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Zhang S, Zhu H, Zhang L, Gao M, Liu C, Zhao Q. Effects of orthokeratology on corneal reshaping and the delaying of axial eye growth in children. Heliyon 2024; 10:e33341. [PMID: 39022009 PMCID: PMC11253518 DOI: 10.1016/j.heliyon.2024.e33341] [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: 11/01/2023] [Revised: 06/19/2024] [Accepted: 06/19/2024] [Indexed: 07/20/2024] Open
Abstract
Purpose To investigate the inhibition of myopia progression and axial elongation in children wearing orthokeratology (OK) lenses, as well as to evaluate the status of corneal reshaping, this study explores the relationship between changes in central corneal curvature (K-value) and e-value induced by OK lenses and axial elongation. Methods In this study, it is planned to select children aged 8-15 who wear orthokeratology lenses at the Pediatric Ophthalmology and Strabismus Clinic of the Second Affiliated Hospital of Dalian Medical University. All children will undergo slit lamp examination, visual acuity assessment, computerized refraction, intraocular pressure measurement, biometry, and corneal topography examination before lens wear and at 1 month, 3 months, and 6 months after lens wear in the pediatric ophthalmology clinic. Based on age (lower age group (8 < age ≤12 years); higher age group (12 < age ≤15 years)) and baseline equivalent spherical (SE) value (mild myopia group (-1.00 D < SE ≤ -3.25D); moderate myopia group (-3.25 D < SE ≤ -6.00 D)), four groups will be formed by pairing these factors. Suitable data will be selected according to inclusion and exclusion criteria, and different groups will be included. Data will be organized, and statistical analysis will be performed using SPSS software to obtain the results. The expected results will be discussed and analyzed. Results After wearing OK lenses, all four groups achieved good visual acuity at follow-up. At 6 months, there were no significant differences in visual acuity among the four groups (P = 0.149, >0.05). There were no significant differences in refractive error among the four groups (P = 0.066, >0.05). Baseline axial length differed significantly among the four groups (P = 0.000, <0.001), with the LM group having longer axial length than the LL group (P < 0.001, paired samples t-test), and the HM group having longer axial length than the HL group (P < 0.001, paired samples t-test). However, there were no significant differences in axial length change compared to baseline among the groups at 1 month, 3 months, and 6 months (P 1 = 0.053; P 3 = 0.557; P 6 = 0.329, >0.05). Significant differences were observed in corneal flat K-value change compared to baseline among the four groups at 1 month, 3 months, and 6 months (P 1 = 0.001, P 3 = 0.001, P 6 = 0.004, <0.05). There were no significant differences in e-value change among the groups at 1 and 3 months (P 1 = 0.205, P 3 = 0.252, >0.05), but significant differences were found in e-value change compared to baseline at 6 months (P 6 = 0.010, <0.05). Multiple regression analysis with changes in central corneal flat K-value and e-value as independent variables and axial elongation as the dependent variable showed a correlation between e-value change at 6 months and axial elongation (P = 0.004, <0.05), indicating a negative correlation. Conclusion Orthokeratology (OK) lenses effectively improve myopic children's vision by reshaping the cornea, leading to reduced central corneal curvature and flattening of its anterior surface. The effectiveness of OK lenses is not significantly affected by age or initial myopia severity. Children of varying ages and myopia levels experience similar levels of axial length control with OK lens wear. Changes in corneal shape due to OK lenses affect axial elongation, with greater changes in corneal morphology associated with smaller increases in axial length.
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Affiliation(s)
- Siqi Zhang
- Second Affiliated Hospital of Dalian Medical University, China
| | - Huailin Zhu
- Second Affiliated Hospital of Dalian Medical University, China
| | - Lan Zhang
- Second Affiliated Hospital of Dalian Medical University, China
| | - Mingjun Gao
- Second Affiliated Hospital of Dalian Medical University, China
| | - Changyang Liu
- Second Affiliated Hospital of Dalian Medical University, China
| | - Qi Zhao
- Second Affiliated Hospital of Dalian Medical University, China
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Domsa P, Bankó ÉM, Körtvélyes J, Meigen C, Széchey R, Lantos K, Nagy ZZ, Csutak A. Astigmatism and maternal myopia as important factors affecting success rate of DIMS lens treatment. BMJ Open Ophthalmol 2024; 9:e001499. [PMID: 38453262 PMCID: PMC10921505 DOI: 10.1136/bmjophth-2023-001499] [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: 09/17/2023] [Accepted: 01/28/2024] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVE To assess the efficacy of myopia control spectacle lenses (defocus incorporated multiple segments/DIMS) in slowing myopia progression among a diverse Central European paediatric population and investigate the contribution of baseline parameters on treatment outcomes. METHODS AND ANALYSIS This retrospective observational study included 62 individuals aged 4-17 years (mean±SD: 10.21±2.70) with progressing myopia but without ocular pathology with a range of -0.88 to -8.25 D spherical equivalent refraction (SER) (-3.73±1.56), coupled with astigmatism up to -3.25 D cylindrical. All participants were prescribed DIMS (Hoya MiyoSmart) spectacles. Key outcome variables were cycloplegic SER, measured for all participants and axial length (AL), assessed in a subset of patients, recorded at baseline, 6 months and 12 months. Quality of life assessments were conducted at baseline, at 2 weeks, and 3, 6, 9 and 12 months. Additionally, parental myopic dioptre was recorded when applicable. RESULTS At the 12-month mark, myopia progression in patients (mean±SE: -0.40±0.05) mirrored findings from prior European DIMS studies, but with 50% of patients showing no progression. A multivariate analysis of covariance model revealed that baseline astigmatism and younger age adversely affected therapy outcomes in both SER and AL, while severe maternal myopia led to greater SER progression. In contrast, only young age but not astigmatism was associated with AL increase in a comparable group of children with myopia, part of the LIFE Child Study, wearing single-vision spectacles. Patients reported consistent satisfaction with treatment, with minimal side effects, which diminished over the year. CONCLUSION In the European population, astigmatism, young age and severe maternal myopia are risk factors for suboptimal outcomes following DIMS therapy. Further research is necessary to elucidate the impact of astigmatism on myopic defocus therapy.
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Affiliation(s)
- Patricia Domsa
- Non Plus Ultra Vision Centre, Budapest, Hungary
- Department of Ophthalmology, University of Pécs Medical School, Pecs, Hungary
| | - Éva M Bankó
- HUN-REN Research Centre for Natural Sciences, Budapest, Hungary
| | - Judit Körtvélyes
- Non Plus Ultra Vision Centre, Budapest, Hungary
- Heim Pál National Pediatric Institute, Budapest, Hungary
| | - Christof Meigen
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Rita Széchey
- Non Plus Ultra Vision Centre, Budapest, Hungary
- Semmelweis University of Medicine, Budapest, Hungary
| | - Krisztina Lantos
- Department of Ophthalmology, University of Pécs Medical School, Pecs, Hungary
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University of Medicine, Budapest, Hungary
| | - Adrienne Csutak
- Department of Ophthalmology, University of Pécs Medical School, Pecs, Hungary
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Mahmood M, Day M, Seidel D, Cameron LA. The effect of multifocal contact lenses on the dynamic accommodation step response. Ophthalmic Physiol Opt 2024; 44:321-333. [PMID: 38303152 DOI: 10.1111/opo.13275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/19/2023] [Accepted: 12/26/2023] [Indexed: 02/03/2024]
Abstract
PURPOSE To measure the dynamic accommodation response (AR) to step stimuli with and without multifocal contact lenses (MFCLs), in emmetropes and myopes. METHODS Twenty-two adult subjects viewed alternating distance (0.25D) and near (3D) Maltese crosses placed in free space, through two contact lens types: single vision (SVCL) or centre-distance multifocal (MFCL; +2.50D add). The AR level was measured along with near to far (N-F) and far to near (F-N) step response characteristics: percentage of correct responses, magnitude, latency, peak velocity and duration of step response. RESULTS There was no difference between N-F and F-N responses, or between refractive groups in any aspect of the accommodation step response dynamics. The percentage of correct responses was unaffected by contact lens type. Through MFCLs, subjects demonstrated smaller magnitude, longer latency, shorter duration and slower peak velocity steps than through SVCLs. When viewing the near target, the AR through MFCLs was significantly lower than through SVCLs. When viewing the distance target with the MFCL, the focal points from rays travelling through the distance and near zones were approximately 0.004D behind and 2.50D in front of the retina, respectively. When viewing the near target, the respective values were approximately 1.89D behind and 0.61D in front of the retina. CONCLUSION The defocus error required for accommodation control appears not to be solely derived from the distance zone of the MFCL. This results in reduced performance in response to abruptly changing vergence stimuli; however, these errors were small and unlikely to impact everyday visual tasks. There was a decrease in ocular accommodation during near tasks, which has previously been correlated with a reduced myopic treatment response through these lenses. With MFCLs, the estimated dioptric myopic defocus was the largest when viewing a distant stimulus, supporting the hypothesis that the outdoors provides a beneficial visual environment to reduce myopia progression.
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Affiliation(s)
- Mubeen Mahmood
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Mhairi Day
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Dirk Seidel
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Lorraine A Cameron
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
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Sah RP, Meyer D, Jaskulski M, Rickert M, Cheng X, Brennan N, Kollbaum PS. Impact of zone geometry on the introduction of myopic defocus in young adult eyes wearing multi-zone lenses. Ophthalmic Physiol Opt 2023; 43:1110-1124. [PMID: 37326329 DOI: 10.1111/opo.13182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/22/2023] [Accepted: 05/29/2023] [Indexed: 06/17/2023]
Abstract
PURPOSE Multizone contact lenses control myopia progression by proposed introduction of myopic defocus. This project investigated how much of the pupil area and how many dioptres of myopic defocus are introduced by different lens zone geometries with near- and off-axis viewing. METHODS Ten young myopic adults (18-25 years) binocularly wore four soft contact lenses including a single vision (SV), concentric-ring dual-focus (DF), centre-distance multifocal (MF) and a RingBoost™ (RB) multi-zone design containing a combination of coaxial and non-coaxial zones. A modified aberrometer captured aberrations and pupil sizes at four target vergences between -0.25 and -4.00 D (on-axis) and across the central ±30° of the horizontal retina (off-axis). Defocus was quantified as the difference between the measured refractive state and the target vergence within each zone of a multi-zone design within the pupil and compared with that of equivalent zone areas of the SV lens. The percentage of the pupil containing myopic defocused light for each lens was calculated. RESULTS Defocus within the distance correction zones of multi-zone lenses was similar to that of the SV lens. When viewing on-axis at -0.25 D target vergence, on average 11% of the pupil was myopic with SV, whereas 62%, 84% and 50% of the pupil was myopic for the DF, MF and RB designs, respectively. At -4.00 D target vergence, all lenses exhibited a systematic decrease in the percentage of pupil area having myopic defocus (SV: 3%; DF: 18%; MF: 5% and RB: 26%). The off-axis proportions were similar across multi-zone lenses; however, multi-zone lenses retained approximately 1.25-3.0× more myopic defocus than the SV lens. CONCLUSIONS Subjects accommodated using the distance-correction zones of multi-zone lenses. Multi-zone contact lenses introduced significant myopic defocus on-axis and across the central ±30° retina. However, the magnitude and proportion of defocus were influenced by zone geometry, add power and pupil size.
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Affiliation(s)
- Raman Prasad Sah
- School of Optometry, Indiana University, Bloomington, Indiana, USA
| | - Dawn Meyer
- School of Optometry, Indiana University, Bloomington, Indiana, USA
| | - Matt Jaskulski
- School of Optometry, Indiana University, Bloomington, Indiana, USA
| | - Martin Rickert
- School of Optometry, Indiana University, Bloomington, Indiana, USA
| | - Xu Cheng
- Johnson & Johnson Vision Care Inc., Jacksonville, Florida, USA
| | - Noel Brennan
- Johnson & Johnson Vision Care Inc., Jacksonville, Florida, USA
| | - Pete S Kollbaum
- School of Optometry, Indiana University, Bloomington, Indiana, USA
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Chandler MA, Robich ML, Jordan LA, Mutti DO, Berntsen DA, Fenton R, Day E, Walline JJ. Accommodation in Children after 4.7 Years of Multifocal Contact Lens Wear in the BLINK Study Randomized Clinical Trial. Optom Vis Sci 2023; 100:425-431. [PMID: 37369096 PMCID: PMC10527037 DOI: 10.1097/opx.0000000000002040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023] Open
Abstract
SIGNIFICANCE When worn for myopia control in children, soft multifocal contact lenses with a +2.50 D add reduced the accommodative response over a 3-year period, but wearing them for more than 4 years did not affect accommodative amplitudes, lag, or facility. PURPOSE This study aimed to compare the accommodative response to a 3D stimulus between single-vision, +1.50-D add, and +2.50-D add multifocal contact lens wearers during 3 years of contact lens wear and then to compare accommodative amplitude, lag, and facility between the three groups after an average of 4.7 years of wear. METHODS Bifocal Lenses In Nearsighted Kids study participants aged 7 to 11 years old were randomly assigned to wear single-vision, +1.50-D add, or +2.50-D add soft contact lenses (CooperVision, Pleasanton, CA). The accommodative response to a 3D stimulus was measured at baseline and annually for 3 years. After 4.7 years, we measured objective accommodative amplitudes, lead/lag, and binocular facility with ±2.00-D flippers. We compared the three accommodative measures using multivariate analysis of variance (MANOVA), adjusting for clinic site, sex, and age group (7 to 9 or 10 to 11 years). RESULTS The +2.50-D add contact lens wearers exhibited lower accommodative response than the single-vision contact lens wearers for 3 years, but the +1.50-D add contact lens wearers exhibited only lower accommodative response than did the single-vision contact lens wearers for 2 years. After adjustment for clinic site, sex, and age group, there were no statistically significant or clinically meaningful differences between the three treatment groups for accommodative amplitude (MANOVA, P = .49), accommodative lag (MANOVA, P = .41), or accommodative facility (MANOVA, P = .87) after an average of 4.7 years of contact lens wear. CONCLUSIONS Almost 5 years of multifocal contact lens wear did not affect the accommodative amplitude, lag, or facility of children.
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Affiliation(s)
| | | | - Lisa A Jordan
- The Ohio State University College of Optometry, Columbus, Ohio
| | - Donald O Mutti
- The Ohio State University College of Optometry, Columbus, Ohio
| | | | - Rachel Fenton
- The Ohio State University College of Optometry, Columbus, Ohio
| | - Elizabeth Day
- The Ohio State University College of Optometry, Columbus, Ohio
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Amorim-de-Sousa A, Pauné J, Silva-Leite S, Fernandes P, Gozález-Méijome JM, Queirós A. Changes in Choroidal Thickness and Retinal Activity with a Myopia Control Contact Lens. J Clin Med 2023; 12:jcm12113618. [PMID: 37297813 DOI: 10.3390/jcm12113618] [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: 04/13/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023] Open
Abstract
PURPOSE The axial elongation in myopia is associated with some structural and functional retinal changes. The purpose of this study was to investigate the effect of a contact lens (CL) intended for myopia control on the choroidal thickness (ChT) and the retinal electrical response. METHODS Ten myopic eyes (10 subjects, 18-35 years of age) with spherical equivalents from -0.75 to -6.00 diopters (D) were enrolled. The ChT at different eccentricities (3 mm temporal, 1.5 mm temporal, sub-foveal ChT, 1.5 mm nasal, and 3 mm nasal), the photopic 3.0 b-wave of ffERG and the PERG were recorded and compared with two material-matched contact lenses following 30 min of wear: a single-vision CL (SV) and a radial power gradient CL with +1.50 D addition (PG). RESULTS Compared with the SV, the PG increased the ChT at all eccentricities, with statistically significant differences at 3.0 mm temporal (10.30 ± 11.51 µm, p = 0.020), in sub-foveal ChT (17.00 ± 20.01 µm, p = 0.025), and at 1.5 mm nasal (10.70 ± 14.50 µm, p = 0.044). The PG decreased significantly the SV amplitude of the ffERG photopic b-wave (11.80 (30.55) µV, p = 0.047), N35-P50 (0.90 (0.96) µV, p = 0.017), and P50-N95 (0.46 (2.50) µV, p = 0.047). The amplitude of the a-wave was negatively correlated with the ChT at 3.0T (r = -0.606, p = 0.038) and 1.5T (r = -0.748, p = 0.013), and the amplitude of the b-wave showed a negative correlation with the ChT at 1.5T (r = -0.693, p = 0.026). CONCLUSIONS The PG increased the ChT in a similar magnitude observed in previous studies. These CLs attenuated the amplitude of the retinal response, possibly due to the combined effect of the induced peripheral defocus high-order aberrations impacting the central retinal image. The decrease in the response of bipolar and ganglion cells suggests a potential retrograde feedback signaling effect from the inner to outer retinal layers observed in previous studies.
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Affiliation(s)
- Ana Amorim-de-Sousa
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
| | - Jaume Pauné
- Teknon Medical Center, 08022 Barcelona, Spain
- Faculty of Optics and Optometry Polytechnic, University of Catalonia, 08222 Terrassa, Spain
| | - Sara Silva-Leite
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
| | - Paulo Fernandes
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
- Physics Center of Minho and Porto Universities, CF-UM-UP, 4710-057 Braga, Portugal
| | - José Manuel Gozález-Méijome
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
- Physics Center of Minho and Porto Universities, CF-UM-UP, 4710-057 Braga, Portugal
| | - António Queirós
- Clinical and Experimental Optometry Research Lab (CEORLab), School of Science, University of Minho, 4710-057 Braga, Portugal
- Physics Center of Minho and Porto Universities, CF-UM-UP, 4710-057 Braga, Portugal
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Erdinest N, London N, Lavy I, Berkow D, Landau D, Morad Y, Levinger N. Peripheral Defocus and Myopia Management: A Mini-Review. KOREAN JOURNAL OF OPHTHALMOLOGY 2023; 37:70-81. [PMID: 36796348 PMCID: PMC9935061 DOI: 10.3341/kjo.2022.0125] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/26/2022] [Indexed: 02/07/2023] Open
Abstract
Myopia is the most common refractive error in the world, and its' prevalence continually increases. The potential pathological and visual complications of progressive myopia have inspired researchers to study the sources of myopia, axial elongation, and explore modalities to arrest progression. Considerable attention has been given over the past few years to the myopia risk factor known as hyperopic peripheral blur, the focus of this review. The primary theories currently believed to be the cause of myopia, the parameters considered to contribute and influence the effect of peripheral blur, such as the surface retinal area or depth of blur will be discussed. The currently available optical devices designed to provide peripheral myopic defocus will be discussed, including bifocal and progressive addition ophthalmic lenses, peripheral defocus single vision ophthalmic lenses, orthokeratology lenses, and bifocal or multifocal center distance soft lenses, as well as their effectivity as mentioned in the literature to date.
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Affiliation(s)
- Nir Erdinest
- Department of Opthalmology, Hadassah-Hebrew University Medical Center, Jerusalem,
Israel
- The Myopia Center, Rishon LeZion,
Israel
| | | | - Itay Lavy
- Department of Opthalmology, Hadassah-Hebrew University Medical Center, Jerusalem,
Israel
| | | | - David Landau
- Department of Opthalmology, Hadassah-Hebrew University Medical Center, Jerusalem,
Israel
| | - Yair Morad
- The Myopia Center, Rishon LeZion,
Israel
- Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin,
Israel
| | - Nadav Levinger
- Department of Opthalmology, Hadassah-Hebrew University Medical Center, Jerusalem,
Israel
- Department of Ophthalmology, Enaim Refractive Surgery Center, Jerusalem,
Israel
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8
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Marcellán MC, Ávila FJ, Ares J, Remón L. Peripheral Refraction of Two Myopia Control Contact Lens Models in a Young Myopic Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1258. [PMID: 36674016 PMCID: PMC9859490 DOI: 10.3390/ijerph20021258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/28/2022] [Accepted: 12/31/2022] [Indexed: 06/17/2023]
Abstract
Peripheral refraction can lead to the development of myopia. The aim of this study was to compare relative peripheral refraction (RPR) in the same cohort of uncorrected (WCL) and corrected eyes with two different soft contact lenses (CL) designed for myopia control, and to analyze RPR depending on the patient’s refraction. A total of 228 myopic eyes (114 healthy adult subjects) (−0.25 D to −10.00 D) were included. Open-field autorefraction was used to measure on- and off- axis refractions when uncorrected and corrected with the two CLs (dual focus (DF) and extended depth of focus (EDOF)). The RPR was measured every 10° out to 30° in a temporal-nasal orientation and analyzed as a component of the power vector (M). The average RPR for all subjects was hyperopic when WCL and when corrected with EDOF CL design, but changed to a myopic RPR when corrected with DF design. Significant differences were found between RPR curves with both CLs in all the eccentricities (Bonferroni correction p < 0.008, except 10°N). An incremental relationship between relative peripheral refraction at 30 degrees and myopia level was found. It is concluded that the two CLs work differently at the periphery in order to achieve myopia control.
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Affiliation(s)
| | | | | | - Laura Remón
- Department of Applied Physics, University of Zaragoza, 50009 Zaragoza, Spain
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London N, Erdinest N, Lavy I, Berkow D, Landau D, Levinger N, Morad Y. Peripheral defocus as it relates to myopia progression: A mini-review. Taiwan J Ophthalmol 2023. [DOI: 10.4103/tjo.tjo-d-22-00100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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10
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Ortiz-Peregrina S, Casares-López M, Castro-Torres JJ, Anera RG, Artal P. Effect of peripheral refractive errors on driving performance. BIOMEDICAL OPTICS EXPRESS 2022; 13:5533-5550. [PMID: 36425634 PMCID: PMC9664894 DOI: 10.1364/boe.468032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 05/30/2023]
Abstract
The effect of peripheral refractive errors on driving while performing secondary tasks at 40° of eccentricity was studied in thirty-one young drivers. They drove a driving simulator under 7 different induced peripheral refractive errors (baseline (0D), spherical lenses of +/- 2D, +/- 4D and cylindrical lenses of +2D and +4D). Peripheral visual acuity and contrast sensitivity were also evaluated at 40°. Driving performance was significantly impaired by the addition of myopic defocus (4D) and astigmatism (4D). Worse driving significantly correlated with worse contrast sensitivity for the route in general, but also with worse visual acuity when participants interacted with the secondary task. Induced peripheral refractive errors may negatively impact driving when performing secondary tasks.
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Affiliation(s)
- Sonia Ortiz-Peregrina
- Department of Optics, Laboratory of Vision Sciences and Applications, University of Granada, Granada 18071, Spain
| | - Miriam Casares-López
- Department of Optics, Laboratory of Vision Sciences and Applications, University of Granada, Granada 18071, Spain
| | - José J. Castro-Torres
- Department of Optics, Laboratory of Vision Sciences and Applications, University of Granada, Granada 18071, Spain
| | - Rosario G. Anera
- Department of Optics, Laboratory of Vision Sciences and Applications, University of Granada, Granada 18071, Spain
| | - Pablo Artal
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo, Murcia 30100, Spain
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Dhiman R, Rakheja V, Gupta V, Saxena R. Current concepts in the management of childhood myopia. Indian J Ophthalmol 2022; 70:2800-2815. [PMID: 35918919 DOI: 10.4103/ijo.ijo_2098_21] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Myopia or short-sightedness is an emerging pandemic affecting more than 50% population in South-Asian countries. It is associated with several sight-threatening complications, such as retinal detachment and choroidal neovascularization, leading to an increased burden of visual impairment and blindness. The pathophysiology of myopia involves a complex interplay of numerous environmental and genetic factors leading to progressive axial elongation. Environmental factors such as decreased outdoor activity, reduced exposure to ambient light, strenuous near work, and role of family history of myopia have been implicated with increased prevalence of this refractive error. While multiple clinical trials have been undertaken to devise appropriate treatment strategies and target the modifiable risk factors, there is no single treatment modality with ideal results; therefore, formulating a comprehensive approach is required to control the myopia epidemic. This review article summarizes the epidemiology, dynamic concepts of pathophysiology, and evolution of the treatment modalities for myopia such as pharmacological (atropine and other agents) and optical methods (spectacles, contact lenses, and orthokeratology).
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Affiliation(s)
- Rebika Dhiman
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Delhi, India
| | - Vaishali Rakheja
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Delhi, India
| | - Vinay Gupta
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Delhi, India
| | - Rohit Saxena
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Delhi, India
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12
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Xu Y, Deng J, Zhang B, Xu X, Cheng T, Wang J, Xiong S, Luan M, Zou H, He X, Tang C, Xu X. Higher-order aberrations and their association with axial elongation in highly myopic children and adolescents. Br J Ophthalmol 2022; 107:862-868. [PMID: 35027355 DOI: 10.1136/bjophthalmol-2021-319769] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 12/20/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Vision-dependent mechanisms play a role in myopia progression in childhood. Thus, we investigated the distribution of ocular and corneal higher-order aberrations (HOAs) in highly myopic Chinese children and adolescents and the relationship between HOA components and 1-year axial eye growth. METHODS Baseline cycloplegic ocular and corneal HOAs, axial length (AL), spherical equivalent (SE), astigmatism and interpupillary distance (IPD) were determined for the right eyes of 458 highly myopic (SE ≤-5.0D) subjects. HOAs were compared among baseline age groups (≤12 years, 13-15 years and 16-18 years). Ninety-nine subjects completed the 1-year follow-up. Linear mixed model analyses were applied to determine the association between HOA components, other known confounding variables (age, gender, SE, astigmatism and IPD) and axial growth. A comparison with data from an early study of moderate myopia were conducted. RESULTS Almost all ocular HOAs and few corneal HOAs exhibited significant differences between different age groups (all p<0.05). After 1 year, only ocular HOA components was significantly negative associated with a longer AL, including secondary horizontal comatic aberration (p=0.019), primary spherical aberration (p<0.001) and spherical HOA (p=0.026). Comparing with the moderate myopia data, the association of comatic aberration with AL growth was only found in high myopia. CONCLUSION In highly myopic children and adolescents, lower levels of annual ocular secondary horizontal comatic aberration changes, besides spherical aberrations, were associated with axial elongation. This suggests that ocular HOA plays a potential role in refractive development in high myopia.
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Affiliation(s)
- Yupeng Xu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.,Department of Ophthalmology, Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Junjie Deng
- Department of Ophthalmology, Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Bo Zhang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Xian Xu
- Department of Ophthalmology, Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Tianyu Cheng
- Department of Ophthalmology, Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Jingjing Wang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Shuyu Xiong
- Department of Ophthalmology, Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Mengli Luan
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Haidong Zou
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.,Department of Ophthalmology, Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Xiangui He
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China .,Department of Ophthalmology, Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Chun Tang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Xun Xu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.,Department of Ophthalmology, Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
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13
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Short-Term Effect of Wearing of Extended Depth-of-Focus Contact Lenses in Myopic Children: A Pilot Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12010431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This pseudo-experimental, prospective, and longitudinal pilot study was conducted to characterize the optical and visual changes occurring in the short-term wear of a hydrophilic contact lens (CL) based on extended focus technology (EDOF). A total of 30 eyes of 15 children (age, 6–16 years) were fitted with the EDOF CL Mylo (Mark’ennovy Care SL), performing an exhaustive follow-up for one month evaluating changes in visual acuity (VA), accommodation, binocularity, ocular aberrometry, visual quality, pupillometry, keratometry and biometry. Far and near VA with the CL improved progressively (p < 0.001), obtaining mean final binocular values of −0.08 ± 0.01 and −0.07 ± 0.01 LogMAR, respectively. There was a mean reduction in the accommodative LAG of 0.30 D (p < 0.001), without associated alterations in the magnitude of the phoria and fusional vergences (p ≥ 0.066). A controlled but statistically significant increase (p ≤ 0.005) of ocular high order aberration (HOA) root mean square (RMS), primary coma RMS, primary spherical aberration Zernike term and secondary astigmatism RMS was found with the CL wear. In conclusion, the EDOF CL evaluated provides adequate visual acuity and quality, with associated increased of several HOAs and a trend to reduction in the accommodative LAG that should be confirmed in future studies.
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14
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Németh J, Tapasztó B, Aclimandos WA, Kestelyn P, Jonas JB, De Faber JTHN, Januleviciene I, Grzybowski A, Nagy ZZ, Pärssinen O, Guggenheim JA, Allen PM, Baraas RC, Saunders KJ, Flitcroft DI, Gray LS, Polling JR, Haarman AEG, Tideman JWL, Wolffsohn JS, Wahl S, Mulder JA, Smirnova IY, Formenti M, Radhakrishnan H, Resnikoff S. Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute. Eur J Ophthalmol 2021; 31:853-883. [PMID: 33673740 PMCID: PMC8369912 DOI: 10.1177/1120672121998960] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/04/2021] [Indexed: 12/13/2022]
Abstract
The prevalence of myopia is increasing extensively worldwide. The number of people with myopia in 2020 is predicted to be 2.6 billion globally, which is expected to rise up to 4.9 billion by 2050, unless preventive actions and interventions are taken. The number of individuals with high myopia is also increasing substantially and pathological myopia is predicted to become the most common cause of irreversible vision impairment and blindness worldwide and also in Europe. These prevalence estimates indicate the importance of reducing the burden of myopia by means of myopia control interventions to prevent myopia onset and to slow down myopia progression. Due to the urgency of the situation, the European Society of Ophthalmology decided to publish this update of the current information and guidance on management of myopia. The pathogenesis and genetics of myopia are also summarized and epidemiology, risk factors, preventive and treatment options are discussed in details.
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Affiliation(s)
- János Németh
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Beáta Tapasztó
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
- Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | | | | | - Jost B Jonas
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
| | | | | | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Olavi Pärssinen
- Gerontology Research Centre and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Peter M Allen
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, University of South-Eastern Norway, Kongsberg, Norway
| | - Kathryn J Saunders
- Centre for Optometry and Vision Science research, Ulster University, Coleraine, UK
| | - Daniel Ian Flitcroft
- Temple Street Children’s Hospital, Dublin, Ireland
- Centre for Eye Research Ireland (CERI) Technological University Dublin, Ireland
| | | | - Jan Roelof Polling
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Optometry and Orthoptics, Hogeschool Utrecht, University of Applied Science, Utrecht, The Netherlands
| | - Annechien EG Haarman
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - J Willem L Tideman
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - James Stuart Wolffsohn
- Optometry and Vision Science, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Siegfried Wahl
- Institute for Ophthalmic Research, University Tübingen, Tübingen, Germany
- Carl Zeiss Vision International GmbH, Tübingen, Germany
| | - Jeroen A Mulder
- Department of Optometry and Orthoptics, Hogeschool Utrecht, University of Applied Science, Utrecht, The Netherlands
| | | | - Marino Formenti
- Department of Physics, School of Science, University of Padova, Padova, Italy
| | | | - Serge Resnikoff
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Brien Holden Vision Institute, Sydney, Australia
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15
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Lopes-Ferreira D, Ruiz-Pomeda A, Peréz-Sanchéz B, Queirós A, Villa-Collar C. Ocular and corneal aberrations changes in controlled randomized clinical trial MiSight® Assessment Study Spain (MASS). BMC Ophthalmol 2021; 21:112. [PMID: 33648464 PMCID: PMC7919067 DOI: 10.1186/s12886-021-01865-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 02/12/2021] [Indexed: 12/22/2022] Open
Abstract
Background To compare ocular and corneal inherent aberrations in the naked eyes of randomly selected children fitted with MiSight contact lenses (CL) for myopia control, versus children corrected with single-vision spectacles (control), over a 24-months period. Methods Children aged 8 to 12 years, with myopia (-0.75 to -4.00 D sphere) and astigmatism (< -1.00 D cylinder) were randomly assigned to the lens study group (MiSight) or the control group (single-vision spectacles). The root mean square aberration (RMS) was determined as corneal (RMS_C), corneal high order RMS (HO_RMS_C), corneal low order RMS (LO_RMS_C), ocular (total) RMS (RMS_T), ocular high order RMS (HO_RMS_T), ocular low order RMS (LO_RMS_T), corneal spherical aberration (SA_C) and ocular SA (SA_T) were calculated by aberrometry measures at the baseline, on 12-months and 24-months visits. A 5 mm diameter was defined for the analysis in all visits for all subjects. Only the dominant eye was analyzed. Results Seventy-four subjects completed the clinical trial: 41 subjects from the MiSight group (age: 11.01 ± 1.23 years) and 33 from the single-vision group (age: 10.12 ± 1.38 years). RMS_T significantly changed (0.57 ± 0.20 µm, p = 0.029) after 24-months in the control group. In the MiSight group no significant changes were registered (p > 0.05). The SA_C and SA_T did not reveal significant changes between visits or between groups (p > 0.05). Conclusions Along 2 years, MiSight CL did not induce significant changes in RMS of anterior cornea or total ocular RMS. Contrary, in control group the RMS_T significantly changed as response of greater eye growth and myopia progression. The results obtained in present study allow to predict corneal or total aberration changes, in children, in response of wearing of MiSight lens along the time. Trial registration : ClinicalTrials.gov Identifier: NCT01917110.
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Affiliation(s)
- Daniela Lopes-Ferreira
- CEORLab, Centre of Physics, Clinical and Experimental Optometry Research Lab, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal.
| | - Alicia Ruiz-Pomeda
- Servicio de Oftalmología. Hospital Universitario de Mostoles, Mostoles, Madrid, Spain
| | - Belén Peréz-Sanchéz
- Department of Statistics, Mathematics and Informatics, Area of Languages and Computer Systems, Miguel Hernández University of Elche, Elche, Alicante, Spain
| | - António Queirós
- CEORLab, Centre of Physics, Clinical and Experimental Optometry Research Lab, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - César Villa-Collar
- Department of Pharmacy, Biotechnology, Optics and Optometry, European University of Madrid, C/Tajo s/n, 28670, Villaviciosa de Odón, Madrid, Spain
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16
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Lin Z, Duarte-Toledo R, Manzanera S, Lan W, Artal P, Yang Z. Two-dimensional peripheral refraction and retinal image quality in orthokeratology lens wearers. BIOMEDICAL OPTICS EXPRESS 2020; 11:3523-3533. [PMID: 33014548 PMCID: PMC7510915 DOI: 10.1364/boe.397077] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/26/2020] [Accepted: 05/26/2020] [Indexed: 05/28/2023]
Abstract
Orthokeratology (O-K) is a common procedure that uses rigid contact lenses to reshape the cornea while worn overnight. Beyond the correction of refractive error, it has been suggested that this approach can also be used to reduce myopia progression, possibly because it induces changes in peripheral optics. As this hypothesis remains unproven, the aim of the present study was to explore changes in peripheral retinal optical quality in a group of myopic children following O-K treatment. We provide a comprehensive description of optical characteristics in a group of myopes before and after achieving stable corneal reshaping using overnight O-K lenses. These characteristics extended across the central visual field (60° horizontal x 36° vertical) as measured with a custom Hartmman-Shack wavefront sensor. After corneal reshaping, peripheral refraction was found to be asymmetrically distributed, with a myopic relative refraction of approximately 3D in the temporal retina. Astigmatism and higher order aberrations also increased in the temporal side. Based on corneal topography following treatment, subjects were divided into two groups: Centred Treatment (CT, decentration ∈ [-0.5 + 0.5] mm) and Slightly Decentred Treatment (subjects with more decentred lenses). The process was also modelled by ray-tracing simulation. The results indicate that increased myopia in the temporal retina is caused by the decentration of lenses towards the temporal side. Peripheral optics differ significantly following O-K lens treatment, but further research is required to determine whether this is likely to affect myopia progression.
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Affiliation(s)
- Zhenghua Lin
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Raul Duarte-Toledo
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo, 30100, Murcia, Spain
| | - Silvestre Manzanera
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo, 30100, Murcia, Spain
| | - Weizhong Lan
- Aier School of Ophthalmology, Central South University, Changsha, China
- Aier School of Optometry, Hubei University of Science and Technology, Xianning, China
| | - Pablo Artal
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo, 30100, Murcia, Spain
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Zhikuan Yang
- Aier School of Ophthalmology, Central South University, Changsha, China
- Aier School of Optometry, Hubei University of Science and Technology, Xianning, China
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17
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Measurement of the peripheral aberrations of human eyes: A comprehensive review. NANOTECHNOLOGY AND PRECISION ENGINEERING 2020. [DOI: 10.1016/j.npe.2020.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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18
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Bifocal and Multifocal Contact Lenses for Presbyopia and Myopia Control. J Ophthalmol 2020; 2020:8067657. [PMID: 32318285 PMCID: PMC7152962 DOI: 10.1155/2020/8067657] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 02/10/2020] [Accepted: 02/24/2020] [Indexed: 02/07/2023] Open
Abstract
Bifocal and multifocal optical devices are intended to get images into focus from objects placed at different distances from the observer. Spectacles, contact lenses, and intraocular lenses can meet the requirements to provide such a solution. Contact lenses provide unique characteristics as a platform for implementing bifocality and multifocality. Compared to spectacles, they are closer to the eye, providing a wider field of view, less distortion, and their use is more consistent as they are not so easily removed along the day. In addition, contact lenses are also minimally invasive, can be easily exchangeable, and, therefore, suitable for conditions in which surgical procedures are not indicated. Contact lenses can remain centered with the eye despite eye movements, providing the possibility for simultaneous imaging from different object distances. The main current indications for bifocal and multifocal contact lenses include presbyopia correction in adult population and myopia control in children. Considering the large numbers of potential candidates for optical correction of presbyopia and the demographic trends in myopia, the potential impact of contact lenses for presbyopia and myopia applications is undoubtedly tremendous. However, the ocular characteristics and expectations vary significantly between young and older candidates and impose different challenges in fitting bifocal and multifocal contact lenses for the correction of presbyopia and myopia control. This review presents the recent developments in material platforms, optical designs, simulated visual performance, and the clinical performance assessment of bifocal and multifocal contact lenses for presbyopia correction and/or myopia progression control.
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19
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Cheng X, Xu J, Brennan NA. Accommodation and its role in myopia progression and control with soft contact lenses. Ophthalmic Physiol Opt 2019; 39:162-171. [PMID: 30994197 DOI: 10.1111/opo.12614] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 03/18/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE To examine the impact of contact lens optical design on accommodative behaviour of children and the correlation between myopia progression and the accommodative response of the eye while wearing a contact lens designed for myopia control. METHODS A post-hoc analysis was conducted on data from a previously published myopia control trial. A total of 109 subjects (aged 8 to 11 years, myopia: -0.75 to -4.00 D) wore either a Control (single-vision, n = 57) or a Test (with positive spherical aberration, +SA, n = 52) soft contact lens, binocularly for 1 year. Accommodative response was measured as the subject observed targets at -1.00 to -4.00 D vergence using the Grand Seiko WAM-5500 open-field autorefractor (www.grandseiko.com). Slope of accommodative response (SAR) as well as distance and near phoria and stimulus accommodative convergence/accommodation (AC/A) were compared between each group at baseline without study lenses and at 1-week and 1-year visits with study lenses. The SAR was also compared to changes in axial length (AL) and spherical equivalent cycloplegic auto refraction (SECAR). RESULTS At baseline, there was no significant difference in SAR between the two study groups (ΔSAR = -0.039, p = 0.84). At 1 week, mean SAR of the Test group was significantly less than for the Control group (ΔSAR = -0.203, p < 0.0001), an effect that persisted to 1 year (ΔSAR = -0.129, p < 0.0001). In the Test group, greater SAR was associated with less change in AL (regression coefficient: -0.59 mm, p < 0.0001) and SECAR (regression coefficient: 1.12 D, p = 0.006) at 1 year. In the Control group, associations between SAR and change in AL and SECAR were not statistically significant. Compared to the Control group, eyes of the Test group appeared to be more exophoric with study lenses, however, the difference between the two groups was only significant at 1 week for distance phoria and 1 year for near phoria. CONCLUSION The soft contact lens with +SA for controlling myopia progression resulted in an apparent decrease in mean accommodation. Within the Test group, reduced accommodative response correlated with greater myopia progression, suggesting some subjects in the Test group utilised the +SA for near viewing, inducing hyperopic defocus at the retina. Accordingly, the potential impact of a lens optics on accommodative function should be considered during design of myopia control lenses.
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Affiliation(s)
- Xu Cheng
- Johnson & Johnson Vision, Jacksonville, Florida, USA
| | - Jing Xu
- Johnson & Johnson Vision, Jacksonville, Florida, USA
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20
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Batres L, Peruzzo S, Serramito M, Carracedo G. Accommodation response and spherical aberration during orthokeratology. Graefes Arch Clin Exp Ophthalmol 2019; 258:117-127. [PMID: 31720836 DOI: 10.1007/s00417-019-04504-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 09/12/2019] [Accepted: 10/03/2019] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To evaluate the changes in the accommodative response and in the corneal and internal spherical aberration during 3 months of wear of orthokeratology lenses from the baseline. METHODS Fifty children aged 8 to 17 were recruited for a prospective study and were fitted with orthokeratology lenses. Refraction without cycloplegia, high and low uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), accommodation lag, horizontal near phoria without correction, corneal topography, corneal, and total wavefront aberration were performed at baseline, 1 day, 1 week, 1 month, and 3 months. Data were analyzed by Student's t test for related samples, repeated measures ANOVA test, and Pearson correlation test. RESULTS The spherical equivalent (SE) before and after 3 months was - 3.33 ± 1.60 D and - 0.30 ± 0.46 D, respectively. Accommodation lag was 0.53 ± 0.38 D and 0.20 ± 0.33 D at baseline and at 3 months, respectively. A moderate correlation between lag at the baseline and its change between baseline and the 3-month visit was found (P < 0.05; R = 0.748). The spherical aberration (SA) increased for anterior corneal and total measurement, being statistically significant for all visits (P < 0.05). The internal SA decreased: - 0.105 ± 0.006 at baseline and - 0.196 ± 0.203 at 1 week (P < 0.05). No difference between baseline and the follow-up visits in posterior corneal SA was found (P > 0.05) CONCLUSION: The negative SA of the lens increases during OK treatment compensated for the increase of the anterior corneal surface positive SA, in addition to increasing the accommodative response.
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Affiliation(s)
- L Batres
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos del Jalon 118, 28032, Madrid, Spain
- Ophthalmological Clinic Doctor Lens, Madrid, Spain
| | - S Peruzzo
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos del Jalon 118, 28032, Madrid, Spain
| | - M Serramito
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos del Jalon 118, 28032, Madrid, Spain
| | - G Carracedo
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos del Jalon 118, 28032, Madrid, Spain.
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21
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Wildsoet CF, Chia A, Cho P, Guggenheim JA, Polling JR, Read S, Sankaridurg P, Saw SM, Trier K, Walline JJ, Wu PC, Wolffsohn JS. IMI - Interventions Myopia Institute: Interventions for Controlling Myopia Onset and Progression Report. Invest Ophthalmol Vis Sci 2019; 60:M106-M131. [PMID: 30817829 DOI: 10.1167/iovs.18-25958] [Citation(s) in RCA: 206] [Impact Index Per Article: 41.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Myopia has been predicted to affect approximately 50% of the world's population based on trending myopia prevalence figures. Critical to minimizing the associated adverse visual consequences of complicating ocular pathologies are interventions to prevent or delay the onset of myopia, slow its progression, and to address the problem of mechanical instability of highly myopic eyes. Although treatment approaches are growing in number, evidence of treatment efficacy is variable. This article reviews research behind such interventions under four categories: optical, pharmacological, environmental (behavioral), and surgical. In summarizing the evidence of efficacy, results from randomized controlled trials have been given most weight, although such data are very limited for some treatments. The overall conclusion of this review is that there are multiple avenues for intervention worthy of exploration in all categories, although in the case of optical, pharmacological, and behavioral interventions for preventing or slowing progression of myopia, treatment efficacy at an individual level appears quite variable, with no one treatment being 100% effective in all patients. Further research is critical to understanding the factors underlying such variability and underlying mechanisms, to guide recommendations for combined treatments. There is also room for research into novel treatment options.
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Affiliation(s)
- Christine F Wildsoet
- Berkeley Myopia Research Group, School of Optometry and Vision Science Program, University of California Berkeley, Berkeley, California, United States
| | - Audrey Chia
- Singapore Eye Research Institute and Singapore National Eye Center, Singapore
| | - Pauline Cho
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong
| | - Jeremy A Guggenheim
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom
| | - Jan Roelof Polling
- Erasmus MC Department of Ophthalmology, Rotterdam, The Netherlands.,HU University of Applied Sciences, Optometry and Orthoptics, Utrecht, The Netherlands
| | - Scott Read
- School of Optometry and Vision Science and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute and 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, Singapore
| | - Klaus Trier
- Trier Research Laboratories, Hellerup, Denmark
| | - Jeffrey J Walline
- The Ohio State University College of Optometry, Columbus, Ohio, United States
| | - Pei-Chang Wu
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - James S Wolffsohn
- Ophthalmic Research Group, Aston University, Birmingham, United Kingdom
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22
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The Topographical Effect of Optical Zone Diameter in Orthokeratology Contact Lenses in High Myopes. J Ophthalmol 2019; 2019:1082472. [PMID: 30719336 PMCID: PMC6334375 DOI: 10.1155/2019/1082472] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 11/29/2018] [Accepted: 12/16/2018] [Indexed: 12/27/2022] Open
Abstract
Purpose To evaluate the effect of the optical zone diameter (OZ) in orthokeratology contact lenses regarding the topographical profile in patients with high myopia (−4.00 D to −7.00 D) and to study its effect over the visual quality. Materials and Methods Twelve patients (18 eyes) were fitted with overnight orthokeratology (OrthoK) with a randomized 6 mm or 5 mm OZ lens worn for 2 weeks, followed by a 2-week washout period, between both designs. Keratometry (K) readings, optical zone treatment diameter (OZT), peripheral ring width (PRW), higher-order aberrations (HOA), high (HC) and low contrast (LC) visual acuity, and subjective vision and comfort were measured at baseline and after 2 weeks of OrthoK lens wear of each contact lens. Results No significant differences were found between any measurements for the same subject at both baselines (p value > 0.05). There was no difference between OZ lens designs found in refraction, subjective vision or comfort, and HC and LC visual acuity. Contrast sensitivity was decreased in the 5 mm OZ lens design compared with 6 mm OZ design (p-value < 0.05). 5 mm OZ design provoked a greater flattening, more powerful midperipheral ring and 4th-order corneal and total spherical aberration than the 6 mm OZ design, being statistically significant after 7 days, for corneal aberration, and 15 days, for corneal and total, of wearing the lens (p-value < 0.05). The OZT obtained were 2.8 ± 0.2 mm and 3.1 ± 0.1 mm for 5 mm and 6 mm OZ design, respectively (p-value < 0.05). Regarding PRW, the 5 mm OZ design had a wider ring width in both the nasal and temporal zones (p-value < 0.05). Conclusions A smaller diameter optical zone (5 mm) in orthokeratology lenses produces a smaller treatment area and a larger and more powerful midperipheral ring, increasing the 4th-order spherical aberration that affects only the contrast sensitivity but without differences in visual acuity and subjective vision compared with a larger OZ diameter (6 mm).
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Cho P, Tan Q. Myopia and orthokeratology for myopia control. Clin Exp Optom 2018; 102:364-377. [PMID: 30380591 DOI: 10.1111/cxo.12839] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 08/17/2018] [Accepted: 08/20/2018] [Indexed: 12/18/2022] Open
Abstract
The prevalence of myopia in children is increasing worldwide and is viewed as a major public health concern. This increase has driven interest in research into myopia prevention and control in children. Although there is still uncertainty in the risk factors underlying differences in myopia prevalence between ethnic groups, rates in children of East Asian descent are typically higher regardless of where they live. Mounting evidence also suggests that myopia prevalence in children increases with age. Earlier commencement and more rigorous education systems in these countries, resulting in more time spent on near-work activities and less time on outdoor activities, may be responsible for the earlier age of myopia onset. However, to date, the mechanisms regulating myopia onset and progression are still poorly understood. Findings from several studies have shown orthokeratology to be effective in slowing axial elongation and it is a well-accepted treatment, particularly in East Asian regions. While our understanding of this treatment has increased in the last decade, more work is required to answer questions, including: How long should the treatment be continued? Is there a rebound effect? Should the amount of myopia control be increased? To whom and when should the treatment be offered? Practitioners are now faced with the need to carefully guide and advise parents on whether and when to undertake a long somewhat complex intervention, which is costly, both in time and money. In the near future, a greater demand for effective prophylaxis against childhood myopia is envisaged. Other than orthokeratology, atropine therapy has been shown to be effective in slowing myopia progression. While its mechanism of control is also not fully understood, it is likely that it acts via a different mechanism from orthokeratology. Thus, a combined treatment of orthokeratology and atropine may have great potential to maximise the effectiveness of myopia control interventions.
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Affiliation(s)
- Pauline Cho
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
| | - Qi Tan
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
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Binocular and accommodative function in the controlled randomized clinical trial MiSight® Assessment Study Spain (MASS). Graefes Arch Clin Exp Ophthalmol 2018; 257:207-215. [PMID: 30196481 DOI: 10.1007/s00417-018-4115-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/27/2018] [Accepted: 08/21/2018] [Indexed: 01/12/2023] Open
Abstract
PURPOSE To evaluate the binocular and accommodative function in children wearing dual focus (DF) MiSight® contact lenses (CLs) for myopia control compared with children wearing single-vision (SV) spectacles. METHODS This was a randomized, controlled clinical trial involving subjects aged 8 to 12, with myopia ranging from - 0.75 to - 4.00D and astigmatism < 1.00D, allocated to MiSight® study CLs group or control group wearing SV. Binocular and accommodative function was determined at baseline, 12-, and 24-month visits, assessed by the following sequence of tests: distance and near horizontal phoria, accommodative convergence/accommodation (AC/A) ratio, stereopsis, accommodative amplitude (AA), and accommodative response (AR) at 33, 25 and 20 cm. RESULTS Seventy-four children completed the study: 41 in the CL group and 33 in the SV group. CLs group did not show any significant differences in binocular and accommodative measurements throughout the study. In control group, distance and near phoria, stereopsis, AC/A and AR at 20 cm did not show any significant change, but AA, AR at 33 cm and AR at 25 cm were greater at 24-month visit compared with baseline (p < 0.05). CONCLUSIONS DF lenses do not change the binocular and accommodative function in children wearing dual focus CLs. TRIAL REGISTRATION NCT01917110.
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Faria-Ribeiro M, Amorim-de-Sousa A, González-Méijome JM. Predicted accommodative response from image quality in young eyes fitted with different dual-focus designs. Ophthalmic Physiol Opt 2018; 38:309-316. [PMID: 29383756 DOI: 10.1111/opo.12443] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/01/2017] [Indexed: 12/22/2022]
Abstract
PURPOSE To investigate the separated and combined influences of inner zone (IZ) diameter and effective add power of dual-focus contact lenses (CL) in the image quality at distance and near viewing, in a functional accommodating model eye. METHODS Computational wave-optics methods were used to define zonal bifocal pupil functions, representing the optic zones of nine dual-focus centre-distance CLs. The dual-focus pupil functions were defined having IZ diameters of 2.10 mm, 3.36 mm and 4.00 mm, with add powers of 1.5 D, 2.0 D and 2.5 D (dioptres), for each design, that resulted in a ratio of 64%/36% between the distance and treatment zone areas, bounded by a 6 mm entrance pupil. A through-focus routine was implemented in MATLAB to simulate the changes in image quality, calculated from the Visual Strehl ratio, as the eye with the dual-focus accommodates, from 0 to -3.00 D target vergences. Accommodative responses were defined as the changes in the defocus coefficient, combined with a change in fourth and sixth order spherical aberration, which produced a peak in image quality at each target vergence. RESULTS Distance viewing image quality was marginally affected by IZ diameter but not by add power. Near image quality obtained when focussing the image formed by the near optics was only higher by a small amount compared to the other two IZ diameters. The mean ± standard deviation values obtained with the three adds were 0.28 ± 0.02, 0.23 ± 0.02 and 0.22 ± 0.02, for the small, medium and larger IZ diameters, respectively. On the other hand, near image quality predicted by focussing the image formed by the distance optics was considerably lower relatively to the other two IZ diameters. The mean ± standard deviation values obtained with the three adds were 0.15 ± 0.01, 0.38 ± 0.00 and 0.54 ± 0.01, for the small, medium and larger IZ diameters, respectively. CONCLUSIONS During near viewing through dual-focus CLs, image quality depends on the diameter of the most inner zone of the CL, while add power only affects the range of clear focus when focussing the image formed by the CL near optics. When only image quality gain is taken into consideration, medium and large IZ diameters designs are most likely to promote normal accommodative responses driven by the CL distance optics, while a smaller IZ diameter design is most likely to promote a reduced accommodative response driven by the dual-focus CL near optics.
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Affiliation(s)
- Miguel Faria-Ribeiro
- Clinical & Experimental Optometry Research Lab (CEORLab), Center of Physics, University of Minho, Braga, Portugal
| | - Ana Amorim-de-Sousa
- Clinical & Experimental Optometry Research Lab (CEORLab), Center of Physics, University of Minho, Braga, Portugal
| | - José M González-Méijome
- Clinical & Experimental Optometry Research Lab (CEORLab), Center of Physics, University of Minho, Braga, Portugal
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Maiello G, Kerber KL, Thorn F, Bex PJ, Vera-Diaz FA. Vergence driven accommodation with simulated disparity in myopia and emmetropia. Exp Eye Res 2017; 166:96-105. [PMID: 29051012 DOI: 10.1016/j.exer.2017.10.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 08/25/2017] [Accepted: 10/08/2017] [Indexed: 11/24/2022]
Abstract
The formation of focused and corresponding foveal images requires a close synergy between the accommodation and vergence systems. This linkage is usually decoupled in virtual reality systems and may be dysfunctional in people who are at risk of developing myopia. We study how refractive error affects vergence-accommodation interactions in stereoscopic displays. Vergence and accommodative responses were measured in 21 young healthy adults (n=9 myopes, 22-31 years) while subjects viewed naturalistic stimuli on a 3D display. In Step 1, vergence was driven behind the monitor using a blurred, non-accommodative, uncrossed disparity target. In Step 2, vergence and accommodation were driven back to the monitor plane using naturalistic images that contained structured depth and focus information from size, blur and/or disparity. In Step 1, both refractive groups converged towards the stereoscopic target depth plane, but the vergence-driven accommodative change was smaller in emmetropes than in myopes (F1,19=5.13, p=0.036). In Step 2, there was little effect of peripheral depth cues on accommodation or vergence in either refractive group. However, vergence responses were significantly slower (F1,19=4.55, p=0.046) and accommodation variability was higher (F1,19=12.9, p=0.0019) in myopes. Vergence and accommodation responses are disrupted in virtual reality displays in both refractive groups. Accommodation responses are less stable in myopes, perhaps due to a lower sensitivity to dioptric blur. Such inaccuracies of accommodation may cause long-term blur on the retina, which has been associated with a failure of emmetropization.
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Affiliation(s)
- Guido Maiello
- UCL Institute of Ophthalmology, University College London, London, UK; Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA.
| | - Kristen L Kerber
- New England College of Optometry, 424 Beacon Street, Boston, MA 02115, USA
| | - Frank Thorn
- New England College of Optometry, 424 Beacon Street, Boston, MA 02115, USA
| | - Peter J Bex
- Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA
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Abstract
SIGNIFICANCE Commercially available aberrometers are essential to clinical studies evaluating refractive error and image quality. The Discovery System (Innovative Visual Systems, Elmhurst, IL) is a promising clinical instrument that allows investigators to export aberration data for research and analysis purposes. An assessment of the Discovery System's performance is essential to the interpretation of the data obtained. PURPOSE The aims of this study were to determine the between-visit repeatability of refractive error and higher-order aberration measurements with the Discovery System and to examine between-instrument agreement of refractive error measurements with the Discovery System and Grand Seiko WAM-5500 open-field autorefractor (Grand Seiko Co., Hiroshima, Japan). METHODS Cycloplegic refractive error values from the Discovery System (over a 3-mm pupil) and the Grand Seiko autorefractor were converted to power vectors (M, J0, and J45), and averaged. Zernike coefficients were also calculated by the Discovery System over a 6-mm pupil through the sixth radial order. Between-visit repeatability and agreement were evaluated using Bland-Altman difference-versus-mean plots. A t-test compared each mean difference (bias) to zero, and the 95% limits of agreement were calculated. RESULTS Twenty-five young adults with a mean (±SD) cycloplegic spherical-equivalent refractive error of -2.91 ± 1.85 diopters (D) (range, -6.96 to +0.74 D) were enrolled. There were no significant between-visit differences with the Discovery System for M, J0, J45, third- through sixth-order root mean square (RMS), higher-order RMS, or spherical aberration (all P > .30), and the repeatability for defocus and higher-order RMS were ±0.31 D and ±0.095 μm, respectively, for a 6-mm pupil. At a 3-mm pupil, the Discovery System, on average, measured slightly more positive values than the Grand Seiko for M (0.28 D), J0 (0.11 D), and J45 (0.12 D; all P < .005). CONCLUSIONS The Discovery System was very repeatable and would be an appropriate instrument to measure cycloplegic refractive error and higher-order aberration changes in adults. Small differences in refractive error were found between the Discovery System and Grand Seiko.
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Affiliation(s)
- Mylan T Nguyen
- The Ocular Surface Institute, University of Houston College of Optometry, Houston, Texas
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