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Castro-Torres JJ, Casares-López M, Ortiz-Peregrina S, Martino F, Gómez-Robledo L, Jiménez JR. Effect of the chromaticity of stimuli on night vision disturbances. Sci Rep 2024; 14:10183. [PMID: 38702452 PMCID: PMC11068904 DOI: 10.1038/s41598-024-61069-4] [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: 10/17/2023] [Accepted: 04/30/2024] [Indexed: 05/06/2024] Open
Abstract
The perception of halos and other night vision disturbances is a common complaint in clinical practice. Such visual disturbances must be assessed in order to fully characterize each patient's visual performance, which is particularly relevant when carrying out a range of daily tasks. Visual problems are usually assessed using achromatic stimuli, yet the stimuli encountered in daily life have very different chromaticities. Hence, it is important to assess the effect of the chromaticity of visual stimuli on night vision disturbances. The aim of this work is to study the influence of the chromaticity of different visual stimuli on night vision disturbances by analyzing straylight and visual discrimination under low-light conditions. For that, we assessed the monocular and binocular visual discrimination of 27 subjects under low illumination using the Halo test. The subjects' visual discrimination was assessed after exposure to different visual stimuli: achromatic, red, green, and blue, both at the monitor's maximum luminance and maintaining the same luminance value for the different visual stimuli. Monocular straylight was also measured for an achromatic, red, green, and blue stimuli. The blue stimulus had the greatest effect on halos in both monocular and binocular conditions. Visual discrimination was similar for the red, green, and achromatic stimuli, but worsened at lower luminance. The greatest influence of straylight was observed for the blue stimulus. In addition, visual discrimination correlated with straylight measurements for achromatic stimuli, wherein greater straylight values correlated with an increased perception of halos and other visual disturbances.
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Affiliation(s)
- José J Castro-Torres
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071, Granada, Spain.
| | - Miriam Casares-López
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071, Granada, Spain
| | - Sonia Ortiz-Peregrina
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071, Granada, Spain
| | - Francesco Martino
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071, Granada, Spain
| | - Luis Gómez-Robledo
- Basic and Applied Colorimetry Lab, Department of Optics, University of Granada, 18071, Granada, Spain
| | - José R Jiménez
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071, Granada, Spain
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Zhao W, Zhao J, Zhang Z, Han T, Wang J, Zhou X. Evaluating early-stage disk halo changes after small incision lenticule extraction. Eur J Ophthalmol 2022; 33:11206721221138306. [PMID: 36377271 DOI: 10.1177/11206721221138306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
PURPOSE To investigate early changes in the disk halo under different light conditions after myopic small incision lenticule extraction (SMILE). METHODS This prospective study included 70 eyes of 70 myopic patients aged 18-33 years, with a spherical equivalent (SE) of -5.87 ± 1.86 D, who underwent SMILE. The subjective refraction, higher-order aberrations (HOAs), pupillometry, and halo were measured preoperatively and postoperatively to analyse disk halo variations and correlated factors. RESULTS At 5 cd/m2 and 1 cd/m2 luminance, the halo radius in the high myopia (HM) group reached a postoperative peak after 1 week (p = 0.000 and 0.019, respectively), and recovered to baseline after 3 months. In the low-to-moderate (LM) myopia group, the halo radius did not differ 1 week postoperatively compared to the preoperative level (p = 0.015), but significantly improved after 3 months (p = 0.000). The halo radius correlated with SE, uncorrected distance visual acuity (UDVA), ocular HOAs, coma, and the pupillary light reflex in the LM group at all time points, but there were no correlations in the HM group. CONCLUSIONS Halo symptoms occurred early after SMILE, but recovered within 3 months. The recovery process was slower in the HM group than in the LM group, and the halo radius correlated with SE, UDVA, ocular HOAs, coma, and the pupillary light reflex.
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Affiliation(s)
- Wuxiao Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
- Present at Center for Optometry and Visual Science, Guangxi Academy of Medical Sciences, Nanning, China
| | - Jing Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Zhe Zhang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Tian Han
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Jifang Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
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Gui X, Zhang R, Li S, Zhao N, Zhang HR, Zhou YK, Huan CY, Zhao CY, Wang HY, Song HY, Shen W, Zhang JH. Comparative analysis of the clinical outcomes between wavefront-guided and conventional femtosecond LASIK in myopia and myopia astigmatism. Int J Ophthalmol 2021; 14:1581-1588. [PMID: 34667736 DOI: 10.18240/ijo.2021.10.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 08/20/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To compare the clinical outcomes of wavefront guided femtosecond LASIK (WFG LASIK) and conventional femtosecond LASIK (NWFG LASIK) in eyes with myopia and myopia astigmatism. METHODS This was a retrospective, nonrandomized, comparative investigation enrolling 236 eyes of 122 patients (18-50y) with low & moderate and high myopia. The WFG group including 97 eyes (50 patients) undergone WFG LASIK and the NWFG group including 139 eyes (72 patients) undergone conventional LASIK. Mean efficacy index, high order aberrations (HOAs), pupil size and the quality of visual questionnaire were evaluated 6mo postoperatively. RESULTS There is no difference between WFG group (-0.054±0.049 in logMAR) and NWFG group (-0.040±0.056) in uncorrected distance visual acuity (UDVA) postoperatively. The myopia astigmatism is higher in WFG group than that in NWFG group (P<0.05). However, the mean efficacy index (MEI) in the WFG group (1.09±0.106) is better than that in the NWFG group (1.036±0.124; P<0.001). Increased HOAs were observed in NWFG group (0.30±0.196) than that in WFG group (0.146±0.188; P<0.001). The pupil size is larger in WFG group (5.15±0.76 mm) than that in NWFG group (4.32±0.52 mm). The patients are satisfied with the clinical surgery, yet WFG group showed better visual quality using the questionnaire survey. Meanwhile, high myopia would result in worse MEI, HOAs and visual quality than low & moderate myopia. CONCLUSION WFG and NWFG FS-LASIK are both effective and safe procedures to correct low & moderate and high myopia, but WFG FS-LASIK gives a better postoperative MEI, aberrometric control and predictable outcome. Meanwhile, WFG FS-LASIK is better than NWFG FS-LASIK in correction of myopia astigmatism. Low & moderate myopia allow better clinical outcomes than high myopia using any surgical method.
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Affiliation(s)
- Xiao Gui
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Rui Zhang
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Sha Li
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Na Zhao
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Hao-Rui Zhang
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Yu-Kun Zhou
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Chen-Yang Huan
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Chun-Yan Zhao
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Hong-Ying Wang
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Hong-Yuan Song
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
| | - Wei Shen
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Jian-Hua Zhang
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
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Li M, Zhang L, Song Y, Hao W, Zhao X, Zhang Y, Jhanji V, Wang Y. Effect of Wavefront Aberrations on Night Vision Problems and Mesopic Contrast Threshold After SMILE. J Refract Surg 2021; 37:446-452. [PMID: 34236902 DOI: 10.3928/1081597x-20210405-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the effect of wavefront aberrations on night vision problems and mesopic contrast threshold after small incision lenticule extraction (SMILE). METHODS Forty-two participants (84 eyes) who underwent SMILE were included in this prospective observational study. Visual outcomes including uncorrected distance visual acuity (UDVA), subjective manifest refraction, mesopic contrast threshold (Binoptometer 4P; Oculus Optikgeräte GmbH), and higher order aberrations (HOAs) were analyzed before and 3 months after surgery. The patient's night vision satisfaction was assessed using a questionnaire. RESULTS The mean spherical equivalent was -5.30 ± 1.38 diopters (D) preoperatively and -0.06 ± 0.15 D postoperatively. UDVA was better than 20/20 in 98.81% of the patients and better than 20/25 in all patients. Scores of night vision satisfaction and glare changed significantly in the postoperative period (F = 8.463, P = .001; F = 69.518, P < .001, respectively). Preoperative spherical diopters (lower order aberrations) were positively correlated with night vision satisfaction (r = -0.329, P = .041) and glare score (r =-0.332, P = .039). Age (odds ratio [OR] = 1.272, 95% CI = 1.019 to 1.589) and preoperative spherical diopter (OR = 0.437, 95% CI = 0.199 to 0.975) were correlated with night vision satisfaction scores by analysis of binary regression. The root mean square value of total HOAs increased 3 months after surgery (t = -6.873, P < .001) with an increase in horizontal coma (Z31) and spherical aberration (Z40) (P < .001). No correlation was observed between glare score and HOAs; however, patients with higher preoperative myopia demonstrated continuously decreasing contrast under mesopic conditions and higher postoperative horizontal coma. CONCLUSIONS Myopic patients with higher preoperative spherical errors experienced more glare at night after SMILE surgery. Postoperative horizontal coma was associated with worse mesopic contrast thresholds. [J Refract Surg. 2021;37(7):446-452.].
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Quantitative Assessment of the Pupil: An Underrecognized Yet Important Factor Related to Orbital Blowout Fracture Repair. J Craniofac Surg 2021; 32:1054-1058. [PMID: 33252528 DOI: 10.1097/scs.0000000000007213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To investigate dynamic pupil changes after orbital blowout fracture repair. To compare postoperative changes in under photopic and mesopic pupil size and center position after orbital blowout fracture repair surgery. METHODS The study evaluated 19 eyes. Pupils were imaged for pupil size and center position before and 3 months after orbital blowout fracture repair surgery. Pupil size changes were measured, and the correlation between preoperative and postoperative pupil centroid shift was evaluated. RESULTS After repair, operative eyes exhibited a growth of 9.3% ± 8.6% in pupil size, and contralateral eyes showed a growth of 8.6% ± 8.2% (P = 0.011, P = 0.007). Similar findings were noted in mesopic conditions. Under mesopic conditions, the pupil of operative eyes in medial orbital wall fracture deviated 0.030 ± 0.019 mm towards the nasal side along the X-axis (P = 0.031). The postoperative orbital floor fracture group demonstrated statistical significance at a spatial frequency of 5 (P = 0.041). CONCLUSIONS Orbital blowout fracture repair surgery affects pupil size and center position.
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Coco G, Cremonesi P, Menassa N, Pagano L, Gadhvi KA, Semeraro F, Kaye SB, Romano V. Changes in pupillometry associated with dissipated energy during phacoemulsification. Eur J Ophthalmol 2020; 31:2962-2968. [PMID: 33372549 DOI: 10.1177/1120672120984377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate the effect of ultrasound level during phacoemulsification on pupil dynamics. METHODS Comparative retrospective study on patients who underwent routine cataract surgery at the Royal Liverpool University Hospital. Clinical parameters, anterior chamber measurements, axial length, surgeon grade, time of surgery, level of ultrasound used (cumulative dissipated energy, CDE), intra- and post-operative complications were collected. Pupil diameters were collected before and 4 ± 1 weeks after surgery in static scotopic, mesopic, photopic pupil conditions. Also, pupil dynamic measurements after luminous stimulus were recorded. Changes in static pupil diameters, relative dilation at 3.5 s after luminous stimulus, and time to reach 75% and 95% of maximum dilation were measured. RESULTS Forty-eight eyes of 24 patients (13 males) were included with a mean age of 73.1 ± 14.6 years. Mean CDE value was 18.11 ± 10.56. Mean scotopic pupil diameters decreased by 0.24 ± 0.48 mm (p = 0.021) in the operated eye. Significant correlation was found between reduction in scotopic pupil diameter and CDE (p = 0.05). A generalized linear model confirmed that the level of CDE was significantly associated with reduction in scotopic pupil diameter (p = 0.026). Patients who underwent surgeries with lower CDE (0 < CDE ⩽ 10 and 10 < CDE ⩽ 20) did not experience significant changes in scotopic pupil diameter after surgery (p = 0.28 and p = 0.79, respectively) as opposed to those with higher CDE (CDE > 20; p = 0.03). CONCLUSION Phacoemulsification cataract surgery and the cumulative dissipated energy may be associated with changes in pupil behaviour.
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Affiliation(s)
- Giulia Coco
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.,Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Pierluca Cremonesi
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.,Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, University of Brescia, Brescia, Italy
| | - Nardine Menassa
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - Luca Pagano
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - Kunal A Gadhvi
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - Francesco Semeraro
- Department of Medical and Surgical Specialties, Radiological Specialties and Public Health, University of Brescia, Brescia, Italy
| | - Stephen B Kaye
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.,Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Vito Romano
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.,Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
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Jiménez JR, Alarcón A, Anera RG, Jiménez Del Barco L. Q-optimized Algorithms: Theoretical Analysis of Factors Influencing Visual Quality After Myopic Corneal Refractive Surgery. J Refract Surg 2017; 32:612-7. [PMID: 27598731 DOI: 10.3928/1081597x-20160531-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 05/03/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To model the effect of pupil size, optical zone, and initial myopic level on the retinal image quality after Q-optimized myopic corneal refractive surgery. METHODS Different Q-optimized and paraxial Munnerlyn algorithms were tested using a schematic myopic eye model to analyze the optical quality of the final retinal image for initial myopic errors from -1.00 to -7.00 diopters (D). Different optical zones (5.5, 6, and 6.5 mm in diameter) and two pupil diameters (5 and 7 mm, mesopic-scotopic conditions) were included in the comparison. Modulation transfer function (MTF) and area under the MTF from 0 to 60 cycles per degree (MTFa) were calculated by ray tracing to evaluate this retinal image quality. RESULTS The Q-optimized algorithm with Q = -0.45 provided the highest MTF and MTFa results for myopic corrections less than -5.00 D. For refractive errors greater than -5.00 D, Q = -0.26 provided the highest MTF and MTFa results. CONCLUSIONS Q-optimized algorithms improve the visual outcomes with respect to the paraxial Munnerlyn algorithm for myopic corneal surgery. The results show that the Q value that optimizes the results of the Q-optimized algorithm depends on the degree of myopia to correct and the size of the pupil. [J Refract Surg. 2016;32(9):612-617.].
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Jiménez JR, Alarcón A, Anera RG, Del Barco LJ. Hyperopic Q-optimized algorithms: a theoretical study on factors influencing optical quality. BIOMEDICAL OPTICS EXPRESS 2017; 8:1405-1414. [PMID: 28663837 PMCID: PMC5480552 DOI: 10.1364/boe.8.001405] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 02/02/2017] [Indexed: 06/07/2023]
Abstract
In this work, we analyze the way in which pupil size, optical zone, and initial hyperopic level influence optical quality for hyperopic Q-optimized corneal refractive surgery. Different Q-optimized algorithms and the Munnerlyn formula were tested to analyze the optical quality of the final retinal image for initial hyperopic errors from 1D to 5D. Three optical zones (5.5, 6, and 6.5 mm) and two pupil diameters (5 and 7 mm) were considered. To evaluate optical quality, we computed the modulation transfer function (MTF) and the area under MTF (MTFa). Q-optimized values at around Q = -0.18 were found to provide the best optical quality for most of the conditions tested. This optimum final asphericity for hyperopic ablation was not depending on the degree of hyperopia corrected, the optical zone or the pupil size being this information important for clinical practice.
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Affiliation(s)
- Jose R. Jiménez
- Departamento de Óptica, Facultad de Ciencias, Edificio Mecenas, Universidad de Granada, Spain
| | - Aixa Alarcón
- Abbott Medical Optics, Groningen, The Netherlands
| | - Rosario G. Anera
- Departamento de Óptica, Facultad de Ciencias, Edificio Mecenas, Universidad de Granada, Spain
| | - L. Jiménez Del Barco
- Departamento de Óptica, Facultad de Ciencias, Edificio Mecenas, Universidad de Granada, Spain
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Kimlin JA, Black AA, Djaja N, Wood JM. Development and validation of a vision and night driving questionnaire. Ophthalmic Physiol Opt 2016; 36:465-76. [PMID: 27350185 DOI: 10.1111/opo.12307] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 05/06/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE Night-time driving difficulties are a common concern of older drivers and those with eye disease. This study aimed to develop and validate a questionnaire for assessing vision-related night driving difficulties in older drivers. METHODS Items from existing vision-related quality of life questionnaires and driving studies were used to develop a questionnaire that was completed by 283 participants who reported visual difficulties for night driving (65% female, 50 to >80 years). The questionnaire included items relating to demographic and night driving characteristics (seven items), general vision ratings (eight items), vision-related night driving difficulties (11 items), and a single open question about specific night driving difficulties. The vision-related night driving difficulty items were analysed separately using Rasch analysis to form the vision and night driving questionnaire (VND-Q). Rasch analysis assessed validity and psychometric properties of the scale. Generalised linear regression models examined associations between VND-Q scores and age, gender, amount of night driving, self-rated vision, and eye conditions. Test-retest repeatability was assessed using intra-class correlation analysis and Bland-Altman methods of agreement for a subset of 30 participants. RESULTS Rasch analysis indicated that a nine-item VND-Q scale was unidimensional, valid and reliable, and showed excellent discriminant ability (person separation index 3.04; person reliability 0.90). Targeting was better for those with greater self-reported night driving difficulties. Participants with self-reported bilateral eye conditions and worse self-reported general vision ratings had significantly more night driving difficulties with the VND-Q scale than individuals without eye conditions (p = 0.03) and with better general vision ratings (p < 0.001). Females reported more difficulties than males (p < 0.001) and drove shorter distances at night per week which was also associated with greater difficulties (p < 0.001). A repeatability coefficient (Rc ) of 2.07 demonstrated excellent test-retest repeatability. CONCLUSIONS The nine-item VND-Q is a unidimensional and reliable questionnaire allowing quantification of the level of visual difficulties that older drivers report at night. The development of this questionnaire is an important step in providing a reliable and validated instrument for use to guide appropriate investigations, referrals, or interventions in clinical and research settings.
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Affiliation(s)
- Janessa A Kimlin
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Alex A Black
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Ngadiman Djaja
- School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Joanne M Wood
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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Wu Y, He JC, Zhou XT, Chu RY. A limitation of Hartmann-Shack system in measuring wavefront aberrations for patients received laser refractive surgery. PLoS One 2015; 10:e0117256. [PMID: 25692489 PMCID: PMC4332858 DOI: 10.1371/journal.pone.0117256] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 12/21/2014] [Indexed: 11/19/2022] Open
Abstract
Purpose To explore the relationship between ablation parameters of myopic laser surgery and measurement area of wavefront aberration (WA) with Hartmann-Shack wavefront sensor. Methods 58 subjects undergone myopic laser surgeries and 74 uncorrected myopic subjects were enrolled in this experiment. The laser ablation parameters were obtained from surgical records, which included spherical error (Rx), depth, and optical zone (OZ) of ablation. The measured area of WA was tested by the WASCA, and the real pupil size was tested by Pentacam. The corneal eccentricity (E value) and curvature was also measured with the Pentacam. All the measurements were performed under mydriatic condition. Results For uncorrected myopic eyes, the measured area of WA was similar with the real pupil size. But for the corrected eyes, the measured area of WA was smaller than the real pupil size with a mean difference of 0.66 ± 0.54 mm for moderate myopia (t = 6.45, p < 0.0001) and 1.76 ± 0.55 mm for high myopia (t = 18.92, p < 0.0001), but not for mild myopia. The Rx (t = -3.20, p = 0.0017), OZ (t = 64.4, p < 0.0001) and postoperative corneal E value (t = 2.52, p = 0.017) were the independent factors of measured area of WA. Measured area of WA = -0.81*Rx + 1.13*OZ + 0.49*postoperative corneal E value (r2 = 0.997). Conclusions The WASCA has a limitation in measuring wavefront aberration over the whole pupil area when it’s used for patients received myopic laser surgery. The measured area is smaller than the real pupil size and depends linearly on ablation depth, optical zone and corneal eccentricity.
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Affiliation(s)
- Ying Wu
- Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Ji C. He
- New England College of Optometry, Boston, Massachusetts, United States of America
| | - Xing T. Zhou
- Eye & ENT Hospital of Fudan University, Shanghai, China
- * E-mail:
| | - Ren Y. Chu
- Eye & ENT Hospital of Fudan University, Shanghai, China
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Lee TJ, Kim HS, Jung JW, Lee H, Seo KY, Lee HK, Kim EK, Kim TI. Comparison of Automatic Pupillometer and Pupil Card for Measuring Pupil Size. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.6.863] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Taek June Lee
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | | | - Ji Won Jung
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Hoon Lee
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Kyoung Yul Seo
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Hyung Keun Lee
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Eung Kweon Kim
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Tae Im Kim
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
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Schallhorn S, Brown M, Venter J, Hettinger K, Hannan S. The Role of the Mesopic Pupil on Patient-Reported Outcomes in Young Patients With Myopia 1 Month After Wavefront-Guided LASIK. J Refract Surg 2014; 30:159-65. [DOI: 10.3928/1081597x-20140217-02] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 11/20/2013] [Indexed: 11/20/2022]
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Myung D, Schallhorn S, Manche EE. Pupil size and LASIK: a review. J Refract Surg 2014; 29:734-41. [PMID: 24203804 DOI: 10.3928/1081597x-20131021-02] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 10/08/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE To provide a literature review on the evidence both for and against pupil size as an independent predictor of adverse visual outcomes after LASIK. METHODS Peer-reviewed publications on the effect of pupil size on LASIK outcomes since 2002 are reviewed. Particular attention was paid to the following attributes of each publication: type of study, number of patients or eyes, mean age, mean level of myopia, mean pupil size, testing conditions, ablation zone diameter, presence or absence of blend zones, and mean follow-up period. RESULTS Among the 19 studies examined, none correlates a persistent relationship between pupil size and night vision complaints (NVCs) beyond 3 months when LASIK was performed with a 6.0-mm optical zone or larger ablation. The studies that did explicitly determine a correlation either included some or all patients with ablation zones smaller than 6.0 mm or did not specify ablation diameter at all. Among the studies that had drawn more mixed conclusions, the studies either covered short follow-up intervals (1 to 3 months) or showed a progressive improvement in NVCs over time in a relatively small patient cohort. CONCLUSIONS As keratorefractive technology continues to evolve, the role of pupil size warrants further investigation; however, based on the literature reviewed herein, modern LASIK has negated the role of the low light pupil in predicting adverse visual outcomes after LASIK outside of the early postoperative period.
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Lim DH, Lyu IJ, Choi SH, Chung ES, Chung TY. Risk factors associated with night vision disturbances after phakic intraocular lens implantation. Am J Ophthalmol 2014; 157:135-141.e1. [PMID: 24182745 DOI: 10.1016/j.ajo.2013.09.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 09/04/2013] [Accepted: 09/05/2013] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate the incidence and severity of night vision disturbances after implantable collamer lens surgery and to analyze the risk factors. DESIGN Retrospective, noncomparative study. METHODS Medical charts from 50 eyes of 25 patients who underwent implantable collamer lens implantation were retrospectively reviewed. The incidence and severity of night vision disturbances were evaluated using questionnaires administered 6 months after surgery. Univariate simple and multiple logistic regression analyses were used to detect risk factors associated with postoperative night vision disturbances. Potential risk factors included in the analysis were keratometric value, anterior chamber depth, postoperative residual refractive error, higher-order aberrations, preoperative and postoperative mesopic pupil size, the difference between preoperative and postoperative mesopic pupil size, the difference between mesopic pupil size and implantable collamer lens optic zone diameter, white-to-white diameter, sulcus-to-sulcus diameter, and postoperative implantable collamer lens vaulting. The power, size, optic zone diameter, and toricity of the implantable collamer lens were also included as variables. RESULTS The incidence of night vision disturbances was 34.0% for halos and 26.0% for glare. Halos were found to be significantly related to the difference between mesopic pupil size and implantable collamer lens optic zone diameter (P = .013), white-to-white diameter of the cornea (P = .028), and implantable collamer lens optic zone diameter (P = .030). For glare, toricity of the implantable collamer lens was revealed as a significant risk factor (P = .047). CONCLUSIONS Although not severe, the incidence of night vision disturbances after implantable collamer lens implantation was not negligible. Possible risk factors for night vision disturbances include implantable collamer lens optic zone diameter, the difference between mesopic pupil size and implantable collamer lens optic zone diameter, and white-to-white diameter of the cornea for causing halos, and the toricity of the implantable collamer lens for causing glare.
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Affiliation(s)
- Dong Hui Lim
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - In Jeong Lyu
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sung-Ho Choi
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Happy Eye Clinic, Gwangju, South Korea
| | - Eui-Sang Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Tae-Young Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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Alarcón A, Rubiño M, Pééérez-Ocón F, Jiménez JR. Theoretical analysis of the effect of pupil size, initial myopic level, and optical zone on quality of vision after corneal refractive surgery. J Refract Surg 2013; 28:901-6. [PMID: 23310967 DOI: 10.3928/1081597x-20121106-01] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To analyze the theoretical effect that pupil size, optical zone, and initial myopic level have on the final retinal image after corneal refractive surgery. METHODS A schematic myopic eye model corrected by the Munnerlyn formula was used to analyze the optical quality of the final retinal image. Root-mean-square radius spot and modulation transfer function were cal- culated by ray tracing to evaluate retinal image quality. RESULTS Pupil size had a negative effect on the retinal image only when it was greater than the diameter of the optical zone. In addition, the greater the initial myopic level, the more the pupil size affected image quality. Thus, a clear dependence exists between the initial myopic level and effect that the pupil size can have on the retinal image after laser refractive surgery. CONCLUSIONS Pupil size may be a risk factor for night vision disturbances, but only when it is larger than the theoretical optical zones utilized in this study. Its effect depends not only on the optical zone size, but also on the initial "myopic level. Therefore, this relationship should be taken into account during patient selection for refractive surgery
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Affiliation(s)
- Aixa Alarcón
- Laboratory of Vision Sciences and Applications, University of Granada, Spain.
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16
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Baek JS, Park JH, Yoo ES, Kwon YA, Song SW, Kim BY, Chung JL. Comparison of Colvardpupillometer, ORBScan II and Sirius in Determining Pupil Size for Refractive Surgery. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.8.1175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Ji Sun Baek
- Department of Ophthalmology, Konyang University, Kim's Eye Hospital, Seoul, Korea
| | | | | | - Young A Kwon
- Department of Ophthalmology, Konyang University, Kim's Eye Hospital, Seoul, Korea
| | - Sang Wroul Song
- Department of Ophthalmology, Konyang University, Kim's Eye Hospital, Seoul, Korea
| | - Byoung Yeop Kim
- Department of Ophthalmology, Konyang University, Kim's Eye Hospital, Seoul, Korea
| | - Jae Lim Chung
- Department of Ophthalmology, Konyang University, Kim's Eye Hospital, Seoul, Korea
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Fritzsch M, Dawczynski J, Jurkutat S, Vollandt R, Strobel J. [Monochromatic aberration in accommodation. Dynamic wavefront analysis]. Ophthalmologe 2012; 108:553-60. [PMID: 21695608 DOI: 10.1007/s00347-011-2336-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Monochromatic aberrations may influence the visual acuity of the eye. They are not stable and can be affected by different factors. The subject of the following paper is the dynamic investigation of the changes in wavefront aberration with accommodation. METHOD Dynamic measurement of higher and lower order aberrations was performed with a WASCA Wavefront Analyzer (Carl-Zeiss-Meditec) and a specially constructed target device for aligning objects in far and near distances on 25 subjects aged from 15 to 27 years old. RESULTS Wavefront aberrations showed some significant changes in accommodation. In addition to the characteristic sphere reaction accompanying miosis and changes in horizontal prism (Z(1) (1)) in the sense of a convergence movement of the eyeball also occurred. Furthermore defocus rose (Z(2) (0)) and astigmatism (Z(2) (-2)) changed. In higher-order aberrations a decrease in coma-like Zernike polynomials (Z(3) (-1), Z(3) (1)) was found. The most obvious change appeared in spherical aberration (Z(4) (0)) which increased and changed from positive to negative. In addition the secondary astigmatism (Z(4) (-2)) and quadrafoil (Z(4) (4)) rise also increased. The total root mean square (RMS), as well as the higher-order aberrations (RMS-HO) significantly increased in accommodation which is associated with a theoretical reduction of visual acuity. An analysis of the influence of pupil size on aberrations showed significant increases in defocus, spherical aberration, quadrafoil, RMS and RMS HO by increasing pupil diameter. By accommodation-associated miosis, the growing aberrations are partially compensated by focusing on near objects. Temporal analysis of the accommodation process with dynamic wavefront analysis revealed significant delays in pupil response and changing of prism in relation to the sphere reaction. In accommodation to near objects a discrete time ahead of third order aberrations in relation to the sphere response was found. CONCLUSION Using dynamic wavefront measurement achieved a sequential analysis of aberrations during accommodation. Significant changes in the lower and higher-order aberrations could be detected. These are additionally varied by the associated pupillary response. Moreover, the synchronicity of wave front reaction in the accommodation process was proven.
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Affiliation(s)
- M Fritzsch
- Klinik für Augenheilkunde, Universitätsklinikum Jena, Jena, Germany.
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18
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Maldonado MJ, López-Miguel A, Piñero DP, Juberías JR, Nieto JC, Alió JL. Can we measure mesopic pupil size with the cobalt blue light slit-lamp biomicroscopy method? Graefes Arch Clin Exp Ophthalmol 2012; 250:1637-47. [DOI: 10.1007/s00417-011-1909-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Revised: 11/22/2011] [Accepted: 12/13/2011] [Indexed: 10/14/2022] Open
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Abstract
BACKGROUND Wavefront-guided corneal surgery is a standard therapeutic option for correcting refractive errors. If the wavefront measured preoperatively is influenced by an incorrect alignment of the bulb, the ablation profile could be distorted and the quality of vision reduced. METHOD Wavefront analysis was done on 49 eyes, examining the primary gaze of the bulb as well as abduction, adduction, elevation, and depression. RESULTS The study demonstrated a significant influence of eye movements on astigmatic aberrations. Horizontal eye movements have a stronger influence than vertical ones do. Adduction especially leads to changes; here, RMS showed a significant difference. CONCLUSIONS Eye movements have a significant effect on wavefront profiles. The amount of aberration induced is generally very low. In individual cases, the numbers of aberrations induced by eye movements are in ranges reported to reduce the postoperative quality of vision when the ablation profile is taken into account.
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Ko BU, Ryu WY, Park WC. Pupil Size in the Normal Korean Population According to Age and Illuminance. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2011. [DOI: 10.3341/jkos.2011.52.4.401] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Byung Uk Ko
- Department of Ophthalmology, Dong-A University College of Medicine, Busan, Korea
| | - Won Yeol Ryu
- Department of Ophthalmology, Dong-A University College of Medicine, Busan, Korea
| | - Woo Chan Park
- Department of Ophthalmology, Dong-A University College of Medicine, Busan, Korea
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Effect of preoperative pupil size on quality of vision after wavefront-guided LASIK. Ophthalmology 2010; 118:736-41. [PMID: 21093922 DOI: 10.1016/j.ophtha.2010.07.030] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Revised: 07/29/2010] [Accepted: 07/29/2010] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To evaluate the effect of preoperative pupil size on quality of vision after wavefront-guided LASIK. DESIGN Prospective study. PARTICIPANTS One hundred two eyes. INTERVENTION LASIK for mild to moderate myopia or astigmatism (preoperative manifest spherical equivalent, -3.99±1.42 diopters). MAIN OUTCOME MEASURES Questionnaires evaluating specific visual symptoms before and after surgery. Each eye was evaluated before surgery, and 1 week and 1, 3, 6, and 12 months postoperatively. Pupils were stratified according to size: small (≤5.5 mm), medium (5.6-6.4 mm), or large (≥6.5 mm). Mesopic pupil size and preoperative and postoperative variables were evaluated using an analysis of variance. A regression model was also performed to determine the correlation between mean spherical equivalent and cylinder and visual symptoms. RESULTS In the early postoperative period, there was no difference between the 3 groups with regard to any of the symptoms. At the final 12-month postoperative visit, patients with medium pupils experienced less glare at night than small pupils (P = 0.02), medium pupils had less halos than small or large pupils (P = 0.001 and P = 0.02, respectively), and medium pupils experienced greater satisfaction in visual improvement than small pupils (P = 0.014). CONCLUSIONS Twelve months after wavefront-guided LASIK surgery, large pupil size does not positively correlate with any postoperative visual symptoms.
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22
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Rosen E. Pupillometry Using the Procyon Pupillometer. J Refract Surg 2010; 26:544; author reply 544-5, discussion 545-6. [DOI: 10.3928/1081597x-20100520-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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23
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Canovetti A, Nardi M, Figus M, Fogagnolo P, Benelli U. Aceclidine, brimonidine tartrate, and dapiprazole: Comparison of miotic effect and tolerability under different lighting conditions. J Cataract Refract Surg 2009; 35:42-6. [DOI: 10.1016/j.jcrs.2008.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2008] [Revised: 09/01/2008] [Accepted: 09/11/2008] [Indexed: 11/30/2022]
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Yoon MK, Schmidt G, Lietman T, McLeod SD. Inter- and Intraobserver Reliability of Pupil Diameter Measurement During 24 Hours Using the Colvard Pupillometer. J Refract Surg 2007; 23:266-71. [PMID: 17385292 DOI: 10.3928/1081-597x-20070301-09] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the inter- and intraobserver agreement of pupil size diameter measurements determined using the Colvard pupillometer. METHODS The eyes of 69 patients were examined (T1) using the Colvard pupillometer under mesopic and scotopic conditions by two examiners and repeated 1 hour (T2) and 24 hours (T3) later. The limits of agreement (mean difference between measurements +/- 2 standard deviations) were calculated for measurements between examiners (inter-examiner agreement) and between different time points measured by the same examiner (intra-examiner agreement). RESULTS At T1, there was a 99% and a 97% chance of two different examiners producing readings within 0.5 mm under mesopic and scotopic conditions, respectively. There was a 15% chance and a 9% chance of finding a pupil difference > 0.5 mm over 1 hour under mesopic and scotopic conditions, respectively. For mesopic and scotopic measurements taken 24 hours apart, there was a 31% chance and a 21% chance, respectively, of finding a difference > 0.5 mm by the same examiner. CONCLUSIONS This study showed high interobserver agreement under scotopic conditions, with 98% of measurements between two examiners falling within 0.5 mm, but substantial variability in pupil diameter measurements over 24 hours. These results suggest that serial office measurements may be necessary to establish the true range of pupil size.
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Affiliation(s)
- Michael K Yoon
- Department of Ophthalmology, Francis I. Proctor Foundation, University of California San Francisco, San Francisco, Calif 94143, USA
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25
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Hachol A, Szczepanowska-Nowak W, Kasprzak H, Zawojska I, Dudzinski A, Kinasz R, Wygledowska-Promienska D. Measurement of pupil reactivity using fast pupillometry. Physiol Meas 2006; 28:61-72. [PMID: 17151420 DOI: 10.1088/0967-3334/28/1/006] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Analysis of human eye pupil reactivity is a very valuable diagnostic method used mainly for evaluation of the condition of the autonomic nervous system and the visual system. The paper presents an experimental pupillometer built in the Institute of Physics of the Wroclaw University of Technology. The apparatus makes it possible to record and analyze pupillary light reflex and spontaneous changes in the pupil diameter during a session in the dark. The detector system used in the pupillometer allows us to record the pupil diameter at a rate of 90 Hz with a linear accuracy of 0.008 mm. In this paper, the proposed detection method, the principle of operation and calibration of the apparatus and the possibilities of the measurement system are presented.
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Affiliation(s)
- A Hachol
- Department of Biomedical Engineering and Instrumentation, Wroclaw University of Technology, B. Prusa 53/55, 50-317 Wroclaw, Poland.
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Michel AW, Kronberg BP, Narváez J, Zimmerman G. Comparison of 2 multiple-measurement infrared pupillometers to determine scotopic pupil diameter. J Cataract Refract Surg 2006; 32:1926-31. [PMID: 17081898 DOI: 10.1016/j.jcrs.2006.07.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2006] [Accepted: 07/06/2006] [Indexed: 10/24/2022]
Abstract
PURPOSE To compare a monocular and a binocular multiple-measurement digital infrared pupillometers for measuring scotopic pupil diameter. SETTING Department of Ophthalmology, Loma Linda University, Loma Linda, California, USA. METHODS Scotopic pupil size was measured after 1 minute of dark adaptation in 42 eyes of 21 volunteers. Measurements were taken twice each with 2 multiple-measurement digital infrared pupillometers, the monocular pupillometer (Neuroptics, Inc.), and the binocular pupillometer (P2000D, Procyon, Ltd.) Intraclass correlation coefficients (ICC) and limits of agreement (LOA) were used to measure repeatability and agreement of measures with each instrument and between instruments. The Wilcoxon signed rank test was used to compare variability of measurements within each instrument. RESULTS The mean scotopic pupil size was 4.79 mm +/- 0.95 (SD) with the Procyon and 4.86 +/- 0.93 mm with the Neuroptics. Repeatability and agreement tests for the Procyon measures showed the following: ICC, 0.954; 95% confidence interval (CI), 0.916-0.975; LOA, -0.60 to 0.56; range, 1.16. The Wilcoxon signed rank test of variability gave a Z score of -2.53 (P = .01, 2 tailed). The repeated measures testing with the Neuroptics pupillometer showed the following: ICC, 0.985; 95% CI, 0.972-0.992; LOA, -0.39 to 0.26; range, 0.64; Z score, -1.15 (P = .25, 2-tailed). Repeatability and agreement tests for measures between instruments showed the following: ICC, 0.954; 95% CI, 0.916-0.975; LOA, -0.60 to 0.50; range 1.11. CONCLUSIONS There was a high repeatability and agreement in scotopic pupil diameter for repeated measures within each device and measurements between the devices. Differences in variability in scotopic pupil diameter evaluated by the Wilcoxon signed rank test were significant only with the Procyon pupillometer.
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Affiliation(s)
- Alan W Michel
- House Staff Office, Loma Linda University, Loma Linda, California, USA
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Abstract
PURPOSE To analyze binocular visual function after LASIK. METHODS Eye aberrometry and corneal topography was obtained for both eyes in 68 patients (136 eyes). To evaluate visual performance, monocular and binocular contrast sensitivity function and disturbance index for quantifying halos were measured. Tests were performed under mesopic conditions. RESULTS Binocular summation and disturbance index diminished significantly (P<.0001) after LASIK with increasing interocular differences in corneal and eye aberrations. Binocular visual deterioration was greater than monocular deterioration for contrast sensitivity function and disturbance index. CONCLUSIONS Binocular function deteriorates more than monocular function after LASIK. This deterioration increases as the interocular differences in aberrations and corneal shape increase. Improvements in ablation algorithms should minimize these interocular differences.
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Affiliation(s)
- José Ramón Jiménez
- Laboratorio de Ciencias de la Visión y Aplicaciones, Departamento de Optica, Facultad de Ciencias, Universidad de Granada, Granada, Spain.
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Abstract
PURPOSE OF REVIEW The role of scotopic pupil size as a factor in predicting night vision complaints is controversial. This review summarizes reports in the literature, some that have found and some that have failed to find a correlation with scotopic pupil size and night vision complaints. RECENT FINDINGS Pupil-measuring devices are discussed along with informed consent issues and reports showing that wavefront aberrations increase with increasing pupil size. A new objective measuring device (Larson) showed a correlation with postoperative starbursts and pupil size and a decrease in starbursts with wavefront-guided treatments compared with conventional excimer laser treatments. Cortical adaptation allows many patients to adapt to their new night vision. Treatment options for those who remain symptomatic include drops to reduce pupil size and wavefront-guided retreatments. SUMMARY Reports in the literature are conflicting, and refractive surgeons would be wise to inform their patients that large scotopic pupil size is a potential risk factor for night vision complaints. By doing this they will follow the recommendations in recent patient information brochures of both VISX (Santa Clara, California) and Alcon (Orlando, Florida) and on the United States Food and Drug Administration web site.
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Affiliation(s)
- James J Salz
- University of Southern California and Los Angeles County Medical Center, Los Angeles, California 90048, USA.
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Schallhorn SC, Amesbury EC, Tanzer DJ. Avoidance, recognition, and management of LASIK complications. Am J Ophthalmol 2006; 141:733-9. [PMID: 16564812 DOI: 10.1016/j.ajo.2005.11.036] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2005] [Revised: 11/20/2005] [Accepted: 11/21/2005] [Indexed: 11/17/2022]
Abstract
PURPOSE To provide important concepts of the latest developments in laser in situ keratomileusis (LASIK) complication avoidance, recognition, and management. DESIGN A perspective. METHODS A comprehensive literature search and review of a total of 816 publications that discussed LASIK complications from 1992 to 2005 was conducted. RESULTS The risk of visually threatening complications is inherent in any ophthalmologic surgical procedure. Not only does LASIK require the use of several complex medical devices, but there can be significant human variation in response to this surgical intervention. As a result, many potential complications can occur after LASIK. The risk of many complications can be mitigated by appropriate patient selection and preoperative, surgical, and postoperative care. Unforeseen complications will occur, despite meticulous planning, and must be managed. Important current developments in the avoidance, recognition, and management of LASIK complications are reviewed. CONCLUSIONS Complications as a result of LASIK can threaten vision and may cause debilitating symptoms in an otherwise healthy eye. Advancing our understanding of the prevention and management of the complications of LASIK is an endeavor that must be continued as long as refractive surgery is performed.
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Affiliation(s)
- Steven C Schallhorn
- Department of Ophthalmology, Naval Medical Center, San Diego, California 92134, USA.
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Randazzo A, Nizzola F, Rossetti L, Orzalesi N, Vinciguerra P. Pharmacological management of night vision disturbances after refractive surgery. J Cataract Refract Surg 2005; 31:1764-72. [PMID: 16246781 DOI: 10.1016/j.jcrs.2005.02.042] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2005] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the efficacy and safety of diluted aceclidine eyedrops in reducing night vision disturbances after refractive surgery. SETTING Department of Ophthalmology, Istituto Clinico Humanitas, Rozzano-Milano, Italy. METHODS This double-masked randomized clinical trial included 30 patients (60 eyes) with chronic night vision disturbance after refractive surgery. Patients were randomly allocated to receive (1) placebo, (2) aceclidine 0.016%, or (3) aceclidine 0.032%. Drugs were administered once or twice daily. Anterior segment, haze, uncorrected visual acuity, best corrected visual acuity, intraocular pressure, corneal maps, and scotopic pupil size were determined at baseline and at follow-up examinations (15 and 30 days after inclusion). Halos and double vision 4-step scales were built to determine subjective grading of night vision disturbance, and the root mean square (RMS) was calculated to determine objective changes in night vision disturbance. RESULTS The effect of diluted aceclidine started about 15 minutes after instillation and lasted for about 5 hours. No difference between the 2 dilutions could be found. Thirty-nine of 40 treated eyes showed a reduction in night vision disturbance. The mean reduction in halos and double vision grading was 1.42 +/- 0.5 (SD) and 1.14 +/- 0.4, respectively. A mean decrease in pupil size of 2.5 mm was measured. Thirty minutes after the instillation of diluted aceclidine, the topography-derived wavefront error showed a statistically significant reduction in RMS values (total, spherical, astigmatic, coma, and higher order), which was maintained for 5 hours. A transitory conjunctival hyperemia was the only side effect reported. CONCLUSION Diluted aceclidine seemed to be an effective and safe treatment for night vision disturbance following refractive surgery.
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Affiliation(s)
- Alessandro Randazzo
- Department of Ophthalmology, Istituto Clinico Humanita-Rozzano, Modena, Italy.
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