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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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Ambrosini G, Poletti S, Roberti G, Carnevale C, Manni G, Coco G. Exploring the relationship between accommodation and intraocular pressure: a systematic literature review and meta-analysis. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06565-z. [PMID: 39039270 DOI: 10.1007/s00417-024-06565-z] [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: 01/15/2024] [Revised: 06/09/2024] [Accepted: 06/20/2024] [Indexed: 07/24/2024] Open
Abstract
PURPOSE To investigate the relationship between accommodation and intraocular pressure (IOP). METHODS Systematic literature search and meta-analysis following PRISMA guidelines was conducted on studies analyzing the relationship between accommodation and intraocular pressure. After removal of duplicates, title and abstract screening, full-text analysis was performed to select relevant articles and meta-analysis was then conducted as well. RESULTS Of the 1357 records identified, 17 met the selection criteria and were included. Overall, all studies showed that accommodation can influence IOP levels and meta-analysis indicated a significant IOP reduction of 1.10 mmHg (95%CI, -1.77; -0.42) following accommodative stimulus in healthy individuals, albeit with high heterogeneity among studies. Differences in IOP changes between emmetropic and progressing myopic individuals were not significant. Controversial results were obtained in patients with glaucoma with significantly lower IOP fluctuations being noted in eyes with previous trabeculectomy; however, the clinical heterogeneity of enrolled patients among studies made it not possible to combine results. Type of accommodative task, extraocular muscle contraction, head and body position all could potentially play a role in the measured IOP changes with, interestingly, near reading on a smartphone suggesting IOP increase. CONCLUSION Accommodation has an impact on IOP measurements and, overall, determines IOP decrease in healthy individuals. While such variations might not hold clinical significance for individuals in good health, their impact in patients with glaucoma should be considered. Further studies focused on specific components of such relationship are required to elucidate their individual impact and to define their potential role as non-pharmacological strategies to reduce IOP levels in selected patient categories.
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Affiliation(s)
- Giacomo Ambrosini
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Silvia Poletti
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Gloria Roberti
- IRCCS-Fondazione Bietti, Rome, Via Livenza, 3, Rome, 00198, Italy
| | | | - Gianluca Manni
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
- IRCCS-Fondazione Bietti, Rome, Via Livenza, 3, Rome, 00198, Italy
| | - Giulia Coco
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy.
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Medina A. Models of myopia: the effect of accommodation, lenses and atropine. Eye (Lond) 2024; 38:1290-1295. [PMID: 38087120 PMCID: PMC11076616 DOI: 10.1038/s41433-023-02884-3] [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: 08/09/2022] [Revised: 11/09/2023] [Accepted: 11/30/2023] [Indexed: 05/09/2024] Open
Abstract
BACKGROUND Two quantitative models for myopia have been proposed and used for myopic intervention, one derived from feedback theory, and the other from physiological and mechanical considerations. This paper shows that they both predict the same results indicating that they are valid and reliable. These models are the only ones that can make predictions about the effect of atropine and lenses on myopia, explain multiple observations heretofore unexplained and offer possible interventions. OBJECTIVE Using their predictive power we test the models by calculating and comparing the effect of accommodation, lenses or atropine. The models offer a rationale that makes atropine equivalent to a positive lens for purposes of refractive development. METHODS This report includes thought experiments, actual experiments and trials, as well as an analysis of clinical data and integrates and tests results from all of them for far-reaching conclusions. RESULTS Both models accurately predict the same myopia progression caused by near work. These models are simple but powerful enough to suggest what treatments are indicated. Interventions for prevention and control of myopia are evaluated analytically, in particular atropine and optical treatments, such as positive lenses and under correction. CONCLUSION Optical treatments have enormous potential; atropine is of questionable value since there are ways to get the same or superior effect with lenses of power calculated as described here.
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Affiliation(s)
- Antonio Medina
- Massachusetts Institute of Technology, EE Research Laboratory, 77 Massachusetts Ave, Cambridge, MA, 02139, USA.
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Mahmood M, Day M, Seidel D, Cameron LA. The effect of multifocal contact lenses on the dynamic accommodation step response. Ophthalmic Physiol Opt 2024; 44:321-333. [PMID: 38303152 DOI: 10.1111/opo.13275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/19/2023] [Accepted: 12/26/2023] [Indexed: 02/03/2024]
Abstract
PURPOSE To measure the dynamic accommodation response (AR) to step stimuli with and without multifocal contact lenses (MFCLs), in emmetropes and myopes. METHODS Twenty-two adult subjects viewed alternating distance (0.25D) and near (3D) Maltese crosses placed in free space, through two contact lens types: single vision (SVCL) or centre-distance multifocal (MFCL; +2.50D add). The AR level was measured along with near to far (N-F) and far to near (F-N) step response characteristics: percentage of correct responses, magnitude, latency, peak velocity and duration of step response. RESULTS There was no difference between N-F and F-N responses, or between refractive groups in any aspect of the accommodation step response dynamics. The percentage of correct responses was unaffected by contact lens type. Through MFCLs, subjects demonstrated smaller magnitude, longer latency, shorter duration and slower peak velocity steps than through SVCLs. When viewing the near target, the AR through MFCLs was significantly lower than through SVCLs. When viewing the distance target with the MFCL, the focal points from rays travelling through the distance and near zones were approximately 0.004D behind and 2.50D in front of the retina, respectively. When viewing the near target, the respective values were approximately 1.89D behind and 0.61D in front of the retina. CONCLUSION The defocus error required for accommodation control appears not to be solely derived from the distance zone of the MFCL. This results in reduced performance in response to abruptly changing vergence stimuli; however, these errors were small and unlikely to impact everyday visual tasks. There was a decrease in ocular accommodation during near tasks, which has previously been correlated with a reduced myopic treatment response through these lenses. With MFCLs, the estimated dioptric myopic defocus was the largest when viewing a distant stimulus, supporting the hypothesis that the outdoors provides a beneficial visual environment to reduce myopia progression.
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Affiliation(s)
- Mubeen Mahmood
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Mhairi Day
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Dirk Seidel
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Lorraine A Cameron
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
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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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Ale Magar JB, Shah SP, Dai S. Comparison of biometric and refractive changes in intermittent exotropia with and without overminus lens therapy. Br J Ophthalmol 2023; 107:1526-1531. [PMID: 35793948 DOI: 10.1136/bjo-2022-321509] [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: 03/18/2022] [Accepted: 06/25/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Overminus lens is an effective non-surgical treatment of intermittent exotropia (IXT). Whether this treatment causes development of myopia is recently debated. This study evaluated ocular biometric changes in IXT children treated with and without overminus lens. METHODS Children with IXT were randomly assigned to control and overminus groups. Cycloplegic refraction, axial length and other parameters (keratometry, anterior chamber depth and lens thickness) were evaluated for up to 30 months and compared between the groups. Axial length to corneal curvature (AL/CR) ratio was examined as an indicator of myopia progression. Changes prior to and after overminus were also assessed in a subgroup. RESULTS Mean age of the total 84 subjects (58% women) was 7.2 years (range 4-15 years). Baseline refractive and biometric parameters of 39 control and 45 overminus subjects were not significantly different. Mean±SD change in refraction was -0.34±0.45D in controls and -0.41±0.66D in overminus group (p=0.527). AL increased by 0.29±0.20 millimetre (mm) in controls and 0.28±0.23 mm in overminus group (p=0.766). In the subgroup, the changes before and after overminus therapy was not significantly different (p>0.05). AL/CR ratio was maintained from baseline to follow-up visit (p=0.298) in both groups. CONCLUSION No significant differences in biometry or refraction were found between the two groups and before and after the therapy. We conclude that the overminus therapy in children, not accounting for other myopia risk factors, does not affect normal refractive growths.
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Affiliation(s)
- Jit B Ale Magar
- Ophthalmology, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Shaheen P Shah
- Ophthalmology, Queensland Children's Hospital, South Brisbane, Queensland, Australia
- School of Clinical Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Shuan Dai
- School of Clinical Medicine, The University of Queensland, Saint Lucia, Queensland, Australia
- Department of Ophthalmology, Queensland Children's Hospital, South Brisbane, Queensland, Australia
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Qu G, Wang B, Ding S, Liu X, Gao L, Wang X. Effects of Cycloplegic Agents on Ocular Parameters in Children with Myopia and Hyperopia. J Ophthalmol 2023; 2023:9003942. [PMID: 37215948 PMCID: PMC10195164 DOI: 10.1155/2023/9003942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/15/2023] [Accepted: 05/03/2023] [Indexed: 05/24/2023] Open
Abstract
Background To study the effect of cycloplegia on ocular parameters in children with myopia and hyperopia. Methods Forty-two myopia and forty-four hyperopia eyes in children between 5 and 10 years of age were included. Measurements were taken before and after cycloplegia using 1% atropine sulfate ointment. The ocular parameters included central corneal thickness (CCT), corneal curvature (CC), anterior chamber depth (ACD), pupil diameter (PD), axial length (AL), and central retinal thickness (CRT). Results There was no significant difference in CCT, CC, and CRT between the two groups without cycloplegia, but the ACD of the myopia (3.64 ± 0.28 mm) group was significantly higher than that of hyperopia (3.40 ± 0.24 mm; t = -4.522; P < 0.0001). The average PD of the myopia (4.85 ± 0.87 mm) group was significantly smaller than that of the hyperopia group (5.47 ± 1.15 mm; t = 2.903; P < 0.0046). The average AL of myopia (24.25 ± 0.77 mm) was significantly higher than that of hyperopia (21.73 ± 1.24 mm; t = 12.084; P < 0.0001). However, it was found that the average PD of myopia (7.68 ± 0.51 mm) was significantly larger than that of hyperopia (7.41 ± 0.57 mm; t = 2.364; P=0.0202) under cycloplegia. As for the changes in refractive factors before and after cycloplegia, deepened ACD and enlarged PD were noted in both the groups after cycloplegia. Conclusions Cycloplegia not only affects ACD and PD but also leads to the reversal of PD differences between the two groups. Cycloplegia effects enabled us to study changes in all known ocular parameters in a short period.
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Affiliation(s)
- Guangzhi Qu
- Department of Ophthalmology, Weifang Eye Hospital, Zhengda Guangming Eye Group, Weifang, China
| | - Bingfeng Wang
- Department of Ophthalmology, Weifang Eye Hospital, Zhengda Guangming Eye Group, Weifang, China
| | - Saisai Ding
- Department of Ophthalmology, Weifang Eye Hospital, Zhengda Guangming Eye Group, Weifang, China
| | - Xiaocui Liu
- Department of Ophthalmology, Weifang Eye Hospital, Zhengda Guangming Eye Group, Weifang, China
| | - Lei Gao
- Department of Ophthalmology, Weifang Eye Hospital, Zhengda Guangming Eye Group, Weifang, China
- Zhengda Guangming International Eye Research Center, Qingdao University, Qingdao, China
| | - Xuli Wang
- Department of Ophthalmology, Weifang Eye Hospital, Zhengda Guangming Eye Group, Weifang, China
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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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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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Xiang A, Du K, Fu Q, Zhang Y, Zhao L, Yan L, Wen D. Do monocular myopia children need to wear glasses? Effects of monocular myopia on visual function and binocular balance. Front Neurosci 2023; 17:1135991. [PMID: 37034177 PMCID: PMC10073496 DOI: 10.3389/fnins.2023.1135991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Objective This study aims to compare the binocular visual functions and balance among monocular myopic adolescents and adults and binocular low myopic adolescents and explore whether monocular myopia requires glasses. Methods A total of 106 patients participated in this study. All patients were divided into three groups: the monocular myopia children group (Group 1 = 41 patients), the monocular myopia adult group (Group 2 = 26 patients) and the binocular low myopia children group (Group 3 = 39 patients). The refractive parameters, accommodation, stereopsis, and binocular balance were compared. Results The binocular refractive difference in Group 1, Group 2, and Group 3 was -1.37 ± 0.93, -1.94 ± 0.91, and -0.32 ± 0.27 D, respectively. Moreover, uncorrected visual acuity (UCVA), spherical equivalent (SE) and monocular accommodative amplitude (AA) between myopic and emmetropic eyes in Group 1 and Group 2 were significantly different (all P < 0.05). There was a significant difference in the accommodative facility (AF) between myopic and emmetropic eyes in Group 2 (t = 2.131, P = 0.043). Furthermore, significant differences were found in monocular AA (t = 6.879, P < 0.001), binocular AA (t = 5.043, P < 0.001) and binocular AF (t = -3.074, P = 0.003) between Group 1 and Group 2. The normal ratio of stereopsis according to the random dots test in Group 1 was higher than in Group 2 (χ2 = 14.596, P < 0.001). The normal ratio of dynamic stereopsis in Group 1 was lower than in Group 3 (χ2 = 13.281, P < 0.001). The normal signal-to-noise ratio of the binocular balance point in Group 1 was lower than Group 3 (χ2 = 4.755, P = 0.029). Conclusion First, monocular myopia could lead to accommodative dysfunction and unbalanced input of binocular visual signals, resulting in myopia progression. Second, monocular myopia may also be accompanied by stereopsis dysfunction, and long-term uncorrected monocular myopia may worsen stereopsis acuity in adulthood. In addition, patients with monocular myopia could exhibit stereopsis dysfunction at an early stage. Therefore, children with monocular myopia must wear glasses to restore binocular balance and visual functions, thereby delaying myopia progression.
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Affiliation(s)
- Aiqun Xiang
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Kaixuan Du
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qiuman Fu
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yanni Zhang
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Liting Zhao
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Li Yan
- National Engineering Research Center for Healthcare Devices, Guangzhou, China
| | - Dan Wen
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- *Correspondence: Dan Wen,
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A Review of Intraocular Pressure (IOP) and Axial Myopia. J Ophthalmol 2022; 2022:5626479. [PMID: 35855886 PMCID: PMC9288324 DOI: 10.1155/2022/5626479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/18/2022] Open
Abstract
The pathogenesis of myopia is driven by genetic and environmental risk factors. Accommodation not only alters the curvature and shape of the lens but also involves contraction of the ciliary and extraocular muscles, which influences intraocular pressure (IOP). Scleral matrix remodeling has been shown to contribute to the biomechanical susceptibility of the sclera to accommodation-induced IOP fluctuations, resulting in reduced scleral thickness, axial length (AL) elongation, and axial myopia. The rise in IOP can increase the burden of scleral stretching and cause axial lengthening. Although the accommodation and IOP hypotheses were proposed long ago, they have not been validated. This review provides a brief and updated overview on studies investigating the potential role of accommodation and IOP in myopia progression.
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12
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Hughes RPJ, Read SA, Collins MJ, Vincent SJ. Axial Elongation During Short-Term Accommodation in Myopic and Nonmyopic Children. Invest Ophthalmol Vis Sci 2022; 63:12. [PMID: 35275173 PMCID: PMC8934556 DOI: 10.1167/iovs.63.3.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Purpose Axial length increases during accommodation in adults and children; however, refractive error group differences are conflicting and have not been explored in pediatric populations. This study aimed to evaluate differences in accommodation-induced axial elongation between myopic and nonmyopic children. Methods A range of ocular biometric measurements were captured during brief accommodation tasks (0, 3, 6, and 9 D) using a Badal optometer mounted to a noncontact optical biometer (Zeiss IOLMaster 700). Reliable measurements were captured for 15 myopic and 15 age- and sex-matched nonmyopic children. The average central corneal thickness (CCT), anterior chamber depth (ACD), crystalline lens thickness (LT), anterior segment length (ASL), vitreous chamber depth (VCD), and axial length (AL) were determined for each accommodation stimulus. Raw measurements of AL and VCD were corrected for the estimated error associated with LT increases during accommodation. Results All biometric parameters, except CCT, changed significantly during accommodation (all P < 0.001). Myopic children exhibited significantly greater accommodation-induced axial elongation than nonmyopic children (P = 0.002) at the 3, 6, and 9 D accommodation stimuli, with a mean difference of 7, 10, and 16 µm, respectively (all pairwise comparisons, P ≤ 0.03). The changes in all other biometric parameters were not different between the refractive error groups (P ≥ 0.23). Conclusions Accommodation-induced axial elongation was greater in myopic than nonmyopic children. This finding could support a potential mechanism linking near work, axial elongation, and myopia development in children or may reflect greater susceptibility to accommodation-induced axial elongation in children with established myopia.
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Affiliation(s)
- Rohan P J Hughes
- Queensland University of Technology, Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Brisbane, Queensland, Australia
| | - Scott A Read
- Queensland University of Technology, Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Brisbane, Queensland, Australia
| | - Michael J Collins
- Queensland University of Technology, Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Brisbane, Queensland, Australia
| | - Stephen J Vincent
- Queensland University of Technology, Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Brisbane, Queensland, Australia
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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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Autrata D, Chrapek O, Drahorád S. EFFECT OF PHARMACOLOGICAL PUPIL DILATION ON INTRAOCULAR LENS POWER CALCULATION IN PATIENTS INDICATED FOR CATARACT SURGERY. CESKA A SLOVENSKA OFTALMOLOGIE : CASOPIS CESKE OFTALMOLOGICKE SPOLECNOSTI A SLOVENSKE OFTALMOLOGICKE SPOLECNOSTI 2021; 77:192-200. [PMID: 34507495 DOI: 10.31348/2021/22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the influence of pupil dilation on ocular parameters measured by optical biometry and the influence of pupil dilation on intraocular lens (PC IOL) power calculation by using the third-generation (SRK/T) and the fourth-generation (Haigis) formula. METHODS 40 eyes of patients indicated for cataract surgery were included in this study. Each patient was examined by optical biometer firstly without artificial mydriasis (AM) and then after AM, which was achieved using local application of short-term acting mydriatics. Biometric data were measured by Lenstar LS 900 optical biometer, we recorded axial length of the eye (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT) and corneal astigmatism and optical power of cornea. These data we measured were used for calculation of the PC IOL optical power using both the SRK/T and the Haigis formula. The target postoperative refraction was set to emmetropia. Statistical analysis was performed for evaluation of influence of AM on each ocular parameter and influence of AM on the recommended PC IOL power calculated by the SRK/T and the Haigis formula. RESULTS No statistically significant effect of AM on AL, LT and keratometry was demonstrated. On the contrary we demonstrated significant effect on CCT and ACD. No effect of AM on the PC IOL power calculation using the SRK/T formula was proved - the PC IOL optical power before AM and after AM did not differ in any case. When using the Haigis formula for the PC IOL power calculation, the recommended optical power of the PC IOL changed by +0.5 Dpt in 9 eyes, i.e., 22.5 % of the whole group, but statistical analysis did not show this change as statistically significant. CONCLUSION Pharmacological dilation of the pupil significantly affects some intraocular parameters measured by optical biometer and in the case of using the Haigis formula it can influence recommended power of the PC IOL. Conversely, when using the SRK/T formula, pharmacological dilation of pupil does not affect the recommended PC IOL power.
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15
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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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16
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Delshad S, Collins MJ, Read SA, Vincent SJ. Effects of brief periods of clear vision on the defocus-mediated changes in axial length and choroidal thickness of human eyes. Ophthalmic Physiol Opt 2021; 41:932-940. [PMID: 33973255 DOI: 10.1111/opo.12833] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 03/23/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate the influence of brief, repeated periods of clear vision on the changes in axial length and choroidal thickness in response to short-term imposed defocus. METHODS The right eye of 16 young adults was exposed to 60 min episodes of continuous and interrupted defocus conditions (+3 DS and -3 DS) over five separate sessions, with the left eye optimally corrected for distance. For interrupted defocus, 2 min episodes of clear vision were imposed before each 15 min episode of myopic or hyperopic defocus (2/15 min). For hyperopic defocus, the effect of frequency of clear vision exposure was also assessed by imposing 1 min of clear vision before each 7.5 min of defocus (1/7.5 min). The right eye axial length and choroidal thickness were measured before, during and after each defocus condition. RESULTS After 60 min of continuous hyperopic defocus the eye elongated significantly by +9 ± 9 μm (p = 0.02). When exposed to interrupted (2/15 min) hyperopic defocus, axial elongation was significantly reduced by 77% compared to continuous hyperopic defocus (p = 0.03), with a final change of only +2 ± 10 μm relative to baseline. During interrupted (1/7.5 min) hyperopic defocus, axial elongation reduced slightly compared to continuous hyperopic defocus (+6 ± 8 μm relative to baseline, p = 0.12). For continuous myopic defocus, a reduction in axial length occurred but was not statistically significant (p > 0.05). A similar pattern of response was observed for choroidal thickness changes with continuous and interrupted (1/7.5 min) hyperopic defocus conditions. CONCLUSIONS Brief periods of clear vision can diminish axial elongation and choroidal thinning induced by hyperopic defocus exposure in human eyes. If hyperopic defocus contributes to myopia progression in humans, then interruption with brief periods of clear vision could reduce its myopiagenic effects.
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Affiliation(s)
- Samaneh Delshad
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Michael J Collins
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Scott A Read
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Stephen J Vincent
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
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17
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Logan NS, Radhakrishnan H, Cruickshank FE, Allen PM, Bandela PK, Davies LN, Hasebe S, Khanal S, Schmid KL, Vera-Diaz FA, Wolffsohn JS. IMI Accommodation and Binocular Vision in Myopia Development and Progression. Invest Ophthalmol Vis Sci 2021; 62:4. [PMID: 33909034 PMCID: PMC8083074 DOI: 10.1167/iovs.62.5.4] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The role of accommodation in myopia development and progression has been debated for decades. More recently, the understanding of the mechanisms involved in accommodation and the consequent alterations in ocular parameters has expanded. This International Myopia Institute white paper reviews the variations in ocular parameters that occur with accommodation and the mechanisms involved in accommodation and myopia development and progression. Convergence is synergistically linked with accommodation and the impact of this on myopia has also been critiqued. Specific topics reviewed included accommodation and myopia, role of spatial frequency, and contrast of the task of objects in the near environment, color cues to accommodation, lag of accommodation, accommodative-convergence ratio, and near phoria status. Aspects of retinal blur from the lag of accommodation, the impact of spatial frequency at near and a short working distance may all be implicated in myopia development and progression. The response of the ciliary body and its links with changes in the choroid remain to be explored. Further research is critical to understanding the factors underlying accommodative and binocular mechanisms for myopia development and its progression and to guide recommendations for targeted interventions to slow myopia progression.
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Affiliation(s)
- Nicola S Logan
- School of Optometry, Aston University, Birmingham, United Kingdom
| | - Hema Radhakrishnan
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Fiona E Cruickshank
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Peter M Allen
- Vision and Hearing Sciences Research Centre, School of Psychology and Sports Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Praveen K Bandela
- Brien Holden Vision Institute, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Leon N Davies
- School of Optometry, Aston University, Birmingham, United Kingdom
| | - Satoshi Hasebe
- Department of Ophthalmology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Safal Khanal
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Katrina L Schmid
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
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18
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Mcmonnies CW. An examination of the baropathic nature of axial myopia. Clin Exp Optom 2021; 97:116-24. [DOI: 10.1111/cxo.12101] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 04/17/2013] [Accepted: 05/05/2013] [Indexed: 11/29/2022] Open
Affiliation(s)
- Charles W Mcmonnies
- School of Optometry and Vision Science, University of New South Wales, Kensington, New South Wales, Australia,
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19
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Vincent SJ, Collins MJ, Read SA, Carney LG. Myopic anisometropia: ocular characteristics and aetiological considerations. Clin Exp Optom 2021; 97:291-307. [DOI: 10.1111/cxo.12171] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 02/14/2014] [Indexed: 12/20/2022] Open
Affiliation(s)
- Stephen J Vincent
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Leo G Carney
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
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20
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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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21
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Hughes RPJ, Read SA, Collins MJ, Vincent SJ. Changes in ocular biometry during short‐term accommodation in children. Ophthalmic Physiol Opt 2020; 40:584-594. [DOI: 10.1111/opo.12711] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 05/29/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Rohan P J Hughes
- Contact Lens and Visual Optics Laboratory School of Optometry and Vision Science Queensland University of Technology (QUT) Brisbane Queensland Australia
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory School of Optometry and Vision Science Queensland University of Technology (QUT) Brisbane Queensland Australia
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory School of Optometry and Vision Science Queensland University of Technology (QUT) Brisbane Queensland Australia
| | - Stephen J Vincent
- Contact Lens and Visual Optics Laboratory School of Optometry and Vision Science Queensland University of Technology (QUT) Brisbane Queensland Australia
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22
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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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Abstract
SIGNIFICANCE This is a proof-of-concept study showing the possibility of pharmacological control for choroidal thickness using pilocarpine as an agent that causes 2 to 5% choroidal thinning in healthy eyes after the instillation. PURPOSE The purpose of this article was to study the effect of instillation of 1% pilocarpine on choroidal thickness in healthy subjects. METHODS Sixteen healthy individuals (seven males and nine females; mean ± standard deviation age, 25.8 ± 3.3 years) were included. All participants received optical coherence tomography to evaluate subfoveal choroidal thickness (SCT) and choroidal area on cross-sectional scan within 4-mm central area. Axial length was measured using optical biometry. Optical coherence tomography was performed before and after pilocarpine was instilled six times for a 75-minute period in one eye; the fellow eye was used as the control. Subfoveal choroidal thickness and choroidal area were measured by two masked graders in random fashion and averaged for analysis. RESULTS After instillation of 1% pilocarpine, percentage SCT change in study and control eye was -3.3 ± 3.8% and 0.4 ± 3.2%, respectively (P = .03). Percentage change choroidal area in study and control eye was -2.3 ± 2.5% and 0.8 ± 3.3%, respectively (P < .001). There was a correlation between percentage SCT change and axial length (r = -0.56, P < .001), as well as between percentage SCT change and baseline SCT (r = 0.72, P < .001). CONCLUSIONS Instillation of 1% pilocarpine causes a decrease of choroidal thickness, which is more substantial in eyes with short axial length and thick choroid.
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Niyazmand H, Read SA, Atchison DA, Collins MJ. Effects of accommodation and simulated convergence on anterior scleral shape. Ophthalmic Physiol Opt 2020; 40:482-490. [DOI: 10.1111/opo.12697] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/07/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Hamed Niyazmand
- Contact Lens and Visual Optics Laboratory Institute of Health & Biomedical Innovation School of Optometry and Vision Science Queensland University of Technology Brisbane Australia
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory Institute of Health & Biomedical Innovation School of Optometry and Vision Science Queensland University of Technology Brisbane Australia
| | - David A Atchison
- Visual and Ophthalmic Optics Laboratory Institute of Health & Biomedical Innovation School of Optometry and Vision Science Queensland University of Technology Brisbane Australia
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory Institute of Health & Biomedical Innovation School of Optometry and Vision Science Queensland University of Technology Brisbane Australia
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The Effect of Pharmacological Dilation on Calculation of Targeted and Ideal IOL Power Using Multivariable Formulas. Ophthalmol Ther 2020; 9:1-11. [PMID: 32462340 PMCID: PMC7406603 DOI: 10.1007/s40123-020-00261-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Indexed: 12/19/2022] Open
Abstract
Background To examine the effect of pharmacologic dilation on biometric parameters
measured by the Lenstar LS 900, and whether these changes affect the power of the
calculated intraocular lens (IOL) using multivariable formulas in an undilated versus
pharmacologically dilated state. Methods Prospective study of 98 phakic eyes from 53 patients. Axial length (AL),
central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT),
and keratometry (K) readings were measured. The first set of measurements was taken
prior to dilation. After dilation (pupil diameter ≥ 6.0 mm), a second set of
measurements was taken. The Barrett, Olsen, Hill-RBF, Haigis, SRK/T, and Holladay I
formulas were used to calculate IOL power before and after dilation. Two calculation
methods were used: method A used a commonly available IOL targeted to achieve
the lowest myopic spheroequivalent residual refraction; method B calculated ideal IOL
power for emmetropia. Results Statistically significant increases were seen in CCT (p < 0.01), ACD (p < 0.01), and AL (p < 0.01)
whereas a statistically significant decrease was seen in LT (p < 0.01) post dilation. Using method A, the percentage of eyes
which would have received an IOL with 0.5 D or 1.0 D of higher power, if
post-dilation measurements were used, were 25.5%, 30.6%, 20.4%, and 23.5% for
Barrett, Olsen, Hill-RBF, and Haigis, respectively. Using method B, only Haigis and
Olsen had a statistically significant increase in ideal IOL power. Conclusions Pharmacologic dilation can be associated with an increase in non-custom
IOL dioptric power when using multivariable formulas, which may lead to a myopic
surprise.
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The time course of the onset and recovery of axial length changes in response to imposed defocus. Sci Rep 2020; 10:8322. [PMID: 32433541 PMCID: PMC7239843 DOI: 10.1038/s41598-020-65151-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 04/20/2020] [Indexed: 12/18/2022] Open
Abstract
The human eye is capable of responding to the presence of blur by changing its axial length, so that the retina moves towards the defocused image plane. We measured how quickly the eye length changed in response to both myopic and hyperopic defocus and how quickly the eye length changed when the defocus was removed. Axial length was measured at baseline and every 10 minutes during 1 hour of exposure to monocular defocus (right eye) with the left eye optimally corrected for two defocus conditions (+3 D and −3 D) and a control condition. Recovery was measured for 20 minutes after blur removal. A rapid increase in axial length was observed after exposure (~2 minutes) to hyperopic defocus (+7 ± 5 μm, p < 0.001) while the reduction in axial length with myopic defocus was slower and only statistically significant after 40 minutes (−8 ± 9 μm, p = 0.017). The eye length also recovered toward baseline levels during clear vision more rapidly following hyperopic than myopic defocus (p < 0.0001). These findings provide evidence that the human eye is able to detect and respond to the presence and sign of blur within minutes.
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Wolffsohn JS, Kollbaum PS, Berntsen DA, Atchison DA, Benavente A, Bradley A, Buckhurst H, Collins M, Fujikado T, Hiraoka T, Hirota M, Jones D, Logan NS, Lundström L, Torii H, Read SA, Naidoo K. IMI - Clinical Myopia Control Trials and Instrumentation Report. Invest Ophthalmol Vis Sci 2019; 60:M132-M160. [PMID: 30817830 DOI: 10.1167/iovs.18-25955] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The evidence-basis based on existing myopia control trials along with the supporting academic literature were reviewed; this informed recommendations on the outcomes suggested from clinical trials aimed at slowing myopia progression to show the effectiveness of treatments and the impact on patients. These outcomes were classified as primary (refractive error and/or axial length), secondary (patient reported outcomes and treatment compliance), and exploratory (peripheral refraction, accommodative changes, ocular alignment, pupil size, outdoor activity/lighting levels, anterior and posterior segment imaging, and tissue biomechanics). The currently available instrumentation, which the literature has shown to best achieve the primary and secondary outcomes, was reviewed and critiqued. Issues relating to study design and patient selection were also identified. These findings and consensus from the International Myopia Institute members led to final recommendations to inform future instrumentation development and to guide clinical trial protocols.
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Affiliation(s)
- James S Wolffsohn
- Ophthalmic Research Group, Aston University, Birmingham, United Kingdom
| | - Pete S Kollbaum
- Indiana University, School of Optometry, Bloomington, Indiana, United States
| | - David A Berntsen
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, Texas, United States
| | - David A Atchison
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | | | - Arthur Bradley
- Indiana University, School of Optometry, Bloomington, Indiana, United States
| | - Hetal Buckhurst
- School of Health Professions, Peninsula Allied Health Centre, Plymouth University, Plymouth, United Kingdom
| | - Michael Collins
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | - Takashi Fujikado
- Department of Applied Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takahiro Hiraoka
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masakazu Hirota
- Department of Applied Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Debbie Jones
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Nicola S Logan
- Ophthalmic Research Group, Aston University, Birmingham, United Kingdom
| | | | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Scott A Read
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | - Kovin Naidoo
- African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa
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Lau JK, Wan K, Cheung SW, Vincent SJ, Cho P. Weekly Changes in Axial Length and Choroidal Thickness in Children During and Following Orthokeratology Treatment With Different Compression Factors. Transl Vis Sci Technol 2019; 8:9. [PMID: 31360614 PMCID: PMC6656409 DOI: 10.1167/tvst.8.4.9] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 05/13/2019] [Indexed: 12/13/2022] Open
Abstract
Purpose To determine the influence of compression factor upon changes in axial length and choroidal thickness during and following orthokeratology treatment. Methods Orthokeratology lenses of different compression factors (one eye with 0.75 D and the fellow eye with 1.75 D) were randomly assigned to 28 subjects (median [range] age: 9.3 [7.8–11.0] years). Ocular biometrics were measured weekly for 1 month of lens wear and after lens cessation until the refraction stabilized (mean duration: 2.8 ± 0.4 weeks). Changes between eyes, and the associations between axial shortening and choroidal thickening with other ocular biometrics were analyzed. Results There were no significant between-eye differences in the changes of ocular biometrics (all P > 0.05). After adjusting for paired-eye data, axial length initially decreased by 26 ± 41 μm (P = 0.03) at week 1, then gradually returned to its original length. An approximate antiphase relationship of choroidal thickness (mean change: 9 ± 12 μm, P < 0.001) with axial length was observed. A significant rebound in axial length, but not choroidal thickness, occurred during the cessation period. Central corneal thinning and choroidal thickening accounted for 70% of initial axial shortening. Conclusions Increasing the compression factor by 1.00 D did not affect changes in ocular biometrics in short-term orthokeratology. Significant axial shortening and choroidal thickening were observed during early treatment period. Axial shortening could not be entirely explained by central corneal thinning and choroidal thickening, which warrants further investigation. Translational Relevance Initial axial shortening in orthokeratology is transient and therefore axial length remains useful for long-term monitoring of axial elongation in children.
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Affiliation(s)
- Jason K Lau
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Kin Wan
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Sin-Wan Cheung
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
| | - Stephen J Vincent
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
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Moderiano D, Do M, Hobbs S, Lam V, Sarin S, Alonso-Caneiro D, Chakraborty R. Influence of the time of day on axial length and choroidal thickness changes to hyperopic and myopic defocus in human eyes. Exp Eye Res 2019; 182:125-136. [DOI: 10.1016/j.exer.2019.03.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 03/15/2019] [Accepted: 03/23/2019] [Indexed: 12/31/2022]
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Read SA, Fuss JA, Vincent SJ, Collins MJ, Alonso-Caneiro D. Choroidal changes in human myopia: insights from optical coherence tomography imaging. Clin Exp Optom 2018; 102:270-285. [PMID: 30565333 DOI: 10.1111/cxo.12862] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 10/23/2018] [Accepted: 11/12/2018] [Indexed: 01/05/2023] Open
Abstract
The choroid is a vascular tissue which plays a range of critical roles in the normal physiology of the eye, such as supplying the outer retina with oxygen and nutrients and the regulation of intraocular pressure. There is also substantial evidence, particularly from animal studies, that the choroid plays an important role in the regulation of eye growth and the development of common refractive errors like myopia. In recent years, advances in optical coherence tomography technology have improved our ability to image and measure the choroid in the human eye. Research using this technology over the past decade has dramatically improved our knowledge of the normal choroid, and its potential role in the regulation of eye growth and refractive error development. This review aims to provide an overview of recent work examining the normal human choroid, its changes with myopia and the possible role of the choroid in the mechanism regulating eye growth. Studies have demonstrated that choroidal thinning accompanies the development and progression of myopia, and have established a close link between eye growth and choroidal thickness changes. Dramatic thinning of the choroid is seen with high myopia, and associations are also observed between choroidal thinning and reduced vision, and the development of retinal pathology associated with high myopia. In the short-term, environmental factors known to be associated with myopia development and more rapid eye growth typically lead to a thinning of the choroid, whereas factors linked to a slowing of eye growth are typically associated with short-term choroidal thickening. Collectively, these findings suggest that the choroid is an important biomarker of eye growth in the human eye, and additional research to better understand the human choroid is likely to further our knowledge of the signals and pathways regulating eye growth, myopia development and progression.
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Affiliation(s)
- Scott A Read
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - James A Fuss
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Stephen J Vincent
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Michael J Collins
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - David Alonso-Caneiro
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
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Martínez-Albert N, Esteve-Taboada JJ, Montés-Micó R, Fernández-Vega-Cueto L, Ferrer-Blasco T. Repeatability assessment of biometric measurements with different refractive states and age using a swept-source biometer. Expert Rev Med Devices 2018; 16:63-69. [DOI: 10.1080/17434440.2019.1557517] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Noelia Martínez-Albert
- Department of Optics and Optometry and Vision Sciences, University of Valencia, Burjassot, Spain
| | - Jose J. Esteve-Taboada
- Department of Optics and Optometry and Vision Sciences, University of Valencia, Burjassot, Spain
| | - Robert Montés-Micó
- Department of Optics and Optometry and Vision Sciences, University of Valencia, Burjassot, Spain
| | | | - Teresa Ferrer-Blasco
- Department of Optics and Optometry and Vision Sciences, University of Valencia, Burjassot, Spain
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Woodman-Pieterse EC, Read SA, Collins MJ, Alonso-Caneiro D. Anterior scleral thickness changes with accommodation in myopes and emmetropes. Exp Eye Res 2018; 177:96-103. [DOI: 10.1016/j.exer.2018.07.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 06/07/2018] [Accepted: 07/20/2018] [Indexed: 11/24/2022]
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Optical Coherence Tomography Reveals Sigmoidal Crystalline Lens Changes during Accommodation. Vision (Basel) 2018; 2:vision2030033. [PMID: 31735896 PMCID: PMC6835499 DOI: 10.3390/vision2030033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 08/15/2018] [Accepted: 08/17/2018] [Indexed: 12/02/2022] Open
Abstract
This study aimed to quantify biometric modifications of the anterior segment (AS) during accommodation and to compare them against changes in both accommodative demand and response. Thirty adults, aged 18–25 years were rendered functionally emmetropic with contact lenses. AS optical coherence tomography (AS-OCT) images were captured along the 180° meridian (Visante, Zeiss Meditec, Jena, Germany) under stimulated accommodative demands (0–4 D). Images were analysed and lens thickness (LT) was measured, applying a refractive index correction of 1.00. Accommodative responses were also measured sequentially through a Badal optical system fitted to an autorefractor (Shin Nippon NVision-K 5001, Rexxam, Japan). Data were compared with Dubbelman schematic eye calculations. Significant changes occurred in LT, anterior chamber depth (ACD), lens centroid (i.e., ACD + LT/2), and AS length (ASL = ACD + LT) with accommodation (all p < 0.01). There was no significant change in CT with accommodation (p = 0.81). Measured CT, ACD, and lens centroid values were similar to Dubbelman modelled parameters, however AS-OCT overestimated LT and ASL. As expected, the accommodative response was less than the demand. Interestingly, up until approximately 1.5 D of response (2.0 D demand), the anterior crystalline lens surface appears to be the primary correlate. Beyond this point, the posterior lens surface moves posteriorly resulting in an over-all sigmoidal trajectory. he posterior crystalline lens surface demonstrates a sigmoidal response with increasing accommodative effort.
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Dong J, Zhang Y, Zhang H, Jia Z, Zhang S, Wang X. Comparison of axial length, anterior chamber depth and intraocular lens power between IOLMaster and ultrasound in normal, long and short eyes. PLoS One 2018; 13:e0194273. [PMID: 29543854 PMCID: PMC5854401 DOI: 10.1371/journal.pone.0194273] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 02/28/2018] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To compare the axial length (AL), anterior chamber depth (ACD) and intraocular lens power (IOLP) of IOLMaster and Ultrasound in normal, long and short eyes. METHODS Seventy-four normal eyes (≥ 22 mm and ≤ 25 mm), 74 long eyes (> 25 mm) and 78 short eyes (< 22 mm) underwent AL and ACD measurements with both devices in the order of IOLMaster followed by Ultrasound. The IOLP were calculated using a free online LADAS IOL formula calculator. RESULTS The difference in AL and IOLP between IOLMaster and Ultrasound was statistically significant when all three groups were combined. The difference in ACD between IOLMaster and Ultrasound was statistically significant in the normal group (P<0.001) and short eye group (P<0.001) but not the long eye group (P = 0.465). For the IOLP difference between IOLMaster and Ultrasound in the normal group, the percentage of IOLP differences <|0.5|D, ≥|0.5|D<|0.75|D, ≥|0.75|D<|1.0|D, and ≥|1.0|D were 90.5%, 8.1%, 1.4% and 0%, respectively. For the long eye group, they were 90.5%, 5.4%, 4.1% and 0%, respectively. For the short eye group, they were 61.5%, 23.1%, 10.3%, and 5.1%, respectively. CONCLUSIONS IOLMaster and Ultrasound have statistically significant differences in AL measurements and IOLP (using LADAS formula) for normal, long eye and short eye. The two instruments agree regarding ACD measurements for the long eye group, but differ for the normal and short eye groups. Moreover, the high percentage of IOLP differences greater than |0.5|D in the short eye group is noteworthy.
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Affiliation(s)
- Jing Dong
- Department of Ophthalmology, The First Hospital of Shanxi Medical University, Shanxi, P.R. China
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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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Aldossari H, Suheimat M, Atchison DA, Schmid KL. Effect of Accommodation on Peripheral Eye Lengths of Emmetropes and Myopes. Optom Vis Sci 2017; 94:361-369. [PMID: 28027274 DOI: 10.1097/opx.0000000000001037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To investigate the effect of accommodation on central and peripheral axial lengths in young adult emmetropes and myopes. METHODS On-axis and peripheral axial lengths were measured with the Haag-Streit Lenstar in 83 young adult participants for 0D and 6D accommodation demands. A Badal system was used to both correct refractive errors and induce accommodation. Participants were emmetropes (n = 29, mean spherical equivalent refraction +0.35 ± 0.35D), low myopes (32, -1.38 ± 0.73D), and higher myopes (22, -4.30 ± 0.73D). Ages were similar for all groups (22 ± 2 years). Pupils were dilated with 2.5% phenylephrine to allow a large field of measurement while maintaining active accommodation. Axial lengths were measured in 5° steps to ±30° across the horizontal visual field. RESULTS With accommodation, axial length increased for all refractive groups at all positions, but with lessening effect away from fixation. Axial length changes were greater for higher myopes than for emmetropes on-axis (higher myopes 41 ± 14 μm, emmetropes 30 ± 12 μm, P = .005), for higher myopes than for low myopes at 30° nasal (P = .03), and for the higher myopes than for the other groups at 20° nasal (P < .05). There were significant correlations between myopia and changes in axial length at all positions, with the highest correlation on-axis (R = 0.30, P < .001). CONCLUSIONS During accommodation, eye length increased out to at least ±30° visual angle in young adult myopes and emmetropes. The increase was significantly greater for higher myopes than for the other groups at some positions. At all positions, there were significant correlations between myopia and accommodation-induced changes in axial length.
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Affiliation(s)
- Hussain Aldossari
- *PhD †DSc, FAAO School of Optometry and Vision Science and Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia (all authors)
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Comparison of ocular biometric measurements between a new swept-source optical coherence tomography and a common optical low coherence reflectometry. Sci Rep 2017; 7:2484. [PMID: 28559547 PMCID: PMC5449389 DOI: 10.1038/s41598-017-02463-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 03/14/2017] [Indexed: 12/28/2022] Open
Abstract
The purpose of the current study was to compare the measurements between a new optical biometer based on swept-source optical coherence tomography (SS-OCT), the OA-2000 (Tomey, Japan), and an optical biometer based on optical low coherence reflectometry (OLCR), the Lenstar (Haag-Streit, Switzerland). Ninety-nine eyes of 99 healthy subjects were included. The axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), aqueous depth (AD), lens thickness (LT), keratometry (K) readings, including flat K (Kf), steep K (Ks), mean K (Km), astigmatism vectors J0, J45 at diameters of 2.5 and 3.0 mm, and white-to-white diameter (WTW) were measured three times each using both biometer in normal eyes by random sequence. Bland-Altman analysis showed good agreement between the SS-OCT and OLCR devices for AL, AD, ACD, LT, with narrow 95% LoA (−0.05 to 0.07 mm, −0.09 to 0.10 mm, −0.10 to 0.09 mm, and −0.06 to 0.22 mm, respectively), and the P values of ACD were both >0.05. The CCT, Kf, Ks, Km, J0, J45 and WTW values provided by the OA-2000 were in good agreement with the Lenstar, and statistically significant differences were detected for some of them but not clinical differences. The agreement was excellent especially for AL.
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Chang YC, Liu K, de Freitas C, Pham A, Cabot F, Williams S, Adre E, Gregori G, Ruggeri M, Yoo SH, Ho A, Parel JM, Manns F. Assessment of eye length changes in accommodation using dynamic extended-depth OCT. BIOMEDICAL OPTICS EXPRESS 2017; 8:2709-2719. [PMID: 28663900 PMCID: PMC5480507 DOI: 10.1364/boe.8.002709] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 04/19/2017] [Accepted: 04/19/2017] [Indexed: 06/07/2023]
Abstract
It has been suggested that accommodation induces increases in axial eye length which could contribute to the development of myopia. However, it is debated whether changes in eye length occur during accommodation as the degree of change varies widely across literature. In this study, an extended-depth optical coherence tomography (OCT) system that provides dynamic whole eye biometry was utilized to assess changes in lens thickness (LT) and axial eye length (AEL) in young subjects responding to step disaccommodation stimuli of amplitude 2D, 4D, and 6D. The decrease in lens thickness with disaccommodation was strongly correlated with stimulus amplitude. No statistically significant changes in AEL during accommodation were observed.
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Affiliation(s)
- Yu-Cherng Chang
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Biomedical Optics and Laser Laboratory, Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
| | - Keke Liu
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Biomedical Optics and Laser Laboratory, Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
| | - Carolina de Freitas
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Alex Pham
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Biomedical Optics and Laser Laboratory, Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
| | - Florence Cabot
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Anne Bates Leach Eye Hospital, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Siobhan Williams
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Biomedical Optics and Laser Laboratory, Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
| | - Ethan Adre
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Biomedical Optics and Laser Laboratory, Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
| | - Giovanni Gregori
- Quantitative Imaging Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Marco Ruggeri
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sonia H. Yoo
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Biomedical Optics and Laser Laboratory, Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
- Anne Bates Leach Eye Hospital, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Arthur Ho
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Vision Cooperative Research Centre, Sydney, NSW, Australia
- Brien Holden Vision Institute, Sydney, NSW, Australia
- School of Optometry & Vision Science, University of New South Wales, Australia
| | - Jean-Marie Parel
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Biomedical Optics and Laser Laboratory, Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
- Vision Cooperative Research Centre, Sydney, NSW, Australia
| | - Fabrice Manns
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Biomedical Optics and Laser Laboratory, Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
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Scleral changes with accommodation. Ophthalmic Physiol Opt 2017; 37:263-274. [DOI: 10.1111/opo.12377] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 02/21/2017] [Indexed: 11/26/2022]
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Laughton DS, Sheppard AL, Mallen EAH, Read SA, Davies LN. Does transient increase in axial length during accommodation attenuate with age? Clin Exp Optom 2017; 100:676-682. [PMID: 28294406 PMCID: PMC5697689 DOI: 10.1111/cxo.12533] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 11/21/2016] [Accepted: 12/22/2016] [Indexed: 11/29/2022] Open
Abstract
Background The aim was to profile transient accommodative axial length changes from early adulthood to advanced presbyopia and to determine whether any differences exist between the responses of myopic and emmetropic individuals. Methods Ocular biometry was measured by the LenStar biometer (Haag‐Streit, Switzerland) in response to zero, 3.00 and 4.50 D accommodative stimuli in 35 emmetropes and 37 myopes, aged 18 to 60 years. All results were corrected to reduce errors arising from the increase in crystalline lens thickness with accommodation. Accommodative responses were measured sequentially by the WAM 5500 Auto Ref/Keratometer (Grand Seiko, Hiroshima, Japan). Results Axial length increased significantly with accommodation (p < 0.001), with a mean corrected increase in axial length of 2 ± 18 µm and 8 ± 16 µm observed at 3.00 and 4.50 D, respectively. The magnitude of accommodative change in axial length was not dependent on refractive error classification (p = 0.959); however, a significant reduction in the magnitude and variance of axial length change was evident after 43 to 44 years of age (p < 0.002). Conclusion The negative association between transient increase in axial length and age, in combination with reduced variance of data after age 43 to 44 years, is consistent with a significant increase in posterior ocular rigidity, which may be influential in the development of presbyopia.
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Affiliation(s)
- Deborah S Laughton
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, UK
| | - Amy L Sheppard
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, UK
| | - Edward A H Mallen
- School of Optometry and Vision Science, University of Bradford, Bradford, UK
| | - Scott A Read
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Park, Queensland, Australia
| | - Leon N Davies
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, UK
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Zoulinakis G, Esteve-Taboada JJ, Ferrer-Blasco T, Madrid-Costa D, Montés-Micó R. Accommodation in human eye models: a comparison between the optical designs of Navarro, Arizona and Liou-Brennan. Int J Ophthalmol 2017; 10:43-50. [PMID: 28149775 DOI: 10.18240/ijo.2017.01.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 06/20/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To simulate and compare accommodation in accommodative and non-accommodative human eye models. METHODS Ray tracing and optical design program was used. Three eye models were designed and studied: the Navarro, the Arizona and the Liou-Brennan. In order to make the Navarro and Liou-Brennan models to accommodate, specific geometric parameters of the models were altered with values that were chosen from the literature. For the Arizona model, its' mathematical functions for accommodation were used for the same accommodative demands. The simulation included four distances of accommodation for each model: at infinity, 3, 1 and 0.5 m.The results were diffraction images of a "letter F" for graphical comparison, spot diagrams on the retinal field and Modulation Transfer Function (MTF) graphs. RESULTS Zernike coefficients for the aberrations, Airy disk diameter, root mean square (RMS) error diameter and total axial length of the model were provided from the program. These were compared between them in all distances. The Navarro model had the smallest axial length change as a simple model. The Arizona did not change its axial length because it is designed to be accommodative. The Liou-Brennan model had different results concerning the aberrations because of the decentration of the pupil. The MTF graphs showed small differences between the models because of the differences in their designs. CONCLUSION All the three models are able to simulate accommodation with the expected results. There is no model that can be assumed as the best choice. Accommodation can be simulated in non-accommodativemodels and in customized ones.
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Affiliation(s)
- Georgios Zoulinakis
- Department of Optics and Optometry and Vision Sciences, Physics Faculty, University of Valencia, Burjassot, Valencia 46100, Spain; Interuniversity laboratory for research in Vision and Optometry, Mixed group University of Valencia, University of Murcia, Spain
| | - Jose Juan Esteve-Taboada
- Department of Optics and Optometry and Vision Sciences, Physics Faculty, University of Valencia, Burjassot, Valencia 46100, Spain; Interuniversity laboratory for research in Vision and Optometry, Mixed group University of Valencia, University of Murcia, Spain
| | - Teresa Ferrer-Blasco
- Department of Optics and Optometry and Vision Sciences, Physics Faculty, University of Valencia, Burjassot, Valencia 46100, Spain; Interuniversity laboratory for research in Vision and Optometry, Mixed group University of Valencia, University of Murcia, Spain
| | - David Madrid-Costa
- Department of Optics and Optometry and Vision Sciences, Physics Faculty, University of Valencia, Burjassot, Valencia 46100, Spain; Interuniversity laboratory for research in Vision and Optometry, Mixed group University of Valencia, University of Murcia, Spain
| | - Robert Montés-Micó
- Department of Optics and Optometry and Vision Sciences, Physics Faculty, University of Valencia, Burjassot, Valencia 46100, Spain; Interuniversity laboratory for research in Vision and Optometry, Mixed group University of Valencia, University of Murcia, Spain
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Effect of Cycloplegia on Keratometric and Biometric Parameters in Keratoconus. J Ophthalmol 2017; 2016:3437125. [PMID: 28058115 PMCID: PMC5183766 DOI: 10.1155/2016/3437125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 10/30/2016] [Accepted: 11/16/2016] [Indexed: 12/26/2022] Open
Abstract
Purpose. To obtain information about effect of cycloplegia on keratometry and biometry in keratoconus. Methods. 48 keratoconus (Group 1) and 52 healthy subjects (Group 2) were included in the study. We measured the flat meridian of the anterior corneal surface (K1), steep meridian of the anterior corneal surface (K2), lens thickness (LT), anterior chamber depth (ACD), and axial length (AL) using the Lenstar LS 900 before and after cycloplegia. Results. The median K1 in Group 1 was 45.64 D before and 45.42 D after cycloplegia, and the difference was statistically significant (P < 0.05). The median K2 in Group 1 was 50.96 D before and 50.17 D after cycloplegia, and the difference was significant (P < 0.05). The median K1 and K2 in Group 2 were 42.84 and 44.49 D, respectively, before cycloplegia, and 42.84 and 44.56 D after cycloplegia, and the differences were not statistically significant (all P > 0.05). There were significant differences in SE, LT, ACD, and RLP between before and after cycloplegia in either Group 1 (all P < 0.05) or Group 2 (all P < 0.05). There were not statistically significant differences in AL between before cycloplegia and after cycloplegia in either Group 1 (P = 0.533) or group 2 (P = 0.529). Conclusions. Flattened corneal curvature and increase in ACD following cycloplegia in keratoconus patients were detected.
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Arriola-Villalobos P, Almendral-Gómez J, Garzón N, Ruiz-Medrano J, Fernández-Pérez C, Martínez-de-la-Casa JM, Díaz-Valle D. Effect of pharmacological pupil dilation on measurements and iol power calculation made using the new swept-source optical coherence tomography-based optical biometer. J Fr Ophtalmol 2016; 39:859-865. [PMID: 27793471 DOI: 10.1016/j.jfo.2016.09.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 08/29/2016] [Accepted: 09/02/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To determine whether pupil dilation affects biometric measurements and intraocular lens (IOL) power calculation made using the new swept-source optical coherence tomography-based optical biometer (IOLMaster 700©; Carl Zeiss Meditec, Jena, Germany). PROCEDURES Eighty-one eyes of 81 patients evaluated for cataract surgery were prospectively examined using the IOLMaster 700© before and after pupil dilation with tropicamide 1%. The measurements made were: axial length (AL), central corneal thickness (CCT), aqueous chamber depth (ACD), lens thickness (LT), mean keratometry (MK), white-to-white distance (WTW) and pupil diameter (PD). Holladay II and SRK/T formulas were used to calculate IOL power. Agreement between measurement modes (with and without dilation) was assessed through intraclass correlation coefficients (ICC) and Bland-Altman plots. RESULTS Mean patient age was 75.17±7.54 years (range: 57-92). Of the variables determined, CCT, ACD, LT and WTW varied significantly according to pupil dilation. Excellent intraobserver correlation was observed between measurements made before and after pupil dilation. Mean IOL power calculation using the Holladay 2 and SRK/T formulas were unmodified by pupil dilation. CONCLUSIONS The use of pupil dilation produces statistical yet not clinically significant differences in some IOLMaster 700© measurements. However, it does not affect mean IOL power calculation.
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Affiliation(s)
- P Arriola-Villalobos
- Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle del Prof. Martín Lagos, s/n, 28040 Madrid, Spain
| | - J Almendral-Gómez
- Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle del Prof. Martín Lagos, s/n, 28040 Madrid, Spain.
| | - N Garzón
- Instituto de Oftalmología Avanzada, 28010 Madrid, Spain
| | - J Ruiz-Medrano
- Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle del Prof. Martín Lagos, s/n, 28040 Madrid, Spain
| | - C Fernández-Pérez
- Investigative Support Unit, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28010 Madrid, Spain
| | - J M Martínez-de-la-Casa
- Ophthalmology, Hospital Clínico San Carlos, Departamento de Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28010 Madrid, Spain
| | - D Díaz-Valle
- Ophthalmology, Hospital Clínico San Carlos, Departamento de Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28010 Madrid, Spain
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Wang XG, Dong J, Pu YL, Liu HJ, Wu Q. Comparison axial length measurements from three biometric instruments in high myopia. Int J Ophthalmol 2016; 9:876-80. [PMID: 27366691 DOI: 10.18240/ijo.2016.06.15] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 02/10/2015] [Indexed: 12/30/2022] Open
Abstract
AIM To compare the axial lengths (ALs) measured with Lenstar, IOLMaster and A-scan contact ultrasound (Ultrasound) in normal and high myopia (HM). METHODS Eighty-four normal eyes and 49 HM eyes were included. Three consecutive measurements were performed on each eye in the following order: Lenstar, IOLMaster, and Ultrasound. The repeatabilities of the AL measurements for each instrument were assessed by calculating the pooled coefficients of variation (CVs) of 18 eyes in each group. Comparisons between the HM and normal groups were made with independent sample t-tests. The inter-device agreements were evaluated with Bland-Altman analyses and paired two-tailed t-tests. RESULTS For normal group, the CVs of the AL measurements taken with the Lenstar, IOLMaster and Ultrasound were 0.001%, 0.01% and 0.14%, respectively. The corresponding CVs for the HM group were 0.005%, 0.02% and 0.15%, respectively. There was significant difference between the Lenstar and the IOLMaster in normal group (P=0.031) but not in HM group (P=0.100). In the two groups, the Lenstar and the IOLMaster produced higher values than did the Ultrasound (all P<0.001). All three instruments exhibited good agreement in terms of AL values. For the intraocular lens (IOL) power calculation using SRK II formula, the Lenstar and the IOLMaster showed 0.5 D higher than Ultrasound in both groups (all P<0.001). No significant difference existed between the Lenstar and the IOLMaster for the IOL power calculation in both normal (P=0.474) and HM group (P=0.103). CONCLUSION The three devices exhibited excellent intra-visit repeatabilities in the AL measurements. The AL and IOL power difference between partial coherence interferometry and ultrasound instruments should be noticed.
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Affiliation(s)
- Xiao-Gang Wang
- Shanxi Eye Hospital, Taiyuan 030002, Shanxi Province, China; Department of Ophthalmology, the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China
| | - Jing Dong
- The First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
| | - Yu-Lan Pu
- Department of Ophthalmology, the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China
| | - Hui-Jun Liu
- Department of Ophthalmology, the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China
| | - Qiang Wu
- Department of Ophthalmology, the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China
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Schmid KL, Strang NC. Differences in the accommodation stimulus response curves of adult myopes and emmetropes: a summary and update. Ophthalmic Physiol Opt 2016; 35:613-21. [PMID: 26497293 DOI: 10.1111/opo.12255] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE To provide a summary of the classic paper "Differences in the accommodation stimulus response curves of adult myopes and emmetropes" published in Ophthalmic and Physiological Optics in 1998 and to provide an update on the topic of accommodation errors in myopia. SUMMARY The accommodation responses of 33 participants (10 emmetropes, 11 early onset myopes and 12 late onset myopes) aged 18-31 years were measured using the Canon Autoref R-1 free space autorefractor using three methods to vary the accommodation demand: decreasing distance (4 m to 0.25 cm), negative lenses (0 to -4 D at 4 m) and positive lenses (+4 to 0 D at 0.25 m). We observed that the greatest accommodation errors occurred for the negative lens method whereas minimal errors were observed using positive lenses. Adult progressing myopes had greater lags of accommodation than stable myopes at higher demands induced by negative lenses. Progressing myopes had shallower response gradients than the emmetropes and stable myopes; however the reduced gradient was much less than that observed in children using similar methods. RECENT FINDINGS This paper has been often cited as evidence that accommodation responses at near may be primarily reduced in adults with progressing myopia and not in stable myopes and/or that challenging accommodation stimuli (negative lenses with monocular viewing) are required to generate larger accommodation errors. As an analogy, animals reared with hyperopic errors develop axial elongation and myopia. Retinal defocus signals are presumably passed to the retinal pigment epithelium and choroid and then ultimately the sclera to modify eye length. A number of lens treatments that act to slow myopia progression may partially work through reducing accommodation errors.
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Affiliation(s)
- Katrina L Schmid
- School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia
| | - Niall C Strang
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
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Mao X, Banta JT, Ke B, Jiang H, He J, Liu C, Wang J. Wavefront Derived Refraction and Full Eye Biometry in Pseudophakic Eyes. PLoS One 2016; 11:e0152293. [PMID: 27010674 PMCID: PMC4806839 DOI: 10.1371/journal.pone.0152293] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 03/12/2016] [Indexed: 11/19/2022] Open
Abstract
Purpose To assess wavefront derived refraction and full eye biometry including ciliary muscle dimension and full eye axial geometry in pseudophakic eyes using spectral domain OCT equipped with a Shack-Hartmann wavefront sensor. Methods Twenty-eight adult subjects (32 pseudophakic eyes) having recently undergone cataract surgery were enrolled in this study. A custom system combining two optical coherence tomography systems with a Shack-Hartmann wavefront sensor was constructed to image and monitor changes in whole eye biometry, the ciliary muscle and ocular aberration in the pseudophakic eye. A Badal optical channel and a visual target aligning with the wavefront sensor were incorporated into the system for measuring the wavefront-derived refraction. The imaging acquisition was performed twice. The coefficients of repeatability (CoR) and intraclass correlation coefficient (ICC) were calculated. Results Images were acquired and processed successfully in all patients. No significant difference was detected between repeated measurements of ciliary muscle dimension, full-eye biometry or defocus aberration. The CoR of full-eye biometry ranged from 0.36% to 3.04% and the ICC ranged from 0.981 to 0.999. The CoR for ciliary muscle dimensions ranged from 12.2% to 41.6% and the ICC ranged from 0.767 to 0.919. The defocus aberrations of the two measurements were 0.443 ± 0.534 D and 0.447 ± 0.586 D and the ICC was 0.951. Conclusions The combined system is capable of measuring full eye biometry and refraction with good repeatability. The system is suitable for future investigation of pseudoaccommodation in the pseudophakic eye.
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Affiliation(s)
- Xinjie Mao
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - James T. Banta
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Bilian Ke
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- Department of Ophthalmology, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hong Jiang
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Jichang He
- New England College of Optometry, Boston, Massachusetts, United States of America
| | - Che Liu
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Jianhua Wang
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, United States of America
- * E-mail:
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Intraocular Pressure Changes during Accommodation in Progressing Myopes, Stable Myopes and Emmetropes. PLoS One 2015; 10:e0141839. [PMID: 26517725 PMCID: PMC4627769 DOI: 10.1371/journal.pone.0141839] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 10/13/2015] [Indexed: 11/19/2022] Open
Abstract
Purpose To investigate the changes of intraocular pressure (IOP) induced by 3-diopter (3 D) accommodation in progressing myopes, stable myopes and emmetropes. Design Cross-sectional study. Participants 318 subjects including 270 myopes and 48 emmetropes. Methods 195 progressing myopes, 75 stable myopes and 48 emmetropes participated in this study. All subjects had their IOP measured using iCare rebound tonometer while accommodative stimuli of 0 D and 3 D were presented. Main Outcome Measures IOP values without accommodation and with 3 D accommodation were measured in all subjects. Baseline IOPs and IOP changes were compared within and between groups. Results There was no significant difference in IOPs between progressing myopes, stable myopes and emmetropes when no accommodation was induced (17.47±3.46, 16.62±2.98 and 16.80±3.62 respectively, p>0.05). IOP experienced an insignificantly slight decrease after 3 D accommodation in three groups (mean change -0.19±2.16, -0.03±1.68 and -0.39±2.65 respectively, p>0.05). Subgroup analysis showed in progressing myopic group, IOP of children (<18 years old) declined with accommodation while IOP of adults (≥18 years) increased, and the difference was statistically significant (p = 0.008). However, after excluding the age factor, accommodation induced IOP changes of high progressing myopes (≤-6 D), low, moderate and non-myopes (>-6 D) was not significantly different after Bonferroni correction (p = 0.838). Conclusions Although no difference was detected between the baseline IOPs and accommodation induced IOP changes in progressing myopes, stable myopes and emmetropes, this study found accommodation could cause transient IOP elevation in adult progressing myopes.
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Laughton DS, Sheppard AL, Davies LN. A longitudinal study of accommodative changes in biometry during incipient presbyopia. Ophthalmic Physiol Opt 2015; 36:33-42. [DOI: 10.1111/opo.12242] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 08/07/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Deborah S. Laughton
- Ophthalmic Research Group Life & Health Sciences Aston University Birmingham UK
| | - Amy L. Sheppard
- Ophthalmic Research Group Life & Health Sciences Aston University Birmingham UK
| | - Leon N. Davies
- Ophthalmic Research Group Life & Health Sciences Aston University Birmingham UK
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Fan S, Li L, Li Q, Dai C, Ren Q, Jiao S, Zhou C. Dual band dual focus optical coherence tomography for imaging the whole eye segment. BIOMEDICAL OPTICS EXPRESS 2015; 6:2481-2493. [PMID: 26203375 PMCID: PMC4505703 DOI: 10.1364/boe.6.002481] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 06/05/2015] [Accepted: 06/08/2015] [Indexed: 05/22/2023]
Abstract
We developed an improved dual band dual focus spectral domain optical coherence tomography (SD-OCT) for in vivo 2D/3D imaging of the whole eye segment, including the whole anterior segment and retina. The system featured two OCT channels with two different bands centered at 840 nm and 1050 nm, which were designed to image the retina and the anterior segments of the eye, respectively. By combing the two probe light beams for co-axial scanning and separating them for focusing at different segments of the eye with a combination of three dichroic mirrors, we not only minimized the loss of the backscattered light from the sample but also improved the imaging depth, scan range and resolution. The full resolved complex (FRC) method was applied to double the imaging depth for the whole anterior segment imaging, with which an imaging depth of 36.71 mm in air was achieved. We demonstrated that this system was capable of measuring the dynamic changes of ocular dimensions, including the asphericity of the cornea and lens, during accommodation.
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Affiliation(s)
- Shanhui Fan
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Lin Li
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Qian Li
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Cuixia Dai
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Qiushi Ren
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing, 100871, China
| | - Shuliang Jiao
- Department of Biomedical Engineering, Florida International University, Miami, FL, 33174, USA
| | - Chuanqing Zhou
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
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McAlinden C, Wang Q, Pesudovs K, Yang X, Bao F, Yu A, Lin S, Feng Y, Huang J. Axial Length Measurement Failure Rates with the IOLMaster and Lenstar LS 900 in Eyes with Cataract. PLoS One 2015; 10:e0128929. [PMID: 26061554 PMCID: PMC4462579 DOI: 10.1371/journal.pone.0128929] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 05/01/2015] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To evaluate axial length (AL) measurement failure rate with the IOLMaster (Carl Zeiss AG, Germany) and Lenstar LS 900 (Haag-Streit AG, Switzerland) in eyes with cataract. METHODS Two hundred and ninety-six eyes of 170 patients with cataract were enrolled. Cataract type and severity were graded using the Lens Opacities Classification System III (LOCS III) and AL measurements were attempted with IOLMaster (version 5.4) and Lenstar LS 900 (version 1.1). Chi-squared analysis was used to assess if the difference in AL measurement acquisition rate was statistically significant between the two devices. The association of the different cataract types and severity with the AL measurement acquisition rate was evaluated with logistic regression analysis. RESULTS AL measurements were obtained in 184 eyes (62.16%) using the IOLMaster and 191 eyes (64.53%) using the Lenstar, which corresponds to a failure rate of 37.84% and 35.47% respectively. Chi-square analysis indicated no significant difference between the Lenstar and IOLMaster for AL measurement failure rate (x2 = 0.356, P = 0.550). Logistic regression analysis indicated no association between acquisition rates and cortical or nuclear cataracts with either device. There was a statistically significant association between acquisition rates and increasing severity of posterior subcapsular cataracts with the IOLMaster (β = -1.491, P<0.001) and Lenstar LS 900 (β = -1.507, P<0.001). CONCLUSION The IOLMaster and Lenstar LS 900 have similar AL measurement failure rates (35-38%) for Chinese public hospital cataract patients. Increasing severity of posterior subcapsular cataracts was problematic for both devices.
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Affiliation(s)
- Colm McAlinden
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Flinders University, Adelaide, South Australia, Australia
| | - Qinmei Wang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China
| | | | - Xin Yang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Fangjun Bao
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China
| | - Ayong Yu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China
| | - Shishi Lin
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yifan Feng
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jinhai Huang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China
- * E-mail:
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