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Jo E, Kim SM, Kim JM, Han SY. Changes in ocular biometrics following cycloplegic refraction in strabismic and amblyopic children. Medicine (Baltimore) 2024; 103:e38143. [PMID: 38758890 PMCID: PMC11098244 DOI: 10.1097/md.0000000000038143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 04/15/2024] [Indexed: 05/19/2024] Open
Abstract
This study was aimed to analyze ocular biometric changes following cycloplegia in pediatric patients with strabismus and amblyopia. Cycloplegia is routinely used to measure refractive error accurately by paralyzing accommodation. However, effects on axial length (AL), anterior chamber depth (ACD), keratometry (Km), and white-to-white distance (WTW) are not well studied in this population. This retrospective study examined 797 patients (1566 eyes) undergoing cycloplegic refraction at a Samsung Kangbuk hospital pediatric ophthalmology clinic from 2010 to 2023. Ocular biometry was measured before and after instilling 1% cyclopentolate and 0.5% phenylephrine/0.5% tropicamide. Patients were categorized by strabismus diagnosis, age, refractive error and amblyopia status. Differences in AL, ACD, Km, WTW, and refractive error pre- and post-cycloplegia were analyzed using paired t tests. ACD (3.44 ± 0.33 vs 3.58 ± 0.29 mm, P < .05) and WTW (12.09 ± 0.42 vs 12.30 ± 0.60 mm, P < .05) increased significantly after cycloplegia in all groups except other strabismus subgroup (Cs) in both parameters and youngest subgroup (G1) in ACD. Refractive error demonstrated a hyperopic shift from -0.48 ± 3.00 D to -0.06 ± 3.32 D (P < .05) in overall and a myopic shift from -6.97 ± 4.27 to -8.10 ± 2.26 in high myopia (HM). Also, AL and Km did not change significantly. In conclusion, cycloplegia impacts ocular biometrics in children with strabismus and amblyopia, significantly increasing ACD and WTW. Refractive error shifts hyperopically in esotropia subgroup (ET) and myopically in high myopia subgroup (HM), eldest subgroup (G3) relating more to anterior segment changes than AL/Km. Understanding cycloplegic effects on biometry is important for optimizing refractive correction in these patients.
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Affiliation(s)
- Eunhui Jo
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joon Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - So Young Han
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Wu S, Hao J, Guo D, Ma Z, Wu Q, Zhang M, Bi H. Characterization of lncRNA and mRNA profiles in ciliary body in experimental myopia. Exp Eye Res 2024; 241:109849. [PMID: 38430983 DOI: 10.1016/j.exer.2024.109849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 02/20/2024] [Accepted: 02/26/2024] [Indexed: 03/05/2024]
Abstract
Currently, researchers have mainly focused on the role of the tissues of the posterior segment of the eyes in the development of myopia. However, the ciliary body, an anterior ocular tissue that contracts to initiate the process of accommodation, may also play an important role in the progression of myopia due to the increased demand for near work. In the present study, we established a lens-induced myopia (LIM) animal model in guinea pigs and investigated the molecular changes in the ciliary body associated with the development of myopia based on RNA sequencing. As a result, 871 differentially expressed (DE) mRNAs and 19 DE lncRNAs were identified in the ciliary body between the LIM group and the normal control group. In addition, the lncRNA-mRNA co-expression analysis was performed to explore the target genes of lncRNAs, which were mainly enriched in the Rap1 signaling pathway, cytokine-cytokine receptor interaction, and complement and coagulation cascades pathways based on the functional enrichment analysis. Among the target genes of lncRNAs, three hub genes, including Ctnnb1, Pik3r1, and Itgb1, were found to be involved in the Rap1 signaling pathway. Interestingly, two crucial genes, Grk1 and Pde6a, which are mainly expressed in retinal photoreceptors, were enriched in visual perception in the ciliary body in functional analysis and were verified to be expressed in the ciliary body. These findings indicate the molecular pathogenetic role of the ciliary body in myopia and provide new insights into the underlying mechanism of myopia development. Further studies are needed to explore the specific contributions of these identified lncRNAs and mRNAs to the development of myopia.
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Affiliation(s)
- Shanshan Wu
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, China; Shandong University of Traditional Chinese Medicine, Jinan, 250002, China
| | - Jiawen Hao
- Shandong University of Traditional Chinese Medicine, Jinan, 250002, China
| | - Dadong Guo
- Shandong Academy of Eye Disease Prevention and Therapy, Medical College of Optometry and Ophthalmology, Shandong University of Traditional Chinese Medicine, Jinan, 250002, China.
| | - Zhongyu Ma
- Shandong University of Traditional Chinese Medicine, Jinan, 250002, China
| | - Qiuxin Wu
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, China
| | - Ming Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Hongsheng Bi
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, 250002, China.
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Kwok HY, Kwok HY, Ng TN, Leung TW, Kang BS, Kee CS. Characteristics of ciliary muscle profile in high myopes measured by swept-source anterior segment optical coherence tomography. PLoS One 2023; 18:e0289135. [PMID: 38033137 PMCID: PMC10688841 DOI: 10.1371/journal.pone.0289135] [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] [Received: 05/15/2023] [Accepted: 07/11/2023] [Indexed: 12/02/2023] Open
Abstract
OBJECTIVE To characterize and compare the ciliary muscle thickness (CMT) between low and high myopes using swept-source anterior segment optical coherence tomography (AS-OCT). METHODS Forty visually healthy young Chinese adults aged 18-25 years were divided into two groups based on refractive errors: low myopia (n = 20, spherical-equivalent refractive error (SER) between -0.50 D to -3.00 D) and high myopia (n = 20, SER ≤ -6.00 D). Cycloplegic refractions were performed before axial length (AL) and CMT were measured using a partial coherence laser interferometer and an AS-OCT respectively. CMT was measured perpendicularly to the sclera-ciliary muscle interface at 1 mm (CMT_1), 2 mm (CMT_2), and 3 mm (CMT_3) posterior to the scleral spur, and at the location with maximal thickness (CMT_MAX). RESULTS High myopes demonstrated thicker CMT at 2 mm (CMT_2, p = 0.035) and 3 mm (CMT_3, p = 0.003) posterior to the scleral spur, but thinner maximal CMT (CMT_MAX, p = 0.005) than low myopes. The apical CMT_1 and CMT_MAX were also thinner in high myopes than in low myopes (both p< 0.001). CMT_MAX, apical CMT_1, and apical CMT_MAX correlated directly with SER and inversely with AL; in contrast, CMT_2 and CMT_3 showed inverse correlations with SER but direct correlations with AL. CONCLUSION Our findings revealed significant differences in CMT between low and high myopes, with high myopes showing thicker CMT at 2 mm and 3 mm posterior to the scleral spur, but thinner maximal CMT. These results provide new evidence of the potential structural differences in ciliary muscles during myopia development and progression.
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Affiliation(s)
- Hiu Yin Kwok
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR, China
| | - Hoi Yee Kwok
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR, China
| | - Tsz Nok Ng
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR, China
| | - Tsz-wing Leung
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR, China
- Research Centre for Sharp Vision, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR, China
- Centre for Eye and Vision Research Limited, Hong Kong, SAR, China
| | - Byung Soo Kang
- Centre for Eye and Vision Research Limited, Hong Kong, SAR, China
| | - Chea-su Kee
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR, China
- Research Centre for Sharp Vision, The Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR, China
- Centre for Eye and Vision Research Limited, Hong Kong, SAR, China
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Owusu E, Shasteen NM, Mitchell GL, Bailey MD, Kao CY, Toole AJ, Richdale K, Kulp MT. Impact of accommodative insufficiency and accommodative/vergence therapy on ciliary muscle thickness in the eye. Ophthalmic Physiol Opt 2023; 43:947-953. [PMID: 37184092 DOI: 10.1111/opo.13155] [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: 08/22/2022] [Revised: 04/14/2023] [Accepted: 04/16/2023] [Indexed: 05/16/2023]
Abstract
PURPOSE Recent evidence suggests that the ciliary muscle apical fibres are most responsive to accommodative load; however, the structure of the ciliary muscle in individuals with accommodative insufficiency is unknown. This study examined ciliary muscle structure in individuals with accommodative insufficiency (AI). We also determined the response of the ciliary muscle to accommodative/vergence therapy and increasing accommodative demands to investigate the muscle's responsiveness to workload. METHODS Subjects with AI were enrolled and matched by age and refractive error with subjects enrolled in another ciliary muscle study as controls. Anterior segment optical coherence tomography was used to measure the ciliary muscle thickness (CMT) at rest (0D), maximum thickness (CMTMAX) and over the area from 0.75 mm (CMT0.75) to 3 mm (CMT3) posterior to the scleral spur of the right eye. For those with AI, the ciliary muscle was also measured at increasing levels of accommodative demand (2D, 4D and 6D), both before and after accommodative/vergence therapy. RESULTS Sixteen subjects with AI (mean age = 17.4 years, SD = 8.0) were matched with 48 controls (mean age = 17.8 years, SD = 8.2). On average, the controls had 52-72 μm thicker ciliary muscles in the apical region at 0D than those with AI (p = 0.03 for both CMTMAX and CMT 0.75). Differences in thickness between the groups in other regions of the muscle were not statistically significant. After 8 weeks of accommodative/vergence therapy, the CMT increased by an average of 22-42 μm (p ≤ 0.04 for all), while AA increased by 7D (p < 0.001). CONCLUSIONS This study demonstrated significantly thinner apical ciliary muscle thickness in those with AI and that the ciliary muscle can thicken in response to increased workload. This may explain the mechanism for improvement in signs and symptoms with accommodative/vergence therapy.
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Affiliation(s)
- Emmanuel Owusu
- College of Optometry, The Ohio State University, Columbus, Ohio, USA
| | | | - G Lynn Mitchell
- College of Optometry, The Ohio State University, Columbus, Ohio, USA
| | - Melissa D Bailey
- College of Optometry, The Ohio State University, Columbus, Ohio, USA
| | - Chiu-Yen Kao
- Department of Mathematical Sciences, Claremont McKenna College, Claremont, California, USA
| | - Andrew J Toole
- College of Optometry, The Ohio State University, Columbus, Ohio, USA
| | - Kathryn Richdale
- College of Optometry, The Ohio State University, Columbus, Ohio, USA
| | - Marjean T Kulp
- College of Optometry, The Ohio State University, Columbus, Ohio, USA
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Wagner S, Strasser T. Impact of text contrast polarity on the retinal activity in myopes and emmetropes using modified pattern ERG. Sci Rep 2023; 13:11101. [PMID: 37423936 DOI: 10.1038/s41598-023-38192-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/05/2023] [Indexed: 07/11/2023] Open
Abstract
Environmental factors favoring myopia development are still being studied and there is accumulating evidence for a significant role of nearwork. Recently, reading standard black-on-white text was found to activate the retinal OFF pathway and induce choroidal thinning, which is associated with myopia onset. Contrarily, reading white-on-black text led to thicker choroids, being protective against myopia. Respective effects on retinal processing are yet unknown. Here, we exploratively assessed the impact of contrast polarity on the retinal activity and possible interactions with eccentricity and refractive error. We recorded pattern electroretinograms in myopic and emmetropic adults while presenting a dead leaves stimulus (DLS), overlaid by masks of different size in ring or circle shape, either filled with uniform gray or text of inverted or standard contrast. In myopes, retinal responses for DLS with standard and inverted contrast were larger when the perifovea was stimulated (6-12 deg), however, including the fovea resulted in smaller amplitudes for inverted contrast than in emmetropes. The retina of emmetropes was more sensitive to inverted contrast than to standard and gray within 12 deg, but most sensitive for gray in the perifovea. This demonstrates that the refractive error influences the sensitivity to text contrast polarity, with a special role of the peripheral retina, which is in line with previous studies about blur sensitivity. Defining whether the differences derive from retinal processing or anatomical features of a myopic eye requires further investigation. Our approach might be a first step to explain how nearwork promotes the eye's elongation.
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Affiliation(s)
- Sandra Wagner
- Institute for Ophthalmic Research, University of Tuebingen, Elfriede-Aulhorn-Str. 7, 72076, Tuebingen, Germany.
| | - Torsten Strasser
- Institute for Ophthalmic Research, University of Tuebingen, Elfriede-Aulhorn-Str. 7, 72076, Tuebingen, Germany
- University Eye Hospital Tuebingen, Elfriede-Aulhorn-Str. 7, 72076, Tuebingen, Germany
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Jia WN, Wang QY, Niu LL, Chen ZX, Jiang YX. Morphometric assessment of the ciliary body in patients with Marfan syndrome and ectopia lentis: A quantitative study using ultrasound biomicroscopy: Ciliary body morphology in Marfan syndrome and ectopia lentis. Am J Ophthalmol 2023; 251:24-31. [PMID: 36948371 DOI: 10.1016/j.ajo.2023.03.003] [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: 11/08/2022] [Revised: 02/28/2023] [Accepted: 03/05/2023] [Indexed: 03/24/2023]
Abstract
PURPOSE To explore the biometric characteristics of the ciliary body in patients with Marfan syndrome (MFS) and ectopia lentis (EL). DESIGN Cross-sectional study. METHODS Seventy-two consecutive MFS patients with EL and 72 non-disease controls were recruited. Ciliary body biometric parameters such as ciliary muscle cross-sectional area at 2000 μm from the scleral spur (CMA2000), ciliary muscle thickness at 1000 μm from the scleral spur (CMT1000), and maximum ciliary body thickness (CBTmax) were measured from multiple directions with ultrasound biomicroscopy (UBM). The relationship between ciliary body parameters and other ocular characteristics was also evaluated. RESULTS Average CMA2000, CMT1000, and CBTmax were 0.692 ± 0.015 mm2, 0.405 ± 0.010 mm, and 0.855±0.023 mm in MFS eyes, respectively, and were significantly smaller than controls (all p < 0.001). The prevalence of ciliary body thinning was 22.2% in the MFS group versus 0 in controls (p < 0.001); eyes with more severe EL had smaller CMA2000 (p = 0.050), thinner CMT1000 (p = 0.022) and shorter CBTmax (p = 0.015). Patients with microspherophakia (MSP) had even smaller CMA2000 (p = 0.033) and CMT1000 (p = 0.044) than those without MSP. The most common subluxation direction was in the superonasal quadrant (25, 39.7%), which probably correlates with the thinnest CMT1000 in the inferotemporal quadrant (p = 0.005). CONCLUSIONS MFS patients with EL had thinner ciliary muscles, shorter ciliary processes, and a higher prevalence of ciliary body thinning, especially those with MSP. Both the extent and direction of subluxation were associated with ciliary body biometry.
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Affiliation(s)
- Wan-Nan Jia
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Qian-Yi Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Ling-Ling Niu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China
| | - Ze-Xu Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China.
| | - Yong-Xiang Jiang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China.
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Mutti DO, Sinnott LT, Zadnik K. Compensation for Vitreous Chamber Elongation in Infancy and Childhood. Optom Vis Sci 2023; 100:43-51. [PMID: 36705714 PMCID: PMC9886320 DOI: 10.1097/opx.0000000000001970] [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: 01/28/2023] Open
Abstract
SIGNIFICANCE The ratios of diopters of change in refractive error produced per millimeter of eye elongation (D/mm) are rarely those predicted from geometric optics because of changes in other ocular components. Quantifying this optical compensation in millimeters instead of ratios reveals some important principles about eye growth and refractive error. PURPOSE The study purpose was to sort total vitreous chamber elongation into millimeters that either contributed (uncompensated) or did not contribute to change in refractive error (compensated). METHODS Participants were infants in the Berkeley Infant Biometry Study (n = 271, ages 3 months to 6 years) or schoolchildren in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (n = 456 emmetropes and 522 myopes, ages 6 to 14 years). Refractive error was measured using cycloplegic retinoscopy in infants (cyclopentolate 1%) and cycloplegic autorefraction in schoolchildren (tropicamide 1% or combined with cyclopentolate 1%). Axial dimensions were assessed using A-scan ultrasonography. Uncompensated millimeters were estimated from ratios of change in refractive error per millimeter of elongation using Gullstrand eye models. Compensated millimeters were the difference between measured elongation and uncompensated millimeters. RESULTS Compensated millimeters exceeded uncompensated millimeters in emmetropic children across ages, but uncompensated millimeters exceeded compensated millimeters in myopic children. Compensated millimeters were highest in infancy and decreased with age, reaching less than 0.10 mm per year by age 10 years in both myopic and emmetropic children. There were no statistically significant differences in compensated millimeters between myopic and emmetropic children between ages 8 and 14 years ( P values from .17 to .73). CONCLUSIONS The ability of the ocular components, primarily crystalline lens, to compensate for vitreous elongation is independent of the higher demands of myopic eye growth. The limited compensation after age 10 years suggests the target for elongation in myopia control needed to arrest myopia progression may be that seen in emmetropes or less.
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Affiliation(s)
| | | | - Karla Zadnik
- The Ohio State University College of Optometry, Columbus, Ohio
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Straßer T, Wagner S. Performance of the Deep Neural Network Ciloctunet, Integrated with Open-Source Software for Ciliary Muscle Segmentation in Anterior Segment OCT Images, Is on Par with Experienced Examiners. Diagnostics (Basel) 2022; 12:diagnostics12123055. [PMID: 36553062 PMCID: PMC9777151 DOI: 10.3390/diagnostics12123055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/24/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022] Open
Abstract
Anterior segment optical coherence tomography (AS-OCT), being non-invasive and well-tolerated, is the method of choice for an in vivo investigation of ciliary muscle morphology and function. The analysis requires the segmentation of the ciliary muscle, which is, when performed manually, both time-consuming and prone to examiner bias. Here, we present a convolutional neural network trained for the automatic segmentation of the ciliary muscle in AS-OCT images. Ciloctunet is based on the Freiburg U-net and was trained and validated using 1244 manually segmented OCT images from two previous studies. An accuracy of 97.5% for the validation dataset was achieved. Ciloctunet's performance was evaluated by replicating the findings of a third study with 180 images as the test data. The replication demonstrated that Ciloctunet performed on par with two experienced examiners. The intersection-over-union index (0.84) of the ciliary muscle thickness profiles between Ciloctunet and an experienced examiner was the same as between the two examiners. The mean absolute error between the ciliary muscle thickness profiles of Ciloctunet and the two examiners (35.16 µm and 45.86 µm) was comparable to the one between the examiners (34.99 µm). A statistically significant effect of the segmentation type on the derived biometric parameters was found for the ciliary muscle area but not for the selective thickness reading ("perpendicular axis"). Both the inter-rater and the intra-rater reliability of Ciloctunet were good to excellent. Ciloctunet avoids time-consuming manual segmentation, thus enabling the analysis of large numbers of images of ample study cohorts while avoiding possible examiner biases. Ciloctunet is available as open-source.
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Affiliation(s)
- Torsten Straßer
- Institute for Ophthalmic Research, University of Tuebingen, 72076 Tuebingen, Germany
- University Eye Hospital Tuebingen, 72076 Tuebingen, Germany
- Correspondence:
| | - Sandra Wagner
- Institute for Ophthalmic Research, University of Tuebingen, 72076 Tuebingen, Germany
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Li M, Luo Z, Yan X, Chen Z. The Anterior Segment Biometrics in High Myopia Eyes. Ophthalmic Res 2022; 66:75-85. [PMID: 35926453 DOI: 10.1159/000526280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/20/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of this study was to investigate and compare the anterior segment biometrics in high myopia and control groups. METHODS Thirty-four eyes of 34 high myopia patients and 42 eyes of 42 control subjects were included. Schlemm's canal (SC) area, trabecular meshwork (TM) thickness and length, scleral spur (SS) length, and anterior scleral thickness (AST) were measured using swept-source optical coherence tomography. Associations between SC area, TM thickness, TM length, SS length, and AST were also estimated. RESULTS SC area, TM thickness, and SS length were significantly associated with AST0 (AST at 0 mm from SS) in both high myopia and control groups. AST0 (702.61 ± 78.05 vs. 729.12 ± 95.87 μm, p = 0.085) and SS length (206.25 ± 52.25 vs. 212.09 ± 51.86 μm, p = 0.556) were not significantly different between high myopia and control groups, whereas SC area (6,622.68 ± 1,130.06 vs. 6,105.85 ± 1,297.84 μm2, p = 0.015) was significantly greater and TM thickness (96.15 ± 34.40 vs. 107.93 ± 29.97 μm, p = 0.048) was significantly thinner in high myopia group than in control group. CONCLUSION SC area and TM thickness were significantly associated with AST0, while AST0 and SS length were not significantly different between high myopia and control groups. The changes in SC and TM dimensions in high myopia eyes might be caused by factors other than AST0 and SS length.
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Affiliation(s)
- Mu Li
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhaoxia Luo
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoqin Yan
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiqi Chen
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Ren J, Gao X, Chen L, Lin H, Liu Y, Zhou Y, Liao Y, Xie C, Zuo C, Lin M. Characteristics of the Ciliary Body in Healthy Chinese Subjects Evaluated by Radial and Transverse Imaging of Ultrasound Biometric Microscopy. J Clin Med 2022; 11:jcm11133696. [PMID: 35806981 PMCID: PMC9267437 DOI: 10.3390/jcm11133696] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/17/2022] [Accepted: 06/21/2022] [Indexed: 12/27/2022] Open
Abstract
Background: The imaging and analysis of the ciliary body (CB) are valuable in many potential clinical applications. This study aims to demonstrate the anatomy characteristics of CB using radial and transverse imaging of ultrasound biometric microscopy (UBM) in healthy Chinese subjects, and to explore the determining factors. Methods: Fifty-four eyes of 30 healthy Chinese subjects were evaluated. Clinical data, including age, body mass index (BMI), intraocular pressure (IOP), axial length (AL), and lens thickness (LT), were collected. Radial and transverse UBM measurements of the ciliary body were performed. Anterior chamber depth (ACD), ciliary sulcus diameter (CSD), ciliary process length (CPL), ciliary process density (CPD), ciliary process area (CPA), ciliary muscle area (CMA), ciliary body area (CBA), ciliary body thickness (CBT0, CBT1, and CBTmax), anterior placement of ciliary body (APCB), and trabecular-ciliary angle (TCA) of four (superior, nasal, inferior, and temporal) quadrants were measured. Results: The average CPL was 0.513 ± 0.074 mm, and the average CPA was 0.890 ± 0.141 mm2. CPL and CPA tended to be longer and larger in the superior quadrant (p < 0.001) than in the other three quadrants. Average CPL was significantly correlated with AL (r = 0.535, p < 0.001), ACD (r = 0.511, p < 0.001), and LT (r = −0.512, p < 0.001). Intraclass correlation coefficient (ICC) scores were high for CPL (0.979), CPD (0.992), CPA (0.966), CMA (0.963), and CBA (0.951). Conclusions: In healthy Chinese subjects, CPL was greatest in the superior quadrant, followed by the inferior, temporal, and nasal quadrants, and CPA was largest in the superior quadrant, followed by the tempdoral, inferior, and nasal quadrants. Transverse UBM images can be used to measure the anatomy of the ciliary process with relatively good repeatability and reliability.
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Affiliation(s)
- Jiawei Ren
- State Key Laboratory of Ophthalmology, Guangzhou 510060, China; (J.R.); (X.G.); (L.C.); (H.L.); (Y.L.); (Y.Z.); (Y.L.); (C.X.)
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
| | - Xinbo Gao
- State Key Laboratory of Ophthalmology, Guangzhou 510060, China; (J.R.); (X.G.); (L.C.); (H.L.); (Y.L.); (Y.Z.); (Y.L.); (C.X.)
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
| | - Liming Chen
- State Key Laboratory of Ophthalmology, Guangzhou 510060, China; (J.R.); (X.G.); (L.C.); (H.L.); (Y.L.); (Y.Z.); (Y.L.); (C.X.)
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
| | - Huishan Lin
- State Key Laboratory of Ophthalmology, Guangzhou 510060, China; (J.R.); (X.G.); (L.C.); (H.L.); (Y.L.); (Y.Z.); (Y.L.); (C.X.)
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
| | - Yao Liu
- State Key Laboratory of Ophthalmology, Guangzhou 510060, China; (J.R.); (X.G.); (L.C.); (H.L.); (Y.L.); (Y.Z.); (Y.L.); (C.X.)
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
| | - Yuying Zhou
- State Key Laboratory of Ophthalmology, Guangzhou 510060, China; (J.R.); (X.G.); (L.C.); (H.L.); (Y.L.); (Y.Z.); (Y.L.); (C.X.)
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
| | - Yunru Liao
- State Key Laboratory of Ophthalmology, Guangzhou 510060, China; (J.R.); (X.G.); (L.C.); (H.L.); (Y.L.); (Y.Z.); (Y.L.); (C.X.)
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
| | - Chunzi Xie
- State Key Laboratory of Ophthalmology, Guangzhou 510060, China; (J.R.); (X.G.); (L.C.); (H.L.); (Y.L.); (Y.Z.); (Y.L.); (C.X.)
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
| | - Chengguo Zuo
- State Key Laboratory of Ophthalmology, Guangzhou 510060, China; (J.R.); (X.G.); (L.C.); (H.L.); (Y.L.); (Y.Z.); (Y.L.); (C.X.)
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
- Correspondence: (C.Z.); (M.L.)
| | - Mingkai Lin
- State Key Laboratory of Ophthalmology, Guangzhou 510060, China; (J.R.); (X.G.); (L.C.); (H.L.); (Y.L.); (Y.Z.); (Y.L.); (C.X.)
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
- Correspondence: (C.Z.); (M.L.)
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11
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Kaphle D, Schmid KL, Davies LN, Suheimat M, Atchison DA. Ciliary Muscle Dimension Changes With Accommodation Vary in Myopia and Emmetropia. Invest Ophthalmol Vis Sci 2022; 63:24. [PMID: 35749128 PMCID: PMC9234357 DOI: 10.1167/iovs.63.6.24] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Purpose The purpose of this study was to determine whether accommodation-induced changes in ciliary muscle dimensions vary between emmetropes and myopes, and the effect of the image analysis method. Methods Seventy adults aged 18 to 27 years consisted of 25 people with emmetropia (spherical equivalent refraction [SER] +0.21 ± 0.36 diopters [D]) and 45 people with myopia (−2.84 ± 1.72 D). There were 23 people with low myopia (>−3 D) and 22 people with moderate myopia (−3 to −6 D). Right eye ciliary muscles were imaged (Visante OCT; Carl Zeiss Meditec) at 0 D and 6 D demands. Measures included ciliary muscle length (CML), ciliary muscle curved length (CMLarc), maximum ciliary muscle thickness (CMTmax), CMT1, CMT2, and CMT3 (fixed distances 1–3 mm from the scleral spur), CM25, CM50, and CM75 (proportional distances 25%–75%). Linear mixed model analysis determined effects of refractive groups, race, and demand on dimensions. Significance was set at P < 0.05. Results Myopic eyes had greater CML and CMLarc nasally than emmetropic eyes. Myopic eyes had thicker muscles than emmetropic eyes at nasal positions, except CM25 and CMT3, and at CM75 temporally. During accommodation and only nasally, CML reduced in emmetropic and myopic eyes, and CMLarc reduced in myopic eyes only. During accommodation, both nasally and temporally, muscles thickened anteriorly (CMT1 and CM25) and thinned posteriorly (CMT3 and CM75) except for temporal CM75. Moderate myopic eyes had greater temporal CMLarc than low myopic eyes, and the moderate myopes had thicker muscles both nasally and temporally using fixed and proportional distances. Conclusions People with myopia had longer and thicker ciliary muscles than people with emmetropia. During accommodation, the anterior muscle thickened and the curved nasal muscle length shortened, more in myopic than in emmetropic eyes. The fixed distance method is recommended for repeat measures in the same individual. The proportional distance method is recommended for comparisons between refractive groups.
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Affiliation(s)
- Dinesh Kaphle
- Centre for Vision and Eye Research, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Discipline of Optometry, Faculty of Health, University of Canberra, Bruce ACT 2617, Australia
| | - Katrina L Schmid
- Centre for Vision and Eye Research, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Leon N Davies
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, United Kingdom
| | - Marwan Suheimat
- Centre for Vision and Eye Research, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - David A Atchison
- Centre for Vision and Eye Research, Queensland University of Technology, Kelvin Grove, Queensland, Australia
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12
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Gajjar S, Ostrin LA. A systematic review of near work and myopia: measurement, relationships, mechanisms and clinical corollaries. Acta Ophthalmol 2022; 100:376-387. [PMID: 34622560 DOI: 10.1111/aos.15043] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 09/02/2021] [Accepted: 09/22/2021] [Indexed: 12/17/2022]
Abstract
After decades of investigation, the role of near work in myopia remains unresolved, with some studies reporting no relationship and others finding the opposite. This systematic review is intended to summarize classic and recent literature investigating near work and the onset and progression of myopia, potential mechanisms and pertinent clinical recommendations. The impact of electronic device use is considered. PubMed and Medline were used to find peer-reviewed cross-sectional and longitudinal studies related to near work and myopia from 1980 to July 2020 using the PRISMA checklist. Studies were chosen using the Joanna Briggs Institute checklist, with a focus on studies with a sample size greater than 50. Studies were independently evaluated; conclusions were drawn per these evaluations. Numerous cross-sectional studies found increased odds ratio of myopia with increased near work. While early longitudinal studies failed to find this relationship, more recent longitudinal studies have found a relationship between myopia and near work. Rather than daily duration of near work, interest has increased regarding absolute working distance and duration of continuous near viewing. Several reports have found that shorter working distances (<30 cm) and continuous near-work activity (>30 min) are risk factors for myopia onset and progression. Novel objective continuously measuring rangefinding devices have been developed to better address these questions. The literature is conflicting, likely due to the subjective and variable nature in which near work has been quantified and a paucity of longitudinal studies. We conclude that more precise objective measures of near viewing behaviour are necessary to make definitive conclusions regarding the relationship between myopia and near work. Focus should shift to utilizing objective and continuously measuring instruments to quantify near-work behaviours in children, followed longitudinally, to understand the complex factors related to near work. A better understanding of the roles of absolute working distance, temporal properties, viewing breaks and electronic device use on myopia development and progression will aid in the development of evidence-based clinical recommendations for behavioural modifications to prevent and slow myopia.
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Affiliation(s)
- Shail Gajjar
- University of Houston College of Optometry Houston TX USA
| | - Lisa A. Ostrin
- University of Houston College of Optometry Houston TX USA
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13
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Ma Y, Liu Y, Xu L, Shi Z, Zhou L. Applying Visual-Motor Training Combined with an Eye Relaxation System Based on Far-Infrared Nanomaterials in Pseudomyopia. J Biomed Nanotechnol 2022; 18:87-96. [PMID: 35180902 DOI: 10.1166/jbn.2022.3187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
To explore the effect of far-infrared nanomaterial eye relaxation system combined with visual-motor training in pseudomyopia, 120 patients with pseudomyopia were included in the experiment and randomly divided into nanomaterial and control groups. The control group received visual-motor training, and the nanomaterial group was treated with an eye relaxation system. This study found that nanozirconia and nanotitanium dioxide used in eye relaxation systems could maintain good stability in acidic and alkaline conditions. Additionally, nanozirconia could produce a warm effect, and nanotitanium dioxide had a clear sterilization effect. Moreover, the two abovementioned nanoparticles could be closely combined with fiberoptic materials. After treatment, the eye adjustment function, visual acuity, and diopter of the two groups were significantly improved, especially in the nanomaterial group. Additionally, using the nanomaterial eye relaxation system could better control intraocular pressure, reduce lens thickness, and improve the symptoms of eye fatigue. Furthermore, anxiety and depression were better reduced in the nanomaterial group, and their quality of life was greatly improved. Therefore, the far-infrared nanomaterial eye relaxation system combined with visual-motor training can be used as a new and effective scheme for pseudomyopia.
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Affiliation(s)
- Yu Ma
- Department of Ophthalmology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou 450052, Henan, PR China
| | - Yi Liu
- School of Medical Technology and Engineering, Zhengzhou Railway Vocational and Technical College, Zhengzhou 450046, Henan, PR China
| | - Limin Xu
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan, PR China
| | - Zongli Shi
- Department of Optometry, Changzhou Banshang Ophthalmic Hospital, Changzhou 213100, Jiangsu, PR China
| | - Lixiao Zhou
- Department of Ophthalmology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou 450052, Henan, PR China
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14
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Xie X, Sultan W, Corradetti G, Lee JY, Song A, Pardeshi A, Yu F, Chopra V, Sadda SR, Xu BY, Huang AS. Assessing accommodative presbyopic biometric changes of the entire anterior segment using single swept-source OCT image acquisitions. Eye (Lond) 2022; 36:119-128. [PMID: 33633350 PMCID: PMC8727625 DOI: 10.1038/s41433-020-01363-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/30/2020] [Accepted: 12/02/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND/OBJECTIVES To evaluate biometric changes throughout the anterior chamber during accommodation and presbyopia using single image acquisition swept-source anterior-segment optical coherence tomography (AS-OCT). SUBJECT/METHODS Anterior-segment images were obtained using a new swept-source AS-OCT device (ANTERION, Heidelberg Engineering) from healthy volunteers (n = 71) across two centers in this prospective observational case series. In one image acquisition, cornea through posterior lens, including the ciliary muscle on both sides of the right eye, was imaged. Subjects undertook no accommodative effort and -1, -3, and -5 D of target vergence. Two-way repeated measures ANOVA modeling was performed for ciliary muscle measurements, lens parameters, aqueous depth (AD), and pupil diameter (PD). The first ANOVA factor was accommodative stimuli, and the second factor included age and refractive status. RESULTS Maximum ciliary muscle thickness increased with accommodative stimuli (p < 0.001), while the distance from the scleral spur to the maximal point on the ciliary muscle and posterior ciliary muscle thickness (CMT2) decreased (p < 0.001-0.002). Older individuals showed no accommodative changes for ciliary muscle parameters, lens thickness, lens vault, PD, and AD (p = 0.07-0.32). Younger- and middle-aged eyes showed statistically significant accommodative structural alterations for these endpoints (p < 0.001-0.002), but with different patterns, including early loss of CMT2 contraction in middle-aged eyes. Within the middle-aged group, myopic eyes maintained better capacity for accommodative structural change. CONCLUSIONS Swept-source AS-OCT demonstrated multiple simultaneous anterior-segment biometric alterations in single acquisition images, including early loss of posterior ciliary muscle function and better maintained capacity for anterior-segment structural change in myopia.
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Affiliation(s)
- Xiaobin Xie
- grid.410318.f0000 0004 0632 3409Eye Hospital of China Academy of Chinese Medical Sciences, Beijing, China ,grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - William Sultan
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - Giulia Corradetti
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - Jong Yeon Lee
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA ,grid.256155.00000 0004 0647 2973Department of Ophthalmology, College of Medicine, Gil Medical Center, Gachon University, Incheon, South Korea
| | - Abe Song
- grid.42505.360000 0001 2156 6853Roski Eye Institute, Department of Ophthalmology, University of Southern California, Los Angeles, CA USA
| | - Anmol Pardeshi
- grid.42505.360000 0001 2156 6853Roski Eye Institute, Department of Ophthalmology, University of Southern California, Los Angeles, CA USA
| | - Fei Yu
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - Vikas Chopra
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - Srinivas R. Sadda
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - Benjamin Y. Xu
- grid.42505.360000 0001 2156 6853Roski Eye Institute, Department of Ophthalmology, University of Southern California, Los Angeles, CA USA
| | - Alex S. Huang
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
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15
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Jin CC, Pei RX, Du B, Liu GH, Jin N, Liu L, Wei RH. Lag of accommodation predicts clinically significant change of spherical equivalents after cycloplegia. Int J Ophthalmol 2021; 14:1052-1058. [PMID: 34282391 DOI: 10.18240/ijo.2021.07.14] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 06/11/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate related factors with the change of spherical equivalents (ΔSE) and determine the suitable predictor of clinically significant ΔSE (≥0.50 D) with cyclopentolate hydrochloride on Chinese children. METHODS A total of 145 right eyes of 145 children aged 4 to 15y were enrolled. Intraocular pressure, axial length and lag of accommodation (LOA) were assessed before cycloplegia induced by 3 drops of 1% cyclopentolate at 5-minute intervals. SE was measured before and 1h after the first drop of cyclopentolate. ΔSE was compared between different gender groups and among refractive groups. Multivariate linear regression analysis was performed to find related factors with ΔSE. ROC analysis was used to figure out the suitable predictor of clinically significant ΔSE. RESULTS For the total 145 eyes, the mean SE reached up to -0.70±1.86 D from -1.30±1.62 D, with the mean ΔSE of 0.60±0.55 D. The mean ΔSE were 0.63±0.55 D and 0.57±0.56 D respectively in the male and female group (P=0.40). The mean ΔSE was significantly different among different refractive groups (P<0.0001), with the ΔSE of hyperopia group (1.12±0.64 D) larger than that of the emmetropia (0.56±0.43 D, P=0.001) and myopia group (0.32±0.28 D, P<0.0001). The ΔSE was correlated with LOA (B=-0.54, P<0.0001), cycloplegic SE (B=0.10, P<0.0001) and age (B=-0.04, P=0.015). ROC curve indicated that LOA predicted clinically significant ΔSE by 82% [area under the curve (AUC)=0.82] alone, while the value was slightly improved to 85% (AUC=0.85) in combination with axial length and 86% (AUC=0.86) in association with axial length as well as age. CONCLUSION After cycloplegia with cyclopentolate, the ΔSE decreases with larger LOA, longer axial length and older age. Specifically, LOA plays a more vital role in predicting clinically significant ΔSE.
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Affiliation(s)
- Cheng-Cheng Jin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Ru-Xia Pei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Bei Du
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Gui-Hua Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Nan Jin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Lin Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
| | - Rui-Hua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
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16
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Summers JA, Schaeffel F, Marcos S, Wu H, Tkatchenko AV. Functional integration of eye tissues and refractive eye development: Mechanisms and pathways. Exp Eye Res 2021; 209:108693. [PMID: 34228967 DOI: 10.1016/j.exer.2021.108693] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 12/16/2022]
Abstract
Refractive eye development is a tightly coordinated developmental process. The general layout of the eye and its various components are established during embryonic development, which involves a complex cross-tissue signaling. The eye then undergoes a refinement process during the postnatal emmetropization process, which relies heavily on the integration of environmental and genetic factors and is controlled by an elaborate genetic network. This genetic network encodes a multilayered signaling cascade, which converts visual stimuli into molecular signals that guide the postnatal growth of the eye. The signaling cascade underlying refractive eye development spans across all ocular tissues and comprises multiple signaling pathways. Notably, tissue-tissue interaction plays a key role in both embryonic eye development and postnatal eye emmetropization. Recent advances in eye biometry, physiological optics and systems genetics of refractive error have significantly advanced our understanding of the biological processes involved in refractive eye development and provided a framework for the development of new treatment options for myopia. In this review, we summarize the recent data on the mechanisms and signaling pathways underlying refractive eye development and discuss new evidence suggesting a wide-spread signal integration across different tissues and ocular components involved in visually guided eye growth.
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Affiliation(s)
- Jody A Summers
- Department of Cell Biology, University of Oklahoma Health Science Center, Oklahoma City, OK, USA
| | - Frank Schaeffel
- Section of Neurobiology of the Eye, Ophthalmic Research Institute, University of Tuebingen, Tuebingen, Germany; Myopia Research Group, Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland
| | - Susana Marcos
- Instituto de Óptica "Daza de Valdés", Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - Hao Wu
- Department of Ophthalmology, Columbia University, New York, USA
| | - Andrei V Tkatchenko
- Department of Ophthalmology, Columbia University, New York, USA; Department of Pathology and Cell Biology, Columbia University, New York, USA.
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17
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Logan NS, Radhakrishnan H, Cruickshank FE, Allen PM, Bandela PK, Davies LN, Hasebe S, Khanal S, Schmid KL, Vera-Diaz FA, Wolffsohn JS. IMI Accommodation and Binocular Vision in Myopia Development and Progression. Invest Ophthalmol Vis Sci 2021; 62:4. [PMID: 33909034 PMCID: PMC8083074 DOI: 10.1167/iovs.62.5.4] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The role of accommodation in myopia development and progression has been debated for decades. More recently, the understanding of the mechanisms involved in accommodation and the consequent alterations in ocular parameters has expanded. This International Myopia Institute white paper reviews the variations in ocular parameters that occur with accommodation and the mechanisms involved in accommodation and myopia development and progression. Convergence is synergistically linked with accommodation and the impact of this on myopia has also been critiqued. Specific topics reviewed included accommodation and myopia, role of spatial frequency, and contrast of the task of objects in the near environment, color cues to accommodation, lag of accommodation, accommodative-convergence ratio, and near phoria status. Aspects of retinal blur from the lag of accommodation, the impact of spatial frequency at near and a short working distance may all be implicated in myopia development and progression. The response of the ciliary body and its links with changes in the choroid remain to be explored. Further research is critical to understanding the factors underlying accommodative and binocular mechanisms for myopia development and its progression and to guide recommendations for targeted interventions to slow myopia progression.
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Affiliation(s)
- Nicola S Logan
- School of Optometry, Aston University, Birmingham, United Kingdom
| | - Hema Radhakrishnan
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Fiona E Cruickshank
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Peter M Allen
- Vision and Hearing Sciences Research Centre, School of Psychology and Sports Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Praveen K Bandela
- Brien Holden Vision Institute, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Leon N Davies
- School of Optometry, Aston University, Birmingham, United Kingdom
| | - Satoshi Hasebe
- Department of Ophthalmology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Safal Khanal
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Katrina L Schmid
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
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18
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Xie X, Corradetti G, Song A, Pardeshi A, Sultan W, Lee JY, Yu F, Zhang L, Chen S, Chopra V, Sadda SR, Xu B, Huang AS. Age- and refraction-related changes in anterior segment anatomical structures measured by swept-source anterior segment OCT. PLoS One 2020; 15:e0240110. [PMID: 33095821 PMCID: PMC7584205 DOI: 10.1371/journal.pone.0240110] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 09/18/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To assess the effects of age and refractive status on anterior segment anatomical structures, including the ciliary body, using a new swept-source anterior segment optical coherence tomography (AS-OCT) device. METHODS This prospective observational study included 63 healthy volunteers (mean age: 44.2 years). Images of the anterior segment were obtained using a new swept-source AS-OCT (ANTERION, Heidelberg Engineering GmbH, Heidelberg, Germany) with tracking and image averaging from the right eye of all participants. Repeatability as well as inter- and intra-observer reliability of biometric measurements were evaluated. The impact of image tracking and averaging on ciliary muscle measurements was tested. Univariate and multivariable statistical models were developed to evaluate the relationship of age and refractive status on anterior segment biometric measurements. RESULTS For all test-retest repeatability and inter- and intra-observer reproducibility of swept-source AS-OCT measurements, high intraclass correlation (ICC) was noted (0.88-1.00). The nasal maximum ciliary muscle thickness (CMTMAX) and distance between scleral spur to the thickest point of the ciliary muscle (SSMAX) were larger than those on the temporal side (p<0.001 and p = 0.006, respectively). Nasal and temporal CMTMAX (p = 0.004 and p<0.001, respectively) and lens thickness (p<0.01) increased with age. Nasal and temporal SSMAX decreased with older age and increasing hyperopia (p = 0.01 and p<0.001, respectively). Image averaging resulted in improved ciliary muscle measurements (p = 0.008 to 0.02). Lens vault increased with older age and increased hyperopia (p<0.01). OCT measurements of the angle decreased with older age and increased hyperopia (p<0.001 to 0.03). Aqueous depth decreased with older age and increased hyperopia (p<0.01). Pupil diameter decreased with older age (p<0.01). CONCLUSIONS Repeatability and reproducibility of biometric measurements using the ANTERION AS-OCT were excellent. Image averaging improved the accuracy of ciliary muscle measurements. The device produced measurements of biometric parameters that described superficial and deep structures including the ciliary body and full lens thickness from a single image.
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Affiliation(s)
- Xiaobin Xie
- Eye Hospital of China Academy of Chinese Medical Sciences, Beijing, China
- Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, California, United States of America
- * E-mail:
| | - Giulia Corradetti
- Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, California, United States of America
| | - Abe Song
- Roski Eye Institute, Department of Ophthalmology, University of Southern California, Los Angeles, California, United States of America
| | - Anmol Pardeshi
- Roski Eye Institute, Department of Ophthalmology, University of Southern California, Los Angeles, California, United States of America
| | - William Sultan
- Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, California, United States of America
| | - Jong Yeon Lee
- Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, California, United States of America
- Department of Ophthalmology, College of Medicine, Gil Medical Center, Gachon University, Incheon, Korea
| | - Fei Yu
- Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, California, United States of America
| | - Lixia Zhang
- Eye Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Shuang Chen
- Eye Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Vikas Chopra
- Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, California, United States of America
| | - Srinivas R. Sadda
- Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, California, United States of America
| | - Benjamin Xu
- Roski Eye Institute, Department of Ophthalmology, University of Southern California, Los Angeles, California, United States of America
| | - Alex S. Huang
- Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, California, United States of America
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Review of the application of the open-source software CilOCT for semi-automatic segmentation and analysis of the ciliary muscle in OCT images. PLoS One 2020; 15:e0234330. [PMID: 32516331 PMCID: PMC7282635 DOI: 10.1371/journal.pone.0234330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/22/2020] [Indexed: 11/25/2022] Open
Abstract
Presbyopia and myopia research shows a growing interest in ciliary muscle biometry using optical coherence tomography (OCT). Until now, segmentation of the ciliary muscle is often performed manually using either custom-developed programs or image processing software. Here we present a novel software for semi-automatic segmentation of the ciliary muscle. It provides direct import of OCT images in DICOM format, a standardized procedure for segmentation, image distortion correction, the export of anatomical ciliary muscle landmarks, like ciliary muscle apex and scleral spur, as well as a continuous thickness profile of the ciliary muscle as a novel way of analysis. All processing steps are stored as XML files, fostering documentation and reproducibility of research through the possibility of replicating the analysis. Additionally, CilOCT supports batch processing for the automated analysis of large numbers of images and the respective data export to tabulated text files based on the stored XML files. CilOCT was successfully applied in several studies and their results will be summarized in this paper.
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Repeatability and Validity of Peripheral Refraction with Two Different Autorefractors. Optom Vis Sci 2020; 97:429-439. [PMID: 32511165 DOI: 10.1097/opx.0000000000001520] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE The Welch Allyn SureSight (Welch Allyn, Skaneateles Falls, NY) and Plusoptix PowerRefractor (Plusoptix, Nuremberg, Germany) are often used with infants, but little is known about the repeatability and validity of their peripheral refractive error measurements. Selecting the best instrument will support future refractive error and emmetropization studies. PURPOSE The purpose of this study was to determine the validity and repeatability of peripheral refractive error measurements and peripheral refraction profiles measured with the Welch Allyn SureSight and Plusoptix PowerRefractor compared with the criterion standard Grand Seiko WR-5100K (Grand Seiko Co., Hiroshima, Japan). METHODS Cycloplegic (tropicamide 1%) autorefraction was measured in the right eyes of 21 adult subjects (31.4 ± 10.4 years) with the three instruments in randomized order on two separate visits, at least 24 hours apart, centrally, and at 30 and 20° temporal and nasal gaze. RESULTS The SureSight measurements were within 0.24 D and not significantly different from the Grand Seiko WR-5100K in any gaze (P < .65), whereas the PowerRefractor measurements were more myopic by as much as -0.97 D and significantly different in four of the five gaze directions (P < .04). The 95% limits of agreement between occasions by gaze ranged from ±0.38 to ±0.61 D for the SureSight, similar to or slightly better than the WR-5100K (±0.31 to ±1.51 D) and the PowerRefractor (±0.72 to ±1.71 D). There were no significant differences between visits for any instrument in any gaze (P < .94). The repeatability of the SureSight was also better than that for the Grand Seiko when peripheral refraction was represented by quadratic fits to the data. CONCLUSIONS These findings suggest that the Welch Allyn SureSight is the most suitable portable autorefractor to use to monitor peripheral autorefraction based on better repeatability between occasions and better validity compared with the criterion standard Grand Seiko WR-5100K.
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Wagner S, Zrenner E, Strasser T. Emmetropes and myopes differ little in their accommodation dynamics but strongly in their ciliary muscle morphology. Vision Res 2019; 163:42-51. [PMID: 31401218 DOI: 10.1016/j.visres.2019.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/23/2019] [Accepted: 08/05/2019] [Indexed: 11/29/2022]
Abstract
Previous work suggested an association between near vision and myopia. We therefore investigated the accommodation process in emmetropes and myopes regarding morphologic changes of the ciliary muscle (CM) and power changes of the lens for different accommodation demands. The temporal CM of 18 emmetropic and 20 myopic students was imaged via anterior segment optical coherence tomography during far and near accommodation (2.5D, 3D, 4D). Additionally, accommodation dynamics to the stimuli pattern far-near-far (15 s each; 2.5D, 3D, 4D) were recorded with eccentric infrared photorefraction. OCT images were processed using custom-developed software facilitating the analysis of selective CM thickness (CMT) readings and CMT profiles. Anterior CMT readings were significantly smaller in myopes. Starting at 1.4 mm posterior to the scleral spur (SP), myopic CM became thicker than emmetropic. Anterior CMT changes (ΔCMT) continuously increased with accommodation demand in myopes while emmetropic ΔCMT only increased from 2.5D to 3D. Compared to emmetropes, myopes showed smaller ΔCMT but increased CM movement relative to SP. There were no significant differences between the groups for accommodation changes from far to near vision and vice versa, velocity, microfluctuations, power spectra or lag of accommodation. At 4 D, larger ΔCMT were associated with lower lens changes for disaccommodation. While CM shape, movement, and thickness showed distinct differences depending on refractive error, emmetropes and myopes did not differ in their dynamic accommodation. Further analysis is necessary to evaluate whether the CM's anatomical shape or predispositions in its intramuscular constituents are causative factors in myopigenesis.
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Affiliation(s)
- Sandra Wagner
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Str. 7, 72076 Tuebingen, Germany.
| | - Eberhart Zrenner
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Str. 7, 72076 Tuebingen, Germany; Werner Reichardt Centre for Integrative Neuroscience (CIN) Tuebingen, Otfried-Mueller-Str. 25, 72076 Tuebingen, Germany
| | - Torsten Strasser
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Str. 7, 72076 Tuebingen, Germany
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Wolffsohn JS, Kollbaum PS, Berntsen DA, Atchison DA, Benavente A, Bradley A, Buckhurst H, Collins M, Fujikado T, Hiraoka T, Hirota M, Jones D, Logan NS, Lundström L, Torii H, Read SA, Naidoo K. IMI - Clinical Myopia Control Trials and Instrumentation Report. Invest Ophthalmol Vis Sci 2019; 60:M132-M160. [PMID: 30817830 DOI: 10.1167/iovs.18-25955] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The evidence-basis based on existing myopia control trials along with the supporting academic literature were reviewed; this informed recommendations on the outcomes suggested from clinical trials aimed at slowing myopia progression to show the effectiveness of treatments and the impact on patients. These outcomes were classified as primary (refractive error and/or axial length), secondary (patient reported outcomes and treatment compliance), and exploratory (peripheral refraction, accommodative changes, ocular alignment, pupil size, outdoor activity/lighting levels, anterior and posterior segment imaging, and tissue biomechanics). The currently available instrumentation, which the literature has shown to best achieve the primary and secondary outcomes, was reviewed and critiqued. Issues relating to study design and patient selection were also identified. These findings and consensus from the International Myopia Institute members led to final recommendations to inform future instrumentation development and to guide clinical trial protocols.
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Affiliation(s)
- James S Wolffsohn
- Ophthalmic Research Group, Aston University, Birmingham, United Kingdom
| | - Pete S Kollbaum
- Indiana University, School of Optometry, Bloomington, Indiana, United States
| | - David A Berntsen
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, Texas, United States
| | - David A Atchison
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | | | - Arthur Bradley
- Indiana University, School of Optometry, Bloomington, Indiana, United States
| | - Hetal Buckhurst
- School of Health Professions, Peninsula Allied Health Centre, Plymouth University, Plymouth, United Kingdom
| | - Michael Collins
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | - Takashi Fujikado
- Department of Applied Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takahiro Hiraoka
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masakazu Hirota
- Department of Applied Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Debbie Jones
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Nicola S Logan
- Ophthalmic Research Group, Aston University, Birmingham, United Kingdom
| | | | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Scott A Read
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | - Kovin Naidoo
- African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa
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Wagner S, Schaeffel F, Zrenner E, Straßer T. Prolonged nearwork affects the ciliary muscle morphology. Exp Eye Res 2019; 186:107741. [PMID: 31336108 DOI: 10.1016/j.exer.2019.107741] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 11/25/2022]
Abstract
There is evidence for a possible link between myopia development and near vision. We investigated the effect of prolonged nearwork on ciliary muscle (CM) morphology and accommodation in 18 myopic and 17 emmetropic subjects (age 19 to 25). The CM was imaged during far (0.25 D) and near vision (4 D) using optical coherence tomography (OCT), and accommodation to a step pulse (0.25 D - 4 D - 0.25 D, 15 s each) was assessed by eccentric infrared photorefraction before and after a 30-min reading task at 25 cm. OCT images were analyzed using a custom-developed semi-automatic segmentation algorithm to determine CM thickness (CMT) profiles and selective CMT readings. Accommodation was assessed using a non-linear model. On average, the CM got thinner after nearwork, predominantly at 0.0-1.4 mm posterior to the scleral spur in emmetropes, and at 1.0-1.9 mm in myopes. Selective CMT readings confirmed a significant thinning after nearwork (univariate ANOVA F1,66 = 26.313, p < 0.001), without any influence of the subjects' refractive state (F1,66 = 1.887, p = 0.174) or the target distance (F1,66 = 0.014, p = 0.907). The mean accommodation response for targets at infinity was significantly increased after nearwork (F1,32 = 7.775, p = 0.009), with a larger myopic shift in myopes (F1,32 = 11.310, p = 0.002). No change in velocity of accommodation was found. Sharing properties of striated muscles, the CM was expected to increase its thickness, but the opposite was found. Previous studies suggesting sustained nearwork to result in a CM spasm cannot be confirmed by the data presented here. Further research exploring the possible impact of sympathetic innervation is necessary as it is activated during intense nearwork.
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Affiliation(s)
- Sandra Wagner
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Str. 7, 72076, Tuebingen, Germany.
| | - Frank Schaeffel
- Section Neurobiology of the Eye, Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Str. 7, 72076, Tuebingen, Germany.
| | - Eberhart Zrenner
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Str. 7, 72076, Tuebingen, Germany; Werner Reichardt Centre for Integrative Neuroscience (CIN), Otfried-Mueller-Str. 25, 72076, Tuebingen, Germany.
| | - Torsten Straßer
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Str. 7, 72076, Tuebingen, Germany.
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Xie Y, Wang M, Cong Y, Cheng M, Wang S, Wang G. The pilocarpine-induced ciliary body contraction affects the elastic modulus and collagen of cornea and sclera in early development. Biomed Pharmacother 2018; 108:1816-1824. [DOI: 10.1016/j.biopha.2018.10.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 09/29/2018] [Accepted: 10/09/2018] [Indexed: 12/26/2022] Open
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Woodman-Pieterse EC, Read SA, Collins MJ, Alonso-Caneiro D. Anterior scleral thickness changes with accommodation in myopes and emmetropes. Exp Eye Res 2018; 177:96-103. [DOI: 10.1016/j.exer.2018.07.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 06/07/2018] [Accepted: 07/20/2018] [Indexed: 11/24/2022]
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Wagner S, Zrenner E, Strasser T. Ciliary muscle thickness profiles derived from optical coherence tomography images. BIOMEDICAL OPTICS EXPRESS 2018; 9:5100-5114. [PMID: 30319924 PMCID: PMC6179398 DOI: 10.1364/boe.9.005100] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/18/2018] [Accepted: 09/18/2018] [Indexed: 05/09/2023]
Abstract
The purpose of this study was to provide an in-depth analysis of the ciliary muscle's (CM) morphological changes during accommodation by evaluating CM thickness (CMT) profiles. The CM of 15 near-emmetropic subjects (age 20-39) was imaged via optical coherence tomography (OCT) during far (0 D) and near vision (3 D). A custom-made Java-based program was used for semi-automatic CM segmentation and thickness measurements. CMT profiles were generated to determine regions of the largest shape changes. The results revealed on average a thinning within the first 0.25 mm and a thickening from 0.36 to 1.48 mm posterior to scleral spur when accommodating from 0 to 3 D. In contrast to previous analyses, this method offers pixel-wise reconstruction of CM shapes and quantification of accommodative change across the entire muscle boundary.
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Affiliation(s)
- Sandra Wagner
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Str. 7, 72076 Tuebingen, Germany
| | - Eberhart Zrenner
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Str. 7, 72076 Tuebingen, Germany
- Werner Reichardt Centre for Integrative Neuroscience (CIN), Otfried-Mueller-Str. 25, 72076 Tuebingen, Germany
| | - Torsten Strasser
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Str. 7, 72076 Tuebingen, Germany
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Aldossari H, Suheimat M, Atchison DA, Schmid KL. Effect of Accommodation on Peripheral Eye Lengths of Emmetropes and Myopes. Optom Vis Sci 2017; 94:361-369. [PMID: 28027274 DOI: 10.1097/opx.0000000000001037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To investigate the effect of accommodation on central and peripheral axial lengths in young adult emmetropes and myopes. METHODS On-axis and peripheral axial lengths were measured with the Haag-Streit Lenstar in 83 young adult participants for 0D and 6D accommodation demands. A Badal system was used to both correct refractive errors and induce accommodation. Participants were emmetropes (n = 29, mean spherical equivalent refraction +0.35 ± 0.35D), low myopes (32, -1.38 ± 0.73D), and higher myopes (22, -4.30 ± 0.73D). Ages were similar for all groups (22 ± 2 years). Pupils were dilated with 2.5% phenylephrine to allow a large field of measurement while maintaining active accommodation. Axial lengths were measured in 5° steps to ±30° across the horizontal visual field. RESULTS With accommodation, axial length increased for all refractive groups at all positions, but with lessening effect away from fixation. Axial length changes were greater for higher myopes than for emmetropes on-axis (higher myopes 41 ± 14 μm, emmetropes 30 ± 12 μm, P = .005), for higher myopes than for low myopes at 30° nasal (P = .03), and for the higher myopes than for the other groups at 20° nasal (P < .05). There were significant correlations between myopia and changes in axial length at all positions, with the highest correlation on-axis (R = 0.30, P < .001). CONCLUSIONS During accommodation, eye length increased out to at least ±30° visual angle in young adult myopes and emmetropes. The increase was significantly greater for higher myopes than for the other groups at some positions. At all positions, there were significant correlations between myopia and accommodation-induced changes in axial length.
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Affiliation(s)
- Hussain Aldossari
- *PhD †DSc, FAAO School of Optometry and Vision Science and Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia (all authors)
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Mutti DO, Mitchell GL, Jones-Jordan LA, Cotter SA, Kleinstein RN, Manny RE, Twelker JD, Zadnik K. The Response AC/A Ratio Before and After the Onset of Myopia. Invest Ophthalmol Vis Sci 2017; 58:1594-1602. [PMID: 28291868 PMCID: PMC5361580 DOI: 10.1167/iovs.16-19093] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Purpose To investigate the ratio of accommodative convergence per diopter of accommodative response (AC/A ratio) before, during, and after myopia onset. Methods Subjects were 698 children aged 6 to 14 years who became myopic and 430 emmetropic children participating in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error. Refractive error was measured using cycloplegic autorefraction, near work by parent survey, and the AC/A ratio by simultaneously monitoring convergence and accommodative response. The response AC/A ratios of children who became myopic were compared with age-, sex-, and ethnicity-matched model estimates for emmetropic children from 5 years before through 5 years after the onset of myopia. Results The response AC/A ratio was not significantly different between the two groups 5 years before onset, then increased monotonically in children who became myopic until reaching a plateau at myopia onset of about 7 Δ/D compared to about 4 Δ/D for children who remained emmetropic (differences between groups significant at P < 0.01 from 4 years before onset through 5 years after onset). A higher AC/A ratio was associated with greater accommodative lag but not with the rate of myopia progression regardless of the level of near work. Conclusions An increasing AC/A ratio is an early sign of becoming myopic, is related to greater accommodative lag, but does not affect the rate of myopia progression. The association with accommodative lag suggests that the AC/A ratio increase is from greater neural effort needed per diopter of accommodation rather than change in the accommodative convergence crosslink gain relationship.
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Affiliation(s)
- Donald O Mutti
- The Ohio State University College of Optometry, Columbus, Ohio, United States
| | - G Lynn Mitchell
- The Ohio State University College of Optometry, Columbus, Ohio, United States
| | - Lisa A Jones-Jordan
- The Ohio State University College of Optometry, Columbus, Ohio, United States
| | - Susan A Cotter
- Southern California College of Optometry at Marshall B. Ketchum University, Fullerton, California, United States
| | - Robert N Kleinstein
- School of Optometry, University of Alabama, Birmingham, Birmingham, Alabama, United States
| | - Ruth E Manny
- University of Houston College of Optometry, Houston, Texas, United States
| | - J Daniel Twelker
- University of Arizona Department of Ophthalmology and Vision Science, Tucson, Arizona, United States
| | - Karla Zadnik
- The Ohio State University College of Optometry, Columbus, Ohio, United States
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Effect of refractive status on Valsalva-induced anterior segment changes. Int Ophthalmol 2017; 38:1205-1210. [PMID: 28600708 DOI: 10.1007/s10792-017-0583-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 06/05/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To evaluate the effect of the Valsalva maneuver (VM) on anterior segment parameters and its association with refractive status. METHOD In this prospective study, 120 eyes of 120 subjects were evaluated. Subjects were divided into three groups: myopic (n = 40 patients), hyperopic (n = 40 patients), and emmetropic (control group, n = 40 subjects). The anterior segment parameters, including keratometric, pachymetric, and anterior chamber parameters, were measured using the Sirius System (Costruzione Strumenti Oftalmici, Florence, Italy) before and during VM. RESULTS There was no statistically significant difference in corneal parameters including keratometric and pachymetric values at rest or during VM in myopic, hyperopic, and control groups (p > 0.05 for all). In the myopic and control groups, anterior chamber depth, anterior chamber volume (ACV), and anterior chamber angle (ACA) were significantly decreased during VM. In the hyperopic group, only anterior chamber depth was significantly decreased during VM, while ACV and ACA did not significantly change. CONCLUSION The Valsalva maneuver may cause significant narrowing in anterior chamber depth, anterior chamber volume, and anterior chamber angle in the myopic and emmetropic groups, whereas it may affect only anterior chamber depth in the hyperopic group.
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Are high lags of accommodation in myopic children due to motor deficits? Vision Res 2016; 130:9-21. [PMID: 27876513 DOI: 10.1016/j.visres.2016.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 11/09/2016] [Accepted: 11/14/2016] [Indexed: 11/21/2022]
Abstract
Children with a progressing myopia exhibit an abnormal pattern of high accommodative lags coupled with high accommodative convergence (AC/A) and high accommodative adaptation. This is not predicted by the current models of accommodation and vergence. Reduced accommodative plant gain and reduced sensitivity to blur have been suggested as potential causes for this abnormal behavior. These etiologies were tested by altering parameters (sensory, controller and plant gains) in the Simulink model of accommodation. Predictions were then compared to the static and dynamic blur accommodation (BA) measures taken using a Badal optical system on 12 children (6 emmetropes and 6 myopes, 8-13years) and 6 adults (20-35years). Other critical parameters such as CA/C, AC/A, and accommodative adaptation were also measured. Usable BA responses were classified as either typical or atypical. Typical accommodation data confirmed the abnormal pattern of myopia along with an unchanged CA/C. Main sequence relationship remained invariant between myopic and nonmyopic children. An overall reduction was noted in the response dynamics such as peak velocity and acceleration with age. Neither a reduced plant gain nor reduced blur sensitivity could predict the abnormal accommodative behavior. A model adjustment reflecting a reduced accommodative sensory gain (ASG) coupled with an increased AC cross-link gain and reduced vergence adaptive gain does predict the empirical findings. Empirical measures also showed a greater frequency of errors in accommodative response generation (atypical responses) in both myopic and control children compared to adults.
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Li SM, Iribarren R, Kang MT, Li H, Li SY, Liu LR, Sun YY, Meng B, Zhan SY, Rozema JJ, Wang N. Corneal Power, Anterior Segment Length and Lens Power in 14-year-old Chinese Children: the Anyang Childhood Eye Study. Sci Rep 2016; 6:20243. [PMID: 26832228 PMCID: PMC4735284 DOI: 10.1038/srep20243] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 12/29/2015] [Indexed: 11/30/2022] Open
Abstract
To analyze the components of young Chinese eyes with special attention to differences in corneal power, anterior segment length and lens power. Cycloplegic refractions and ocular biometry with LENSTAR were used to calculate lens power with Bennett’s method. Mean refraction and mean values for the ocular components of five different refractive groups were studied with ANOVA and post-hoc Scheffé tests. There were 1889 subjects included with full data of refraction and ocular components. As expected, mean axial length was significantly longer in myopic eyes compared to emmetropes. Girls had steeper corneas, more powerful lenses and shorter eyes than boys. Lens power was lower in boys and also lower in myopic eyes. Lens thickness was the same for both genders but was lower in myopic eyes. Although cornea was steeper in myopic eyes in the whole sample, this was a gender effect (more girls in the myopic group) as this difference disappeared when the analysis was split by gender. Anterior segment length was longer in myopic eyes. In conclusion, myopic eyes have lower lens power and longer anterior segment length, that partially compensate their longer axial length. When analyzed by gender, the corneal power is not greater in low and moderate myopic eyes.
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Affiliation(s)
- Shi-Ming Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Rafael Iribarren
- Department of Ophthalmology, San Luis Medical Center, Buenos Aires, Argentina
| | - Meng-Tian Kang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - He Li
- Anyang Eye Hospital, Henan Province, China
| | - Si-Yuan Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Luo-Ru Liu
- Anyang Eye Hospital, Henan Province, China
| | - Yun-Yun Sun
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Bo Meng
- Department of Epidemiology and Health Statistics, Peking University School of Public Health, Beijing, China
| | - Si-Yan Zhan
- Department of Epidemiology and Health Statistics, Peking University School of Public Health, Beijing, China
| | - Jos J Rozema
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium.,Department of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Laughton DS, Coldrick BJ, Sheppard AL, Davies LN. A program to analyse optical coherence tomography images of the ciliary muscle. Cont Lens Anterior Eye 2015; 38:402-8. [DOI: 10.1016/j.clae.2015.05.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 05/08/2015] [Accepted: 05/13/2015] [Indexed: 11/28/2022]
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Affiliation(s)
- W Neil Charman
- Faculty of Life Sciences, University of Manchester, Manchester, UK
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Wu C, Han Z, Wang S, Li J, Singh M, Liu CH, Aglyamov S, Emelianov S, Manns F, Larin KV. Assessing age-related changes in the biomechanical properties of rabbit lens using a coaligned ultrasound and optical coherence elastography system. Invest Ophthalmol Vis Sci 2015; 56:1292-300. [PMID: 25613945 DOI: 10.1167/iovs.14-15654] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
PURPOSE To evaluate the capability of a novel, coaligned focused ultrasound and phase-sensitive optical coherence elastography (US-OCE) system to assess age-related changes in biomechanical properties of the crystalline lens in situ. METHODS Low-amplitude elastic deformations in young and mature rabbit lenses were measured by an US-OCE system consisting of a spectral-domain optical coherence tomography (OCT) system coaligned with a focused ultrasound system used to produce a transient force on the lens surface. Uniaxial compressional tests were used to validate the OCE data. RESULTS The OCE measurements showed that the maximum displacements of the young rabbit lenses were significantly larger than those of the mature lenses, indicating a gradual increase of the lens stiffness with age. Temporal analyses of the displacements also demonstrate a similar trend of elastic properties in these lenses. The stress-strain measurements using uniaxial mechanical tests confirmed the results obtained by the US-OCE system. CONCLUSIONS The results demonstrate that the US-OCE system can be used for noninvasive analysis and quantification of lens biomechanical properties in situ and possibly in vivo.
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Affiliation(s)
- Chen Wu
- Department of Biomedical Engineering, University of Houston, Houston, Texas, United States
| | - Zhaolong Han
- Department of Biomedical Engineering, University of Houston, Houston, Texas, United States
| | - Shang Wang
- Department of Biomedical Engineering, University of Houston, Houston, Texas, United States Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, Texas, United States
| | - Jiasong Li
- Department of Biomedical Engineering, University of Houston, Houston, Texas, United States
| | - Manmohan Singh
- Department of Biomedical Engineering, University of Houston, Houston, Texas, United States
| | - Chih-Hao Liu
- Department of Biomedical Engineering, University of Houston, Houston, Texas, United States
| | - Salavat Aglyamov
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, United States
| | - Stanislav Emelianov
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, United States
| | - Fabrice Manns
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, United States Biomedical Optics and Laser Laboratory, Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, Florida, United States
| | - Kirill V Larin
- Department of Biomedical Engineering, University of Houston, Houston, Texas, United States Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, Texas, United States
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Sreenivasan V, Irving EL, Bobier WR. Can current models of accommodation and vergence predict accommodative behavior in myopic children? Vision Res 2014; 101:51-61. [DOI: 10.1016/j.visres.2014.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 04/23/2014] [Accepted: 05/26/2014] [Indexed: 11/26/2022]
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