and eye growth.

Peripheral refraction and higher order aberrations

Peripheral image quality influences several aspects of human vision. Apart from off-axis visual functions, the manipulation of peripheral optical errors is widely used in myopia control interventions. This, together with recent technological advancements enabling the measurement of peripheral errors, has inspired many studies concerning off-axis optical aberrations. However, direct comparison between these studies is often not straightforward. To enable between-study comparisons and to summarise the current state of knowledge, this review presents population data analysed using a consistent approach from 16 studies on peripheral ocular optical quality (in total over 2,400 eyes). The presented data include refractive errors and higher order monochromatic aberrations expressed as Zernike co-efficients (reported in a subset of the studies) over the horizontal visual field. Additionally, modulation transfer functions, describing the monochromatic image quality, are calculated using individual wavefront data from three studies. The analysed data show that optical errors increase with increasing eccentricity as expected from theoretical modelling. Compared to emmetropes, myopes tend to have more hypermetropic relative peripheral refraction over the horizontal field and worse image quality in the near-periphery of the nasal visual field. The modulation transfer functions depend considerably on pupil shape (for angles larger than 30°) and to some extent, the number of Zernike terms included. Moreover, modulation transfer functions calculated from the average Zernike co-efficients of a cohort are artificially inflated compared to the average of individual modulation transfer functions from the same cohort. The data collated in this review are important for the design of ocular corrections and the development and assessment of optical eye models.