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Davies LN, Biswas S, Bullimore M, Cruickshank F, Estevez JJ, Khanal S, Kollbaum P, Marcotte-Collard R, Montani G, Plainis S, Richdale K, Simard P, Wolffsohn JS. BCLA CLEAR presbyopia: Mechanism and optics. Cont Lens Anterior Eye 2024; 47:102185. [PMID: 38796331 DOI: 10.1016/j.clae.2024.102185] [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] [Indexed: 05/28/2024]
Abstract
With over a billion adults worldwide currently affected, presbyopia remains a ubiquitous, global problem. Despite over a century of study, the precise mechanism of ocular accommodation and presbyopia progression remains a topic of debate. Accordingly, this narrative review outlines the lenticular and extralenticular components of accommodation together with the impact of age on the accommodative apparatus, neural control of accommodation, models of accommodation, the impact of presbyopia on retinal image quality, and both historic and contemporary theories of presbyopia.
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Affiliation(s)
- Leon N Davies
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK.
| | - Sayantan Biswas
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | | | - Fiona Cruickshank
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Jose J Estevez
- Caring Futures Institute, College of Nursing and Health Sciences, Optometry and Vision Science, Flinders University, Adelaide, Australia; Flinders Centre for Ophthalmology, Eye and Vision Research, Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Safal Khanal
- Department of Optometry and Vision Science, The University of Alabama at Birmingham, USA
| | | | | | | | - Sotiris Plainis
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK; Laboratory of Optics and Vision, School of Medicine, University of Crete, Greece
| | | | - Patrick Simard
- School of Optometry, Universite de Montreal, Montreal, Quebec, Canada
| | - James S Wolffsohn
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
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Ma L, Li X, Hu J, Li Y, Wang S, Wang K, Zhao M. Influence of a long-distance optical imaging workbench on accommodation and choroidal response in myopic children. Clin Exp Optom 2024; 107:420-427. [PMID: 37406457 DOI: 10.1080/08164622.2023.2228810] [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: 12/02/2022] [Revised: 05/30/2023] [Accepted: 06/20/2023] [Indexed: 07/07/2023] Open
Abstract
CLINICAL RELEVANCE Optical approaches to modulating near work may be beneficial in arresting the progression of myopia. BACKGROUND To explore whether a long-distance optical image workbench (LOIW) can replace traditional near-distance reading and has beneficial influences on accommodation and choroidal parameters. METHODS This self-control study included two sessions. In session 1, an open-field autorefractor measured sustained accommodative response and pupil diameter when participants viewed virtual images from 3.42 m away through LOIW with + 0.50 D over-correction lenses (3.42 m/+0.50 D), LOIW with full-correction lenses (3.42 m/FC), or the visual target at a given distance of 0.33 m with + 0.50 D over-correction lenses (0.33 m/+0.50 D), with full-correction lenses (0.33 m/FC). In session 2, swept-source optical coherence tomography angiography assessed subfoveal choroidal thickness (SFChT), choroidal volume (CV), and choriocapillaris flow void percentage (FV%) at baseline and before and after reading via LOIW with + 0.50 D over-correction lenses (Far/+0.50 D) or in habitual near distance with full-correction (Near/FC) for a sustained 30-min period. RESULTS Thirty-five myopic (mean spherical equivalent refraction: -1.11 ± 0.78 D) children (median [range] age: 8.36 [8-10] years) were analysed. Children viewing virtual images in 3.42 m/+0.50 D exhibited mild-degree accommodative leads (-0.54 ± 0.17 D), much smaller pupil diameter (3.39 ± 0.63 mm) and microfluctuations (0.13 ± 0.04 D); accommodative lags (0.88 ± 0.04 D), larger pupil diameter (5.05 ± 0.75 mm) and microfluctuations (0.88 ± 0.16 D) were observed in 0.33 m/+0.50 D, and the microfluctuations were unstable (F = 2.185, p = 0.038). Compared with baseline data, SFChT, CV, and FV% changed by 13.40 ± 4.71 μm, 0.26 ± 0.21 mm3, and - 0.14%±3.66% in Far/+0.50 D, respectively, while changes under Near/FC were - 10.19 ± 7.48 μm, -0.15 ± 0.22 mm3 and 1.95%±2.92%, respectively. All changes differed significantly between these two conditions (all p < 0.001). CONCLUSION The long-distance working mode may exert beneficial effects on accommodative and choroidal parameters in myopic children compared with traditional near work.
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Affiliation(s)
- Lu Ma
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Xuewei Li
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Jie Hu
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Yan Li
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
| | - Shanshan Wang
- Beijing Key Laboratory for Precision Optoelectronic Measurement Instrument and Technology, School of Optics and Photonics, Beijing Institute of Technology, Beijing, China
| | - Kai Wang
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Mingwei Zhao
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
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Liu M, Wang Y, Li H, Zhao Y, Ma M, Xu S, Wei X, Xu R, Tian R, Zhou X, Wu H. Differences in choroidal responses to near work between myopic children and young adults. EYE AND VISION (LONDON, ENGLAND) 2024; 11:12. [PMID: 38561862 PMCID: PMC10986059 DOI: 10.1186/s40662-024-00382-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 03/13/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Near work is generally considered as a risk factor for myopia onset and progression. This study aimed to investigate the choroidal responses to a brief-period of near work in children and young adults. METHODS Thirty myopic medical students (aged 18-28 years) and 30 myopic children (aged 8-12 years) participated in this study. The submacular total choroidal area (TCA), luminal area (LA), stromal area (SA), choroidal vascularity index (CVI) and choriocapillaris flow deficit (CcFD), as well as subfoveal choroidal thickness (SFCT) were measured with swept-source optical coherence tomography/optical coherence tomography angiography (SS-OCT/OCTA) before and immediately after 20 min, 40 min, 60 min of near work at a distance of 33 cm. RESULTS In adults, 20 min of near work induced a significant reduction in SFCT (- 5.1 ± 6.5 μm), LA [(- 19.2 ± 18.6) × 103 μm2], SA [(- 8.2 ± 12.6) × 103 μm2] and TCA [(- 27.4 ± 24.9) × 103 μm2] (all P < 0.01). After 40 min of near work, LA was still reduced [(- 9.4 ± 18.3) × 103 μm2], accompanied with a decreased CVI (- 0.39% ± 0.70%) and an increased CcFD (0.30% ± 0.78%) (all P < 0.05). After 60 min of near work, CVI was still reduced (- 0.28% ± 0.59%), and CcFD was still increased (0.37% ± 0.75%) (all P < 0.05). In children, 20 min of near work induced a significant increase in CcFD (0.55% ± 0.64%), while 60 min of near work induced increases in SA [(7.2 ± 13.0) × 103 μm2] and TCA [(9.7 ± 25.3) × 103 μm2] and a reduction in CVI (- 0.28% ± 0.72%) (all P < 0.05). Children exhibited lower near work-induced LA and TCA reduction than adults, with a mean difference of - 0.86% and - 0.82%, respectively (all P < 0.05). CONCLUSIONS The temporal characteristics and magnitude of changes of choroidal vascularity and choriocapillaris perfusion during near work was not identical between children and adults. The initial response to near work was observed in choriocapillaris in children, whereas it was observed in the medium- and large-sized vessels in adults. TRIAL REGISTRATION Clinical Trial Registry (ChiCTR), ChiCTR2000040205. Registered on 25 November 2020, https://www.chictr.org.cn/bin/project/edit?pid=64501 .
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Affiliation(s)
- Mengqi Liu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Yuanyuan Wang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Haoer Li
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Yunpeng Zhao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Min Ma
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Shihan Xu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Xiaohuan Wei
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Ruiyan Xu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Ruikang Tian
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Xiangtian Zhou
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
- Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, Zhejiang, China.
| | - Hao Wu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
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Huang Y, Qiu K, Li Y, Wang H, Zhang M. Temporal trend of anisometropia incidence in Chinese school-aged children before and during the COVID-19 pandemic. Front Med (Lausanne) 2024; 11:1322402. [PMID: 38410753 PMCID: PMC10894982 DOI: 10.3389/fmed.2024.1322402] [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: 10/16/2023] [Accepted: 01/18/2024] [Indexed: 02/28/2024] Open
Abstract
Objective To analyze and compare the temporal trends in the incidence of anisometropia among Chinese school-aged children both before and during the COVID-19 pandemic, and to investigate the impact of the pandemic on the incidence of anisometropia. Methods We conducted a retrospective study comprising six distinct and independent longitudinal cohorts, each including children aged 6 to 13 years who visited the Joint Shantou International Eye Center between January 2010 and December 2021. Children were grouped into cohorts based on the year of their first eye clinic visit: 2010, 2012, 2014, 2016, 2018, or 2020. Only children without anisometropia at initial visits, followed for 18 ± 6 months, were included. The cumulative incidence and risk factors of anisometropia were analyzed using Kaplan-Meier estimation and Cox proportional hazards regression models. Subgroup analyses were performed based on sex, age groups, initial refractive error status, and initial interocular SE difference. Anisometropic children were further categorized into myopic and non-myopic, with subsequent subgroup analyses conducted. Results Of 11,235 children were recruited from six cohorts (2010: n = 1,366; 2012: n = 1,708; 2014: n = 1,896; 2016: n = 2,354; 2018: n = 2,514; 2020: n = 1,397), 869 children developed anisometropia during a mean follow-up of 17.5 ± 3.7 months. After adjustment of confounding factors, we found that the risk of anisometropia remained relatively stable before 2020 but significantly increased in the 2020 cohort (adjusted HR 2.93, 95% CI 2.23 to 3.86; p < 0.001). This trend persisted in studies of spherical anisometropia (adjusted HR 2.52, 95% CI 1.60 to 3.97; p < 0.001) and cylindrical anisometropia (adjusted HR 2.91, 95% CI 1.69 to 3.62; p < 0.001). Older age and a greater initial difference in SE between the two eyes were also significantly associated with a higher risk of developing anisometropia (p < 0.001). Subgroup analyses consistently showed increased risk in the 2020 cohort. Conclusion This study reveals a concerning rise in anisometropia incidence among Chinese school-aged children during the period of the COVID-19 pandemic. These findings highlight the worrisome rise in anisometropia risk during the COVID-19 pandemic and emphasize the importance of early detection and management to safeguard children's visual health.
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Affiliation(s)
- Yin Huang
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou University Medical College, Shantou, China
| | - Kunliang Qiu
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou University Medical College, Shantou, China
| | - Yuancun Li
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou University Medical College, Shantou, China
| | - Hongxi Wang
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou University Medical College, Shantou, China
| | - Mingzhi Zhang
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou University Medical College, Shantou, China
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Biswas S, El Kareh A, Qureshi M, Lee DMX, Sun CH, Lam JSH, Saw SM, Najjar RP. The influence of the environment and lifestyle on myopia. J Physiol Anthropol 2024; 43:7. [PMID: 38297353 PMCID: PMC10829372 DOI: 10.1186/s40101-024-00354-7] [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: 10/23/2023] [Accepted: 01/05/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Myopia, commonly known as near-sightedness, has emerged as a global epidemic, impacting almost one in three individuals across the world. The increasing prevalence of myopia during early childhood has heightened the risk of developing high myopia and related sight-threatening eye conditions in adulthood. This surge in myopia rates, occurring within a relatively stable genetic framework, underscores the profound influence of environmental and lifestyle factors on this condition. In this comprehensive narrative review, we shed light on both established and potential environmental and lifestyle contributors that affect the development and progression of myopia. MAIN BODY Epidemiological and interventional research has consistently revealed a compelling connection between increased outdoor time and a decreased risk of myopia in children. This protective effect may primarily be attributed to exposure to the characteristics of natural light (i.e., sunlight) and the release of retinal dopamine. Conversely, irrespective of outdoor time, excessive engagement in near work can further worsen the onset of myopia. While the exact mechanisms behind this exacerbation are not fully comprehended, it appears to involve shifts in relative peripheral refraction, the overstimulation of accommodation, or a complex interplay of these factors, leading to issues like retinal image defocus, blur, and chromatic aberration. Other potential factors like the spatial frequency of the visual environment, circadian rhythm, sleep, nutrition, smoking, socio-economic status, and education have debatable independent influences on myopia development. CONCLUSION The environment exerts a significant influence on the development and progression of myopia. Improving the modifiable key environmental predictors like time spent outdoors and engagement in near work can prevent or slow the progression of myopia. The intricate connections between lifestyle and environmental factors often obscure research findings, making it challenging to disentangle their individual effects. This complexity underscores the necessity for prospective studies that employ objective assessments, such as quantifying light exposure and near work, among others. These studies are crucial for gaining a more comprehensive understanding of how various environmental factors can be modified to prevent or slow the progression of myopia.
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Affiliation(s)
- Sayantan Biswas
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Antonio El Kareh
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | - Mariyem Qureshi
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | | | - Chen-Hsin Sun
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Janice S H Lam
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Seang-Mei Saw
- Singapore Eye Research Institute, Singapore, Singapore
- Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Raymond P Najjar
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Singapore Eye Research Institute, Singapore, Singapore.
- Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.
- Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore, Singapore.
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Che D, Qiao D, Cao Y, Zhang Y, Zhou Q, Tong S, Miao P, Zhou J. Changes in choroidal hemodynamics of form-deprivation myopia in Guinea pigs. Biochem Biophys Res Commun 2024; 692:149348. [PMID: 38064999 DOI: 10.1016/j.bbrc.2023.149348] [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: 10/06/2023] [Revised: 11/21/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE We studied changes in the choroid, particularly variation in blood flow, during the development of myopia. The hemodynamic mechanism in play remains unclear. We evaluated blood flow by quantitating indocyanine green (ICG) fluorescence in a guinea pig model of form-deprivation myopia. METHODS Guinea pigs were divided into form-deprivation myopia (FDM) and normal control (NC) groups. Ocular biometric and choroidal hemodynamics parameters were quantitatively derived via ICG imaging, and included the maximal ICG fluorescence intensity (Imax), rising time (Trising), blood flow index (BFI), and mean transit time (MTT). RESULTS Form deprivation was associated with significant interocular differences in terms of both refractive error and axial length. ICG fluorescence hemodynamic maps of fundal blood flow and vasculature density were evident. In deprived eyes, the fluorescence signals exhibited significantly longer Trising and MTT but lower Imax and BFI than fellow eyes and NC group. The interocular differences in terms of the ocular biometric and hemodynamic parameters were significantly correlated. Hemodynamic analysis of choriocapillaris lobules revealed weakened fluorescence intensity and prolonged arrival and filling times in deprived eyes. Form deprivation reduced the number of lobulated choriocapillaris structures. CONCLUSION Form-deprivation myopia triggered changes in the hemodynamic and vascular network structures of the choroid and choriocapillaris. The ICG fluorescence imaging/analysis method provides a unique tool for further myopia research.
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Affiliation(s)
- Danyang Che
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Danlei Qiao
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yiting Cao
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingjie Zhang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qimin Zhou
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shanbao Tong
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Peng Miao
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
| | - Jibo Zhou
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Nilsen NG, Gilson SJ, Pedersen HR, Hagen LA, Wildsoet CF, Baraas RC. The effect of topical 1 % atropine on ocular dimensions and diurnal rhythms of the human eye. Vision Res 2024; 214:108341. [PMID: 38065032 DOI: 10.1016/j.visres.2023.108341] [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: 07/10/2023] [Revised: 11/10/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023]
Abstract
The effect of topical 1 % atropine on the diurnal rhythms of the human eye was investigated. Participants wore an activity monitor on Days 1-7. A set of measures (epochs) encompassing intraocular pressure (IOP), ocular biometry, and retinal imaging were obtained on Day 7 (baseline), followed by eight epochs on Day 8, and one on Day 9 from both eyes of healthy participants (n = 22, 19-25 years). The sleep time of participants (collected via actigraphy) was used as a reference in scheduling epochs. Topical 1 % atropine was instilled in the dominant eye on Day 8, 2 h after habitual wake time, using the fellow eye as control (paired-eye design). Sinusoids with a 24-h period were fitted to the data, and a non-linear mixed-effects model was used to estimate rhythmic statistics. There were no interocular differences in any of the measured parameters at baseline. Comparing pre- versus post-atropine in treated eyes revealed lower IOP, deeper anterior chamber (ACD), decreased crystalline lens thickness and shorter axial length (AL). The same trends were observed when comparing atropine-treated versus fellow control eyes, except for IOP and AL (no differences). Both atropine-treated and fellow control eyes showed significant diurnal variations in all ocular parameters, with atropine-treated eyes revealing larger AL and retinal thickness amplitudes, smaller vitreous chamber depth (VCD) amplitudes, and a significant phase advancement for ACD and VCD. There were no interocular differences in choroidal thickness rhythms. In conclusion, while ocular diurnal rhythms persisted after instillation of 1 % atropine, many rhythmic parameters were altered.
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Affiliation(s)
- Nickolai G Nilsen
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Stuart J Gilson
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Hilde R Pedersen
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Lene A Hagen
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Christine F Wildsoet
- Herbert Wertheim School of Optometry & Vision Science, University of California Berkeley, USA
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway.
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Li DL, Qin Y, Zheng YJ, Yin ZJ, Li YZ, Ma R, Liang G, Pan CW. Refractive Associations With Whole Eye Movement Distance and Time Among Chinese University Students: A Corvis ST Study. Transl Vis Sci Technol 2023; 12:13. [PMID: 38085247 PMCID: PMC10720759 DOI: 10.1167/tvst.12.12.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/08/2023] [Indexed: 12/17/2023] Open
Abstract
Purpose Eye movement has been frequently studied in clinical conditions, but the association with myopia has been less explored, especially in population-based samples. The purpose of this study was to assess the associations of eye movement measured by the Corvis ST with refractive status in healthy university students. Methods A total of 1640 healthy students were included in the study (19.0 ± 0.9 years). Eye movement parameters (whole eye movement [WEM]; whole eye movement time [WEMT]) were measured by the Corvis ST. Spherical equivalent (SE) was measured using an autorefractor without cycloplegia. IOL Master was used to assess axial length (AL). Results AL was negatively correlated with WEM and WEMT (rWEM = -0.28, rWEMT = -0.08), and SE was positively correlated with WEM and WEMT (rWEM = 0.21, rWEMT = 0.14). For the risk of high myopia, breakpoint analysis and restricted cubic spline model showed that the knots of the significant steep downward trend of WEM and WEMT were 0.27 mm and 20.4 ms, respectively. The piecewise linear regression model revealed a significant correlation between AL, SE, and WEM when the value of WEM was below 0.27 mm. Additionally, when WEMT exceeded 20.4 ms, a significant decrease in AL and an increase in SE were observed with increasing WEMT. Conclusions A larger distance and longer duration of eye movement were correlated with a lower degree of myopia and shorter AL, and there was a threshold effect. Translational Relevance The findings might aid in understanding the pathogenesis of myopia and provide a theoretical foundation for clinical diagnosis and prediction.
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Affiliation(s)
- Dan-Lin Li
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Yu Qin
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China
| | - Ya-Jie Zheng
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China
| | - Zhi-Jian Yin
- Department of Ophthalmology, the First Affiliated Hospital of Dali University, Dali, China
| | - Yue-Zu Li
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China
| | - Rong Ma
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China
| | - Gang Liang
- Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China
| | - Chen-Wei Pan
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
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Huang Y, Li X, Wu J, Huo J, Zhou F, Zhang J, Yang A, Spiegel DP, Chen H, Bao J. Effect of spectacle lenses with aspherical lenslets on choroidal thickness in myopic children: a 2-year randomised clinical trial. Br J Ophthalmol 2023; 107:1806-1811. [PMID: 36167484 DOI: 10.1136/bjo-2022-321815] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 09/07/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Spectacle lenses with highly aspherical lenslets (HAL) and slightly aspherical lenslets (SAL) showed effective myopia control. This study was to investigate their effects on macular choroidal thickness (ChT) in myopic children. METHODS Exploratory analysis from a 2-year, double-masked, randomised trial. 170 children aged 8-13 years with myopia between -0.75D and -4.75D, astigmatism of 1.50D or less, and anisometropia of 1.00D or less were recruited. Participants were randomly assigned in a 1:1:1 ratio to receive HAL, SAL or single vision spectacle lenses (SVL). The subfoveal, parafoveal and perifoveal ChT were evaluated every 6 months. RESULTS 154 participants completed all examinations. The ChT showed significant changes over time in all three groups in all regions (all p<0.05). The ChTs continuously decreased in the SVL group (ranging from -20.75 (SD 22.34) μm to -12.18 (22.57) μm after 2 years in different regions). Compared with the SVL group, ChT in the SAL group decreased less (ranging from -16.49 (21.27) μm to -5.29 (18.15) μm). In the HAL group, ChT increased in the first year and then decreased in the second year (ranging from -0.30 (27.54) μm to 8.92 (23.97) μm after two years). The perifoveal ChT decreased less than the parafoveal ChT, and the superior region decreased the least. CONCLUSIONS The ChT of the macula decreased after 2 years of myopia progression with SVL. Wearing spectacle lenses with aspherical lenslets reduced or abolished the ChT thinning and HAL had a more pronounced effect. TRIAL REGISTRATION NUMBER ChiCTR1800017683.
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Affiliation(s)
- Yingying Huang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, China
| | - Xue Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, China
| | - Junqian Wu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jiawen Huo
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Fengchao Zhou
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jiali Zhang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Adeline Yang
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, China
- Essilor International SA, Singapore
| | - Daniel P Spiegel
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, China
- Essilor International SA, Singapore
| | - Hao Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jinhua Bao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, China
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10
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Cheong KX, Lim SY, Dan YS, Silverman RH, Chang S, Yannuzzi LA, Freund KB, Ito K, Hoang QV. Ultrasound Assessment of Gaze-induced Posterior Eyewall Deformation in Highly Myopic Eyes. Invest Ophthalmol Vis Sci 2023; 64:38. [PMID: 37878303 PMCID: PMC10615140 DOI: 10.1167/iovs.64.13.38] [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: 04/06/2023] [Accepted: 09/24/2023] [Indexed: 10/26/2023] Open
Abstract
Purpose To establish a quantitative metric of posterior eyewall deformability in different directions of gaze in highly myopic eyes with and without posterior staphyloma. Methods A prospective study was performed on 53 highly myopic patients (106 eyes). Ultrasound scans were acquired in primary, up, downward, nasal, and temporal gazes. A validated intensity-based segmentation algorithm was used to quantify the posterior eyewall geometry on digitalized B-scan images. Posterior eyewall local curvature (K) and distance (L) to the transducer were calculated. The associations between directions of gaze, axial length (AL), and presence of staphyloma with the K and L parameters were assessed. Results A total of 53 participants (106 eyes) were studied. Multivariate regression analysis demonstrated that, after accounting for longer AL, and presence of staphyloma, eccentric gaze was often independently associated with various K and L parameters. Specifically, downward gaze was associated with increased posterior eyewall concavity as reflected in the maximum of K (KMax) (β = 0.050, P < 0.001) and absolute value of KMax (β = 0.041, P = 0.011). Both downward gaze and upgaze were independently associated with increase in the derivative of absolute KMax (which is consistent with more apparent, steeper staphyloma ridges), local KMax (which detects KMax at smaller intervals), and Kstd (which represents likelihood of staphyloma presence) and decrease in maximum of L (which represents movement of the staphyloma apex) with all P < 0.05. The β coefficients for downward gaze were consistently greater in magnitude compared with those in upgaze. After accounting for AL and presence of staphyloma, horizontal gazes were independently associated only with decrease in the standard deviation of L (which also represents likelihood of staphyloma presence) and maximum of L. Conclusions Downward gaze results in a significant increase in posterior eyewall concavity in highly myopic eyes after accounting for AL and staphyloma presence. In comparison with downward gaze, upgaze resulted in a lower magnitude, but significant changes in staphyloma ridge steepness and the likelihood of staphyloma presence. Horizontal gazes seemed to be associated with less posterior eyewall geometric parameters. Studies are required to further assess the association between downward gaze during near work on posterior eyewall concavity and possible effects on myopia development and progression.
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Affiliation(s)
- Kai Xiong Cheong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Shen Yi Lim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Yee Shan Dan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Ronald H. Silverman
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Vagelos College of Physicians and Surgeons, New York City, New York, United States
| | - Stanley Chang
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Vagelos College of Physicians and Surgeons, New York City, New York, United States
| | - Lawrence A. Yannuzzi
- Vitreous Retina Macula Consultants of New York, New York City, New York, United States
| | - K. Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York City, New York, United States
| | - Kazuyo Ito
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Quan V. Hoang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Vagelos College of Physicians and Surgeons, New York City, New York, United States
- Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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11
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Maldoddi R, Thakur S, Verkicharla PK. Authors response: Near work, light levels and dioptric profile - Which factor dominates and influence the short-term changes in axial length? Ophthalmic Physiol Opt 2023. [PMID: 37133239 DOI: 10.1111/opo.13154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 04/11/2023] [Indexed: 05/04/2023]
Affiliation(s)
- Rakesh Maldoddi
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Swapnil Thakur
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Pavan K Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
- Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
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12
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Ostrin LA, Harb E, Nickla DL, Read SA, Alonso-Caneiro D, Schroedl F, Kaser-Eichberger A, Zhou X, Wildsoet CF. IMI-The Dynamic Choroid: New Insights, Challenges, and Potential Significance for Human Myopia. Invest Ophthalmol Vis Sci 2023; 64:4. [PMID: 37126359 PMCID: PMC10153586 DOI: 10.1167/iovs.64.6.4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
The choroid is the richly vascular layer of the eye located between the sclera and Bruch's membrane. Early studies in animals, as well as more recent studies in humans, have demonstrated that the choroid is a dynamic, multifunctional structure, with its thickness directly and indirectly subject to modulation by a variety of physiologic and visual stimuli. In this review, the anatomy and function of the choroid are summarized and links between the choroid, eye growth regulation, and myopia, as demonstrated in animal models, discussed. Methods for quantifying choroidal thickness in the human eye and associated challenges are described, the literature examining choroidal changes in response to various visual stimuli and refractive error-related differences are summarized, and the potential implications of the latter for myopia are considered. This review also allowed for the reexamination of the hypothesis that short-term changes in choroidal thickness induced by pharmacologic, optical, or environmental stimuli are predictive of future long-term changes in axial elongation, and the speculation that short-term choroidal thickening can be used as a biomarker of treatment efficacy for myopia control therapies, with the general conclusion that current evidence is not sufficient.
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Affiliation(s)
- Lisa A Ostrin
- University of Houston College of Optometry, Houston, Texas, United States
| | - Elise Harb
- Herbert Wertheim School of Optometry and Vision Science, University of California Berkeley, Berkeley, California, United States
| | - Debora L Nickla
- Department of Biomedical Sciences and Disease, New England College of Optometry, Boston, Massachusetts, United States
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - David Alonso-Caneiro
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Falk Schroedl
- Center for Anatomy and Cell Biology, Institute of Anatomy and Cell Biology-Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Alexandra Kaser-Eichberger
- Center for Anatomy and Cell Biology, Institute of Anatomy and Cell Biology-Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Xiangtian Zhou
- Eye Hospital and School of Optometry and Ophthalmology, National Clinical Research Center for Ocular Diseases, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Christine F Wildsoet
- Herbert Wertheim School of Optometry and Vision Science, University of California Berkeley, Berkeley, California, United States
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
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13
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Lou L, Ostrin LA. The outdoor environment affects retinal and choroidal thickness. Ophthalmic Physiol Opt 2023; 43:572-583. [PMID: 36779486 PMCID: PMC10081136 DOI: 10.1111/opo.13107] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/27/2023] [Accepted: 01/28/2023] [Indexed: 02/14/2023]
Abstract
PURPOSE Accumulating evidence suggests that time outdoors is protective against myopia development and that the choroid may be involved in this effect. The goal of this study was to examine the effect of 2 h of time outdoors in sunlight on retinal and choroidal thickness in adults. METHODS Twenty adults, ages 23-46 years, each participated in three experimental sessions on different days, consisting of 2 h of exposure to (1) indoor illumination (350 lux), (2) darkness (<0.1 lux) or (3) outdoor environment (6000-50,000 lux). Spectral-domain optical coherence tomography (SD-OCT) imaging was conducted at baseline, after 1 and 2 h of exposure, and after 1 and 2 h of follow-up. Choroidal, total retinal, photoreceptor outer segment + retinal pigment epithelium (RPE) and photoreceptor inner segment thicknesses were determined. RESULTS At 2 h, the choroid was significantly thinner during the outdoor compared with the indoor and dark conditions (p < 0.01) but was not significantly different at follow-up. Total retinal thickness was significantly thicker during and after the outdoor compared with the indoor and dark conditions. The outer segment + RPE was significantly thinner during the outdoor compared with the indoor condition but was not significantly different at follow-up. The inner segment was significantly thicker during the outdoor compared with the indoor and dark conditions during exposure and follow-up. CONCLUSIONS Spending 2 h outdoors under high-intensity sunlight resulted in an unexpected thinning of the choroid, which recovered post-exposure. Retinal thickness showed different responses to the outdoor and indoor environments and was sensitive to the duration of exposure.
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Affiliation(s)
- Linjiang Lou
- College of Optometry, University of Houston, Houston, Texas, USA
| | - Lisa A. Ostrin
- College of Optometry, University of Houston, Houston, Texas, USA
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14
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Maldoddi R, Thakur S, Verkicharla PK. Near work, light levels and dioptric profile - Which factor dominates and influences the short-term changes in axial length? Ophthalmic Physiol Opt 2023; 43:426-434. [PMID: 36734816 DOI: 10.1111/opo.13103] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 01/14/2023] [Accepted: 01/18/2023] [Indexed: 02/04/2023]
Abstract
PURPOSE Given the agonistic nature of near work to promote axial elongation and the antagonistic nature of time outdoors to prevent myopia, we aimed to investigate the following: (a) how the short-term effect of near work performed outdoors (Experiment 1) influences axial length and (b) how near work performed in two different dioptric profiles (uncluttered and cluttered) alters the changes in central axial length (Experiment 2). METHODS Forty-six adults (age range: 19-32 years) participated in the study. In Experiment 1, 22 participants completed a 15-min distance task and a reading task in both the outdoor (~30,000 lux) and indoor (~70 lux) locations. In Experiment 2, 24 participants performed the same reading task at a study desk in uncluttered and cluttered reading environments. Pre- and post-task ocular biometry measurements were performed for each session using a non-contact biometer. RESULTS In Experiment 1, a significant increase in axial length from baseline was found after performing reading tasks in both outdoor (mean ± SEM: +12.3 ± 3.4 μm, p = 0.001) and indoor locations (+11.9 ± 3.1 μm, p = 0.001). In Experiment 2, axial length increased significantly from baseline to post reading task, in both uncluttered (+17.9 ± 3.5 μm, p < 0.001) and cluttered reading environments (+19.2 ± 2.9 μm, p < 0.001). No significant changes in axial length were observed either between outdoor and indoor locations (p = 0.92) or between the uncluttered and cluttered reading environment (p = 0.75). CONCLUSION Independent of light intensity (outdoor or indoor location) and dioptric profile of the near-work environment (uncluttered or cluttered), a 15-min reading task led to a significant increase in axial length. While the long-term effects of these findings need to be evaluated, practitioners should emphasise how near work can reduce the beneficial effects of time outdoors, while providing recommendations related to time outdoors for myopia control.
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Affiliation(s)
- Rakesh Maldoddi
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Swapnil Thakur
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Pavan K Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India.,Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
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15
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Itoi M, Hieda O, Kusada N, Miyatani T, Kojima K, Sotozono C. Progression of Myopic Maculopathy: A Systematic Review and Meta-Analysis. Eye Contact Lens 2023; 49:83-87. [PMID: 36239602 DOI: 10.1097/icl.0000000000000948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE The purpose of this study was to elucidate the risk factors for the progression of myopic maculopathy (MM) based on severity. METHODS In this study, we conducted a systematic review and meta-analysis of the literature published before December 2020 on the risk factors for the progression of MM in patients with pathologic myopia (PM) and high myopia (HM). Odds ratios (ORs) for different stages of myopic maculopathy categorized based on the International Meta-Analysis for PM (META-PM) classification were calculated using fixed and random effects models. RESULTS A total of 12,070 affected eyes derived from 5 cohort studies were included in the systematic review. The presence of PM at baseline was found to be significantly associated with an increased risk of MM progression (pooled ORs: 7.17, 95% confidence interval [CI]: 3.29-15.6), and the greater category of MM at baseline was found to be significantly associated with an increased risk of MM progression, that is, eyes with MM category 3 or more compared with eyes with MM category 2 (pooled OR: 10.95, 95% CI: 6.07-19.76) and eyes with MM category 4 compared with eyes with MM category 3 (pooled ORs: 2.45, 95% CI: 0.28-21.37). CONCLUSIONS The findings in this systematic review and meta-analysis indicate that the progression of MM is associated with more severe MM at baseline.
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Affiliation(s)
- Motohiro Itoi
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
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16
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Bai WL, Kang YT, Li SM, Gan JH, Wei SF, Kang MT, Sun YY, Sun MH, Li H, Zhang FJ, Wang NL. Ocular Perfusion Pressure in 7- and 12-Year-Old Chinese Children: The Anyang Childhood Eye Study. Transl Vis Sci Technol 2022; 11:26. [PMID: 36255359 PMCID: PMC9587466 DOI: 10.1167/tvst.11.10.26] [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] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to report the distribution of mean ocular perfusion pressure (MOPP) and its associated factors in Chinese children. Methods We enrolled 3048 grade 1 students and 2258 grade 7 students of the Anyang Childhood Eye Study in central China. Systolic and diastolic blood pressure (SBP and DBP) were recorded with a digital automatic sphygmomanometer. Intraocular pressure (IOP) was assessed by a non-contact tonometer. MOPP was calculated as 2/3 × (DBP + 1/3[SBP – DBP]) - IOP. Risk factors for myopia were obtained through a questionnaire survey. Results The MOPP was 33.83 ± 6.37 mm Hg (mean ± SD) in grade 1, which was lower than 36.99 ± 6.80 mm Hg in grade 7 (P < 0.001). Compared with myopic eyes, non-myopic eyes had higher MOPP in grade 7 (37.72 ± 6.72 mm Hg versus 36.58 ± 6.57 mm Hg, P < 0.001) and in grade 1 (33.88 ± 6.29 mm Hg versus 33.12 ± 7.03 mm Hg, P = 0.12). Multivariable analysis showed that higher MOPP was associated with less myopia (P < 0.001), higher body mass index (BMI; P < 0.001), thinner central corneal thickness (P < 0.001), less time on near work (P < 0.001), and more time on sleeping (P = 0.04). Conclusions MOPP was higher in children of older age, with higher BMI, less time on near work, and more time on sleeping, and was higher in eyes with less myopia. Translational Relevance We found that MOPP might be an indicator for the detection of myopia development.
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Affiliation(s)
- Wei-Ling Bai
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Yu-Ting Kang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Shi-Ming Li
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Jia-He Gan
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Shi-Fei Wei
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Meng-Tian Kang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Yun-Yun Sun
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Ming-Hao Sun
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - He Li
- Anyang Eye Hospital, Henan Province, Anyang, China
| | - Feng-Ju Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
| | - Ning-Li Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Laboratory, Beijing, China
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Chang X, Li M, Lv L, Yan X, Liu Y, Zhu M, Wang J, Wang P, Xiang Y. Assessment of Choroidal Vascularity and Choriocapillaris Blood Perfusion After Accommodation in Myopia, Emmetropia, and Hyperopia Groups Among Children. Front Physiol 2022; 13:854240. [PMID: 35370764 PMCID: PMC8968861 DOI: 10.3389/fphys.2022.854240] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/24/2022] [Indexed: 11/15/2022] Open
Abstract
Purpose To investigate choroidal vascularity (CV) and choriocapillaris blood perfusion before and after accommodation in myopia, emmetropia, and hyperopia groups among children. Methods This study included 39 myopic eyes from 22 subjects, 17 emmetropic eyes from 11 subjects, and 18 hyperopic eyes from 10 subjects. All subjects were children. Choroidal thickness (CT) and CV, including total choroidal area (TCA), luminal area (LA), and stromal area (SA) were measured using swept-source optical coherence tomography (SS-OCT). Choriocapillaris luminal area (CLA) was measured using SS-OCT-angiography before and after accommodation (near reading with an additional −3 diopter lens). Results For baseline results, except horizontal CV (showing no significant differences between myopia and emmetropia groups), both horizontal and vertical CT and CV were significantly smaller in the myopia group than in the emmetropia or hyperopia groups. In terms of CLA, no significant differences were observed among the myopia, emmetropia, and hyperopia groups. In addition, only myopic eyes showed significant decreases in CT and CV, whereas most CT and CV of emmetropic and hyperopic eyes showed non-significant decreases after accommodation. Furthermore, accommodation induced no significant changes in CLA in the myopia, emmetropia, or hyperopia groups. Conclusion Myopia had thinner baseline choroid and lower baseline choroidal blood perfusion. Furthermore, myopic eyes were more prone to choroidal thinning and blood perfusion decreases after accommodation.
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Affiliation(s)
- Xuejiao Chang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mu Li
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liang Lv
- Department of Ophthalmology, Hankou Aier Eye Hospital, Wuhan, China
| | - Xiaoqin Yan
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ying Liu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengxia Zhu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junming Wang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Wang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Ping Wang,
| | - Yan Xiang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Yan Xiang,
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Malinowski A, Mrugacz M, Stopa M, Filipek E, Moniuszko-Malinowska A, Czupryna P. A Clinical Study of the Impact of Soft Contact Lenses on the Progression of Myopia in Young Patients. Clin Ophthalmol 2022; 16:51-62. [PMID: 35058685 PMCID: PMC8765077 DOI: 10.2147/opth.s338199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/12/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To assess the impact of soft contact lenses on the progression of myopia in young patients. PATIENTS AND METHODS The observational study included 102 patients divided into 3 groups: MFCL (multifocal contact lenses) group: 15 girls and 9 boys, aged 8-20 (= 14.12 ± 2.863) with soft multifocal contact lenses with myopia: = -3.12 D ± 1.776 D and mean myopia progression -0.23 ± 0.233D after 2 years; SVCL (single vision contact lenses) group: 30 girls and 5 boys, 11-20 years old (=15.5 ± 2.24) with myopia = -2.88 ± 2.122 D at admission and mean myopia progression -0.54 ± 0.464 D after 2 years; the spectacle (single vision glasses) group: 25 girls and 18 boys, aged 8-18 years ( = 13.65 ± 2.448) with single vision glasses with myopia: = -1.74 ± 1.412 D at admission and mean myopia progression -0.86 ± 0.489D after 2 years. Medical history and physical examination were performed every 6, 12, 18 and 24 months. Refractive error was examined using the autorefractometry after cycloplegia. RESULTS The analysis of myopia correction after 2 years showed differences between MFCL and spectacle correction. The change in myopia progression after 2 years was statistically significant for MFCL vs SVCL and MFCL vs spectacle correction when the myopia occured before the period of intensive growth. When myopia occurred during the period of intensive growth, difference was noted for MFCL vs spectacle correction and SVCL vs spectacle correction. When myopia occurred after a period of intensive growth, no significant differences between the groups were observed. CONCLUSION 1) Multifocal contact lenses and some single vision contact lenses (Biofinity) may be useful in the control of myopia in younger patients, slowing the progression of nearsightedness; therefore, they can be a therapeutic option in inhibiting the progression of myopia. 2) The best effects of using multifocal contact lenses occur if myopia is diagnosed before the period of intensive growth.
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Affiliation(s)
| | - Małgorzata Mrugacz
- Laboratory of Eye Rehabilitation; Medical University of Białystok, Białystok, Poland
| | - Marcin Stopa
- Department of Ophthalmology, Heliodor Swiecicki University Hospital, Poznan University of Medical Sciences, Poznan, Poland
| | - Erita Filipek
- Clinic and Department of Pediatric Ophthalmology, School of Medicine in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Anna Moniuszko-Malinowska
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Białystok, Poland
| | - Piotr Czupryna
- Department of Infectious Diseases and Neuroinfections, Medical University of Białystok, Białystok, Poland
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Hoseini-Yazdi H, Read SA, Alonso-Caneiro D, Collins MJ. Retinal OFF-Pathway Overstimulation Leads to Greater Accommodation-Induced Choroidal Thinning. Invest Ophthalmol Vis Sci 2021; 62:5. [PMID: 34636878 PMCID: PMC8525845 DOI: 10.1167/iovs.62.13.5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose To examine the interactions between accommodation and overstimulation of the retinal ON- and OFF-pathways, and their association with changes in choroidal thickness (ChT) and vascularity. Methods Optical coherence tomography imaging of the choroid of twenty young adults (ages 25 ± 5 years) was performed before and after a series of 30-minute-long viewing tasks, including reading a bright text on dark background (ON-pathway overstimulation) and dark text on bright background (OFF-pathway overstimulation), and a control task of viewing a movie with unbiased ON-/OFF-pathway activation. The viewing tasks were performed with relaxed, and 5 diopter (D) accommodation (induced by soft contact lenses) demands. Both reading texts were matched for the mean luminance (35 cd/m2), luminance contrast (87%), and letter size (approximately 11.8 arc minutes). The change in ChT from baseline associated with contrast polarity and accommodation was examined using linear mixed model analysis. Results The subfoveal ChT decreased significantly by −7 ± 1 µm with 5 D accommodation compared with relaxed accommodation (−3 ± 1 µm; P < 0.001), and by −9 ± 1 µm with OFF-pathway compared with ON-pathway overstimulation (−4 ± 1 µm; P = 0.002) and the control condition (−2 ± 1 µm; P < 0.001). Overstimulation of the OFF-pathway, but not the ON-pathway, resulted in a significantly greater choroidal thinning compared with the control condition, both at relaxed (−7 ± 1 µm; P = 0.003) and 5 D (−11 ± 1 µm; P = 0.005) accommodation levels. Similar changes were also observed for macular total, stromal, and luminal ChT. Conclusions Retinal OFF-pathway stimulation enhanced the choroidal thinning associated with accommodation, thereby providing a potential mechanism that involves accommodation and the retinal OFF-signaling pathway, linking near work and myopia.
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Affiliation(s)
- Hosein Hoseini-Yazdi
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - David Alonso-Caneiro
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
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Thakur S, Verkicharla PK. Greater axial elongation associated with low accommodative lag: new insights on accommodative lag theory for myopia. Ophthalmic Physiol Opt 2021; 41:1355-1362. [PMID: 34569632 DOI: 10.1111/opo.12893] [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: 05/05/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE We aimed to test the accommodative lag and mechanical tension theories for myopia by assessing the influence of the lag of accommodation on axial elongation by using three different near targets that are known to influence the accommodative response differently. METHODS Forty-two young adults were recruited for the study. Axial length was measured using a non-contact biometer, before and immediately after a 15 minute visual task, with one of the three near targets placed 20 cm from the eye: reading text from a paper, reading text from a smartphone and watching a video on a smartphone. The accommodative response was determined using an open-field autorefractor while the participants viewed the near target monocularly. RESULTS Lag of accommodation was significantly different for the three tasks: watching a video (mean ± standard error of the mean [SEM] 0.92 ± 0.10 D); reading text on the smartphone (0.59 ± 0.08 D); and reading text on paper (0.24 ± 0.09 D). There was a significant (p < 0.05) increase in axial length after reading text from a paper (10.5 ± 1.9 µm after 15-min) and reading text from a smartphone (5.2 ± 2.7 µm), but not after watching a video on a smartphone (-0.5 ± 1.7 µm, p = 0.47). Vitreous chamber depth increased significantly more with the reading tasks compared with watching a video (reading text from a paper and smartphone: 33.9 ± 4 µm and 31.7 ± 4 µm vs. watching a video on a smartphone: 14.6 ± 5 µm, p = 0.001). CONCLUSION Greater changes in axial length associated with the low lag of accommodation failed to support the theory that lag of accommodation during visual tasks could be the trigger for axial elongation. Reading on paper and smartphone at the closest reading distance may stimulate high accommodative demand and axial elongation as a consequence, possibly due to increased "ciliary muscle tension" during accommodation.
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Affiliation(s)
- Swapnil Thakur
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Pavan K Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, 500034, India
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21
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Vasudeva A, Dhakal R, Vupparaboina KK, Verkicharla PK. Do rectus muscle parameters vary between emmetropes and myopes? Ophthalmic Physiol Opt 2021; 41:1300-1307. [PMID: 34549823 DOI: 10.1111/opo.12890] [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: 05/14/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE This study investigated the thickness, area, and insertion site of the medial (MR) and lateral (LR) rectus muscles in individuals with emmetropia and different degrees of myopia. METHODS Swept-source optical coherence tomography images of the MR and LR muscles in 80 participants including emmetropes (spherical equivalent refractive error [SER] ±0.50 D, N = 14) and myopes (≤ -0.75 D, N = 66), were analysed. Custom-designed, semi-automated software was used to measure parameters such as insertion distance from limbus, muscle thickness at every 1 mm interval to 3 mm periphery and muscle area from insertion site to 3 mm. RESULTS The median (Q1, Q3) SER error and axial length were -6.00 D (-13.25, -2.12) and 25.78 mm (23.78, 28.61), respectively. The MR was significantly thinner (mean ± SE: 137.7 ± 8.9 vs. 159.7 ± 8.9 µm, p < 0.01) and occupied less area than the LR (0.35 ± 0.01 vs. 0.42 ± 0.01 mm2 , respectively, p < 0.01). The thickness of the MR gradually increased from the insertion site to a 3 mm peripheral eccentric location (106.5 3.8 µm at 1 mm, 135.5 ± 4.5 µm at 2 mm and 156.1 ± 5.9 µm at 3 mm, p < 0.01). The overall median thickness of the MR was significantly less in myopes (129 µm [111.5, 152.2]) than emmetropes (158.1 [134.3, 167.7] µm, p = 0.03). However, no such trend was seen in the LR muscle. Muscle area and insertion distance were not different between emmetropes and myopes in both horizontal rectus muscles. CONCLUSION Unlike the LR, the parameters of the MR (thin and occupying less area) show significant association with myopia. While the key finding of this study indicates the possible association of MR parameters with myopia, the clinical relevance of this finding and its role in myopiogenesis/progression needs to be investigated further.
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Affiliation(s)
- Ashish Vasudeva
- Myopia Research Lab, Brien Holden Institute of Optometry and Vision Sciences, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Rohit Dhakal
- Myopia Research Lab, Brien Holden Institute of Optometry and Vision Sciences, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Kiran Kumar Vupparaboina
- Ophthalmic Engineering Group, LVPEI Centre for Innovation, L V Prasad Eye Institute, Hyderabad, India
| | - Pavan K Verkicharla
- Myopia Research Lab, Brien Holden Institute of Optometry and Vision Sciences, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
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22
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Wang X, Chang S, Grinband J, Yannuzzi LA, Freund KB, Hoang QV, Girard MJ. Optic nerve tortuosity and displacements during horizontal eye movements in healthy and highly myopic subjects. Br J Ophthalmol 2021; 106:1596-1602. [PMID: 34039559 DOI: 10.1136/bjophthalmol-2021-318968] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 05/13/2021] [Indexed: 11/03/2022]
Abstract
AIMS (1) To assess the morphology and 3-dimensional (3D) displacements of the eye globe and optic nerve (ON) in adduction/abduction using MRI. (2) To assess differences between healthy emmetropic and highly myopic (HM) subjects. METHODS MRI volumes of both eyes from 18 controls and 20 HM subjects in primary gaze, abduction and adduction (15°) were postprocessed. All ONs were manually segmented and fitted to a 3D curve to assess ON tortuosity. ON displacements were evaluated in four quasicoronal planes which were perpendicular to the ON in primary gaze and were 3 mm apart. RESULTS Axial length was higher in the HM group (28.62±2.60 vs 22.84±0.89 mm; p<0.0001). Adjusted ON tortuosities (ie, ON tortuosities estimated before myopia onset) were lower in HM eyes (0.9063±0.0591) versus controls (1.0152±0.02981) in primary gaze, adduction (0.9023±0.05538 vs 1.0137±0.0299) and abduction (0.9100±0.0594 vs 1.0182±0.0316); p<0.0001 for all cases. In all eyes, ON displacements in adduction were significantly different from those in abduction in the naso-temporal direction (p<0.0001 in all planes) but not in the supero-inferior direction. ON displacements in the posterior segments of the ON were smaller in the HM group in both gaze directions and were larger in the anterior-most ON segment in adduction only. CONCLUSION The adjusted tortuosity of the ON was significantly lower in HM eyes, suggesting that eyes destined towards HM exhibited higher ON traction forces during eye movements before the onset of myopia. Our ON metrics may be valuable to explore a potential link between eye movements and axial elongation.
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Affiliation(s)
- Xiaofei Wang
- Beijing Advanced Innovation Center for Biomedical Engineering, Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.,Ophthalmic Engineering & Innovation Laboratory, Singapore Eye Research Institute, Singapore
| | - Stanley Chang
- Department of Ophthalmology, College of Physicians and Surgeons, Edward S. Harkness Eye Institute, Columbia University, New York, New York, USA
| | - Jack Grinband
- Department of Radiology, Columbia University Irving Medical Center, New York, New York, USA
| | | | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, New York, USA
| | - Quan V Hoang
- Department of Ophthalmology, College of Physicians and Surgeons, Edward S. Harkness Eye Institute, Columbia University, New York, New York, USA .,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Duke-NUS Medical School, Singapore
| | - Michael Ja Girard
- Ophthalmic Engineering & Innovation Laboratory, Singapore Eye Research Institute, Singapore .,Duke-NUS Medical School, Singapore
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23
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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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24
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Hoang QV, Chang S, Yu DJG, Yannuzzi LA, Freund KB, Grinband J. 3-D assessment of gaze-induced eye shape deformations and downgaze-induced vitreous chamber volume increase in highly myopic eyes with staphyloma. Br J Ophthalmol 2020; 105:1149-1154. [PMID: 32830122 DOI: 10.1136/bjophthalmol-2020-316084] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 07/08/2020] [Accepted: 07/20/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE To determine if the stress of normal eye movements results in gaze-induced globe deformations, vitreous chamber axial length and vitreous chamber axial volume (VCAV) change in highly myopic eyes. METHODS A prospective imaging study was performed on 82 eyes of 43 patients with high myopia (>27 mm of axial length) with a clinical diagnosis of staphyloma. Three-dimensional MRI scans were acquired while subjects gazed in five directions (primary, nasal, temporal, superior and inferior). Surface renderings were generated, and a processing pipeline was created to automate alignment of the eye and to measure VCAV within 5.5 mm of the visual axis for each eye in every gaze. The degree of gaze-induced globe deformation was determined by calculating the Dice coefficient to assess the degree of overlap of the sclera at each eccentric gaze with that found in primary gaze. Each eccentric gaze VCAV was compared to VCAV in primary gaze using a fixed-effects regression allowing for subject-specific and eye-specific effects. RESULTS The Dice coefficient showed significant gaze-induced eye shape changes in all gazes (all p<0.0001). There were no statistically significant gaze-induced VCAV changes when comparing primary gaze to nasal, temporal or upgaze. However, when changing from primary to downgaze, VCAV was increased by +4.79 mm3 (p=0.002, 95% CI 1.71 to 7.86). CONCLUSION Significant gaze-induced globe deformation was noted in all gazes, but a reversible, instantaneous VCAV increase occurred only in downgaze, which is consistent with studies supporting the association of environmental factors such as near work with myopia development and progression.
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Affiliation(s)
- Quan V Hoang
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke National University of Singapore, Singapore .,Ophthalmology, Columbia University College of Physicians and Surgeons, New York City, New York, USA
| | - Stanley Chang
- Ophthalmology, Columbia University College of Physicians and Surgeons, New York City, New York, USA
| | - Daryle Jason Go Yu
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke National University of Singapore, Singapore
| | | | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, New York, USA
| | - Jack Grinband
- Radiology, Columbia University College of Physicians and Surgeons, New York City, New York, USA
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25
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Wong K, Dahlmann-Noor A. Myopia and its progression in children in London, UK: a retrospective evaluation. JOURNAL OF OPTOMETRY 2020; 13:146-154. [PMID: 31992534 PMCID: PMC7301194 DOI: 10.1016/j.optom.2019.06.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/29/2019] [Accepted: 06/26/2019] [Indexed: 05/13/2023]
Abstract
PURPOSE Worldwide, the prevalence of myopia is increasing. Myopia begins at younger ages and progresses faster, leading to more adults with high myopia and risk of sight-threatening complications. No data are available about myopia trends in children in urban areas in the UK. We present a 10-year review of children attending a secondary and tertiary eye care facility in London, focussing on the proportion of glasses prescriptions for myopia and progression rates. METHODS We collated refraction and demographic data from children under the age of 17 years seen at Moorfields Eye Hospital, London, UK, between 2008 and 2017. RESULTS We included 63,854 datasets from 23,593 children (51.2% boys, median age 5.4 years, interquartile range IQR 3.8-7.1). The proportion of myopic prescriptions increased from 24 to 32%. In n = 3355 with initial mild/moderate myopia, median progression rate was -0.16 (-0.5 to 0.04) D/year. In those with progression (n = 2095), the rate was -0.40 (-0.19 to -0.74) D/year, slightly higher in girls than in boys (-0.42 vs -0.38 D/year; p = 0.02). Progression was faster in initial moderate than initial mild myopia (-0.54 vs -0.37 D/year; p < 0.001), and before than after average age of onset of puberty (-0.41 vs -0.35 D/year; p = 0.013). There was no statistically significant difference between children of different ethnic backgrounds. CONCLUSIONS In this cohort, the proportion of glasses prescriptions for myopia and the rate of progression are higher than previously reported for European countries. Living in an urban environment may result in similar progression rates despite different genetic backgrounds.
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Affiliation(s)
- Karen Wong
- Paediatric Service, Moorfields Eye Hospital and UCL Institute of Ophthalmology, 162 City Road, London EC1V 2PD, UK
| | - Annegret Dahlmann-Noor
- Paediatric Service, Moorfields Eye Hospital and UCL Institute of Ophthalmology, 162 City Road, London EC1V 2PD, UK; NIHR Moorfields Biomedical Research Centre, 162 City Road, London EC1V 2PD, UK.
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26
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Tong L, Cui D, Zeng J. Effects of topical pilocarpine on ocular growth and refractive development in rabbits. Eur J Ophthalmol 2020; 31:2107-2115. [PMID: 32524847 DOI: 10.1177/1120672120934962] [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] [Indexed: 11/16/2022]
Abstract
PURPOSE This study aimed to investigate whether topical pilocarpine affects ocular growth and refractive development as well as the underlying biochemical processes in early eye development in rabbits. METHODS Twenty three-week-old New Zealand white rabbits were treated with 0.5% pilocarpine in the right eye for 6 weeks. The left eyes served as contralateral controls. The effects of pilocarpine on refractive error, corneal curvature and ocular biometrics were assessed using streak retinoscopy, keratometry, and A-scan ultrasonography, respectively. Eyeballs were enucleated for histological analysis. The ciliary body and sclera were homogenized to determine the mRNA and protein expression levels of five subtypes of muscarinic receptors. RESULTS Compared to control eyes, pilocarpine-treated eyes exhibited approximately -1.63 ± 0.54 D myopia accompanied by a 0.11 ± 0.04 mm increase in axial length (AL) (p < 0.001, respectively). The anterior chamber depth (ACD) was reduced, whereas the lens thickness (LT) and vitreous chamber depth (VCD) increased (p < 0.001, respectively). Corneal curvature decreased over time but was not significantly different between treated and control eyes. The mRNA and protein expression levels of five subtypes of muscarinic receptors were upregulated in the ciliary body and downregulated in the sclera. CONCLUSIONS Based on these results, pilocarpine can induce myopic shift, increase LT, elongate VCD and AL, and reduce muscarinic receptor expression in the sclera early in development. These changes raise the possibility that pilocarpine may promote axial elongation in ocular development and facilitate the emmetropization of hyperopic eyes.
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Affiliation(s)
- Liyang Tong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Dongmei Cui
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Junwen Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
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27
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Shao Y, Jiang Q, Hu D, Zhang L, Shen M, Huang S, Leng L, Yuan Y, Chen Q, Zhu D, Wang J, Lu F. Axial elongation measured by long scan depth optical coherence tomography during pilocarpine-induced accommodation in intraocular lens-implanted eyes. Sci Rep 2018; 8:1981. [PMID: 29386651 PMCID: PMC5792446 DOI: 10.1038/s41598-018-19910-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 01/09/2018] [Indexed: 12/30/2022] Open
Abstract
We used an ultra-long scan depth optical coherence tomography (UL-OCT) system to investigate changes in axial biometry of pseudophakic eyes during pilocarpine- induced accommodation. The right eyes from 25 healthy subjects (age range 49 to 84 years) with an intraocular lens (IOL) were imaged twice in the non-accommodative and the accommodative states. A custom-built UL-OCT instrument imaged the whole eye. Then accommodation was induced by two drops of 0.5% pilocarpine hydrochloride separated by a 5-minute interval. Following the same protocol, images were acquired again 30 minutes after the first drop. The central corneal thickness (CCT), anterior chamber depth (ACD), IOL thickness (IOLT), and vitreous length (VL) were obtained using custom automated software. The axial length (AL) was calculated by summing the CCT, ACD, IOLT, and VL. With accommodation, ACD increased by +0.08 ± 0.09 mm, while the VL decreased by −0.04 ± 0.09 mm (paired t-test each, P<0.05). CCT and IOLT remained constant during accommodation (P > 0.05). The non-accommodative AL was 23.47 ± 0.93 mm, and it increased by +0.04 ± 0.04 mm after accommodation (P<0.01). The AL increased and the IOL moved backward during pilocarpine-induced accommodation in pseudophakic eyes.
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Affiliation(s)
- Yilei Shao
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qiuruo Jiang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Di Hu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lingmin Zhang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Meixiao Shen
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shenghai Huang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lin Leng
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yimin Yuan
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qi Chen
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Dexi Zhu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jianhua Wang
- Bascom Palmer Eye Institute, Department of Ophthalmology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Fan Lu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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28
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Lee CW, Fang SY, Tsai DC, Huang N, Hsu CC, Chen SY, Chiu AWH, Liu CJL. Prevalence and association of refractive anisometropia with near work habits among young schoolchildren: The evidence from a population-based study. PLoS One 2017; 12:e0173519. [PMID: 28273153 PMCID: PMC5342266 DOI: 10.1371/journal.pone.0173519] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 02/21/2017] [Indexed: 12/15/2022] Open
Abstract
Background Lifestyle behaviour may play a role in refractive error among children, but the association between near work habits and refractive anisometropia remains unclear. Methods We estimated the prevalence of refractive anisometropia and examined its association with near work activities among 23,114 children in the Myopia Investigation Study in Taipei who were grade 2 elementary school students at baseline in 2013 and 2014. Baseline data on demographics, medical history, parental history and near work habits were collected by parent-administered questionnaire survey. Refractive status was determined by cycloplegic autorefraction. Refractive anisometropia was defined as the spherical equivalent difference ≥ 1.0 diopter between eyes. Results The prevalence of refractive anisometropia was 5.3% (95% confidence interval [CI], 5.0% to 5.6%). The prevalence and severity of refractive anisometropia increased with both myopic and hyperopic refractive error. Multivariate logistic regression analysis revealed that refractive anisometropia was significantly associated with myopia (odds ratio [OR], 2.98; 95% CI, 2.53–3.51), hyperopia (OR, 2.37; 95% CI, 1.98–2.83), degree of astigmatism (OR, 1.005; 95% CI, 1.005–1.006), amblyopia (OR, 2.54; 95% CI, 2.06–3.12), male gender (OR, 0.88; 95% CI, 0.78–0.99) and senior high school level of maternal education (OR, 0.69; 95% CI, 0.52–0.92). Though anisometropic children were more likely to spend more time on near work (crude OR, 1.15; 95% CI, 1.02–1.29) and to have less eye-to-object distance in doing near work (crude OR, 1.15; 95% CI, 1.01–1.30), these associations became insignificant after additional adjustment for ocular, demographic and parental factors. Conclusions The present study provides large-scale, population-based evidence showing no independent association between refractive anisometropia and near work habits, though myopia is associated with refractive anisometropia.
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Affiliation(s)
- Chia-Wei Lee
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shao-You Fang
- Children and Family Research Center, National Taiwan University, Taipei, Taiwan
| | - Der-Chong Tsai
- National Yang-Ming University School of Medicine, Taipei, Taiwan
- Department of Ophthalmology, National Yang-Ming University Hospital, Yilan, Taiwan
- * E-mail: (CJLL); (DCT)
| | - Nicole Huang
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Chih-Chien Hsu
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shing-Yi Chen
- Department of Health, Taipei City Government, Taipei, Taiwan
| | | | - Catherine Jui-Ling Liu
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
- National Yang-Ming University School of Medicine, Taipei, Taiwan
- * E-mail: (CJLL); (DCT)
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