Peripheral aberration measurements: elliptical pupil transformation and variations in horizontal coma across the visual field

The Effect of Accommodation on Peripheral Refraction under Two Illumination Conditions

The clinical importance of peripheral refraction as a function of accommodation has become increasingly evident in the last years with special attention given to myopia control. Low order ocular aberrations were measured with a Hartmann–Shack aberrometer in a sample of 28 young emmetropic subjects. A stationary Maltese cross was presented at 2.5 D and 5.0 D of accommodative demand and at 0°, 10° and 20° of eccentricity in the horizontal visual field under two different illumination conditions (white and red light). Wavefront data for a 3 mm pupil diameter were analyzed in terms of the vector components of refraction (M, J0 and J45) and the relative peripheral refractive error (RPRE) was calculated. M was myopic at both accommodative demands and showed a statistically significant myopic increase with red illumination. No significant change in J0 and J45 was found with accommodation nor between illumination conditions. However, J0 increased significantly with eccentricity, exhibiting a nasal-temporal asymmetry. The RPRE was myopic at both accommodation demands and showed a statistically significant hyperopic shift at 20° in the nasal retina. The use of red light introduced statistically and clinically significant changes in M, explained by the variation of the ocular focal length under a higher wavelength illumination, increasing the experimental accommodative demand. These findings may be of relevance for research exploring peripheral refraction under accommodation, as the choice of target illumination is not trivial.

Effect of Accommodation on Peripheral Higher Order Aberrations

Knowledge of the effect of accommodation on image quality of peripheral retina is crucial for better understanding of the visual system, but only a few studies have been carried out in this area. This study was designed to evaluate the effect of accommodation on higher order aberrations from third to sixth Zernike polynomials in central and peripheral retina up to 23° off-axis. We used a Hartmann–Shack aberrometer to measure Zernike coefficients with both accommodated and non-accommodated eyes of 15 healthy subjects. Each Zernike coefficient, total higher order aberrations, spherical aberrations and astigmatism were compared between accommodated and non-accommodated status. Additionally, aberrations in the central retina were compared with the peripheral retina. Accommodation induced significant changes in the Zernike coefficients of vertical pentafoil C5−5 and secondary vertical tetrafoil C6−4 in central retina, secondary vertical astigmatism C4−2 on 23° of temporal retina, secondary vertical tetrafoil C6−4 and tertiary vertical astigmatism C6−2 on 10° of nasal retina, secondary vertical trefoil C5−3 and secondary vertical tetrafoil C6−4 on 23° of nasal retina, and horizontal tetrafoil C44, and secondary horizontal tetrafoil C64 on 23° of inferior retina (p < 0.05). Total higher order aberration was lower in each retinal area examined with accommodation, but it was statistically significant only on 23° temporal retina and 11.5° and 23° of superior retina (p < 0.05). Spherical aberration decreased with accommodation on 23° temporal retina (p = 0.036). Astigmatism was similar in non-accommodated and accommodated eyes. Overall, accommodation affected higher order aberration (HOA) asymmetrically in different peripheral retinal areas.

Lower sensitivity to peripheral hypermetropic defocus due to higher order ocular aberrations

PURPOSE

Many myopia control interventions are designed to induce myopic relative peripheral refraction. However, myopes tend to show asymmetries in their sensitivity to defocus, seeing better with hypermetropic rather than myopic defocus. This study aims to determine the influence of chromatic aberrations (CA) and higher-order monochromatic aberrations (HOA) in the peripheral asymmetry to defocus.

METHODS

Peripheral (20° nasal visual field) low-contrast (10%) resolution acuity of nine subjects (four myopes, four emmetropes, one hypermetrope) was evaluated under induced myopic and hypermetropic defocus between ±5 D, under four conditions: (a) Peripheral Best Sphere and Cylinder (BSC) correction in white light; (b) Peripheral BSC correction + CA elimination (green light); (c) Peripheral BSC correction + HOA correction in white light; and (d) Peripheral BSC correction + CA elimination + HOA correction. No cycloplegia was used, and all measurements were repeated three times.

RESULTS

The slopes of the peripheral acuity as a function of positive and negative defocus differed, especially when the natural HOA and CA were present. This asymmetry was quantified as the average of the absolute sum of positive and negative defocus slopes for all subjects (AVS). The AVS was 0.081 and 0.063 logMAR/D for white and green light respectively, when the ocular HOA were present. With adaptive optics correction for HOA, the asymmetry reduced to 0.021 logMAR/D for white and 0.031 logMAR/D for green light, mainly because the sensitivity to hypermetropic defocus increased when HOA were corrected.

CONCLUSION

The asymmetry was only slightly affected by the elimination of the CA of the eye, whereas adaptive optics correction for HOA reduced the asymmetry. The HOA mainly affected the sensitivity to hypermetropic defocus.