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Wang X, Luo R, Shan G, He H, Chen T, Wang X, Gan L, Wang Y, Chou Y, Cui J, Li P, Zhong Y, Ma J. Prevalence and risk factors for refractive error in older adults in eight ethnicities in China: The China national health survey. Heliyon 2024; 10:e36354. [PMID: 39281499 PMCID: PMC11401125 DOI: 10.1016/j.heliyon.2024.e36354] [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: 12/23/2023] [Revised: 08/11/2024] [Accepted: 08/14/2024] [Indexed: 09/18/2024] Open
Abstract
Purpose This study aimed to investigate the prevalence of refractive error (RE) and risk factors for myopia among older adults in the Han and various minority ethnic groups across seven provinces in China. Methods This cross-sectional study forms a part of the ophthalmic dataset of the China National Health Survey (CNHS). Face-to-face interviews and ophthalmic examinations were conducted in seven provinces located in western and northern China. The age- and sex-adjusted prevalence of RE among Han and seven other ethnic groups aged 50-80 years were compared. A mixed-effects model was used to identify the risk factors associated with RE. Results A total of 12,902 participants, including 8800 Han and 4102 from ethnic minorities, were included in the study. The age- and sex-adjusted prevalence of myopia, high myopia, hyperopia, and astigmatism ranged from 15.3 % (Manchu) to 22.9 % (Han), 0.2 % (Yugur) to 2.8 % (Han), 21.6 % (Tibetan) to 48.9 % (Uyghur), and 38.7 % (Yi) to 57.5 % (Manchu) across different ethnicities, respectively. Compared to the Han population, the Mongolian (odds ratios (OR) 0.62, 95 % confidence interval (CI) 0.46-0.84, p = 0.002), Tibetan (OR 0.66, 95 % CI 0.52-0.85, p = 0.001), Uyghur (OR 0.63, 95 % CI 0.49-0.80, p < 0.001), Yi (OR 0.65, 95 % CI 0.46-0.92, p = 0.014), and Yugur (OR 0.65, 95 % CI 0.50-0.85, p = 0.001) ethnicities were less likely to have myopia. There was no significant difference in the prevalence of myopia between the Manchu, Korean, and Han ethnic groups. Factors associated with a lower prevalence of myopia included rural residence (p < 0.001), a body mass index (BMI) > 18.5 kg/m2 (all p < 0.001), residence in higher latitude areas (p = 0.020), and a history of smoking (p = 0.002 in the past smoking group, p = 0.031 in the current smoking group). The Mongolian (p = 0.006) and Yugur (p = 0.007) populations, participants living in rural areas (p = 0.012), and those with a BMI >24 kg/m2 (p = 0.038 in the >24.0 ≤ 27.0 kg/m2 group or p = 0.041 in the >27.0 kg/m2 group) were less likely to have high myopia. Factors associated with a higher prevalence of hyperopia included older age (all p < 0.001), rural residence (p = 0.039), higher latitude areas (p = 0.031), smoking history (p = 0.040), and Mongolian (p = 0.001), Uyghur (p < 0.001), Yi (p < 0.001), and Yugur (p = 0.002) ethnicities. Conversely, the Manchu population (p = 0.004) and individuals with higher education levels than illiteracy (p = 0.024 or p < 0.001) were less likely to have hyperopia. Conclusions Myopia affected more than one-fifth of the older adults in the Han population in this survey. Significant differences in the prevalence of RE were observed between minority ethnicities and Han individuals, except for the Manchu and Korean groups.
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Affiliation(s)
- Xuqian Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Rui Luo
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Ting Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China
| | - Xuejiao Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Department of Ophthalmology, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - Linyang Gan
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Yuhan Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Yuyu Chou
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Jiantao Cui
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Pan Li
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Yong Zhong
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Jin Ma
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China
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Sharma S, Rose L, Schulz A, Sharma DP, Zeldovich A, Azzi C, Nischal K. Myopia intervention and ultraviolet radiation related eye diseases: A narrative literature review. Taiwan J Ophthalmol 2024; 14:151-158. [PMID: 39027060 PMCID: PMC11253989 DOI: 10.4103/tjo.tjo-d-24-00011] [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: 01/23/2024] [Accepted: 03/05/2024] [Indexed: 07/20/2024] Open
Abstract
There has been an increased understanding of the protective effect of two or more hours in high lux light on the development and progression of myopia. The aim of myopia management is to reduce the incidence of high myopia and sight-threatening myopic complications. Equally important are the sight-threatening complications of ultraviolet radiation (UVR) on the eye and adnexal structures. This review will analyze the literature for both these epidemics to help guide public health policy. Whilst increasing childhood high lux light exposure is important, consideration of a holistic eye health policy should ensure that UV eye diseases are also prevented. The advent of ultraviolet (UV) fluorescence photography has increased our understanding that significant UV eye damage occurs in childhood, with 81% of children aged 12-15 years having signs of UV eye damage. Hence, the need to reduce myopia and protect from UV-related eye diseases needs simultaneous consideration. Advocating for eye protection is important, particularly as the natural squint reflex is disabled with dark sunglasses lenses. The pathways UV reaches the eye need to be considered and addressed to ensure that sunglasses offer optimum UV eye protection. The design of protective sunglasses that simultaneously allow high lux light exposure and protect from UVR is critical in combating both these epidemics.
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Affiliation(s)
| | | | | | | | | | | | - Ken Nischal
- UPMC Children’s Hospital Pittsburgh, Pennsylvania, USA
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Kuoliene K, Danieliene E, Tutkuviene J. Eye morphometry, body size, and flexibility parameters in myopic adolescents. Sci Rep 2024; 14:6787. [PMID: 38514709 PMCID: PMC10958051 DOI: 10.1038/s41598-024-57347-w] [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: 04/13/2023] [Accepted: 03/18/2024] [Indexed: 03/23/2024] Open
Abstract
The aim of this study was to investigate the anatomical and physiological ocular parameters in adolescents with myopia and to examine the relations between refractive error (SER), ocular biometry, body size and flexibility parameters in myopic adolescents. A cross-sectional study of 184 myopic adolescents, aged 15 to 19 years was conducted. Refractive error and corneal curvature measures of the eye were evaluated using an autorefractometer under cycloplegia. Central corneal thickness was determined by contact pachymetry. The ocular axial length, anterior and vitreous chamber depth, and lens thickness were measured using A-scan biometry ultrasonography. Height and body weight were measured according to a standardized protocol. Body mass index (BMI) was subsequently calculated. Beighton scale was used to measure joint flexibility. Body stature was positively correlated with ocular axial length (r = 0.39, p < 0.001) and vitreous chamber depth (r = 0.37, p < 0.001). There was a negative correlation between height and SER (r = - 0.46; p < 0.001). Beighton score and body weight had weak positive correlations with axial length and vitreous chamber depth, and a weak negative correlation with SER. A significantly more negative SER was observed in the increased joint mobility group (p < 0.05; U = 5065.5) as compared to normal joint mobility group: mean - 4.37 ± 1.85 D (median - 4.25; IQR - 6.25 to - 3.25 D) and mean - 3.72 ± 1.66 D (median - 3.50; IQR - 4.75 to - 2.25 D) respectively. There was a strong association between height and axial length, as well as SER. Higher degree of myopia significantly correlated with greater Beighton score (increased joint mobility).
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Affiliation(s)
- Kristina Kuoliene
- Department of Anatomy, Histology and Anthropology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Egle Danieliene
- Clinic of Ear, Nose, Throat and Eye Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Janina Tutkuviene
- Department of Anatomy, Histology and Anthropology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
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Hashemi H, Khabazkhoob M, Lança C, Emamian MH, Fotouhi A. Prevalence of anisometropia and its associated factors in school-age children. Strabismus 2024; 32:1-10. [PMID: 38230509 DOI: 10.1080/09273972.2023.2293883] [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] [Indexed: 01/18/2024]
Abstract
PURPOSE To determine the prevalence of anisometropia and the associated demographic and biometric risk factors in children. METHODS This cross-sectional study was conducted on the elementary school children of Shahroud, east of Iran, in 2015. All rural students were recruited, while multistage cluster sampling was used to select the students in urban areas. All children underwent optometric examinations including the measurement of uncorrected and corrected visual acuity, autorefraction, and subjective refraction with cycloplegia. Biometric components were measured using the Allegro Biograph. Myopia and hyperopia were defined as a spherical equivalent ≤-0.5 and ≥ +2.00 diopter, respectively. Students with a history of ocular trauma or lack of cycloplegic refraction at least in one eye were excluded from the study. RESULTS Of 6624 selected children, 5620 participated in the study. After applying the exclusion criteria, the data of 5357 students (boys: 52.8%, n = 2834) were analyzed. The mean age of the subjects was 9.2 ± 1.7 years (range: 6-12 years). The prevalence of anisometropia ≥ 1 D was 1.1% (95% CI: 0.8 to 1.4) in all children, 1.0% (95% CI: 0.7-1.3) in boys, 1.3% (95% CI: 0.8-1.7) in girls, 1.1% (95% CI: 0.8-1.4) in urban children, and 1.4% (95% CI: 0.5-2.3) in rural children. The prevalence of anisometropia was 8.8% (95% CI: 5.3-12.2) in myopic and 5.7% (95% CI: 2.8-8.5) in hyperopic children. Axial length asymmetry (OR = 40.9; 95%CI: 10.2-164.1), myopia (OR = 17.9; 95% CI: 9.4-33.9), and hyperopia (OR = 10.1; 95% CI: (5.1-19.7) were associated with anisometropia in multiple logistic regression model. More anisometropia was associated with more severe amblyopia. The odds of amblyopia (OR = 82.3: 38.2-177-3) and strabismus (OR = 17.6: 5.5-56.4) were significantly higher in anisometropic children. The prevalence of amblyopia was 21.7% in children with myopic anisometropia ≥ 3D, 66.7% in children with hyperopic anisometropia ≥ 3D, and 100% in cases with antimetropia ≥ 3D. CONCLUSION The prevalence of anisometropia was low in Iranian school children. However, a high percentage of anisometropic students had amblyopia and strabismus. Axial length was the most important biometric component associated with anisometropia.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Carla Lança
- Escola Superior de Tecnologia da Saúde de Lisboa (ESTeSL), Instituto Politécnico de Lisboa, Lisboa, Portugal
- Comprehensive Health Research Center (CHRC), Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Miki A, Fuse N, Fujimoto S, Taira M, Saito T, Okazaki T, Shiraki A, Sato S, Kawasaki R, Nakamura T, Kinoshita K, Nishida K, Yamamoto M. Prevalence, Associated Factors, and Inter-Eye Differences of Refractive Errors in a Population-Based Japanese Cohort: The Tohoku Medical Megabank Eye Study. Ophthalmic Epidemiol 2024; 31:46-54. [PMID: 37095711 DOI: 10.1080/09286586.2023.2203226] [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: 07/07/2022] [Accepted: 04/09/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE To investigate the prevalence, associated factors, and inter-eye differences of myopia and astigmatism in an adult Japanese population-based cohort. METHODS A total of 4282 participants from the Tohoku Medical Megabank Organization Eye Study (ToMMo Eye Study) underwent comprehensive ocular examinations as well as extensive physiological tests and a lifestyle questionnaire. The spherical equivalent (SE) and cylinder power were obtained as refractive parameters. The age- and gender-stratified prevalences of high myopia (SE < -5D), myopia (SE < -0.5D), hyperopia (SE > 0.5D), astigmatism (cylinder power < -0.5D), and anisometropia (SE difference >1D) were calculated. Multivariable analyses were performed to identify associated factors for refractive error (RE). Distribution and associated factors of the inter-eye difference in RE were also investigated. RESULTS The age-adjusted prevalence of high myopia, myopia, hyperopia, astigmatism, and anisometropia was 15.9%, 63.5%, 14.7%, 51.1%, and 14.7%, respectively. Both myopia and high myopia were more prevalent in the younger age group, while astigmatism was more prevalent in the older age group. Age, education, blood pressure, intraocular pressure, and corneal thickness are significantly associated with myopic refraction. Age, gender, intraocular pressure, and corneal thickness are correlated with astigmatism. Older age was associated with against-the-rule astigmatism. Older age, myopia, and longer education showed a significant correlation with large inter-eye differences in SERE. CONCLUSIONS This study demonstrated the high prevalence of myopia in young Japanese, which may be caused by a generational shift. This study also confirmed the influence of age and education on both the prevalence and inter-eye differences of RE.
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Affiliation(s)
- Atsuya Miki
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Myopia Control Resaerch, Aichi Medical University, Aichi, Japan
| | - Nobuo Fuse
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Satoko Fujimoto
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
- Hawaii Macula and Retina Institute, Aiea, HI, USA
| | - Makiko Taira
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomo Saito
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Tomoyuki Okazaki
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Akihiko Shiraki
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shigeru Sato
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
- Laboratory of Regenerative Medicine and Development, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Applied Information Science, Tohoku University Graduate School of Information Sciences, Sendai, Japan
| | - Ryo Kawasaki
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Vision Informatics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tomohiro Nakamura
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Kengo Kinoshita
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Department of Applied Information Science, Tohoku University Graduate School of Information Sciences, Sendai, Japan
| | - Kohji Nishida
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
- Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Osaka, Japan
| | - Masayuki Yamamoto
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Tohoku University Graduate School of Medicine, Sendai, Japan
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Wei D, Wang H, Huang L, Hou M, Liang HG, Shi X, Wei X, Li J, Gan L, Lv B, Deng J, Qing L. A Mendelian randomization study on the causal relationship between smoking, alcohol consumption, and the development of myopia and astigmatism. Sci Rep 2024; 14:1868. [PMID: 38253641 PMCID: PMC10803726 DOI: 10.1038/s41598-024-52316-9] [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: 10/15/2023] [Accepted: 01/17/2024] [Indexed: 01/24/2024] Open
Abstract
The influence of environmental factors like smoking and alcohol on myopia and astigmatism is controversial. However, due to ethical concerns, alternative study designs are urgently needed to assess causal inference, as mandatory exposure to cigarettes and alcohol is unethical. Following comprehensive screenings, 326 single nucleotide polymorphisms (SNPs) related to myopia and astigmatism were included in the dataset. To validate the causal association between exposures such as cigarette smoking, alcohol consumption, and coffee intake, and outcomes namely astigmatism and myopia, five regression models were employed. These models encompassed MR-Egger regression, random-effects inverse-variance weighted (IVW), weighted median estimator (WME), weighted model, and simple model. The instrumental variables utilized in these analyses were the aforementioned SNPs. Apply Cochran's Q test to determine heterogeneity of SNPs; if heterogeneity exists, focus on IVW model results. The IVW model showed a 1.379-fold increase in the risk of astigmatism (OR = 1.379, 95%CI 0.822~2.313, P = 0.224) and a 0.963-fold increase in the risk of myopia (OR = 0.963, 95%CI 0.666~1.393, P = 0.841) for each unit increase in smoking. For each unit increase in coffee intake, the risk of astigmatism increased 1.610-fold (OR = 1.610, 95%CI 0.444~5.835, P = 0.469) and the risk of myopia increased 0.788-fold (OR = 0.788, 95%CI 0.340~1.824, P = 0.578). For each additional unit of alcohol consumption, the risk of astigmatism increased by 0.763-fold (OR = 0.763, 95%CI 0.380~1.530, P = 0.446), and none of the differences were statistically significant. However, for each unit of alcohol consumption, the risk of myopia increased by 1.597 times, and the difference was statistically significant (OR = 1.597, 95%CI 1.023~2.493, P = 0.039). The findings indicate that alcohol consumption is a risk factor for myopia but smoking and coffee intake do not affect its development. Additionally, there is no association between smoking, alcohol consumption, coffee intake, and the risk of astigmatism.
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Affiliation(s)
- Diyao Wei
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Huanyan Wang
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China.
| | - Ling Huang
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Minghui Hou
- Department of Pediatrics, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China
| | - Hong-Gang Liang
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Xiang Shi
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Xianghui Wei
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Jingrong Li
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Liuzhu Gan
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Bi Lv
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Jiabi Deng
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Lulu Qing
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
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Ferrara M, Song A, Al-Zubaidy M, Avery P, Laidlaw DA, Williamson TH, Yorston D, Steel DHW. The effect of sex and laterality on the phenotype of primary rhegmatogenous retinal detachment. Eye (Lond) 2023; 37:2926-2933. [PMID: 36849827 PMCID: PMC10517129 DOI: 10.1038/s41433-023-02443-w] [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: 12/04/2021] [Revised: 11/21/2022] [Accepted: 02/02/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND To assess the effect of sex and laterality on clinical features of primary rhegmatogenous retinal detachment (RRD). METHOD This study is a retrospective analysis of data prospectively collected. We extracted data from two online datasets over a 7-year period of patients older than 16 years who had undergone surgery for primary RRD. Data on baseline characteristics were analyzed to compare males versus females, and right versus left eyes. RESULTS Of 8133 eyes analyzed, 4342 (53.4%) were right. The overall male predominance (63.7%) was more marked in the age range 50-69 years. Men were more commonly pseudophakic and presented more frequently with baseline posterior vitreous detachment (PVD). Female sex was significantly associated with baseline myopia, retinal holes as causative retinal break, and isolated inferior RD. Men had more frequent foveal involvement, greater RRD extent, greater numbers and larger sized retinal tears including dialysis and giant retinal tears. Regarding laterality, foveal involvement, larger retinal breaks, isolated temporal RD and temporal retinal breaks were more common in right eyes, whereas left eyes were more myopic at baseline and presented more frequently with isolated nasal RD and nasal retinal breaks. CONCLUSIONS This study confirmed the predominance of male sex and right laterality in RRD. Sex and laterality were associated with multiple presenting features of RRD including extent, break distribution, number, size and type, as well as RD distribution.
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Affiliation(s)
- Mariantonia Ferrara
- Newcastle Eye Centre, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4PL, UK
| | - Anna Song
- Biosciences Institute, Newcastle University, Catherine Cookson Building, Newcastle upon Tyne, NE2 4HH, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Mohaimen Al-Zubaidy
- Biosciences Institute, Newcastle University, Catherine Cookson Building, Newcastle upon Tyne, NE2 4HH, UK
| | - Peter Avery
- School of Mathematics & Statistics, Newcastle University, Herschel Building, Newcastle Upon Tyne, NE1 7RU, UK
| | - D Alistair Laidlaw
- Guy's and St. Thomas' NHS Foundation Trust, New City Court 20 St. Thomas Street, London, SE1 9RT, UK
| | - Tom H Williamson
- Guy's and St. Thomas' NHS Foundation Trust, New City Court 20 St. Thomas Street, London, SE1 9RT, UK
| | - David Yorston
- Gartnavel Hospital, 1053 Great Western Road, Glasgow, G12 0YN, UK
| | - David H W Steel
- Biosciences Institute, Newcastle University, Catherine Cookson Building, Newcastle upon Tyne, NE2 4HH, UK.
- Sunderland Eye Infirmary, Queen Alexandra Road, Sunderland, SR2 9HP, UK.
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Gil P, Farcas A, Benito A, Tabernero J. Functional visual tests to evaluate the effect of small astigmatism correction with toric contact lenses. BIOMEDICAL OPTICS EXPRESS 2023; 14:2811-2820. [PMID: 37342708 PMCID: PMC10278640 DOI: 10.1364/boe.487410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/31/2023] [Accepted: 04/26/2023] [Indexed: 06/23/2023]
Abstract
The prescription of daily contact lenses does not often include a full astigmatic correction. We question here whether this full astigmatic correction (for low to moderate astigmatism) provides a substantial improvement in the overall visual performance compared to a more conservative approach based only on the prescription of spherical contact lenses. The visual performance of 56 contact lens neophytes divided in two contact lens fitting groups (toric versus spherical lens fit) was assessed using standard visual acuity and contrast sensitivity tests. A new set of functional tests simulating everyday tasks was also used. Results showed that subjects with toric lenses had significantly better visual acuity and contrast sensitivity than those with spherical lenses. Functional tests did not render significant differences between groups, which was explained by several factors like i) the visual demand of the functional tests, ii) the dynamic blur due to misalignments and iii) small misfits between the available and measured axis of the astigmatic contact lens.
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Affiliation(s)
- Pedro Gil
- Departamento de Electromagnetismo y Electrónica, Facultad de Química, Universidad de Murcia, Murcia 30100, Spain
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo (Edificio 34), Murcia 30100, Spain
| | - Alexandra Farcas
- Departamento de Electromagnetismo y Electrónica, Facultad de Química, Universidad de Murcia, Murcia 30100, Spain
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo (Edificio 34), Murcia 30100, Spain
| | - Antonio Benito
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo (Edificio 34), Murcia 30100, Spain
| | - Juan Tabernero
- Departamento de Electromagnetismo y Electrónica, Facultad de Química, Universidad de Murcia, Murcia 30100, Spain
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo (Edificio 34), Murcia 30100, Spain
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Kuriakose RK, Gulati R, Bains H, Ramaprasad A, Chan NK, Basti S. Change in major ocular biometry parameters axial length and keratometry in adults over time. J Cataract Refract Surg 2023; 49:474-478. [PMID: 36700942 DOI: 10.1097/j.jcrs.0000000000001144] [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: 05/26/2022] [Accepted: 01/11/2023] [Indexed: 01/27/2023]
Abstract
PURPOSE To determine how much axial length (AL) and average keratometry (K) change over time in elderly patients and to assess clinical necessity of repeating biometry in instances where the second eye is operated on 6 months or more after the first. SETTING Northwestern Memorial Hospital, Chicago, Illinois. DESIGN Retrospective study. METHODS Inclusion criteria were patients older than 35 years, with 2 biometry measurements over 6 months apart, measured with the IOL Master 700 from January 1, 2016, to September 15, 2020. Patients were excluded if they had any other intraocular surgery besides cataract. A linear mixed model and SPSS software was used to compare measurements among timepoints. RESULTS 201 patients (402 eyes) were included (average age 73.3, 59.3% female). Average time between biometry measurements was 21.5 months (range 6 to 48 months). The mean change in AL was 0.04 mm (95% CI, 0.03 to 0.05, P = .10). The mean change in K was 0.01 diopters (95% CI, -0.10 to 0.30, P = .33). At the 6-month to 1-year interval (n = 73), mean change in AL was 0.04 mm. Mean change in AL did not significantly increase with greater time intervals. There was no correlation between time and ΔAL ( P = .70), nor between time and ΔK ( P = .98). CONCLUSIONS In this cohort, biometric parameters did not change significantly over time. Repeating biometry at a 1- to 2-year interval for elderly patients receiving monofocal implants may offer limited benefit.
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Affiliation(s)
- Robin K Kuriakose
- From the Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (Kuriakose, Ramaprasad, Chan, Basti); Northwestern University Feinberg School of Medicine, Chicago, Illinois (Gulati); Texas Tech University Health Sciences Center, El Paso, Texas (Bains)
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10
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Ryu S, Kang HC, Lee SC, Byeon SH, Kim SS, Lee CS. Refractive Errors, Retinal Findings, and Genotype of Tuberous Sclerosis Complex: A Retrospective Cohort Study. Yonsei Med J 2023; 64:133-138. [PMID: 36719021 PMCID: PMC9892541 DOI: 10.3349/ymj.2022.0451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/24/2022] [Accepted: 12/28/2022] [Indexed: 01/21/2023] Open
Abstract
PURPOSE To examine the refractive errors, retinal manifestations, and genotype in tuberous sclerosis complex (TSC) patients in a Korean population. MATERIALS AND METHODS A total of 98 patients with TSC were enrolled in Severance Hospital for a retrospective cohort study. The number of retinal astrocytic hamartoma and retinal achromic patch within a patient, as well as the size, bilaterality, and morphological type were studied. In addition, the refractive status of patients and the comorbidity of intellectual disability and epilepsy were also examined. RESULTS Retinal astrocytic hamartoma was found in 37 patients, and bilateral invasion was observed in 20 patients (54%). TSC1 mutation was associated with myopia (p=0.01), while TSC2 mutation was associated with emmetropia (p=0.01). Retinal astrocytic hamartoma was categorized into three morphological types and examined as follows: type I (87%), type II (35%), and type III (14%). Single invasion of retinal astrocytic hamartoma was identified in 32% of the patients, and multiple invasions in 68%. The TSC1/TSC2 detection rate was 91% (41/45). Among them, TSC1 variant was detected in 23 patients (54%), whereas TSC2 variant was detected in 18 patients (40%). The results showed that TSC2 mutations are correlated with a higher rate of retinal astrocytic hamartoma involvement (all p<0.05), and multiple and bilateral involvement of retinal hamartomas (all p<0.05). However, the size of retinal astrocytic hamartomas, comorbidity of epilepsy, or intellectual disability did not show correlation with the genetic variant. CONCLUSION TSC1 variant patients were more myopic, while TSC2 variant patients showed association with more extensive involvement of retinal astrocytic hamartoma.
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Affiliation(s)
- Soyoung Ryu
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Hoon-Chul Kang
- Division of Pediatric Neurology, Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Chul Lee
- Department of Ophthalmology, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Suk Ho Byeon
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Soo Kim
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Christopher Seungkyu Lee
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
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11
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Hashemi A, Khabazkhoob M, Hashemi H. High prevalence of refractive errors in an elderly population; a public health issue. BMC Ophthalmol 2023; 23:38. [PMID: 36707798 PMCID: PMC9881344 DOI: 10.1186/s12886-023-02791-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/20/2023] [Indexed: 01/28/2023] Open
Abstract
PURPOSE To determine the prevalence of myopia and hyperopia and their associated demographic and ocular factors in people 60 years of age and above. METHODS The sampling was performed using a multi-stage stratified random cluster sampling method. The complete demographic and case history information were collected through an interview. Then, all participants underwent optometric examinations including measurement of uncorrected and best-corrected visual acuity, objective, and subjective refraction. Myopia and hyperopia were defined as a spherical equivalent (SE) refraction worse than -0.50 diopters (D) and + 0.50 D, respectively. RESULTS Three thousand three hundred ten of 3791 invitees participated, and the data of 3263 individuals were analyzed for this report. The mean age of participants was 68.25 ± 6.53 (60 to 97) years, and 1895 (58.1%) of them were female (number of male/female participants = 1368/1895). The prevalence of myopia and hyperopia was 31.65% (95% CI: 29.68 -33.61) and 45.36% (95% CI: 43.36 -47.37), respectively. The prevalence of severe myopia and hyperopia was 1.14% (95% CI: 0.73 -1.55) and 2.27% (95% CI: 1.57 -2.97), respectively. Based on the results of multiple logistic regression, the prevalence of myopia had a statistically significant direct relationship with age (OR: 1.04; p < 0.001), history of glaucoma surgery (OR:2.75; p < 0.001), pseudophakia (OR: 2.27; p < 0.001), axial length (OR:3.05; p < 0.001), and mean keratometry (OR:1.61; p < 0.001). The education level was significantly inversely related to the myopia prevalence. Moreover, a history of glaucoma surgery (OR:0.44; p < 0.001), pseudophakia (OR = 0.15; p < 0.001), axial length (OR:35; p < 0.001) and mean keratometry (OR:0.62; p < 0.001) were significantly inversely related to the prevalence of hyperopia. 19% and 40.02% of myopic and hyperopic patients had complete visual acuity after correction of refractive error, respectively. CONCLUSION The prevalence of refractive errors was high in the Iranian elderly population. A large percentage of the elderly still did not have complete visual acuity after the correction of refractive errors indicating the necessity for attention to other ocular diseases in this age group. The history of cataract and glaucoma surgery could be associated with a myopic shift of refractive error.
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Affiliation(s)
- Alireza Hashemi
- grid.416362.40000 0004 0456 5893Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Mehdi Khabazkhoob
- grid.411600.2Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Hashemi
- grid.416362.40000 0004 0456 5893Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
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Balicka A, Zwolska J, Szadkowski M, Trbolova A, Balicki I. Refractive errors in mixed breed dogs of different ages. VET MED-CZECH 2023; 68:11-16. [PMID: 38384993 PMCID: PMC10878259 DOI: 10.17221/106/2021-vetmed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/08/2022] [Indexed: 02/23/2024] Open
Abstract
The purpose of the study was to evaluate the occurrence and range of refractive errors in dogs of different ages. A total of 99 clinically healthy, mixed-breed mesocephalic dogs were included in the study and divided into three different age groups according to the current human/pet analogy chart: 40 adults (23 males, 17 females, 1-8 years old, 3-70 kg), 21 seniors (14 males, 7 females, 6-11 years old, 7-42 kg), and 38 geriatrics (22 males, 16 females, 8-13 years old, 5-45 kg). All the dogs underwent an ophthalmic examination, including Schirmer tear test, tonometry, biomicroscopy, and ophthalmoscopy. Neither eye drops nor pharmacological sedatives were administered before the autorefractometry. The refractive states were assessed bilaterally using a hand-held Retinomax 3 (Righton) autorefractor. The results underwent statistical analysis using Statistica v12 software (ANOVA and t-test). A P-value < 0.05 was considered as significant. Emmetropia, defined as a refractive state > -0.5 D and < +0.5 D, was found in 36% of the adult, 43% of the senior, and 38% of the geriatric patients. Anisometropia was found in 1% of the adult, 9.5% of the senior and 5.5% of the geriatric dogs when the refractive power of the two eyes differed ≥ 1.0 myopia ≤ -0.5 D and hyperopia ≥ +0.5 D were found in 23% and 41% of the adult eye globes as well as 24% and 33% in the senior dogs and 15% and 47% in the geriatric dogs, respectively. The maximal values of the myopia in the adult and geriatric dogs were -2.5 D and -2.75 D, respectively. The maximal values of the hyperopia in the adult and geriatric dogs were 1.75 D and 2.5 D, respectively. No statistically significant correlation was found between the groups. Ametropia is a common refractive state for dogs of different ages. The most frequent refractive state in ametropic mixed-bed dogs in all age groups is hyperopia.
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Affiliation(s)
- Agnieszka Balicka
- Small Animals Clinic, University of Veterinary Medicine and Pharmacy in Košice, Košice, Slovak Republic
| | - Jowita Zwolska
- Department and Clinic of Animal Surgery, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, Lublin, Poland
| | - Mateusz Szadkowski
- Department and Clinic of Animal Surgery, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, Lublin, Poland
| | - Alexandra Trbolova
- Small Animals Clinic, University of Veterinary Medicine and Pharmacy in Košice, Košice, Slovak Republic
| | - Ireneusz Balicki
- Department and Clinic of Animal Surgery, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, Lublin, Poland
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Liang Y, Shen R, Zhou W, Fan S, Chan PP, Tham CCY, Congdon N, Friedman DS, Wang N. Prevalence and Ocular Biometric Characteristics of Myopia in Primary Angle Closure Disease in Rural China: The Handan Eye Study. Invest Ophthalmol Vis Sci 2022; 63:19. [DOI: 10.1167/iovs.63.12.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Yuanbo Liang
- Clinical & Epidemiological Eye Research Center, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
- Glaucoma Institute, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ruyue Shen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Weihe Zhou
- Clinical & Epidemiological Eye Research Center, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | | | - Poemen P. Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Clement C. Y. Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Nathan Congdon
- Centre for Public Health, Queen's University, Belfast, United Kingdom
- Orbis International, New York, New York, United States
| | - David S. Friedman
- Glaucoma Center of Excellence, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab, Beijing, China
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Longwill S, Moore M, Flitcroft DI, Loughman J. Using electronic medical record data to establish and monitor the distribution of refractive errors . JOURNAL OF OPTOMETRY 2022; 15 Suppl 1:S32-S42. [PMID: 36220741 PMCID: PMC9732486 DOI: 10.1016/j.optom.2022.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 09/09/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To establish the baseline distribution of refractive errors and associated factors amongst a population that attended primary care optometry clinics. DESIGN Retrospective cross sectional cohort study of electronic medical records (EMR). METHODS Electronic medical record data was extracted from forty optometry clinics, representing a mix of urban and rural areas in Ireland. The analysis was confined to demographic and clinical data gathered over a sixty-month period between 2015 and 2019. Distribution rates were calculated using the absolute and relative frequencies of refractive error in the dataset, stratified for age and gender using the following definitions: high myopia ≤ -6.00 D, myopia ≤ -0.50 D, hyperopia ≥ +0.50 D, astigmatism ≤ -0.75 DC and anisometropia ≥ 1.00 D. Visual acuity data was used to explore vision impairment rates in the population. Further analysis was carried out on a gender and age-adjusted subset of the EMR data, to match the proportion of patients in each age grouping to the population distribution in the most recent (2016) Irish census. RESULTS 153,598 clinic records were eligible for analysis. Refractive errors ranged from -26.00 to +18.50 D. Myopia was present in 32.7%, of which high myopia represented 2.4%, hyperopia in 40.1%, astigmatism in 38.3% and anisometropia in 13.4% of participants. The clinic distribution of hyperopia, astigmatism and anisometropia peaked in older age groups, whilst the myopia burden was highest amongst people in their twenties. A higher proportion of females were myopic, whilst a higher proportion of males were hyperopic and astigmatic. Vision impairment (LogMAR > 0.3) was present in 2.4% of participants. In the gender and age- adjusted distribution model, myopia was the most common refractive state, affecting 38.8% of patients. CONCLUSION Although EMR data is not representative of the population as a whole, it is likely to provide a reasonable representation of the distribution of clinically significant (symptomatic) refractive errors. In the absence of any ongoing traditional epidemiological studies of refractive error in Ireland, this study establishes, for the first time, the distribution of refractive errors observed in clinical practice settings. This will serve as a baseline for future temporal trend analysis of the changing pattern of the distribution of refractive error in EMR data. This methodology could be deployed as a useful epidemiological resource in similar settings where primary eyecare coverage for the management of refractive error is well established.
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Affiliation(s)
- Seán Longwill
- Centre for Eye Research Ireland, School of Physics and Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland.
| | - Michael Moore
- Centre for Eye Research Ireland, School of Physics and Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland
| | - Daniel Ian Flitcroft
- Centre for Eye Research Ireland, School of Physics and Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland; Children's University Hospital, Dublin, Ireland
| | - James Loughman
- Centre for Eye Research Ireland, School of Physics and Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland
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Evaluation of Visual and Patient-Reported Outcomes, Spectacle Dependence after Bilateral Implantation with a Non-Diffractive Extended Depth of Focus Intraocular Lens Compared to Other Intraocular Lenses. J Clin Med 2022; 11:jcm11175246. [PMID: 36079174 PMCID: PMC9456700 DOI: 10.3390/jcm11175246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose: To evaluate postoperative outcomes, spectacle dependance and the occurrence of the photic phenomena in patients after cataract surgery following the implantation of a non-diffractive extended depth of focus (EDOF) intraocular lens was compared to monofocal and multifocal lenses. Methods: We enrolled patients with bilateral cataracts who wanted to reduce their dependence on glasses in the study. They were followed for 6 months. The study group in which the EDOF lens was implanted consisted of 70 eyes in 35 patients. The control groups consisted of: 52 eyes in 26 patients in whom a multifocal was implanted and 52 eyes in 26 patients with implanted monofocal lens. After a total of 2 weeks, 2 months and 6 months post-surgery the following were evaluated: uncorrected and corrected visual acuity at 4 m, 80 cm, 40 cm, manifest refraction expressed as mean refractive spherical equivalent (MRSE), contrast sensitivity, intraocular pressure. A questionnaire on independence from ocular correction, the occurrence of photic phenomena, and patient satisfaction was also completed. Results: Monocular and binocular visual acuity and MRSE 6 months after the procedure were compared between three groups. All of the main analyses, except for comparisons of uncorrected distance visual acuity (both monocular and binocular) level, were significant. Contrast sensitivity was lower among patients with multifocal lens than among patients with EDOF lens. Halo and glare after 6 months were seen more often among patients with multifocal lens than among patients with the other lens (65% of eyes with multifocal lens vs. 6% of eyes with EDOF lens and 0% of eyes with monofocal lens). Glasses were needed by 35% of patients with EDOF lens, and by 96% of patients with monofocal lens and in none of the patients with multifocal lens. Conclusions: Most patients qualify for the implantation of a non-diffractive EDOF lens. Post-operative visual acuity improves at any distance. The best monocular visual acuity for intermediate distances is provided by an EDOF lens, and for near distance by a multifocal lens. The EDOF lens definitely increases independence from spectacle correction compared to monofocal lenses; however, the greatest degree of independence from spectacles is provided by multifocal lenses. The incidence of photic phenomena is slightly higher than that of a monofocal lens, and much lower for a multifocal lens.
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Hashemi H, Asharlous A, Yekta A, Aghamirsalim M, Nabovati P, Sadoughi MM, Khabazkhoob M. Astigmatism profile in the elderly population: Tehran Geriatric Eye Study. Jpn J Ophthalmol 2022; 66:461-473. [PMID: 35947225 DOI: 10.1007/s10384-022-00936-x] [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: 02/11/2022] [Accepted: 06/23/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine the prevalence of astigmatism and its associated factors and examine astigmatism symmetry patterns in an elderly population. STUDY DESIGN Population based cross-sectional study. METHODS The present population-based cross-sectional study was conducted on an elderly population above 60 years of age in Tehran, Iran in 2019. The sampling was done using the stratified multistage random cluster sampling method. All study participants underwent a complete optometric examination and slit-lamp biomicroscopy. RESULTS The prevalence of astigmatism higher than -0.50, -1.00, and -2.00 D was 83% (95% CI: 81 -84), 52 % (95% CI: 50 -54), and 19% (95% CI: 17-20), respectively. These prevalence was 79%(95% CI: 77-81), 46(95% CI: 44-49) and 14(95% CI: 13-16) in subjects without a history of ocular surgery, respectively. Based on cylinder power worse than -1.00 D, 10% (95% CI: 9-12), 20% (95% CI: 18-22), and 21% (95% CI:19-23) of study participants had with the rule, against the rule, and oblique astigmatism, respectively. According to the results of the multiple regression model, male gender, older age, low education level, pure posterior subcapsular cataract, pseudophakia, and myopia were independent factors associated with astigmatism. The prevalence of anisorule astigmatism was 57 % (95% CI: 56-59), the most common anisorule astigmatism was against the rule-oblique type with a prevalence of 36% (95% CI: 34-38). CONCLUSION The prevalence of astigmatism was high in the elderly population of Tehran. More than half of the participants in this study had anisorule astigmatism, and against the rule-oblique combination was more prevalent than other types. A posterior subcapsular cataract, a history of cataract surgery, and myopia were the associated factors of astigmatism in this study.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Amir Asharlous
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Abbasali Yekta
- Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Payam Nabovati
- Rehabilitation Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mehdi Sadoughi
- Department of Ophthalmology, School of Medicine, Shahid Labbafinezhad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Kumar M, Mahaseth A, Parveen S, Rafeeq U, Chauhan L. Refractive errors among commercial drivers. Indian J Ophthalmol 2022; 70:2112-2116. [PMID: 35647994 PMCID: PMC9359264 DOI: 10.4103/ijo.ijo_2510_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose To determine the pattern of refractive error among commercial drivers in north India. Methods Descriptive study with convenient sampling conducted among commercial drivers of north India. Results A total of 213 (75.8%) heavy-vehicle and 68 (24.2%) light-vehicle drivers were screened for eye diseases. Refractive error for distance was reported in 44 (15.7%; 95% CI: 11.6-20.4) drivers. Hyperopia was reported in 23 (8.2%; 95% CI: 5.2-12) drivers, followed by myopia in 15 (5.3%; 95% CI: 3-8.6) drivers and astigmatism in six (2.1%; 95% CI: 0.7-4.5) drivers. Presbyopia was reported in 157 (55.8%) drivers. Dry eye was reported in 70 (24.9%), stereo deficiency in 77 (27.4%), and color vision deficiency in 11 (3.9%) drivers. Three drivers were diagnosed with cataract, and two were referred for retina evaluation. Conclusion Hyperopia in both eyes was the most common refractive error. Dry eye disease and color vision deficiency were also reported. Most of the drivers were not using spectacles for refractive error correction. Due to their mobile nature, drivers with cataract and retina diseases did not turn up for follow-up.
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Affiliation(s)
- Mukesh Kumar
- Department of Glaucoma, C L Gupta Eye Institute, Moradabad, Uttar Pradesh, India,Correspondence to: Dr. Mukesh Kumar, Research Associate, Department of Clinical and Public Health Research, CL Gupta Eye Institute, Ram Ganga Vihar, Phase 2(Ext) Moradabad - 244 001, Uttar Pradesh, India. E-mail:
| | - Aarti Mahaseth
- Department of Optometry and Visual Sciences, C L Gupta Eye Institute, Moradabad, Uttar Pradesh, India
| | - Shafia Parveen
- Department of Optometry and Visual Sciences, C L Gupta Eye Institute, Moradabad, Uttar Pradesh, India
| | - Uzma Rafeeq
- Department of Optometry and Visual Sciences, C L Gupta Eye Institute, Moradabad, Uttar Pradesh, India
| | - Lokesh Chauhan
- Clinical and Public Health Research, C L Gupta Eye Institute, Moradabad, Uttar Pradesh, India
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Khatwani N, Makhija S, Ahuja A. Clinical profile and distribution of peripheral retinal changes in myopic population in a hospital-based study in North India. Indian J Ophthalmol 2022; 70:1280-1285. [PMID: 35326034 PMCID: PMC9240558 DOI: 10.4103/ijo.ijo_946_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose To evaluate the prevalence of different types of peripheral retinal changes in a myopic population in North India and correlate them with axial length. Methods This cross-sectional, hospital-based survey included 600 eyes of 300 myopic individuals, aged between 10 and 40 years, attending the outdoor ophthalmology clinic of a tertiary eye care hospital in North India were examined from July 2019 to July 2020. They were divided into mild, moderate, high, and severe myopia according to the spherical equivalent of refraction. Axial length was recorded. Peripheral retinal changes were examined by scleral indentation binocular indirect ophthalmoscopy. Standardized findings considered with their fundus location were lattice degeneration, white without pressure and white with pressure, snail-track degenerations, peripheral chorioretinal atrophy, retinal holes, tears, and detachment. The study was approved by the institutional ethics committee, and all participants provided informed consent. Results Peripheral retinal degenerations were found in almost half (53%) of all myopes included in the study. The most common peripheral retinal degeneration found was lattice degeneration, followed by white without pressure, white with pressure, and chorioretinal atrophy. Most of the peripheral retinal degenerations were seen in the temporal quadrant of the fundus, either superotemporal or inferotemporal. There was a significant positive association between the prevalence of peripheral retinal degeneration with age, increased axial length, and severity of myopia. Conclusion The results of our study indicate the necessity for careful peripheral fundus examinations of all myopes, irrespective of age and degree of myopia, for early diagnosis and better management of visual-threatening complications like retinal detachment.
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Affiliation(s)
- Neelam Khatwani
- Department of Ophthalmology, Sant Parmanand Hospital, Delhi, India
| | - Sandhya Makhija
- Department of Ophthalmology, Sant Parmanand Hospital, Delhi, India
| | - Ashish Ahuja
- Department of Ophthalmology, Sant Parmanand Hospital, Delhi, India
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Asefa NG, Neustaeter A, Vehof J, Nolte IM, Snieder H, Jansonius NM. Development and validation of a questionnaire-based myopia proxy in adults: the LifeLines Cohort Study. Br J Ophthalmol 2022:bjophthalmol-2021-319166. [PMID: 35273020 DOI: 10.1136/bjophthalmol-2021-319166] [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: 03/01/2021] [Accepted: 02/13/2022] [Indexed: 11/04/2022]
Abstract
AIMS To build a questionnaire-based myopia proxy and to validate the proxy by confirming its association with educational attainment and a Polygenic Risk Score (PRS) for myopia. METHODS Data were collected between 2014 and 2017 from 88 646 Dutch adults from the LifeLines Cohort. First, we performed principal component analysis (PCA) to responses of five refraction-status questions. Second, we measured the refractive state in a subset of LifeLines participants (n=326) and performed logistic regression using myopia (mean spherical equivalent <-0.5 D) as a dependent variable and the principal components (PCs) as independent variables. We identified specificity, sensitivity and the classification threshold. Third, the classification equation was applied to the remaining LifeLines participants. The value of the proxy was then explored by calculating its association with educational attainment and a PRS of myopia. RESULTS A total of 77 096 participants (58.1% women) were eligible for the PCA. The first two PCs had a specificity of 91.9% (95% CI 87.8% to 95.4%) and a sensitivity of 90.4% (95% CI 84.3% to 96.4%) for myopia. The area under the receiver operating characteristic curve was 95.0% (95% CI 92.2% to 97.8%). The age-standardised prevalence of proxy-inferred myopia was 33.8% (95% CI 33.4% to 34.3%). Compared with low education level, the ORs of proxy-inferred myopia were 1.66 (95% CI 1.58 to 1.74, p=5.94×10-90) and 2.54 (95% CI 2.41 to 2.68, p=4.04×10-271) for medium and high education levels, respectively. Similarly, individuals at the top 10% of PRS (vs lower 90%) had an OR of 2.18 (95% CI 1.98 to 2.41, p=6.57×10-56) for proxy-inferred myopia, whereas those at the highest decile had an OR of 4.51 (95% CI 3.9 to 5.21, p=1.74×10-89) when compared with the lowest decile. CONCLUSION Self-administered refractive error-related questions could be used as an effective tool to capture proxy-inferred myopic cases in a population-based setting.
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Affiliation(s)
- Nigus G Asefa
- Department of Epidemiology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Anna Neustaeter
- Department of Ophthalmology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Jelle Vehof
- Department of Ophthalmology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Ilja M Nolte
- Department of Epidemiology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Harold Snieder
- Department of Epidemiology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Nomdo M Jansonius
- Department of Ophthalmology, University Medical Centre Groningen, Groningen, The Netherlands
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20
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Fuse N, Sakurai M, Motoike IN, Kojima K, Takai-Igarashi T, Nakaya N, Tsuchiya N, Nakamura T, Ishikuro M, Obara T, Miyazawa A, Homma K, Ido K, Taira M, Kobayashi T, Shimizu R, Uruno A, Kodama EN, Suzuki K, Hamanaka Y, Tomita H, Sugawara J, Suzuki Y, Nagami F, Ogishima S, Katsuoka F, Minegishi N, Hozawa A, Kuriyama S, Yaegashi N, Kure S, Kinoshita K, Yamamoto M. Genome-wide Association Study of Axial Length in Population-based Cohorts in Japan. OPHTHALMOLOGY SCIENCE 2022; 2:100113. [PMID: 36246171 PMCID: PMC9559092 DOI: 10.1016/j.xops.2022.100113] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 01/07/2022] [Accepted: 01/07/2022] [Indexed: 11/20/2022]
Abstract
Purpose To elucidate the differences in ocular biometric parameters by generation and gender and to identify axial length (AL)-associated genetic variants in Japanese individuals, we analyzed Tohoku Medical Megabank Organization (ToMMo) Eye Study data. Design We designed the ToMMo Eye Study, examined AL variations, and conducted genome-wide association studies (GWASs). Participants In total, 33 483 participants aged > 18 years who were recruited into the community-based cohort (CommCohort) and the birth and three-generation cohort (BirThree Cohort) of the ToMMo Eye Study were examined. Methods Each participant was screened with an interview, ophthalmic examinations, and a microarray analysis. The GWASs were performed in 22 379 participants in the CommCohort (discovery stage) and 11 104 participants in the BirThree Cohort (replication stage). We evaluated the associations of single nucleotide polymorphisms (SNPs) with AL using a genome-wide significance threshold (5 × 10-8) in each stage of the study and in the subsequent meta-analysis. Main Outcome Measures We identified the association of SNPs with AL and distributions of AL in right and left eyes and individuals of different sexes and ages. Results In the discovery stage, the mean AL of the right eye (23.99 mm) was significantly greater than that of the left eye (23.95 mm). This difference was reproducible across sexes and ages. The GWASs revealed 703 and 215 AL-associated SNPs with genome-wide significance in the discovery and validation stages, respectively, and many of the SNPs in the discovery stage were replicated in the validation stage. Validated SNPs and their associated loci were meta-analyzed for statistical significance (P < 5 × 10-8). This study identified 1478 SNPs spread over 31 loci. Of the 31 loci, 5 are known AL loci, 15 are known refractive-error loci, 4 are known corneal-curvature loci, and 7 loci are newly identified loci that are not known to be associated with AL. Of note, some of them shared functional relationships with previously identified loci. Conclusions Our large-scale GWASs exploiting ToMMo Eye Study data identified 31 loci linked to variations in AL, 7 of which are newly reported in this article. The results revealed genetic heterogeneity and similarity in SNPs related to ethnic variations in AL.
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21
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Longitudinal analysis of 5-year refractive changes in a large Japanese population. Sci Rep 2022; 12:2879. [PMID: 35190604 PMCID: PMC8861094 DOI: 10.1038/s41598-022-06898-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 02/08/2022] [Indexed: 11/13/2022] Open
Abstract
Refractive changes are reportedly affected by age, sex, and current refractive error. To clarify the pattern of refractive changes in a Japanese population, we conducted a 5-year follow-up longitudinal analysis of spherical equivalent (SE) refractive changes with stratification by sex, age, and SE in 593,273 eyes from Japanese individuals ages 3–91 years. The 5-year SE change with myopic shift dramatically increased over time after age 4 years, and the largest change was observed in both males and females who were age 8 years at baseline [males: − 2.654 ± 0.048 diopters (D); females: − 3.110 ± 0.038 D]. During school age, the 5-year myopic change was greater in females than in males, and emmetropic and low-to-moderate myopic eyes underwent larger myopic changes than hyperopic and high-to-severe myopic eyes. After the peak at age 8 years, the 5-year myopic change gradually declined with age and fell below − 0.25 D at age 27 in males and age 26 years in females. The 5-year SE changes transitioned from a myopic to a hyperopic shift at age 51 in both sexes, and hyperopization advanced more quickly in hyperopic eyes. Our findings highlight the importance of myopia prevention in school-aged children.
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22
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Cumberland PM, Bountziouka V, Hammond CJ, Hysi PG, Rahi JS. Temporal trends in frequency, type and severity of myopia and associations with key environmental risk factors in the UK: Findings from the UK Biobank Study. PLoS One 2022; 17:e0260993. [PMID: 35045072 PMCID: PMC8769366 DOI: 10.1371/journal.pone.0260993] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/20/2021] [Indexed: 01/13/2023] Open
Abstract
This study investigated temporal trends in the epidemiology of primary myopia and associations with key environmental risk factors in a UK population. Data were collected at recruitment (non-cycloplegic autorefraction, year of birth, sex, ethnicity, highest educational attainment, reason and age of first wearing glasses and history of eye disease) from 107,442 UK Biobank study participants aged 40 to 69 years, born between 1939 and 1970. Myopia was defined as mean spherical equivalent (MSE) ≤-1 dioptre (D). Temporal changes in myopia frequency by birth cohort (5-year bands using date of birth) and associations with environmental factors were analysed, distinguishing both type (childhood-onset, <18 years versus adult-onset) and severity (three categories: low -1.00 to -2.99D, moderate -3.00 to -5.99D or high ≥-6.00D). Overall myopia frequency increased from 20.0% in the oldest cohort (births 1939-1944) to 29.2% in the youngest (1965-1970), reflecting a relatively higher increase in frequency of adult-onset and low myopia. Childhood-onset myopia peaked in participants born in 1950-54, adult-onset myopia peaked in the cohort born a decade later. The distribution of MSE only shifted for childhood-onset myopia (median: -3.8 [IQR -2.4, -5.4] to -4.4 [IQR -3.0, -6.2]). The magnitude of the association between higher educational attainment (proxy for educational intensity) and myopia overall increased over time (adjusted Odds Ratio (OR) 2.7 [2.5, 2.9] in the oldest versus 4.2 [3.3, 5.2] in the youngest cohort), being substantially greater for childhood-onset myopia (OR 3.3 [2.8, 4.0] to 8.0 [4.2, 13]). Without delineating childhood-onset from adult-onset myopia, important temporal trends would have been obscured. The differential impact of educational experience/intensity on both childhood-onset and high myopia, amplified over time, suggests a cohort effect in gene-environment interaction with potential for increasing myopia frequency if increasing childhood educational intensity is unchecked. However, historical plateauing of myopia frequency does suggest some potential for effective intervention.
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Affiliation(s)
- Phillippa M. Cumberland
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Ulverscroft Vision Research Group, Ulverscroft Foundation, Leicester, United Kingdom
| | - Vasiliki Bountziouka
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Ulverscroft Vision Research Group, Ulverscroft Foundation, Leicester, United Kingdom
| | - Christopher J. Hammond
- Department of Ophthalmology, King’s College London, St Thomas’ Hospital Campus, London, United Kingdom
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas’ Hospital Campus, London, United Kingdom
| | - Pirro G. Hysi
- Department of Ophthalmology, King’s College London, St Thomas’ Hospital Campus, London, United Kingdom
| | - Jugnoo S. Rahi
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Ulverscroft Vision Research Group, Ulverscroft Foundation, Leicester, United Kingdom
- National Institute for Health Research (NIHR) Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
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Das S, Shergill SS. Prevalence of uncorrected refractive errors among adults attending at a tertiary care hospital – A retrospective study. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_145_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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24
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Son S, Moon J, Kang H, Kim Y, Lee J. Induced astigmatism biases the orientation information represented in multivariate electroencephalogram activities. Hum Brain Mapp 2021; 42:4336-4347. [PMID: 34060695 PMCID: PMC8357008 DOI: 10.1002/hbm.25550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/20/2021] [Accepted: 05/23/2021] [Indexed: 01/23/2023] Open
Abstract
A small physical change in the eye influences the entire neural information process along the visual pathway, causing perceptual errors and behavioral changes. Astigmatism, a refractive error in which visual images do not evenly focus on the retina, modulates visual perception, and the accompanying neural processes in the brain. However, studies on the neural representation of visual stimuli in astigmatism are scarce. We investigated the relationship between retinal input distortions and neural bias in astigmatism and how modulated neural information causes a perceptual error. We induced astigmatism by placing a cylindrical lens on the dominant eye of human participants, while they reported the orientations of the presented Gabor patches. The simultaneously recorded electroencephalogram activity revealed that stimulus orientation information estimated from the multivariate electroencephalogram activity was biased away from the neural representation of the astigmatic axis and predictive of behavioral bias. The representational neural dynamics underlying the perceptual error revealed the temporal state transition; it was transiently dynamic and unstable (approximately 350 ms from stimulus onset) that soon stabilized. The biased stimulus orientation information represented by the spatially distributed electroencephalogram activity mediated the distorted retinal images and biased orientation perception in induced astigmatism.
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Affiliation(s)
- Sangkyu Son
- Center for Neuroscience Imaging ResearchInstitute for Basic Science (IBS)SuwonRepublic of Korea
- Department of Biomedical EngineeringSungkyunkwan UniversitySuwonRepublic of Korea
| | - Joonsik Moon
- Center for Neuroscience Imaging ResearchInstitute for Basic Science (IBS)SuwonRepublic of Korea
| | - Hyungoo Kang
- Department of OptometryCatholic Kwandong UniversityGangneungRepublic of Korea
| | - Yee‐Joon Kim
- Center for Cognition and SocialityInstitute for Basic Science (IBS)DaejeonRepublic of Korea
| | - Joonyeol Lee
- Center for Neuroscience Imaging ResearchInstitute for Basic Science (IBS)SuwonRepublic of Korea
- Department of Biomedical EngineeringSungkyunkwan UniversitySuwonRepublic of Korea
- Department of Intelligent Precision Healthcare ConvergenceSungkyunkwan UniversitySuwonRepublic of Korea
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25
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Abstract
Healthcare in the twenty-first century has witnessed an increased use of prescription drugs. As a member of a patient's health care team, optometrists should be aware of the pharmaceuticals taken by patients and their potential ocular complications. This paper will discuss the most prescribed medications in Australia today and their effects on the visual system. The paper will review the agents used to treat six common systemic conditions, their frequency of use, mechanism of action, clinical indications, and potential ocular manifestations. Literature has documented both positive and negative associations of systemic medications on the eye's health. Many associations documented here have shown conflicting evidence, thus warranting further investigation. Based on the frequency and severity of the ocular manifestations in the literature, recommendations for clinical care are given. Being familiar with the most common ocular side effects associated with common systemic medications aids in the correct and timely diagnosis of ocular complications to prevent permanent sequelae.
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Affiliation(s)
- Rachel Williams
- University of Houston College of Optometry, Houston, United States
| | - Alex Hui
- School of Optometry and Vision Science, UNSW, Sydney, Australia
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26
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Mackey DA, Lingham G, Lee SSY, Hunter M, Wood D, Hewitt AW, Mitchell P, Taylor HR, Hammond CJ, Yazar S. Change in the prevalence of myopia in Australian middle-aged adults across 20 years. Clin Exp Ophthalmol 2021; 49:1039-1047. [PMID: 34378302 DOI: 10.1111/ceo.13980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 07/27/2021] [Accepted: 08/06/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND The prevalence of myopia is increasing globally including in Europe and parts of Asia but Australian data are lacking. This study aim described the change in myopia prevalence in middle-aged Australian adults over approximately a 20-year period. METHODS Two contemporary Western Australian studies (conducted in mid-late 2010s): the coastal-regional Busselton Healthy Ageing Study (BHAS) and the urban Gen1 of the Raine Study (G1RS) were compared to two earlier studies (early-mid 1990s) in Australia: the urban Blue Mountains Eye Study (BMES) and urban/regional Melbourne Visual Impairment Project (MVIP). Refractive error was measured by autorefraction, vertometry, or subjective refraction. Participants (49-70 years) of European descent without self-reported/diagnosed cataract, corneal disease, or refractive or corneal surgery were included. RESULTS After exclusions, data were available from 2217, 1760, 700, 2987 and 756 participants from BMES, urban MVIP, regional MVIP, BHAS, and G1RS, respectively. The mean age ranged from 57.1 ± 4.6 years in the G1RS to 60.1 ± 6.0 years in the BMES; 44-48% of participants were male. When stratified by location, the contemporary urban G1RS cohort had a higher age-standardised myopia prevalence than the urban MVIP and BMES cohorts (29.2%, 16.4%, and 23.9%, p < 0.001). The contemporary coastal-regional BHAS had a higher age-standardised myopia prevalence than the regional MVIP cohort (19.4% vs. 13.8%, p = 0.001). CONCLUSIONS We report an increase in myopia prevalence in older adults in Australia born after World War ll compared to cohorts born before, accounting for urban/regional location. The prevalence of myopia remains relatively low in middle-aged Australian adults.
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Affiliation(s)
- David A Mackey
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Gareth Lingham
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Samantha Sze-Yee Lee
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Michael Hunter
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia.,Busselton Population Medical Research Institute, Busselton, Western Australia, Australia
| | - Diane Wood
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Alex W Hewitt
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Paul Mitchell
- Department of Ophthalmology (Centre for Vision Research, Westmead Hospital), Westmead Millennium Institute, Sydney, New South Wales, Australia
| | - Hugh R Taylor
- Melbourne School of Population Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Christopher J Hammond
- Department of Twin Research and Genetic Epidemiology, Kings College London, St. Thomas' Hospital, London, UK
| | - Seyhan Yazar
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia.,Single Cell and Computational Genomics Lab, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
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27
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Morgan IG, Wu PC, Ostrin LA, Tideman JWL, Yam JC, Lan W, Baraas RC, He X, Sankaridurg P, Saw SM, French AN, Rose KA, Guggenheim JA. IMI Risk Factors for Myopia. Invest Ophthalmol Vis Sci 2021; 62:3. [PMID: 33909035 PMCID: PMC8083079 DOI: 10.1167/iovs.62.5.3] [Citation(s) in RCA: 153] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Risk factor analysis provides an important basis for developing interventions for any condition. In the case of myopia, evidence for a large number of risk factors has been presented, but they have not been systematically tested for confounding. To be useful for designing preventive interventions, risk factor analysis ideally needs to be carried through to demonstration of a causal connection, with a defined mechanism. Statistical analysis is often complicated by covariation of variables, and demonstration of a causal relationship between a factor and myopia using Mendelian randomization or in a randomized clinical trial should be aimed for. When strict analysis of this kind is applied, associations between various measures of educational pressure and myopia are consistently observed. However, associations between more nearwork and more myopia are generally weak and inconsistent, but have been supported by meta-analysis. Associations between time outdoors and less myopia are stronger and more consistently observed, including by meta-analysis. Measurement of nearwork and time outdoors has traditionally been performed with questionnaires, but is increasingly being pursued with wearable objective devices. A causal link between increased years of education and more myopia has been confirmed by Mendelian randomization, whereas the protective effect of increased time outdoors from the development of myopia has been confirmed in randomized clinical trials. Other proposed risk factors need to be tested to see if they modulate these variables. The evidence linking increased screen time to myopia is weak and inconsistent, although limitations on screen time are increasingly under consideration as interventions to control the epidemic of myopia.
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Affiliation(s)
- Ian G Morgan
- Research School of Biology, Australian National University, Canberra, ACT, Australia.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Pei-Chang Wu
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Lisa A Ostrin
- College of Optometry, University of Houston, Houston, Texas, United States
| | - J Willem L Tideman
- Department of Ophthalmology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Eye Hospital, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Weizhong Lan
- Aier School of Ophthalmology, Central South University, Changsha, China.,Aier School of Optometry, Hubei University of Science and Technology, Xianning, China.,Aier Institute of Optometry and Vision Science, Aier Eye Hospital Group, Changsha, China.,Guangzhou Aier Eye Hospital, Jinan University, Guangzhou, China
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Xiangui He
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Ocular Fundus Diseases, National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute Limited, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore.,Singapore Eye Research Institute, Singapore.,Duke-NUS Medical School, Singapore
| | - Amanda N French
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Kathryn A Rose
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Jeremy A Guggenheim
- School of Optometry & Vision Sciences, Cardiff University, Cardiff, United Kingdom
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28
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Biometry, Refractive Errors, and the Results of Cataract Surgery: A Large Sample Study. J Ophthalmol 2021; 2021:9918763. [PMID: 34007484 PMCID: PMC8099509 DOI: 10.1155/2021/9918763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 04/09/2021] [Indexed: 11/18/2022] Open
Abstract
The statistical characteristics of biometry and refractive error in a large sample of cataractous Cuban patients are presented, comparing between sexes and age groups. All patients were studied at the Cuban Institute of Ophthalmology “Ramón Pando Ferrer,” La Habana. The sample consists of 28252 eyes of 25068 patients, subjected to cataract surgery during the time period between 2006 and 2019. Their biometry was obtained using IOL Master devices; also, visual acuity, refraction, and corneal power were registered. After surgery, the visual acuity and refraction were measured. The refractive prediction error was determined. For patients with both eyes registered, anisometropia was also calculated. Age and sex were used to segment the data. The preoperative biometric parameters show highly significant differences between sexes, with male eyes being longer and with a deeper anterior chamber but with a thinner lens. Also, keratometry shows highly significant differences, with female eyes being steeper than male. Before surgery, both sexes have myopic eyes as average, with males being more myopic than females (p < 0.001). After surgery, the average spherical equivalent is −0.36 D and female eyes are more myopic than males (p < 0.001). Visual acuity with and without distance correction has a significant increase after surgery. These results are of importance not only for Cuba but also for other countries with a large Cuban population and/or similar ethnic composition, such as the USA (particularly the south of Florida), Spain, and many countries in Latin America.
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29
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Saw SM. A synopsis of the prevalence rates and environmental risk factors for myopia. Clin Exp Optom 2021; 86:289-94. [PMID: 14558850 DOI: 10.1111/j.1444-0938.2003.tb03124.x] [Citation(s) in RCA: 125] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2002] [Revised: 01/10/2003] [Accepted: 02/03/2003] [Indexed: 11/28/2022] Open
Abstract
The prevalence rates of myopia are higher in urban Asian cities such as Hong Kong and Singapore. One observation over the past few decades is that the prevalence rates of myopia have been rising and there is an epidemic of myopia in Asia. The age-old question of the roles of nature and nurture in this process remains unanswered. The strongest evidence for an environmental link to myopia is near work activity. Childhood exposure to night lighting has also been explored in different studies but the results have been mixed. Twin studies, segregation analysis and association studies have demonstrated that hereditary factors play an important role in myopia development. The exact nature and interplay of genetic and environmental factors is not known and data suggest that environmental factors may interact with genetic factors to increase the risks of developing myopia. Future research is needed to identify specific modifiable lifestyle factors and genetic markers for myopia. This will enable preventive measures such as health education to be instituted.
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Affiliation(s)
- Seang-Mei Saw
- Department of Community Occupational and Family Medicine, National University of Singapore, 16 Medical Drive, Singapore, 117597, Republic of Singapore
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30
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Morgan IG, Rose KA. Myopia: is the nature‐nurture debate finally over? Clin Exp Optom 2021; 102:3-17. [DOI: 10.1111/cxo.12845] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 09/10/2018] [Accepted: 09/12/2018] [Indexed: 02/06/2023] Open
Affiliation(s)
- Ian G Morgan
- Research School of Biology, Australian National University, Canberra, Australian Capital Territory, Australia,
- State Key Laboratory of Ophthalmology and Division of Preventive Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‐Sen University, Guangzhou, China,
| | - Kathryn A Rose
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia,
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31
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Morgan IG. The biological basis of myopic refractive error. Clin Exp Optom 2021; 86:276-88. [PMID: 14558849 DOI: 10.1111/j.1444-0938.2003.tb03123.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2003] [Revised: 08/04/2003] [Accepted: 09/02/2003] [Indexed: 11/28/2022] Open
Abstract
Myopia is among the most common refractive errors and is associated with the greatest risk of pathological outcomes. Most animals, including humans, are born with hyperopic errors. During development, axial elongation of the eye occurs and is regulated through a vision-dependent process, known as emmetropisation The extremely rapid changes in the prevalence of myopia and the dependence of myopia on the level of education indicate that there are very strong environmental impacts on the development of myopia. This conflicts with the common occurrence of familial patterns of inheritance of myopia, which suggests a role for genetic determination. There are more than 150 defined genetic syndromes in which familial high myopia is one of the features, including some that are not associated with other syndromes. The evidence for the roles of both nature and nurture in the aetiology of myopia is discussed. This review also examines the experimentally induced refractive errors associated with form-deprivation, recovery from form deprivation and the effects of both negative and positive lenses. In addition, it looks at the local and optical control of eye growth. Finally, the various control pathways for growth are considered. These include dopamine, ZENK-glucagon, retinoic acid and retinoic acid receptors, crystallin, seratonin and melatonin, vasoactive intestinal peptide and enkephalins, nitric oxide and various growth factors.
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Affiliation(s)
- Ian G Morgan
- Visual Sciences Group, Research School of Biological Science and Centre for VIsual Science, Australian National University, GPO Box 475, Canberra, ACT, 2601, Australia
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Ramamurthy D, Lin chua SY, Saw S. A review of environmental risk factors for myopia during early life, childhood and adolescence. Clin Exp Optom 2021; 98:497-506. [DOI: 10.1111/cxo.12346] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 08/16/2015] [Accepted: 08/20/2015] [Indexed: 01/01/2023] Open
Affiliation(s)
- Dharani Ramamurthy
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore,
| | | | - Seang‐mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore,
- Myopia Unit, Singapore Eye Research Institute, Singapore,
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Lin HT, Zheng CM, Fang YA, Liu JC, Wu YC, Chang YH, Chen JT, Liang CM, Chang TJ, Zheng JQ, Tai MC, Lin YF. Prevalence and risk factors for myopia in Taiwanese diabetes mellitus patients: a multicenter case-control study in Taiwan. Sci Rep 2021; 11:8195. [PMID: 33854140 PMCID: PMC8046800 DOI: 10.1038/s41598-021-87499-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 03/30/2021] [Indexed: 11/09/2022] Open
Abstract
This population-based retrospective cohort study investigated the prevalence of myopia among patients with Type 1 and Type 2 diabetes mellitus (DM) and evaluate risk factors for myopia in these groups. Records from 2000 to 2012 with at least one year of follow-up from the Taiwan National Health Insurance Research Database were included. This study included 35,538 patients with DM and 71,076 patients without DM. Patients with DM had a significantly higher adjusted hazard ratio for myopia in all age groups and both sexes compared with patients without DM. The subgroup analysis results revealed that the rates of myopia and astigmatism were significantly higher among patients with DM compared with patients without DM aged < 60 years. However, the rates of high myopia or myopia progression to high myopia did not differ significantly between the two groups. These findings indicate that DM is a critical risk factor for myopia and astigmatism among patients aged < 60 years. Therefore, active surveillance and earlier treatment of myopia are critical for patients with DM.
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Affiliation(s)
- Hsin-Ting Lin
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Cai-Mei Zheng
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- TMU Research Center of Urology and Kidney, Taipei Medical University, Taipei, Taiwan
| | - Yu-Ann Fang
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
- Cardiovascular Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Ju-Chi Liu
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
- Cardiovascular Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yun-Chun Wu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yun-Hsiang Chang
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jiann-Torng Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chang-Min Liang
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Tian-Jong Chang
- Department of Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Jing-Quan Zheng
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Critical Care Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Ming-Cheng Tai
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Yuh-Feng Lin
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
- Department of Internal Medicine, School of Medicine, National Defense Medical Center, Taipei, Taiwan.
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Types and Presentation of Refractive Error among Individuals Aged 0-30 Years: Hospital-Based Cross-Sectional Study, Yemen. Adv Med 2021; 2021:5557761. [PMID: 34285926 PMCID: PMC8275419 DOI: 10.1155/2021/5557761] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/15/2021] [Accepted: 06/23/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Refractive errors are the most common cause of visual impairment worldwide. Its proportion varied among societies and is considered as a public health challenge. Symptoms and signs associated with refractive errors are the most worrisome and common presentations in the general practice in eye clinics. AIM The goal of this study was to determine the types and presentations of refractive error among the 0-30-year-old Yemeni population to aid early identification, diagnosis, referral, and treatment. Methodology. A cross-sectional study including 1,500 out-patients aged from 0 to 30 years attending the ophthalmology clinic in Sanaa, Yemen (between 2012 and 2015). All patients underwent visual acuity examination, autorefractometer, and anterior and posterior segment examination and were grouped according to type, that is, myopia, hyperopia, and astigmatism. RESULTS Hyperopia was the most common single diagnosis (53.3%) followed by myopia (33.3%). Astigmatism was uncommon as a single diagnosis (13.4%) but commonly associated with hyperopia or myopia. Myopia was more common in males (42.9%) than in females (25%). Hyperopia was more in females (62.5%) than in males (42.9%). Age groups most affected by refractive errors were 13-18 years (27.7%), 19-24 years (24.8%), and 25-30 years (24.6%), respectively. Decreased vision (53%) was a common presentation in myopia and astigmatism (41.5%) and less in hyperopia (39.6%). Headache was common in astigmatism (56%), hyperopia (28.8%), and myopia (17.8%). Muscle imbalance, namely, exotropia (27.2%), is mainly found in myopia and esotropia (24.3%) in hyperopia. CONCLUSIONS In addition to decreased vision, our patients with refractive errors mostly complain of headaches with clear variations with age and type of refractive error. Early identification and proper categorization of refractive errors by age, gender, and other demographics by general physicians in primary care can better deduce and make useful referrals to eye specialists.
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Cheng LN, Lin YX, Liu L, Zhang XH, Xue YQ, Zhou SD, Liu ZL, Zhang H. Assessment of conbercept therapy for high myopia macular neovascularization by optical coherence tomography angiography. Sci Rep 2020; 10:16959. [PMID: 33046787 PMCID: PMC7550325 DOI: 10.1038/s41598-020-74073-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/31/2020] [Indexed: 11/09/2022] Open
Abstract
This study aimed to evaluate the efficacy and safety of the intravitreal injection of conbercept in the treatment of macular neovascularization (MNV) secondary to high myopia and to observe the application of optical coherence tomography angiography (OCTA) in the treatment follow-up. We reviewed the medical records of 20 patients (21 eyes) with MNV secondary to high myopia who were enrolled in the Department of Ophthalmology of the First Hospital of China Medical University between May 2018 and January 2020. Each patient received one or more intravitreal injections of conbercept (0.5 mg/0.05 mL). The treatment was conducted according to a 1 + PRN (pro re nata) regimen. The changes of best corrected visual acuity (BCVA), central macular thickness (CMT), and selected MNV and flow areas measured by OCTA were observed over a 6-month follow-up period. The mean logarithm of the minimum angle of resolution (logMAR) BCVA was 1.03 ± 0.61 before treatment and improved to 0.83 ± 0.59 (P = 0.007), 0.78 ± 0.62 (P = 0.001), 0.81 ± 0.73 (P = 0.027), and 0.79 ± 0.72 (P = 0.023) at 1 month, 2 months, 3 months, and 6 months after treatment, respectively. The mean CMT was 358.16 ± 206.11 μm before treatment and decreased to 295.38 ± 178.70 μm (P = 0.003), 288.34 ± 165.60 μm (P = 0.004), 284.36 ± 163.07 μm (P = 0.005), and 283.00 ± 160.32 μm (P = 0.004) at 1 month, 2 months, 3 months, and 6 months after treatment, respectively. Nineteen eyes (90.5%) had stable or improved vision at 6 months of follow-up. One month after conbercept injection, in OCTA images, the small-diameter blood vessels of the MNV decreased, the intertwined small blood vessels decreased or even disappeared, and the main or larger-diameter blood vessels were still present. The mean selected MNV and blood flow areas were 0.62 ± 0.81 and 0.22 ± 0.27 mm2, respectively, before treatment and decreased to 0.23 ± 0.33 and 0.07 ± 0.08 mm2 (P = 0.04 for both), respectively, 1 month after treatment. No drug-related systemic or ocular adverse effects were observed. Our results suggest that conbercept can effectively and safely improve BCVA and reduce CMT in patients with myopic MVN (mMNV). OCTA can be used to observe MNV area, blood flow area, and MNV morphological changes after treatment with conbercept, thus providing a reference for treatment follow-up.
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Affiliation(s)
- Lu-Na Cheng
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Yu-Xi Lin
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Lei Liu
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China.,Department of Public Service, The First Hospital of China Medical University, Shenyang, 110001, China
| | - Xu-He Zhang
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Yan-Qi Xue
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Sheng-Di Zhou
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Zhe-Li Liu
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Han Zhang
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China.
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36
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Nakao SY, Miyake M, Hosoda Y, Nakano E, Mori Y, Takahashi A, Ooto S, Tamura H, Tabara Y, Yamashiro K, Matsuda F, Tsujikawa A. Myopia Prevalence and Ocular Biometry Features in a General Japanese Population: The Nagahama Study. Ophthalmology 2020; 128:522-531. [PMID: 32861683 DOI: 10.1016/j.ophtha.2020.08.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/17/2020] [Accepted: 08/21/2020] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To describe the distribution of ocular biometry and refraction in Japanese adults. DESIGN Cross-sectional analysis of a prospective cohort study. PARTICIPANTS A total of 9850 individuals participated in the first follow-up of the Nagahama Prospective Cohort for Comprehensive Human Bioscience (the Nagahama Study) conducted between 2013 and 2016. Participants were between 34 and 80 years of age. METHODS All participants underwent axial length (AL; in millimeters), anterior chamber depth (ACD; in millimeters), corneal diameter (white to white; in millimeters), and central corneal thickness (CCT; in micrometers) measurement (IOL Master; Carl Zeiss Meditec, Dublin, CA) and refraction (spherical equivalent [SE]; in diopters [D]) and corneal curvature (CC; in millimeters) measurement (ARK-530A; Nidek, Aichi, Japan). Distribution of these ocular biometric parameters and prevalence of myopia, high myopia, and extreme myopia were summarized. MAIN OUTCOME MEASURES Distribution of ocular biometry and refraction. RESULTS After standardization to the national population of 2015, estimates of mean AL and SE were 24.21 mm and -1.44 D, respectively. Estimates of mean CC, corneal diameter, CCT, and ACD were 7.69 mm, 12.01 mm, 543.96 μm, and 3.21 mm, respectively. After standardization of age and gender, the prevalence of myopia (SE, ≤-0.5 D) and high myopia (SE, ≤-6.0 D) were 49.97% and 7.89%, respectively. Approximately 70% of the younger participants (34-59 years of age) showed myopia, whereas high myopia was observed in approximately 10%. Although the number of individuals with myopia or high myopia was higher in the younger age groups, the prevalence of more extreme phenotypes remained stable across all ages, especially in women. Axial length of more than 30 mm was observed only in older women (n = 5 [0.05%]). CONCLUSIONS We showed detailed distributions of various ocular biometry and refraction parameters using a large general Japanese cohort. Prevalences of myopia and high myopia from 2013 through 2016 were higher than those in earlier studies, which reflects recent environmental change. However, constant prevalence of extreme myopia across all ages suggests high genetic predisposition of the extreme phenotype.
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Affiliation(s)
- Shin-Ya Nakao
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Ophthalmology, Tenri General Hospital, Nara, Japan
| | - Masahiro Miyake
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan; Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | | | - Eri Nakano
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuki Mori
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ayako Takahashi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sotaro Ooto
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroshi Tamura
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kenji Yamashiro
- Department of Ophthalmology, Otsu Red Cross Hospital, Shiga, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Rodriguez-Pozo JA, Ramos-Lopez JF, Gonzalez-Gallardo MC, Campos F, Sanchez-Porras D, Oyonarte S, Oruezabal RI, Campos A, Martin-Piedra MA, Alaminos M. Evaluation of myopic cornea lenticules. A histochemical and clinical correlation. Exp Eye Res 2020; 196:108066. [PMID: 32439395 DOI: 10.1016/j.exer.2020.108066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 03/31/2020] [Accepted: 05/10/2020] [Indexed: 10/24/2022]
Abstract
In this work, we have analyzed the main clinical and corneal histological parameters that may be associated to the spherical equivalent (SE), age and gender of individuals with myopic refractive errors. For this purpose, 108 cornea stroma lenticules were obtained from patients subjected to ReLEx-SMILE myopia correction. Histological analyses were carried out and histochemistry and immunohistochemistry were used to quantify key histological components of the cornea stroma, including mature collagen fibers, reticular and elastic fibers, glycoproteins, proteoglycans, type-V collagen and several crystallins. Clinical and histological data were analyzed to determine their association with SE, age and gender. Results showed a significant correlation between the age range of the patients and the expression of crystallins CRY-α-A, CRY-λ1 and type-V collagen and between CRY-λ1 and corneal thickness, spherical diopters (D) and SE, although correlation between CRY-λ1 and SE was non-significant when age was controlled. Comparison of cases with low myopia and high/moderate myopia found statistical differences for D and lenticule thickness and diameter. The binary logistic regression analysis allowed us to construct a model using two clinical parameters (D and lenticule thickness). Parameters showing significant correlation with the age were the corneal radius, keratometry reading (K), OZ, CRY-α-A and type-V collagen, whereas SE, lenticule thickness, OZ, CRY-λ1 and type-V collagen showed statistically significant differences between the youngest and the oldest patients. A binary logistic regression analysis model was generated including 3 variables (D, cornea radius and OZ). No gender differences were found. The specific clinical and histological modifications found to be associated to the SE and age could be useful for a better understanding of the mechanisms involved in the genesis or progression of myopia and could establish the basement for future therapeutic options.
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Affiliation(s)
- J A Rodriguez-Pozo
- Tissue Engineering Group, Department of Histology, University of Granada, Spain
| | - J F Ramos-Lopez
- University Hospital Virgen de las Nieves, Granada, Spain; Instituto Oftalmológico de Granada, Spain
| | - M C Gonzalez-Gallardo
- Tissue Engineering Group, Department of Histology, University of Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Spain; University Hospital San Cecilio, Granada, Spain
| | - F Campos
- Tissue Engineering Group, Department of Histology, University of Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Spain
| | - D Sanchez-Porras
- Tissue Engineering Group, Department of Histology, University of Granada, Spain
| | - S Oyonarte
- Tissue Engineering Group, Department of Histology, University of Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Spain; Blood and Tissue Bank of Granada, Spain
| | - R I Oruezabal
- Andalusian Network for the design and translation of Advanced Therapies, Sevilla, Spain
| | - A Campos
- Tissue Engineering Group, Department of Histology, University of Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Spain
| | - M A Martin-Piedra
- Tissue Engineering Group, Department of Histology, University of Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Spain.
| | - M Alaminos
- Tissue Engineering Group, Department of Histology, University of Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Spain
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Correlation of myopia severity with visual performance. Int Ophthalmol 2020; 40:2201-2211. [PMID: 32385613 DOI: 10.1007/s10792-020-01403-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 04/25/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To describe visual performance in high myopia. METHODS In this cross-sectional study, 148 emmetropes [spherical equivalent (SE) - 0.50 to + 1.00 D] and 564 high myopes [SE ≤ - 6.00 D] were categorised into three groups (Group 1: SE - 6.00 to > - 8.00 D; Group 2: SE - 8.00 to > - 10.00 D; and Group 3: SE ≤ - 10.00 D). Multivariate regression analyses adjusting for age and ethnicity examined the relationship between corrected distance visual acuity (CDVA) [photopic, mesopic and super vision test-night vision goggles (SVT-NVG)] and contrast sensitivity (CS)] (mesopic and SVT-NVG) with SE and axial length (AL). RESULTS Mean age of subjects was 21.07 ± 1.17 years, and majority were Chinese (91.9%). Mean SE was 0.10 ± 0.23 D (emmetropes) and - 8.76 ± 2.04 D (high myopes), p < 0.001. Higher degrees of myopia were associated with reduced CDVA and CS, and increased AL (all p < 0.001). Among high myopes, Group 1 had the highest proportion of subjects with good CDVA (photopic ≤ 0.00 LogMAR, mesopic ≤ 0.00 LogMAR and NVG ≤ 0.10 LogMAR) and CS (mesopic ≥ 0.75 LogCS and NVG ≥ 0.35 LogCS) compared with Groups 2 and 3 (all p < 0.001). Among high myopes with good VA (photopic ≤ 0.00 LogMAR, mesopic ≤ 0.00 LogMAR and NVG ≤ 0.10 LogMAR), Group 1 also had the highest proportion of subjects who achieved mesopic ≥ 0.75 LogCS and NVG ≥ 0.35 LogCS (both p < 0.001). Multivariate analyses demonstrated that reduced VA and CS were associated with decreased SE and increased AL (all p < 0.001). CONCLUSIONS High myopia is associated with reduced VA and reduced CS.
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McGlacken-Byrne AB, Drinkwater JJ, Mackey DA, Turner AW. Gender and ethnic differences in pterygium prevalence: an audit of remote Australian clinics. Clin Exp Optom 2020; 104:74-77. [PMID: 32363676 DOI: 10.1111/cxo.13081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
CLINICAL RELEVANCE Developing an accurate picture of the demographic profile and refractive status of Aboriginal and non-Aboriginal individuals with pterygium will facilitate health planning and appropriate deployment of health-care resources in rural Australia. BACKGROUND To date, there is a paucity of reports in the literature regarding Aboriginal ocular health and refractive error. This study examines clinical data from a rural ophthalmology outreach clinic - a predominantly Aboriginal population. METHODS An assessment was undertaken of data of 293 patients noted to have pterygium present in at least one eye, from a sample of 2,072 individuals seen in rural northern Western Australia in 2017 by the Lions Outback Vision Visiting Optometry Service. RESULTS Pterygium was found in 14.1 per cent (n = 293) of patients using the Lions Outback Vision service. The mean age of those with pterygium (n = 293) was 57.1 ± 11.9-years (mean ± standard deviation); 188 were female (64.1 per cent); 260 identified as Aboriginal (88.7 per cent), 22 identified as non-Aboriginal (7.5 per cent) and 11 did not specify (3.8 per cent). There were more males than females with pterygium in the non-Aboriginal group (18.0 per cent versus 6.4 per cent); however, the reverse was true in the Aboriginal group (11.7 per cent versus 17.0 per cent). Analysis of the subjective refractive data in those with pterygium revealed an overall mean spherical equivalent value of +0.66 ± 1.28 DS. The median (interquartile range) best-corrected visual acuity was 0.0 (-0.1 to 0.0) logMAR (6/6 Snellen equivalent). CONCLUSIONS This paper increases our knowledge of ocular health in a remote Australian population, with an emphasis on the differences between Aboriginal and non-Aboriginal individuals, males and females.
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Affiliation(s)
| | | | - David A Mackey
- Lions Outback Vision, Lions Eye Institute , Perth, Australia.,Centre of Ophthalmology and Visual Science, The University of Western Australia , Perth, Australia
| | - Angus W Turner
- Lions Outback Vision, Lions Eye Institute , Perth, Australia.,Centre of Ophthalmology and Visual Science, The University of Western Australia , Perth, Australia
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40
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Lee SSY, Lingham G, Yazar S, Sanfilippo PG, Charng J, Chen FK, Hewitt AW, Ng F, Hammond C, Straker LM, Eastwood PR, MacGregor S, Rose KA, Lucas RM, Guggenheim JA, Saw SM, Coroneo MT, He M, Mackey DA. Rationale and protocol for the 7- and 8-year longitudinal assessments of eye health in a cohort of young adults in the Raine Study. BMJ Open 2020; 10:e033440. [PMID: 32217560 PMCID: PMC7170556 DOI: 10.1136/bmjopen-2019-033440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Eye diseases and visual impairment more commonly affect elderly adults, thus, the majority of ophthalmic cohort studies have focused on older adults. Cohort studies on the ocular health of younger adults, on the other hand, have been few. The Raine Study is a longitudinal study that has been following a cohort since their birth in 1989-1991. As part of the 20-year follow-up of the Raine Study, participants underwent a comprehensive eye examination. As part of the 27- and 28-year follow-ups, eye assessments are being conducted and the data collected will be compared with those of the 20-year follow-up. This will provide an estimate of population incidence and updated prevalence of ocular conditions such as myopia and keratoconus, as well as longitudinal change in ocular parameters in young Australian adults. Additionally, the data will allow exploration of the environmental, health and genetic factors underlying inter-subject differential long-term ocular changes. METHODS AND ANALYSIS Participants are being contacted via telephone, email and/or social media and invited to participate in the eye examination. At the 27-year follow-up, participants completed a follow-up eye screening, which assessed visual acuity, autorefraction, ocular biometry and ocular sun exposure. Currently, at the 28-year follow-up, a comprehensive eye examination is being conducted which, in addition to all the eye tests performed at the 27-year follow-up visit, includes tonometry, optical coherence tomography, funduscopy and anterior segment topography, among others. Outcome measures include the incidence of refractive error and pterygium, an updated prevalence of these conditions, and the 8-year change in ocular parameters. ETHICS AND DISSEMINATION The Raine Study is registered in the Australian New Zealand Clinical Trials Registry. The Gen2 20-year, 27-year and 28-year follow-ups are approved by the Human Research Ethics Committee of the University of Western Australia. Findings resulting from the study will be published in health or medical journals and presented at conferences. TRIAL REGISTRATION NUMBER ACTRN12617001599369; Active, not recruiting.
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Affiliation(s)
- Samantha Sze-Yee Lee
- Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia, Australia
| | - Gareth Lingham
- Lions Eye Institute, Nedlands, Western Australia, Australia
| | - Seyhan Yazar
- Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia, Australia
- Single Cell and Computational Genomics Lab, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - Paul G Sanfilippo
- Centre for Eye Research Australia Ltd, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Jason Charng
- Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia, Australia
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia, Australia
- Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Alex W Hewitt
- Centre for Eye Research Australia Ltd, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
| | - Fletcher Ng
- Lions Eye Institute, Nedlands, Western Australia, Australia
| | - Christopher Hammond
- Department of Twin Research & Genetic Epidemiology, King's College London, London, UK
| | - Leon M Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Peter R Eastwood
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, Western Australia, Australia
- Sir Charles Gairdner Hospital, West Australian Sleep Disorders Research Institute, Nedlands, Western Australia, Australia
| | - Stuart MacGregor
- Genetics and Population Health, Queensland Institute of Medical Research - QIMR, Brisbane, Queensland, Australia
| | - Kathryn A Rose
- University of Sydney, Sydney, New South Wales, Australia
| | - Robyn M Lucas
- Australian National University, Research School of Population Health, College of Health and Medicine, Canberra, Australian Capital Territory, Australia
| | - Jeremy A Guggenheim
- School of Optometry and Vision Science, Cardiff University, Cardiff, South Glamorgan, UK
| | - Seang-Mei Saw
- Singapore Eye Research Institute, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Minas T Coroneo
- Department of Ophthalmology, University of New South Wales, Sydney, New South Wales, Australia
| | - Mingguang He
- Centre for Eye Research Australia Ltd, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - David A Mackey
- Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia, Australia
- Centre for Eye Research Australia Ltd, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
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Zhang J, Deng G. Protective effects of increased outdoor time against myopia: a review. J Int Med Res 2020; 48:300060519893866. [PMID: 31854216 PMCID: PMC7607527 DOI: 10.1177/0300060519893866] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 11/19/2019] [Indexed: 12/27/2022] Open
Abstract
Myopia has become a major cause for concern globally, particularly in East Asian countries. The increasing prevalence of myopia has been associated with a high socioeconomic burden owing to severe ocular complications that may occur with progressive myopia. There is an urgent need to identify effective and safe measures to address the growing number of people with myopia in the general population. Among the numerous strategies implemented to slow the progression of myopia, longer time spent outdoors has come to be recognized as a protective factor against this disorder. Although our understanding of the protective effects of outdoor time has increased in the past decade, considerably more research is needed to understand the mechanisms of action. Here, we summarize the main potential factors associated with the protective effects against myopia of increased outdoor time, namely, exposure to elevated levels and shorter wavelengths of light, and increased dopamine and vitamin D levels. In this review, we aimed to identify safe and effective therapeutic interventions to prevent myopia-related complications and vision loss.
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Affiliation(s)
- Jun Zhang
- Department of Ophthalmology, The Third People’s Hospital of Changzhou, Changzhou, Jiangsu, China
| | - Guohua Deng
- Department of Ophthalmology, The Third People’s Hospital of Changzhou, Changzhou, Jiangsu, China
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Dikkaya F, Karaman Erdur S. Comparison of optical coherence tomography measurements between high hyperopic and low hyperopic children. Ther Adv Ophthalmol 2020; 12:2515841419899819. [PMID: 32010880 PMCID: PMC6971970 DOI: 10.1177/2515841419899819] [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: 08/23/2019] [Accepted: 12/10/2019] [Indexed: 12/13/2022] Open
Abstract
Purpose: To identify the peripapillary retinal nerve fiber layer, total macular, ganglion cell layer, and inner plexiform layer thicknesses in children with high hyperopia using spectral domain optical coherence tomography. Methods: Twenty-one children with high hyperopia and 20 controls were enrolled in this study. Subjects with spherical equivalent +5.0 D or higher were evaluated in the study group and subject with spherical equivalent between +0.25 and +2.0 D in the control group. The retinal nerve fiber layer thickness, macular thickness, macular ganglion cell layer and inner plexiform layer thicknesses were measured using a spectral domain optical coherence tomography, and results were compared between groups. Results: The nasal and inferior quadrant and the global retinal nerve fiber layer thickness were significantly thicker in the study group. The mean thickness of inferior quadrant of the inner macula was significantly thicker in the study group than those in the control group. The mean thickness of the ganglion cell layer in nasal, temporal and inferior quadrant of outer macula was significantly thinner in the study group than the control group. The mean thickness of the inner plexiform layer in the inferior quadrant of the inner macula and nasal and inferior quadrant of the outer macula were significantly higher in study group than those in control group. Conclusion: High hyperopic children had thicker retinal nerve fiber layer when compared to the controls. This difference should be taken into account when evaluating children with glaucoma or other optic disc disorders.
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Affiliation(s)
- Funda Dikkaya
- Department of Ophthalmology, School of Medicine, Istanbul Medipol University, Bağcılar, 34124 Istanbul, Turkey
| | - Sevil Karaman Erdur
- Department of Ophthalmology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
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Vainer I, Mimouni M, Rabina G, Spierer O, Nemet AY, Shapira Y, Sela T, Kaiserman I. Age- and Gender-Related Characteristics of Corneal Refractive Parameters in a Large Cohort Study. Am J Ophthalmol 2020; 209:45-54. [PMID: 31526796 DOI: 10.1016/j.ajo.2019.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 09/07/2019] [Accepted: 09/10/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE To characterize age- and sex-related changes in corneal refractive parameters in myopic and hyperopic patients undergoing refractive surgery. DESIGN A retrospective cross-sectional study. METHODS Analysis of demographic and refractive parameters of myopic and hyperopic patients who underwent laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) between January 2000 and December 2014 at the Care-Vision Laser Centers, Tel-Aviv, Israel. RESULTS A total of 62,422 eyes of 31,211 patients were included. With advancing age, refractive surgery was performed for lower magnitudes of myopia and hyperopia. The magnitude of cylinder was higher in men than in women in both myopic and hyperopic patients. In comparison, women were significantly more myopic than men (spherical equivalent of -3.73 diopter [D] versus -4.07 D; P < 0.01). The myopic group sphere (r = 0.044; P < 0.001) had a positive correlation with age, whereas other parameters had a negative correlation with age: astigmatism (r = -0.09; P < 0.001), best-correct visual acuity (BCVA) (r = -0.04; P < 0.001), flat K (r = -0.09; P < 0.001), steep K (r = -0.06; P < 0.001), average K (r = -0.07; P < 0.001), and J0 (r = -0.05; P < 0.001). For hyperopic patients, astigmatism (r = 0.35; P < 0.001), BCVA (r = 0.11; P < 0.001), flat K (r = 0.30; P < 0.001), average K (0.14; P < 0.001), and central corneal thickness (r = 0.10; P < 0.001) correlated positively with age, whereas sphere (r = -0.23; P < 0.001), J0 (r = -0.31; P < 0.001), and overall blurring strength (r = -0.31; P < 0.001) had negative correlations with age. CONCLUSIONS This large cohort study shows age- and sex-related refractive parameters among myopic and hyperopic patients seeking refractive surgery. These parameters can explain and predict trends in patients attending refractive surgery.
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Affiliation(s)
- Igor Vainer
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel; Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Michael Mimouni
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel; Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
| | - Gilad Rabina
- Department of Ophthalmology, Tel Aviv Sarisky Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Oriel Spierer
- Department of Ophthalmology, Edith Wolfson Medical Center, Holon, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arie Y Nemet
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel
| | - Yinon Shapira
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel; Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Tzahi Sela
- Care-Vision Laser Centers, Tel-Aviv, Israel
| | - Igor Kaiserman
- Care-Vision Laser Centers, Tel-Aviv, Israel; Department of Ophthalmology, Barzilai Medical Center, Ashkelon, and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
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Webers VSC, Bauer NJC, Visser N, Berendschot TTJM, van den Biggelaar FJHM, Nuijts RMMA. Image-guided system versus manual marking for toric intraocular lens alignment in cataract surgery. J Cataract Refract Surg 2019; 43:781-788. [PMID: 28732612 DOI: 10.1016/j.jcrs.2017.03.041] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 03/08/2017] [Accepted: 03/13/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE To compare the accuracy of toric intraocular lens (IOL) alignment using the Verion Image-Guided System versus a conventional manual ink-marking procedure. SETTING University Eye Clinic Maastricht, Maastricht, the Netherlands. DESIGN Prospective randomized clinical trial. METHODS Eyes with regular corneal astigmatism of at least 1.25 diopters (D) that required cataract surgery and toric IOL implantation (Acrysof SN6AT3-T9) were randomly assigned to the image-guided group or the manual-marking group. The primary outcome was the alignment of the toric IOL based on preoperative images and images taken immediately after surgery. Secondary outcome measures were residual astigmatism, uncorrected distance visual acuity (UDVA), and complications. RESULTS The study enrolled 36 eyes (24 patients). The mean toric IOL misalignment was significantly less in the image-guided group than in the manual group 1 hour (1.3 degrees ± 1.6 [SD] versus 2.8 ± 1.8 degrees; P = .02) and 3 months (1.7 ± 1.5 degrees versus 3.1 ± 2.1 degrees; P < .05) postoperatively. The mean residual refractive cylinder was -0.36 ± 0.32 D and -0.47 ± 0.28 D in the image-guided group and manual group, respectively (P > .05). The mean UDVA was 0.03 ± 0.10 logarithm of minimum angle of resolution (logMAR) and 0.04 ± 0.09 logMAR, respectively (both P > .05). No intraoperative complications occurred during any surgery. CONCLUSION The IOL misalignment was significantly less with digital marking than with manual marking; this did not result in a better UDVA or lower residual refractive astigmatism.
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Affiliation(s)
- Valentijn S C Webers
- From the University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands.
| | - Noel J C Bauer
- From the University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Nienke Visser
- From the University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Tos T J M Berendschot
- From the University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands
| | | | - Rudy M M A Nuijts
- From the University Eye Clinic Maastricht, Maastricht University Medical Center+, Maastricht, the Netherlands
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High Myopia and Its Associated Factors in JPHC-NEXT Eye Study: A Cross-Sectional Observational Study. J Clin Med 2019; 8:jcm8111788. [PMID: 31731571 PMCID: PMC6912595 DOI: 10.3390/jcm8111788] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 10/22/2019] [Indexed: 11/30/2022] Open
Abstract
The increasing prevalence of high myopia has been noted. We investigated the epidemiological characteristics and the related factors of high myopia in a Japanese adult population. Japan Public Health Center-Based Prospective Study for the Next Generation (JPHC-NEXT) Eye Study was performed in Chikusei-city, a rural area in mid-east Japan, between 2013 and 2015. A cross-sectional observational analysis was conducted to investigate prevalence and related factors of high myopia. A total of 6101 participants aged ≥40 years without a history of ocular surgeries was included. High myopia was defined as a spherical equivalent refraction of ≤−6.00 diopters according to the American Academy of Ophthalmology. Potential high myopia-related factors included intraocular pressure (IOP), corneal structure, corneal endothelial cell density, age, height, body mass index, heart rate, blood pressure, biochemical profile, and current history of systemic and ocular disorders. The odds ratios of high myopia were estimated using the logistic regression models adjusted for the associated factors. The prevalence of high myopia was 3.8% in males and 5.9% in females with a significant difference. Age was inversely associated, IOP was positively associated, and none of other factors were associated with high myopia in both sexes. In conclusion, only age and IOP were associated with high myopia in this community-based sample.
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Keel S, McGuinness MB, Foreman J, Scheetz J, Taylor HR, Dirani M. Prevalence, associations and characteristics of severe uncorrected refractive error in the Australian National Eye Health Survey. Clin Exp Ophthalmol 2019; 48:14-23. [PMID: 31574581 DOI: 10.1111/ceo.13647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 08/20/2019] [Accepted: 09/21/2019] [Indexed: 11/26/2022]
Abstract
IMPORTANCE In Australia, nationally representative data of the burden and associations of severe uncorrected refractive error are scarce. BACKGROUND To report the prevalence and characteristics of severe uncorrected refractive error in Indigenous and non-Indigenous Australians. DESIGN Population-based cross-sectional study. PARTICIPANTS A total of 3098 non-Indigenous Australians aged 50 to 98 and 1738 Indigenous Australians aged 40 to 92 living in 30 randomly selected Australian sites were examined. METHODS Severe uncorrected refractive error was defined as an improvement of ≥2 lines on the logMAR chart in one or both eyes in participants with a presenting visual acuity <6/12. MAIN OUTCOME MEASURE Severe uncorrected refractive error RESULTS: Prevalence of severe uncorrected refractive error was 11.0% (95% confidence interval 9.3-13.0) in non-Indigenous and 14.5% (12.5-16.7) in Indigenous Australians. Eighty-two percent of non-Indigenous and 77% of Indigenous participants had a spherical equivalent refraction between -2.00D and +2.00D. Indigenous Australians who were older (odds ratio [OR] for 70-79 years vs 40-49 years = 3.59), resided in outer regional areas (OR = 1.78) and did not have an eye examination in the previous 2-years (OR = 1.50) were associated with higher odds of severe uncorrected refractive error. Geographical remoteness (OR = .68 for inner regional), male gender (OR = 1.30), older age (OR for 70-79 years vs 50-59 years = 1.51) and failure to have an eye examination in the previous 2-years (OR = 2.06) were associated with severe uncorrected refractive error among non-Indigenous participants. CONCLUSIONS AND RELEVANCE Increased public awareness of the importance of regular optometric examinations may be required in groups at high risk of severe uncorrected refractive error.
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Affiliation(s)
- Stuart Keel
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, Melbourne, Victoria, Australia
| | - Myra B McGuinness
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, Melbourne, Victoria, Australia
| | - Joshua Foreman
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, Melbourne, Victoria, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Scheetz
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, Melbourne, Victoria, Australia
| | - Hugh R Taylor
- Indigenous Eye Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mohamed Dirani
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
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Pontikos N, Chua S, Foster PJ, Tuft SJ, Day AC. Frequency and distribution of corneal astigmatism and keratometry features in adult life: Methodology and findings of the UK Biobank study. PLoS One 2019; 14:e0218144. [PMID: 31536508 PMCID: PMC6752876 DOI: 10.1371/journal.pone.0218144] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 08/27/2019] [Indexed: 01/29/2023] Open
Abstract
PURPOSE To describe corneal astigmatism in the UK Biobank population and to look for associations with other biometric variables and socio-demographic factors. METHODS This analysis included a subsample of 107,452 participants of the UK Biobank study who underwent an enhanced ophthalmic examination including autorefractor keratometry (Tomey RC 5000, Tomey Corp., Nagoya, Japan). Participants were recruited from across the United Kingdom between 2006 and 2010, and all were between 40 to 69 years. After quality control and applying relevant exclusions, data on corneal astigmatism on 83,751 participants were included for analysis. Potential associations were tested through univariable regression and significant parameters carried forward for multivariable analysis. RESULTS In univariable analysis, the characteristics significantly associated with higher corneal astigmatism (P<0.001), by order of magnitude were, female gender, white ethnicity, lighter skin colour, use of UV protection, lower alcohol intake, lower corneal-compensated intraocular pressure (ccIOP), older age at completion of education, younger age, higher Townsend deprivation index, lower height and lower systolic blood pressure. After inclusion in the multivariable analysis, gender, skin colour, alcohol intake, age at completion of full-time education, ccIOP, age and Townsend deprivation score remained significant (all P<0.001). Increased corneal astigmatism was also found to be significantly associated with amblyopia or strabismus. CONCLUSIONS This analysis confirms previous associations with astigmatism such as younger age and female gender, and identified novel risk factors including lighter skin colour, lower alcohol intake, later age having completed full time education later, lower ccIOP and higher Townsend deprivation index. Further research is needed to investigate these novel associations.
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Affiliation(s)
- Nikolas Pontikos
- UCL Institute of Ophthalmology, London, England, United Kingdom
- NIHR Biomedical Research Centre, Moorfields Eye Hospital, London, England, United Kingdom
| | - Sharon Chua
- UCL Institute of Ophthalmology, London, England, United Kingdom
- NIHR Biomedical Research Centre, Moorfields Eye Hospital, London, England, United Kingdom
| | - Paul J. Foster
- UCL Institute of Ophthalmology, London, England, United Kingdom
- NIHR Biomedical Research Centre, Moorfields Eye Hospital, London, England, United Kingdom
| | - Stephen J. Tuft
- UCL Institute of Ophthalmology, London, England, United Kingdom
- NIHR Biomedical Research Centre, Moorfields Eye Hospital, London, England, United Kingdom
| | - Alexander C. Day
- UCL Institute of Ophthalmology, London, England, United Kingdom
- NIHR Biomedical Research Centre, Moorfields Eye Hospital, London, England, United Kingdom
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Mirzajani A, Qasemi F, Asharlous A, Yekta A, Doostdar A, Khabazkhoob M, Hashemi H. Are the results of handheld auto-refractometer as valid as the result of table-mounted refractometer? J Curr Ophthalmol 2019; 31:305-311. [PMID: 31528766 PMCID: PMC6742606 DOI: 10.1016/j.joco.2018.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/23/2018] [Accepted: 10/31/2018] [Indexed: 10/27/2022] Open
Abstract
Purpose To determine the agreement of table-mounted and handheld auto-refractometers and to evaluate the effect of age and different types of refractive errors on this comparison. Methods In this cross-sectional study conducted in 2015 using multi-stage cluster sampling, two underserved villages were selected randomly in the north and southwest of Iran. All the selected participants underwent optometric and ophthalmic examinations. Refraction was measured using handheld and table-mounted auto-refractometers in 652 subjects. Results The mean age of the subjects was 32.7 ± 18.72 years, and 58.3% of them were female. A significant difference was observed in the results of sphere, spherical equivalent (SE), and J45 vector between the two devices (P < 0.012), but there was no significant difference in J0 vector. There was a significant difference in the results of sphere between the two devices in all age groups under 50 years (P = 0.005), but there was no difference in age groups above 50 years. Correlation coefficients of the two devices were 0.989, 0.986, 0.908, and 0.951 for the results of sphere, SE, J0 vector, and J45 vector, respectively (P < 0.0001). The 95% limit of agreement (LOA) of the two devices was -0.31 to +0.53 for sphere, -0.27 to +0.63 for SE, -0.27 to +0.27 for J0 vector, and -0.16 to -0.17 for J45 vector. Conclusions According to our findings, the spherical error and cylindrical power measurements of the two devices have a significant correlation. Although there is a significant difference in the mean values between the two devices, this difference may be considered clinically insignificant, and considering the narrow 95% LOA between the two devices, the results may be used interchangeably.
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Affiliation(s)
- Ali Mirzajani
- Department of Optometry, Iran University of Medical Sciences, Tehran, Iran
| | - Fateme Qasemi
- Department of Optometry, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Asharlous
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Abbasali Yekta
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Asgar Doostdar
- Department of Optometry, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
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Hughes RP, Vincent SJ, Read SA, Collins MJ. Higher order aberrations, refractive error development and myopia control: a review. Clin Exp Optom 2019; 103:68-85. [PMID: 31489693 DOI: 10.1111/cxo.12960] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 07/01/2019] [Accepted: 07/28/2019] [Indexed: 01/25/2023] Open
Abstract
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.
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Affiliation(s)
- Rohan Pj Hughes
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Stephen J Vincent
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
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Pärssinen O, Kauppinen M, Halekoh U, Kaprio J, Rantanen T. Heredity of interocular similarities in components of refraction: a population-based twin study among 66- to 79-year-old female twins. Acta Ophthalmol 2019; 97:603-607. [PMID: 30702215 DOI: 10.1111/aos.14033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 01/02/2019] [Indexed: 01/25/2023]
Abstract
PURPOSE To examine genetic influences on interocular similarities in ocular refraction and components of refraction among elderly female twins. METHODS Refraction was assessed in 94 monozygotic (MZ) and 74 dizygotic (DZ) female twins aged 66-78 years. Absolute values of interocular differences (Aniso variables) in spherical refraction (SR), refractive astigmatism (AST), spherical equivalent (SE), corneal refractive power (CR), corneal astigmatism (CAST), anterior chamber depth (ACD) and axial length (AL) were calculated. The differences between sisters in each of the Aniso variables were calculated and graded into two categories, best differentiating the groups, here isometropic and anisometropic values. The cut-offs for grading as isometropic were AnisoSR < 0.75 D, AnisoAST < 0.5 D, AnisoSE < 1.0 D, AnisoCR < 0.5 D, AnisoCAST < 0.50 D, AnisoACD < 0.1 mm and AniosAL < 0.1 mm. Genetic influences on these traits were investigated by comparing the prevalence of isometropic and anisometropic differences between the MZ and DZ pairs in the Aniso variables and the interrelationships between the Aniso variables. RESULTS When the Aniso variables were treated as continuous, no significant differences were found between the MZ and DZ subjects. When the proportions of isometropic intratwinpair interocular differences in the Aniso variables in the MZ and DZ cotwins were compared, the prevalences (MZ/DZ) were AnisoSR: 68%/60%; AnisoAST: 66%/57%; AnisoSE: 87%/68%; AnisoCR: 83%/78%; AnisoCAST: 69%/35%; AnisoACD: 77%/63%; and AnisoAL: 76%/60%. The differences were statistically significant for Aniso SE (p = 0.035, Fisher's exact test) and CAST (p = 0.007). The greater homogeneity in the interocular differences between the MZ sisters supports the assumption that isometropia of different elements of refraction is genetically influenced and tending to continue up to older ages. In cases where AnisoSE was <1.0 D, higher CR in one eye was associated with shorter AL (r = -0.398, p < 0.001), thereby contributing to emmetropization, irrespective of zygosity. In the cases of AnisoSE ≥1 D, no similar influence on emmetropization was observed. The difference between sisters in AnisoSE was associated with the intratwinpair difference in Aniso AL, but not with the intratwinpair differences in AnisoCR, irrespective of zygosity. CONCLUSION The higher prevalence of similarities in isometropia of the spherical equivalent and corneal astigmatism between the MZ pairs compared to DZ pairs is consistent with the view that genetic influences on the refractive elements of the eye, tending to isometropia, continue into older age. The interrelation between CR and AL tends to maintain isometropia of SE irrespective of zygosity.
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Affiliation(s)
- Olavi Pärssinen
- Department of Ophthalmology Central Hospital of Central Finland Jyväskylä Finland
- Gerontology Research Center and Faculty of Sport and Health Sciences University of Jyvaskyla Jyväskylä Finland
| | - Markku Kauppinen
- Gerontology Research Center and Faculty of Sport and Health Sciences University of Jyvaskyla Jyväskylä Finland
| | - Ulrich Halekoh
- Department of Public Health University of Southern Denmark Odense Denmark
| | - Jaakko Kaprio
- Department of Public Health University of Helsinki Helsinki Finland
- Institute for Molecular Medicine FIMM University of Helsinki Helsinki Finland
- Department of Health National Institute for Health and Welfare Helsinki Finland
| | - Taina Rantanen
- Gerontology Research Center and Faculty of Sport and Health Sciences University of Jyvaskyla Jyväskylä Finland
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