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Chow AHY, Mungalsingh MA, Thai D, Selimos Z, Yan SK, Xu H, Jones DA. Suitability of multifunction devices Myah and Myopia Master for monitoring myopia progression in children and adults. Ophthalmic Physiol Opt 2024; 44:1017-1030. [PMID: 38760986 DOI: 10.1111/opo.13332] [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: 12/22/2023] [Revised: 04/22/2024] [Accepted: 04/28/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE To assess the feasibility of using multifunction instruments to measure axial length for monitoring myopia progression in children and adults. METHODS Axial length was measured in 60 children (aged 6-18 years) and 60 adults (aged 19-50 years) with multifunction instruments (Myah and Myopia Master) and stand-alone biometers (Lenstar LS900 and IOLMaster 700). Repeatability (measurements by the same examiner) and reproducibility (measurements by different examiners) were computed as the within-subject standard deviation (Sw) and 95% limits of agreement (LoA). Inter-instrument agreement was computed as intraclass correlation coefficients. The threshold for detecting myopic progression was taken as 0.1 mm. Measures were repeated only in children following the administration of 1% tropicamide to determine the impact of cycloplegia on axial length. RESULTS Overall, the IOLMaster 700 had the best repeatability in children (0.014 mm) and adults (0.009 mm). Repeatability Sw values for all devices ranged from 0.005 to 0.021 mm (children) and 0.003 to 0.016 mm (adults). In children, reproducibility fell within 0.1 mm 95% of the time for the Myah, Myopia Master and IOLMaster 700. Agreement among all devices was classified as excellent (ICC 0.999; 95% CI 0.998-0.999), but the 95% LoA among the Myah, Myopia Master and Lenstar LS900 was ≥0.1 mm. Cycloplegia had no statistically significant effect on axial length (all p > 0.13). CONCLUSIONS The Myah and Myopia Master multifunction instruments demonstrated good repeatability and reproducibility, and their accuracy was comparable to stand-alone biometers. Axial length measurements using different instruments can be considered interchangeable but should be compared with some caution. Accurate axial length measurements can be obtained without cycloplegia. The multifunction instruments Myah and Myopia Master are as well suited for monitoring myopia progression in children as the stand-alone biometers IOLMaster 700 and Lenstar LS900.
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Affiliation(s)
- Amy H Y Chow
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
- Centre for Eye and Vision Research, Hong Kong, SAR China
| | - Melanie A Mungalsingh
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Danny Thai
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Zoe Selimos
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Sarah Kathryn Yan
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Hellen Xu
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Deborah A Jones
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
- Centre for Eye and Vision Research, Hong Kong, SAR China
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Banerjee K, Pramanik S, Mondal LK. Statistical Methods for Best and Worst Eye Measurements. Clin Ophthalmol 2024; 18:1901-1908. [PMID: 38974663 PMCID: PMC11227045 DOI: 10.2147/opth.s461511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/27/2024] [Indexed: 07/09/2024] Open
Abstract
Introduction The focus is often on the best and worst eyes to detect early predictive and non-invasive biomarkers of diabetic retinopathy. Typically, such data have been dealt with in a case-control setting, which applies two-sample tests and ignores the correlation between the fellow eyes. Practitioners are mostly unaware that such measurements hide the labels of the fellow eyes, which rules out standard tools, such as paired t or signed-rank tests. Methods This report discusses the problems with such data on best and worst eye measurements, and illustrates alternative paired tests for equality of means or locations using a case-control dataset. Results This report illustrates that methods which ignore the correlation between fellow eyes result in grossly conservative tests. A battery of Z-tests which consider this correlation can resolve this issue. Discussion This finding emphasizes the importance of selecting an appropriate control group for the detection of possible markers. Further, it cites an example to show that using data from fellow eyes and adjusting for their correlation may not always be the best option, contrary to common perception.
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Affiliation(s)
- Kaustav Banerjee
- Decision Sciences Area, Indian Institute of Management Lucknow, Uttar Pradesh, 226013, India
| | - Subhasish Pramanik
- Department of Endocrinology & Metabolism, Institute of Post Graduate Medical Education & Research and SSKM Hospital, Kolkata, West Bengal, 700020, India
| | - Lakshmi Kanta Mondal
- Department of Ophthalmology, Regional Institute of Ophthalmology, Medical College Campus, Kolkata, West Bengal, 700073, India
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Biran A, Sayar M, Lazzar M, Mimouni M, Beiran I. Accuracy of a novel method for IOP measurement without applying pressure on the cornea. Int Ophthalmol 2024; 44:300. [PMID: 38951418 PMCID: PMC11217116 DOI: 10.1007/s10792-024-03213-7] [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: 01/29/2023] [Accepted: 06/16/2024] [Indexed: 07/03/2024]
Abstract
PURPOSE To assess the accuracy of a prototype novel instrument for intra ocular pressure (IOP) measurements not involving corneal pressure application. DESIGN Prospective case control study. METHODS An institutional study including 16 healthy volunteers without ocular pathology. IOP in both eyes of the participants was measured four times in different body positions with the novel prototype and reference instrument (Goldmann applanation tonometer (GAT) or iCare (iCare Finland OY, Vantaa, Finland)). IOP results were compared between the prototype and the reference instruments in 116 pairs of measurement. RESULTS Overall no statistically significant difference was found between the presented prototype and the reference instrument. Stratifying measurements by instrument used revealed no significant difference for GAT and statistical significant (yet clinically insignificant) difference for iCare. CONCLUSIONS The presented prototype demonstrates good clinical agreement of IOP measuring results with reference instruments Further large-scale studies assessing this instrument in glaucoma patients are warranted.
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Affiliation(s)
- Amit Biran
- Department of Ophthalmology, Soraski Medical Center, Tel Aviv, Israel
| | - Mordehai Sayar
- Department of Applied Physics, Weizmann Institute of Science, Rehovot, Israel
| | - Moshe Lazzar
- Department of Ophthalmology, Soraski Medical Center, Tel Aviv, Israel
| | - Michael Mimouni
- Department of Ophthalmology, Rambam Health Care Campus Affiliated With the Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, POB 9602, 3109601, Haifa, Israel.
| | - Itzchak Beiran
- Department of Ophthalmology, Rambam Health Care Campus Affiliated With the Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, POB 9602, 3109601, Haifa, Israel
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Canleblebici M, Celiker U, Yıldırım H, Balbaba M. Evaluation of lamina cribrosa curvature index in different types of glaucoma. Int Ophthalmol 2024; 44:284. [PMID: 38926206 DOI: 10.1007/s10792-024-03190-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE The aim of this study was to evaluate the lamina cribrosa curvature index in different types of glaucoma in comparison with clinical findings and conventional measurement methods. MATERIAL AND METHOD Patients older than 18 years who were followed up in Glaucoma Unit of Department of Ophthalmology at Fırat University Faculty of Medicine, whose disease had been under control at least for 1 year, who had at least three reliable visual fields, whose refractive error was between - 6 and + 5 diopter and who did not have any disease other than glaucoma that would affect the visual field, were included in the study. Clinical and demographic characteristics, visual field, optical coherence tomography and lamina cribrosa curvature index (LCCI) results were evaluated. The study patients were divided into six groups: early-stage primary open-angle glaucoma (POAG) as group 1 and intermediate-advanced stage POAG as group 2, pseudo-exfoliation glaucoma (PEXG) as group 3, normal tension glaucoma (NTG) as group 4, ocular hypertension patients whom subsequently developed POAG as group 5 and healthy control as group 6. RESULTS A total of 189 eyes of 101 patients were included in our study. Forty-seven patients were male (46.5%) and 54 were female (53.5%). The mean age was 62.43 ± 1.49 years. LCCI, mean deviation (MD), visual field index (VFI), pattern standard deviation (PSD) and retinal nerve fiber layer thickness (RNFL) values were analyzed in all groups and Pearson correlation analysis showed statistically significant correlation between PSD and RNFL measurements with LCCI values in all groups. MD value was correlated with LCCI in groups 2, 3 and 4, while VFI value was correlated with LCCI in all groups except group 5. When the groups were compared with each other according to the Post-Hoc Tamhane test, LCCI measurement showed statistically significant results in accordance with MD, VFI, PSD and RNFL values. CONCLUSION The LCCI assessment is mostly consistent with conventional tests. In this study, in which different types of glaucoma and healthy subjects were examined simultaneously, LCCI shows promise as a detailed and reliable assessment method.
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Affiliation(s)
| | - Ulku Celiker
- Faculty of Medicine, Department of Ophthalmology, Fırat University, Elazığ, Turkey
| | - Hakan Yıldırım
- Faculty of Medicine, Department of Ophthalmology, Fırat University, Elazığ, Turkey
| | - Mehmet Balbaba
- Faculty of Medicine, Department of Ophthalmology, Fırat University, Elazığ, Turkey
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Larrosa M, Gispets J, Lupón N, Cardona G, Sempere A. Central and peripheral corneal sagittal height in keratoconus and healthy eyes. Cont Lens Anterior Eye 2024; 47:102132. [PMID: 38462405 DOI: 10.1016/j.clae.2024.102132] [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: 11/17/2023] [Revised: 02/16/2024] [Accepted: 02/28/2024] [Indexed: 03/12/2024]
Abstract
PURPOSE To determine central and peripheral corneal sagittal height (z) values in keratoconus and healthy eyes with the Oculus Pentacam point-by-point data extraction software. METHODS Forty eyes from patients with central or paracentral (4 mm) keratoconus (32.0 ± 12.5 years) and 40 eyes from healthy subjects (29.1 ± 7.9 years) were included. The Oculus Pentacam software was employed to determine z values referenced to a plane tangent to the corneal apex for five circles concentric with the centre of the pupil with diameters 4, 6, 8, 9 and 10.5 mm. The variability in z values within each circle and in terms of corneal meridians and quadrants was explored in keratoconus and healthy eyes. RESULTS Keratoconus apex was mainly located at the inferior-temporal quadrant, at a distance from 0.083 mm to 3.59 mm with reference to the centre of the pupil. Mean z was larger in keratoconus than in healthy eyes in all explored corneal diameters (all p < 0.001). Variation in z values was larger in keratoconus than healthy eyes only at the central areas of the cornea (4 mm, p = 0.02; 6 mm, p = 0.011), but not in the periphery (8, 9 and 10.5 mm). In keratoconus, the frequency of minimum z values in the IT quadrant was greater than in healthy eyes. CONCLUSION Although peripheral z values were larger in keratoconus, rotational variations were comparable between keratoconus and healthy eyes, suggesting that large diameter spherical rigid corneal contact lenses may be an alternative to scleral lenses in central and paracentral keratoconus.
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Affiliation(s)
- Manel Larrosa
- Department of Optics and Optometry, Universitat Politècnica de Catalunya, Violinista Vellsolà, 37, E08222 Terrassa, Spain
| | - Joan Gispets
- Department of Optics and Optometry, Universitat Politècnica de Catalunya, Violinista Vellsolà, 37, E08222 Terrassa, Spain.
| | - Núria Lupón
- Department of Optics and Optometry, Universitat Politècnica de Catalunya, Violinista Vellsolà, 37, E08222 Terrassa, Spain
| | - Genis Cardona
- Department of Optics and Optometry, Universitat Politècnica de Catalunya, Violinista Vellsolà, 37, E08222 Terrassa, Spain
| | - Anaïs Sempere
- Department of Optics and Optometry, Universitat Politècnica de Catalunya, Violinista Vellsolà, 37, E08222 Terrassa, Spain
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Shanidze NM, Verghese P. Smooth pursuit deficits impact dynamic visual acuity in macular degeneration. Optom Vis Sci 2024; 101:435-442. [PMID: 38913934 DOI: 10.1097/opx.0000000000002144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024] Open
Abstract
SIGNIFICANCE Prior studies with large, highly visible targets report low smooth pursuit gains in individuals with macular degeneration (MD). We show that lower gains persist even when observers are pursuing a target that requires discrimination at the acuity limit. This low gain causes retinal slip, potentially leading to motion blur and target disappearance in the scotoma, which further compromise the visibility of moving object. PURPOSE In this study, we examine whether the characteristics of smooth pursuit (pursuit gain and placement of the fixational locus relative to the target) change when the task requires dynamic visual acuity. METHODS Using the scanning laser ophthalmoscope, we recorded smooth pursuit eye movements in 10 eyes of 6 MD participants and 7 eyes of 4 age-matched controls in response to leftward- or rightward-moving annular targets (O) that briefly (300 milliseconds) changed to a Landolt C at one of several time points during the pursuit trial. Participants were asked to pursue the target and indicate the direction of the C opening. RESULTS Individuals with MD had lower pursuit gains and fewer saccades during the C presentation than during the O, compared with their age-matched peers. Further, pursuit gain, but not the distance of the retinal pursuit locus from the target, predicted task performance in the MD group. CONCLUSIONS Our findings suggest that compromised pursuit gain in MD participants likely further compromises their dynamic visual acuity and thus ability to view moving targets.
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Affiliation(s)
| | - Preeti Verghese
- The Smith-Kettlewell Eye Research Institute, San Francisco, California
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Bhattacharya P, Edwards K, Harkin D, Schmid KL. Corneal Epithelial Cell Density Is Reduced in Young Adults With Conjunctival Ultraviolet Autofluorescence. Cornea 2024; 43:693-701. [PMID: 37713663 DOI: 10.1097/ico.0000000000003389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 08/08/2023] [Indexed: 09/17/2023]
Abstract
PURPOSE The aim of this study was to investigate the effects of chronic ultraviolet (UV) radiation exposure on the corneal microstructure using conjunctival UV autofluorescence (CUVAF) as a marker of exposure. METHODS Young healthy adults aged 18 to 35 years were recruited. Participant's demographics and sun exposure behavior were recorded using questionnaires. Images of the bulbar conjunctiva from the right eye were captured and analyzed for the CUVAF area. Corneal microstructure was assessed by in vivo confocal microscopy and anterior segment optical coherence tomography. The presence of palisades of Vogt in all 4 limbal quadrants was recorded. RESULTS CUVAF was observed in 31 of 52 eyes (60%), with a mean (±SD) nasal, temporal, and total CUVAF area of 5.39 ± 4.16 mm 2 , 4.29 ± 4.27 mm 2 , and 9.67 ± 7.01 mm 2 , respectively. Individuals with CUVAF were significantly more likely to report undertaking moderate-intensity to high-intensity outdoor exercise ( P = 0.021). Individuals with CUVAF were less likely to have visible nasal and temporal palisades of Vogt ( P = 0.011). Corneal basal cell densities anterior to the nerve whorl ( P < 0.001) and nasally ( P = 0.005) were lower in individuals with CUVAF. Wing cell density anterior to the nerve whorl was lower in individuals with CUVAF ( P = 0.011). No significant changes in the central and limbal corneal epithelial thickness were observed. CONCLUSIONS Significant reductions in corneal epithelial cell density were observed in individuals with CUVAF, a biomarker of chronic UV exposure. This observation suggests that chronic UV exposure is damaging to the corneal microstructure.
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Affiliation(s)
- Pradipta Bhattacharya
- School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia; and
| | - Katie Edwards
- School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia; and
| | - Damien Harkin
- School of Biomedical Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Katrina L Schmid
- School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia; and
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Sella R, Sorkin N, Safir M, Beylin Y, Sela T, Munzer G, Kaiserman I, Mimouni M. Hyperopic LASIK and postoperative corneal steepness: revisiting the 49-diopter limit. J Cataract Refract Surg 2024; 50:550-557. [PMID: 38305328 PMCID: PMC11146188 DOI: 10.1097/j.jcrs.0000000000001411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 01/10/2024] [Accepted: 01/28/2024] [Indexed: 02/03/2024]
Abstract
PURPOSE To compare corrected distance visual acuity (CDVA) outcomes of hyperopic laser in situ keratomileusis (LASIK) with a postoperative corneal steepness above vs below 49 diopters (D). SETTING Care-Vision Laser Centers, Tel-Aviv, Israel. DESIGN Retrospective study. METHODS This study included consecutive patients who underwent hyperopic LASIK between January 2013 and December 2019. Hyperopic patients were divided into 2 groups based on postoperative corneal steepness with steep corneas defined >49.0 D and the control group ≤49.0 D. Adjustments were performed to account for differences in baseline and intraoperative parameters. RESULTS Overall, 1703 eyes of 1703 patients were included. Mean age was 48.3 ± 10.0 years, and 45.3% were male. Preoperatively, the steep group (2.4%, n = 41/1703) had steeper mean (44.6 D vs 43.1 D, P < .001) and steep (45.1 D vs 43.5 D, P < .001) keratometry, worse logMAR CDVA (0.07 vs 0.04, P = .02), and higher sphere (4.9 D vs 2.9 D, P < .001). Intraoperatively, they had a higher spherical treatment (4.6 D vs 2.8 D, P < .001). After hyperopic LASIK, the steep group had worse logMAR CDVA (0.10 vs 0.06, P = .01). However, after accounting for differences in baseline and spherical treatment, no significant differences were found in postoperative logMAR CDVA (0.06 vs 0.06, P = .99). The factors that remained associated with worse postoperative CDVA were higher spherical treatment (0.01 logMAR per 1 D, P < .001) and preoperative CDVA (0.60 logMAR per 1.00 logMAR, P < .001). CONCLUSIONS Postoperative corneal steepness greater than 49 D is not associated with worse visual outcomes after hyperopic LASIK. However, lower preoperative visual potential and higher spherical treatment applied are associated with worse outcomes. The 49 D cutoff should be revisited.
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Affiliation(s)
- Ruti Sella
- From the Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel (Sella); Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (Sella, Sorkin); Care Vision Laser Centers, Tel-Aviv, Israel (Sella, Sela, Munzer, Kaiserman, Mimouni); Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv, Israel (Sorkin); Department of Ophthalmology, Itzhak Shamir Medical Center, Beer Yaakov, Israel (Safir); Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (Beylin, Mimouni); Department of Ophthalmology, Barzilai Medical Center, Ashkelon and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel (Kaiserman); Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel (Mimouni)
| | - Nir Sorkin
- From the Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel (Sella); Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (Sella, Sorkin); Care Vision Laser Centers, Tel-Aviv, Israel (Sella, Sela, Munzer, Kaiserman, Mimouni); Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv, Israel (Sorkin); Department of Ophthalmology, Itzhak Shamir Medical Center, Beer Yaakov, Israel (Safir); Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (Beylin, Mimouni); Department of Ophthalmology, Barzilai Medical Center, Ashkelon and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel (Kaiserman); Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel (Mimouni)
| | - Margarita Safir
- From the Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel (Sella); Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (Sella, Sorkin); Care Vision Laser Centers, Tel-Aviv, Israel (Sella, Sela, Munzer, Kaiserman, Mimouni); Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv, Israel (Sorkin); Department of Ophthalmology, Itzhak Shamir Medical Center, Beer Yaakov, Israel (Safir); Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (Beylin, Mimouni); Department of Ophthalmology, Barzilai Medical Center, Ashkelon and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel (Kaiserman); Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel (Mimouni)
| | - Yonatan Beylin
- From the Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel (Sella); Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (Sella, Sorkin); Care Vision Laser Centers, Tel-Aviv, Israel (Sella, Sela, Munzer, Kaiserman, Mimouni); Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv, Israel (Sorkin); Department of Ophthalmology, Itzhak Shamir Medical Center, Beer Yaakov, Israel (Safir); Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (Beylin, Mimouni); Department of Ophthalmology, Barzilai Medical Center, Ashkelon and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel (Kaiserman); Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel (Mimouni)
| | - Tzahi Sela
- From the Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel (Sella); Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (Sella, Sorkin); Care Vision Laser Centers, Tel-Aviv, Israel (Sella, Sela, Munzer, Kaiserman, Mimouni); Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv, Israel (Sorkin); Department of Ophthalmology, Itzhak Shamir Medical Center, Beer Yaakov, Israel (Safir); Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (Beylin, Mimouni); Department of Ophthalmology, Barzilai Medical Center, Ashkelon and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel (Kaiserman); Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel (Mimouni)
| | - Gur Munzer
- From the Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel (Sella); Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (Sella, Sorkin); Care Vision Laser Centers, Tel-Aviv, Israel (Sella, Sela, Munzer, Kaiserman, Mimouni); Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv, Israel (Sorkin); Department of Ophthalmology, Itzhak Shamir Medical Center, Beer Yaakov, Israel (Safir); Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (Beylin, Mimouni); Department of Ophthalmology, Barzilai Medical Center, Ashkelon and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel (Kaiserman); Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel (Mimouni)
| | - Igor Kaiserman
- From the Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel (Sella); Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (Sella, Sorkin); Care Vision Laser Centers, Tel-Aviv, Israel (Sella, Sela, Munzer, Kaiserman, Mimouni); Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv, Israel (Sorkin); Department of Ophthalmology, Itzhak Shamir Medical Center, Beer Yaakov, Israel (Safir); Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (Beylin, Mimouni); Department of Ophthalmology, Barzilai Medical Center, Ashkelon and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel (Kaiserman); Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel (Mimouni)
| | - Michael Mimouni
- From the Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel (Sella); Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (Sella, Sorkin); Care Vision Laser Centers, Tel-Aviv, Israel (Sella, Sela, Munzer, Kaiserman, Mimouni); Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv, Israel (Sorkin); Department of Ophthalmology, Itzhak Shamir Medical Center, Beer Yaakov, Israel (Safir); Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (Beylin, Mimouni); Department of Ophthalmology, Barzilai Medical Center, Ashkelon and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel (Kaiserman); Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel (Mimouni)
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Simonaviciute D, Grzybowski A, Gelzinis A, Zemaitiene R. Efficacy and Safety of 0.03% Atropine Eye Drops in Controlling Myopia Progression: A One-Year Prospective Clinical Study. J Clin Med 2024; 13:3218. [PMID: 38892929 PMCID: PMC11173064 DOI: 10.3390/jcm13113218] [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: 04/17/2024] [Revised: 05/26/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024] Open
Abstract
Objective: To investigate the efficacy and safety of one-year treatment with 0.03% atropine eye drops for slowing myopia progression among children aged 6-12 years. Methods: Healthy Caucasian children aged 6-12 years with cycloplegic spherical equivalent (SE) from -1.0 D to -5.0 D and astigmatism and anisometropia ≤1.5 D were included. Changes in mean axial length (AL) and objective SE as well as changes in intraocular pressure (IOP), central corneal thickness (CCT), anterior chamber depth (ACD) and lens thickness (LT) were assessed in the 0.03% atropine eye drops group and the control group from baseline through the 1-year follow-up. The proportion of participants showing myopia progression of <0.5 D from baseline in each group and any potential side effects in 0.03% atropine group were evaluated. Results: The study involved 31 patients in the 0.03% atropine eye drops group and 41 in the control group. Administration of 0.03% atropine for 1 year resulted in a mean change in SE of -0.34 (0.44) D/year, significantly lower than the -0.60 (0.50) D/year observed in the control group (p = 0.024). The change in AL was 0.19 (0.17) mm in the 0.03% atropine group, compared to 0.31 (0.20) mm in the control group (p = 0.015). There were no significant differences in changes of IOP, CCT and LT between the groups (all p ≥ 0.05). The 0.03% atropine group had a significantly greater increase in ACD compared to the control group (p = 0.015). In total, 64.5% of patients in the 0.03% atropine group showed progression <0.5 D/year, in contrast to 39.0% in the control group (p = 0.032). Adverse events were reported in 13 (35.0%) out of 37 patients in the treatment group, leading to discontinuation of the eye drops in six (16.0%) cases. None of the adverse events were severe. Conclusions: Despite a higher incidence of adverse events, 0.03% atropine eye drops effectively slowed the progression of myopia over 1-year.
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Affiliation(s)
- Dovile Simonaviciute
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, 44037 Kaunas, Lithuania; (A.G.); (R.Z.)
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, 10-724 Olsztyn, Poland;
- Institute for Research in Ophthalmology, 60-554 Poznan, Poland
| | - Arvydas Gelzinis
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, 44037 Kaunas, Lithuania; (A.G.); (R.Z.)
| | - Reda Zemaitiene
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, 44037 Kaunas, Lithuania; (A.G.); (R.Z.)
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10
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Du Y, Di Y, Yang S, Mo F, Cui G, Chen D, Li Y. Association of myopia and astigmatism with postoperative ocular high order aberration after small incision lenticule extraction. BMC Ophthalmol 2024; 24:211. [PMID: 38741093 DOI: 10.1186/s12886-024-03475-w] [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: 02/08/2024] [Accepted: 05/02/2024] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVE To investigate the correlation between higher-order aberrations (HOA) after small incision lenticule extraction (SMILE) and the severity of myopia and astigmatism, along with the relevant factors. These findings will provide valuable insights for decreasing the occurrence of HOA after SMILE and enhancing visual quality. METHODS A total of 75 patients (150 eyes) with myopia and astigmatism who underwent SMILE were categorized into four groups based on the severity of myopia and astigmatism: Myopia Group 1 (Group M1, spherical diopter ranged from -1.00 D to -4.00 D), Myopia Group 2 (Group M2, spherical diopter ranged from -4.10 D to -10.00 D), Astigmatism Group 1 (Group A1, cylindrical diopter ranged from 0 D to -1.00 D), and Astigmatism Group 2 (Group A2, cylindrical diopter ranged from -1.10 D to -3.00 D). A comprehensive assessment was performed to examine the association between HOA and various relevant factors, including a detailed analysis of the subgroups. RESULTS Group M1 had significantly lower levels of total eye coma aberration (CA), corneal total HOA (tHOA), internal tHOA, and vertical CA ( Z 3 - 1 ) after SMILE than Group M2 (P < 0.05). Similarly, Group A1 had significantly lower levels of total eye tHOA, CA, trefoil aberration (TA), corneal tHOA, TA, and vertical TA ( Z 3 - 3 ) after SMILE than Group A2 (P < 0.05). Pearson correlation analysis indicated a statistically significant positive relationship between the severity of myopia/astigmatism and most HOA (P < 0.05). Subgroup evaluations demonstrated a notable increase in postoperative HOA associated with myopia and astigmatism in Groups M2 and A2 compared with the control group. Lenticule thickness, postoperative central corneal thickness (CCT), postoperative uncorrected distance visual acuity (UDVA), and postoperative corneal Km and Cyl were strongly correlated with most HOA. Age, eyes, and postoperative intraocular pressure (IOP) were only associated with specific HOA. CONCLUSION HOA positively correlated with the severity of myopia and astigmatism after SMILE. However, this relationship was not linear. HOA after SMILE was influenced by various factors, and additional specialized investigations are required to establish its clinical importance.
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Affiliation(s)
- Yifan Du
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Yu Di
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Shan Yang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Fei Mo
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Ge Cui
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Di Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Ying Li
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.
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11
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Barequet D, Shor R, Segal O, Greenbaum E, Trivizki O, Loewenstein A, Rabina G. Treatment patterns and visual acuity change of AMD patients, before, during and after the COVID-19 pandemic lockdowns: A large cohort. Acta Ophthalmol 2024; 102:e322-e327. [PMID: 37698269 DOI: 10.1111/aos.15756] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 07/02/2023] [Accepted: 08/29/2023] [Indexed: 09/13/2023]
Abstract
PURPOSE To evaluate the impact of the changes in treatment patterns before, during and after the COVID-19 pandemic on best-corrected visual acuity (BCVA) in previously treated neovascular age-related macular degeneration (nAMD) patients. METHODS A multi-centre, retrospective, observational study of consecutive nAMD patients during 2019-2021. Data collected included demographics, BCVA, dates of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections and clinic visits. RESULTS A total of 1652 eyes of 1652 nAMD patients were included, out of which 850 eyes were assessed in 2019 (pre-COVID-19), 630 eyes were assessed in 2020 (COVID-19) and 974 eyes were assessed in 2021 (post-COVID-19). During the COVID-19 period, the mean number of anti-VEGF injections was significantly lower than the corresponding pre-COVID-19 and post-COVID-19 periods (5.55 compared to 6.13 and 6.60, respectively p < 0.01). A constant lower ratio of injections per patient/month was observed during COVID-19 compared to previous and following years, with a notable decline during March-April, reaching a ratio of 0.4 in 2020 versus 0.65 in 2019 and 0.62 in 2021 (p < 0.01). Baseline BCVA (0.825, p < 0.001), number of injections (-0.007, p < 0.001), gender (-0.027, p = 0.037) and age (0.004, p < 0.001) were shown to be significant predictors of final BCVA. CONCLUSION During the COVID-19 period, patients were treated with significantly less intravitreal anti-VEGF injection compared to the previous year with compensation in the following year. These changes in treatment patterns did not have a significant impact on BCVA outcomes. Age, gender, baseline BCVA and number of injections are predictors of final visual outcomes.
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Affiliation(s)
- Dana Barequet
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Reut Shor
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ori Segal
- Department of Ophthalmology, Meir Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Kfar Saba, Israel
| | - Eran Greenbaum
- Department of Ophthalmology, Meir Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Kfar Saba, Israel
| | - Omer Trivizki
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anat Loewenstein
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gilad Rabina
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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12
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Taufik SA, Ramli N, Tan AH, Lim SY, Ghani MTA, Shahrizaila N. Longitudinal Changes in the Retinal Nerve Fiber Layer Thickness in Amyotrophic Lateral Sclerosis and Parkinson's Disease. J Clin Neurol 2024; 20:285-292. [PMID: 38627230 PMCID: PMC11076187 DOI: 10.3988/jcn.2023.0353] [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: 09/05/2023] [Revised: 11/05/2023] [Accepted: 11/22/2023] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND AND PURPOSE There is increasing evidence that the anterior visual pathways are involved in neurodegenerative diseases including amyotrophic lateral sclerosis (ALS) and Parkinson's disease (PD). This study investigated longitudinal changes in retinal nerve fiber layer (RNFL) thickness in patients with ALS and PD with the aim of better understanding their roles as biomarkers of disease progression. METHODS This study recruited 21 ALS patients, 19 age-matched PD patients, and 21 agematched healthy controls. Patient demographics and clinical scores relating to the respective diseases were documented. The RNFL thickness was measured using optical coherence tomography at baseline and after 6 months. RESULTS At baseline, the RNFL in the superior quadrant was significantly thinner in the patients with ALS than in healthy controls (109.90±22.41 µm vs. 127.81±17.05 µm [mean±standard deviation], p=0.008). The RNFL thickness did not differ significantly between the ALS and PD patients or between the PD patients and healthy controls. At 6 months, there was further significant RNFL thinning in patients with ALS, for both the overall thickness (baseline: median=94.5 µm, range=83.0-106.0 µm; follow-up: median=93.5 µm, range=82.5-104.5 µm, p=0.043) and the thickness in the inferior quadrant (median=126 µm, range=109.5-142.5 µm; and median=117.5 µm, range=98.5-136.5 µm; respectively, p=0.032). However, these changes were not correlated with the ALS functional scores. In contrast, the patients with PD did not demonstrate a significant change in RNFL thickness between the two time points. CONCLUSIONS The RNFL thickness is a promising biomarker of disease progression in patients with ALS but not in those with PD, which has a slower disease progression.
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Affiliation(s)
- Sharifah Azira Taufik
- UM Eye Research Centre, Department of Ophthalmology, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia
| | - Norlina Ramli
- UM Eye Research Centre, Department of Ophthalmology, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia.
| | - Ai Huey Tan
- Division of Neurology, Department of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia
| | - Shen-Yang Lim
- Division of Neurology, Department of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia
| | - Mohd Taufiq Abdul Ghani
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia
| | - Nortina Shahrizaila
- Division of Neurology, Department of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia.
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13
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Mimouni M, Kaiserman I, Gutkovitch E, Ben-Shaul O, Lavy I, Sela T, Munzer G, Sorkin N. Factors Predicting Loss of Best-Corrected Visual Acuity After Hyperopic Laser-Assisted In Situ Keratomileusis. Cornea 2024; 43:598-602. [PMID: 37713651 DOI: 10.1097/ico.0000000000003358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 06/25/2023] [Indexed: 09/17/2023]
Abstract
PURPOSE The aim of this study was to identify risk factors for the loss of corrected distance visual acuity (CDVA) after uncomplicated hyperopic laser-assisted in situ keratomileusis (LASIK). METHODS A retrospective study including hyperopic patients who underwent microkeratome-assisted LASIK between January 2000 and December 2019 at Care-Vision Laser Centers, Tel-Aviv, Israel. Loss of CDVA was defined as ≥ 2 lines (0.20 logarithm of the minimum angle of resolution [logMAR] increase). Excluded were patients who had loss of CDVA because of intraoperative or postoperative complications or developed cataract at their final visit. RESULTS Overall, 1998 eyes of 1998 patients were included in the study, of which 35 eyes (1.75%) had CDVA loss at final follow-up (mean 387 days). The vision-loss group had a significantly greater spherical treatment (3.4 vs. 2.8 D, P = 0.02), ablation depth (69.4 vs. 53.8 μm, P = 0.01), a higher proportion of treatments with a smaller optic zone (6.0 mm) (31.4% vs. 13.4%, P = 0.002), treatment with the EX200 (Alcon) excimer rather than the EX500 (Alcon) (74.3% vs. 39.0%, P < 0.001), and treatment with the Moria M2-90 microkeratome rather than the Moria Sub-Bowman's keratomileusis (SBK) microkeratome (65.7% vs. 29.6%, P < 0.001). In multivariate binary logistic regression, factors that remained significant predictors of CDVA loss were a greater spherical treatment (per 1 D treatment, odds ratio = 1.42, 95% CI, 1.11-1.81, P = 0.004) and the use of the Moria M2-90 microkeratome (odds ratio = 4.66, 95% CI, 2.30-9.45, P < 0.001). CONCLUSIONS In patients undergoing uncomplicated hyperopic LASIK, a greater spherical hyperopic treatment is associated with a higher risk for vision loss. Transition to a newer microkeratome model significantly reduced vision loss rate.
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Affiliation(s)
- Michael Mimouni
- Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
- Care-Vision Laser Centers, Tel-Aviv, Israel
| | - Igor Kaiserman
- Care-Vision Laser Centers, Tel-Aviv, Israel
- Department of Ophthalmology, Barzilai Medical Center, Ashkelon and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
| | - Elena Gutkovitch
- Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Department of Ophthalmology, Western Galilee-Nahariya Medical Center, Nahariya, Israel
| | - Or Ben-Shaul
- Department of Ophthalmology, Lady Davis Carmel Medical Center, Haifa, Israel
| | - Itay Lavy
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; and
| | - Tzahi Sela
- Care-Vision Laser Centers, Tel-Aviv, Israel
| | - Gur Munzer
- Care-Vision Laser Centers, Tel-Aviv, Israel
| | - Nir Sorkin
- Department of Ophthalmology, Lady Davis Carmel Medical Center, Haifa, Israel
- Department of Ophthalmology, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
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14
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Sorkin N, Zadok R, Savini G, Kan-Tor Y, Benjamini Y, Levinger E, Bardugo J, Abulafia A. Comparison of Intraocular Lens Power Prediction Accuracy Between 2 Swept-Source Optical Coherence Tomography Biometry Devices. Am J Ophthalmol 2024; 265:156-164. [PMID: 38643892 DOI: 10.1016/j.ajo.2024.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 04/14/2024] [Accepted: 04/14/2024] [Indexed: 04/23/2024]
Abstract
PURPOSE To compare intraocular lens (IOL) power prediction accuracy of the Eyestar 900 (EyeS900) and the IOLMaster 700 (IOLM700) based on estimated and measured posterior corneal power. DESIGN Retrospective, interinstrument reliability study. METHODS Setting: Institutional. PARTICIPANTS Two hundred twenty-five eyes of 225 cataract surgery patients. MEASUREMENTS Patients underwent measurements by both devices preoperatively. MAIN OUTCOME MEASURES Spherical Equivalent Prediction Error (SEQ-PE), spread of the SEQ-PE (precision) and the absolute SEQ-PE (accuracy) of each device using Barrett Universal II (BUII) formula with either estimated posterior keratometry (E-PK) or measured posterior keratometry (M-PK). RESULTS Trimmed mean SEQ-PEs of EyeS900 E-PK, EyeS900 M-PK, IOLM700 E-PK, and IOLM700 M-PK were 0.03, 0.08, 0.02, and 0.09 D, respectively with no significant differences between EyeS900 E-PK and IOLM700 E-PK (P = 0.31) as well as between EyeS900 M-PK and IOLM700 M-PK (P = 0.31). Statistically significant SEQ-PE differences were found when E-PK and M-PK were compared, regardless of the device used, showing hyperopic SEQ-PE in M-PK calculations. Excellent correlation and agreement in SEQ-PE were found between the devices for both E-PK (P < 0.001, r = 0.848, mean bias: +0.01 D, 95% LOA of -0.32 to +0.34 D) and M-PK (P < 0.001, r = 0.776, mean bias: -0.01 D, 95% LOA of -0.42 to +0.39 D). No significant differences were found comparing absolute SEQ-PE and precision of the devices. CONCLUSION The Eyestar 900 and the IOLMaster 700 show comparable IOL power prediction accuracy by the BUII formula using either estimated or measured posterior keratometry. An adjusted lens factor may be required for BUII when utilizing measured posterior keratometry in both devices.
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Affiliation(s)
- Nir Sorkin
- Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Rotem Zadok
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Yoav Kan-Tor
- The Alexander Grass Center for Bioengineering, School of Computer Science and Engineering, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yuval Benjamini
- Department of Statistics and Data Science, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Eliya Levinger
- Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Judith Bardugo
- Department of Ophthalmology, Shaare Zedek Medical Center and the Hebrew University-Hadassah Medical School, Jerusalem, Israel
| | - Adi Abulafia
- Department of Ophthalmology, Shaare Zedek Medical Center and the Hebrew University-Hadassah Medical School, Jerusalem, Israel
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15
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Kanclerz P, Przewłócka K, Mimouni M. Does the introduction of streamlight decrease refractive surgery operating time? Int Ophthalmol 2024; 44:185. [PMID: 38634955 PMCID: PMC11026198 DOI: 10.1007/s10792-024-03093-x] [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: 05/24/2023] [Accepted: 03/05/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE The aim of the study was to analyze the time-savings associated with introduction of Streamlight™ (Alcon Laboratories, Fort Worth, TX, USA) transepithelial photorefractive keratectomy (PRK) in surface corneal ablations. METHODS All refractive surgeries were performed using the Alcon WaveLight® EX500 at the ArtLife Clinic, Gdańsk, Poland. The study included patients treated for refractive errors with transepithelial PRK between April 2019 and October 2021, who were matched with patients treated with alcohol-assisted PRK during the same period. Only results for the left eye were analyzed. RESULTS One-hundred-five patients underwent transepithelial PRK (age 33.42 ± 8.67 years) and were matched with 105 patients that underwent alcohol-assisted PRK (age 33.05 ± 10.16 years; p = 0.11). The mean preoperative spherical equivalent refraction was - 2.04 ± 2.28 D, and - 1.9 ± 1.71 D for the transepithelial and alcohol-assisted PRK group, respectively (p = 0.20). The total surgery time was non-significantly shorter in transepithelial PRK (349.46 ± 47.83 s) than in alcohol-assisted PRK (354.93 ± 137.63 s; p = 0.7); however, the variance of surgical time was significantly lower in transepithelial PRK (p < 0.001). The laser treatment duration was greater in transepithelial PRK (41.78 ± 17.2 s) than in alcohol-assisted PRK (8.48 ± 6.12 s; p < 0.001), and so was the number of breaks during the laser treatment (0.95 ± 0.63 vs. 0.53 ± 0.88, respectively; p < 0.001). CONCLUSION The introduction of transepithelial PRK did not bring significant time-associated savings into the refractive surgery suite.
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Affiliation(s)
- Piotr Kanclerz
- ArtLife Ophthalmological Center, ul. Obrońców Wybrzeża 23, 80-398, Gdańsk, Poland.
- Department of Ophthalmology, Hygeia Clinic, Gdańsk, Poland.
- Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland.
| | | | - Michael Mimouni
- Department of Ophthalmology, Rambam Health Care Campus Affiliated with the Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Ben-Eli H, Banin E, Levy J, Glik M, Afriat S, Magal Y, Harari R, Benyamin A, Shein S, Chowers I. Development and Evaluation of a New Self-Administered Near Visual Acuity Chart: Accuracy and Feasibility of Usage. J Clin Med 2024; 13:2064. [PMID: 38610827 PMCID: PMC11012905 DOI: 10.3390/jcm13072064] [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: 03/05/2024] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Visual acuity (VA) assessments are crucial in ophthalmology but traditionally rely on in-clinic evaluations. The emergence of telemedicine has spurred interest in creating dependable self-administered VA tests for use beyond standard clinical environments. This study evaluated the practicality and validity of a self-administered near VA card test against traditional Snellen and Rosenbaum Pocket Vision Screener (RPVS) methods for home monitoring and enhancing clinical workflow. Methods: In a cross-sectional study, a near VA card (Hadassah Self-Visual Acuity Screener (HSVA)) was developed with written and videotaped instructions for self-use. Patients with a minimal best-corrected VA (BCVA) of 1.0 LogMAR in at least one eye were recruited from ophthalmology and optometry clinics. Outcomes included the mean BCVA difference between the self-administered values and those obtained by the examiner, and correlations between BCVA values obtained by the Snellen, RPVS, HSVA, and previous distance BCVA methods according to the patients' electronic medical records. Results: A total of 275 participants (mean age: 42.5 ± 19.4 years; range: 18-89 years; 47% female) were included. Test-retest reliability analysis of the HSVA demonstrated a very good correlation and repeatability (n = 38 patients; Rs = 1.0; p < 0.001). Accuracy analysis revealed the mean LogMAR BCVA values of an additional 237 patients obtained by the Snellen, RPVS, and HSVA methods were similar (p = 0.10). The self-test BCVA results obtained by the HSVA agreed with the masked examiner-tested VA results (n = 67 patients; p = 0.17; Rs = 0.87; ICC = 0.96). Similar results were obtained when stratification by median age (42 years) was performed. Bland-Altman analysis of the HSVA and RPVS methods demonstrated a good agreement. To assess whether the HSVA could predict the VA results in the clinically used charts, multivariate analysis was used and revealed that the HSVA predicted the RPVS results (β = 0.91; p = 0.001; R2 = 0.88), and the self-test HSVA predicted the Snellen VA results within two lines (β = 0.93; p = 0.01; R2 = 0.36). Conclusions: The home-based HSVA assessment exhibited high test-retest reliability, accuracy, and alignment with clinical-standard VA tests. Its efficacy in self-testing mirrored examiner-conducted VA assessments and accurately predicted Snellen VA outcomes, indicating the HSVA's suitability for self-monitoring in chronic ocular conditions or when access to conventional examinations is limited. The utility of self-administered VA tests may extend beyond ophthalmology and optometry, potentially benefiting primary care, emergency medicine, and neurology. Further research is needed to explore and validate the practical applications of remote VA testing.
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Affiliation(s)
- Hadas Ben-Eli
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, P.O. Box 12000, Jerusalem 91120, Israel (J.L.); (Y.M.); (R.H.); (S.S.); (I.C.)
- Department of Optometry and Vision Science, Hadassah Academic College, 37 Neviim St., Jerusalem 9101001, Israel; (M.G.); (S.A.); (A.B.)
| | - Eyal Banin
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, P.O. Box 12000, Jerusalem 91120, Israel (J.L.); (Y.M.); (R.H.); (S.S.); (I.C.)
| | - Jaime Levy
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, P.O. Box 12000, Jerusalem 91120, Israel (J.L.); (Y.M.); (R.H.); (S.S.); (I.C.)
| | - Miryam Glik
- Department of Optometry and Vision Science, Hadassah Academic College, 37 Neviim St., Jerusalem 9101001, Israel; (M.G.); (S.A.); (A.B.)
| | - Sarah Afriat
- Department of Optometry and Vision Science, Hadassah Academic College, 37 Neviim St., Jerusalem 9101001, Israel; (M.G.); (S.A.); (A.B.)
| | - Yasmin Magal
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, P.O. Box 12000, Jerusalem 91120, Israel (J.L.); (Y.M.); (R.H.); (S.S.); (I.C.)
| | - Rivka Harari
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, P.O. Box 12000, Jerusalem 91120, Israel (J.L.); (Y.M.); (R.H.); (S.S.); (I.C.)
- Department of Optometry and Vision Science, Hadassah Academic College, 37 Neviim St., Jerusalem 9101001, Israel; (M.G.); (S.A.); (A.B.)
| | - Aviya Benyamin
- Department of Optometry and Vision Science, Hadassah Academic College, 37 Neviim St., Jerusalem 9101001, Israel; (M.G.); (S.A.); (A.B.)
| | - Shira Shein
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, P.O. Box 12000, Jerusalem 91120, Israel (J.L.); (Y.M.); (R.H.); (S.S.); (I.C.)
| | - Itay Chowers
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, P.O. Box 12000, Jerusalem 91120, Israel (J.L.); (Y.M.); (R.H.); (S.S.); (I.C.)
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Elliott DB. Red flags in submissions to Optometry and Vision Science. Optom Vis Sci 2024; 101:173-175. [PMID: 38684058 DOI: 10.1097/opx.0000000000002133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
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Kreps EO, Epps SJ, Consejo A, Dick AD, Guly CM, Ramanan AV. Infliximab in chronic non-infectious paediatric uveitis refractory to previous biologic therapy. Eye (Lond) 2024; 38:871-876. [PMID: 37848676 DOI: 10.1038/s41433-023-02795-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 09/30/2023] [Accepted: 10/10/2023] [Indexed: 10/19/2023] Open
Abstract
OBJECTIVES To examine the outcome of infliximab treatment in patients with non-infectious paediatric uveitis who have previously failed biologic treatment. METHODS A retrospective cohort study was performed at Bristol Eye Hospital, UK. Paediatric patients with chronic non-infectious uveitis who had been switched to infliximab due to inadequate uveitis control were identified. Two separate groups were evaluated: group 1 consisted of 20 children (36 eyes) who had been switched to infliximab following treatment failure with adalimumab (=in-class switching), while group 2 (5 patients; 9 eyes) included those who had been switched to infliximab from a non-TNF antagonist after failing several biologics (=across-class switching). The change in anterior chamber (AC) activity between baseline and 6- and 24-months follow-up was the primary outcome measure. RESULTS A statistically significant reduction in AC activity was found between baseline and 6-months follow-up (RE: p = 0.002; LE: p < 0.001) and between baseline and 24-months follow-up (RE: p = 0.016; LE: p = 0.011) in group 1. No statistically significant difference was found for either eye in the number of steroid eye drops needed between time points or the difference in visual acuity in time. In group 2, analysis of change of AC activity, number of steroid eye drops and visual acuity failed to reach statistical significance. Treatment failure occurred in four patients (20% of group 1) and adverse events developed in six patients including three patients with acute infusion reactions. CONCLUSIONS This study supports the efficacy and safety of infliximab in adalimumab-refractory patients with paediatric non-infectious uveitis.
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Affiliation(s)
- E O Kreps
- Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium
| | - S J Epps
- Bristol Eye Hospital, University Hospitals Bristol and Weston, Lower Maudlin Street, Bristol, BS1 2LX, United Kingdom
| | - A Consejo
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
| | - A D Dick
- Bristol Eye Hospital, University Hospitals Bristol and Weston, Lower Maudlin Street, Bristol, BS1 2LX, United Kingdom
- University College London, Institute of Ophthalmology, London, United Kingdom
- Academic Unit of Ophthalmology, Translational Health Sciences, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre of Ophthalmology, Moorfields Eye Hospital, London, UK
| | - C M Guly
- Bristol Eye Hospital, University Hospitals Bristol and Weston, Lower Maudlin Street, Bristol, BS1 2LX, United Kingdom
| | - A V Ramanan
- Paediatric Rheumatology, Bristol Royal Hospital for Children and Translational Health Sciences, University of Bristol, Upper Maudlin Street, Bristol, BS2 8BJ, United Kingdom.
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19
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Camellin U, Ninotta I, Latino G, Alibrandi A, Aragona P, Roszkowska AM. Prediction of total corneal power in keratoconus using anterior surface data. Clin Exp Optom 2024; 107:274-280. [PMID: 37271161 DOI: 10.1080/08164622.2023.2215382] [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: 07/05/2022] [Revised: 05/09/2023] [Accepted: 05/12/2023] [Indexed: 06/06/2023] Open
Abstract
CLINICAL RELEVANCE Keratoconus results in an increase in anterior and posterior curvatures and a reduction in corneal thickness. Anterior corneal ectasia is partially compensated by remodelling the corneal epithelium. Therefore, there is an alteration in the relationship between corneal surfaces and variation in corneal power. The variation in corneal power is one of the sources that induces errors in IOL power calculation. BACKGROUND This study aimed to assess a method for predicting total corneal power in keratoconus using several anterior surface parameters at 3 mm and 4 mm. METHODS Tomographic data obtained using Pentacam (Oculus, Germany) were analysed from 280 eyes of 140 patients with keratoconus using anterior and posterior keratometry, anterior Q-value at 8 mm, central corneal thickness, Kmax location and value, and true net power at 4 mm (TNP). Calculated total corneal power (TCPc) at 3 mm was obtained using the Gauss formula. Predicted total corneal power at 3 mm (TCPp3) and 4 mm (TCPp4) was obtained from univariate (TCPp3u and TCPp4u) and multivariate linear regression formulae (TCPp3m and TCPp4m). SimK, anterior Q-value, vertical location, and Kmax value were used in the multivariate formulae. Mean absolute error (MAE) and median absolute error (MedAE) were also calculated. Absolute frequencies within dioptric ranges of all formulas divided for keratoconus grading were evaluated. RESULTS TCPc and TNP exhibited a good correlation (R2 = 0.58, p < 0.05) with a higher dispersion above 50 D of corneal power. Highly significant correlations were observed between TCPp3u and TCPc (R2 = 0.978, p < 0.05) and TCPp3m and TCPc (R2 = 0.989, p < 0.05). Lower but significant correlations were observed between TCPp4u and TNP (R2 = 0.692, p < 0.05) and between TCPp4m and TNP (R2 = 0.887, p < 0.05). The best results for TCP prediction at 3 and 4 mm were obtained with TCPp3m and TCPp4m as follows: MAE of TCPp3m was 0.24 ± 0.20 (SD) D with MedAE of 0.20 D, while MAE of TCPp4m was 0.96 ± 0.77 D with MedAE of 0.80 D. The 3 mm multivariate regression formula results in higher absolute frequencies of prediction errors in the total eyes within 0.5 D (93%) than the univariate formula (81%). At 4mm, the multivariate regression formula has a lower percentage within 0.5 D (32%) than the univariate formula (41%), but the percentage of the multivariate formula is higher within 1 D (63%) than the univariate formula (56%). CONCLUSION All formulas show a decrease in accuracy with increasing grades of keratoconus. Multivariate linear regression formulae using only anterior surface data can predict TCP with good approximation in eyes with keratoconus in cases where posterior surface parameters are unavailable. The vertical location of Kmax and the anterior asphericity could play a relevant role in the prediction of total corneal power in keratoconus.
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Affiliation(s)
- Umberto Camellin
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Ivan Ninotta
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Gianluigi Latino
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | | | - Pasquale Aragona
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Anna M Roszkowska
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
- Department of Ophthalmology, Andrzej Frycz Modrzewski Krakow University, Kraków, Poland
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Kobia-Acquah E, Flitcroft DI, Lingham G, Kerin E, Loughman J. Short-term effects of cyclopentolate and tropicamide eye drops on macular choroidal thickness in myopic children. Ophthalmic Physiol Opt 2024; 44:280-291. [PMID: 38037443 DOI: 10.1111/opo.13256] [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: 08/11/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND To investigate the short-term effects of cyclopentolate and tropicamide eyedrops on choroidal thickness (ChT) in myopic children using placebo or low-dose atropine eyedrops. METHODS The analysis included 242 myopic individuals (7-19 years) enrolled in two randomised placebo-controlled clinical trials of low-dose atropine eyedrops. Cycloplegia was induced using either one drop of 1% cyclopentolate (n = 161), two drops of 1% cyclopentolate (n = 32) or two drops of 1% tropicamide (n = 49). ChT measurements were taken using swept-source optical coherence tomography before and 30 min after administering the cycloplegic eye drops. A subset of 51 participants underwent test-retest measurements prior to cycloplegia. RESULTS Mean changes in subfoveal ChT after two drops of tropicamide and one and two drops of cyclopentolate were -2.5 μm (p = 0.10), -4.3 μm (p < 0.001) and -9.6 μm (p < 0.001), respectively. Subfoveal ChT changes after one and two drops of cyclopentolate were significantly greater than the test-retest changes (test-retest mean change: -3.1 μm; p < 0.05), while the tropicamide group was not significantly different (p = 0.64). Choroidal thinning post-cyclopentolate was not significantly different between atropine and placebo treatment groups (p > 0.05 for all macular locations). The coefficient of repeatability (CoR) in the tropicamide group (range: 8.2-14.4 μm) was similar to test-retest (range: 7.5-12.2 μm), whereas greater CoR values were observed in the cyclopentolate groups (one drop: range: 10.8-15.3 μm; two drops: range: 12.2-24.6 μm). CONCLUSIONS Cyclopentolate eye drops caused dose-dependent choroidal thinning and increased variation in pre- to post-cycloplegia measurements compared with test-retest variability, whereas tropicamide did not. These findings have practical implications for ChT measurements when cyclopentolate is used, particularly for successive measurements.
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Affiliation(s)
- Emmanuel Kobia-Acquah
- Centre for Eye Research Ireland, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - Daniel Ian Flitcroft
- Centre for Eye Research Ireland, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
- Department of Ophthalmology, Children's Health Ireland at Temple Street Hospital, Dublin, Ireland
| | - Gareth Lingham
- Centre for Eye Research Ireland, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - Eoin Kerin
- Centre for Eye Research Ireland, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - James Loughman
- Centre for Eye Research Ireland, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
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21
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Terravecchia C, Mostile G, Chisari CG, Rascunà C, Terranova R, Cicero CE, Giuliano L, Donzuso G, Sciacca G, Luca A, Preux PM, Jankovic J, Zappia M, Nicoletti A. Retinal Thickness in Essential Tremor and Early Parkinson Disease: Exploring Diagnostic Insights. J Neuroophthalmol 2024; 44:35-40. [PMID: 37523235 PMCID: PMC10855993 DOI: 10.1097/wno.0000000000001959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
BACKGROUND Essential tremor (ET) represents a heterogeneous condition which may overlap with Parkinson disease (PD) even at early stages, by sharing some subtle clinical aspects. Longstanding ET demonstrated also higher risk of developing PD, especially with a Tremor-dominant (TD-PD) phenotype. Therefore, differential diagnosis between ET and early PD could be quite challenging. Optical coherence tomography (OCT) has been recognized as a reliable tool to assess the retina as a proxy of neurodegeneration. We aimed to explore the possible role of retinal assessment in differential diagnosis between ET and early PD. METHODS Macular layers and peripapillary retinal nerve fiber layer (RNFL) thickness among ET, early PD, and healthy controls (HCs) were assessed using OCT. RESULTS Forty-two eyes from 23 ET, 41 eyes from 21 early PD, and 33 eyes from 17 HCs were analyzed. Macular RNFL, ganglion cell layer, inner plexiform layer, and inner nuclear layer were thinner in PD as compared with ET and even more in HCs. Differences between ET and PD were more evident when considering the TD-PD subgroup, especially for RNFL. Among ET patients, thickness of the inner macular layers showed negative linear relationship with both age at onset and disease duration. Peripapillary temporal quadrant thinning was found in ET compared with HCs. CONCLUSIONS Macular inner retina was thinner in patients with ET and early PD compared with HCs. These findings suggest that the retinal assessment may have a utility in the differential diagnosis between ET and PD.
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Shor R, Segal O, Barequet D, Greenbaum E, Trivizki O, Loewenstein A, Rabina G. Branch retinal vein occlusion treated with anti-VEGF: to switch or not to switch? CANADIAN JOURNAL OF OPHTHALMOLOGY 2024:S0008-4182(24)00033-4. [PMID: 38395414 DOI: 10.1016/j.jcjo.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/11/2023] [Accepted: 01/29/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVE To evaluate visual outcomes after switching from bevacizumab to ranibizumab or aflibercept in patients with macular edema (ME) secondary to branch retinal vein occlusion (BRVO). DESIGN A retrospective, multi-center, observational study. PARTICIPANTS Patients diagnosed with BRVO and were treated with at least 3 bevacizumab injections, before anti VEGF switch. METHODS The follow-up period was 36 months, and the primary study outcomes assessed changes in best corrected visual acuity (BCVA) after anti VEGF switch. RESULTS A total of 263 eyes of 263 patients with a mean age of 71.5 ± 11.2 years of which 50% were of male gender met the inclusion criteria. Of them, 175 eyes did not undergo switch, whereas 88 eyes underwent anti-VEGF switch. There was not a significant difference in mean age (p = 0.634) and gender (p = 0.269) between the groups. Baseline BCVA of the no-switch group was 0.47 ± 0.43 logMAR (20/59 Snellen) versus 0.6 ± 0.49 logMAR (20/79 Snellen) (p = 0.031) in the switch group, and at 36-months it was 0.41 ± 0.39 (20/51 Snellen) logMAR versus 0.54 ± 0.49 logMAR (20/69 Snellen) (p = 0.035), respectively. The difference between the rate of change in BCVA per year was insignificant between groups (p = 0.414). In multivariate analysis, baseline BCVA was the single significant predictor for switch (beta 0.137, p = 0.035). Patients with more than one anti-VEGF switch suffer from decrease in BCVA. CONCLUSIONS Worse baseline BCVA is a significant predictor for anti-VEGF switch execution, though the switch has no significant impact on the change in BCVA over time. Multiple anti-VEGF switch is not recommended.
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Affiliation(s)
- Reut Shor
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ori Segal
- Department of Ophthalmology, Meir Medical Center, Kfar Saba, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dana Barequet
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eran Greenbaum
- Department of Ophthalmology, Meir Medical Center, Kfar Saba, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Omer Trivizki
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anat Loewenstein
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gilad Rabina
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Arias-Alvarez M, Tomas-Grasa C, Sopeña-Pinilla M, Orduna-Hospital E, Fernandez-Espinosa G, Bielsa-Alonso S, Acha-Perez J, Rodriguez-Mena D, Pinilla I. Electrophysiological findings in long-term type 1 diabetes patients without diabetic retinopathy using different ERG recording systems. Sci Rep 2024; 14:3520. [PMID: 38347052 PMCID: PMC10861544 DOI: 10.1038/s41598-024-54099-5] [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: 10/24/2023] [Accepted: 02/08/2024] [Indexed: 02/15/2024] Open
Abstract
To assess full-field electroretinogram findings in long-term type 1 diabetes patients without diabetic retinopathy. Prospective study including 46 eyes of 23 patients with type 1 diabetes and 46 age-matched healthy eyes evaluated by the RETI-port/scan21 and the portable system RETeval following ISCEV guidelines. The average duration of diabetes was 28.88 ± 8.04 years. In scotopic conditions, using the RETI-port/scan21, diabetic patients showed an increase in b-wave implicit time (IT) (p = 0.017) with the lowest stimuli; a diminished b-wave amplitude (p = 0.005) in the mixed response, an increased IT (p = 0.004) with the high-intensity stimuli and an OP2 increased IT (p = 0.008) and decreased amplitude (p = 0.002). Under photopic conditions, b-wave amplitude was lower (p < 0.001) and 30-Hz flicker response was diminished (p = 0.021). Using the RETeval, in scotopic conditions, diabetic patients showed a reduction in the rod b-wave amplitude (p = 0.009), an increase in a-wave IT with the 280 Td.s stimulus (p = 0.005). OP2 had an increased IT and diminished amplitude (p = 0.003 and p = 0.002 respectively). 16 Td.s flicker showed an increased IT (p = 0.008) and diminished amplitude (p = 0.048). Despite variations in values between both systems, nearly all results displayed positive correlations. Long-term type 1 diabetes patients without diabetic retinopathy exhibit alterations in scotopic conditions, as evidenced by both conventional and portable electroretinogram devices. These findings suggest a modified retinal function, particularly in rod-driven pathways, even in the absence of vascular signs.
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Affiliation(s)
- Marta Arias-Alvarez
- Department of Neurophysiology, Lozano Blesa University Hospital, 50009, Zaragoza, Spain
- Aragon Institute for Health Research (IIS Aragon), 50009, Zaragoza, Spain
| | - Cristina Tomas-Grasa
- Department of Internal Medicine, Lozano Blesa University Hospital, 50009, Zaragoza, Spain
| | - Maria Sopeña-Pinilla
- Aragon Institute for Health Research (IIS Aragon), 50009, Zaragoza, Spain
- Department of Ophthalmology, Miguel Servet University Hospital, 50009, Zaragoza, Spain
| | - Elvira Orduna-Hospital
- Aragon Institute for Health Research (IIS Aragon), 50009, Zaragoza, Spain
- Department of Applied Physics, University of Zaragoza, 50009, Zaragoza, Spain
| | | | | | - Javier Acha-Perez
- Aragon Institute for Health Research (IIS Aragon), 50009, Zaragoza, Spain
- Department of Endocrinology, Miguel Servet University Hospital, 50009, Zaragoza, Spain
| | - Diego Rodriguez-Mena
- Department of Neurophysiology, Lozano Blesa University Hospital, 50009, Zaragoza, Spain
| | - Isabel Pinilla
- Aragon Institute for Health Research (IIS Aragon), 50009, Zaragoza, Spain.
- Department of Surgery, University of Zaragoza, 50009, Zaragoza, Spain.
- Department of Ophthalmology, Lozano Blesa University Hospital, 50009, Zaragoza, Spain.
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Sorkin N, Kaiserman I, Kayal M, Levinger E, Mashour RS, Sela T, Munzer G, Mimouni M. Factors Predicting the Need for Re-treatment After Laser Refractive Surgery in Patients With Mixed Astigmatism. J Refract Surg 2024; 40:e73-e78. [PMID: 38346124 DOI: 10.3928/1081597x-20231212-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
PURPOSE To identify risk factors that increase the likelihood of re-treatment following refractive surgery in patients with mixed astigmatism. METHODS This was a retrospective study including patients who underwent either laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) between 2000 and 2019 and had mixed astigmatism (spherical error of +0.50 D or greater and spherical equivalent of less than 0.00 diopters [D]). Patients were divided into two groups according to whether they underwent re-treatments during the study period. RESULTS Overall, 785 eyes (785 patients) were included. In total, 5.2% of the eyes (n = 41) underwent re-treatment. The re-treatment group was more likely to have preoperative high astigmatism (80.5% vs 48.3%, P < .001), moderate to high hyperopia (36.6% vs 22.3%, P = .035), and to have undergone surgery earlier during the study period (P < .001). They were also more likely to have undergone surgery using the Wave-Light EX200 rather than the EX500 laser platform (Alcon Laboratories, Inc) (P < .001), have a treated optical zone of 6 mm rather than 6.5 mm (P < .001 for both), and their maximum ablation depth was greater (P < .001). There was no difference between the re-treatment and control groups regarding procedure type (PRK vs LASIK). Binary logistic regression found preoperative high astigmatism (odds ratio = 3.97, P < .001) and the type of laser platform used (EX200, odds ratio = 7.78, P < .001) as the only independent factors associated with re-treatment. CONCLUSIONS Re-treatment rates following correction of mixed astigmatism were 5.2% over 20 years. Use of a sixth-generation laser platform significantly reduced the risk of re-treatment. Presence of high astigmatism is a significant risk factor for re-treatment. There was no difference in retreatment risk between PRK and LASIK. [J Refract Surg. 2024;40(2):e73-e78.].
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Zeri F, Rizzo GC, Ponzini E, Tavazzi S. Comparing automated and manual assessments of tear break-up time using different non-invasive devices and a fluorescein procedure. Sci Rep 2024; 14:2516. [PMID: 38291100 PMCID: PMC10827797 DOI: 10.1038/s41598-024-52686-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/22/2024] [Indexed: 02/01/2024] Open
Abstract
To evaluate the agreement and repeatability of an automated topography-based method for non-invasive break-up time (NIBUT) analyses in comparison with two other NIBUT procedures, the fluorescein procedure (fBUT), and with the manual assessment with the same device. In the first experiment, a semi-randomised crossover study was performed on forty-three participants (23.1 ± 2.1 years). NIBUT measurements were collected in a randomised order, in both eyes of participants with EasyTear View + (Easytear, Rovereto), Polaris, and Sirius + (CSO, Firenze). Then a fBUT was collected. The overall measurement procedure was repeated in a further session (retest) on the same day. In a second experiment, a retrospective randomised crossover study was performed on eighty-five NIBUT videos previously recorded by the Sirius+. Two observers assessed manually the videos and the NIBUTs were compared with the automatic ones. In the first experiment, ANOVA showed a significant difference between the four measures in both eyes (p < 0.001). Significant differences were found in the paired comparisons between each NIBUT procedure and fBUT (Wicoxon; p < 0.05). Sirius+ resulted in agreement only with Polaris in the left eye. Correlations between all NIBUT procedures resulted in statistical significance in both eyes. All procedures showed very good test-rest reliability. In the second experiment, a significant correlation between automated and manual NIBUT was found, but also a significant statistical difference between the two measurements, although clinically negligible (0.3 s). The investigated NIBUT devices perform differently from each other (and from fBUT), so they cannot be considered interchangeable. The automated measure of NIBUT with Sirius+ has a negligible clinical difference compared to manual assessment on the same device.
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Affiliation(s)
- Fabrizio Zeri
- Department of Materials Science, University of Milano-Bicocca, Via Roberto Cozzi, 55, 20125, Milan, Italy
- COMiB Research Centre in Optics and Optometry, University of Milano-Bicocca, Milan, Italy
- College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Giulia Carlotta Rizzo
- Department of Materials Science, University of Milano-Bicocca, Via Roberto Cozzi, 55, 20125, Milan, Italy.
- COMiB Research Centre in Optics and Optometry, University of Milano-Bicocca, Milan, Italy.
| | - Erika Ponzini
- Department of Materials Science, University of Milano-Bicocca, Via Roberto Cozzi, 55, 20125, Milan, Italy
- COMiB Research Centre in Optics and Optometry, University of Milano-Bicocca, Milan, Italy
| | - Silvia Tavazzi
- Department of Materials Science, University of Milano-Bicocca, Via Roberto Cozzi, 55, 20125, Milan, Italy
- COMiB Research Centre in Optics and Optometry, University of Milano-Bicocca, Milan, Italy
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Ng D, Altamirano-Vallejo JC, Navarro-Partida J, Sanchez-Aguilar OE, Inzunza A, Valdez-Garcia JE, Gonzalez-de-la-Rosa A, Bustamante-Arias A, Armendariz-Borunda J, Santos A. Enhancing Ocular Surface in Dry Eye Disease Patients: A Clinical Evaluation of a Topical Formulation Containing Sesquiterpene Lactone Helenalin. Pharmaceuticals (Basel) 2024; 17:175. [PMID: 38399390 PMCID: PMC10892869 DOI: 10.3390/ph17020175] [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: 12/30/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024] Open
Abstract
The aim of this work was to assess the tolerability, safety, and efficacy of an ophthalmic topical formulation containing helenalin from Arnica montana and hyaluronic acid 0.4% (HA) in patients with mild-to-moderate Dry Eye Disease (DED) exhibiting positive Matrix Metalloproteinase 9 (MMP-9) test results. Tolerability and safety were evaluated in 24 healthy subjects. Participants were instructed to apply one drop of the formulation three times a day in the study eye, for 2 weeks, followed by a clinical follow-up of 21 days. Efficacy was studied in 48 DED patients randomized into Study (Group 1/receiving the studied formulation) or Control (Group 2/Receiving HA 0.4% eye lubricant) groups for 1 month. Assessments included an MMP-9 positivity test, conjunctival impression cytology (CIC), Ocular Surface Disease Index (OSDI), non-invasive film tear breakup time (NIBUT), non-invasive average breakup time (NIAvg-BUT), ocular surface staining, Schirmer's test, and meibomiography. A crossover design with an additional 1-month follow-up was applied to both groups. Healthy subjects receiving the studied formulation exhibited good tolerability and no adverse events. Regarding the efficacy study, Group 1 exhibited a statistically significant reduction in the MMP-9 positivity rate compared to Group 2 (p < 0.001). Both Group 1 and Group 2 exhibited substantial improvements in OSDI and NIBUT scores (p < 0.001). However, Group 1 demonstrated a significant improvement in NI-Avg-BUT and Schirmer's test scores (p < 0.001), whereas Group 2 did not (p > 0.05). Finally, after the crossover, the proportion of MMP-9-positive subjects in Group 1 increased from 25% to 91.6%, while Group 2 showed a significant decrease from 87.5% to 20.8%. Overall, the topical formulation containing sesquiterpene helenalin from Arnica montana and hyaluronic acid was well tolerated and exhibited a favorable safety profile. Our formulation reduces DED symptomatology and modulates the ocular surface inflammatory process; this is evidenced by the enhancement of CIC, the improvement of DED-related tear film status, and the reduction of the MMP-9 positivity rate.
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Affiliation(s)
- Dalia Ng
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64849, Nuevo Leon, Mexico; (D.N.); (J.C.A.-V.); (J.N.-P.); (O.E.S.-A.); (A.I.); (J.E.V.-G.); (A.G.-d.-l.-R.); (J.A.-B.)
- Grupo Oftalmologico Acosta, Hospital Puerta de Hierro, Zapopan 45116, Jalisco, Mexico
| | - Juan Carlos Altamirano-Vallejo
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64849, Nuevo Leon, Mexico; (D.N.); (J.C.A.-V.); (J.N.-P.); (O.E.S.-A.); (A.I.); (J.E.V.-G.); (A.G.-d.-l.-R.); (J.A.-B.)
- Centro de Retina Medica y Quirurgica, Hospital Puerta de Hierro, Zapopan 45116, Jalisco, Mexico
| | - Jose Navarro-Partida
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64849, Nuevo Leon, Mexico; (D.N.); (J.C.A.-V.); (J.N.-P.); (O.E.S.-A.); (A.I.); (J.E.V.-G.); (A.G.-d.-l.-R.); (J.A.-B.)
- Centro de Retina Medica y Quirurgica, Hospital Puerta de Hierro, Zapopan 45116, Jalisco, Mexico
| | - Oscar Eduardo Sanchez-Aguilar
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64849, Nuevo Leon, Mexico; (D.N.); (J.C.A.-V.); (J.N.-P.); (O.E.S.-A.); (A.I.); (J.E.V.-G.); (A.G.-d.-l.-R.); (J.A.-B.)
| | - Andres Inzunza
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64849, Nuevo Leon, Mexico; (D.N.); (J.C.A.-V.); (J.N.-P.); (O.E.S.-A.); (A.I.); (J.E.V.-G.); (A.G.-d.-l.-R.); (J.A.-B.)
| | - Jorge Eugenio Valdez-Garcia
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64849, Nuevo Leon, Mexico; (D.N.); (J.C.A.-V.); (J.N.-P.); (O.E.S.-A.); (A.I.); (J.E.V.-G.); (A.G.-d.-l.-R.); (J.A.-B.)
| | - Alejandro Gonzalez-de-la-Rosa
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64849, Nuevo Leon, Mexico; (D.N.); (J.C.A.-V.); (J.N.-P.); (O.E.S.-A.); (A.I.); (J.E.V.-G.); (A.G.-d.-l.-R.); (J.A.-B.)
- Centro de Retina Medica y Quirurgica, Hospital Puerta de Hierro, Zapopan 45116, Jalisco, Mexico
| | | | - Juan Armendariz-Borunda
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64849, Nuevo Leon, Mexico; (D.N.); (J.C.A.-V.); (J.N.-P.); (O.E.S.-A.); (A.I.); (J.E.V.-G.); (A.G.-d.-l.-R.); (J.A.-B.)
- Centro Universitario Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Arturo Santos
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64849, Nuevo Leon, Mexico; (D.N.); (J.C.A.-V.); (J.N.-P.); (O.E.S.-A.); (A.I.); (J.E.V.-G.); (A.G.-d.-l.-R.); (J.A.-B.)
- Centro de Retina Medica y Quirurgica, Hospital Puerta de Hierro, Zapopan 45116, Jalisco, Mexico
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Pena-Verdeal H, Garcia-Queiruga J, Sabucedo-Villamarin B, Garcia-Resua C, Giraldez MJ, Yebra-Pimentel E. A Comprehensive Study on Tear Meniscus Height Inter-Eye Differences in Aqueous Deficient Dry Eye Diagnosis. J Clin Med 2024; 13:659. [PMID: 38337353 PMCID: PMC10856492 DOI: 10.3390/jcm13030659] [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: 12/27/2023] [Revised: 01/18/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Background: Dry eye disease (DED) is a chronic ocular surface condition that requires precise diagnostic tools. The present study aimed to investigate the diagnostic potential of the absolute inter-eye difference (|OD-OS|) in tear meniscus height (TMH) for the detection of the presence of aqueous deficient dry eye (ADDE). (2) Methods: A sample of 260 participants with dry eye complaints underwent ocular surface examinations thorough diagnostic assessments based on the Tear Film and Ocular Surface Society guidelines (TFOS DEWS II). Participants were subsequently categorized as No ADDE and ADDE based on TMH. Statistical analyses to determine the optimal TMH|OD-OS| cut-off value in a randomly selected study group (200 participants) were performed, while a separate validation analysis of the cut-off value obtained in a random cross-validation group (60 participants) was also performed. (3) Results: The significant diagnostic capability of TMH|OD-OS| (area under the curve = 0.719 ± 0.036, p < 0.001) was found. The identified cut-off value of 0.033 mm demonstrated reliable specificity (77.6%) and moderate sensitivity (59.1%). Cross-validation confirmed the cut-off value's association with the TFOS DEWS II diagnostic criterion (Cramer's V = 0.354, p = 0.006). (4) Conclusions: The present study provides evidence for the diagnostic potential of TMH|OD-OS| in identifying ADDE. The identified cut-off value enhances the specificity and offers moderate sensitivity, providing an objective tool for clinical decision making.
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Affiliation(s)
- Hugo Pena-Verdeal
- GI-2092—Optometría, Departamento de Física Aplicada (Área de Optometría), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, Campus Vida S/N, 15705 Santiago de Compostela, Spain; (B.S.-V.); (C.G.-R.); (M.J.G.); (E.Y.-P.)
- Instituto de Investigación Sanitaria (IDIS), Travesía da Choupana S/N, 15706 Santiago de Compostela, Spain
| | - Jacobo Garcia-Queiruga
- GI-2092—Optometría, Departamento de Física Aplicada (Área de Optometría), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, Campus Vida S/N, 15705 Santiago de Compostela, Spain; (B.S.-V.); (C.G.-R.); (M.J.G.); (E.Y.-P.)
- Instituto de Investigación Sanitaria (IDIS), Travesía da Choupana S/N, 15706 Santiago de Compostela, Spain
| | - Belen Sabucedo-Villamarin
- GI-2092—Optometría, Departamento de Física Aplicada (Área de Optometría), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, Campus Vida S/N, 15705 Santiago de Compostela, Spain; (B.S.-V.); (C.G.-R.); (M.J.G.); (E.Y.-P.)
| | - Carlos Garcia-Resua
- GI-2092—Optometría, Departamento de Física Aplicada (Área de Optometría), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, Campus Vida S/N, 15705 Santiago de Compostela, Spain; (B.S.-V.); (C.G.-R.); (M.J.G.); (E.Y.-P.)
- Instituto de Investigación Sanitaria (IDIS), Travesía da Choupana S/N, 15706 Santiago de Compostela, Spain
| | - Maria J. Giraldez
- GI-2092—Optometría, Departamento de Física Aplicada (Área de Optometría), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, Campus Vida S/N, 15705 Santiago de Compostela, Spain; (B.S.-V.); (C.G.-R.); (M.J.G.); (E.Y.-P.)
- Instituto de Investigación Sanitaria (IDIS), Travesía da Choupana S/N, 15706 Santiago de Compostela, Spain
| | - Eva Yebra-Pimentel
- GI-2092—Optometría, Departamento de Física Aplicada (Área de Optometría), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, Campus Vida S/N, 15705 Santiago de Compostela, Spain; (B.S.-V.); (C.G.-R.); (M.J.G.); (E.Y.-P.)
- Instituto de Investigación Sanitaria (IDIS), Travesía da Choupana S/N, 15706 Santiago de Compostela, Spain
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Hecht I, Shemer A, Vardi M, Braudo S, Dubinsky-Pertzov B, Or L, Pras E. Between-eye correlation of ocular parameters. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024:S0008-4182(23)00389-7. [PMID: 38219792 DOI: 10.1016/j.jcjo.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 09/28/2023] [Accepted: 12/20/2023] [Indexed: 01/16/2024]
Abstract
OBJECTIVE It is accepted that ocular parameters are more correlated with the fellow eye. This poses a challenge in ophthalmic research. There is a relative scarcity of data concerning the extent of correlation. The aim of this study was to analyze and quantify the correlation of different ocular parameters. DESIGN Historical registry analysis. PARTICIPANTS All patients examined in a 10-year period (2011-2021) in one academic tertiary medical centre in central Israel. METHODS Data from optical coherence tomography examinations and biometry of a single examination of both eyes taken at the same time from each patient was included. Pearson's r values were calculated to estimate the extent of correlation. RESULTS A total of 17,212 patients were included. Mean age was 73 ± 12.7 years, and 54.5% were female. All examined parameters were highly statistically significantly correlated between eyes (all with p < 0.1 × 10-36), whereas the strength of correlation differed. Very weak correlation was seen in central macular thickness (r = 0.189), and a weak correlation was seen in anterior-chamber depth (r = 0.379) and retinal nerve fibre layer thickness (r = 0.479). A strong correlation was seen in central corneal thickness (r = 0.754), and a very strong correlation was seen in axial length (r = 0.900). CONCLUSIONS In a retrospective analysis of optical coherence tomography and biometry measurements of >10,000 patients, all examined parameters were highly statistically significantly correlated. Correlation magnitude varied, with structural characteristics more correlated than functional ones. Including both eyes in an outcome analysis likely will introduce bias. We recommend adjusting for inter-eye correlation in all studies assessing ocular outcome measures.
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Affiliation(s)
- Idan Hecht
- Department of Ophthalmology, Shamir Medical Center, Tzrifin, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Asaf Shemer
- Department of Ophthalmology, Shamir Medical Center, Tzrifin, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maya Vardi
- Department of Ophthalmology, Shamir Medical Center, Tzrifin, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharon Braudo
- Department of Ophthalmology, Shamir Medical Center, Tzrifin, Israel
| | - Biana Dubinsky-Pertzov
- Department of Ophthalmology, Shamir Medical Center, Tzrifin, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lior Or
- Department of Ophthalmology, Shamir Medical Center, Tzrifin, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eran Pras
- Department of Ophthalmology, Shamir Medical Center, Tzrifin, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Matlow's Ophthalmo-Genetics Laboratory, Department of Ophthalmology, Shamir Medical Center, Tzrifin, Israel
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Cui G, Wang T, Di Y, Yang S, Li Y, Chen D. Changes of dry eye parameters after small incision lenticule extraction surgery in patients with different ocular surface disease index scores. Sci Rep 2024; 14:863. [PMID: 38195676 PMCID: PMC10776785 DOI: 10.1038/s41598-023-49645-6] [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: 03/22/2023] [Accepted: 12/11/2023] [Indexed: 01/11/2024] Open
Abstract
To evaluate the changes of dry eye parameters after small incision lenticule extraction (SMILE) surgery in patients with different ocular surface disease index (OSDI) scores. Prospective research. Participants were divided into two groups: Group A, OSDI < 13; and Group B, OSDI ≥ 13. The OSDI scores, tear meniscus height (TMH), first non-invasive tear film break-up time (NIBUT-First), and meibomian gland loss (MGL, %) were recorded at postoperative 1 -week and 1-month.113 eyes (57 patients) were enrolled, 70 eyes in Group A, and 43 eyes in Group B. In Group A, the OSDI scores significantly increased at 1-week and 1-month postoperative (all P < 0.001); the TMH, NIBUT-First and lipid layer grade significantly decreased at postoperative 1-week (P = 0.003, 0.005, 0.007, 0.004, respectively), but returned to preoperative level at 1-month postoperative. In Group B, only the lipid layer grade significantly decreased at postoperative 1-week (P < 0.05). Patients with different preoperative OSDI scores may experience different changes early after SMILE surgery. Patients with OSDI scores < 13 may experience more dramatic changes in dry eye symptoms which would resolve, while subjective complains could still exists at 1 month after surgery.
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Affiliation(s)
- Ge Cui
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Tianjiao Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yu Di
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shan Yang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ying Li
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Di Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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Beesley J, Elliott DB. Changes in ocular astigmatism with age: A longitudinal study. Ophthalmic Physiol Opt 2024; 44:71-77. [PMID: 37743700 DOI: 10.1111/opo.13234] [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: 06/01/2023] [Revised: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 09/26/2023]
Abstract
PURPOSE To investigate changes in astigmatism with age. Are changes from with-the-rule (WTR) in younger ages to against-the-rule (ATR) in older patients mediated through oblique astigmatic axes or spherical prescriptions, and at what ages do these changes occur? METHODS Prescription data were gathered retrospectively from one optical practice belonging to a large multiple group in the UK. Longitudinal assessments were made of the changes in astigmatism for 326 patients (mean age at first prescription 46 years, range 28-69 years) and 640 eyes through their recorded prescription history (median 20 years of prescription data per participant, IQR 19-22 years, range 18-29 years). RESULTS Changes in small degrees of astigmatism (0.25 or 0.50 DC) from WTR to ATR were more than three times more likely to pass through an oblique cylinder axis as through a spherical prescription (56 vs. 16,χ 1 2 = 22.2, p < 0.0001). For patients aged 28-40 years at their first recorded eye examination, 55% (92/167) of eyes had an onset of astigmatic changes at a mean of 44 years (SD 6.2) and 41% (68/167) of eyes had no change until after a mean of 54 years (SD 4.6). Compared with a measured prevalence of oblique astigmatism in the literature of 11%-19%, 36% (232/640) of the eyes in this study had an oblique cylinder prescribed at least once in their refraction history and of these oblique cylinders, 78% were transient in nature. CONCLUSIONS The change in ocular astigmatism with age, from WTR to ATR, was more than three times more likely (56 vs. 16) to pass through oblique cylinder axes as through a spherical prescription. Changes in oblique astigmatism have been implicated in complaints with new spectacles, so given this prevalence of oblique cylinder axes (232/640, 36%), continuing professional development is needed regarding reconciling these oblique changes with previous prescriptions.
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Affiliation(s)
- Jeremy Beesley
- Bradford School of Optometry and Vision Science, University of Bradford, Bradford, UK
| | - David B Elliott
- Bradford School of Optometry and Vision Science, University of Bradford, Bradford, UK
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Salvador-Roger R, Albarrán-Diego C, Garzón N, García-Montero M, Muñoz G, Micó V, Esteve-Taboada JJ. Revisiting Javal's rule: a fresh and improved power vector approach according to age. Graefes Arch Clin Exp Ophthalmol 2024; 262:249-260. [PMID: 37552315 PMCID: PMC10805827 DOI: 10.1007/s00417-023-06195-x] [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: 05/03/2023] [Revised: 07/19/2023] [Accepted: 07/30/2023] [Indexed: 08/09/2023] Open
Abstract
PURPOSE The scientific community has established Javal's rule as a model linking refractive (RA) and keratometric (KA) astigmatism since its appearance more than 100 years ago. The aim was to improve the accuracy of this relationship according to subject's age by applying the power vector analysis. Posterior corneal curvature has also been studied. METHODS The IOLMaster 700 optical biometer was used to measure the corneal thickness and the radius of curvature of the anterior and posterior corneal surfaces. Refractive error was determined by a non-cycloplegic subjective refraction process with trial lenses. Linear regression analyses were applied using J0 and J45 power vector components. An evaluation was carried out according to the subject's age resulting into eight regression relationships for each astigmatic vector component for each relationship. RESULTS A total of 2254 right eyes from 2254 healthy subjects were evaluated. A trend towards against-the-rule astigmatism (ATR) was found with aging, both for refractive astigmatism (RA) and keratometric astigmatism (KA), with 95.2% of subjects under 20 years old having with-the-rule (WTR) KA, and only 22.8% above 79 years old. The following regression equations were found between RA and KA: [Formula: see text] = 0.73 × [Formula: see text] - 0.18 (R = 0.78) and [Formula: see text] = 0.70 × [Formula: see text] + 0.04 (R = 0.69) and between RA and total corneal astigmatism (TCA): [Formula: see text] = 0.73 × [Formula: see text] + 0.13 (R=0.78) and [Formula: see text] = 0.70 × [Formula: see text] - 0.06 (R = 0.68) for the whole sample, but with sensible differences among age groups, both in the slope and in the intercept. CONCLUSION Ignoring the age of the subject when using Javal's rule could lead to an error in the final cylinder calculation that would increase in high astigmatisms. Applying this new power vector approach based on subject's age could improve the accuracy of the astigmatism prediction.
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Affiliation(s)
- Raquel Salvador-Roger
- Department of Optics and Optometry and Vision Sciences, University of Valencia, 46100, Burjassot, Valencia, Spain.
| | - César Albarrán-Diego
- Department of Optics and Optometry and Vision Sciences, University of Valencia, 46100, Burjassot, Valencia, Spain
| | - Nuria Garzón
- Department of Optometry and Vision, Universidad Complutense de Madrid, 28037, Madrid, Spain
| | - María García-Montero
- Department of Optometry and Vision, Universidad Complutense de Madrid, 28037, Madrid, Spain
| | - Gonzalo Muñoz
- Marqués de Sotelo Ophthalmological Clinic, 46002, Valencia,, Spain
- Baviera Castellón Ophthalmological Clinic, 12003, Castelló de la Plana, Spain
| | - Vicente Micó
- Department of Optics and Optometry and Vision Sciences, University of Valencia, 46100, Burjassot, Valencia, Spain
| | - José J Esteve-Taboada
- Department of Optics and Optometry and Vision Sciences, University of Valencia, 46100, Burjassot, Valencia, Spain
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Safir M, Sorkin N, Kaiserman I, Sela T, Munzer G, Spierer O, Mimouni M. Factors Predicting Slow Visual Recovery Following Hyperopic LASIK. J Refract Surg 2024; 40:e42-e47. [PMID: 38190557 DOI: 10.3928/1081597x-20231212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
PURPOSE To identify factors predicting slow visual recovery following hyperopic laser in situ keratomileusis (LASIK). METHODS The study included consecutive patients who underwent hyperopic LASIK between January 2005 and December 2019 at a single medical center. Patients were divided into two groups according to whether they experienced normal recovery of visual acuity (1-week visit) or slow visual recovery (1-month visit). Visual recovery was defined as achieving an efficacy index of 0.9 or greater. Efficacy index was calculated as postoperative uncorrected distance visual acuity / preoperative corrected distance visual acuity. A comparison of baseline and intraoperative parameters was performed. Binary logistic regression was performed to identify potential predictors of slow visual recovery. RESULTS Overall, 861 eyes of 861 patients were included. Mean age was 48.0 ± 9.5 years and 55.9% were women. Two hundred forty-nine patients (28.9%) experienced slow visual recovery. Younger age (P = .01), a larger preoperative spherical equivalence (P = .002), and greater maximum ablation depth (P = .002) were predictors of slow visual recovery. In binary logistic regression, female gender (P = .036) and greater spherical equivalence (P = .007) remained significant predictors of slow visual recovery. CONCLUSIONS Female gender and greater preoperative spherical equivalence were associated with slow visual recovery. Patients may be advised accordingly. [J Refract Surg. 2024;40(1):e42-e47.].
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Safir M, Sorkin N, Kaiserman I, Sela T, Munzer G, Spierer O, Mimouni M. Factors Predicting Slow Visual Recovery Following Hyperopic LASIK. J Refract Surg 2024; 40:e42-e47. [PMID: 38190563 DOI: 10.3928/1081597x-20231212-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
PURPOSE To identify factors predicting slow visual recovery following hyperopic laser in situ keratomileusis (LASIK). METHODS The study included consecutive patients who underwent hyperopic LASIK between January 2005 and December 2019 at a single medical center. Patients were divided into two groups according to whether they experienced normal recovery of visual acuity (1-week visit) or slow visual recovery (1-month visit). Visual recovery was defined as achieving an efficacy index of 0.9 or greater. Efficacy index was calculated as postoperative uncorrected distance visual acuity / preoperative corrected distance visual acuity. A comparison of baseline and intraoperative parameters was performed. Binary logistic regression was performed to identify potential predictors of slow visual recovery. RESULTS Overall, 861 eyes of 861 patients were included. Mean age was 48.0 ± 9.5 years and 55.9% were women. Two hundred forty-nine patients (28.9%) experienced slow visual recovery. Younger age (P = .01), a larger preoperative spherical equivalence (P = .002), and greater maximum ablation depth (P = .002) were predictors of slow visual recovery. In binary logistic regression, female gender (P = .036) and greater spherical equivalence (P = .007) remained significant predictors of slow visual recovery. CONCLUSIONS Female gender and greater preoperative spherical equivalence were associated with slow visual recovery. Patients may be advised accordingly. [J Refract Surg. 2024;40(1):e42-e47.].
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Barraquer-López D, Cifuentes-González C, Peña-Pulgar LF, Rojas-Carabali W, Villa-Piñeros J, de-la-Torre A. De Novo Uveitis in the Colombian Elderly Population: Characteristics and Comparison with Patients Under 60 Years of Age. Ocul Immunol Inflamm 2024; 32:71-78. [PMID: 36624966 DOI: 10.1080/09273948.2022.2155841] [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: 07/02/2022] [Accepted: 12/01/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE To describe the differences between de novo uveitis in elderly patients (≥60 years of age) and younger patients (< 60 years of age) in Colombia. METHODS Observational, analytic, cross-sectional study. RESULTS In the elderly group, idiopathic was the most common type of uveitis, followed by immune-mediated and infectious uveitis.No masquerade syndromes were diagnosed. Elderly patients had worse average visual acuities than young. Significant differences between both groups were observed in corneal edema, macular edema, cataract, glaucoma, and epiretinal membrane. Additionally, there were differences in the drugs used, such as topical hypotensive drugs, ocular lubricants, topical steroids, methotrexate, hydroxychloroquine, and adalimumab. CONCLUSION The present study demonstrated significant differences between elderly and young Colombian patients with de novo uveitis. The ophthalmologists should be aware of these patterns of presentation, which would help reach an adequate diagnosis and prevent complications based on the characteristics of each group.
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Affiliation(s)
- Doménico Barraquer-López
- Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Institute of Translational Medicine (IMT), Universidad Del Rosario Escuela de Medicina y Ciencias de la Salud, Bogotá, Colombia
| | - Carlos Cifuentes-González
- Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Institute of Translational Medicine (IMT), Universidad Del Rosario Escuela de Medicina y Ciencias de la Salud, Bogotá, Colombia
| | - Luisa Fernanda Peña-Pulgar
- Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Institute of Translational Medicine (IMT), Universidad Del Rosario Escuela de Medicina y Ciencias de la Salud, Bogotá, Colombia
| | - William Rojas-Carabali
- Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Institute of Translational Medicine (IMT), Universidad Del Rosario Escuela de Medicina y Ciencias de la Salud, Bogotá, Colombia
| | - Jerónimo Villa-Piñeros
- Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Institute of Translational Medicine (IMT), Universidad Del Rosario Escuela de Medicina y Ciencias de la Salud, Bogotá, Colombia
| | - Alejandra de-la-Torre
- Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Institute of Translational Medicine (IMT), Universidad Del Rosario Escuela de Medicina y Ciencias de la Salud, Bogotá, Colombia
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Moshirfar M, Han KD, Jaafar MA, Santos JM, Theis JS, Stoakes IM, Hoopes PC. Comparative evaluation of multiple nomograms for predicting postoperative vault after implantable collamer lens surgery. J Cataract Refract Surg 2024; 50:64-71. [PMID: 37702514 DOI: 10.1097/j.jcrs.0000000000001304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE To compare the vault predictability of most available implantable collamer lens (ICL) sizing nomograms and identify which preoperative measurements are predictive of vault. SETTING Private practice in Draper, Utah. DESIGN Retrospective chart review. METHODS This study was a retrospective analysis of 209 eyes of 106 patients who underwent STAAR Surgical ICL implantation. Analyses were performed based on the availability of preoperative parameters, varying the number of eyes for each test. Mean absolute error (MAE) of predicted vs actual postoperative vault was calculated for each nomogram. The frequency of Kim, Rocamora (least absolute shrinkage and selection operator-optical coherence tomography), Russo, and Reinstein recommending the correct ICL size in instances when Parkhurst, optimized white-to-white (WTW), and STAAR could not recommend a definitive ICL size was determined. Univariate and multivariate linear regression analysis was performed between preoperative measurements and vault. RESULTS The Kim, Rocamora, Russo, and Reinstein nomograms had significantly lower MAE of predicted vs actual postoperative vault than the KSV2 and Nakamura V3 nomograms. The Russo formula most frequently recommended the correct ICL size when the Parkhurst, Optimized WTW, and STAAR nomograms could not provide ICL size recommendations. At the 0.05 significance level, anterior chamber depth (ACD), ciliary body inner diameter (CBID), and pupil diameter were the parameters found to have significant correlation with postoperative vault. CONCLUSIONS The Kim, Rocamora, Russo, and Reinstein nomograms were the most predictive of vault. Additionally, ACD, CBID, and pupil diameter were found to be significantly correlated with vault and should be considered for use in future ICL sizing nomograms.
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Affiliation(s)
- Majid Moshirfar
- From the Hoopes Vision Research Center, Hoopes Vision, Draper, Utah (Moshirfar, Hoopes); John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, Utah (Moshirfar); Utah Lions Eye Bank, Murray, Utah (Moshirfar); University of Arizona College of Medicine Phoenix, Phoenix, Arizona (Han, Jaafar, Santos, Theis); Pacific Northwest University of Health Sciences, Yakima, Washington (Stoakes)
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Abdolrahimzadeh S, Zweifel SA, Di Pippo M, Bajka A, Scuderi G, Lotery AJ. Central macular choriocapillaris impairment as a manifestation of microvascular disease in eyes with subretinal drusenoid deposits. Eye (Lond) 2024; 38:173-178. [PMID: 37419959 PMCID: PMC10764916 DOI: 10.1038/s41433-023-02654-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND/OBJECTIVES Microvascular alterations and choroidal impairment are emerging as a pathologic pathway in age-related macular degeneration (AMD). This study aimed to evaluate the central macular choriocapillaris (CC) in eyes with subretinal drusenoid deposits (SDD) and the retinal microvasculature in patients with early AMD phenotypes. SUBJECTS/METHODS This was an institutional, multicentric observational cross-sectional study. Ninety-nine eyes of 99 subjects; 33 eyes with SDD only, 33 eyes with conventional drusen (CD) only, and 33 eyes of healthy age-matched subjects were included. Comprehensive ophthalmologic examination and optical coherence tomography angiography (OCTA) was performed. The central macular flow area of the CC was analysed in the SDD group and the vessel density of the retinal superficial capillary plexus (SCP) and deep capillary plexus (DCP) was analysed in the SDD and CD groups using automated OCTA output parameters. RESULTS The flow area of the CC in the SDD group was significantly reduced (p ≤ 0.001) with respect to the healthy control group. There was a trend of reduction of vessel density of the SCP and the DCP in the SDD and CD group with respect to controls, although this did not reach statistical significance. CONCLUSIONS OCTA data in the present report corroborate the role of vascular damage in early AMD with CC impairment in the central macular area in eyes with SDD.
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Affiliation(s)
- Solmaz Abdolrahimzadeh
- Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy.
- St. Andrea Hospital, Via di Grottarossa 1035/1039, Rome, Italy.
| | - Sandrine Anne Zweifel
- Department of Ophthalmology, University Hospital Zurich (USZ), University of Zurich, Zurich, Switzerland
| | - Mariachiara Di Pippo
- Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy
| | - Anahita Bajka
- Department of Ophthalmology, University Hospital Zurich (USZ), University of Zurich, Zurich, Switzerland
| | - Gianluca Scuderi
- Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, Rome, Italy
- St. Andrea Hospital, Via di Grottarossa 1035/1039, Rome, Italy
| | - Andrew John Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
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Liang K, Li X, Guo Q, Ma J, Yang H, Fan Y, Yang D, Shi X, She Z, Qi X, Gu Q, Chen S, Zheng J, Li D. Structural changes in the retina and serum HMGB1 levels are associated with decreased cognitive function in patients with Parkinson's disease. Neurobiol Dis 2024; 190:106379. [PMID: 38104911 DOI: 10.1016/j.nbd.2023.106379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Cognitive impairment is a serious nonmotor symptom in patients with Parkinson's disease (PD). Currently, there are few studies investigating the relationship of serum markers and retinal structural changes with cognitive function in PD. OBJECTIVE To investigate the relationship between retinal structural changes, serum high mobility group box-1 (HMGB1) levels and cognitive function and motor symptoms in PD patients. METHODS Eighty-nine participants, including 47 PD patients and 42 healthy subjects, were enrolled. PD patients were divided into Parkinson's disease with normal cognitive (PD-NC), Parkinson's disease with mild cognitive impairment (PD-MCI), and Parkinson's disease with dementia (PDD) groups. The motor and nonmotor symptoms of PD patients were evaluated with clinical scale. Serum HMGB1 levels were detected by enzyme-linked immunosorbent assay (ELISA), and ganglion cell-inner plexiform layer complex (GCIPL) thickness changes in the macula were quantitatively analyzed by swept source optical coherence tomography (SS-OCT) in all patients. RESULTS Compared with the control group, the macular GCIPL (t = -2.308, P = 0.023) was thinner and serum HMGB1 (z = -2.285, P = 0.022) was increased in PD patients. Macular GCIPL thickness in patients with PD-MCI and PDD were significantly lower than that in PD-NC patients, but there were no significant difference between the PD-MCI and PDD groups. Serum HMGB1 levels in patients with PD-MCI and PDD were significantly higher than those in PD-NC patients, and serum HMGB1 levels in PDD patients were higher than those in PD-MCI patients. Correlation analysis showed that serum HMGB1 levels in PD patients were positively correlated with disease duration, HY stage, UPDRS-I score, UPDRS-III score, and UPDRS total score and negatively correlated with MOCA score. Macular GCIPL thickness was negatively correlated with HY stage and positively correlated with MOCA score, and macular GCIPL thickness was negatively correlated with serum HMGB1 level. Logistic regression analysis showed that elevated serum HMGB1 level, thinner macular GCIPL thickness, and higher HY stage were independent risk factors for Parkinson's disease with cognitive impairment (PD-CI). The areas under the receiver operating characteristic curve (AUC) for the serum HMGB1 level and macular GCIPL thickness-based diagnosis of PD-MCI, PDD and PD-CI based on in patients with PD were 0.786 and 0.825, 0.915 and 0.856, 0.852 and 0.841, respectively. The AUC for the diagnosis of PD-MCI, PDD and PD-CI with serum HMGB1 level and GCIPL thickness combined were 0.869, 0.967 and 0.916, respectively. CONCLUSION The macular GCIPL thickness and serum HMGB1 level are potential markers of cognitive impairment in PD patients, and their combination can significantly improve the accuracy of the diagnosis of cognitive impairment in PD.
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Affiliation(s)
- Keke Liang
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Xiaohuan Li
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Qingge Guo
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, Zhengzhou, China
| | - Jianjun Ma
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China.
| | - Hongqi Yang
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China.
| | - Yongyan Fan
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Dawei Yang
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Xiaoxue Shi
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Zonghan She
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Xuelin Qi
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Qi Gu
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Siyuan Chen
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Jinhua Zheng
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Dongsheng Li
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China; Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
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Raciborska A, Sidorczuk P, Konopińska J, Dmuchowska DA. Interocular Symmetry of Choroidal Parameters in Patients with Diabetic Retinopathy with and without Diabetic Macular Edema. J Clin Med 2023; 13:176. [PMID: 38202183 PMCID: PMC10779809 DOI: 10.3390/jcm13010176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 12/19/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024] Open
Abstract
This study focuses on the interocular comparison of choroidal parameters in diabetic patients with diabetic retinopathy (DR) with and without diabetic macular edema (DME), as well as in patients with unilateral DME (present in only one eye). The aim of this study was to determine the symmetry in order to obtain better insights into the pathophysiology of diabetic choroidopathy. This retrospective single-center cross-sectional study included 170 eyes from 85 patients (61 with DR and 24 controls), divided into subgroups depending on the presence of DME. The patients underwent fluorescein angiography and spectral domain optical coherence tomography examination, and the analysis included various choroidal parameters: choroidal thickness, volume, and the choroidal vascularity index (CVI). In terms of the choroidal thickness, one eye of a patient with DR, regardless of the presence, absence, or unilaterality of DME, may be treated as representative for that patient. CVI proved symmetrical for controls and patients with DR without DME. However, there was some asymmetry of CVI in patients with bilateral or unilateral DME. There was no straightforward relationship between choroidopathy and DME. Other mechanisms were also involved in the pathogenesis.
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Affiliation(s)
| | | | | | - Diana Anna Dmuchowska
- Ophthalmology Department, Medical University of Bialystok, 24a M. Sklodowskiej-Curie, 15-276 Bialystok, Poland; (A.R.); (J.K.)
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López-Muñoz A, López-Castaño I, Torres-Parejo Ú, García-Romera MC. A Corneal Biomechanical Study Measured with a Scheimpflug Dynamic Analyser in Soft Contact Lens Wearers. Life (Basel) 2023; 13:2313. [PMID: 38137914 PMCID: PMC10744429 DOI: 10.3390/life13122313] [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: 10/10/2023] [Revised: 12/01/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
The aim of this study was to evaluate the biomechanical changes in the cornea after wearing soft contact lenses (CLs) in healthy myopic patients measured with a Corvis ST® (CST, Oculus Optikgeräte GmbH, Wetzlar, Germany) analyser. This prospective, cross-sectional, single-centre study was performed on twenty-two Caucasian patients aged between 19 and 24 years (20.64 ± 1.21 years) range. Five device-specific biomechanical parameters, the central corneal thickness (CCT), and biomechanically corrected intraocular pressure (bIOP) were measured prior to fitting and one month after CL wear. Differences between the means of the deflection amplitude ratio (DA Ratio) and the standard deviation of the DA Ratio (SD DA Ratio) pre- and post-CL wear were found to be significant (p value = 0.002 in both cases). Significant differences were found between pre- and post-CL wear values in CCT (p value = 0.013). For all other biomechanical measures, no significant differences were observed before and after treatment. A significant association was found between changes in bIOP and classification according to changes in Int. Radius (p value = 0.047) and SSI (p value = 0.026) standard deviations. The corneal biomechanical indices provided by CST demonstrate that the fitting of soft CLs is a safe optical compensation method for the stability of corneal stiffness. No significant differences were found pre- and post-CL wear in the assessment of bIOP.
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Affiliation(s)
- Alfredo López-Muñoz
- Department of Physics of Condensed Matter, Optics Area, Vision Sciences Research Group (CIVIUS), Pharmacy School, University of Seville, 41009 Seville, Spain; (I.L.-C.); (M.-C.G.-R.)
- Research & Development Department (Miranza Virgen de Luján®), Ophthalmology Center, 41011 Seville, Spain
| | - Isabel López-Castaño
- Department of Physics of Condensed Matter, Optics Area, Vision Sciences Research Group (CIVIUS), Pharmacy School, University of Seville, 41009 Seville, Spain; (I.L.-C.); (M.-C.G.-R.)
| | - Úrsula Torres-Parejo
- Department of Statistics and Operations Research, University of Grenade, 18071 Grenade, Spain;
| | - Marta-C. García-Romera
- Department of Physics of Condensed Matter, Optics Area, Vision Sciences Research Group (CIVIUS), Pharmacy School, University of Seville, 41009 Seville, Spain; (I.L.-C.); (M.-C.G.-R.)
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Wykrota AA, Abdin AD, Munteanu C, Löw U, Seitz B. Incidence and treatment approach of intraocular pressure elevation after various types of local steroids for retinal diseases. Graefes Arch Clin Exp Ophthalmol 2023; 261:3569-3579. [PMID: 37432451 PMCID: PMC10667145 DOI: 10.1007/s00417-023-06163-5] [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: 02/19/2023] [Revised: 06/13/2023] [Accepted: 06/28/2023] [Indexed: 07/12/2023] Open
Abstract
PURPOSE For the treatment of macular edema, in addition to the use of antivascular endothelial growth factors, steroids are also used intravitreally and sub-Tenon. Side effects include among others cataract formation and elevation of intraocular pressure (IOP). The aim of this retrospective study was to elicit the IOP elevation after administration of various steroidal medication, the time of onset, and the efficacy of the administered IOP-lowering therapies. METHODS We included 428 eyes with a postoperative (n = 136), diabetic (n = 148), uveitic macular edema (n = 61), and macular edema after retinal vein occlusion (n = 83). These patients were treated with one or more diverse steroidal agents once or multiple times. These drugs included: triamcinolone acetonide (TMC) as intravitreal injection (TMC IVI) or sub-Tenon (TMC ST), as well as dexamethasone (DXM) and fluocinolone acetonide (FA) intravitreally. An increase of IOP of ≥ 25 mmHg was designated as pathological. A steroid response in anamnesis, the time of onset of IOP rise from the first administration, and the therapy administered were documented. RESULTS Of 428 eyes, 168 eyes (39.3%) had IOP elevation up to a mean of 29.7 (SD ± 5.6) mmHg, which occurred at a median of 5.5 months. Steroids most frequently leading to rise of IOP included DXM (39.1% of all eyes receiving that drug), TMC IVI (47.6%), TMC ST combined with DXM (51.5%), DXM with FA (56.8%), and TMC IVI with DXM (57.4%). A Kaplan-Meier analysis and the Log Rank test showed a significant difference (p < 0.001). IOP rise was treated as follows: 119 conservatively (70.8%), and 21 surgically (12.5%, cyclophotocoagulation 8.3%, filtering surgery 1.8%, in 4 the steroidal drug implant was removed 2.4%), and 28 eyes received no therapy (16.7%). Sufficient IOP regulation was achieved in 82 eyes (68.9%) with topical therapy. In 37 eyes (31.1%) with persistently elevated intraocular pressure, topical therapy had to be continued over the follow-up of 20 ± 7 months. CONCLUSIONS IOP increases after any type of steroid application are not rare. Results of our study let us suspect that especially therapy with intravitreal dexamethasone, either as a monotherapy or in combination with another steroid, tends to increase IOP more than other steroids. Regular IOP checks are necessary after each steroid administration, with possible initiation of long-term conservative and/or surgical therapy if necessary.
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Affiliation(s)
- Agata Anna Wykrota
- Department of Ophthalmology, Saarland University Medical Center (UKS), Homburg/Saar, Germany.
| | - Alaa Din Abdin
- Department of Ophthalmology, Saarland University Medical Center (UKS), Homburg/Saar, Germany
| | - Cristian Munteanu
- Department of Ophthalmology, Saarland University Medical Center (UKS), Homburg/Saar, Germany
| | - Ursula Löw
- Department of Ophthalmology, Saarland University Medical Center (UKS), Homburg/Saar, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center (UKS), Homburg/Saar, Germany
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Hasrod N, Rubin A. Multivariate analysis of repeatability for the Near Eye Tool for Refractive Assessment (NETRA). BMJ Open Ophthalmol 2023; 8:e001458. [PMID: 38007230 PMCID: PMC10679991 DOI: 10.1136/bmjophth-2023-001458] [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: 08/14/2023] [Accepted: 11/02/2023] [Indexed: 11/27/2023] Open
Abstract
OBJECTIVE To investigate repeatability of refractive state using a smartphone-based assessment tool, the Near Eye Tool for Refractive Assessment (NETRA). METHODS AND ANALYSIS This study included 279 participants, predominantly female (66.7%) of African descent (49.1%). The age range was 9-63 years with mean age (s) 22.6 (8.9) years. Two consecutive measurements per eye with the NETRA were measured for both eyes of all participants. However, analyses for the right eyes only are included here. Multivariate statistical analysis included stereo-pair comets and scatterplots with 95% surfaces of constant probability density. Correlation coefficients for repeated samples were determined. Repeatability and agreement for NETRA were assessed with Bland-Altman plots, coefficients of repeatability ([Formula: see text] ; [Formula: see text] is the SD of differences) and intraclass correlation coefficients (ICCs). RESULTS Bland-Altman plots, within-subject SD (sw ), coefficients of repeatability and ICC indicated that repeated measurements were similar for many but not all eyes and there was good agreement (ICC=0.96) for the spherical coefficient (F I=M) but less so for antistigmatic coefficients (F J=J 0 and F K=J 45) of power. Although mean differences for repeated samples were almost zero, 95% limits of agreement widths were larger for the stigmatic coefficients. Without cycloplegia, repeatability (2.77sw ) was 1.63 D, 0.58 D and 0.56 D for the stigmatic and antistigmatic coefficients, respectively. CONCLUSION NETRA is a potentially useful and inexpensive portable method in clinical and primary health settings, and especially in less-developed regions of the world. The subjective nature of the self-refraction task can be challenging for younger individuals, and cycloplegia is recommended for NETRA with such patients.
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Affiliation(s)
- Nabeela Hasrod
- Optometry, University of Johannesburg, Johannesburg, Gauteng, South Africa
| | - Alan Rubin
- Optometry, University of Johannesburg, Johannesburg, Gauteng, South Africa
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Consejo A, Roman DM, Roll V, Remon L. Relationship between corneal tissue and shape in short-term soft contact lens wear. Ophthalmic Physiol Opt 2023; 43:1372-1378. [PMID: 37551625 DOI: 10.1111/opo.13211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/09/2023]
Abstract
PURPOSE To investigate which morphometric and ocular surface tissue parameters are affected by short-term soft contact lens (CL) wear and to assess whether they carry related or independent information. METHODS Twenty-two healthy participants wore silicone hydrogel (SiHy; MyDay, CooperVision) soft CLs for 8 h in their left eye. Corneal tomography and corneoscleral topography were captured before and immediately after CL wear. Central corneal thickness (CCT), corneoscleral parameters (limbus position and corneoscleral junction [CSJ] angle) and corneal tissue parameters (corneal transparency and homogeneity) were evaluated. RESULTS Corneoscleral parameters (limbus position and CSJ angle) were independent of corneal tissue parameters (transparency and homogeneity) at baseline and after CL wear. CCT was independent of all the other parameters examined at baseline, but baseline values of corneal tissue parameters were moderately correlated with CCT change (transparency: r = -0.51; p = 0.007), homogeneity: r = -0.46; p = 0.02). CONCLUSIONS A complete characterisation of ocular surface changes following CL wear should consider corneoscleral topography and corneal densitometry simultaneously, since they carry complementary information.
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Affiliation(s)
- Alejandra Consejo
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
- Aragon Institute for Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
| | - Denisa M Roman
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
| | - Vanesa Roll
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
| | - Laura Remon
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
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Consejo A, Roll V, Roman DM, Remon L. The influence of soft contact lens material on the corneoscleral profile. Ophthalmic Physiol Opt 2023; 43:1364-1371. [PMID: 37376806 DOI: 10.1111/opo.13193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/30/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE To objectively quantify changes in corneoscleral profile, as evaluated by the limbus position and corneoscleral junction (CSJ) angle, as a consequence of wearing different soft contact lens (CL) materials. METHODS Twenty-two healthy participants wore silicone hydrogel (SiHy, MyDay, CooperVision) and hydrogel (Hy, Biomedics 1 day extra, CooperVision) soft CLs for 8 h per lens in their left eye. In each session, corneoscleral topography was captured before and immediately after CL removal with an Eye Surface Profiler. Previously validated automatic and objective algorithms for limbal position and CSJ angle calculation were applied to 360 semi-meridians to investigate the effect of short-term CL wear on corneoscleral topography, globally and by sectors, depending on the soft CL material worn. RESULTS Short-term soft CL wear significantly impacted limbal position (SiHy: 120 ± 97 μm, Hy: 128 ± 85 μm) and CSJ angle (SiHy: 0.57 ± 0.36°, Hy: 0.55 ± 0.40°); all p < 0.05. A statistically significant difference was found between the sectors with regard to limbus position and CSJ angle before CL wear that remained following lens wear (all pairwise comparisons, p < 0.001). Although individual differences were observed, there was no evidence that one material caused more substantial corneoscleral alterations. CONCLUSION Corneoscleral profile parameters were altered significantly following 8 h of soft CL wear. The observed changes in limbus position and CSJ angle support the importance of participant-material biocompatibility.
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Affiliation(s)
- Alejandra Consejo
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
- Aragon Institute for Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
| | - Vanesa Roll
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
| | - Denisa M Roman
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
| | - Laura Remon
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
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Noya-Padin V, Garcia-Queiruga J, Sabucedo-Villamarin B, Nores-Palmas N, Taboada-Mecias R, Yebra-Pimentel E. Intraocular Pressure Fluctuation Throughout the Day. Cureus 2023; 15:e48826. [PMID: 38106705 PMCID: PMC10722343 DOI: 10.7759/cureus.48826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2023] [Indexed: 12/19/2023] Open
Abstract
Purpose To compare intraocular pressure (IOP) values at different time points, both in the total sample and according to iridocorneal angle aperture, to assess whether IOP fluctuations were constant throughout the day, and to examine correlations with other factors. Methods Over a single day, the IOP of 34 volunteers was measured at three-hour intervals from 9:00 a.m. to 6:00 p.m. To avoid any IOP value being affected by other measurements, anamnesis, slit-lamp evaluation (with iridocorneal angle measurement), and refractive status were performed after the final measurement. The differences between IOP values at different time points and IOP fluctuation at three-hour intervals were compared by ANOVA and Friedman test, respectively, both for the total group and according to iridocorneal angle aperture. For relationships, Pearson's correlation was performed for parametric variables and Spearman's correlation for nonparametric variables. Results Significant differences were observed in IOP between time points for the total sample (p < 0.001), but not for a narrow-angle group (p = 0.058). No significant differences were found in IOP fluctuations at three-hour intervals either in the total sample or according to angle aperture (all p ≥ 0.332). There was a positive correlation of IOP at different time points (all r ≥ 0.646, all p < 0.001) but no relationship with spherical equivalent, age, or sleep duration (all p ≥ 0.057). IOP at 12:00 p.m. was correlated with a 12:00 p.m. to 3:00 p.m. fluctuation (r = 0.428, p = 0.012); and IOP fluctuation between 9:00 a.m. and 12:00 p.m. was correlated with age (r = 0.485, p = 0.004). Conclusion As IOP decreases from morning until at least 6:00 p.m., measuring these two values during clinical evaluation is essential for the effective monitoring and prevention of IOP-related diseases.
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Affiliation(s)
- Veronica Noya-Padin
- Department of Applied Physics (Optometry Area), Universidade de Santiago de Compostela, Santiago de Compostela, ESP
- Department of Optometry, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, ESP
| | - Jacobo Garcia-Queiruga
- Department of Applied Physics (Optometry Area), Universidade de Santiago de Compostela, Santiago de Compostela, ESP
- Department of Optometry, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, ESP
| | - Belen Sabucedo-Villamarin
- Department of Applied Physics (Optometry Area), Universidade de Santiago de Compostela, Santiago de Compostela, ESP
| | - Noelia Nores-Palmas
- Department of Applied Physics (Optometry Area), Universidade de Santiago de Compostela, Santiago de Compostela, ESP
| | - Ricardo Taboada-Mecias
- Department of Applied Physics (Optometry Area), Universidade de Santiago de Compostela, Santiago de Compostela, ESP
| | - Eva Yebra-Pimentel
- Department of Applied Physics (Optometry Area), Universidade de Santiago de Compostela, Santiago de Compostela, ESP
- Department of Optometry, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, ESP
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Balparda K, Silva-Quintero LA, Acevedo-Urrego A, Herrera-Chalarca T. Ocular residual astigmatism (ORA) does not seem to correlate with baseline refractive error among refractive surgery candidates. Int Ophthalmol 2023; 43:4087-4096. [PMID: 37548824 DOI: 10.1007/s10792-023-02826-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 07/09/2023] [Indexed: 08/08/2023]
Abstract
PURPOSE Ocular residual astigmatism (ORA) is defined as the difference between refractive astigmatism and anterior corneal astigmatism. A high ORA may be correlated with poorer results in patients undergoing corneal-based laser surgery. Is a high baseline refractive error related to a higher degree of ORA? METHODS This was a retrospective analytical study including 181 right eyes of an equal number of refractive surgery candidates. Manifest subjective refraction was measured, along with a Pentacam AXL Wave corneal tomography. Via a vector analysis with this methodology, subjective cylinder was translated into the corneal plane and a vectorial subtraction was performed in order to measure ORA. Spearman's rank order test, one-way ANOVA and Chi-square were used to determine whether different levels of baseline refractive error correlate with different levels of ORA. RESULTS Mean age was 28.33 ± 4.71 years with a female preponderance (65.7%). Mean ORA was 0.74 ± 0.39 D, with 33.1% of eyes having an ORA ≥ 0.90 D. There was not a correlation between ORA and level of myopia (rho = - 0.022; p = 0.764), nor between ORA and spherical equivalent (rho = 0.009; p = 0.903). Refractive astigmatism did not demonstrate to be correlated with ORA level either (rho = 0.078; p = 0.329). One-way ANOVA tests failed to demonstrate an association between different classifications of refractive error and level of ORA. CONCLUSIONS In the studied population, ORA is not correlated with baseline refractive error. Every patient presenting for possible corneal-based laser refractive surgery should be evaluated for a possible high level of ORA, irrespective of their baseline ametropia level.
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Affiliation(s)
- Kepa Balparda
- Black Mammoth Surgical, Carrera 43 # 29 - 35, Office 712., Medellín, Colombia.
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Abusharha A, Pearce EI, Afsar T, Razak S. Protecting Tear-Film Stability under Adverse Environmental Conditions Using a Mucomimetic with a Non-Newtonian Viscosity Agent. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1862. [PMID: 37893580 PMCID: PMC10608101 DOI: 10.3390/medicina59101862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/11/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Tamarind-seed polysaccharide (TSP) and hyaluronic acid (HA) have mucoadhesive properties that improve drug absorption and delay in drug elimination from the ocular surface. We aimed to evaluate TSP/HA-containing formulation for its efficiency in dry-eye symptoms induced by adverse environments and the interaction between mucomimic polymer and tear-film parameters. Materials and Methods: The participants were exposed to 5% relative humidity (RH) in a Controlled Environment Chamber (CEC) under constant room temperature (21 °C). Tear-film parameters were assessed at 40% RH and 5% RH. Rohto Dry Eye Relief drops were used in the two treatment modalities, protection (drops instilled before exposure to the dry environment) and relief (drops instilled after exposure to the dry environment). The HIRCAL grid, Servomed EP3 Evaporimeter, and Keeler's TearScope-Plus were used to screen for non-invasive tear break-up time (NITBUT), tear evaporation rate, and lipid-layer thickness (LLT) using protection and relief treatment methodology. Results: LLT was found to be significantly thinner at 5% RH compared with at 40% RH (p = 0.007). The median LLT dropped from 50-70 nm (grade 3) at 40% RH to 10-50 nm (grade 2) at 5% RH. TSP/HA eye drops significantly augment LLT in both treatment modalities, protection (p = 0.01) and relief (p = 0.004) at 5% RH. The mean evaporation rate doubled from 40.93 at 40% RH to 82.42 g/m2/h after exposure to 5% RH. In protection mode, the TSP/HA allowed the average evaporation rate to be much lower than when no TSP/HA was used at 5% RH (p < 0.008). No alteration in evaporation rate was recorded when the TSP/HA drop was used after exposure (relief). The mean NITBUT was reduced from 13 s in normal conditions to 6 s in the dry environment. Instillation of TSP/HA eye drops resulted in significant improvement (p = 0.006) in tear stability, where the NITBUT increased to 8 s in both protection (before exposure) and relief (after exposure) (p = 0.001). Although improved, these values were still significantly lower than NITBUT observed at 40% RH. Conclusions: Significant protection of tear-film parameters was recorded post instillation of TSP/HA eye drop under a desiccating environment. Both treatment methods (protection and relief) were shown to be effective. The presence of TSP/HA enhances the effectiveness of teardrops in protecting the tear-film parameters when exposed to adverse environments.
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Affiliation(s)
- Ali Abusharha
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia;
| | - E. Ian Pearce
- Department of Vision Science, School of Health and Life Sciences, Glasgow Caledonian University, 70 Cowcaddence Road, Glasgow G4 0BA, UK;
| | - Tayyaba Afsar
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia;
| | - Suhail Razak
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia;
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Ortiz-Peregrina S, Ortiz C, Casares-López M, Martino F, Granados-Delgado P, Anera RG. The Relationship between Anxiety, Visual Function, and Symptomatology in University Students. J Clin Med 2023; 12:6595. [PMID: 37892731 PMCID: PMC10607452 DOI: 10.3390/jcm12206595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/16/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
Mental health concerns have emerged at the university level, with the psychological well-being of students being increasingly affected. This cross-sectional study investigated the proportion of university students having anxiety, and its effects on their visual function and symptomatology. We included 41 students (26.1 ± 4.8 years), and their visual function was assessed through several tests to produce a general visual performance index (VPI). The visual symptomatology was studied using the Conlon Visual Discomfort Survey and the Quality of Vision (QoV) questionnaire. The students were classified into two groups according to the Generalized Anxiety Disorder Screener (GAD-7) test ("no anxiety" and "anxiety" groups). The visual function evaluation indicated significantly worse VPI in the anxiety group (p = 0.047). These students also showed significantly higher scores in the Conlon survey (p = 0.004) and two subscales of the QoV questionnaire: symptom severity (p = 0.041) and symptom bothersomeness (p = 0.013). Moreover, the multiple linear regression model showed a significant association between visual discomfort according to the Conlon questionnaire and the level of anxiety (r = 0.405; R2 = 0.164; B = 0.405; p = 0.012). It is important to study the influence of psychological factors on vision, not only for refractive error, but also for binocular and accommodative disorders.
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Affiliation(s)
- Sonia Ortiz-Peregrina
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071 Granada, Spain
| | - Carolina Ortiz
- 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
| | - Francesco Martino
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071 Granada, Spain
| | - Pilar Granados-Delgado
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071 Granada, Spain
| | - Rosario G Anera
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071 Granada, Spain
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Muñoz-Villegas PDC, Sánchez-Ríos A, Olvera-Montaño O. The Effect of Sodium Hyaluronate Eye Drops 2, 4 or 6 Times a Day on Signs and Symptoms of Dry Eye Disease. Clin Ophthalmol 2023; 17:2945-2955. [PMID: 37822327 PMCID: PMC10563771 DOI: 10.2147/opth.s433709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
Purpose A randomized clinical trial was run to evaluate the effectiveness of a preservative-free 0.4% sodium hyaluronate eye drop (LOF) in different dosage schemes to alleviate signs and symptoms of dry eye disease (DED). Methods A total of 116 subjects with mild-to-moderate DED were included, and 111 completed the study (from which 67.6% were female and 65.3% were users of oral contraceptives). Patients were randomly assigned to instill a drop of LOF either 2 (BID), 4 (QID) or 6 (6TD) times a day (at least 3 hours apart) for 30 days. The clinical parameters and symptom endpoints were Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), ocular surface staining, and conjunctival hyperemia. Other parameters evaluated were chemosis, best corrected visual acuity, and the incidence of adverse events (AE). Results There was a significant reduction in OSDI scores by day 30 in all groups. The recovery of the OSDI score back to normal values was observed in 51.4% of patients treated (50%, 48.6%, and 55.6% in BID, QID, and 6TD, respectively, p = 0.822). Similar improvement was observed for TBUT, 50.5% of patients increased this variable to >10 seconds (39.5%, 51.4%, and 61.1%, p = 0.175), and for ocular surface staining, ≥72% showed Grade 0. There were no significant differences among posology groups regarding ocular surface staining, conjunctival hyperemia, or any safety parameters. No overall improvement in OSDI and TBUT to normal values was noted for 31 patients (21 were female and 71.4% users of contraceptive drugs). Conclusion The ophthalmic use of preservative free LOF, 2, 4 or 6 times a day, may alleviate clinical parameters and symptoms in 50% of patients with mild-to-moderate DED after a one-month treatment. This improvement seemed to be less ubiquitous in patients within reproductive age and using oral contraceptives. Trial Registration This trial is registered at clinicaltrials.gov (NCT0704531).
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Affiliation(s)
- Patricia del Carmen Muñoz-Villegas
- Regional Medical Affairs Department, Laboratorios Sophia, S.A. de C.V, Zapopan, Jalisco, Mexico
- Centro de Investigación en Matemáticas A.C. (CIMAT), Unidad Aguascalientes, Aguascalientes, Mexico
| | - Alejandra Sánchez-Ríos
- Regional Medical Affairs Department, Laboratorios Sophia, S.A. de C.V, Zapopan, Jalisco, Mexico
| | - Oscar Olvera-Montaño
- Regional Medical Affairs Department, Laboratorios Sophia, S.A. de C.V, Zapopan, Jalisco, Mexico
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Pérez-Sanz L, Gonzalez-Fernandez V, Gómez-Pedrero JA, Albarrán-Diego C, García-Montero M, Garzón N. Optical and Clinical Outcomes of an Isofocal Intraocular Lens vs. a Monofocal Standard Lens. Life (Basel) 2023; 13:2001. [PMID: 37895383 PMCID: PMC10608665 DOI: 10.3390/life13102001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/23/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
The aim of this study is to evaluate the results obtained on the optical bench and clinically with an isofocal lens (ISOPure, BVI medical, Belgium) to compare them to a standard monofocal one (MicroPure, BVI medical, Belgium). To do so, we have combined laboratory investigation and a prospective, comparative, and randomized clinical study. First, we have measured the wavefront of the two models studied using a NIMO TR1504 (Lambda-X, Belgium) deflectometer for three nominal powers: +10.00, +20.00 and +30.00 D. In the randomized study with 48 patients, half of them implanted with ISOPure and the other with MicroPure, we have measured visual acuities and contrast sensitivity under photopic and mesopic conditions. The optical bench results show that the isofocal lens presented higher power than the monofocal one, at the lens center, due to the spherical aberration (coefficients Z(4,0), Z(6,0) and Z(8,0)) induced by the greater asphericity of its design. The addition obtained depended on the nominal power, from +1.00 to +1.50 D. The results of the clinical study showed that the ISOPure lens presented better visual outcomes, which were statistically significant, at intermediate distance compared to the MicroPure lens (p-values of 0.014 and 0.022 for 80 and 60 cm, respectively) without decreasing the contrast sensitivity. Clinical outcomes were not affected by pupillary size. In conclusion, due to the increase in power at the lens center due to its highly aspherical design, the isofocal lens evaluated showed better intermediate vision than the monofocal one.
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Affiliation(s)
- Lidia Pérez-Sanz
- Optometry and Vision Department, Facultad de Óptica y Optometría, Universidad Complutense de Madrid, C/Arcos de Jalón, 118, 28037 Madrid, Spain; (L.P.-S.); (M.G.-M.); (N.G.)
- Miranza IOA, C/Galileo, 104, 28003 Madrid, Spain
| | - Veronica Gonzalez-Fernandez
- Optics Department, Facultad de Óptica y Optometría, Universidad Complutense de Madrid, C/Arcos de Jalón, 118, 28037 Madrid, Spain;
| | - José Antonio Gómez-Pedrero
- Optics Department, Facultad de Óptica y Optometría, Universidad Complutense de Madrid, C/Arcos de Jalón, 118, 28037 Madrid, Spain;
| | - César Albarrán-Diego
- Departament d’Òptica i Optometria i Ciències de la Visió, Facultat de Física, Universitat de València, C/Doctor Moliner, 46100 Burjassot, Spain;
| | - María García-Montero
- Optometry and Vision Department, Facultad de Óptica y Optometría, Universidad Complutense de Madrid, C/Arcos de Jalón, 118, 28037 Madrid, Spain; (L.P.-S.); (M.G.-M.); (N.G.)
| | - Nuria Garzón
- Optometry and Vision Department, Facultad de Óptica y Optometría, Universidad Complutense de Madrid, C/Arcos de Jalón, 118, 28037 Madrid, Spain; (L.P.-S.); (M.G.-M.); (N.G.)
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Moreno JRA, Micó V, Albarrán Diego C. Subjective refraction using power vectors by updating a conventional phoropter with a Stokes lens for continuous astigmatic power generation. Ophthalmic Physiol Opt 2023; 43:1029-1039. [PMID: 37264763 DOI: 10.1111/opo.13181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 06/03/2023]
Abstract
PURPOSE To implement a pure power vector method for monocular subjective refraction using a regular phoropter with the only modification being the inclusion of a Stokes lens. The proposed methodology was tested with three different Stokes lenses, and the results were compared with conventional clinical refraction procedures. METHODS Power vector subjective refraction was performed by attaching a Stokes lens to the Risley prism holder. Stokes lenses allow for pure astigmatic compensation in the form of the J0 , J45 components while the spherical lenses in the phoropter allow determination of the spherical component in the form of M (spherical equivalent). The proposed routine is presented step-by-step using three Stokes lenses having different astigmatic powers. RESULTS Monocular subjective refraction was performed on 26 healthy subjects with a mean age of 44 ± 16 years, mean spherical equivalent of -0.56 D (range -5.50 to +2.38 D) and refractive astigmatism ≤1.50 D. No differences were found between the results obtained with the conventional technique versus the vector-based procedure for the spherical equivalent (p = 0.28) or astigmatic components (p = 0.34). In addition, visual acuity (VA) was equivalent through the refractions measured with the conventional and vector procedures (p = 0.12). Repeatability coefficients for J0 and J45 with the new vector methodology were <0.38 D. CONCLUSIONS The proposed routine could be helpful for cases where it is difficult to get a valid starting point for conventional refraction (e.g., irregular corneas and media opacities), for testing facilities with limited resources/equipment and/or for motivated clinicians who wish to know about alternative methods of refractive error determination.
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Affiliation(s)
| | - Vicente Micó
- Departamento de Óptica y Optometría y Ciencias de la Visión, Universitat de València, Burjassot, Spain
| | - Cesar Albarrán Diego
- Departamento de Óptica y Optometría y Ciencias de la Visión, Universitat de València, Burjassot, Spain
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