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Yuexin W, Yu Z, Yifei Y, Yan L, Yueguo C. The impact of accommodation function on the difference between noncycloplegic and cycloplegic refraction in adult myopes. Acta Ophthalmol 2024; 102:e727-e735. [PMID: 38235947 DOI: 10.1111/aos.16632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/21/2023] [Accepted: 01/04/2024] [Indexed: 01/19/2024]
Abstract
PURPOSE To investigate the impact of accommodation function on the difference between cycloplegic and noncycloplegic subjective and automatic refraction in adult myopes. METHODS Myopic patients between 18 and 50 years old evaluated at Peking University Third Hospital who underwent cycloplegic and noncycloplegic automatic and subjective refraction were enrolled. Accommodation function, including negative and positive relative accommodation (PRA/NRA) and accommodation response (binocular cross cylinder, BCC) was examined. RESULTS Of the 3268 individuals enrolled, the mean age was 27.3 ± 6.9 years, and 34.8% of participants were male. The noncycloplegic spherical equivalent (SE) was 0.23 ± 0.29 D and 0.64 ± 0.61 D more myopic than cycloplegic subjective and automatic refraction. Adjusting for associated factors, participants with at least 0.50 D of more myopia SE refraction by noncycloplegic subjective refraction were more likely to be older (odds ratio [OR], 1.029; 95% confidence interval [CI], 1.013-1.045) and with insufficient (OR, 1.514; 95% CI, 1.093-2.096) and excessive (OR, 2.196; 95% CI, 1.538-3.137) NRA value. The automatic refraction SE difference of at least 1.00 D more myopia was more likely to be found in individuals with older age (OR, 1.036; 95% CI, 1.022-1.050) and accommodative lead (OR, 1.255; 95% CI, 1.004-1.568). CONCLUSION A quarter of adult myopes had at least 0.50 and 1.00 D of subjective and automatic SE difference with cycloplegia. The accommodation function significantly affects the difference between cycloplegic and noncycloplegic refraction. Investigating the differences in refraction measurement guarantees the proper use of cycloplegia in adults for myopia correction.
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Affiliation(s)
- Wang Yuexin
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
| | - Zhang Yu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
| | - Yuan Yifei
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
| | - Liu Yan
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
| | - Chen Yueguo
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
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Liu Y, Shang J, Wang Y, Zhu X, Ye C, Qu X. Refractive and ocular biometric characteristics of non-myopic and pseudomyopic eyes in mild hyperopic Chinese children aged 3-12 years. Heliyon 2024; 10:e33987. [PMID: 39055816 PMCID: PMC11269864 DOI: 10.1016/j.heliyon.2024.e33987] [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: 10/24/2023] [Revised: 06/28/2024] [Accepted: 07/01/2024] [Indexed: 07/28/2024] Open
Abstract
Purpose To investigate the refractive and ocular biometric characteristics of children with mild hyperopia and distinguish between non-myopic and pseudomyopic eyes before cycloplegia. Methods The eligible children underwent refractive error measurements using a NIDEK autorefractor before and after the administration of 0.5 % tropicamide. Ocular biometric parameters, including axial length (AL), anterior chamber depth (ACD), and lens thickness (LT), were measured using the IOLMaster 700 before cycloplegia. We performed comparative analyses between the non-myopic and pseudomyopic groups, categorized based on whether the spherical equivalent (SE) before cycloplegia exceeded -0.50 diopters (D). Univariable and multivariable regression analyses were performed to control for confounding factors. Results The final analysis included 968 eyes. The participants with pseudomyopia were more likely to be boys (P = 0.029), younger (P = 0.004), less hyperopic (P < 0.001) after cycloplegia, and exhibit a higher delta SE (P < 0.001) compared to the non-myopic participants. Pseudomyopic eyes were associated with a shallower ACD (P = 0.004) and thicker LT (P < 0.001) than non-myopic eyes. After adjusting for sex, age, and SE, pseudomyopic eyes showed increased AL (P = 0.001) and LT (P < 0.001) and decreased ACD (P = 0.005) compared with non-myopic eyes before cycloplegia. Conclusions Among the children with mild hyperopia, pseudomyopia was more common in younger boys with a lower cycloplegic SE and higher delta SE. A thicker LT, shallower ACD, and increased AL may indicate the presence of pseudomyopia, which may provide insights into the rapid progression of myopia in children with pseudomyopia.
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Affiliation(s)
- Yujia Liu
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China
- Key Laboratory of Myopia and Related Eye Diseases, NHC, China
- Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, China
| | - Jianmin Shang
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China
- Key Laboratory of Myopia and Related Eye Diseases, NHC, China
- Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, China
| | - Yuliang Wang
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China
- Key Laboratory of Myopia and Related Eye Diseases, NHC, China
- Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, China
| | - Xingxue Zhu
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China
- Key Laboratory of Myopia and Related Eye Diseases, NHC, China
- Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, China
| | - Chaoying Ye
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China
- Key Laboratory of Myopia and Related Eye Diseases, NHC, China
- Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, China
| | - Xiaomei Qu
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China
- Key Laboratory of Myopia and Related Eye Diseases, NHC, China
- Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, China
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Khan HA, Tran H, Naduvilath TJ, Tahhan N, Ha T, Sankaridurg P. Comparison between cycloplegic and noncycloplegic refraction in young adult myopes. Optom Vis Sci 2024; 101:470-476. [PMID: 39094022 DOI: 10.1097/opx.0000000000002169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024] Open
Abstract
SIGNIFICANCE This study explores the difference between cycloplegic and noncycloplegic refraction in young adult myopes. PURPOSE From the available literature, it is unclear whether cycloplegia is necessary when refracting young adults. This study investigates the agreement between noncycloplegic autorefraction and cycloplegic autorefraction and investigates factors affecting the agreement between the two methods. METHODS In total, 125 myopes with ages ranging between 18 and 26 years were included from Australia and Vietnam. Each participant underwent noncycloplegic autorefraction and cycloplegic autorefraction. Cycloplegia was induced with 1% ophthalmic tropicamide. RESULTS The mean spherical equivalent difference (95% confidence interval) between noncycloplegic autorefraction and cycloplegic autorefraction was -0.20 D (-0.25 to -0.14 D; t124 = -7.18, p<0.0001 ) . A mean difference of >0.25 D was seen in 46.8% of eyes. The lower and upper limits of agreement were -0.80 and 0.41 D, respectively. With univariate analysis, factors including age, degree of refractive error, accommodation amplitude, and distance phorias showed no impact on the average difference between cycloplegic autorefraction and noncycloplegic autorefraction. Yet, eyes with near exophoria ( F2,120 = 6.63, p=0.0019) and Caucasian eyes ( F3,121 = 2.85, p=0.040) exhibited the smallest paired differences. However, in the multivariate analysis, only near exophoria was associated with a lower mean difference. A significantly smaller proportion (34.9%) of eyes with near exophoria had a paired difference of -0.25 D or more compared with esophoria (50%) and orthophoria (65%; χ2 = 6.6, p=0.038). CONCLUSIONS Noncycloplegic autorefraction results in more myopic refractive error than cycloplegic autorefraction in young adults.
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Affiliation(s)
| | | | | | | | - Thao Ha
- Hai Yen Eye Care, Ho Chi Minh City, Vietnam
| | - Padmaja Sankaridurg
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Killeen OJ, Niziol LM, Elam AR, Bicket AK, John D, Wood SD, Musch DC, Zhang J, Johnson L, Kershaw M, Woodward MA, Newman-Casey PA. Visual Impairment from Uncorrected Refractive Error among Participants in a Novel Program to Improve Eye Care Access among Low-Income Adults in Michigan. Ophthalmology 2024; 131:349-359. [PMID: 37758028 PMCID: PMC10922592 DOI: 10.1016/j.ophtha.2023.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/07/2023] [Accepted: 09/15/2023] [Indexed: 10/03/2023] Open
Abstract
PURPOSE To assess the rate of visual impairment (VI) from uncorrected refractive error (URE) and associations with demographic and socioeconomic factors among low-income patients presenting to the Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine (MI-SIGHT) program. DESIGN Cross-sectional study. PARTICIPANTS Adults ≥ 18 years without acute ocular symptoms. METHODS MI-SIGHT program participants received a telemedicine-based eye disease screening and ordered glasses through an online optical store. Participants were categorized based on refractive error (RE) status: VI from URE (presenting visual acuity [PVA], ≤ 20/50; best-corrected visual acuity [BCVA], ≥ 20/40), URE without VI (PVA, ≥ 20/40; ≥ 2-line improvement to BCVA), and no or adequately corrected RE (PVA, ≥ 20/40; < 2-line improvement to BCVA). Patient demographics, self-reported visual function, and satisfaction with glasses obtained through the program were compared among groups using analysis of variance, Kruskal-Wallis, chi-square, and Fisher exact testing. MAIN OUTCOME MEASURES PVA, BCVA, and presence of VI (defined as PVA ≤ 20/50). RESULTS Of 1171 participants enrolled in the MI-SIGHT program during the first year, average age was 55.1 years (SD = 14.5), 37.7% were male, 54.1% identified as Black, and 1166 (99.6%) had both PVA and BCVA measured. VI was observed in 120 participants (10.3%); 96 had VI from URE (8.2%), 168 participants (14.4%) had URE without VI, and 878 (75.3%) had no or adequately corrected RE. A smaller percentage of participants with VI resulting from URE reported having a college degree, and a larger percentage reported income < $10 000 compared with participants with no or adequately corrected RE (3.2% vs. 14.2% [P = 0.02]; 45.5% vs. 21.6% [P < 0.0001], respectively). Visual function was lowest among participants with VI from URE, followed by those with URE without VI, and then those with no or adequately corrected RE (9-item National Eye Institute Visual Function Questionnaire composite score, 67.3 ± 19.6 vs. 77.0 ± 14.4 vs. 82.2 ± 13.3, respectively; P < 0.0001). In total, 71.2% (n = 830) ordered glasses for an average cost of $36.80 ± $32.60; 97.7% were satisfied with their glasses. CONCLUSIONS URE was the main cause of VI at 2 clinics serving low-income communities and was associated with reduced vision-related quality of life. An online optical store with lower prices made eyeglasses accessible to low-income patients. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Olivia J Killeen
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
| | - Leslie M Niziol
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
| | - Angela R Elam
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
| | - Amanda K Bicket
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
| | - Denise John
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
| | - Sarah Dougherty Wood
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
| | - David C Musch
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
| | - Jason Zhang
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
| | | | | | - Maria A Woodward
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
| | - Paula Anne Newman-Casey
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan.
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Kozlov Y, Kinori M, Armarnik S, Yahalomi T, Ekshtein A, Levian L, Mezad-Koursh D, Pikkel J, Ben-Ari O. Subjective versus objective refraction in healthy young adults. BMC Ophthalmol 2024; 24:79. [PMID: 38378511 PMCID: PMC10877844 DOI: 10.1186/s12886-024-03340-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 02/05/2024] [Indexed: 02/22/2024] Open
Abstract
PURPOSE To evaluate objective and subjective refraction differences in healthy young adults. METHODS Data concerning candidates for the Israeli Air Force Flight Academy, as well as active air force pilots in all stages of service who underwent a routine health checkup between the years 2018 and 2019 were retrospectively analyzed. Objective refraction measured using a single autorefractometer was compared with subjective refraction measured by an experienced military optometrist during the same visit. The results were converted to power vectors (spherical equivalent [SE], J0, and J45). To interpret astigmatism using power vector values, the cylinder power (Cp) was determined. RESULTS This study included 1,395 young adult participants. The average age was 22.17 years (range, 17-39, 84.8% males). The average SE was - 0.65 ± 1.19 diopter (D) compared with - 0.71 ± 0.91D in the auto- and subjective refraction, respectively (p = 0.001). Cp was 0.91 ± 0.52D and 0.67 ± 0.40D, respectively (p < 0.001). This difference was more common in older participants (p < 0.001). J0 and J45 value differences were not significant. The absolute SE value of subjective refraction was lower in the myopic (p < 0.001) and hyperopic (p < 0.001) patients. CONCLUSIONS Young hyperopic participants tended to prefer "less plus" in subjective refraction compared with autorefraction. Young myopic participants tended to prefer "less minus" in subjective refraction compared with autorefraction. All participants, but mainly older participants, preferred slightly "less Cp" than that measured using autorefraction; The astigmatic axis did not differ significantly between the methods.
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Affiliation(s)
- Yuval Kozlov
- Department of Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- The Israeli Air Force Aeromedical Center, Tel Hashomer, Israel
| | - Michael Kinori
- Department of Ophthalmology, Assuta Ashdod Medical Center, Ashdod, Israel.
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Sharon Armarnik
- The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel
| | - Tal Yahalomi
- Department of Ophthalmology, Assuta Ashdod Medical Center, Ashdod, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Aya Ekshtein
- Department of Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- The Israeli Air Force Aeromedical Center, Tel Hashomer, Israel
| | - Leora Levian
- The Israeli Air Force Aeromedical Center, Tel Hashomer, Israel
| | - Daphna Mezad-Koursh
- Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel
- The Adelson School of Medicine, Ariel University, Ariel, Israel
| | - Joseph Pikkel
- Department of Ophthalmology, Assuta Ashdod Medical Center, Ashdod, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Oded Ben-Ari
- Department of Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- The Israeli Air Force Aeromedical Center, Tel Hashomer, Israel
- The Adelson School of Medicine, Ariel University, Ariel, Israel
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Zhang Y, Su M, Liang L, Shi B, Gong D, Wu Y, Zhang J, Wang M. The Guiding Significance of Ocular Biometry in Evaluating the Refractive Status of Preschool Children. Ophthalmic Res 2023; 66:1213-1221. [PMID: 37666230 PMCID: PMC10614507 DOI: 10.1159/000533782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 08/22/2023] [Indexed: 09/06/2023]
Abstract
INTRODUCTIONS This study aimed to analyze the correlation between refractive status and ocular biological parameters in preschool-age children (3-6 years old), establish a regression curve, guide the clinical judgment of children's refractive status, and improve the accuracy of refractive screening for this age group. METHODS A total of 508 children, aged 3-6 years, were admitted to the hospital, exhibiting symptoms of ametropia and a need for dilation optometry. Among these, 326 children were included in the statistics group, having been examined between August 2021 and October 2022, and 182 children were included in the validation group, having been examined between November 2022 and March 2023. Using IOL Master700, ocular biometry parameters were measured for all participants, including axial length (AL), keratometry readings (K1 and K2), anterior chamber depth (ACD), lens thickness (LT), and central corneal thickness (CCT). One percent atropine sulfate eye gel was administered, and then the spherical equivalent (SE) was calculated by Bennett's formula. The correlation between SE and other ocular biometrics was analyzed, followed by the establishment of an SE prediction equation. The SE prediction equation was used to calculate the spherical equivalent (SE#) using ocular biometry data from the validation group, and the consistency between SE and SE# was evaluated. RESULTS SE showed a negative correlation with AL/CR (r = -0.936), AL (r = -0.811), ACD (r = -0.500), age (r = -0.396), and Km (r = -0.213) (p < 0.001), and positive correlation with LT (r = 0.301), LP (r = 0.176) (p < 0.001). A multiple linear regression equation was established for SE using the stepwise selection method, SE = 49.232 - 23.583 × AL/CR + 1.703 × ACD + 0.589 × Km - 0.609 × LP + 1.103 × LT (R2 = 0.997). Based on the regression equation, the predicted SE# highly correlated with SE after cycloplegia in the validation group (r = 0.998, p < 0.001). CONCLUSION The main ocular biological factors of ocular diopter in children aged 3-6 years are AL/CR, ACD, Km, LP, and LT, which are jointly influenced by multiple factors. Ocular biometry is a reliable predictor of real refraction among children aged 3-6.
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Affiliation(s)
- Ya Zhang
- Department of Optometry, Shijiazhuang Aier Eye Hospital, Shijiazhuang, China,
| | - Ming Su
- Department of Optometry, Shijiazhuang Aier Eye Hospital, Shijiazhuang, China
| | - Lingling Liang
- Department of Optometry, Shijiazhuang Aier Eye Hospital, Shijiazhuang, China
| | - Bingjie Shi
- Department of Optometry, Shijiazhuang Aier Eye Hospital, Shijiazhuang, China
| | - Dongmei Gong
- Department of Optometry, Shijiazhuang Aier Eye Hospital, Shijiazhuang, China
| | - Yidan Wu
- Department of Optometry, Shijiazhuang Aier Eye Hospital, Shijiazhuang, China
| | - Junying Zhang
- Department of Optometry, Shijiazhuang Aier Eye Hospital, Shijiazhuang, China
| | - Ming Wang
- Department of Optometry, Beijing Aier Intech Hospital, Beijing, China
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Kim YJ, Kim TG. Analysis of 2-year spherical equivalent progression in emmetropic children with non-cycloplegic refraction: a retrospective chart review. BMC Ophthalmol 2023; 23:131. [PMID: 36997895 PMCID: PMC10064540 DOI: 10.1186/s12886-023-02869-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 03/20/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND We aimed to investigate children with an emmetropic non-cycloplegic refraction (NCR) to compare the difference in progression of NC spherical equivalent (SE) over 2 years between the children with emmetropic and hyperopic cycloplegic refraction (CR) values. METHODS Through a retrospective medical record review, 59 children aged under 10 years were evaluated. Refractive error was calculated as the average of the SE values of both eyes. According to the CR results, children with emmetropia (-0.50 to 1.00 diopter [D]) were assigned to group 1 (n = 29), and those with hyperopia (≥ 1.00 D) were assigned to group 2 (n = 30). The prevalence of myopia and SE progression were compared over 2 years. Correlations between final SE progression and baseline age and refractive error were analyzed and multiple regression analysis was conducted. Receiver operating characteristic curves that achieved the best cutoff points to distinguish between the groups were calculated. RESULTS Group 1 showed significantly myopic SE changes compared to baseline at the 1-year follow-up, and group 1 was significantly myopic compared with group 2 at the 2-year follow-up. Myopia prevalence was 51.7% in group 1 and 6.7% in group 2 after 1 year, and 61.1% and 16.7% after 2 years, respectively. In the correlation analysis, baseline age, baseline CR, and difference between CR and NCR showed significant correlations with the 2-year SE progression (r = -0.359, p = 0.005; r = 0.450, p < 0.001; r = -0.562, p < 0.001, respectively). However, NCR refractive error showed no significant correlation (r = -0.097, p = 0.468). In multiple regression analysis, baseline age (β= -0.082), and CR-NCR difference (β= -0.214) showed a significant effect on SE progression for 2 years. When an NCR value of 0.20 D was set as the cut-off value to distinguish between the groups, a sensitivity of 70% and specificity of 92% were obtained. CONCLUSION Even if NCR showed emmetropia, children with baseline CR values of emmetropia showed greater SE progression compared with those with hyperopia. Cycloplegia is essential to confirm the correct refractive status in children. It may be useful for predicting prognosis of SE progression.
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Affiliation(s)
- Yoo Jin Kim
- Department of Ophthalmology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Tae Gi Kim
- Department of Ophthalmology, Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seoul, Korea.
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Duran M, Cevher S. Effect of cycloplegic agents (1% cyclopentolate hydrochloride and 1% tropicamide) on anterior segment parameters. Ther Adv Ophthalmol 2023; 15:25158414231180984. [PMID: 37434779 PMCID: PMC10331352 DOI: 10.1177/25158414231180984] [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: 01/07/2023] [Accepted: 05/22/2023] [Indexed: 07/13/2023] Open
Abstract
Background Cycloplegic drops are commonly used in ophthalmology practice. Changes in anterior segment parameters may occur after cycloplegia. These changes can be evaluated with corneal topography. Objective This study aimed to compare the effects of 1% cyclopentolate hydrochloride and 1% tropicamide on anterior segment parameters using the Sirius Scheimpflug imaging technique. Design A cross-sectional study. Methods One hundred twenty eyes of sixty healthy volunteers with spherical equivalent (SE) values of 0 to ±1 diopter (D) were studied. The right eye of each subject had instillation of cyclopentolate hydrochloride 1% (Group 1) and the left eye of each subject had instillation of tropicamide 1% (Group 2). SE, intraocular pressure, and corneal topography measurements were performed before and 40 min after instillation were compared. Results In Group 1, SE, aqueous depth, anterior chamber depth, iridocorneal angle (ICA), anterior chamber volume (ACV), and pupil size (PS) values were significantly increased (p < 0.001, p = 0.01, p < 0.001, p = 0.03, p < 0.001, and p < 0.001, respectively). In Group 2, SE, ICA, ACV, and PS were significantly increased (p < 0.001 for all). Keratometric values (K1 and K2) and central corneal thickness changed insignificantly in both groups (p > 0.05). The effects of the two administered agents on all parameters were similar (p > 0.05). Conclusions Cyclopentolate hydrochloride and tropicamide affected SE, ICA, ACV, and PS values significantly. These parameters are important in intraocular lens (IOL) power calculations. PS is also important in refractive surgery and cataract surgery with multifocal IOL implantation. Although there was an insignificant difference between the agents, the effects of tropicamide on the parameters were smaller than those of cyclopentolate.
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Affiliation(s)
- Mustafa Duran
- Department of Ophthalmology, Specialist of Ophthalmology, Minister of Health Hitit University Erol Olçok Education and Research Hospital, Çorum, Turkey
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Du B, Wang Q, Luo Y, Jin N, Rong H, Wang X, Nian H, Guo L, Liang M, Wei R. Prediction of spherical equivalent difference before and after cycloplegia in school-age children with machine learning algorithms. Front Public Health 2023; 11:1096330. [PMID: 37113174 PMCID: PMC10126339 DOI: 10.3389/fpubh.2023.1096330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 03/17/2023] [Indexed: 04/29/2023] Open
Abstract
Purpose To predict the need for cycloplegic assessment, as well as refractive state under cycloplegia, based on non-cycloplegic ocular parameters in school-age children. Design Random cluster sampling. Methods The cross-sectional study was conducted from December 2018 to January 2019. Random cluster sampling was used to select 2,467 students aged 6-18 years. All participants were from primary school, middle school and high school. Visual acuity, optical biometry, intraocular pressure, accommodation lag, gaze deviation in primary position, non-cycloplegic and cycloplegic autorefraction were conducted. A binary classification model and a three-way classification model were established to predict the necessity of cycloplegia and the refractive status, respectively. A regression model was also developed to predict the refractive error using machine learning algorithms. Results The accuracy of the model recognizing requirement of cycloplegia was 68.5-77.0% and the AUC was 0.762-0.833. The model for prediction of SE had performances of R^2 0.889-0.927, MSE 0.250-0.380, MAE 0.372-0.436 and r 0.943-0.963. As the prediction of refractive error status, the accuracy and F1 score was 80.3-81.7% and 0.757-0.775, respectively. There was no statistical difference between the distribution of refractive status predicted by the machine learning models and the one obtained under cycloplegic conditions in school-age students. Conclusion Based on big data acquisition and machine learning techniques, the difference before and after cycloplegia can be effectively predicted in school-age children. This study provides a theoretical basis and supporting evidence for the epidemiological study of myopia and the accurate analysis of vision screening data and optometry services.
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Affiliation(s)
- Bei Du
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Qingxin Wang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yuan Luo
- School of Medical Technology, Tianjin Medical University, Tianjin, China
| | - Nan Jin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Hua Rong
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xilian Wang
- Tianjin Beichen Traditional Chinese Medicine Hospital, Tianjin, China
| | - Hong Nian
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Li Guo
- School of Medical Technology, Tianjin Medical University, Tianjin, China
- *Correspondence: Li Guo,
| | - Meng Liang
- School of Medical Technology, Tianjin Medical University, Tianjin, China
- Meng Liang,
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
- Ruihua Wei,
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10
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Sun Y, Jin ZB, Wei S, Jia H, Cao K, Hu J, Lin C, An W, Guo J, Li H, Fu J, Li SM, Wang N. New loci for refractive errors and ocular biometric parameters in young Chinese Han adults. SCIENCE CHINA. LIFE SCIENCES 2022; 65:2050-2061. [PMID: 35301706 DOI: 10.1007/s11427-021-2069-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 01/25/2022] [Indexed: 12/20/2022]
Abstract
Myopia has become a major public health issue with an increasing prevalence. There are still individuals who experience similar environmental risk factors and, yet, remain non-myopic. Thus, there might be genetic factors protecting people from myopia. Considering the opposite ocular characteristics of primary angle closure glaucoma (PACG) to myopia and possible common pathway between them, we propose that certain risk genes for PACG might act as a protective factor for myopia. In this study, 2,678 young adults were genotyped for 37 targeted single nucleotide polymorphisms. Compared with emmetropia, rs1401999 (allele C: OR=0.795, P=0.03; genotype in dominant model: OR=0.759, P=0.02) and rs1258267 (allele A: OR=0.824, P=0.03; genotype in dominant model: OR=0.603, P=0.01) were associated with low to moderate myopia and high myopia, respectively. Genotype under recessive model of rs11024102 was correlated with myopia (OR=1.456, P=0.01), low to moderate myopia (OR=1.443, P=0.02) and high myopia (OR=1.453, P=0.02). However, these associations did not survive Bonferroni correction. Moreover, rs1401999, rs1258267, and rs11024102 showed associations with certain ocular biometric parameters in different groups. Our study suggests that ABCC5, CHAT and PLEKHA7 might be associated with refractive errors by contributing to the regulation of ocular biometry, in terms of uncorrected results and their biological functions.
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Affiliation(s)
- Yunyun Sun
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100730, China
| | - Zi-Bing Jin
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100730, China.,Beijing Institute of Ophthalmology, Beijing, 100730, China
| | - Shifei Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100730, China
| | - Hongyan Jia
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100730, China
| | - Kai Cao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100730, China.,Beijing Institute of Ophthalmology, Beijing, 100730, China
| | - Jianping Hu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100730, China.,Beijing Institute of Ophthalmology, Beijing, 100730, China
| | - Caixia Lin
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100730, China
| | - Wenzai An
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100730, China.,Beijing Institute of Ophthalmology, Beijing, 100730, China
| | - Jiyuan Guo
- Anyang Eye Hospital, Anyang, 455000, China
| | - He Li
- Anyang Eye Hospital, Anyang, 455000, China
| | - Jing Fu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100730, China
| | - Shi-Ming Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100730, China.
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, 100730, China. .,Beijing Institute of Ophthalmology, Beijing, 100730, China.
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11
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Shneor E, Doron R, Ostrin LA, Gordon-Shaag A. The prevalence of refractive errors in college students in Israel. JOURNAL OF OPTOMETRY 2022; 15:284-292. [PMID: 34969625 PMCID: PMC9537245 DOI: 10.1016/j.optom.2021.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE To determine the prevalence of refractive errors in Jewish and Arab college students in Israel and associations with ethnicity and sex. METHODS In this retrospective cross-sectional study, first-year college students underwent non-cycloplegic autorefraction and answered a questionnaire to assess age, sex, and self-identified ethnicity. Spherical equivalent refractive error (SER) was calculated, and the prevalence of hyperopia (>+0.50 Diopter, D), emmetropia (>-0.50 to +0.50 D), myopia (≤-0.50D, low ≤-0.50 to >-3.0D, moderate <-3.0 to >-6.0D, high ≤-6.0D), and astigmatism (>0.50D) were determined. Groups were compared using Chi-square or Fisher test. Univariate and multivariate analyses were conducted to identify factors associated with refractive errors. RESULTS Participants (n = 807) had a mean age of 22.1 ± 2.6 years (range: 17-30 years) and SER of -1.7 ± 2.2D (range: -13.3 to +5.7D). The prevalence and 95% confidence internal of myopia was 66.3% (63.0-69.6). Jewish students had a higher prevalence than Arab students for myopia (69.2% vs 60.3%), moderate (18.5% vs 12.2%) and high myopia (5.9% vs 1.9%) and astigmatism (51.4% vs 43.9%, p<0.05 for all), but not low myopia or hyperopia. Females had a higher prevalence of myopia than males (68.1% vs 58.7%, p<0.03). Jewish ethnicity was associated with myopia (OR=1.48, p = 0.01) and moderate myopia (OR=1.72, p = 0.01), and studying optometry was associated with moderate myopia (OR=1.63, p = 0.02). Sex and age were not associated with myopia. CONCLUSION Myopia prevalence in Israeli college students is high, showing associations with Jewish, but not Arab, ethnicity, suggesting that ethnic factors may play a role in the refractive differences between Arabs and Jews.
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Affiliation(s)
- Einat Shneor
- Department of Optometry, Hadassah Academic College, Haniviim St. 37, Jerusalem 9101001, Israel.
| | - Ravid Doron
- Department of Optometry, Hadassah Academic College, Haniviim St. 37, Jerusalem 9101001, Israel.
| | - Lisa A Ostrin
- University of Houston College of Optometry, 4901 Calhoun Rd, Houston, TX 77204, United States.
| | - Ariela Gordon-Shaag
- Department of Optometry, Hadassah Academic College, Haniviim St. 37, Jerusalem 9101001, Israel.
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12
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REPLY. Ophthalmology 2022; 129:e157-e158. [PMID: 36184435 DOI: 10.1016/j.ophtha.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 08/19/2022] [Indexed: 11/23/2022] Open
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13
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Németh J, Daiki T, Dankovics G, Barna I, Limburg H, Nagy ZZ. Prevalence of refractive errors in Hungary reveals three-fold increase in myopia. Int J Ophthalmol 2022; 15:1174-1179. [PMID: 35919318 PMCID: PMC9318100 DOI: 10.18240/ijo.2022.07.19] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/21/2022] [Indexed: 11/23/2022] Open
Abstract
AIM To examine the prevalence and composition of refractive errors in Hungary. METHODS Nationwide cross-sectional data collected between 2014 and 2019 were analysed from the Comprehensive Health Screening Program of Hungary, which provided spectacle dioptric power and autorefractometry data for 68 227 people (35 850 women and 32 377 men). Their age distribution, 18-99y, was similar to the national demographic distributions. RESULTS Of the total population, 16.50% of the refractive errors exhibited hyperopia, 40.05% emmetropia, and 43.45% myopia. Myopia was 3 times more frequent (58.7%) in younger ages (18-35y of age) compared to older age groups (19.4% of those 56-70y of age; P<0.001). High myopia showed a low prevalence (0.21%), and an increase parallel with ageing (r=0.716; P=0.009). CONCLUSION Myopia is the most frequent refractive error in Hungary. The prevalence of myopia is especially increased, up to 2-3 times, in the younger age groups. Nationwide actions need to be taken to reduce the onset of myopia and its associated consequences.
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Affiliation(s)
- János Németh
- Department of Ophthalmology, Semmelweis University, Budapest 1085, Hungary
- Comprehensive Health Test Program of Hungary, Szentendre 2000, Hungary
| | - Tennó Daiki
- Comprehensive Health Test Program of Hungary, Szentendre 2000, Hungary
- Department of Media and Education Informatics, Eötvös Loránd University, Budapest 1053, Hungary
| | - Gergely Dankovics
- Comprehensive Health Test Program of Hungary, Szentendre 2000, Hungary
| | - István Barna
- Comprehensive Health Test Program of Hungary, Szentendre 2000, Hungary
- 1 Department of Internal Medicine, Semmelweis University, Budapest 1083, Hungary
| | - Hans Limburg
- Health Information Services, Grootebroek 1613LC, The Netherlands
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest 1085, Hungary
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14
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Guo X, Shakarchi AF, Block SS, Friedman DS, Repka MX, Collins ME. Noncycloplegic Compared with Cycloplegic Refraction in a Chicago School-Aged Population. Ophthalmology 2022; 129:813-820. [PMID: 35245603 DOI: 10.1016/j.ophtha.2022.02.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 02/20/2022] [Accepted: 02/23/2022] [Indexed: 01/06/2023] Open
Abstract
PURPOSE To evaluate differences between autorefraction measurements with and without cycloplegia among school-aged individuals and to explore factors associated with significant differences. DESIGN Cross-sectional, retrospective study. PARTICIPANTS Individuals between 3 and 22 years of age evaluated at the Illinois College of Optometry from September 2016 through June 2019 who underwent same-day noncycloplegic and cycloplegic autorefraction of the right eye. METHODS Demographic information including age, sex, and race or ethnicity were collected during the eye examination. Autorefraction was performed before and after cycloplegia. Myopia, defined as at least -0.50 diopter (D) spherical equivalent (SE), hyperopia, defined as at least +0.50 D SE, and astigmatism of at least 1.00 D cylinder were determined using noncycloplegic and cycloplegic autorefractions. Factors associated with at least 1.00 D more myopic SE or at least 0.75 D cylindrical difference by noncycloplegic autorefraction were assessed using logistic regression models. MAIN OUTCOME MEASURES Differences between noncycloplegic and cycloplegic autorefraction measurements. RESULTS The mean age was 10.8 ± 4.0 years for the 11 119 individuals; 52.4% of participants were female. Noncycloplegic SE measured 0.65 ± 1.04 D more myopic than cycloplegic SE. After adjusting for demographic factors and refractive error, individuals with at least 1.00 D of more myopic SE refraction by noncycloplegic autorefraction (25.9%) were more likely to be younger than 5 years (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.18-1.79) and 5 to younger than 10 years (OR, 1.32; 95% CI, 1.18-1.48) than those 10 to younger than 15 years. This difference of at least 1.00 D of more myopic SE was more likely to be observed in Hispanic people (OR, 1.23; 95% CI, 1.10-1.36) and those with hyperopia (OR range, 4.20-13.31). Individuals with 0.75 D or more of cylindrical difference (5.1%) between refractions were more likely to be younger than 5 years, to be male, and to have mild-moderate-high myopia or moderate-high hyperopia. CONCLUSIONS Three quarters of school-aged individuals had < 1 D of myopic SE difference using noncycloplegic compared with cycloplegic autorefraction. Understanding measurement differences obtained for refractive error and associated factors may provide useful information for future studies or programs involving refraction in school-aged children.
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Affiliation(s)
- Xinxing Guo
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Dana Center for Preventive Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ahmed F Shakarchi
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Dana Center for Preventive Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - David S Friedman
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | - Michael X Repka
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Megan E Collins
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; Dana Center for Preventive Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland.
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15
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Machine Learning to Determine Risk Factors for Myopia Progression in Primary School Children: The Anyang Childhood Eye Study. Ophthalmol Ther 2022; 11:573-585. [PMID: 35061239 PMCID: PMC8927561 DOI: 10.1007/s40123-021-00450-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/23/2021] [Indexed: 02/01/2023] Open
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16
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Morgan IG, Jan CL. China Turns to School Reform to Control the Myopia Epidemic: A Narrative Review. Asia Pac J Ophthalmol (Phila) 2022; 11:27-35. [PMID: 35044336 DOI: 10.1097/apo.0000000000000489] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Myopia is now a major public health issue in parts of East and Southeast Asia, including mainland China. In this region, around 80% of students completing 12 years of school education are now myopic, and from 10% to 20% have high myopia in excess of -6D. Interventions to prevent the onset of myopia based on increasing time outdoors have now been implemented at a system-wide scale in Chinese Taipei (Taiwan) and Singapore with some success, but the prevalence of myopia still remains high by international standards. In mainland China, until recently, myopia prevention was largely based on eye exercises, but these have not been sufficient to prevent an epidemic. Control of myopia progression with atropine eye drops has been widely practiced in Singapore and Taiwan, with recent practice concentrating on low-dose concentrations. Orthokeratology has also been widely used across the region. Recent research has produced both contact and spectacle lenses that slow myopia progression by imposing myopic defocus. The new approaches to myopia control are ready for systematic use, which may be facilitated by system-wide screening and referral. In recent years, renewed emphasis has been placed on the prevention of myopia in mainland China by China's President Xi Jinping. In addition to making use of all the measures outlined above, China now seems to be aiming for major reforms to schooling, reducing educational pressures, particularly in the early school years, freeing more time for outdoor play and learning. These new initiatives may be crucial to myopia prevention and control.
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Affiliation(s)
- Ian G Morgan
- Research School of Biology, Australian National University, Canberra, ACT, Australia
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Catherine L Jan
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Lost Child's Vision Project, Sydney, Australia, Department of Ophthalmology and Surgery, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Melbourne, Australia
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17
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Zhang Y, Su M, Liu H, Song Y, Liu J, Sun H, Wu X, Yang X, Qi L, Du F, Liu L, Chen L, Huang J, Guo X, Yang Z, Yang X. Development of Refractive Parameters in 3- to 6-Year-Old Children and Its Application in Myopia Prediction and Intervention Guidance. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2021; 2021:3656831. [PMID: 34956396 PMCID: PMC8702317 DOI: 10.1155/2021/3656831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/17/2021] [Accepted: 11/23/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate refractive development and prevalence of myopia in children aged 3-6 years in Hebei Province, China, and to explore the developmental law of refraction, so as to clinically guide the prediction and intervention of myopia. METHODS In May 2019, a total of 6120 people were inspected in 68 kindergartens in 11 cities in Hebei Province. Child refractive refraction was checked under noncycloplegia using a handheld binocular vision screener (SW-800, SUOER, Tianjin, China). Axial length (AL) and corneal radius of curvature (CR) were measured using an ocular biometry (IOLMaster 500, Carl Zeiss, Germany). Myopia was defined as spherical equivalent (SE) ≤ -0.75 D. RESULTS A total of 5506 children aged 3-6 years met the criteria and were included in the statistical analysis. The prevalence of myopia was 3.49% (1.93% at age 3, 2.90% at age 4, 3.78% at age 5, and 3.88% at age 6). Overall, the mean SE was +0.67 ± 1.05 D (+0.81 ± 1.00 D at age 3, +0.79 ± 1.05 D at age 4, +0.67 ± 1.08 D at age 5, and +0.13 ± 1.01 D at age 6); the mean CR was 7.76 ± 0.26 mm (7.78 ± 0.26 mm at age3, 7.75 ± 0.25 mm at age 4, 7.77 ± 0.26 mm at age 5, and 7.76 ± 0.25 mm at age 6); the mean AL was 22.31 ± 0.73 mm (21.98 ± 0.63 mm at age 3, 22.12 ± 0.69 mm at age 4, 22.34 ± 0.73 mm at age 5, and 22.49 ± 0.73 mm at age 6). CONCLUSIONS Prevalence of myopia increases with age in children aged 3-6 years in Hebei, China. With the increase of age, CR is basically stable, and AL increases gradually. AL/CR, which is closely related to SE, can be used as an indicator to predict myopia and guide clinical work.
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Affiliation(s)
- Ya Zhang
- The First Affiliated Hospital of Jinan University, Guangzhou 510632, China
- Shijiazhuang Aier Eye Hospital, Shijiazhuang 050000, China
| | - Ming Su
- Shijiazhuang Aier Eye Hospital, Shijiazhuang 050000, China
- Hebei Children's Hospital, Shijiazhuang 050000, China
| | - Hua Liu
- Jinan University, Guangzhou 510632, China
- The Third Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, China
| | - Yanxia Song
- Hebei Children's Hospital, Shijiazhuang 050000, China
| | - Jing Liu
- Hebei Women and Children Health Care Center, 050000, China
| | - Huihui Sun
- Hebei Children's Hospital, Shijiazhuang 050000, China
| | - Xueya Wu
- Shijiazhuang Aier Eye Hospital, Shijiazhuang 050000, China
| | - Xiaoge Yang
- Hebei Children's Hospital, Shijiazhuang 050000, China
| | - Liqin Qi
- Shijiazhuang Aier Eye Hospital, Shijiazhuang 050000, China
| | - Feifan Du
- Hebei Children's Hospital, Shijiazhuang 050000, China
| | - Lili Liu
- Baoding Aier Eye Hospital, 071000, China
| | - Lu Chen
- Hebei Children's Hospital, Shijiazhuang 050000, China
| | - Jing Huang
- Cangzhou Aier Eye Hospital, 061000, China
| | - Xiting Guo
- Hebei Children's Hospital, Shijiazhuang 050000, China
| | - Zhongnan Yang
- Qinhuangdao Aier Eye Hospital, Qinhuangdao 066000, China
| | - Xueping Yang
- Shijiazhuang Aier Eye Hospital, Shijiazhuang 050000, China
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18
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Ee CL, Samsudin A. COMPARISON OF SMARTPHONE-BASED AND AUTOMATED REFRACTION WITH SUBJECTIVE REFRACTION FOR SCREENING OF REFRACTIVE ERRORS. Ophthalmic Epidemiol 2021; 29:588-594. [PMID: 34620023 DOI: 10.1080/09286586.2021.1986550] [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: 10/20/2022]
Abstract
PURPOSE To compare Netra smartphone-based and automated refraction with subjective refraction for screening of refractive errors. METHODS Cross-sectional study at the University of Malaya Medical Centre, Kuala Lumpur. Subjects underwent subjective refraction, then automated refraction, and finally Netra smartphone-based refraction. All results were converted to power vectors (M, J0 and J45) and were analysed using repeated-measures ANOVA and Bland-Altman plots. Sensitivity and specificity were determined. The best cut-off points were determined from ROC curve analysis. P < .05 was considered statistically significant. RESULTS Data from the right eyes of 204 subjects were analysed. Mean age was 36.6 ± 15.7 years (range 16-78 years). Spherical equivalent [mean (95% CI)] from Netra and automated refraction were similar, and both more myopic than subjective refraction; -2.87 (-3.23 to -2.51), -2.85 (-3.21 to -2.49) and -2.46 (-2.83 to -2.10) respectively (p < .001). Differences in J0 and J45 between Netra and subjective refraction were not statistically significant (0.10 vs 0.11 and 0.01 vs -0.02 respectively, both p > .05), but those between automated and subjective refraction were (0.06 vs 0.11 and 0.07 vs -0.02, p = .004 and p < .001 respectively). Bland Altman plots showed the 95% limits of agreement with Netra refraction were wider than with automated refraction (-2.21D to 1.42D vs. -1.90D to 1.16D respectively). CONCLUSION Netra smartphone-based refraction gives similar readings to automated refraction, and both show myopic overestimation when compared to subjective refraction. However, due to non-insignificant practical usage issues, its use as a screening tool for refractive errors is limited.
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Affiliation(s)
- Chye Li Ee
- University of Malaya Eye Research Centre, Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Amir Samsudin
- University of Malaya Eye Research Centre, Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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19
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Sun Y, Fu J, Li L, Chen W, Meng Z, Su H, Yao Y, Dai W. Stereoacuity and its determinants in 7-year-old children: the Lhasa Childhood Eye Study. Graefes Arch Clin Exp Ophthalmol 2021; 260:599-608. [PMID: 34499245 DOI: 10.1007/s00417-021-05390-y] [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: 06/10/2021] [Revised: 08/01/2021] [Accepted: 08/13/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To explore the distribution of stereoacuity and to examine its determinants in school-age children in Tibetan plateau, Southwest China. METHODS This is the cross-sectional part of a school-based cohort study of 7-year-old children in Lhasa, Tibet Autonomous Region, Southwest China. Children in first year of primary school were invited to undergo a comprehensive examination, including height, weight, visual acuity, cycloplegic autorefraction (1% cyclopentolate), anterior segment, cover and uncover test, and stereoacuity (Titmus Stereo Test). RESULTS A total of 1833 eligible subjects were included, with a mean age of 6.82 ± 0.46 years. Mean stereoacuity was 1.78 ± 0.21 in log units (median: 60 arcsec). Children with stereoacuity equal to 40 arcsec and stereoacuity worse than 100 arcsec accounted for 29.24% and 8.18% of the cohort, respectively. Tibetan ethnicity (OR = 1.98; 95%CI, 1.30-3.03), astigmatism (OR = 1.65; 95%CI, 1.26-2.17), strabismus (OR = 2.92; 95%CI, 1.38-6.18), and amblyopia (OR = 3.77; 95%CI, 1.14-12.49) were risk factors for normal stereoacuity (= 40 arcsec). Shorter height, younger age, strabismus, and worse BCVA (P < 0.05 for all) were both related to lower stereoacuity in Spearman correlation analysis and associated with lower stereoacuity in multivariate regression analysis. CONCLUSION Stereoacuity maturation does not appear fully completed in 7-year-old children, while few children present stereoacuity worse than 100 arcsec (8.18%). Lower stereoacuity was associated with younger age, shorter height, strabismus, and lower best-corrected visual acuity.
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Affiliation(s)
- Yunyun Sun
- Department of Strabismus and Pediatric Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang Street, Dongcheng District, 100730, Beijing, China.,Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, No. 1 Dongjiaominxiang Street, Dongcheng District, 100730, Beijing, China
| | - Jing Fu
- Department of Strabismus and Pediatric Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang Street, Dongcheng District, 100730, Beijing, China. .,Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, No. 1 Dongjiaominxiang Street, Dongcheng District, 100730, Beijing, China.
| | - Lei Li
- Department of Strabismus and Pediatric Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang Street, Dongcheng District, 100730, Beijing, China.,Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, No. 1 Dongjiaominxiang Street, Dongcheng District, 100730, Beijing, China
| | - Weiwei Chen
- Department of Strabismus and Pediatric Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang Street, Dongcheng District, 100730, Beijing, China.,Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, No. 1 Dongjiaominxiang Street, Dongcheng District, 100730, Beijing, China
| | - Zhaojun Meng
- Department of Strabismus and Pediatric Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang Street, Dongcheng District, 100730, Beijing, China.,Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, No. 1 Dongjiaominxiang Street, Dongcheng District, 100730, Beijing, China
| | - Han Su
- Department of Strabismus and Pediatric Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang Street, Dongcheng District, 100730, Beijing, China.,Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, No. 1 Dongjiaominxiang Street, Dongcheng District, 100730, Beijing, China
| | - Yao Yao
- Department of Strabismus and Pediatric Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang Street, Dongcheng District, 100730, Beijing, China.,Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, No. 1 Dongjiaominxiang Street, Dongcheng District, 100730, Beijing, China
| | - Wei Dai
- Department of Strabismus and Pediatric Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 1 Dongjiaominxiang Street, Dongcheng District, 100730, Beijing, China.,Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, No. 1 Dongjiaominxiang Street, Dongcheng District, 100730, Beijing, China
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20
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Bharadwaj SR, Ravisankar C, Roy S, Satgunam P. Fluctuations of Steady-State Accommodation Is a Marker for Screening Spasm of Near Reflex. Transl Vis Sci Technol 2021; 10:9. [PMID: 34491286 PMCID: PMC8431981 DOI: 10.1167/tvst.10.11.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/03/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine the utility of root mean squared (RMS) deviations of steady-state accommodation as a noncycloplegic marker for spasm of near reflex (SNR) vis-à-vis regular refractive errors. Methods Binocular steady-state responses of accommodation, pupil, and vergence of 20 patients with accommodative spasm subtype of SNR (SNR-A; 9-23 years) and 91 with regular refractive errors (29 emmetropes, 41 myopes, 21 hyperopes; 19-38 years) was recorded in the uncorrected refractive error state for 120 seconds using a dynamic (50 frames per second), infrared photorefractor. Mean and RMS deviation of raw data was calculated for three 20-second-long epochs and their diagnostic utility was determined using standard ROC curves. Results RMS deviations of accommodation increased with mean refractive error in SNR-A (y = -0.23x + 0.38; r2 = 0.69; P < 0.001) and regular refractive error (y = -0.02x + 0.10; r2 = 0.14; P = 0.002) cohorts, albeit with steeper slope and higher y-intercept in the former rather than the latter cohort. RMS deviation of 0.19D reliably distinguished SNR-A from regular refractive errors with a sensitivity and specificity of 95.2% and 92.2%, respectively [mean (±1 SEM) area under ROC curve: 0.98 ± 0.01]. The sensitivity, specificity, and area under ROC curve for RMS deviations of pupil (66.7%, 80%, and 0.70 ± 0.09) and vergence (52.4%, 84.6%, and 0.68 ± 0.08) were smaller than accommodation. Conclusions RMS deviations of steady-state accommodation is a robust noncycloplegic marker for differentiating SNR-A from regular refractive errors. Pupil and vergence fluctuations have limited utility in this regard. Translational Relevance RMS deviations of accommodation may be easily obtained using commercial photorefractors, and the cut-off values reported herein may be implemented to identify SNR-A during refractive error screening.
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Affiliation(s)
- Shrikant R. Bharadwaj
- Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
- Prof Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Chandrika Ravisankar
- Prof Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Saujanwita Roy
- Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
| | - PremNandhini Satgunam
- Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
- Prof Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
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21
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Pei R, Liu Z, Rong H, Zhao L, Du B, Jin N, Zhang H, Wang B, Pang Y, Wei R. A randomized clinical trial using cyclopentolate and tropicamide to compare cycloplegic refraction in Chinese young adults with dark irises. BMC Ophthalmol 2021; 21:256. [PMID: 34112149 PMCID: PMC8194231 DOI: 10.1186/s12886-021-02001-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 05/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the necessity of cycloplegia for epidemiological studies of refraction in Chinese young adults (aged 17-22 years) with dark irises, and to compare the cycloplegic effects of 1% cyclopentolate and 0.5% tropicamide in them. METHODS A total of 300 young adults (108 males and 192 females) aged 17 to 22 years (mean 19.03 ± 1.01) were recruited from Tianjin Medical University from November 2019 to January 2020. Participants were randomly divided into two groups. In the cyclopentolate group, two drops of 1% cyclopentolate eye drop were administrated (one drop every 5 min), followed by autorefraction and subjective refraction 30 to 45 min later. In the tropicamide group, four drops of 1% Mydrin P (Tropicamide 0.5%, phenylephrine HCl 0.5%) eye drop were given (one drop every 5 min), followed by autorefraction and subjective refraction 20 to 30 min later. The participants and the examiners were masked to the medication. Distance visual acuity, intraocular pressure (IOP), non-cycloplegic and cycloplegic autorefraction (Topcon KR-800, Topcon Co. Tokyo, Japan), non-cycloplegic and cycloplegic subjective refraction and ocular biometry (Lenstar LS-900) were performed. RESULTS The values of spherical equivalent (SE) and sphere component were significantly different before and after cycloplegia in the cyclopentolate group and the tropicamide group (p < 0.05). The mean difference between noncycloplegic and cycloplegic autorefraction SE was 0.39 D (±0.66 D) in the cyclopentolate group and 0.39 D (±0.34 D) in the tropicamide group. There was no significant difference in the change of SE and sphere component after cycloplegia between the cyclopentolate group and the tropicamide group (p > 0.05). In each group, no significant difference was found between autorefraction and subjective refraction after cycloplegia (p > 0.05). We also found that more positive or less negative cycloplegic refraction was associated with the higher difference in SE in each group. CONCLUSIONS Cycloplegic refractions were generally more positive or less negative than non-cycloplegic refractions. It is necessary to perform cycloplegia for Chinese young adults with dark irises to obtain accurate refractive errors. We suggest that cycloplegic autorefraction using tropicamide may be considered as a reliable method for epidemiological studies of refraction in Chinese young adults with dark irises. TRIAL REGISTRATION The study was registered on September 7, 2019 (Registration number: ChiCTR1900025774 ).
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Affiliation(s)
- Ruxia Pei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Nankai District, Tianjin, China
| | - Zhuzhu Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Nankai District, Tianjin, China
| | - Hua Rong
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Nankai District, Tianjin, China
| | - Liqiong Zhao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Nankai District, Tianjin, China
| | - Bei Du
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Nankai District, Tianjin, China
| | - Na Jin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Nankai District, Tianjin, China
| | - Hongmei Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Nankai District, Tianjin, China
| | - Biying Wang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Nankai District, Tianjin, China
| | - Yi Pang
- Illinois College of Optometry, 3241 S, Michigan Ave, Chicago, IL, 60616, USA.
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 251 Fukang Road, Nankai District, Tianjin, China.
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22
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Jong M, Jonas JB, Wolffsohn JS, Berntsen DA, Cho P, Clarkson-Townsend D, Flitcroft DI, Gifford KL, Haarman AEG, Pardue MT, Richdale K, Sankaridurg P, Tedja MS, Wildsoet CF, Bailey-Wilson JE, Guggenheim JA, Hammond CJ, Kaprio J, MacGregor S, Mackey DA, Musolf AM, Klaver CCW, Verhoeven VJM, Vitart V, Smith EL. IMI 2021 Yearly Digest. Invest Ophthalmol Vis Sci 2021; 62:7. [PMID: 33909031 PMCID: PMC8088231 DOI: 10.1167/iovs.62.5.7] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 01/24/2021] [Indexed: 12/17/2022] Open
Abstract
Purpose The International Myopia Institute (IMI) Yearly Digest highlights new research considered to be of importance since the publication of the first series of IMI white papers. Methods A literature search was conducted for articles on myopia between 2019 and mid-2020 to inform definitions and classifications, experimental models, genetics, interventions, clinical trials, and clinical management. Conference abstracts from key meetings in the same period were also considered. Results One thousand articles on myopia have been published between 2019 and mid-2020. Key advances include the use of the definition of premyopia in studies currently under way to test interventions in myopia, new definitions in the field of pathologic myopia, the role of new pharmacologic treatments in experimental models such as intraocular pressure-lowering latanoprost, a large meta-analysis of refractive error identifying 336 new genetic loci, new clinical interventions such as the defocus incorporated multisegment spectacles and combination therapy with low-dose atropine and orthokeratology (OK), normative standards in refractive error, the ethical dilemma of a placebo control group when myopia control treatments are established, reporting the physical metric of myopia reduction versus a percentage reduction, comparison of the risk of pediatric OK wear with risk of vision impairment in myopia, the justification of preventing myopic and axial length increase versus quality of life, and future vision loss. Conclusions Large amounts of research in myopia have been published since the IMI 2019 white papers were released. The yearly digest serves to highlight the latest research and advances in myopia.
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Affiliation(s)
- Monica Jong
- Discipline of Optometry and Vision Science, University of Canberra, Canberra, Australian Capital Territory, Australia
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Jost B. Jonas
- Department of Ophthalmology Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - James S. Wolffsohn
- Optometry and Vision Science Research Group, Aston University, Birmingham, United Kingdom
| | - David A. Berntsen
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, Texas, United States
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Danielle Clarkson-Townsend
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, Georgia, United States
- Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, United States
| | - Daniel I. Flitcroft
- Department of Ophthalmology, Children's University Hospital, Dublin, Ireland
| | - Kate L. Gifford
- Myopia Profile Pty Ltd, Brisbane, Queensland, Australia
- Queensland University of Technology (QUT) School of Optometry and Vision Science, Kelvin Grove, Queensland, Australia
| | - Annechien E. G. Haarman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Machelle T. Pardue
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, Georgia, United States
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, United States
| | - Kathryn Richdale
- College of Optometry, University of Houston, Houston, Texas, United States
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Milly S. Tedja
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Joan E. Bailey-Wilson
- Computational and Statistical Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Baltimore, Maryland, United States
| | - Jeremy A. Guggenheim
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom
| | - Christopher J. Hammond
- Section of Academic Ophthalmology, School of Life Course Sciences, King's College London, London, United Kingdom
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Stuart MacGregor
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - David A. Mackey
- Centre for Eye Research Australia, Ophthalmology, Department of Surgery, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- Department of Ophthalmology, Menzies Institute of Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Anthony M. Musolf
- Computational and Statistical Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Baltimore, Maryland, United States
| | - Caroline C. W. Klaver
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Virginie J. M. Verhoeven
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Veronique Vitart
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Earl L. Smith
- College of Optometry, University of Houston, Houston, Texas, United States
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23
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Ma D, Wei S, Sun Y, Li SM, An WZ, Hu JP, Cao K, Yang XH, Lin CX, Guo JY, Li H, Fu J, Wang N. Distribution of IOP and its relationship with refractive error and other factors: the Anyang University Students Eye Study. Int J Ophthalmol 2021; 14:554-559. [PMID: 33875947 DOI: 10.18240/ijo.2021.04.12] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/29/2020] [Indexed: 02/02/2023] Open
Abstract
AIM To investigate the distribution of intraocular pressure (IOP) and its relationship with refractive error and other factors in university students from Anyang, China. METHODS A university-based study was conducted. Subjects were invited to complete ophthalmic examinations, including visual acuity, noncontact tonometry (NCT), cycloplegic autorefraction, and ocular biometry. Univariable and multivariable analyses were used to evaluate the associations between IOP and other factors. Only data from right eyes were used in analysis. RESULTS A total of 7720 subjects aged 16 to 26 years old were included, and 2834 (36.4%) of the participants were male. The mean IOP of the right eye for all subjects was 15.52±3.20 mm Hg (95%CI: 15.45, 15.59). Using multivariate linear regression analysis, IOP was found to correlate significantly with younger age (P<0.001; standardized regression coefficient β, -0.061; regression coefficient β, -0.139; 95%CI: -0.18, -0.09), higher myopic refractive error (P=0.044; standardized β, -0.060; regression coefficient β, -0.770; 95%CI: -0.15, -0.002), higher central corneal thickness (P<0.001; standardized β, 0.450; regression coefficient β, 0.044; 95%CI: 0.04, 0.05), and shorter axial length (AL; P<0.001; standardized β, -0.061; regression coefficient β, -0.163; 95%CI: -0.25, -0.07). CONCLUSION This study described the normal distribution of IOP. In Chinese university students aged 16-26y, higher IOP is associated with younger age, higher myopic refractive error, higher thickness of the central cornea, and shorter AL.
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Affiliation(s)
- Dandan Ma
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China
| | - Shifei Wei
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China
| | - Yunyun Sun
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China
| | - Shi-Ming Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China
| | - Wen-Zai An
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China
| | - Jian-Ping Hu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China.,Beijing Institute of Ophthalmology, Beijing 100730, China
| | - Kai Cao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China.,Beijing Institute of Ophthalmology, Beijing 100730, China
| | - Xiao-Hui Yang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China.,Beijing Institute of Ophthalmology, Beijing 100730, China
| | - Cai-Xia Lin
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China
| | - Ji-Yuan Guo
- Anyang Eye Hospital, Anyang 455000, Henan Province, China
| | - He Li
- Anyang Eye Hospital, Anyang 455000, Henan Province, China
| | - Jing Fu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Capital Medical University, Beijing 100730, China.,Beijing Institute of Ophthalmology, Beijing 100730, China
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24
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Gopalakrishnan A, Hussaindeen JR, Sivaraman V, Swaminathan M, Wong YL, Armitage JA, Gentle A, Backhouse S. The Sankara Nethralaya Tamil Nadu Essilor Myopia (STEM) Study-Defining a Threshold for Non-Cycloplegic Myopia Prevalence in Children. J Clin Med 2021; 10:jcm10061215. [PMID: 33804031 PMCID: PMC8001787 DOI: 10.3390/jcm10061215] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/19/2021] [Accepted: 02/21/2021] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to investigate the agreement between cycloplegic and non-cycloplegic autorefraction with an open-field auto refractor in a school vision screening set up, and to define a threshold for myopia that agrees with the standard cycloplegic refraction threshold. The study was conducted as part of the Sankara Nethralaya Tamil Nadu Essilor Myopia (STEM) study, which investigated the prevalence, incidence, and risk factors for myopia among children in South India. Children from two schools aged 5 to 15 years, with no ocular abnormalities and whose parents gave informed consent for cycloplegic refraction were included in the study. All the children underwent visual acuity assessment (Pocket Vision Screener, Elite school of Optometry, India), followed by non-cycloplegic and cycloplegic (1% tropicamide) open-field autorefraction (Grand Seiko, WAM-5500). A total of 387 children were included in the study, of whom 201 were boys. The mean (SD) age of the children was 12.2 (±2.1) years. Overall, the mean difference between cycloplegic and non-cycloplegic spherical equivalent (SE) open-field autorefraction measures was 0.34 D (limits of agreement (LOA), 1.06 D to −0.38 D). For myopes, the mean difference between cycloplegic and non-cycloplegic SE was 0.13 D (LOA, 0.63D to −0.36D). The prevalence of myopia was 12% (95% CI, 8% to 15%) using the threshold of cycloplegic SE ≤ −0.50 D, and was 14% (95% CI, 11% to 17%) with SE ≤ −0.50 D using non-cycloplegic refraction. When myopia was defined as SE of ≤−0.75 D under non-cycloplegic conditions, there was no difference between cycloplegic and non-cycloplegic open-field autorefraction prevalence estimates (12%; 95% CI, 8% to 15%; p = 1.00). Overall, non-cycloplegic refraction underestimates hyperopia and overestimates myopia; but for subjects with myopia, this difference is minimal and not clinically significant. A threshold of SE ≤ −0.75 D agrees well for the estimation of myopia prevalence among children when using non-cycloplegic refraction and is comparable with the standard definition of cycloplegic myopic refraction of SE ≤ −0.50 D.
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Affiliation(s)
- Aparna Gopalakrishnan
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai 600 006, India; (J.R.H.); (V.S.); (M.S.)
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, VIC 3216, Australia; (J.A.A.); (A.G.); (S.B.)
- Correspondence:
| | - Jameel Rizwana Hussaindeen
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai 600 006, India; (J.R.H.); (V.S.); (M.S.)
| | - Viswanathan Sivaraman
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai 600 006, India; (J.R.H.); (V.S.); (M.S.)
| | - Meenakshi Swaminathan
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai 600 006, India; (J.R.H.); (V.S.); (M.S.)
| | - Yee Ling Wong
- R&D AMERA, Essilor International Singapore, Singapore 339346, Singapore;
| | - James Andrew Armitage
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, VIC 3216, Australia; (J.A.A.); (A.G.); (S.B.)
| | - Alex Gentle
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, VIC 3216, Australia; (J.A.A.); (A.G.); (S.B.)
| | - Simon Backhouse
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, VIC 3216, Australia; (J.A.A.); (A.G.); (S.B.)
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25
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Kang MT, Jan C, Li S, Yusufu M, Liang X, Cao K, Liu LR, Li H, Wang N, Congdon N. Prevalence and risk factors of pseudomyopia in a Chinese children population: the Anyang Childhood Eye Study. Br J Ophthalmol 2020; 105:1216-1221. [PMID: 32859718 DOI: 10.1136/bjophthalmol-2020-316341] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/05/2020] [Accepted: 08/03/2020] [Indexed: 11/03/2022]
Abstract
AIMS To investigate the prevalence and predictors of pseudomyopia in Chinese children and its association with myopia progression. METHODS A prospective, school-based, cohort study of 6- and 13-year-old children was conducted in Anyang, China. Pre-cycloplegic and post-cycloplegic autorefraction were performed at baseline and 1 year later. Pseudomyopia was defined as spherical equivalent refractive (SER) error in the better-seeing eye ≤-0.50 D before cycloplegia and >-0.50 D after cycloplegia. Among pseudomyopic children, pseudomyopic power was defined as non-cycloplegic SER subtracted from cycloplegic SER. Market survey was collected in all optometry stores in Anyang city to investigate how cycloplegia is used for refracting children. RESULTS A total of 2612 children aged 6 years and 1984 children aged 13 years were included. Of the two cohorts, median cycloplegic SER (IQR) was 1.00 D (0.50, 1.38) and -1.13 D (-2.63, 0.13) respectively, myopia prevalence was 5.2% and 61.0%, pseudomyopia prevalence was 24.1% and 18.9%, and median pseudomyopic power was 1.13 D (0.63, 1.63) and 0.38 D (0.13, 0.88). In both cohorts, greater baseline hyperopia was the strongest predictor of pseudomyopia (p<0.001), whereas time spent on near work was not associated with pseudomyopic power (p>0.05). After 1 year, 15.6% (98/629) of 6-year-olds and 10.7% (40/374) of 13-year-olds with pseudomyopia developed myopia. Compared with myopes, pseudomyopic children with the same pre-cycloplegic SER had slower myopic progression (p<0.001). Among all 127 optometry stores in Anyang, only 4 (3.15%) used cycloplegia for refracting children. CONCLUSION Pseudomyopia is more prevalent in younger, more hyperopic children. Pseudomyopia is not an independent risk factor for myopic progression in this setting.
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Affiliation(s)
- Meng-Tian Kang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing, China.,Beijing Institute of Ophthalmology, Beijing, China
| | - Catherine Jan
- The George Institute for Global Health, University of New South Wales Faculty of Medicine, Sydney, Australia.,Center for Brain and Cognitive Sciences and School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - ShiMing Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing, China.,Beijing Institute of Ophthalmology, Beijing, China
| | - Mayinuer Yusufu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing, China.,Beijing Institute of Ophthalmology, Beijing, China
| | - Xintong Liang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing, China.,Beijing Institute of Ophthalmology, Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing, China
| | | | - He Li
- Anyang Eye Hospital, Anyang, China
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing, China .,Beijing Institute of Ophthalmology, Beijing, China
| | - Nathan Congdon
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.,Centre for Public Health, Queen's University Belfast, Belfast, UK
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School-based epidemiology study of myopia in Tianjin, China. Int Ophthalmol 2020; 40:2213-2222. [PMID: 32472421 PMCID: PMC7481173 DOI: 10.1007/s10792-020-01400-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 04/25/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE To study the epidemiology of myopia in school-aged children in Tianjin and the relationship between visual acuity-based screening and refraction-based screening. METHOD This school-based prospective cohort study was performed on children from 42 elementary schools and 17 middle schools in Tianjin, China. Totally 14,551 children, ages ranging from 5 to 16 years, were included in this study. Uncorrected visual acuity (UCVA) was determined by logarithmic tumbling E chart. Non-cycloplegic photorefraction was examined by the Spot (v2.1.4) photoscreener. The relationship between the UCVA and refractive error was investigated for different age groups. RESULTS The overall prevalence of myopia at this school based screen is 78.2%, ranged from 10% at age of 5 to 95% at age of 16. The most dramatic increase in prevalence is from age of 6 (14.8%) to age of 7 (38.5%). The overall prevalence of high myopia is 2.5%. UCVA is found corresponding to spherical equivalent refraction (SER) in a manner of normal distribution and is significantly affected by age. When using UCVA to estimate the prevalence of myopia, the overall sensitivity and specificity are 0.824 and 0.820, respectively. Age-dependent optimal cutoff points and 95% confident intervals of such estimation are reported. CONCLUSIONS Myopia is heavily affecting school-aged children in Tianjin, China. The refraction screening is preferable for myopia screening, whereas the UCVA screening results need to be interpreted in an age-dependent manner for myopia estimation.
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Ozulken K, Ilhan C, Yuksel E, Mumcuoglu T. Preliminary effects of treating the half of high latent hyperopia on refractive and visual results of femtosecond laser-assisted in situ keratomileusis in subjects with hyperopia. Int Ophthalmol 2020; 40:2361-2369. [PMID: 32430870 DOI: 10.1007/s10792-020-01421-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 05/11/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND To evaluate the preliminary effects of treating the half of high latent hyperopia on refractive and visual outcomes of femtosecond laser-assisted in situ keratomileusis (LASIK) in young subjects with hyperopia. METHODS This non-randomized comparative study includes 120 eyes of 60 subjects who underwent femtosecond LASIK to correct hyperopia. Group 1 (n = 60) includes subjects with ≤ 1D algebraic difference (DRSE) between cycloplegic (CRSE) and manifest (MRSE) refraction spherical equivalents and was treated by entering manifest refraction values. Group 2 includes subjects with > 1D DRSE and was treated by entering the mean manifest and cycloplegic refraction values. Refractive and subjective outcomes obtained at the 1-, 3-, and 6-month postoperative visits were compared. RESULTS The mean age of the subjects was 26.2 ± 3.5 and 26.2 ± 5.2 years for Group 1 and Group 2, respectively. The male-to-female ratios were 10/10 in both groups. Demographic values of the groups were similar (p > 0.05). Preoperative MRSE values were similar (p = 0.924), while CRSE and DRSE values were significantly higher in Group 2 (p < 0.001). At the 1- and 3-month postoperative visits, MRSE was higher and uncorrected distance visual acuity (UDVA) was lower in Group 2 (p < 0.001). Subjective visual parameters and quality of vision scores were also worse in Group 2 during these visits (p < 0.001); however, at the 6-month visit, all outcomes for Group 2 improved, and MRSE, UDVA, some subjective visual parameters, and quality of vision scores became similar between groups (p > 0.05). CONCLUSION At the 6-month visit after treating the half of > 1D latent hyperopia with femtosecond LASIK, refractive and visual outcomes like MRSE, UDVA, subjective visual parameters, and quality of vision scores become similar to those obtained in ≤ 1D latent hyperopia.
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Affiliation(s)
- Kemal Ozulken
- Department of Ophthalmology, TOBB ETU, Ankara, Turkey
| | - Cagri Ilhan
- Department of Ophthalmology, Hatay State Hospital, Antakya, Hatay, Turkey.
| | - Erdem Yuksel
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
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Wei S, Sun Y, Li S, Hu J, Yang X, Lin C, Cao K, Du J, Guo J, Li H, Wang N. Refractive Errors in University Students in Central China: The Anyang University Students Eye Study. Invest Ophthalmol Vis Sci 2019; 59:4691-4700. [PMID: 30267091 DOI: 10.1167/iovs.18-24363] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To assess the prevalence of refractive errors and associated factors in university students in urban areas of Anyang, Central China. Methods This is a cross-sectional university-based study of 16- to 26-year-old students in China. Subjects from two universities were invited to undergo a comprehensive eye examination. Cycloplegic refraction was acquired by autorefractor with two drops of 1% cyclopentolate. The prevalence of myopia, high myopia, hyperopia, astigmatism, and anisometropia was calculated. Only data from right eyes were included in analysis. Results A total of 7732 eligible subjects were included, with an average age of 20.2 ± 1.4 years. Overall, the mean spherical equivalent (SE) was -2.92 ± 2.48 diopters (D). The prevalence of myopia (SE ≤ -0.50 D), emmetropia, and hyperopia (SE ≥ +0.50 D) was 83.2%, 9.5%, and 7.3%, respectively. Female sex (OR = 1.542; P < 0.001) and science and engineering students (OR = 1.219; P = 0.004) were more likely to be myopic. The prevalence of high myopia, defined using SE ≤ -5.0 D, ≤ -6.0 D, and ≤ -10.0 D, respectively, occurred in 20.2%, 11.1 %, and 0.5%. High myopia (SE ≤ -6.0 D) was statistically associated with female sex (OR = 1.202; P = 0.029) and younger age (OR = 0.896; P = 0.001). The prevalence of astigmatism (cylinder of ≤ -0.75 D) was 28.8%. Astigmatism was associated with male sex (OR = 0.824; P = 0.001) and younger age (OR = 0.925; P = 0.001). Conclusions A prevalence of 83.2% for myopia and 11.1% for high myopia (SE ≤ -6.0 D) was found in central Chinese university students. In the future, this generation of university students may encounter long-term, vision-threatening effects, especially pathologic myopia.
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Affiliation(s)
- Shifei Wei
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Yunyun Sun
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Shiming Li
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Jianping Hu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Xiaohui Yang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Caixia Lin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Jialing Du
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Jiyuan Guo
- Anyang Eye Hospital, Henan Province, China
| | - He Li
- Anyang Eye Hospital, Henan Province, China
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
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Clinical Performance of the Spot Vision Photo Screener before and after Induction of Cycloplegia in Children. J Ophthalmol 2019; 2019:5329121. [PMID: 31511789 PMCID: PMC6714320 DOI: 10.1155/2019/5329121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 02/27/2019] [Accepted: 03/11/2019] [Indexed: 12/18/2022] Open
Abstract
Aim To compare the clinical performance of the Spot Vision Screener used to detect amblyopia risk factors (ARFs) in children before and after induction of cycloplegia; the children were referred because they met the screening criteria of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS). Methods The Spot Vision Screener and a standard autorefractometer were used to examine 200 eyes of 100 children aged 3–10 years, before and after cycloplegia induction, in terms of ARFs. Sensitivity, specificity, and positive and negative predictive values for the detection of significant refractive errors were measured using the AAPOS referral criteria. It was explored that Spot Screener data were affected by cycloplegia. The extent of agreement between cycloplegic/noncycloplegic photoscreening data and cycloplegic autorefraction measurements was assessed using Wilcoxon and Spearman correlation analyses. Results The Spot's sensitivity was improved from 60.9% to 85.3% and specificity from 94.9% to 87.4% with cycloplegia compared to cycloplegic standard autorefractometer results. The positive predictive value of Spot was 75.7%, and the negative predictive value was 90.4% without cycloplegia. With cycloplegia, the positive predictive value of Spot was 63.6% and the negative predictive value was 95.8%. Conclusions The Spot Screener afforded moderate sensitivity and high specificity prior to cycloplegia. The sensitivity and negative predictive value improved after induction of cycloplegia. Examiners should be aware of the effects of cycloplegia on their findings.
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Alsaif BA, Aljindan MY, Alrammah HM, Almulla MO, Alshahrani SS. Refractive errors among Saudi college students and associated risk factors. Clin Ophthalmol 2019; 13:437-443. [PMID: 30880904 PMCID: PMC6398403 DOI: 10.2147/opth.s193213] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives To determine the prevalence of refractive errors among freshman students of Imam Abdulrahman Bin Faisal University (IAU), and to examine the relationship of near-work activities and outdoor activities with refractive errors. Methods A cross-sectional study of 338 freshman students of IAU (162 males, 176 females) was carried out. Students were selected using a simple random sampling technique. Eye examination was done including non-cycloplegic autorefraction for determining the refractive error status. Myopia was defined as spherical equivalent refraction (SER) ≤−0.75 diopters (D), and it was further divided into low myopia (SER from −0.75 D to −2.99 D), moderate myopia (SER from −3.00 to −5.99 D), and high myopia (SER ≤−6.00 D). Hyperopia was defined as SER ≥1.00 D and emmetropia as having an SER value between that of low myopia and hyperopia. SER was calculated as sphere + 1/2 cylinder. A questionnaire detailed on activities was completed by participants. Results Myopia was found in 47.9% of the students (95% CI 42.7%–53.3%). The most prevalent type of myopia was low myopia (66.7%; 95% CI 59.1%–73.5%). Hyperopia and emmetropia were found in 6.5% (95% CI 4.3%–9.7%) and 45.6% (95% CI 40.3%–50.9%) of the students, respectively. Parental myopia was significantly associated with the myopic status of the students (P=0.007, Fisher’s exact test). About 6% of myopic students had a history of myopia in both parents. In addition, both parents had a history of myopia in 1.9% of emmetropic students, whereas such an association was absent in the hyperopic students. Refractive error type in both genders was not significantly predicted by the activity type. Conclusion Although the different types of activities did not predict the types of refractive errors, the high prevalence of myopia among the college students at this age requires further studies to explore more about the clinical characteristics and risk factors of the disease.
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Affiliation(s)
- Bayan A Alsaif
- College of Medicine, King Fahad Hospital of the University, Imam Abdulrahamn Bin Fasial University, Khobar, Saudi Arabia,
| | - Mohanna Y Aljindan
- Department of Ophthalmology, King Fahad Hospital of the University, Imam Abdulrahman Bin Fasial University, Khobar, Saudi Arabia
| | - Hanan M Alrammah
- College of Medicine, King Fahad Hospital of the University, Imam Abdulrahamn Bin Fasial University, Khobar, Saudi Arabia,
| | - Malak O Almulla
- College of Medicine, King Fahad Hospital of the University, Imam Abdulrahamn Bin Fasial University, Khobar, Saudi Arabia,
| | - Saad S Alshahrani
- Epidemiology Department, King Fahd Specialist Hospital, Dammam, Saudi Arabia
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