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Ma L, Li X, Hu J, Li Y, Wang S, Wang K, Zhao M. Influence of a long-distance optical imaging workbench on accommodation and choroidal response in myopic children. Clin Exp Optom 2024; 107:420-427. [PMID: 37406457 DOI: 10.1080/08164622.2023.2228810] [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: 12/02/2022] [Revised: 05/30/2023] [Accepted: 06/20/2023] [Indexed: 07/07/2023] Open
Abstract
CLINICAL RELEVANCE Optical approaches to modulating near work may be beneficial in arresting the progression of myopia. BACKGROUND To explore whether a long-distance optical image workbench (LOIW) can replace traditional near-distance reading and has beneficial influences on accommodation and choroidal parameters. METHODS This self-control study included two sessions. In session 1, an open-field autorefractor measured sustained accommodative response and pupil diameter when participants viewed virtual images from 3.42 m away through LOIW with + 0.50 D over-correction lenses (3.42 m/+0.50 D), LOIW with full-correction lenses (3.42 m/FC), or the visual target at a given distance of 0.33 m with + 0.50 D over-correction lenses (0.33 m/+0.50 D), with full-correction lenses (0.33 m/FC). In session 2, swept-source optical coherence tomography angiography assessed subfoveal choroidal thickness (SFChT), choroidal volume (CV), and choriocapillaris flow void percentage (FV%) at baseline and before and after reading via LOIW with + 0.50 D over-correction lenses (Far/+0.50 D) or in habitual near distance with full-correction (Near/FC) for a sustained 30-min period. RESULTS Thirty-five myopic (mean spherical equivalent refraction: -1.11 ± 0.78 D) children (median [range] age: 8.36 [8-10] years) were analysed. Children viewing virtual images in 3.42 m/+0.50 D exhibited mild-degree accommodative leads (-0.54 ± 0.17 D), much smaller pupil diameter (3.39 ± 0.63 mm) and microfluctuations (0.13 ± 0.04 D); accommodative lags (0.88 ± 0.04 D), larger pupil diameter (5.05 ± 0.75 mm) and microfluctuations (0.88 ± 0.16 D) were observed in 0.33 m/+0.50 D, and the microfluctuations were unstable (F = 2.185, p = 0.038). Compared with baseline data, SFChT, CV, and FV% changed by 13.40 ± 4.71 μm, 0.26 ± 0.21 mm3, and - 0.14%±3.66% in Far/+0.50 D, respectively, while changes under Near/FC were - 10.19 ± 7.48 μm, -0.15 ± 0.22 mm3 and 1.95%±2.92%, respectively. All changes differed significantly between these two conditions (all p < 0.001). CONCLUSION The long-distance working mode may exert beneficial effects on accommodative and choroidal parameters in myopic children compared with traditional near work.
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Affiliation(s)
- Lu Ma
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Xuewei Li
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Jie Hu
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Yan Li
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
| | - Shanshan Wang
- Beijing Key Laboratory for Precision Optoelectronic Measurement Instrument and Technology, School of Optics and Photonics, Beijing Institute of Technology, Beijing, China
| | - Kai Wang
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Mingwei Zhao
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
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Nilsen NG, Gilson SJ, Pedersen HR, Hagen LA, Wildsoet CF, Baraas RC. The effect of topical 1 % atropine on ocular dimensions and diurnal rhythms of the human eye. Vision Res 2024; 214:108341. [PMID: 38065032 DOI: 10.1016/j.visres.2023.108341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 11/10/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023]
Abstract
The effect of topical 1 % atropine on the diurnal rhythms of the human eye was investigated. Participants wore an activity monitor on Days 1-7. A set of measures (epochs) encompassing intraocular pressure (IOP), ocular biometry, and retinal imaging were obtained on Day 7 (baseline), followed by eight epochs on Day 8, and one on Day 9 from both eyes of healthy participants (n = 22, 19-25 years). The sleep time of participants (collected via actigraphy) was used as a reference in scheduling epochs. Topical 1 % atropine was instilled in the dominant eye on Day 8, 2 h after habitual wake time, using the fellow eye as control (paired-eye design). Sinusoids with a 24-h period were fitted to the data, and a non-linear mixed-effects model was used to estimate rhythmic statistics. There were no interocular differences in any of the measured parameters at baseline. Comparing pre- versus post-atropine in treated eyes revealed lower IOP, deeper anterior chamber (ACD), decreased crystalline lens thickness and shorter axial length (AL). The same trends were observed when comparing atropine-treated versus fellow control eyes, except for IOP and AL (no differences). Both atropine-treated and fellow control eyes showed significant diurnal variations in all ocular parameters, with atropine-treated eyes revealing larger AL and retinal thickness amplitudes, smaller vitreous chamber depth (VCD) amplitudes, and a significant phase advancement for ACD and VCD. There were no interocular differences in choroidal thickness rhythms. In conclusion, while ocular diurnal rhythms persisted after instillation of 1 % atropine, many rhythmic parameters were altered.
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Affiliation(s)
- Nickolai G Nilsen
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Stuart J Gilson
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Hilde R Pedersen
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Lene A Hagen
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Christine F Wildsoet
- Herbert Wertheim School of Optometry & Vision Science, University of California Berkeley, USA
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway.
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Redondo B, Serramito M, Vera J, Alguacil-Espejo M, Rubio-Martínez M, Molina R, Jiménez R. Diurnal Variation in Accommodation, Binocular Vergence, and Pupil Size. Optom Vis Sci 2023; 100:847-854. [PMID: 38019970 DOI: 10.1097/opx.0000000000002091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
SIGNIFICANCE Our results show significant diurnal variations in accommodative function and the magnitude of the phoria. Therefore, when comparing visual measures in clinical or laboratory settings, performing the visual examination at the same time of day (±1 hour) is encouraged. PURPOSE The aim of this study was to evaluate the accommodation, binocular vergence, and pupil behavior on three different times during the day. METHODS Twenty collegiate students (22.8 ± 2.1 years) participated in this study. Participants visited the laboratory on three different days at 2-hourly intervals (morning, 9:00 to 11:00 am ; afternoon, 2:00 to 4:00 pm ; evening, 7:00 to 9:00 pm ). The binocular vergence and accommodative function were measured using clinical optometric procedures, and the accommodative response and pupil function were evaluated in binocular conditions using the WAM-5500 autorefractometer. RESULTS The accommodative amplitude for the right and left eyes showed statistically significant differences for the time interval ( P = .001 and P = .02, respectively), revealing higher accommodative amplitude in the morning and afternoon in comparison with the evening. Participants were more esophoric when assessed in the morning in comparison with the evening at far and near ( P = .02 and P = .01, respectively) and when assessed in the afternoon in comparison with the evening at far distance ( P = .02). The magnitude of accommodative response was higher in the morning, and it decreased throughout the day at 500 ( P < .001), 40 ( P = .05), and 20 cm ( P < .001). No statistically significant differences were obtained for any other variable. CONCLUSIONS This study shows small diurnal variations in some accommodative and binocular vergence parameters, but no effects were observed for the pupil response. These outcomes are of special relevance for eye care specialists when performing repeated accommodative or binocular vergence measures. However, the diurnal variations were modest and may not influence a routine orthoptic examination.
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Affiliation(s)
| | - María Serramito
- Ocupharm Research Group, Faculty of Optic and Optometry, University Complutense of Madrid, Madrid, Spain
| | | | - Marina Alguacil-Espejo
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Spain
| | - Mercedes Rubio-Martínez
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Spain
| | - Rubén Molina
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Spain
| | - Raimundo Jiménez
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Spain
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Liu XN, Naduvilath TJ, Sankaridurg PR. Myopia and sleep in children-a systematic review. Sleep 2023; 46:zsad162. [PMID: 37381700 PMCID: PMC10639155 DOI: 10.1093/sleep/zsad162] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 05/22/2023] [Indexed: 06/30/2023] Open
Abstract
Worldwide, approximately one in three people are myopic or short-sighted. Myopia in children is of particular concern as younger onset age implies a higher risk of progression, and consequently greater risk of developing vision-threatening complications. The importance of sleep in children's health has long been acknowledged, but evidence for its role in childhood myopia is fairly new and mixed results were presented across studies. To facilitate better understanding of this relationship, a broad literature search, up to and including October 31, 2022, was performed using three databases (PubMed, Embase, and Scopus). Seventeen studies were included in the review, covering four main aspects of sleep, namely duration, quality, timing, and efficiency, and their associations with myopia in children. The present literature review discussed these studies, revealed potential limitations in their methodologies, and identified gaps that need to be addressed in the future. The review also acknowledges that current evidence is insufficient, and the role of sleep in childhood myopia is far from being fully understood. Future studies that primarily, objectively, and accurately assess sleep and myopia, taking other characteristics of sleep beyond duration into consideration, with a more diverse sample in terms of age, ethnicity, and cultural/environmental background, and control for confounders such as light exposure and education load are much needed. Although more research is required, myopia management should be a holistic approach and the inclusion of sleep hygiene in myopia education targeting children and parents ought to be encouraged.
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Affiliation(s)
- Xiao Nicole Liu
- School of Optometry and Vision Science, University of New South Wales, Sydney, SYD, Australia
- Brien Holden Vision Institute Limited, Sydney, SYD, Australia
| | - Thomas John Naduvilath
- School of Optometry and Vision Science, University of New South Wales, Sydney, SYD, Australia
- Brien Holden Vision Institute Limited, Sydney, SYD, Australia
| | - Padmaja R Sankaridurg
- School of Optometry and Vision Science, University of New South Wales, Sydney, SYD, Australia
- Brien Holden Vision Institute Limited, Sydney, SYD, Australia
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Hussain A, Gopalakrishnan A, Scott H, Seby C, Tang V, Ostrin L, Chakraborty R. Associations between systemic melatonin and human myopia: A systematic review. Ophthalmic Physiol Opt 2023; 43:1478-1490. [PMID: 37568264 DOI: 10.1111/opo.13214] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023]
Abstract
PURPOSE Experimental models have implicated the role of melatonin circadian rhythm disruption in refractive error development. Recent studies have examined melatonin concentration and its diurnal patterns on refractive error with equivocal results. This systematic review aimed to summarise the literature on melatonin circadian rhythms in myopia. RECENT FINDINGS PubMed, EMBASE, Web of Science, Scopus, ProQuest Central, LILACS, Cochrane and Medline databases were searched for papers between January 2010 and December 2022 using defined search terms. Seven studies measured melatonin and circadian rhythms in three biological fluids (blood serum, saliva and urine) in both myopes and non-myopes. Morning melatonin concentrations derived from blood serum varied significantly between studies in individuals aged 10-30 years, with a maximum of 89.45 pg/mL and a minimum of 5.43 pg/mL using liquid chromatography and mass spectrometry. The diurnal variation of salivary melatonin was not significantly different between myopes and emmetropes when measured every 4 h for 24 h and quantified with enzyme-linked immunosorbent assay. Significantly elevated salivary melatonin concentrations were reported in myopes compared with emmetropes, aged 18-30 years when measured hourly from evening until their habitual bedtime using liquid chromatography. However, the relationship between dim light melatonin onset and refractive group was inconsistent between studies. The 6-sulphatoxymelatonin concentration derived from overnight urine volume, measured using a double antibody radioimmunoassay, was found to be significantly lower in myopes (29.17 pg/mL) than emmetropes (42.51 pg/mL). SUMMARY The role of melatonin concentration and rhythm in myopia has not been studied extensively. This systematic review confirms conflicting findings across studies, with potential relationships existing. Future studies with uniform methodological approaches are required to ascertain the causal relationship between melatonin dysregulation and myopia in humans.
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Affiliation(s)
- Azfira Hussain
- Myopia Clinic, Unit of Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Aparna Gopalakrishnan
- Myopia Clinic, Unit of Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Hannah Scott
- Flinders Health and Medical Research Institute: Sleep Health, Flinders University, Adelaide, South Australia, Australia
| | - Chris Seby
- Caring Futures Institute, Myopia and Visual Development Lab, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Victoria Tang
- Caring Futures Institute, Myopia and Visual Development Lab, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Lisa Ostrin
- College of Optometry, University of Houston, Houston, Texas, USA
| | - Ranjay Chakraborty
- Caring Futures Institute, Myopia and Visual Development Lab, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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Fulton JM, Flanagan SC, Sittlington JJ, Cobice D, Dobbin S, McCullough SJ, Orr G, Richardson P, Saunders KJ. A Cross-Sectional Study of Myopia and Morning Melatonin Status in Northern Irish Adolescent Children. J Ophthalmol 2023; 2023:7961623. [PMID: 37946723 PMCID: PMC10632006 DOI: 10.1155/2023/7961623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 11/12/2023] Open
Abstract
Purpose Previous studies have demonstrated an association between melatonin status and both refractive error and axial length in young adult myopes. This study aimed to determine if this relationship extends to a younger adolescent cohort. Methods Healthy children aged 12-15 years provided morning saliva samples before attending Ulster University (55°N) for cycloplegic autorefraction and axial length measures. Participants completed questionnaires describing recent sleep habits and physical activity. Salivary melatonin was quantified using high-performance liquid chromatography-tandem mass spectrometry. Data collection for all participants occurred over a 1-week period (April 2021). Results Seventy participants aged 14.3 (95% CI: 14.2-14.5) years were categorised by spherical equivalent refraction [SER] (range: -5.38DS to +1.88DS) into two groups; myopic SER ≤ -0.50DS (n = 22) or nonmyopic -0.50DS < SER ≤ +2.00DS (n = 48). Median morning salivary melatonin levels were 4.52 pg/ml (95% CI: 2.60-6.02) and 4.89 pg/ml (95% CI: 3.18-5.66) for myopic and nonmyopic subjects, respectively, and did not differ significantly between refractive groups (P = 0.91). Melatonin levels were not significantly correlated with SER, axial length, sleep, or activity scores (Spearman's rank, all P > 0.39). Higher levels of physical activity were associated with higher sleep quality (Spearman's rank, ρ = -0.28, P = 0.02). Conclusion The present study found no significant relationship between morning salivary melatonin levels and refractive error or axial length in young adolescents. This contrasts with outcomes from a previous study of adults with comparable methodology, season of data collection, and geographical location. Prospective studies are needed to understand the discrepancies between adult and childhood findings and evaluate whether melatonin levels in childhood are indicative of an increased risk for future onset of myopia and/or faster axial growth trajectories and myopia progression in established myopes. Future work should opt for a comprehensive dim-light melatonin onset protocol to determine circadian phase.
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Affiliation(s)
- Jane M. Fulton
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Sarah C. Flanagan
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Julie J. Sittlington
- Nutrition Innovation Centre for Food and Health (NICHE), Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Diego Cobice
- Mass Spectrometry Centre, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Sara Dobbin
- Mass Spectrometry Centre, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Sara J. McCullough
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Gareth Orr
- Mass Spectrometry Centre, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Patrick Richardson
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Kathryn J. Saunders
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
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Hönekopp A, Weigelt S. Using Light Meters to Investigate the Light-Myopia Association - A Literature Review of Devices and Research Methods. Clin Ophthalmol 2023; 17:2737-2760. [PMID: 37743889 PMCID: PMC10517690 DOI: 10.2147/opth.s420631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
With the increasing prevalence of myopia, evaluating its relationship with objective light exposure as a potential adjustable environmental factor in myopia development has been an emerging research field in recent years. From a thorough literature search, we identify ten wearable light meters from human studies on light exposure and myopia and present an overview of their parameters, thereby demonstrating the wide between-device variability and discussing its implications. We further identify 20 publications, including two reanalyses, reporting investigations of light-myopia associations with data from human subjects wearing light meters. We thoroughly review the publications with respect to general characteristics, aspects of data collection, participant population, as well as data analysis and interpretation, and also assess potential patterns regarding the absence or presence of light-myopia associations in their results. In doing so, we highlight areas in which more research is needed as well as several aspects that warrant consideration in the study of light exposure and myopia.
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Affiliation(s)
- Astrid Hönekopp
- Department of Rehabilitation Sciences, Research Unit Vision, Visual Impairments & Blindness, TU Dortmund University, Dortmund, Germany
| | - Sarah Weigelt
- Department of Rehabilitation Sciences, Research Unit Vision, Visual Impairments & Blindness, TU Dortmund University, Dortmund, Germany
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Gyawali P, Jnawali A, Kharal A, Subedi M, Kandel S, Puri PR, Paudel N. SubFoveal Choroidal Imaging in High Myopic Nepalese Cohort. J Ophthalmol 2023; 2023:2209496. [PMID: 37215947 PMCID: PMC10195179 DOI: 10.1155/2023/2209496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 03/31/2023] [Accepted: 04/21/2023] [Indexed: 05/24/2023] Open
Abstract
Purpose Evidence suggests that choroid is thinner in myopes as compared to nonmyopes. However, choroidal thickness varies with the refractive error, age, axial length, and ethnicity. The purpose of this study was to determine the subfoveal choroidal thickness (SFCT) in high myopic Nepalese subjects and to investigate its association with the mean spherical equivalent refractive error (MSE), axial length, and age. Methods Ninety-two eyes of 92 high myopic subjects (MSE ≤ -6 diopters) and 83 eyes of 83 emmetropic subjects (MSE: 0.00 Diopters) were included in the study. SFCT was assessed using spectral domain optical coherence tomography, and the axial length was measured using partial coherence interferometry. SFCT was measured manually using the inbuilt tool within the imaging software. Results SFCT in the high myopic subjects was significantly thinner (mean ± SD: 224.17 ± 68.91 μm) as compared to the emmetropic subjects (353.24 ± 65.63 μm) (mean difference, 127.76 ± 130.80 μm, and p < 0.001). In high myopic subjects, there was a significant negative correlation of choroidal thickness with the axial length (rho = -0.75; p < 0.001) and MSE (rho = -0.404; p < 0.01). Regression analysis demonstrated a decrease of choroidal thickness by 40.32 μm (p < 0.001) for every 1 millimeter increase in the axial length and by 11.65 μm (p < 0.001) for every 1 diopter increase in the MSE. Conclusion High myopic Nepalese subjects had significantly thinner choroid as compared to emmetropes. The MSE and axial length were inversely correlated with the SFCT. Age had no effect on SFCT in this study. These findings may have implications in interpreting choroidal thickness values in clinical and epidemiological studies in myopes, especially in the south Asian population.
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Affiliation(s)
- Parash Gyawali
- B. P. Koirala Lions Center for Ophthalmic Studies, Institute of Medicine, Tribhuvan University, Kirtipur, Nepal
| | - Ashutosh Jnawali
- B. P. Koirala Lions Center for Ophthalmic Studies, Institute of Medicine, Tribhuvan University, Kirtipur, Nepal
| | - Anish Kharal
- College of Optometry, The University of Houston, Houston, Texas, USA
| | - Manish Subedi
- B. P. Koirala Lions Center for Ophthalmic Studies, Institute of Medicine, Tribhuvan University, Kirtipur, Nepal
| | | | - Prajjol Raj Puri
- B. P. Koirala Lions Center for Ophthalmic Studies, Institute of Medicine, Tribhuvan University, Kirtipur, Nepal
| | - Nabin Paudel
- Centre for Eye Research Ireland, Technological University Dublin, Dublin, Ireland
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Xu S, Zong Z, Zhu Y, Zhang X, Zhang Y, Wang X, Tao S, Wu X, Tao F. Association between sleep-wake schedules and myopia among Chinese school-aged children and adolescents: a cross-sectional study. BMC Ophthalmol 2023; 23:135. [PMID: 37013536 PMCID: PMC10071756 DOI: 10.1186/s12886-023-02874-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 03/21/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND This study aimed to investigate the relationship between sleep-wake schedules and self-reported myopia in the pediatric population. METHODS In this cross-sectional study in 2019, school-aged children and adolescents in the Baoan District of Shenzhen City were sampled using a stratified cluster sampling approach. Sleep-wake schedules of children were determined by a self-administered questionnaire. The age that participants first reported using myopia correction glasses or contact lenses was used to identify those with myopia. Pearson χ2 test was used to examine differences in myopia prevalence among participants with different characteristics. Multivariate logistic regression, adjusted for potential confounding variables, was applied to examine the relationship between sleep-wake schedule and risk of self-reported myopia, and a stratification analysis by school grade was also performed. RESULTS A total of 30,188 students were recruited. In this study, the overall prevalence of myopia was 49.8%, with prevalence rates of 25.6%, 62.4%, and 75.7% for primary, junior high, and senior high school students, respectively. Students with irregular sleep-wake times reported a higher prevalence of myopia than those with regular sleep-wake times. Nighttime sleep duration of < 7 hours/day (h/d) (OR = 1.27, 95%CI: 1.17-1.38), no daytime nap (OR = 1.10, 95%CI: 1.03-1.18), irregular weekday bedtime (OR = 1.11, 95%CI: 1.05-1.17), irregular weekday wake time (OR = 1.21, 95%CI: 1.12-1.30), weekend bedtime delayed > = 1 h/d (OR = 1.20, 95%CI: 1.11-1.29, P < 0.001), weekend wake time delayed > = 1 h/d (OR = 1.11, 95%CI: 1.03-1.19), irregular sleep-wake time on weekdays (OR = 1.13, 95%CI: 1.07-1.19), and social jetlag > = 1 h (OR = 1.08, 95%CI: 1.03-1.14) were likely to be associated with increased risks of self-reported myopia after adjusting age, sex, grade, parental education level, family income, parental myopia, academic record, and academic workload. When stratified by school grade, we observed that nighttime sleep duration < 7 h/d, no daytime naps, and irregular sleep-wake time on weekdays were significantly associated with self-reported myopia in primary school students. CONCLUSION Insufficient sleep and irregular sleep-wake schedules can increase the risk of self-reported myopia in children and adolescents.
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Affiliation(s)
- Shaojun Xu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 230032, Hefei, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), 230032, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, 230032, Hefei, Anhui, China
| | - Zhiqiang Zong
- The Second School of Clinical Medicine, Anhui Medical University, 230032, Hefei, Anhui, China
| | - Yi Zhu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 230032, Hefei, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), 230032, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, 230032, Hefei, Anhui, China
| | - Xindong Zhang
- Baoan District Center for Disease Control and Prevention, 518101, Shenzhen, Guangdong, China
| | - Yi Zhang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 230032, Hefei, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), 230032, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, 230032, Hefei, Anhui, China
| | - Xi Wang
- Baoan District Center for Disease Control and Prevention, 518101, Shenzhen, Guangdong, China
| | - Shuman Tao
- MOE Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), 230032, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, 230032, Hefei, Anhui, China
- Department of Ophthalmology, The Second Hospital of Anhui Medical University, 230601, Hefei, Anhui, China
| | - Xiaoyan Wu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 230032, Hefei, Anhui, China
- MOE Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), 230032, Hefei, Anhui, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, 230032, Hefei, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 230032, Hefei, Anhui, China.
- MOE Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), 230032, Hefei, Anhui, China.
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, 230032, Hefei, Anhui, China.
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10
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Lal B, Alonso-Caneiro D, Read SA, Carkeet A. Diurnal changes in choroidal optical coherence tomography angiography indices over 24 hours in healthy young adults. Sci Rep 2023; 13:3551. [PMID: 36864086 PMCID: PMC9981752 DOI: 10.1038/s41598-023-30433-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 02/22/2023] [Indexed: 03/04/2023] Open
Abstract
This prospective study investigated the magnitude and pattern of variation in choroidal optical coherence tomography angiography (OCT-A) indices every 4 h over 24 h in healthy young myopic (n = 24) and non-myopic (n = 20) adults. Choriocapillaris and deep choroid en-face images from macular OCT-A scans were analysed from each session to extract magnification-corrected vascular indices including choriocapillaris flow deficit number, size and density and deep choroid perfusion density in the sub-foveal, sub-parafoveal, and sub-perifoveal regions. Choroidal thickness was also obtained from structural OCT scans. Significant variations over 24 h (P < 0.05) were observed in most of the choroidal OCT-A indices excluding sub-perifoveal flow deficit number, with peaks observed between 2 to 6 AM. For myopes, peaks occurred significantly earlier (3-5 h), and the diurnal amplitude was significantly greater for sub-foveal flow deficit density (P = 0.02) and deep choroidal perfusion density (P = 0.03) compared with non-myopes. Choroidal thickness also showed significant diurnal changes (P < 0.05) with peaks between 2 to 4 AM. Significant correlations were found between diurnal amplitudes or acrophases of choroidal OCT-A indices and choroidal thickness, intraocular pressure, and systemic blood pressure. This provides the first comprehensive diurnal assessment of choroidal OCT-A indices over 24 h.
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Affiliation(s)
- Barsha Lal
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia.
| | - David Alonso-Caneiro
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Scott A Read
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Andrew Carkeet
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
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11
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Zhang C, Zhu Z, Zhao J, Li Y, Zhang Z, Zheng Y. Ubiquitous light-emitting diodes: Potential threats to retinal circadian rhythms and refractive development. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 862:160809. [PMID: 36502986 DOI: 10.1016/j.scitotenv.2022.160809] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/08/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
The use of light-emitting diodes (LEDs) has increased considerably in the 21st century with humans living in a modern photoperiod with brighter nights and dimmer days. Prolonged exposure to LEDs, especially at night, is considered a new source of pollution because it may affect the synthesis and secretion of retinal melatonin and dopamine, resulting in negative impacts on retinal circadian clocks and potentially disrupting retinal circadian rhythms. The control of ocular refraction is believed to be related to retinal circadian rhythms. Moreover, the global prevalence of myopia has increased at an alarming rate in recent decades. The widespread use of LEDs and the rapid increase in the prevalence of myopia overlap, which is unlikely to be a coincidence. The connection among LEDs, retinal circadian rhythms, and refractive development is both fascinating and confusing. In this review, we aim to develop a systematic framework that includes LEDs, retinal circadian rhythms and refractive development. This paper summarizes the possible mechanisms by which LEDs may disrupt retinal circadian rhythms. We propose that prolonged exposure to LEDs may induce myopia by disrupting retinal circadian rhythms. Finally, we suggest several possible countermeasures to prevent LED interference on retinal circadian rhythms, with the hope of reducing the onset and progression of myopia.
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Affiliation(s)
- Chenchen Zhang
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun 130000, China
| | - Zhe Zhu
- Department of Ophthalmology, Eye Hospital of Shandong First Medical University, Shandong Eye Institute, Jinan 250000, China
| | - Jing Zhao
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun 130000, China
| | - Yanxia Li
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun 130000, China
| | - Zhaoying Zhang
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun 130000, China
| | - Yajuan Zheng
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun 130000, China.
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12
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Hvid-Hansen A, Jacobsen N, Møller F, Bek T, Ozenne B, Kessel L. Myopia Control with Low-Dose Atropine in European Children: Six-Month Results from a Randomized, Double-Masked, Placebo-Controlled, Multicenter Study. J Pers Med 2023; 13:jpm13020325. [PMID: 36836559 PMCID: PMC9960354 DOI: 10.3390/jpm13020325] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 02/16/2023] Open
Abstract
The effect and safety of low-dose atropine in myopia control have not been studied in randomized, placebo-controlled trials outside Asia. We investigated the efficacy and safety of 0.1% atropine loading dose and 0.01% atropine compared with a placebo in a European population. Investigator-initiated, randomized, double-masked, placebo-controlled, equal-allocation, multicenter study comparing 0.1% atropine loading dose (six months) followed by 0.01% atropine (18 months), 0.01% atropine (24 months), and placebo (24 months). Participants were monitored for a 12-months washout period. Outcome measures were axial length (AL), cycloplegic spherical equivalent (SE), photopic and mesopic pupil size, accommodation amplitude, visual acuity, intraocular pressure (IOP), and adverse reactions and events. We randomized 97 participants (mean [standard deviation] age, 9.4 [1.7] years; 55 girls (57%) and 42 boys (43%)). After six months, AL was 0.13 mm shorter (95% confidence interval [CI], -0.18 to -0.07 [adjusted p < 0.001]) with 0.1% atropine loading dose and 0.06 mm shorter (95% CI, -0.11 to -0.01 [adjusted p = 0.06]) with 0.01% atropine than in the placebo group. We observed similar dose-dependent changes in SE, pupil size, accommodation amplitude, and adverse reactions. No significant differences in visual acuity or IOP were found between groups, and no serious adverse reactions were reported. We found a dose-dependent effect of low-dose atropine in European children without adverse reactions requiring photochromatic or progressive spectacles. Our results are comparable to those observed in East Asia, indicating that results on myopia control with low-dose atropine are generalizable across populations with different racial backgrounds.
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Affiliation(s)
- Anders Hvid-Hansen
- Department of Ophthalmology, Copenhagen University Hospital—Rigshospitalet-Glostrup, DK-2600 Glostrup, Denmark
- Correspondence:
| | - Nina Jacobsen
- Department of Ophthalmology, Copenhagen University Hospital—Rigshospitalet-Glostrup, DK-2600 Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, DK-2200 København N, Denmark
| | - Flemming Møller
- Department of Ophthalmology, University Hospital of Southern Denmark—Vejle Hospital, DK-7100 Vejle, Denmark
| | - Toke Bek
- Department of Ophthalmology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Brice Ozenne
- Department of Public Health, Section of Biostatistics, University of Copenhagen, DK-1014 København K, Denmark
- Neurobiology Research Unit, Copenhagen University Hospital—Rigshospitalet, DK-2200 København N, Denmark
| | - Line Kessel
- Department of Ophthalmology, Copenhagen University Hospital—Rigshospitalet-Glostrup, DK-2600 Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, DK-2200 København N, Denmark
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13
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Huang L, Chen X, Lin J, Fan X, Chen T, Yu Y, Chen J, Hu J. Association between sleep duration and myopia among Chinese children during the COVID-19 pandemic: A cross-sectional study. Front Public Health 2023; 10:1015138. [PMID: 36699911 PMCID: PMC9868807 DOI: 10.3389/fpubh.2022.1015138] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
Background The studies on the association between sleep duration and myopia are limited, and the evidence is inconsistent. This study aimed to evaluate the association between sleep duration and myopia, cycloplegic spherical equivalent (SE) and axial length (AL) among Chinese children during the Corona Virus Disease 2019 (COVID-19) pandemic. Methods The study was a cross-sectional study on Chinese children aged 6-18 years. The comprehensive ophthalmic examinations for children included cycloplegic SE, AL, and standardized questionnaires. The questionnaire included sleep duration, parental myopia, outdoor time, and continuous near work duration without breaks. Myopia was defined as SE ≤-0.50 diopters (D). Results A total of 1,140 children were included in the analyses, with 84.7% of myopic children and 74.4% of children's daily sleep duration being more than 8 h/d. In univariate regression analysis, compared with sleep duration < 8 h/d, children with sleep duration of 8-9 and >9 h/d were less myopia (p < 0.01 for all), and had less myopic SE (p < 0.01 for all), and shorter AL (p < 0.01 for all). After adjusting for age, gender, parental myopia, outdoor time, and continuous near work duration without breaks, sleep duration was not associated with myopia, cycloplegic SE, and AL (p > 0.05 for all). Conclusions This study showed sleep duration was related to myopia, cycloplegic SE, and AL among Chinese children during the COVID-19 pandemic-related lifestyles, but no independent association.
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Affiliation(s)
- Luoming Huang
- Department of Ophthalmology and Optometry, The School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, China,The Research Center for Juvenile Myopia Prevention and Control of Fujian Province, Fuzhou, China
| | - Xuelan Chen
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China,The Research Center for Juvenile Myopia Prevention and Control of Fujian Province, Fuzhou, China,Engineering Research Center of Assistive Technology for Visual Impairment, Fujian Province University, Quanzhou, China
| | - Jiajia Lin
- Eye Institute and Affiliated Xiamen Eye Center of Xiamen University, Xiamen, China
| | | | - Ting Chen
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China,The Research Center for Juvenile Myopia Prevention and Control of Fujian Province, Fuzhou, China,Engineering Research Center of Assistive Technology for Visual Impairment, Fujian Province University, Quanzhou, China
| | - Yang Yu
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China,The Research Center for Juvenile Myopia Prevention and Control of Fujian Province, Fuzhou, China,Engineering Research Center of Assistive Technology for Visual Impairment, Fujian Province University, Quanzhou, China
| | - Jiaxin Chen
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China,The Research Center for Juvenile Myopia Prevention and Control of Fujian Province, Fuzhou, China,Engineering Research Center of Assistive Technology for Visual Impairment, Fujian Province University, Quanzhou, China
| | - Jianmin Hu
- Department of Ophthalmology and Optometry, The School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, China,Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China,The Research Center for Juvenile Myopia Prevention and Control of Fujian Province, Fuzhou, China,Engineering Research Center of Assistive Technology for Visual Impairment, Fujian Province University, Quanzhou, China,*Correspondence: Jianmin Hu ✉
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14
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Nilsen NG, Gilson SJ, Pedersen HR, Hagen LA, Knoblauch K, Baraas RC. Seasonal Variation in Diurnal Rhythms of the Human Eye: Implications for Continuing Ocular Growth in Adolescents and Young Adults. Invest Ophthalmol Vis Sci 2022; 63:20. [PMID: 36282117 PMCID: PMC9617503 DOI: 10.1167/iovs.63.11.20] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Purpose To investigate the diurnal rhythms in the human eye in winter and summer in southeast Norway (latitude 60°N). Methods Eight measures (epochs) of intraocular pressure, ocular biometry, and optical coherence tomography were obtained from healthy participants (17–24 years of age) on a mid-winter's day (n = 35; 6 hours of daylight at solstice) and on a day the following summer (n = 24; 18 hours of daylight at solstice). Participants wore an activity monitor 7 days before measurements. The epochs were scheduled relative to the individual's habitual wake and sleep time: two in the day (morning and midday) and six in the evening (every hour until and 1 hour after sleep time). Saliva was collected for melatonin. A linear mixed-effects model was used to determine significant diurnal variations, and a sinusoid with a 24-hour period was fitted to the data with a nonlinear mixed-effects model to estimate rhythmic statistics. Results All parameters underwent significant diurnal variation in winter and summer (P < 0.002). A 1-hour phase advance was observed for melatonin and ocular axial length in the summer (P < 0.001). The degree of change in axial length was associated with axial length phase advance (R2 = 0.81, P < 0.001) and choroidal thickening (R2 = 0.54, P < 0.001) in summer. Conclusions Diurnal rhythms in ocular biometry appear to be synchronized with melatonin secretion in both winter and summer, revealing seasonal variation of diurnal rhythms in young adult eyes. The association between axial length and seasonal changes in the phase relationships between ocular parameters and melatonin suggests a between-individual variation in adaptation to seasonal changes in ocular diurnal rhythms.
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Affiliation(s)
- Nickolai G Nilsen
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Stuart J Gilson
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Hilde R Pedersen
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Lene A Hagen
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Kenneth Knoblauch
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway.,Stem-Cell and Brain Research Institute, INSERM U1208, Bron, France.,Université de Lyon, Université Lyon I, Lyon, France
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
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15
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Fan S, Gulati V, Neely DG, Andersen A, Toris CB. Changes in Ocular Biometric Parameters Over a 24-Hour Period in Ocular Hypertensive Patients. J Ocul Pharmacol Ther 2022; 38:489-495. [PMID: 35856838 PMCID: PMC9508877 DOI: 10.1089/jop.2021.0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 06/05/2022] [Indexed: 11/12/2022] Open
Abstract
Purpose: To identify 24-h changes in ocular biometric parameters in subjects with ocular hypertension (OHT), and to determine if an intraocular pressure (IOP)-lowering drug alters these parameters. Methods: Thirty volunteers with OHT (58.6 ± 9.2 years of age) were enrolled in this randomized, double-masked, placebo-controlled, crossover study. Participants self-administered 0.2% brimonidine or placebo 3 times daily for 6 weeks. Measurements of seated and supine IOP, central cornea thickness (CCT), anterior chamber depth (ACD), axial length (AXL), and lens thickness were made at 8 am, 3 pm, 8 pm, and 3 am. Statistical tests were Student's 2-tailed paired t-tests or 2-way analysis of variance (ANOVA) followed by one-way ANOVA and post hoc testing. Results: Time of day had a significant effect on IOP, CCT, ACD, and AXL. In placebo-treated eyes, CCT was greater at 3 am than at any other time (P < 0.01), ACD and AXL were greater at 3 am and 8 pm than at 3 pm (P < 0.01). Daytime IOPs were higher than nighttime (seated, P = 0.007; supine, P = 0.018), and supine IOP at night was higher than seated IOP during the day (P < 0.001). Brimonidine did not lower IOP at night nor did it alter the 24-h patterns of CCT, ACD, and AXL. Conclusions: Ocular biometric parameters exhibit characteristic 24-h fluctuations in patients with OHT. At night compared with day, the supine IOP increases, the cornea thickens, the anterior chamber deepens, and the AXL increases. Brimonidine does not alter these parameters at times when it lowers IOP (day) nor when it does not (night). Clinical Trial Registration number: NCT0132419.
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Affiliation(s)
- Shan Fan
- Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Vikas Gulati
- Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Donna G. Neely
- Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Austin Andersen
- Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Carol B. Toris
- Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA
- Department of Ophthalmology and Visual Science, The Ohio State University, Omaha, Nebraska, USA
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16
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Relationships between Sleep Duration, Timing, Consistency, and Chronotype with Myopia among School-Aged Children. J Ophthalmol 2022; 2022:7071801. [PMID: 35903175 PMCID: PMC9325560 DOI: 10.1155/2022/7071801] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 06/22/2022] [Indexed: 11/17/2022] Open
Abstract
Background The role of sleep in childhood myopia has been a research focus; however, the existing evidence is conflicting on sleep duration and timing, and as yet, no studies involve sleep consistency and chronotype. This study is done to make multiple-perspective analyses on the associations between sleep variables and myopia. Methods A population-based cross-sectional study was conducted in Shanghai, China, which included 10,142 school-aged children (7–12 years old, 53.2% boys). The Chinese version of the Children's Sleep Habits Questionnaire (CSHQ) was used to assess sleep variables. Propensity score matching was adopted to balance the difference of covariates between nonmyopic and myopic groups. Logistic regression models were implemented to examine the associations between sleep variables and myopia. Results Sleep duration and timing, mainly during weekdays, were correlated with myopia in a dose-dependent pattern, in which longer sleep duration was associated with decreased risk of myopia (9-10 hours/day: odds ratio (OR) = 0.87; ≥10 hours/day: OR = 0.77; by comparison with <9 hours/day); later bedtime (9 pm to 9:30 pm: OR = 1.46; 9:30 pm to 10 pm: OR = 1.51; 10 pm and after: OR = 2.08; by comparison with before 9 pm) and later wake-up time (7 am and after: OR = 1.36; by comparison with before 6:30 am) increased the risk (all P < 0.05). Moreover, longer weekend catch-up sleep duration and intermediate and evening chronotype were positively correlated with myopia, while social jetlag was associated with a lower odds of myopia. All these findings were also similarly observed in the matching sample. Conclusions Multiple dimensions of sleep were involved in childhood myopia. In addition to sleep duration and timing, sleep consistency and chronotype were also strictly related to myopia. More studies are needed to enrich the current evidence, thus further clarifying the association between sleep and childhood myopia.
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17
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Lou L, Ostrin LA. Effects of Monocular Light Deprivation on the Diurnal Rhythms in Retinal and Choroidal Thickness. Invest Ophthalmol Vis Sci 2022; 63:6. [PMID: 35816044 PMCID: PMC9284467 DOI: 10.1167/iovs.63.8.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine the effects of monocular light deprivation on diurnal rhythms in retinal and choroidal thickness. Methods Twenty participants, ages 22 to 45 years, underwent spectral domain optical coherence tomography imaging every three hours, from 8 AM to 8 PM, on two consecutive days. Participants wore an eye patch over the left eye starting at bedtime of day 1 until the end of the last measurement on day 2. Choroidal, total retinal, photoreceptor outer segment + retinal pigment epithelium (RPE), and photoreceptor inner segment thicknesses were determined. Results For both eyes, significant diurnal variations were observed in choroidal, total retinal, outer segment + RPE, and inner segment thickness (P < 0.001). For light-deprived eyes, choroid diurnal variation persisted, although the choroid was significantly thinner at 8 AM and 11 AM (P < 0.01) on day 2 compared to day 1. On the other hand, diurnal variations in retinal thickness were eliminated in the light-deprived eye on day 2 when the eye was patched (P > 0.05). Total retinal and inner segment thicknesses significantly decreased (P < 0.001) and outer segment + RPE thickness significantly increased (P < 0.05) on day 2 compared to day 1. Conclusions Blocking light exposure in one eye abolished the rhythms in retinal thickness, but not in choroidal thickness, of the deprived eye. Findings suggest that the rhythms in retinal thickness are, at least in part, driven by light exposure, whereas the rhythm in choroidal thickness is not impacted by short-term light deprivation.
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Affiliation(s)
- Linjiang Lou
- College of Optometry, University of Houston, Houston, Texas, United States
| | - Lisa A Ostrin
- College of Optometry, University of Houston, Houston, Texas, United States
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18
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Furundaoturan O, Değirmenci C, Akkın C, Demirkılınç Biler E, Üretmen Ö, Nalçacı S, Afrashi F. Evaluation of Choroidal Vascular Index in Amblyopic Patients. Turk J Ophthalmol 2022; 52:168-173. [PMID: 35769903 PMCID: PMC9249111 DOI: 10.4274/tjo.galenos.2021.48275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objectives: To compare subfoveal choroidal thickness (SFCT) and choroidal vascular index (CVI) in patients with hyperopic refractive and strabismic amblyopia and healthy subjects. Materials and Methods: The study included 17 patients with strabismic amblyopia (Group 1), 29 patients with hyperopic refractive amblyopia (Group 2), and 16 eyes of 16 healthy volunteers (Group 3). Best corrected visual acuity was noted in all patients and volunteers. In addition to detailed anterior and posterior segment examinations, macular images were obtained by enhanced-depth imaging mode of optical coherence tomography (OCT). SFCT measurements were made from these images and CVI was calculated using the Image J program. Results: No significant difference was found between the groups in terms of age, gender, and intraocular pressure (p=0.27, 0.64, and 0.85, respectively). Mean BCVAs in Group 1 were 0.57±0.16 (0.3-0.8) in the amblyopic eyes, 0.94±0.08 (0.8-1.0) in the fellow eyes, and in Group 2 were 0.61±0.17 (0.2-0.8) in amblyopic eyes, 0.92±0.1 (0.8-1.0) in fellow eyes. BCVA in Group 3 was 1.0±0 (1.0-1.0). Mean SFCT of the amblyopic eyes in Groups 1 and 2 was 341.50±60.4 (277-481) and 370.06±65.3 (247-462), respectively, and in the healthy eyes of Groups 1 and 2 and Group 3 was 321.92±68.26 (251-440), 330.35±74.00 (194-502), and 327.62±40.79 (238-385), respectively. SFCT was significantly greater in the amblyopic eyes of Group 2 compared to Group 3 (p=0.01). Mean CVI was 0.681±0.032 (0.642-0.736) in the amblyopic eyes and 0.685±0.054 (0.587-0.788) in the fellow eyes of Group 1 patients; 0.664±0.033 (0.592-0.719) in the amblyopic eye and 0.707±0.039 (0.625-0.779) in the fellow eye in Group 2 patients; and 0.689±0.031 (0.612-0.748) in Group 3 patients. CVI was significantly lower in the amblyopic eyes of Group 2 compared with fellow eyes (p=0.02) and Group 3 (p=0.025). Conclusion: Morphological changes may be seen in the choroid in amblyopic eyes. We observed that the choroidal stromal component is increased in hyperopic amblyopic patients especially.
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19
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Fiorito TM, Krilov LR. Diurnal Temperature Variation: Addressing Once-Daily Nighttime Fevers in the Era of COVID-19. Pediatr Ann 2022; 51:e202-e205. [PMID: 35575539 DOI: 10.3928/19382359-20220314-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Pediatric patients with "once-daily" fevers are often referred to pediatric infectious disease specialists for evaluation. Often, these fevers occur at nighttime in the absence of additional symptoms and come to the caregiver's attention after a viral illness. It is crucial for caregivers and providers to be able to define and measure fever accurately when trying to ascertain the true etiology of this clinical picture. Fever education is critical in providing reassurance to parents, and fever diaries should be encouraged. In a well-appearing child without any additional symptoms, at least a percentage of these fevers can be explained by normal diurnal variation of temperature. [Pediatr Ann. 2022;51(5):e202-e205.].
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20
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Lal B, Alonso-Caneiro D, Read SA, Tran B, Van Bui C, Tang D, Fiedler JT, Ho S, Carkeet A. Changes in Retinal Optical Coherence Tomography Angiography Indexes Over 24 Hours. Invest Ophthalmol Vis Sci 2022; 63:25. [PMID: 35348589 PMCID: PMC8976927 DOI: 10.1167/iovs.63.3.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Purpose To evaluate changes in the retinal microvasculature of young adults over 24 hours using optical coherence tomography angiography (OCT-A). Methods Participants (n = 44, mean age 23.2 ± 4.1 years, 24 myopes and 20 nonmyopes) with normal ophthalmological findings were recruited. Two macular OCT-A and OCT scans, systemic blood pressure, intraocular pressure (IOP), and biometry measurements were taken every four hours over 24 hours. Superficial and deep retinal layer en face images were analyzed to extract magnification-corrected vascular indexes using image analysis including foveal avascular zone metrics, vessel density, and perfusion density for the foveal, parafoveal, and perifoveal zones. Results Significant diurnal variations (P < 0.001) were observed in the vessel and perfusion density in the three superficial retinal layer regions, with acrophase between 4:30 PM and 8:30 PM. Only foveal and parafoveal regions of the deep retinal layer exhibited significant diurnal variations with acrophase between 9 AM and 3 PM. Myopes and nonmyopes had different acrophases but not amplitudes in the parafoveal perfusion density of superficial retinal layer (P = 0.039). Significant correlations were observed between diurnal amplitudes or acrophases of superficial retinal layer indexes and systemic pulse pressure, IOP, axial length and retinal thickness. Conclusions This study shows, for the first time, that significant diurnal variation exists in OCT-A indexes of macular superficial and deep retinal layer over 24 hours and were related to variations in various ocular and systemic measurements. Myopes and nonmyopes showed differences in the timing but not in amplitude of the superficial retinal layer parafoveal perfusion density variations but not in deep retinal layer.
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Affiliation(s)
- Barsha Lal
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - David Alonso-Caneiro
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Scott A Read
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Binh Tran
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Cong Van Bui
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Daniel Tang
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Joshua T Fiedler
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Steven Ho
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Andrew Carkeet
- School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
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21
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Lee YS, Choi SE, Hahm J, Kim MJ, Bae HS, Yi K, Lim HT, Hyon JY. Digital Therapeutics: Exploring the Possibilities of Digital Intervention for Myopia. Front Digit Health 2021; 3:710644. [PMID: 34713181 PMCID: PMC8521975 DOI: 10.3389/fdgth.2021.710644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/03/2021] [Indexed: 11/23/2022] Open
Abstract
Pediatric myopia is increasing globally and has become a major public health issue. However, the mechanism of pediatric myopia is still poorly understood, and there is no effective treatment to prevent its progression. Based on results from animal and clinical studies, certain neuronal–humoral factors (NHFs), such as IGF-1, dopamine, and cortisol may be involved in the progression of pediatric myopia. Digital therapeutics uses evidence-based software as therapeutic interventions and it has the potential to offer innovative treatment strategies for pediatric myopia beyond conventional treatment methods. In this perspective article, we introduce digital therapeutics SAT-001, a software algorithm that modulates the level of NHFs to reduce the progression of pediatric myopia. The proposed mechanism is based on a theoretical hypothesis derived from scientific research and clinical studies and will be further confirmed by evidence generated from clinical studies involving pediatric myopia.
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Affiliation(s)
| | | | - Jarang Hahm
- S-Alpha Therapeutics, Inc., Seoul, South Korea
| | - Myoung Joon Kim
- S-Alpha Therapeutics, Inc., Seoul, South Korea.,Renew Seoul Eye Center, Seoul, South Korea
| | | | - Kayoung Yi
- Department of Ophthalmology, Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea
| | - Hyun Taek Lim
- Department of Ophthalmology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea
| | - Joon Young Hyon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul University Bundang Hospital, Seongnam, South Korea
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22
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Kurultay I, Sancakli O. Evaluation of choroidal thickness in children with acute asthma attack by optical coherence tomography. Eur J Ophthalmol 2021; 32:1424-1429. [PMID: 34482738 DOI: 10.1177/11206721211039349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the change in central choroidal thickness in children with asthma attack before and after treatment with β2 agonists. MATERIALS AND METHODS About 100 eyes of 50 patients (5-17 years old) with visual acuity of 20/20 who had no retinal, choroidal, and systemic comorbidity were examined by enhanced depth optical coherence tomography (EDI-OCT) before and after asthma attack treatment. Sixty eyes of 30 healthy children of similar age and gender were evaluated as the control group. The central choroidal thickness, peak expiratory flow (PEF), forced expiratory volume 1(FEV1), oxygen saturation, and heart rate were evaluated. RESULTS The mean age of the patients was 9.2 ± 3.1 years, and the mean saturation values of patients was 97.2 ± 1.3 before treatment, and it increased to 98.3 ± 0.9 after treatment with a statistically significant difference. The mean FEV1 values were 80.8 ± 15.2 before, and 92.7 ± 12.9 after the treatment and PEF values were 75.9 ± 18.6 before and 89.3 ± 18.9 after treatment. This differences were statistically significant (p < 0.001). The average choroidal thickness before the treatment were 310.4 ± 34.2 μm and decreased to 302.7 ± 34.4 μm after the treatment, this decrease was statistically significant (p < 0.001). The mean choroidal thickness of the control group was 303.0 ± 7.3 μm and compared to the pre-treatment and post-treatment values, it was more similar to the post-treatment values, although there was no statistically difference. CONCLUSION In our study, it was shown that choroidal thickness was significantly reduced in children with asthma who received attack treatment with β2 agonists, and it was similar to the control group after the treatment.
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Affiliation(s)
- Isil Kurultay
- Department of Ophthalmology, Baskent University Zubeyde Hanim Practice and Research Center, Izmir, Turkey
| | - Ozlem Sancakli
- Department of Pediatrics, Baskent University Zubeyde Hanim Practice and Research Center, Izmir, Turkey
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23
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Shneor E, Doron R, Levine J, Zimmerman DR, Benoit JS, Ostrin LA, Gordon-Shaag A. Objective Behavioral Measures in Children before, during, and after the COVID-19 Lockdown in Israel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168732. [PMID: 34444483 PMCID: PMC8394769 DOI: 10.3390/ijerph18168732] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 02/06/2023]
Abstract
Studies using questionnaires report that COVID-19 restrictions resulted in children spending significantly less time outdoors. This study used objective measures to assess the impact of pandemic-related restrictions on children’s behavior. A total of 19 healthy 8–12-year-old boys were observed before and during social restriction periods. Of these, 11 boys were reassessed after restrictions were lifted. For each session, Actiwatches were dispensed for measures of time outdoors, activity, and sleep. Changes overall and by school status were assessed using signed-rank test and Wilcoxon rank sum tests. During restrictions, children spent significantly less time outdoors (p = 0.001), were less active (p = 0.001), and spent less time engaged in moderate-to-vigorous physical activity (p = 0.004). Sleep duration was not significantly different between sessions (p > 0.99), but bedtime and wake time shifted to a later time during restrictions (p < 0.05 for both). Time outdoors and activity returned close to pre-pandemic levels after restrictions were lifted (p > 0.05 for both). Children’s behaviors significantly changed during the COVID-19 pandemic. The reduction in outdoor light exposure is of importance due to the role of light in the etiology of myopia and vitamin D production. The reduction in physical activity may have negative health effects in terms of obesity and depression, although further research is required to ascertain the long-term effects.
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Affiliation(s)
- Einat Shneor
- Department of Optometry, Hadassah Academic College, Jerusalem 9101001, Israel; (E.S.); (R.D.); (J.L.)
| | - Ravid Doron
- Department of Optometry, Hadassah Academic College, Jerusalem 9101001, Israel; (E.S.); (R.D.); (J.L.)
| | - Jonathan Levine
- Department of Optometry, Hadassah Academic College, Jerusalem 9101001, Israel; (E.S.); (R.D.); (J.L.)
| | - Deena Rachel Zimmerman
- Maternal Child and Adolescent Division Public Health Services, Israel Ministry of Health, Jerusalem 9101002, Israel;
| | - Julia S. Benoit
- Texas Institute for Measurement, Evaluation, and Statistics, Houston, TX 77004, USA;
- College of Optometry, University of Houston, Houston, TX 77004, USA;
| | - Lisa A. Ostrin
- College of Optometry, University of Houston, Houston, TX 77004, USA;
| | - Ariela Gordon-Shaag
- Department of Optometry, Hadassah Academic College, Jerusalem 9101001, Israel; (E.S.); (R.D.); (J.L.)
- Correspondence:
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24
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Nicou CM, Pillai A, Passaglia CL. Effects of acute stress, general anesthetics, tonometry, and temperature on intraocular pressure in rats. Exp Eye Res 2021; 210:108727. [PMID: 34390732 DOI: 10.1016/j.exer.2021.108727] [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: 04/30/2021] [Revised: 07/30/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
Intraocular pressure (IOP) is important for eye health as abnormal levels can led to ocular tissue damage. IOP is typically estimated by tonometry, which only provides snapshots of pressure history. Tonometry also requires subject cooperation and corneal contact that may influence IOP readings. The aim of this research was to investigate IOP dynamics of conscious animals in response to stressors, common anesthetics, tonometry, and temperature manipulations. An eye of male Brown-Norway rats was implanted with a fluid-filled cannula connected to a wireless telemetry system that records IOP continuously. Stress effects were examined by restricting animal movements. Anesthetic effects were examined by varying isoflurane concentration or injecting a bolus of ketamine. Tonometry effects were examined using applanation and rebound tonometers. Temperature effects were examined by exposing anesthetized and conscious animals to warm or cool surfaces. Telemetry recordings revealed that IOP fluctuates spontaneously by several mmHg, even in idle and anesthetized animals. Environmental disturbances also caused transient IOP fluctuations that were synchronous in recorded animals and could last over a half hour. Animal immobilization produced a rapid sustained elevation of IOP that was blocked by anesthetics, whereas little-to-no IOP change was detected in isoflurane- or ketamine-anesthetized animals if body temperature (BT) was maintained. IOP and BT decreased precipitously when heat support was not provided and were highly correlated during surface temperature manipulations. Surface temperature had no impact on IOP of conscious animals. IOP increased slightly during applanation tonometry but not rebound tonometry. The results show that IOP is dynamically modulated by internal and external factors that can activate rapidly and last long beyond the initiating event. Wireless telemetry indicates that animal interaction induces startle and stress responses that raise IOP. Anesthesia blocks these responses, which allows for better tonometry estimates of resting IOP provided that BT is controlled.
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Affiliation(s)
- Christina M Nicou
- Medical Engineering Department, University of South Florida, Tampa, FL, 33620, USA
| | - Aditi Pillai
- Medical Engineering Department, University of South Florida, Tampa, FL, 33620, USA
| | - Christopher L Passaglia
- Medical Engineering Department, University of South Florida, Tampa, FL, 33620, USA; Ophthalmology Department, University of South Florida, Tampa, FL, 33620, USA.
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25
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Rayapoullé A, Gronfier C, Forhan A, Heude B, Charles MA, Plancoulaine S. Longitudinal association between sleep features and refractive errors in preschoolers from the EDEN birth-cohort. Sci Rep 2021; 11:9044. [PMID: 33907290 PMCID: PMC8079679 DOI: 10.1038/s41598-021-88756-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/13/2021] [Indexed: 11/09/2022] Open
Abstract
Refractive errors are common, especially in children and adolescents, leading to global health issues, academic implications and economic costs. Circadian rhythm and sleep habits may play a role. The study included 1130 children from the EDEN birth-cohort. Data were collected through parental questionnaires at age 2 and 5 for sleep duration and timing, and at age 5 for refractive error. At 5 years, 20.4% were prescribed glasses (2% for myopia, 11.9% for hyperopia and 6.8% for unknown reason). Children slept on average (SD) 11h05/night (± 30 min) and 10h49/night (± 48 min) at age 2 and 5, respectively. Average bedtime and midsleep was 8.36 pm (± 30 min), 2.06 am (± 36 min), and 8.54 pm (± 30 min), 2.06 am (± 24 min) at age 2 and 5, respectively. A U-shaped association was observed between sleep duration at age 2 and eyeglass prescription at age 5. Later midsleep and bedtime at age 2 were associated with an increased risk of eyeglass prescription at age 5. Associations became borderline significant after adjustment for confounding factors. Sleep duration and timing at age 2 were associated with subsequent refractive errors in preschoolers from general population. Sleep hygiene might be a target for refractive errors prevention.
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Affiliation(s)
- Alexis Rayapoullé
- CRESS, Inserm, INRAE, Université de Paris, 75004, Paris, France.,Hôpitaux de Paris, 3 rue Victoria, 75004, Paris, France
| | - Claude Gronfier
- Lyon Neuroscience Research Center (CRNL), Waking Team, Inserm UMRS 1028, CNRS UMR 5292, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France
| | - Anne Forhan
- CRESS, Inserm, INRAE, Université de Paris, 75004, Paris, France
| | - Barbara Heude
- CRESS, Inserm, INRAE, Université de Paris, 75004, Paris, France
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26
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Qiu Q, Song X, Sun C, Tan Y, Xu Y, Huang G, Zhang N, Li Z, Wei W. [Effect of general anesthesia on postoperative melatonin secretion in 4-to 6-year-old children with snoring]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2021; 41:128-134. [PMID: 33509765 DOI: 10.12122/j.issn.1673-4254.2021.01.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To evaluate the effect of general anesthesia on postoperative melatonin secretion in 4-to 6-year-old children with snoring. METHODS Twenty children with snoring aged 4-6 years of either gender (ASA grade Ⅰ and Ⅱ) were selected for adenoidectomy.Before, during and 3 days after the operation, salivary melatonin levels of the children were measured at 11 selected time points (T1-T11).The illumination intensity and body temperature of the children were recorded at each time point of measurement.The sleep time of the children in 3 days after the operation was recorded, and postoperative pain scores (FLACC) and Riker and Rehabilitation Quality Rating Scale-15(QoR-15) scores were assessed.Sleep Apnea Life Quality Evaluation Questionnaire (OSA-18) was used to evaluate postoperative recovery of the children at 28 days after the operation.The incidence of major adverse events of the children during hospitalization was recorded. RESULTS No significant difference was found in baseline salivary melatonin level among the 20 children before the operation.Salivary melatonin level at 7 am after the operation (T8) was significantly lowered as compared with that before the surgery (T4)(P < 0.05) but recovered at 7 am on the second day after the surgery (T11);salivary melatonin levels at T4, T8, and T11 exceeded 3 pg/mL on the third day.No significant difference was found in illumination intensity or body temperature across the time points when melatonin level was measured.The children showed no significant changes in FLACC score, Riker score or QOR- 15 score after the operation, but the OSA-18 score was significantly lowered after the operation (P < 0.05).None of the 20 children had such adverse events as respiratory depression, sinus bradycardia, sinus tachycardia, hypertension, hypotension, nausea or vomiting during hospitalization. CONCLUSIONS In preschool children with snoring, general anesthesia affects but does not inhibit melatonin secretion on the first night after surgery, and minor surgeries under general anesthesia in the morning do not cause significant changes in melatonin secretion to cause disturbance of the circadian rhythm in these children.
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Affiliation(s)
- Qianqi Qiu
- Department of Anesthesiology, Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University, Guangzhou 510623, China
| | - Xingrong Song
- Department of Anesthesiology, Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University, Guangzhou 510623, China
| | - Changzhi Sun
- Department of Otolaryngology, Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University, Guangzhou 510623, China
| | - Yonghong Tan
- Department of Anesthesiology, Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University, Guangzhou 510623, China
| | - Yingyi Xu
- Department of Anesthesiology, Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University, Guangzhou 510623, China
| | - Guiliang Huang
- Department of Otolaryngology, Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University, Guangzhou 510623, China
| | - Na Zhang
- Department of Anesthesiology, Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University, Guangzhou 510623, China
| | - Zhengke Li
- Department of Otolaryngology, Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University, Guangzhou 510623, China
| | - Wei Wei
- Department of Anesthesiology, Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University, Guangzhou 510623, China
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27
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Flanagan SC, Cobice D, Richardson P, Sittlington JJ, Saunders KJ. Elevated Melatonin Levels Found in Young Myopic Adults Are Not Attributable to a Shift in Circadian Phase. Invest Ophthalmol Vis Sci 2021; 61:45. [PMID: 32729910 PMCID: PMC7425780 DOI: 10.1167/iovs.61.8.45] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose To evaluate the relationship between refractive error, circadian phase, and melatonin with consideration of prior light exposure, physical activity, and sleep. Methods Healthy young myopic (spherical equivalent refraction [SER] ≤−0.50DS) and emmetropic adults underwent noncycloplegic autorefraction and axial length (AL) measures. Objective measurements of light exposure, physical activity, and sleep were captured across 7 days by wrist-worn Actiwatch-2 devices. Questionnaires assessed sleep quality and chronotype. Hourly evening saliva sampling during a dim-light melatonin onset (DLMO) protocol evaluated circadian phase, and both morning serum and saliva samples were collected. Liquid chromatography/mass spectrometry quantified melatonin. Results Subjects (n = 51) were aged 21.4 (interquartile range, 20.1−24.0) years. Melatonin was significantly higher in the myopic group at every evening time point and with both morning serum and saliva sampling (P ≤ 0.001 for all). DLMO-derived circadian phase did not differ between groups (P = 0.98). Multiple linear regression analysis demonstrated significant associations between serum melatonin and SER (B = –.34, β = –.42, P = 0.001), moderate activity (B = .009, β = .32, P = 0.01), and mesopic illumination (B = –.007, β = –.29, P = 0.02), F(3, 46) = 7.23, P < 0.001, R2 = 0.32, R2adjusted = .28. Myopes spent significantly more time exposed to “indoor” photopic illumination (3 to ≤1000 lux; P = 0.05), but “indoor” photopic illumination was not associated with SER, AL, or melatonin, and neither sleep, physical activity, nor any other light exposure metric differed significantly between groups (P > 0.05 for all). Conclusions While circadian phase is aligned in adult myopes and emmetropes, myopia is associated with both elevated serum and salivary melatonin levels. Prospective studies are required to ascertain whether elevated melatonin levels occur before, during, or after myopia development.
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28
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Wan K, Cheung SW, Wolffsohn JS, Cho P. Repeatability of corneal biomechanics waveform signal parameters derived from Ocular Response Analyzer in children. Cont Lens Anterior Eye 2020; 44:101373. [PMID: 33268269 DOI: 10.1016/j.clae.2020.10.003] [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: 07/04/2020] [Revised: 09/29/2020] [Accepted: 10/05/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To investigate the repeatability of waveform signal parameters, measured with the Ocular Response Analyzer (ORA), in children. METHODS Two sets of ORA measurements, with a 10-min break between them, were performed on children, aged six to <11 years old, either wearing single-vision spectacles (SVS) or orthokeratology (ortho-k) lenses. Intraclass correlation coefficients (ICCs) were used to assess agreements between two sets of measurements (37 waveform signal parameters). Bland-Altman (BA) plots were used to further analyse waveform signal parameters which had ICC 95 % confidence interval (95 % CI) between 0.50 to >0.90 (regarded as moderate to excellent agreement). RESULTS A total of 30 participants [15 SVS, 15 ortho-k (3.6 ± 2.4 months)] completed the study. Since no significant between-group differences were detected in demographic data (p > 0.28) and all waveform signal parameters (p > 0.05), data from the two groups of participants were pooled for the analysis of repeatability. Six parameters, h2, h21, p1area, p1area1, p2area, and p2area1, achieved ICCs (95 % CI) of 0.82-0.85 (0.61-0.93). The mean (SD) of these six parameters were 372 (91), 248 (61), 4077 (854), 1762 (399), 2359 (670), and 1020 (300), respectively. Bland-Altman plots and 95 % limits of agreement (95 % LoA) showed considerable agreement for all six parameters, the mean difference (95 % LoA) were -3 (-101 to 94), -2 (-67.56-62.70), 111 (-723 to 946), 102 (-334 to 539), 25 (-718 to 768), and -3 (-350 to 343), respectively. CONCLUSIONS Six waveform signal parameters (h2, h21, p1area, p1area1, p2area, and p2area1), which represent or are related to the areas under the waveform at the peaks in the signal, had moderate to excellent agreement in children. Results of the current study provides fundamental information for further studies on the potential clinical application of these waveform signal parameters in children.
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Affiliation(s)
- Kin Wan
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Sin Wan Cheung
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
| | | | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
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29
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Liu WQ, Wang DD, Yang XX, Pan YY, Song X, Hou YS, Wang CX. Topographic distribution features of the choroidal and retinal nerve fiber layer thickness in Chinese school-aged children. Int J Ophthalmol 2020; 13:1459-1466. [PMID: 32953587 DOI: 10.18240/ijo.2020.09.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 01/20/2020] [Indexed: 12/27/2022] Open
Abstract
AIM To explore the topographic distribution features of choroidal thickness (CT) and retinal nerve fiber layer thickness (RNFLT), and determine the relationship between CT and ocular parameters in school-aged children. METHODS The healthy school-aged children with low ametropia or emmetropia in Wenzhou were recruited for this cross-sectional study. With high-density optical coherence tomography (HD-OCT) combined with MATLAB software, the CT and RNFLT values in the macular area were measured at different locations and compared. Statistical analyses were performed to evaluate the correlation between CT and ophthalmic parameters, such as spherical equivalent (SE) and the axial length (AL). RESULTS A total of 279 school-aged children with 8.00±1.35 years of mean age (range, 6-10y) were included. The mean AL was 23.66±0.86 mm. The mean CT in CT-C (264.31±48.93 µm) was thicker than that in CT-N1 (249.54±50.52 µm), and the average CT in the parafoveal region was also thicker than that in CT-N2 (235.65±50.63 µm). The subfoveal CT also varied substantially across refractive errors (P<0.001), and those with myopia (250.59±47.01 µm) exhibited a thinner choroid compared with those with emmetropia (278.74±48.06 µm). CT negatively correlated with AL (y=-21.72x+779.17; R 2=0.1458), and positively correlated with SE (y=15.76x+271.9; R 2=0.0727, OD; y=18.31x+269.8; R 2=0.1007, OS). The average RNFLT was thickest in the peripapillary region (236.35±19.03 µm), the mean RNFLT-S (131.10±15.16 µm) was thicker than the RNFLT-I (128.20±16.59 µm), and the mean RNFLT-T (76.54±11.99 µm) was thicker than the RNFLT-N (64.28±8.55 µm). The variations in the RNFLT between quadrants did differ between those with myopia and emmetropia (P<0.05). CONCLUSION We establish demographic information for the choroid and RNFLT. These findings provide information that should be considered in future analyses of the CT and RNFLT in OCT studies in school-aged children.
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Affiliation(s)
- Wei-Qin Liu
- The Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,Optometry Academy of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Dan-Dan Wang
- The Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,Optometry Academy of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Xiao-Xia Yang
- The Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,Optometry Academy of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Yan-Yan Pan
- The Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,Optometry Academy of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Xue Song
- The Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,Optometry Academy of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Yu-Shan Hou
- The Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.,Optometry Academy of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Chen-Xiao Wang
- The Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
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30
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Ostrin LA, Read SA, Vincent SJ, Collins MJ. Sleep in Myopic and Non-Myopic Children. Transl Vis Sci Technol 2020; 9:22. [PMID: 32879778 PMCID: PMC7442863 DOI: 10.1167/tvst.9.9.22] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 06/07/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose To examine differences in sleep between myopic and non-myopic children. Methods Objective measurements of sleep, light exposure, and physical activity were collected from 91 children, aged 10 to 15 years, for two 14-day periods approximately 6 months apart. Sleep parameters were analyzed with respect to refractive error, season, day of the week, age, and sex. Results Myopic children exhibited differences in sleep duration by day of the week (P < 0.001) and season (P = 0.007). Additionally, myopic children exhibited shorter sleep latency than non-myopic children (P = 0.04). For all children, wake time was later (P < 0.001) and sleep duration was longer (P = 0.03) during the cooler season compared with the warmer season. On weekends, children went to bed later (P < 0.001), woke up later (P < 0.001), and had increased sleep duration (P < 0.001) than on weekdays. Younger children exhibited earlier bedtime (P = 0.005) and wake time (P = 0.01) than older children. Time spent outdoors was positively associated with sleep duration (P = 0.03), and daily physical activity was negatively associated with wake time (P < 0.001). Conclusions Myopic children tended to have more variable sleep duration and shorter latency than non-myopic children. Sleep patterns were influenced by season, day of the week, age, time outdoors, and activity. Translational Relevance Myopic children tended to have more variable sleep duration and shorter latency than non-myopic children, which may reflect previously reported differences in environmental and behavioral factors between refractive error groups.
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Affiliation(s)
- Lisa A Ostrin
- College of Optometry, University of Houston, Houston, TX, USA
| | - Scott A Read
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Brisbane, Queensland, Australia
| | - Stephen J Vincent
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Brisbane, Queensland, Australia
| | - Michael J Collins
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Brisbane, Queensland, Australia
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31
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García García M, Breher K, Ohlendorf A, Wahl S. To Correct or Not Correct? Actual Evidence, Controversy and the Questions That Remain Open. J Clin Med 2020; 9:jcm9061975. [PMID: 32599775 PMCID: PMC7356996 DOI: 10.3390/jcm9061975] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 06/19/2020] [Accepted: 06/23/2020] [Indexed: 12/31/2022] Open
Abstract
Clinical studies and basic research have attempted to establish a relationship between myopia progression and single vision spectacle wear, albeit with unclear results. Single vision spectacle lenses are continuously used as the control group in myopia control trials. Hence, it is a matter of high relevance to investigate further whether they yield any shift on the refractive state, which could have been masked by being used as a control. In this review, eye development in relation to eyes fully corrected versus those under-corrected is discussed, and new guidelines are provided for the analysis of structural eye changes due to optical treatments. These guidelines are tested and optimised, while ethical implications are revisited. This newly described methodology can be translated to larger clinical trials, finally exerting the real effect of full correction via single vision spectacle lens wear on eye growth and myopia progression.
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Affiliation(s)
- Miguel García García
- Carl Zeiss Vision International GmbH, ZEISS Group, Turnstrasse 27, 73430 Aalen, Germany; (A.O.); (S.W.)
- Ophthalmic Research Institute, Elfriede-Aulhorn-Straße 7, 72076 Tuebingen, Germany;
- Correspondence:
| | - Katharina Breher
- Ophthalmic Research Institute, Elfriede-Aulhorn-Straße 7, 72076 Tuebingen, Germany;
| | - Arne Ohlendorf
- Carl Zeiss Vision International GmbH, ZEISS Group, Turnstrasse 27, 73430 Aalen, Germany; (A.O.); (S.W.)
- Ophthalmic Research Institute, Elfriede-Aulhorn-Straße 7, 72076 Tuebingen, Germany;
| | - Siegfried Wahl
- Carl Zeiss Vision International GmbH, ZEISS Group, Turnstrasse 27, 73430 Aalen, Germany; (A.O.); (S.W.)
- Ophthalmic Research Institute, Elfriede-Aulhorn-Straße 7, 72076 Tuebingen, Germany;
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Jnawali A, Mirhajianmoghadam H, Musial G, Porter J, Ostrin LA. The optic nerve head, lamina cribrosa, and nerve fiber layer in non-myopic and myopic children. Exp Eye Res 2020; 195:108041. [PMID: 32353426 PMCID: PMC7282968 DOI: 10.1016/j.exer.2020.108041] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 12/18/2022]
Abstract
The purpose of this study was to evaluate the optic nerve head, lamina cribrosa, retina, and choroid in school age children using spectral domain optical coherence tomography (SD-OCT) and to assess these structural parameters in relation to age, axial length, and refractive error. Healthy children, ages 11.15 ± 2.62 years (range 6-15 years, n = 53), underwent cycloplegic autorefraction, biometry, and SD-OCT imaging in both eyes. Images were analyzed using custom written programs in MATLAB, after adjustment for lateral magnification. Peripapillary retinal nerve fiber layer (RNFL) thickness, retinal and choroidal thicknesses, Bruch's membrane opening (BMO) area, minimum rim width (MRW), and anterior lamina cribrosa surface depth (ALCSD) were determined and analyzed with age, axial length, and refraction. Results show that axial length increased and refractive error became more myopic with increasing age (R2 = 0.25, β = 0.18, P < 0.0001 and R2 = 0.27, β = -0.37, P < 0.0001, respectively). Minimum foveal thickness and central 1 mm retinal thickness increased with increasing age (R2 = 0.15, β = 2.38, P < 0.01 and R2 = 0.11, β = 3.16, P < 0.05, respectively). Age-adjusted raw values for peripapillary RNFL thickness decreased with increasing axial length (R2 = 0.11, β = -3.18, P < 0.05); however, this relationship was not present when image magnification was corrected (R2 = 0.07, β = 2.72, P = 0.09). BMO area increased with myopic refractive error (R2 = 0.16, β = -0.10, P < 0.01). Age-adjusted vertical cup-to-disc ratio decreased with increasing axial length and myopic refractive error (R2 = 0.12, β = -0.05, P < 0.05 and R2 = 0.11, β = 0.03, P = 0.05, respectively). Mean MRW, mean ALCSD, and peripapillary choroidal thickness were not associated with age, axial length, or refraction. Mean MRW was significantly thinner in eyes with deeper ALCS (R2 = 0.41, β = -0.83, P < 0.0001). These findings provide normal values for retinal and optic nerve head parameters in school age children, and also suggest that ocular remodeling occurs in some structures in school age children with normal eye growth and during early stages of myopia development.
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Affiliation(s)
- Ashutosh Jnawali
- University of Houston College of Optometry, 4901 Calhoun, Houston, TX, 77004, USA
| | | | - Gwen Musial
- University of Houston Department of Biomedical Engineering, 4800 Calhoun, Houston, TX, 77204, USA
| | - Jason Porter
- University of Houston College of Optometry, 4901 Calhoun, Houston, TX, 77004, USA
| | - Lisa A Ostrin
- University of Houston College of Optometry, 4901 Calhoun, Houston, TX, 77004, USA.
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