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Qiuxin W, Xiuyan Z, Qingmei T, jiaojiao F, Xiaoxiao G, yijie L, Dadong G, Jike S, Hongsheng B. Analysis of the peripheral refraction in myopic adults using a novel multispectral refraction topography. Heliyon 2024; 10:e36020. [PMID: 39229498 PMCID: PMC11369475 DOI: 10.1016/j.heliyon.2024.e36020] [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: 09/16/2023] [Revised: 08/05/2024] [Accepted: 08/08/2024] [Indexed: 09/05/2024] Open
Abstract
Purpose To determine the distribution and characteristics of peripheral refraction in adults with myopia using the novel multispectral refraction topography. Method A total of 187 adults with myopia were recruited for this study. This study was conducted in two stages. Part I: participants were divided into 6 groups based on the central refraction of the right eyes, Part II: according to the interocular differences in refractive error (IOD) of the central refraction, we divided the participants into isomyopia group (IOD<1.00 D) and anisomyopia group (IOD≥1.0 D). We surveyed the characteristics of peripheral refraction and relative peripheral refraction (RPR), as well as the correlation between RPR and central refraction, age, sex, and axial length. Result Part I: With an increase in the degree of myopia, relative peripheral hyperopia developed from the center to the periphery. A statistically significant hyperopia shift compared to the center (P < 0.05) was first observed on the temporal side within a 40° field of view at the posterior pole of the retina. The RPR of the temporal, superior, and inferior retinas positively correlated only with age. Part II: In the isomyopic participants, there was no difference in peripheral refraction between the eyes (P < 0.05). In the anisomyopic participants, the RPR of the more myopic eyes was more hyperopic than that of the less myopic eyes in NRDV40-50, SRDV10-20, SRDV30-50, TRDV20-30, TRDV40-50, and IRDV10-40. Conclusion With an increase in the degree of myopia, relative peripheral hyperopia developed from the center to the periphery, and peripheral refraction progressed at different rates in various retinal zones.
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Affiliation(s)
- Wu Qiuxin
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, No.48#, Yingxiongshan Road, Jinan, 250002, PR China
- Shandong University of Traditional Chinese Medicine, No. 16369#, Jingshi Road, Jinan, 250014, PR China
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Shandong Academy of Eye Disease Prevention and Therapy , No. 48#, Yingxiongshan Road, Jinan, 250002, PR China
| | - Zhang Xiuyan
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, No.48#, Yingxiongshan Road, Jinan, 250002, PR China
- Shandong University of Traditional Chinese Medicine, No. 16369#, Jingshi Road, Jinan, 250014, PR China
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Shandong Academy of Eye Disease Prevention and Therapy , No. 48#, Yingxiongshan Road, Jinan, 250002, PR China
| | - Tian Qingmei
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, No.48#, Yingxiongshan Road, Jinan, 250002, PR China
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Shandong Academy of Eye Disease Prevention and Therapy , No. 48#, Yingxiongshan Road, Jinan, 250002, PR China
| | - Feng jiaojiao
- Shandong University of Traditional Chinese Medicine, No. 16369#, Jingshi Road, Jinan, 250014, PR China
| | - Guo Xiaoxiao
- Shandong University of Traditional Chinese Medicine, No. 16369#, Jingshi Road, Jinan, 250014, PR China
| | - Liu yijie
- Shandong University of Traditional Chinese Medicine, No. 16369#, Jingshi Road, Jinan, 250014, PR China
| | - Guo Dadong
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Shandong Academy of Eye Disease Prevention and Therapy , No. 48#, Yingxiongshan Road, Jinan, 250002, PR China
| | - Song Jike
- Shandong University of Traditional Chinese Medicine, No. 16369#, Jingshi Road, Jinan, 250014, PR China
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Shandong Academy of Eye Disease Prevention and Therapy , No. 48#, Yingxiongshan Road, Jinan, 250002, PR China
| | - Bi Hongsheng
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, No.48#, Yingxiongshan Road, Jinan, 250002, PR China
- Shandong University of Traditional Chinese Medicine, No. 16369#, Jingshi Road, Jinan, 250014, PR China
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Shandong Academy of Eye Disease Prevention and Therapy , No. 48#, Yingxiongshan Road, Jinan, 250002, PR China
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Mi X, Fang Y, Pu J, Chen W, Zhou Z, Qin M, Zhang R, Wang D, Yang Y, Peng C, Bian S, Jin M, Xu H, Jiao Y. Temporal vascular arcade angle in fundus image was associated with the rate of spherical equivalent refractive error and axial length changes in myopia children with young school age. Photodiagnosis Photodyn Ther 2024; 49:104305. [PMID: 39134251 DOI: 10.1016/j.pdpdt.2024.104305] [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: 06/17/2024] [Revised: 07/28/2024] [Accepted: 08/09/2024] [Indexed: 08/25/2024]
Abstract
PURPOSE To evaluate temporal vascular arcade angle and its influencing factors in myopic children. METHODS It was a retrospective study, we reviewed the records of 119 patients aged 6-10 years with myopia (spherical equivalent refractive error (SER) ≤ -0.05D) in the third year of follow-up in Beijing Hyperopia Reserve Research. We measured temporal vascular arcade angles on the fundus photographs and measured 3-year rate of spherical equivalent(D/year) and axial length (AXL) changes(mm/year). RESULTS Mean age at initial visit was 7.71±1.20 years and mean SER was -1.32±1.09D. Children were divided into two groups according to the refractive status of children at baseline: Myopia onset group (SER>-0.50D at baseline) (n = 107) and Myopia progression group (SER≤-0.50D at baseline) (n = 12). The mean SER in Myopia progression group was much smaller than Myopia onset group (P < 0.001) and mean AXL in Myopia progression group was much longer than Myopia onset group (P = 0.042). AXL (r=-0.320, P < 0.001), SER change rate (r=-0.209, P = 0.022) and AXL change rate (r=-0.232, P = 0.011) were associated with temporal vascular arcade angle in all participants. In Myopia onset group, AXL (r=-0.317, P < 0.001) and AXL change rate (r=-0.190, P = 0.05) were associated with temporal vascular arcade angle. There were no parameters were associated with temporal vascular arcade angle (all P > 0.05) in Myopia progression group. Only AXL (r=-0.306, P = 0.018) was associated with temporal vascular arcade angle in girls while AXL (r=-0.370, P = 0.004), SER change rate (r=-0.317, P = 0.013) and AXL change rate (r=-0.365, P = 0.004) were all associated with the Angle in boys. CONCLUSION Temporal vascular arcade angle was associated with the rate of SER and AXL changes in myopia onset children, and showed gender differences. These may suggest that lamina cribrosa location has different influencing factors in different genders and different stages of myopia development. Due to the small number of people in Myopia progression group, large sample size studies are still needed in the future.
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Affiliation(s)
- Xuejing Mi
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
| | - Yuxin Fang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
| | - Jianing Pu
- Maternal and Child Health Hospital of Haidian District, Beijing, China
| | - Wei Chen
- Maternal and Child Health Hospital of Haidian District, Beijing, China
| | - Zhen Zhou
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Mengmeng Qin
- School of Geosciences and Surveying Engineering, China University of Mining and Technology-Beijing, Beijing 100083, China
| | - Ranran Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
| | - Dan Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
| | - Yanyan Yang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
| | - Chuzhi Peng
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
| | - Shimeng Bian
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
| | - Mingrui Jin
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
| | - Huaying Xu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China
| | - Yonghong Jiao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing. No. 1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China.
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Su B, Cho P, Vincent SJ, Zheng J, Chen J, Ye C, Wang T, Zhang J, Zhang K, Lu F, Jiang J. Novel Lenslet-ARray-Integrated Spectacle Lenses for Myopia Control: A 1-Year Randomized, Double-Masked, Controlled Trial. Ophthalmology 2024:S0161-6420(24)00413-5. [PMID: 38972357 DOI: 10.1016/j.ophtha.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 06/27/2024] [Accepted: 07/01/2024] [Indexed: 07/09/2024] Open
Abstract
PURPOSE To investigate the myopia control efficacy of novel Lenslet-ARray-Integrated (LARI) spectacle lenses with positive power lenslets (PLARI) and negative power lenslets (NLARI) worn for 1 year in myopic children. DESIGN Randomized, double-masked, controlled clinical trial. PARTICIPANTS A total of 240 children 6 to 12 years of age with spherical equivalent refraction (SER) between -4.00 and -1.00 diopters (D), astigmatism of ≤ 1.50 D, and anisometropia of ≤ 1.00 D. METHODS Participants were assigned randomly in a 1:1:1 ratio to PLARI, NLARI, and control (single-vision [SV]) groups. Cycloplegic autorefraction and axial length were measured at baseline and 6-month intervals after lens wear. MAIN OUTCOME MEASURES Changes in SER, axial elongation (AE), and differences between groups. RESULTS After 1 year, SER changes and AE in the PLARI and NLARI groups were significantly less than those in the SV group (SER: -0.30 ± 0.48 D, -0.21 ± 0.35 D, and -0.66 ± 0.40 D, respectively; AE: 0.19 ± 0.20 mm, 0.17 ± 0.14 mm, 0.34 ± 0.18 mm, respectively; all P < 0.001). No significant differences were found in SER changes and AE between PLARI and NLARI groups (P = 0.54 and P = 1.00, respectively). Younger age was associated with more rapid SER increase and larger AE in the SV group (r = 0.40 [P < 0.001] and r = -0.59 [P < 0.001], respectively) and PLARI group (r = 0.46 [P < 0.001] and r = -0.52 [P < 0.001], respectively), but not in the NLARI group (r = -0.002 [P = 0.98] and r = -0.08 [P = 0.48], respectively). CONCLUSIONS Compared with the SV group, both PLARI and NARI groups showed significantly slower myopia progression in terms of SER and AE. Faster myopia progression, in terms of both SER and AE, was associated with younger age in the SV and PLARI groups but not the NLARI group. 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)
- Binbin Su
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Pauline Cho
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China; Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China; Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Stephen J Vincent
- Discipline of Optometry and Vision Science, Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jingwei Zheng
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jiaojie Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Cong Ye
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Tengfei Wang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jingwei Zhang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Kou Zhang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Fan Lu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China.
| | - Jun Jiang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China.
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Schaeffel F, Swiatczak B. Mechanisms of emmetropization and what might go wrong in myopia. Vision Res 2024; 220:108402. [PMID: 38705024 DOI: 10.1016/j.visres.2024.108402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 03/25/2024] [Accepted: 03/25/2024] [Indexed: 05/07/2024]
Abstract
Studies in animal models and humans have shown that refractive state is optimized during postnatal development by a closed-loop negative feedback system that uses retinal image defocus as an error signal, a mechanism called emmetropization. The sensor to detect defocus and its sign resides in the retina itself. The retina and/or the retinal pigment epithelium (RPE) presumably releases biochemical messengers to change choroidal thickness and modulate the growth rates of the underlying sclera. A central question arises: if emmetropization operates as a closed-loop system, why does it not stop myopia development? Recent experiments in young human subjects have shown that (1) the emmetropic retina can perfectly distinguish between real positive defocus and simulated defocus, and trigger transient axial eye shortening or elongation, respectively. (2) Strikingly, the myopic retina has reduced ability to inhibit eye growth when positive defocus is imposed. (3) The bi-directional response of the emmetropic retina is elicited with low spatial frequency information below 8 cyc/deg, which makes it unlikely that optical higher-order aberrations play a role. (4) The retinal mechanism for the detection of the sign of defocus involves a comparison of defocus blur in the blue (S-cone) and red end of the spectrum (L + M-cones) but, again, the myopic retina is not responsive, at least not in short-term experiments. This suggests that it cannot fully trigger the inhibitory arm of the emmetropization feedback loop. As a result, with an open feedback loop, myopia development becomes "open-loop".
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Affiliation(s)
- Frank Schaeffel
- Myopia Research Group, Institute of Molecular and Clinical Ophthalmology Basel (IOB), Switzerland; Section Neurobiology of the Eye, Institute of Ophthalmic Research, University of Tübingen, Germany; Zeiss Vision Lab, Institute of Ophthalmic Research, University of Tübingen, Germany.
| | - Barbara Swiatczak
- Myopia Research Group, Institute of Molecular and Clinical Ophthalmology Basel (IOB), Switzerland
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Peng Z, Xiang A, He H, Luo Y, Wu S, Luo Y, Yang J, Nie K, Zhong X. Brimonidine as a possible treatment for myopia. BMC Ophthalmol 2024; 24:161. [PMID: 38605375 PMCID: PMC11007938 DOI: 10.1186/s12886-024-03433-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/04/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Myopia is becoming a huge burden on the world's public health systems. The purpose of this study was to explore the effect of brimonidine in the treatment of form-deprivation myopia (FDM) and the relationship between intraocular pressure (IOP) and myopia development. METHODS Monocular form deprivation myopia (FDM) was induced in three-week-old pigmented male guinea pigs. They were treated with 3 different methods of brimonidine administration (eye drops, and subconjunctival or intravitreal injections). Four different concentrations of brimonidine were tested for each method (2µg/µL, 4µg/µL, 20µg/µL, and 40µg/µL). All treatments continued for a period of 21 days. Tonometry, retinoscopy, and A-scan ultrasonography were used to monitor intraocular pressure, refractive error and axial length (AL), respectively. RESULTS Treatment with subconjunctival brimonidine at 40µg/µL, and intravitreal brimonidine at 2µg/µL and 4µg/µL, inhibited the development of FDM. The myopic refraction, excessive axial length, and elevation of IOP were significantly decreased. Brimonidine in eye drops was ineffective. CONCLUSION Brimonidine at appropriate doses significantly reduced the development of FD myopia in guinea pigs. The IOP may change with FD myopia.
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Affiliation(s)
- Zixuan Peng
- Hainan Provincial Key Laboratory of Ophthalmology, Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, No. 19 Xiuhua Road, Xiuying District, 570300, Haikou, Hainan, China
- Hainan Medical University, Haikou, Hainan, China
| | - Aiqun Xiang
- Hainan Provincial Key Laboratory of Ophthalmology, Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, No. 19 Xiuhua Road, Xiuying District, 570300, Haikou, Hainan, China
| | - Hong He
- Hainan Provincial Key Laboratory of Ophthalmology, Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, No. 19 Xiuhua Road, Xiuying District, 570300, Haikou, Hainan, China.
| | - Yaqi Luo
- Hainan Provincial Key Laboratory of Ophthalmology, Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, No. 19 Xiuhua Road, Xiuying District, 570300, Haikou, Hainan, China
- Hainan Medical University, Haikou, Hainan, China
| | - Shunliang Wu
- Hainan Provincial Key Laboratory of Ophthalmology, Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, No. 19 Xiuhua Road, Xiuying District, 570300, Haikou, Hainan, China
- Hainan Medical University, Haikou, Hainan, China
| | - Yanting Luo
- Hainan Provincial Key Laboratory of Ophthalmology, Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, No. 19 Xiuhua Road, Xiuying District, 570300, Haikou, Hainan, China
- Hainan Medical University, Haikou, Hainan, China
| | - Junming Yang
- Hainan Provincial Key Laboratory of Ophthalmology, Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, No. 19 Xiuhua Road, Xiuying District, 570300, Haikou, Hainan, China
- Hainan Medical University, Haikou, Hainan, China
| | - Ke Nie
- Hainan Provincial Key Laboratory of Ophthalmology, Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, No. 19 Xiuhua Road, Xiuying District, 570300, Haikou, Hainan, China
- Hainan Medical University, Haikou, Hainan, China
| | - Xingwu Zhong
- Hainan Provincial Key Laboratory of Ophthalmology, Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-sen University, No. 19 Xiuhua Road, Xiuying District, 570300, Haikou, Hainan, China.
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
- Hainan Medical University, Haikou, Hainan, China.
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Lu W, Ji R, Jiang D, Shi L, Ding W, Tian Y, Zhao C, Leng L. Different efficacy in myopia control: Comparison between orthokeratology and defocus-incorporated multiple segment lenses. Cont Lens Anterior Eye 2024; 47:102122. [PMID: 38220497 DOI: 10.1016/j.clae.2024.102122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/31/2023] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
PURPOSE To compare the efficiency of orthokeratology (OK) and defocus-incorporated multiple segment (DIMS) lenses in myopia control in children. METHODS This prospective study involved 540 subjects (7-14 years) categorized into three groups: DIMS lenses (180 cases), OK lenses (180 cases), or single-vision spectacles (SVS) (180 cases). After a one-year follow-up, changes in axial length (AL) and differences among the groups were analyzed. The subjects were further divided into a low myopia degree subgroup (LM, -1.50 D ≤ SE ≤ -0.50 D), a moderate myopia degree subgroup (MM, -3.00 D ≤ SE < -1.50 D), and a high myopia degree subgroup (HM, -5.00 D ≤ SE < -3.00 D). A one-way ANOVA and multiple linear regression analysis were used to compare AL elongation and the factors influencing the different groups. RESULTS A total of 496 (92 %) subjects completed the study. The mean AL change in the OK lenses, DIMS lenses, and SVS were 0.20±0.18 mm, 0.30±0.22 mm, and 0.38±0.19 mm, respectively (P < 0.001). In the LM subgroup, the OK and DIMS groups showed similar AL changes, but both exhibited slower changes than the SVS group (P = 0.001). In the MM and HM subgroups, the OK lens performed the shortest AL elongation compared with the DIMS lenses and SVS (P < 0.001). Multiple regression analysis showed that the AL change was associated with age (β = -0.038 and P = 0.005), initial AL (β = -0.010 and P = 0.011), initial SE (β = 0.028 and P = 0.007), and interventions using OK lenses (β = -0.172 and P = 0.020) and DIMS lenses (β = -0.089 and P = 0.020). CONCLUSION Over a one-year treatment period, OK and DIMS lenses can significantly retard AL elongation compared with SVS. In addition, the OK lenses were more effective than the DIMS lenses in controlling AL in patients with higher degrees of myopia.
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Affiliation(s)
- Weicong Lu
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China; School of Ophthalmology, Shandong First Medical University, China
| | - Rongyuan Ji
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China; School of Ophthalmology, Shandong First Medical University, China
| | - Dongdong Jiang
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China; School of Ophthalmology, Shandong First Medical University, China
| | - Lin Shi
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China; School of Ophthalmology, Shandong First Medical University, China
| | - Wenzhi Ding
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China; School of Ophthalmology, Shandong First Medical University, China
| | - Yuyin Tian
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China; School of Ophthalmology, Shandong First Medical University, China
| | - Chenpei Zhao
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China; School of Ophthalmology, Shandong First Medical University, China
| | - Lin Leng
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China; School of Ophthalmology, Shandong First Medical University, China.
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Hung LF. Visual information and the development/control of myopia: Insights from nonhuman primate experiences. Taiwan J Ophthalmol 2024; 14:172-178. [PMID: 39027077 PMCID: PMC11254003 DOI: 10.4103/tjo.tjo-d-24-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 03/16/2024] [Indexed: 07/20/2024] Open
Abstract
Over the past few decades, primarily by animal studies, correspondingly reinforced by epidemiological, clinical studies and controlled trials, researchers have identified that visual feedback regulates eye refractive developments, with visual image alterations being the most influential myopiagenic environmental factor. This article reviews studies using nonhuman primates to investigate visual risk factors for myopia development and evaluates and summarizes which visual factors contribute to the occurrence and progression of myopia. The possible underlying myopiagenic mechanisms and related myopia prevention/control strategies are also discussed.
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Affiliation(s)
- Li-Fang Hung
- College of Optometry, University of Houston, Houston, TX, USA
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Wang Y, Liu F, Zhu X, Liu Y, He JC, Zhou X, Qu X. Effects on radius of curvature and refractive power of the cornea and crystalline lens by atropine 0.01% eye drops. Acta Ophthalmol 2024; 102:e69-e77. [PMID: 37143398 DOI: 10.1111/aos.15679] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 03/02/2023] [Accepted: 04/21/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE The morphological changes in the cornea and crystalline lens have not been closely evaluated after the administration of atropine 0.01%. This study aims to evaluate the radii of curvature and refractive power of the cornea and lens in myopic eyes during atropine 0.01% treatment. METHODS Children aged 6-14 years with myopia <-6.0 D were randomized to receive atropine 0.01% once nightly with single vision lenses or simply wear single vision lenses. Ocular biometric parameters were measured using the IOLMaster 700 biometry and the radii of corneal and lenticular curvature were simulated using a customized program. RESULTS At the 9-month visit, 69 atropine-treated eyes and 50 control eyes were included in the final analyses. In atropine-treated eyes, the posterior corneal surface steepened (-0.05 ± 0.13 mm) and the anterior lenticular surface flattened (0.20 ± 0.69 mm) significantly within 3-6 months, whereas the posterior corneal surface and anterior lenticular surface gradually flattened (0.07 ± 0.23 and 0.32 ± 0.80 mm respectively) in the control eyes over 9 months. The difference in the change of corneal refractive power was significant between groups (-0.03 ± 0.18 D vs. 0.11 ± 0.24 D, p = 0.001), while that in the change of lenticular refractive power was statistically insignificant (0.01 ± 0.92 D vs. -0.22 ± 0.86 D, p = 0.161). CONCLUSIONS The administration of atropine 0.01% exhibited a clinically short and subtle impact on the cornea and lens, which may shed light on new targets of action for atropine in inhibiting myopia.
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Affiliation(s)
- Yuliang Wang
- Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Fang Liu
- Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xingxue Zhu
- Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Yujia Liu
- Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Ji C He
- Department of Vision Science, New England College of Optometry, Boston, Massachusetts, USA
| | - Xingtao Zhou
- Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xiaomei Qu
- Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
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9
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Peng X, Huang Y, Wang Y, Shang J, Shen Y, Chen Z, Zhou X, Han T. Early regional changes in retina and choroid of chicks following monocular hemifield form deprivation. Exp Eye Res 2024; 239:109786. [PMID: 38211681 DOI: 10.1016/j.exer.2024.109786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 12/21/2023] [Accepted: 01/08/2024] [Indexed: 01/13/2024]
Abstract
To investigate regional changes in the chick retina and choroid after hemifield form deprivation (HFD). Ten chicks were randomly and equally divided into a temporal retinal deprivation (TRD) and nasal retinal deprivation (NRD) group. HFD was induced with half-lateral translucent plastic goggles in the right eye; the left eye was kept untreated. Swept-source optical coherence tomography (SS-OCT) images obtained at 0, 3, and 72 hours (h) were analyzed using customized software. After 72 h of TRD, the retinal thickness (RT) of the treated eyes was significantly less than that of the fellow eyes in the temporal (P = 0.034) rather than the nasal (P = 0.083) region. In the NRD group, the RT of the treated eyes was thinner in both the nasal and temporal regions than that of the fellow eyes (P < 0.01). The RT alterations were more pronounced in the temporal (Δ = -16.86 ± 7.14 μm) than in the nasal (Δ = -13.44 ± 4.83 μm) region after 72-h TRD (P = 0.036), whereas the opposite was observed in the NRD group (P = 0.008). The choroidal thickness (ChT) of the treated eyes was less in both the nasal and temporal regions than that of the fellow eyes in both groups after 72-h treatment (P < 0.01). The ChT alterations were more pronounced in the temporal (Δ = -2.48 ± 8.95 μm) than in the nasal (Δ = 23.65 ± 13.58 μm) region after 72-h TRD (P = 0.021), whereas the NRD group showed the opposite effect (P = 0.019). HFD in chicks can lead to retinal and choroidal thinning in the corresponding regions.
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Affiliation(s)
- Xiaoliao Peng
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Research Center of Ophthalmology and Optometry, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, China
| | - Yangyi Huang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Research Center of Ophthalmology and Optometry, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, China
| | - Yuliang Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Research Center of Ophthalmology and Optometry, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, China
| | - Jianmin Shang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Research Center of Ophthalmology and Optometry, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, China
| | - Yang Shen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Research Center of Ophthalmology and Optometry, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, China
| | - Zhi Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Research Center of Ophthalmology and Optometry, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Research Center of Ophthalmology and Optometry, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, China.
| | - Tian Han
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, 200031, China; Shanghai Research Center of Ophthalmology and Optometry, China; Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, China.
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10
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Marcellán Vidosa MC, Remón L, Ávila FJ. Peripheral refraction under different levels of illuminance. Ophthalmic Physiol Opt 2024; 44:191-198. [PMID: 37950504 DOI: 10.1111/opo.13244] [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: 06/09/2023] [Revised: 10/21/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Abstract
Peripheral refraction is believed to be involved in the development of myopia. The aim of this study was to compare the relative peripheral refraction (RPR) at four different levels of illuminance, ranging from photopic conditions to complete darkness, using an open-field autorefraction method. The RPR was calculated for each eccentricity by subtracting central from peripheral autorefraction measurements. The study included 114 myopic eyes from 114 subjects (mean age of 21.81 ± 1.91 years) and the mean difference in RPR between scotopic and photopic conditions (0 and 300 lux, respectively) was +0.32 D at 30° temporal and +0.37 D at 30° in the nasal visual field (NVF). Statistically significant differences were observed between 0 and 300 lux at 30° in the temporal visual field and at 30° and 20° in the NVF. Our results revealed a significant increase in relative peripheral hyperopia with increasing visual field eccentricity along the horizontal visual field in myopic eyes of young adults. Furthermore, this relative peripheral hyperopia increased as illumination decreased. These findings suggest that an increase in peripheral illuminance may protect against myopic eye growth.
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Affiliation(s)
| | - Laura Remón
- Department of Applied Physics, Universidad de Zaragoza, Zaragoza, Spain
| | - Francisco J Ávila
- Department of Applied Physics, Universidad de Zaragoza, Zaragoza, Spain
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11
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Shen L, He W, Yang W, Yan W, Yang C. Effect of wearing peripheral focus-out glasses on emmetropization in Chinese children aged 6-8 years: study protocol for a 2-year randomized controlled intervention trial. Trials 2023; 24:746. [PMID: 37993963 PMCID: PMC10666424 DOI: 10.1186/s13063-023-07799-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/10/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Myopia is one of the most common eye diseases causing visual impairment and blindness, and the high prevalence in adolescents remains a major public health concern. Based on clinical studies using optical defocus to regulate ocular growth and refractive changes through visual feedback, we hypothesize that early wearing of peripheral myopic defocusing spectacles in children with high risk of myopia may slow the process of emmetropization and even prevent the onset of myopia by inducing more peripheral myopic defocus. The aim of this study is to investigate whether the wearing of peripheral focus-out glasses can be effective in delaying emmetropization in non-myopic children aged 6-8 years. METHODS The study is a 2-year randomized controlled trial. A total of 160 subjects will be randomized into the experimental group or the control group. The experimental group will be fitted with direct emmetropia with focus-out glasses (DEFOG) to guide the emmetropization process. The control group will not receive any treatment and will serve as a blank control group. The primary aim is to determine whether non-myopic children wearing DEFOG lenses are superior to those who do not receive any intervention on the progression of cycloplegic objective refraction over 2 years. DISCUSSION This is the first randomized controlled trial aiming at myopic prevention by non-invasive intervention in non-myopic children. This study aims to initially investigate whether wearing peripheral focus-out glasses can effectively delay the process of emmetropization in children aged 6-8 years with high risk of myopia, which might give potential clues for further exploration on early prevention of myopia. TRIAL REGISTRATION ClinicalTrials.gov NCT05689567. Registered on 10 January 2023.
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Affiliation(s)
- Li Shen
- Department of Ophthalmology, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Shanghai, China
| | - Wennan He
- Department of Clinical Epidemiology & Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Shanghai, China
| | - Weiming Yang
- Department of Ophthalmology, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Shanghai, China
| | - Weili Yan
- Department of Clinical Epidemiology & Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Shanghai, China.
| | - Chenhao Yang
- Department of Ophthalmology, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Shanghai, China.
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12
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Berntsen DA, Ticak A, Sinnott LT, Chandler MA, Jones JH, Morrison A, Jones-Jordan LA, Walline JJ, Mutti DO. Peripheral Defocus, Pupil Size, and Axial Eye Growth in Children Wearing Soft Multifocal Contact Lenses in the BLINK Study. Invest Ophthalmol Vis Sci 2023; 64:3. [PMID: 37910092 PMCID: PMC10627291 DOI: 10.1167/iovs.64.14.3] [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: 07/06/2023] [Accepted: 10/10/2023] [Indexed: 11/03/2023] Open
Abstract
Purpose The purpose of this study was to evaluate the relationship between peripheral defocus and pupil size on axial growth in children randomly assigned to wear either single vision contact lenses, +1.50 diopter (D), or +2.50 D addition multifocal contact lenses (MFCLs). Methods Children 7 to 11 years old with myopia (-0.75 to -5.00 D; spherical component) and ≤1.00 D astigmatism were enrolled. Autorefraction (horizontal meridian; right eye) was measured annually wearing contact lenses centrally and ±20 degrees, ±30 degrees, and ±40 degrees from the line of sight at near and distance. Photopic and mesopic pupil size were measured. The effects of peripheral defocus, treatment group, and pupil size on the 3-year change in axial length were modeled using multiple variables that evaluated defocus across the retina. Results Although several peripheral defocus variables were associated with slower axial growth with MFCLs, they were either no longer significant or not meaningfully associated with eye growth after the treatment group was included in the model. The treatment group assignment better explained the slower eye growth with +2.50 MFCLs than peripheral defocus. Photopic and mesopic pupil size did not modify eye growth with the +2.50 MFCL (all P ≥ 0.37). Conclusions The optical signal causing slower axial elongation with +2.50 MFCLs is better explained by the lens type worn than by peripheral defocus. The signal might be something other than peripheral defocus, or there is not a linear dose-response relationship within treatment groups. We found no evidence to support pupil size as a criterion when deciding which myopic children to treat with MFCLs.
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Affiliation(s)
- David A. Berntsen
- College of Optometry, The University of Houston, Houston, Texas, United States
| | - Anita Ticak
- College of Optometry, The University of Houston, Houston, Texas, United States
| | - Loraine T. Sinnott
- College of Optometry, The Ohio State University, Columbus, Ohio, United States
| | - Moriah A. Chandler
- College of Optometry, The University of Houston, Houston, Texas, United States
| | - Jenny Huang Jones
- College of Optometry, The Ohio State University, Columbus, Ohio, United States
| | - Ann Morrison
- College of Optometry, The Ohio State University, Columbus, Ohio, United States
| | | | - Jeffrey J. Walline
- College of Optometry, The Ohio State University, Columbus, Ohio, United States
| | - Donald O. Mutti
- College of Optometry, The Ohio State University, Columbus, Ohio, United States
| | - for the BLINK Study Group
- College of Optometry, The University of Houston, Houston, Texas, United States
- College of Optometry, The Ohio State University, Columbus, Ohio, United States
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13
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Huang Y, Zhang J, Yin Z, Yang A, Spiegel DP, Drobe B, Chen H, Bao J, Li X. Effects of Spectacle Lenses With Aspherical Lenslets on Peripheral Eye Length and Peripheral Refraction in Myopic Children: A 2-Year Randomized Clinical Trial. Transl Vis Sci Technol 2023; 12:15. [PMID: 37955608 PMCID: PMC10653269 DOI: 10.1167/tvst.12.11.15] [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: 04/17/2023] [Accepted: 07/27/2023] [Indexed: 11/14/2023] Open
Abstract
Purpose To investigate changes in peripheral eye length (PEL) and peripheral refraction (PR) in myopic children after wearing spectacle lenses with highly or slightly aspherical lenslets (HAL or SAL) for 2 years. Methods We recruited 170 children aged 8 to 13 years with myopia between -0.75 diopters (D) and -4.75 D. Participants were randomized to wear HAL, SAL, or single vision spectacle lenses (SVL). PEL and PR were measured at 0° central and 15° and 30° in the nasal and temporal retina every 6 months for 2 years. The relative PR (RPR) was calculated by subtracting central from peripheral values. Results PELs significantly increased with time (all P < 0.001), with the greatest elongation in the SVL group and the least in the HAL group. In the SVL and SAL groups, axial length elongated faster than the periphery. Whereas in the HAL group, N30 elongated faster than other PELs, axial length elongated less than the periphery. With time, the PR became more negative (all P < 0.001), with the most negative changes in the SVL group and the least negative changes in the HAL group. RPR became more hyperopic in the SVL and SAL groups, but less hyperopic in the HAL group (all P < 0.001). Conclusions Over the 2-year myopia progression, steeper retina and greater peripheral hyperopic defocus were found in the SVL group. In the SAL group, changes were attenuated. In the HAL group, the retina flattened and peripheral defocus became less hyperopic. Translational Relevance HAL and SAL lenses had little impact on PEL elongation.
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Affiliation(s)
- Yingying Huang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jiali Zhang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ziang Yin
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Adeline Yang
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
- R&D Singapore, Essilor International, Singapore, Singapore
| | - Daniel P. Spiegel
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
- R&D Singapore, Essilor International, Singapore, Singapore
| | - Björn Drobe
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
- R&D Singapore, Essilor International, Singapore, Singapore
| | - Hao Chen
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jinhua Bao
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xue Li
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
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14
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Luo N, Wang Y, Alimu S, Zhao L, Huang Y, Guo Z, Zhao X, Liu B, Chen S, Lu L. Assessment of Ocular Deformation in Pathologic Myopia Using 3-Dimensional Magnetic Resonance Imaging. JAMA Ophthalmol 2023; 141:768-774. [PMID: 37440241 PMCID: PMC10346513 DOI: 10.1001/jamaophthalmol.2023.2869] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/16/2023] [Indexed: 07/14/2023]
Abstract
IMPORTANCE Ocular deformation in pathologic myopia can affect the entire globe. However, few studies have investigated the equatorial pattern of ocular shape. In addition, the correlation between equatorial and posterior morphology needs to be further explored. OBJECTIVE To assess global ocular deformation in pathologic myopia. DESIGN, SETTING, AND PARTICIPANTS This hospital-based, cross-sectional study included 180 pathologic myopic eyes with atrophic maculopathy grading C2 (diffuse chorioretinal atrophy) or more from 180 participants who underwent comprehensive ophthalmic examination, including high-resolution 3-dimensional magnetic resonance imaging. In addition, 10 nonpathologic myopic eyes of 10 participants were set as the control group. Main Outcomes and Measures According to the cross-sectional view of equator, equatorial shape was classified as round, rectangular, pyriform (noncircular and more protruded in 1 direction), vertical-elliptical, or horizontal-elliptical; according to the nasal and inferior views, the posterior shape was categorized as spheroidal, conical, bulb-shaped, ellipsoidal, multidistorted, and barrel-shaped. Equatorial circularity and ocular sphericity were used to quantitatively assess the morphological variability of the equatorial and posterior regions, respectively. The association between ocular morphology and ocular parameters and myopic maculopathy was also investigated. Results The mean (SD) age of 180 participants with pathologic myopia was 55.14 (10.74) years, 127 were female (70.6%), and the mean (SD) axial length of studied eyes was 30.22 (2.25) mm. The predominant equatorial shape was pyriform (66 eyes [36.7%]), followed by round (45 eyes [25.0%]). The predominant posterior shape was bulb-shaped (97 eyes [52.2%]), followed by multidistorted (46 eyes [24.7%]). Equatorial circularity and equatorial shapes were correlated (r = -0.469; 95% CI, -0.584 to -0.346; P < .001) and ocular sphericity was correlated with posterior shapes (r = -0.533; 95% CI, -0.627 to -0.427; P < .001). In eyes with a vertical-elliptical equator, equatorial circularity and ocular sphericity were positively linearly correlated (R2 = 0.246; 95% CI, 0.050-0.496; P = .002) and the prevalence of inferior staphyloma was higher (27.8%; P = .04). Eyes with a horizontal-elliptical equator have the most horizontally oriented axis of corneal flat keratometry (median, 43.55 [interquartile range, 43.84] degrees; P = .01) and tended to present with multidistorted posterior shape (21.7%; P = .04). Conclusions and Relevance These findings suggest ocular deformation is common in pathologic myopia and can affect the entire eye, including the equatorial and posterior regions. The morphological classification may enhance the understanding of the diverse patterns of ocular shape in pathologic myopia.
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Affiliation(s)
- Nan Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yanbing Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Subinuer Alimu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Liyi Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yanqiao Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Ziyi Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiujuan Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Bingqian Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Shida Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Lin Lu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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15
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Manoharan MK, Thakur S, Dhakal R, Gupta SK, Priscilla JJ, Bhandary SK, Srivastava A, Marmamula S, Poigal N, Verkicharla PK. Myopia progression risk assessment score (MPRAS): a promising new tool for risk stratification. Sci Rep 2023; 13:8858. [PMID: 37258536 DOI: 10.1038/s41598-023-35696-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/22/2023] [Indexed: 06/02/2023] Open
Abstract
Timely identification of individuals "at-risk" for myopia progression is the leading requisite for myopia practice as it aids in the decision of appropriate management. This study aimed to develop 'myopia progression risk assessment score' (MPRAS) based on multiple risk factors (10) to determine whether a myope is "at-risk" or "low-risk" for myopia progression. Two risk-score models (model-1: non-weightage, model-2: weightage) were developed. Ability of MPRAS to diagnose individual "at-risk" for myopia progression was compared against decision of five clinicians in 149 myopes, aged 6-29 years. Using model-1 (no-weightage), further 7 sub-models were created with varying number of risk factors in decreasing step-wise manner (1a: 10 factors to 1g: 4 factors). In random eye analysis for model-1, the highest Youden's J-index (0.63-0.65) led to the MPRAS cut-off score of 41.50-43.50 for 5 clinicians with a sensitivity ranging from 78 to 85% and specificity ranging from 79 to 87%. For this cut-off score, the mean area under the curve (AUC) between clinicians and the MPRAS model ranged from 0.89 to 0.90. Model-2 (weighted for few risk-factors) provided similar sensitivity, specificity, and AUC. Sub-model analysis revealed greater AUC with high sensitivity (89%) and specificity (94%) in model-1g that has 4 risk factors compared to other sub-models (1a-1f). All the MPRAS models showed good agreement with the clinician's decision in identifying individuals "at-risk" for myopia progression.
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Affiliation(s)
- Manoj K Manoharan
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
- Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Swapnil Thakur
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
| | - Rohit Dhakal
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
- Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Satish K Gupta
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
| | - Jacinth J Priscilla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
| | - Shashank K Bhandary
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
| | - Alok Srivastava
- L V Prasad Eye Institute, Hyderabad, Telangana, India
- Sri Innovation and Research Foundation, Ghaziabad, Uttar Pradesh, India
| | - Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Nitish Poigal
- L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Pavan K Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India.
- Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India.
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16
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Lu W, Peng Z, Ding W, Ji R, Tian Y, Zhao C, Leng L. The Influence of Accommodation on Retinal Peripheral Refraction Changes in Different Measurement Areas. J Ophthalmol 2023; 2023:5553468. [PMID: 37261103 PMCID: PMC10228221 DOI: 10.1155/2023/5553468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 05/10/2023] [Accepted: 05/15/2023] [Indexed: 06/02/2023] Open
Abstract
Background The change in refraction caused by accommodation inevitably affects the peripheral defocus state and thus may influence the effect of retinal peripheral myopic defocus measures in myopia control. This study investigated accommodation changes in different peripheral retinas under cycloplegia to help improve myopia control. Methods Fifty-six eyes of fifty-six myopic subjects were recruited for this prospective study. The center and peripheral retina refractions were measured using multispectral refractive topography. The subjects were divided into low-to-moderate myopia group (range: -1.25 D to -6.00 D) and high myopia group (range: -6.25 D to -9.75 D) according to spherical equivalent (SE). The compound tropicamide (0.5% tropicamide and 0.5% phenylephrine) was used to relax the accommodation. The difference between cycloplegia and non-cycloplegia peripheral retinal refraction was analyzed using the t-test. The correlation between eccentricity and changes in peripheral refraction was analyzed using Pearson's correlation analysis. Results The manifest refraction of the retina significantly decreased with an increase in eccentricity after cycloplegia. The annular refraction difference value at 50°-53° (ARDV 50-53) showed the largest refraction decrease of 1.31 D compared with the central retinal refraction decrease of 0.84 D. The inferior quadrantal refraction difference value had the least change compared to the other quadrants. The relative peripheral refraction (RPR) changes in refraction difference value (RDV) at 15° (RDV-15), RDV-30, and RDV-45 were less than 0.15 D. When the range of annulus narrowed to 5°, the narrower annulus showed faster change with eccentricity increase in ARDV 30-35, ARDV 35-40, ARDV 40-45, ARDV 45-50, and ARDV 50-53. The RPR was highly correlated with eccentricity (R = 0.938 and P < 0.001). The high myopia group had a greater hyperopic shift in the periphery than the low-to-moderate group after cycloplegia. Conclusions Peripheral refraction showed a significant hyperopic shift after cycloplegia with an increase in eccentricity. The RPR became more hyperopic than the central refraction. The high myopia group showed more hyperopic shifts in the peripheral region. Accommodation should be taken into consideration in peripheral defocus treatment.
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Affiliation(s)
- Weicong Lu
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Zisu Peng
- Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
| | - Wenzhi Ding
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Rongyuan Ji
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Yuyin Tian
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Chenpei Zhao
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
| | - Lin Leng
- Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
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17
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Jonas JB, Spaide RF, Ostrin LA, Logan NS, Flitcroft I, Panda-Jonas S. IMI-Nonpathological Human Ocular Tissue Changes With Axial Myopia. Invest Ophthalmol Vis Sci 2023; 64:5. [PMID: 37126358 PMCID: PMC10153585 DOI: 10.1167/iovs.64.6.5] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
Purpose To describe nonpathological myopia-related characteristics of the human eye. Methods Based on histomorphometric and clinical studies, qualitative and quantitative findings associated with myopic axial elongation are presented. Results In axial myopia, the eye changes from a spherical shape to a prolate ellipsoid, photoreceptor, and retinal pigment epithelium cell density and total retinal thickness decrease, most marked in the retroequatorial region, followed by the equator. The choroid and sclera are thin, most markedly at the posterior pole and least markedly at the ora serrata. The sclera undergoes alterations in fibroblast activity, changes in extracellular matrix content, and remodeling. Bruch's membrane (BM) thickness is unrelated to axial length, although the BM volume increases. In moderate myopia, the BM opening shifts, usually toward the fovea, leading to the BM overhanging into the nasal intrapapillary compartment. Subsequently, the BM is absent in the temporal region (such as parapapillary gamma zone), the optic disc takes on a vertically oval shape, the fovea-optic disc distance elongates without macular BM elongation, the angle kappa reduces, and the papillomacular retinal vessels and nerve fibers straighten and stretch. In high myopia, the BM opening and the optic disc enlarge, the lamina cribrosa, the peripapillary scleral flange (such as parapapillary delta zone) and the peripapillary choroidal border tissue lengthen and thin, and a circular gamma and delta zone develop. Conclusions A thorough characterization of ocular changes in nonpathological myopia are of importance to better understand the mechanisms of myopic axial elongation, pathological structural changes, and psychophysical sequelae of myopia on visual function.
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Affiliation(s)
- Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
| | - Richard F Spaide
- Vitreous, Retina, Macula Consultants of New York, New York, New York, United States
| | - Lisa A Ostrin
- College of Optometry, University of Houston, Houston, Texas, United States
| | - Nicola S Logan
- School of Optometry, Aston University, Birmingham, United Kingdom
| | - Ian Flitcroft
- Centre for Eye Research, School of Physics and Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland
- Department of Ophthalmology, Children's Health Ireland at Temple Street Hospital, Dublin, Ireland
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18
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Ma Z, Jeong H, Yang Y, Jiang X, Ikeda SI, Negishi K, Kurihara T, Tsubota K. Contralateral effect in progression and recovery of lens-induced myopia in mice. Ophthalmic Physiol Opt 2023; 43:558-565. [PMID: 36930524 DOI: 10.1111/opo.13125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE Apart from genetic factors, recent animal studies on myopia have focused on localised mechanisms. In this study, we aimed to examine the contralateral effects of monocular experimental myopia and recovery, which cannot be explained by a mere local mechanism. METHODS One eye of 3-week-old C57BL/6 male mice was fitted with a -30 dioptre (D) lens. The mice were distributed into two groups based on different conditions in the contralateral eye: either no lens (NLC) (n = 10) or a Plano lens on the contralateral eye (PLC) group (n = 6). Mice receiving no treatment on either eye were set as a control group (n = 6). Lenses were removed after 3 weeks of myopia induction. All mice were allowed to recover for 1 week in the same environment. Refractive status, axial length (AL) and choroidal thickness were measured before myopia induction, after 1 and 3 weeks of lens wear and after 1 week of recovery. RESULTS One week after removing the lenses, complete recovery was observed in the eyes that wore the -30 D lenses. In both the PLC and NLC groups, the refractive status showed a myopic shift after lens removal. Additionally, the choroid was significantly thinned in these eyes. The -30 D wearing eye showed a significant increase in AL after 3 weeks of lens wear. While the AL of the -30 D wearing eye ceased to grow after the lens was removed, the AL in the PLC and NLC contralateral eyes increased, and the binocular ALs gradually converged. CONCLUSIONS Recovery of lens-induced myopia was observed in mouse models. In the fellow eyes, the effects, including thinning of the choroid and changes in refractive status, were triggered by contralateral visual cues.
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Affiliation(s)
- Ziyan Ma
- Laboratory of Photobiology, Keio University School of Medicine, Tokyo, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Heonuk Jeong
- Laboratory of Photobiology, Keio University School of Medicine, Tokyo, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Yajing Yang
- Laboratory of Photobiology, Keio University School of Medicine, Tokyo, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Xiaoyan Jiang
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Shin-Ichi Ikeda
- Laboratory of Photobiology, Keio University School of Medicine, Tokyo, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Toshihide Kurihara
- Laboratory of Photobiology, Keio University School of Medicine, Tokyo, Japan
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- Tsubota Laboratory, Inc., Tokyo, Japan
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19
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Gupta SK, Chakraborty R, Verkicharla PK. Association between relative peripheral refraction and corresponding electro-retinal signals. Ophthalmic Physiol Opt 2023; 43:482-493. [PMID: 36881496 DOI: 10.1111/opo.13114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 03/08/2023]
Abstract
PURPOSE Considering the potential role of the peripheral retina in refractive development and given that peripheral refraction varies significantly with increasing eccentricity from the fovea, we investigated the association between relative peripheral refraction (RPR) and corresponding relative peripheral multifocal electroretinogram (mfERG) responses (electro-retinal signals) from the central to the peripheral retina in young adults. METHODS Central and peripheral refraction using an open-field autorefractor and mfERG responses using an electrophysiology stimulator were recorded from the right eyes of 17 non-myopes and 24 myopes aged 20-27 years. The relative mfERG N1, P1 and N2 components (amplitude density and implicit time) of a mfERG waveform were compared with the corresponding RPR measurements at the best-matched eccentricities along the principal meridians, that is at the fovea (0°), horizontal (±5°, ±10° and ± 25°) and vertical meridians (±10° and ± 15°). RESULTS The mean absolute mfERG N1, P1 and N2 amplitude densities (nV/deg2 ) were maximum at the fovea in both non-myopes (N1: 57.29 ± 14.70 nV/deg2 , P1: 106.29 ± 24.46 nV/deg2 , N2: 116.41 ± 27.96 nV/deg2 ) and myopes (N1: 56.25 ± 15.79 nV/deg2 , P1: 100.79 ± 30.81 nV/deg2 , N2: 105.75 ± 37.91 nV/deg2 ), which significantly reduced with increasing retinal eccentricity (p < 0.01). No significant association was reported between the RPR and corresponding relative mfERG amplitudes at each retinal eccentricity (overall Pearson's correlation, r = -0.25 to 0.26, p ≥ 0.09). In addition, the presence of relative peripheral myopia or hyperopia at extreme peripheral retinal eccentricities did not differentially influence the corresponding relative peripheral mfERG amplitudes (p ≥ 0.24). CONCLUSIONS Relative peripheral mfERG signals are not associated with corresponding RPR in young adults. It is plausible that the electro-retinal signals may respond to the presence of absolute hyperopia (and not relative peripheral hyperopia), which requires further investigation.
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Affiliation(s)
- Satish Kumar Gupta
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India
| | - Ranjay Chakraborty
- Department of Optometry and Vision Science, College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, Australia
| | - Pavan Kumar Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad, India.,The INFOR Myopia Centre (Prevention and Control), L V Prasad Eye Institute, Hyderabad, India
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20
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Rozema J, Dankert S, Iribarren R. Emmetropization and nonmyopic eye growth. Surv Ophthalmol 2023:S0039-6257(23)00037-1. [PMID: 36796457 DOI: 10.1016/j.survophthal.2023.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 02/16/2023]
Abstract
Most eyes start with a hypermetropic refractive error at birth, but the growth rates of the ocular components, guided by visual cues, will slow in such a way that this refractive error decreases during the first 2 years of life. Once reaching its target, the eye enters a period of stable refractive error as it continues to grow by balancing the loss in corneal and lens power with the axial elongation. Although these basic ideas were first proposed over a century ago by Straub, the exact details on the controlling mechanism and the growth process remained elusive. Thanks to the observations collected in the last 40 years in both animals and humans, we are now beginning to get an understanding how environmental and behavioral factors stabilize or disrupt ocular growth. We survey these efforts to present what is currently known regarding the regulation of ocular growth rates.
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Affiliation(s)
- Jos Rozema
- Visual Optics Lab Antwerp (VOLANTIS), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium; Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany.
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21
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Marcellán MC, Ávila FJ, Ares J, Remón L. Peripheral Refraction of Two Myopia Control Contact Lens Models in a Young Myopic Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1258. [PMID: 36674016 PMCID: PMC9859490 DOI: 10.3390/ijerph20021258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/28/2022] [Accepted: 12/31/2022] [Indexed: 06/17/2023]
Abstract
Peripheral refraction can lead to the development of myopia. The aim of this study was to compare relative peripheral refraction (RPR) in the same cohort of uncorrected (WCL) and corrected eyes with two different soft contact lenses (CL) designed for myopia control, and to analyze RPR depending on the patient’s refraction. A total of 228 myopic eyes (114 healthy adult subjects) (−0.25 D to −10.00 D) were included. Open-field autorefraction was used to measure on- and off- axis refractions when uncorrected and corrected with the two CLs (dual focus (DF) and extended depth of focus (EDOF)). The RPR was measured every 10° out to 30° in a temporal-nasal orientation and analyzed as a component of the power vector (M). The average RPR for all subjects was hyperopic when WCL and when corrected with EDOF CL design, but changed to a myopic RPR when corrected with DF design. Significant differences were found between RPR curves with both CLs in all the eccentricities (Bonferroni correction p < 0.008, except 10°N). An incremental relationship between relative peripheral refraction at 30 degrees and myopia level was found. It is concluded that the two CLs work differently at the periphery in order to achieve myopia control.
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Affiliation(s)
| | | | | | - Laura Remón
- Department of Applied Physics, University of Zaragoza, 50009 Zaragoza, Spain
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22
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Pucker AD, Gawne TJ. Fighting Myopia with Intermittent Nearwork Breaks: 20 Seconds Every 20 Minutes Might Not Be Enough Time. Optom Vis Sci 2023; 100:31-32. [PMID: 36705713 DOI: 10.1097/opx.0000000000001965] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
SIGNIFICANCE Practitioners commonly prescribe the 20/20/20 rule with hopes that, if patients follow it, they will reduce their myopic progression. This clinical perspective provides evidence that 20-second break from nearwork every 20 minutes are not enough time to impact ocular growth.The ongoing myopia epidemic is a major public health crisis. Although the correlation between nearwork tasks such as reading, computers, and smartphones and myopia development is controversial, multiple lines of research suggest that sustained nearwork contributes to myopia development. Clinicians have proposed that children should take short breaks from nearwork with a 20-second break every 20 minutes being a common suggestion. Animal model data do strongly support the idea that multiple short breaks across time can cancel out the effects of longer periods of myopia-promoting activities. However, the animal model data also suggest that repeated episodes of 20 seconds are ineffective at reducing myopia development and instead indicate that sustained breaks of 5 minutes or more every hour are needed to negate myopiagenic effects.
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23
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Figueirido B, Pérez-Ramos A, Hotchner A, Lovelace DM, Pastor FJ, Palmqvist P. The brain of the North American cheetah-like cat Miracinonyx trumani. iScience 2022; 25:105671. [PMID: 36536677 PMCID: PMC9758517 DOI: 10.1016/j.isci.2022.105671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/21/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022] Open
Abstract
The cheetah Acinonyx jubatus, the fastest living land mammal, is an atypical member of the family Felidae. The extinct feline Miracinonyx trumani, known as the North American cheetah, is thought to have convergently evolved with Acinonyx to pursue fast and open-country prey across prairies and steppe environments of the North American Pleistocene. The brain of Acinonyx is unique among the living felids, but it is unknown whether the brain of the extinct M. trumani is convergent to that of Acinonyx. Here, we investigate the brain of M. trumani from a cranium endocast, using a comparative sample of other big cats. We demonstrate that the brain of M. trumani was different from that of the living A. jubatus. Indeed, its brain shows a unique combination of traits among living cats. This suggests that the case of extreme convergence between Miracinonyx and its living Old World vicar should be reconsidered.
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Affiliation(s)
- Borja Figueirido
- Departamento de Ecología y Geología, Facultad de Ciencias, Universidad de Málaga, 29071 Málaga, Spain
| | - Alejandro Pérez-Ramos
- Departamento de Ecología y Geología, Facultad de Ciencias, Universidad de Málaga, 29071 Málaga, Spain
| | - Anthony Hotchner
- Anatomy Department, Des Moines University, 3200 Grand Avenue, Des Moines, IA 50312, USA
| | - David M. Lovelace
- University of Wisconsin-Madison, Department of Geoscience, Madison, WI 53706, USA
| | - Francisco J. Pastor
- Departamento de Anatomía y Radiología, Museo de Anatomía, Universidad de Valladolid, 47005 Valladolid, Spain
| | - Paul Palmqvist
- Departamento de Ecología y Geología, Facultad de Ciencias, Universidad de Málaga, 29071 Málaga, Spain
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24
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Panda-Jonas S, Jonas JB, Jonas RA. Photoreceptor density in relation to axial length and retinal location in human eyes. Sci Rep 2022; 12:21371. [PMID: 36494438 PMCID: PMC9734646 DOI: 10.1038/s41598-022-25460-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022] Open
Abstract
The purpose of the study was to examine the density of retinal photoreceptors and retinal pigment epithelium (RPE) cells in relation to myopic axial elongation in human eyes. Using light microscopy, we assessed the density of photoreceptors and RPE cells at the ora serrata, equator, and midperiphery (equator/posterior pole midpoint), and the RPE cell density additionally at the posterior pole, in enucleated human globes. The study included 78 eyes (mean age: 59.2 ± 15.6 years; range: 32-85 years) with a mean axial length of 27.3 ± 3.6 mm (range: 21.5-37.0 mm). Close to the ora serrata, at the equator and midperiphery, photoreceptor and RPE cell density was 246 ± 183, 605 ± 299 and 1089 ± 441 photoreceptors/mm and 56.1 ± 13.7, 45.2 ± 15.1, and 48.8 ± 15.6 RPE cells/mm, respectively. Densities of both cell types in all three regions were positively correlated with each other (all P < 0.001) and decreased with longer axial length (all P < 0.001) and longer distance between the ora serrata and the posterior pole (all P < 0.001), most marked at the midperiphery and least marked close to the ora serrata. The PRE cell density at the posterior pole was not significantly (P = 0.35) related to axial length. The photoreceptor density at the ora serrata (beta:- 0.33) and equator (beta: - 0.27) and RPE cell density at the ora serrata (beta: - 0.27) decreased additionally with the presence of glaucoma. The findings suggest that the axial elongation-related decrease in photoreceptor and RPE cell density is most marked at the midperiphery, followed by the equator and finally the ora serrata region. It suggests that the axial elongation-related enlargement of the eye wall predominantly takes place in the retro-equatorial region, followed by the equatorial region.
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Affiliation(s)
- Songhomitra Panda-Jonas
- Department of Ophthalmology, University of Heidelberg, 69120, Heidelberg, Germany. .,Privatpraxis Prof Jonas Und Dr Panda-Jonas, Adenauerplatz 2, 69115, Heidelberg, Germany.
| | - Jost B Jonas
- Department of Ophthalmology, University of Heidelberg, 69120, Heidelberg, Germany.,Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
| | - Rahul A Jonas
- Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany
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25
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Gupta SK, Chakraborty R, Verkicharla PK. Electroretinogram responses in myopia: a review. Doc Ophthalmol 2022; 145:77-95. [PMID: 34787722 PMCID: PMC9470726 DOI: 10.1007/s10633-021-09857-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/11/2021] [Indexed: 11/02/2022]
Abstract
The stretching of a myopic eye is associated with several structural and functional changes in the retina and posterior segment of the eye. Recent research highlights the role of retinal signaling in ocular growth. Evidence from studies conducted on animal models and humans suggests that visual mechanisms regulating refractive development are primarily localized at the retina and that the visual signals from the retinal periphery are also critical for visually guided eye growth. Therefore, it is important to study the structural and functional changes in the retina in relation to refractive errors. This review will specifically focus on electroretinogram (ERG) changes in myopia and their implications in understanding the nature of retinal functioning in myopic eyes. Based on the available literature, we will discuss the fundamentals of retinal neurophysiology in the regulation of vision-dependent ocular growth, findings from various studies that investigated global and localized retinal functions in myopia using various types of ERGs.
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Affiliation(s)
- Satish Kumar Gupta
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, India
| | - Ranjay Chakraborty
- Caring Futures Institute, College of Nursing and Health Sciences, Optometry and Vision Science, Flinders University, Adelaide, South Australia, Australia
| | - Pavan Kumar Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, India.
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26
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Prousali E, Haidich AB, Dastiridou A, Tzamalis A, Ziakas N, Mataftsi A. Part-time Versus Full-time Spectacles for Myopia Control (ParMA Study): A Randomized Clinical Trial. Cureus 2022; 14:e25995. [PMID: 35720776 PMCID: PMC9202340 DOI: 10.7759/cureus.25995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2022] [Indexed: 11/05/2022] Open
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27
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Brown DM, Mazade R, Clarkson-Townsend D, Hogan K, Datta Roy PM, Pardue MT. Candidate pathways for retina to scleral signaling in refractive eye growth. Exp Eye Res 2022; 219:109071. [PMID: 35447101 PMCID: PMC9701099 DOI: 10.1016/j.exer.2022.109071] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/25/2022] [Accepted: 04/05/2022] [Indexed: 12/22/2022]
Abstract
The global prevalence of myopia, or nearsightedness, has increased at an alarming rate over the last few decades. An eye is myopic if incoming light focuses prior to reaching the retinal photoreceptors, which indicates a mismatch in its shape and optical power. This mismatch commonly results from excessive axial elongation. Important drivers of the myopia epidemic include environmental factors, genetic factors, and their interactions, e.g., genetic factors influencing the effects of environmental factors. One factor often hypothesized to be a driver of the myopia epidemic is environmental light, which has changed drastically and rapidly on a global scale. In support of this, it is well established that eye size is regulated by a homeostatic process that incorporates visual cues (emmetropization). This process allows the eye to detect and minimize refractive errors quite accurately and locally over time by modulating the rate of elongation of the eye via remodeling its outermost coat, the sclera. Critically, emmetropization is not dependent on post-retinal processing. Thus, visual cues appear to influence axial elongation through a retina-to-sclera, or retinoscleral, signaling cascade, capable of transmitting information from the innermost layer of the eye to the outermost layer. Despite significant global research interest, the specifics of retinoscleral signaling pathways remain elusive. While a few pharmacological treatments have proven to be effective in slowing axial elongation (most notably topical atropine), the mechanisms behind these treatments are still not fully understood. Additionally, several retinal neuromodulators, neurotransmitters, and other small molecules have been found to influence axial length and/or refractive error or be influenced by myopigenic cues, yet little progress has been made explaining how the signal that originates in the retina crosses the highly vascular choroid to affect the sclera. Here, we compile and synthesize the evidence surrounding three of the major candidate pathways receiving significant research attention - dopamine, retinoic acid, and adenosine. All three candidates have both correlational and causal evidence backing their involvement in axial elongation and have been implicated by multiple independent research groups across diverse species. Two hypothesized mechanisms are presented for how a retina-originating signal crosses the choroid - via 1) all-trans retinoic acid or 2) choroidal blood flow influencing scleral oxygenation. Evidence of crosstalk between the pathways is discussed in the context of these two mechanisms.
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Affiliation(s)
- Dillon M Brown
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, 313 Ferst Drive, Atlanta, GA, 30332, USA; Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, 1670 Clairmont Rd, Atlanta, GA, 30033, USA
| | - Reece Mazade
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, 313 Ferst Drive, Atlanta, GA, 30332, USA; Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, 1670 Clairmont Rd, Atlanta, GA, 30033, USA
| | - Danielle Clarkson-Townsend
- Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, 1670 Clairmont Rd, Atlanta, GA, 30033, USA; Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA, 02115, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, 02115, USA; Gangarosa Department of Environmental Health, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA
| | - Kelleigh Hogan
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, 313 Ferst Drive, Atlanta, GA, 30332, USA; Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, 1670 Clairmont Rd, Atlanta, GA, 30033, USA
| | - Pooja M Datta Roy
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, 313 Ferst Drive, Atlanta, GA, 30332, USA; Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, 1670 Clairmont Rd, Atlanta, GA, 30033, USA
| | - Machelle T Pardue
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, 313 Ferst Drive, Atlanta, GA, 30332, USA; Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affairs Healthcare System, 1670 Clairmont Rd, Atlanta, GA, 30033, USA.
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Li Q, Zhu H, Fan M, Sun J, Reinach PS, Wang Y, Qu J, Zhou X, Zhao F. Form-deprivation myopia downregulates calcium levels in retinal horizontal cells in mice. Exp Eye Res 2022; 218:109018. [PMID: 35240197 DOI: 10.1016/j.exer.2022.109018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/14/2022] [Accepted: 02/25/2022] [Indexed: 11/25/2022]
Abstract
The process of eye axis lengthening in myopic eyes is regulated by multiple mechanisms in the retina, and horizontal cells (HCs) are an essential interneuron in the visual regulatory system. Wherein intracellular Ca2+ plays an important role in the events involved in the regulatory role of HCs in the retinal neural network. It is unknown if intracellular Ca2+ regulation in HCs mediates changes in the retinal neural network during myopia progression. We describe here a novel calcium fluorescence indicator system that monitors HCs' intracellular Ca2+ levels during form-deprivation myopia (FDM) in mice. AAV injection of GCaMP6s, as a protein calcium sensor, into a Gja10-Cre mouse monitored the changes in Ca2+signaling in HC that accompany FDM progression in mice. An alternative Gja10-Cre/Ai96-GCaMP6s mouse model was created by cross mating Gja10-Cre with Ai96 mice. Immunofluorescence imaging and live imaging of the retinal cells verified the identity of these animal models. Changes in retinal horizontal cellular Ca2+ levels were resolved during FDM development. The numbers of GCaMP6s and the proportion of HCs were tracked based on profiling changes in GCaMP6s+calbindin+/calbindin+ coimmunostaining patterns. They significantly decreased more after either two days (P < 0.01) or two weeks (P < 0.001) in form deprived eyes than in the untreated fellow eyes. These decreases in their proportion reached significance only in the retinal central region rather than also in the retinal periphery. A novel approach employing a GCaMP6s mouse model was developed that may ultimately clarify if HCs mediate Ca2+ signals that contribute to controlling FDM progression in mice. The results indicate so far that FDM progression is associated with declines in HC Ca2+ signaling activity.
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Affiliation(s)
- Qihang Li
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China
| | - He Zhu
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China
| | - Miaomiao Fan
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China
| | - Jing Sun
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China
| | - Peter S Reinach
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China
| | - Yuhan Wang
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China
| | - Jia Qu
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China; Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, Zhejiang, China; Oujiang Laboratory, Zhejiang Lab for Regenerative Medicine, Vision and Brain Health, Wenzhou, Zhejiang, China
| | - Xiangtian Zhou
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China; Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, Zhejiang, China; Oujiang Laboratory, Zhejiang Lab for Regenerative Medicine, Vision and Brain Health, Wenzhou, Zhejiang, China.
| | - Fuxin Zhao
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.
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Asymmetric Peripheral Refraction Profile in Myopes along the Horizontal Meridian. Optom Vis Sci 2022; 99:350-357. [DOI: 10.1097/opx.0000000000001890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Li Z, Yang Z, Liao Y, Zhan Z, Zeng R, Zhang Y, Lan Y. Relative Peripheral Refraction Characteristics and Their Relationship with Retinal Microvasculature in Young Adults: Using a Novel Quantitative Approach. Photodiagnosis Photodyn Ther 2022; 38:102750. [DOI: 10.1016/j.pdpdt.2022.102750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 02/01/2022] [Accepted: 02/04/2022] [Indexed: 11/16/2022]
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Jonas SB, Jonas RA, Panda‐Jonas S, Jonas JB. Histopathology of myopic cobblestones. Acta Ophthalmol 2022; 100:111-117. [PMID: 33960132 DOI: 10.1111/aos.14894] [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: 01/23/2021] [Accepted: 04/18/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To search for the histological correlate of peripheral 'cobblestones' in highly myopic eyes. METHODS The histomorphometric investigation included histologic sections of enucleated eyes of Caucasian patients. Using light microscopy, we measured the thickness of the retina, Bruch's membrane (BM) and choriocapillaris. RESULTS The study included 50 eyes (mean age:60.6 ± 18.7 years;axial length:26.5 ± 3.8 mm), with cobblestone regions detected in 7 eyes. BM thickness and choriocapillaris thickness in the cobblestone region were thinner (1.1 ± 0.2 µm versus 2.4 ± 0.8 µm; p < 0.001 and 1.6 ± 0.5 µm versus 2.6 ± 1.9 µm; p = 0.02, respectively), and just outside of the cobblestone region they were thicker (3.3 ± 0.6 µm versus 2.4 ± 0.8 µm; p = 0.005 and 5.7 ± 1.6 µm versus 2.6 ± 1.9 µm; p = 0.002, respectively) than in corresponding regions of eyes without cobblestones. Within the group of eyes with cobblestones, BM thickness (1.1 ± 0.2 mm versus 3.3 ± 0.6 mm; p < 0.001), choriocapillaris thickness (1.6 ± 0.5 mm versus 5.7 ± 1.6 mm; p < 0.001) and choriocapillaris density (48±15 µm/300 µm versus 159 ± 66 µm/300 µm;PP=0.002) were significantly lower in the cobblestone region than just outside of the cobblestone region. The cobblestone regions were characterized by firm adhesion of disorganized retina with thinned BM, few retinal pigment epithelium (RPE) islands within cobblestone regions, and absence of regional scleral or overall choroidal thinning. BM was mono-layered within, and double-layered outside of cobblestone regions, with the inner layer missing within the cobblestone region (except for the RPE islands). CONCLUSIONS Peripheral cobblestone regions in highly myopic eyes are characterized by marked BM thinning with absence of an inner BM layer, almost complete RPE absence, choriocapillaris thinning and firm connection of a disorganized retina to BM. These findings may help elucidating the process of axial elongation in myopic eyes.
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Affiliation(s)
| | - Rahul A. Jonas
- Department of Ophthalmology Medical Faculty University of Cologne Cologne Germany
| | - Songhomitra Panda‐Jonas
- Institute of Clinical and Scientific Ophthalmology and Acupuncture Jonas & Panda Heidelberg Germany
| | - Jost B. Jonas
- Department of Ophthalmology Medical Faculty Mannheim Ruprecht‐Karls‐University of Heidelberg Mannheim Germany
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Prousali E, Haidich AB, Tzamalis A, Ziakas N, Mataftsi A. 'The role of accommodative function in myopic development: A review.'. Semin Ophthalmol 2021; 37:455-461. [PMID: 34821535 DOI: 10.1080/08820538.2021.2006724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Purpose: Involvement of the accommodative mechanism in myopia progression has been hypothesised and investigated over the past years, given the emerging myopia crisis across the globe. This review aimed at exploring the clinical role of accommodative function in myopia development.Methods: A literature search of MEDLINE and EMBASE was performed from conception to May 2021.Results:The initial stimulus for accommodation is derived from near work, in an attempt of the eye to obtain a clear image. When there is a lag in the accommodative response, the resulting blurred retinal image is believed to precipitate axial elongation and lead to myopia development. The dynamic accommodative functions implicated in binocular vision evaluation include the accommodative accuracy, amplitude and facility. Association of these accommodative parameters to current treatment options for myopia control is of great clinical interest. Effective myopia treatments, including orthokeratology, multifocal lenses and atropine eyedrops appear to induce changes in the dynamic accommodative response.Conclusions: Current knowledge indicates an evident relationship between the accommodative mechanism and myopia development. Further investigation by future studies is warranted in order to explore the use of accommodative function as a promising myopia-monitoring tool.
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Affiliation(s)
- Efthymia Prousali
- 2nd Department of Ophthalmology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anna-Bettina Haidich
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Argyrios Tzamalis
- 2 Department of Ophthalmology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Ziakas
- 2 Department of Ophthalmology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Asimina Mataftsi
- 2 Department of Ophthalmology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Damani JM, Annasagaram M, Kumar P, Verkicharla PK. Alterations in peripheral refraction with spectacles, soft contact lenses and orthokeratology during near viewing: implications for myopia control. Clin Exp Optom 2021; 105:761-770. [PMID: 34538199 DOI: 10.1080/08164622.2021.1970480] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
CLINICAL RELEVANCE The peripheral refraction profile in myopes with different corrective modalities varies significantly for both distance and near viewing and will have implications in managing myopia. BACKGROUND This study investigated how the magnitude of peripheral myopic defocus induced by Ortho-K varies with and without accommodation, and how this compares to single vision spectacles and soft-contact-lenses (SCL). METHODS Relative peripheral refraction (RPR) of 18 young adults (spherical equivalent -1.00 D to -4.50 D) was determined along the horizontal meridian (±10°, ±20°, ±25°) during distance (3-metres) and near viewing (0.2-metres), and along vertical meridian (±10°, ±15°) for distance viewing alone. Measurements were obtained in an uncorrected state and with single vision spectacles, soft contact lens and Ortho-K. Changes in RPR and astigmatic components were compared between distance and near viewing with all different modalities. RESULTS A significant interaction (p = 0.02) between relative peripheral refraction and the target distance (distance and near viewing) was found among different refractive modalities. Single overnight Ortho-K lens wear alone led to relative peripheral myopia for both distance (mean RPR ± SE: -0.92 ± 0.21D and -1.04 ± 0.22D) and near viewing (-0.71 ± 0.17D and -0.76 ± 0.20D). Comparisons of relative peripheral refraction between different corrective modalities at each eccentricity indicated statistical significance of RPR at extreme locations along both temporal and nasal meridian (±20 and ±25°, p < 0.05). RPR with soft contact lenses and spectacles were similar for both distance and near viewing (p > 0.05). CONCLUSION Single overnight Ortho-K lens wear alone shifted the RPR in the myopic direction for both distance and near viewing in comparison with single vision spectacles and soft contact lenses. The Ortho-K lens designs that offer a large amount of mid-peripheral corneal steeping, in-turn leading to high relative peripheral myopia for both distance and near viewing and might offer beneficial effects on myopia control.
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Affiliation(s)
- Jyoti M Damani
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Madhuri Annasagaram
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Preetam Kumar
- Bausch & Lomb Contact Lens Center, L V Prasad Eye Institute, Hyderabad, India
| | - Pavan Kumar Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India.,Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
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Guo B, Lau JK, Cheung SW, Cho P. Repeatability and reproducibility of manual choroidal thickness measurement using Lenstar images in children before and after orthokeratology treatment. Cont Lens Anterior Eye 2021; 45:101484. [PMID: 34303626 DOI: 10.1016/j.clae.2021.101484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE To investigate the repeatability and reproducibility of choroidal thickness measurements using Lenstar images in young myopic children before and after one-month orthokeratology (ortho-k) treatment. METHOD Ocular biometry of 39 subjects were performed using the Lenstar 900. The first five measurements with maximum differences of 0.02 mm in axial length in the right eyes were saved and used for measurement of choroidal thickness. Subfoveal choroidal thickness were manually measured by identifying the signals from the retinal pigmented epithelium layer and chorioscleral interface. Repeatability was determined by comparing measurements of the same images made by the same observer on two separate occasions (four weeks apart), while reproducibility was calculated by comparing measurements of the same images made by two independent observers. Data was analysed using intra-class correlation coefficients (ICC) and non-parametric Bland and Altman plots. RESULTS The choroidal peaks could not be identified in all five measurements in all subjects. On average, only 71% subjects had at least four definable images. Compared with the use of fewer than four images, reliability using an average of four definable images improved statistically, but remained clinically unacceptable (>10 µm), although pre- and post-ortho-k ICC values were good to excellent for repeatability (0.867 and 0.975, respectively) and excellent and good for reproducibility (0.959 and 0.868, respectively). Non-parametric pre- and post-ortho-k limits of agreement (2.5% and 97.5% percentiles) obtained were -45.8 to 79.3 µm and -30.3 to 9.5 µm, respectively for repeatability, and -29.0 to 33.5 µm and -21.8 to 70.0 µm, respectively for reproducibility. CONCLUSION Choroidal thickness measurements using the Lenstar did not show good reliability, despite the high ICC values, non-parametric Bland and Altman plots demonstrated a wide variability of measurement errors. Any changes in subfoveal choroidal thickness, measured by Lenstar, of <80 µm may not represent real changes.
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Affiliation(s)
- Biyue Guo
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region.
| | - Jason K Lau
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region
| | - Sin Wan Cheung
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region
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Tian F, Zheng D, Zhang J, Liu L, Duan J, Guo Y, Wang Y, Wang S, Sang Y, Zhang X, Cao W, Zhang J, Sun M, Tian Q, Meng X, Guo X, Wu L. Choroidal and Retinal Thickness and Axial Eye Elongation in Chinese Junior Students. Invest Ophthalmol Vis Sci 2021; 62:26. [PMID: 34279570 PMCID: PMC8297418 DOI: 10.1167/iovs.62.9.26] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Purpose To explore the associations between macular choroidal and retinal thickness and axial elongation in non-myopic and myopic junior students. Methods In this school-based longitudinal observational study, axial length was measured by optical low-coherence reflectometry, and choroidal thickness and retinal thickness were measured by spectral-domain optical coherence tomography. Myopia was defined as non-cycloplegic objective spherical equivalent refraction ≤ −0.50 diopters. Structural equation modeling and multiple linear regression models were used to analyze the associations between baseline choroidal and retinal thickness with axial elongation. Results Out of 1307 students examined at baseline in 2017, 1197 (91.58%) returned for follow-up examination in 2018, with a median age of 12.00 years (interquartile range [IQR], 1.00) and included 667 boys (55.72%). Within a 1-year period, the median axial elongation of right eyes was 230 µm (IQR, 180) in boys and 200 µm (IQR, 160) in girls (P = 0.032). The thinner temporal choroidal thickness was associated with greater 1-year axial elongation only in myopic students (β, −0.20; 95% confidence interval [CI], −0.37, −0.03), the thinner temporal retinal thickness was associated with greater 1-year axial elongation in both non-myopic (β, −2.67; 95% CI, −4.52, −0.82) and myopic (β, −0.99; 95% CI, −1.68, −0.30) students, after adjustment for sex, age, and height. Subfoveal and nasal choroidal and retinal thickness were not significantly associated with axial elongation in either non-myopic or myopic students. Conclusions A thinner temporal choroid at age 12 years may predict greater 1-year axial elongation in myopic students, and a thinner temporal retina may predict greater 1-year axial elongation in both non-myopic and myopic students. This finding may help to identify children at risk and control axial elongation with potential preventive strategies.
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Affiliation(s)
- Feifei Tian
- School of Public Health, Capital Medical University, Beijing, China.,Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Deqiang Zheng
- School of Public Health, Capital Medical University, Beijing, China.,Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jie Zhang
- School of Public Health, Capital Medical University, Beijing, China.,Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Lijuan Liu
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jiali Duan
- Beijing Center for Disease Prevention and Control, Beijing, China
| | - Yin Guo
- Beijing Haidian Hospital, Beijing, China
| | - Youxin Wang
- School of Public Health, Capital Medical University, Beijing, China.,Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Shuo Wang
- School of Public Health, Capital Medical University, Beijing, China.,Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yujian Sang
- School of Public Health, Capital Medical University, Beijing, China.,Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xiaoyu Zhang
- School of Public Health, Capital Medical University, Beijing, China.,Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Weijie Cao
- School of Public Health, Capital Medical University, Beijing, China.,Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jinxia Zhang
- School of Public Health, Capital Medical University, Beijing, China.,Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Ming Sun
- School of Public Health, Capital Medical University, Beijing, China.,Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Qiuyue Tian
- School of Public Health, Capital Medical University, Beijing, China.,Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xiaoni Meng
- School of Public Health, Capital Medical University, Beijing, China.,Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xiuhua Guo
- School of Public Health, Capital Medical University, Beijing, China.,Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Lijuan Wu
- School of Public Health, Capital Medical University, Beijing, China.,Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
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Abstract
Angles subtended at the second nodal point of the eye (NP2) are approximately the same as input visual angles over a very large angular range, despite the nodal point being a paraxial lens property. Raytracing using an average pseudophakic eye showed that the angular nodal point criterion was only valid up to about 10°, and that the linear relationship was due instead to the cornea and lens initially creating chief ray angles at the exit pupil that are about 0.83 times input values for this particular eye, and then by the retina curving around to meet the rays in a manner that compensates for increasing angle. This linear relationship is then also maintained when retinal intersections are calculated relative to other axial points, with angles rescaled approximately using the equation R/(R + delta), where delta is the axial distance from the center of a spherical retina of radius R. Angles at NP2 approximately match the input angles, but the terminology is misleading because this is not a paraxial property of the eye. Chief rays are used with finite raytracing to determine the actual behavior.
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Klaver C, Polling JR. Myopia management in the Netherlands. Ophthalmic Physiol Opt 2021; 40:230-240. [PMID: 32202320 DOI: 10.1111/opo.12676] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/24/2020] [Accepted: 01/26/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE A trend that myopia is becoming gradually more common is shown in studies worldwide. Highest frequencies have been found in East Asian urban populations (96.5%) but also a study in Europe shows that nearly half of the 25-29 year olds has myopia. With the increase in prevalence, high myopia, i.e. a spherical equivalent of -6 or more and an axial length of 26 mm or more is also on the rise. High myopia particularly carries a significant risk of ocular pathology related to the long axial length. This highlights the need for myopia management in children with progressive myopia, in particular progression to high myopia. RECENT FINDINGS During the last decade, many intervention studies for myopia progression have emerged. Although lifestyle adjustments are effective, pharmacological and optical interventions have shown the highest efficacy on reduction of eye growth. High concentration atropine (0.5%-1.0%) shows the most reduction in axial length progression, but has drawbacks of light sensitivity and loss of accommodation. Nevertheless, when these side effects are mitigated by multifocal photochromatic glasses, the long-term adherence to high dose atropine is high. Lower concentrations of atropine are less effective, but have less side effects. Studies on optical interventions have reported reduction of progression for Ortho-K and multifocal contact lenses, but are in need for replication in larger studies with longer duration. SUMMARY The field of myopia management is rapidly evolving, and a position on the best approach for daily clinics is desirable. Over the last 10 years, our team of clinical researchers has developed a strategy which involves decision-making based on age, axial length, position on the axial length growth chart, progression rate, risk of high myopia, risk profile based on lifestyle and familial risk, side effects, and individual preference. This personalised approach ensures the most optimal long-term myopia control, and helps fight against visual impairment and blindness in the next generations of elderly.
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Affiliation(s)
- Caroline Klaver
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands.,Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands.,Institute for Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Jan Roelof Polling
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands.,Department of Optometry and Orthoptics, Hogeschool Utrecht, University of Applied Science, Utrecht, the Netherlands
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Summers JA, Schaeffel F, Marcos S, Wu H, Tkatchenko AV. Functional integration of eye tissues and refractive eye development: Mechanisms and pathways. Exp Eye Res 2021; 209:108693. [PMID: 34228967 DOI: 10.1016/j.exer.2021.108693] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 12/16/2022]
Abstract
Refractive eye development is a tightly coordinated developmental process. The general layout of the eye and its various components are established during embryonic development, which involves a complex cross-tissue signaling. The eye then undergoes a refinement process during the postnatal emmetropization process, which relies heavily on the integration of environmental and genetic factors and is controlled by an elaborate genetic network. This genetic network encodes a multilayered signaling cascade, which converts visual stimuli into molecular signals that guide the postnatal growth of the eye. The signaling cascade underlying refractive eye development spans across all ocular tissues and comprises multiple signaling pathways. Notably, tissue-tissue interaction plays a key role in both embryonic eye development and postnatal eye emmetropization. Recent advances in eye biometry, physiological optics and systems genetics of refractive error have significantly advanced our understanding of the biological processes involved in refractive eye development and provided a framework for the development of new treatment options for myopia. In this review, we summarize the recent data on the mechanisms and signaling pathways underlying refractive eye development and discuss new evidence suggesting a wide-spread signal integration across different tissues and ocular components involved in visually guided eye growth.
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Affiliation(s)
- Jody A Summers
- Department of Cell Biology, University of Oklahoma Health Science Center, Oklahoma City, OK, USA
| | - Frank Schaeffel
- Section of Neurobiology of the Eye, Ophthalmic Research Institute, University of Tuebingen, Tuebingen, Germany; Myopia Research Group, Institute of Molecular and Clinical Ophthalmology Basel (IOB), Basel, Switzerland
| | - Susana Marcos
- Instituto de Óptica "Daza de Valdés", Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - Hao Wu
- Department of Ophthalmology, Columbia University, New York, USA
| | - Andrei V Tkatchenko
- Department of Ophthalmology, Columbia University, New York, USA; Department of Pathology and Cell Biology, Columbia University, New York, USA.
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Jonas RA, Brandt CF, Zhang Q, Wang YX, Jonas JB. Location of Parapapillary Gamma Zone and Vertical Fovea Location. The Beijing Eye Study 2011. Invest Ophthalmol Vis Sci 2021; 62:18. [PMID: 33464277 PMCID: PMC7817880 DOI: 10.1167/iovs.62.1.18] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose To assess the spatial relationship between the locations of the parapapillary gamma zone and the fovea. Methods In a non-glaucomatous subgroup of the population-based Beijing Eye Study population, we measured the mean angle between the optic disc–fovea line and the horizontal (disc–fovea angle), the vertical distance of the fovea from the horizontal through the optic disc center (fovea vertical distance), and the location and width of the widest part of parapapillary gamma zone. Results The study included 203 individuals (203 eyes; mean axial length, 24.4 ± 1.5 mm; range, 22.03–28.87 mm). The widest gamma zone part was located most often temporal horizontally (51.7%), then inferiorly (43.8%), superiorly (2.5%), and nasally (2.0%). The disc–fovea angle (mean, 7.50° ± 4.00°; range, –6.30° to –23.25°) was significantly higher (P = 0.003; i.e., fovea located more inferiorly) in eyes with the widest gamma zone inferiorly (8.46° ± 4.37°) than in eyes with the widest gamma zone temporally (6.71° ± 3.46°) and in eyes with the widest gamma zone temporally, superiorly, or nasally combined (6.75° ± 3.53°; P = 0.003). The fovea vertical distance (mean, 0.65 ± 0.33 mm; range, –0.20 to 1.67 mm) was longer (P = 0.001; i.e., fovea located more inferiorly) in eyes with the widest gamma zone inferiorly (0.73 ± 0.33 mm) than in eyes with the widest gamma zone temporally (0.58 ± 0.30 mm) and in eyes with a temporal, superior, or nasal gamma zone combined (0.58 ± 0.31 mm; P = 0.001). The fovea vertical distance increased (multivariate analysis) with the widest gamma zone location inferiorly (β = 0.25; P = 0.001) and wider width of the gamma zone (β = 0.19; P = 0.01). Conclusions An inferior fovea location is associated with a wider inferior gamma zone and vice versa, supporting the notion of an inferior shifting of Bruch's membrane as the cause for an inferior gamma zone.
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Affiliation(s)
- Rahul A Jonas
- Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany.,Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Camilla F Brandt
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Qi Zhang
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ya X Wang
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jost B Jonas
- Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, China.,Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
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40
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Tkatchenko TV, Tkatchenko AV. Genome-wide analysis of retinal transcriptome reveals common genetic network underlying perception of contrast and optical defocus detection. BMC Med Genomics 2021; 14:153. [PMID: 34107987 PMCID: PMC8190860 DOI: 10.1186/s12920-021-01005-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 06/04/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Refractive eye development is regulated by optical defocus in a process of emmetropization. Excessive exposure to negative optical defocus often leads to the development of myopia. However, it is still largely unknown how optical defocus is detected by the retina. METHODS Here, we used genome-wide RNA-sequencing to conduct analysis of the retinal gene expression network underlying contrast perception and refractive eye development. RESULTS We report that the genetic network subserving contrast perception plays an important role in optical defocus detection and emmetropization. Our results demonstrate an interaction between contrast perception, the retinal circadian clock pathway and the signaling pathway underlying optical defocus detection. We also observe that the relative majority of genes causing human myopia are involved in the processing of optical defocus. CONCLUSIONS Together, our results support the hypothesis that optical defocus is perceived by the retina using contrast as a proxy and provide new insights into molecular signaling underlying refractive eye development.
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Affiliation(s)
| | - Andrei V. Tkatchenko
- Department of Ophthalmology, Columbia University, New York, NY USA
- Department of Pathology and Cell Biology, Columbia University, New York, NY USA
- Edward S. Harkness Eye Institute, Research Annex Room 415, 635 W. 165th Street, New York, NY 10032 USA
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41
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Wei J, Kong D, Yu X, Wei L, Xiong Y, Yang A, Drobe B, Bao J, Zhou J, Gao Y, He Z. Is Peripheral Motion Detection Affected by Myopia? Front Neurosci 2021; 15:683153. [PMID: 34163327 PMCID: PMC8215660 DOI: 10.3389/fnins.2021.683153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 05/14/2021] [Indexed: 12/04/2022] Open
Abstract
Purpose The current study was to investigate whether myopia affected peripheral motion detection and whether the potential effect interacted with spatial frequency, motion speed, or eccentricity. Methods Seventeen young adults aged 22–26 years participated in the study. They were six low to medium myopes [spherical equivalent refractions −1.0 to −5.0 D (diopter)], five high myopes (<-5.5 D) and six emmetropes (+0.5 to −0.5 D). All myopes were corrected by self-prepared, habitual soft contact lenses. A four-alternative forced-choice task in which the subject was to determine the location of the phase-shifting Gabor from the four quadrants (superior, inferior, nasal, and temporal) of the visual field, was employed. The experiment was blocked by eccentricity (20° and 27°), spatial frequency (0.6, 1.2, 2.4, and 4.0 cycles per degree (c/d) for 20° eccentricity, and 0.6, 1.2, 2.0, and 3.2 c/d for 27° eccentricity), as well as the motion speed [2 and 6 degree per second (d/s)]. Results Mixed-model analysis of variances showed no significant difference in the thresholds of peripheral motion detection between three refractive groups at either 20° (F[2,14] = 0.145, p = 0.866) or 27° (F[2,14] = 0.475, p = 0.632). At 20°, lower motion detection thresholds were associated with higher myopia (p < 0.05) mostly for low spatial frequency and high-speed targets in the nasal and superior quadrants, and for high spatial frequency and high-speed targets in the temporal quadrant in myopic viewers. Whereas at 27°, no significant correlation was found between the spherical equivalent and the peripheral motion detection threshold under all conditions (all p > 0.1). Spatial frequency, speed, and quadrant of the visual field all showed significant effect on the peripheral motion detection threshold. Conclusion There was no significant difference between the three refractive groups in peripheral motion detection. However, lower motion detection thresholds were associated with higher myopia, mostly for low spatial frequency targets, at 20° in myopic viewers.
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Affiliation(s)
- Junhan Wei
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, School of Ophthalmology and Optometry, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Deying Kong
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, School of Ophthalmology and Optometry, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xi Yu
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, School of Ophthalmology and Optometry, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Lili Wei
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, School of Ophthalmology and Optometry, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yue Xiong
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, School of Ophthalmology and Optometry, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Adeline Yang
- WEIRC, WMU-Essilor International Research Centre, Wenzhou, China.,R&D AMERA, Essilor International, Singapore, Singapore
| | - Björn Drobe
- WEIRC, WMU-Essilor International Research Centre, Wenzhou, China.,R&D AMERA, Essilor International, Singapore, Singapore
| | - Jinhua Bao
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, School of Ophthalmology and Optometry, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, China.,WEIRC, WMU-Essilor International Research Centre, Wenzhou, China
| | - Jiawei Zhou
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, School of Ophthalmology and Optometry, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yi Gao
- WEIRC, WMU-Essilor International Research Centre, Wenzhou, China.,R&D AMERA, Essilor International, Singapore, Singapore
| | - Zhifen He
- State Key Laboratory of Ophthalmology, Optometry and Vision Science, School of Ophthalmology and Optometry, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, China
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Németh J, Tapasztó B, Aclimandos WA, Kestelyn P, Jonas JB, De Faber JTHN, Januleviciene I, Grzybowski A, Nagy ZZ, Pärssinen O, Guggenheim JA, Allen PM, Baraas RC, Saunders KJ, Flitcroft DI, Gray LS, Polling JR, Haarman AEG, Tideman JWL, Wolffsohn JS, Wahl S, Mulder JA, Smirnova IY, Formenti M, Radhakrishnan H, Resnikoff S. Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute. Eur J Ophthalmol 2021; 31:853-883. [PMID: 33673740 PMCID: PMC8369912 DOI: 10.1177/1120672121998960] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/04/2021] [Indexed: 12/13/2022]
Abstract
The prevalence of myopia is increasing extensively worldwide. The number of people with myopia in 2020 is predicted to be 2.6 billion globally, which is expected to rise up to 4.9 billion by 2050, unless preventive actions and interventions are taken. The number of individuals with high myopia is also increasing substantially and pathological myopia is predicted to become the most common cause of irreversible vision impairment and blindness worldwide and also in Europe. These prevalence estimates indicate the importance of reducing the burden of myopia by means of myopia control interventions to prevent myopia onset and to slow down myopia progression. Due to the urgency of the situation, the European Society of Ophthalmology decided to publish this update of the current information and guidance on management of myopia. The pathogenesis and genetics of myopia are also summarized and epidemiology, risk factors, preventive and treatment options are discussed in details.
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Affiliation(s)
- János Németh
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Beáta Tapasztó
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
- Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | | | | | - Jost B Jonas
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
| | | | | | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Olavi Pärssinen
- Gerontology Research Centre and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Peter M Allen
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, University of South-Eastern Norway, Kongsberg, Norway
| | - Kathryn J Saunders
- Centre for Optometry and Vision Science research, Ulster University, Coleraine, UK
| | - Daniel Ian Flitcroft
- Temple Street Children’s Hospital, Dublin, Ireland
- Centre for Eye Research Ireland (CERI) Technological University Dublin, Ireland
| | | | - Jan Roelof Polling
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Optometry and Orthoptics, Hogeschool Utrecht, University of Applied Science, Utrecht, The Netherlands
| | - Annechien EG Haarman
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - J Willem L Tideman
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - James Stuart Wolffsohn
- Optometry and Vision Science, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Siegfried Wahl
- Institute for Ophthalmic Research, University Tübingen, Tübingen, Germany
- Carl Zeiss Vision International GmbH, Tübingen, Germany
| | - Jeroen A Mulder
- Department of Optometry and Orthoptics, Hogeschool Utrecht, University of Applied Science, Utrecht, The Netherlands
| | | | - Marino Formenti
- Department of Physics, School of Science, University of Padova, Padova, Italy
| | | | - Serge Resnikoff
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Brien Holden Vision Institute, Sydney, Australia
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43
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She Z, Hung LF, Arumugam B, Beach KM, Smith EL. The development of and recovery from form-deprivation myopia in infant rhesus monkeys reared under reduced ambient lighting. Vision Res 2021; 183:106-117. [PMID: 33799131 DOI: 10.1016/j.visres.2021.02.004] [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: 09/28/2020] [Revised: 01/25/2021] [Accepted: 02/01/2021] [Indexed: 12/23/2022]
Abstract
Although reduced ambient lighting ("dim" light) can cause myopia in emmetropizing chicks, it does not necessarily lead to myopic changes in emmetropizing rhesus monkeys. Because myopia is rarely spontaneous, a question remained whether dim light would hasten the progression of visually induced myopia. To determine the effects of dim light on the development of and recovery from form-deprivation myopia (FDM), seven 3-week-old infant rhesus monkeys were reared under dim light (mean ± SD = 55 ± 9 lx) with monocular diffuser spectacles until ~154 days of age, then maintained in dim light with unrestricted vision until ~337 days of age to allow for recovery. Refractive errors, corneal powers, ocular axial dimensions and sub-foveal choroidal thicknesses were measured longitudinally and compared to those obtained from form-deprived monkeys reared under typical laboratory lighting (504 ± 168 lx). Five of the seven subjects developed FDMs that were similar to those observed among their normal-light-reared counterparts. The average degree of form-deprivation-induced myopic anisometropia did not differ significantly between dim-light subjects (-3.88 ± 3.26D) and normal-light subjects (-4.45 ± 3.75D). However, three of the five dim-light subjects that developed obvious FDM failed to exhibit any signs of recovery and the two monkeys that were isometropic at the end of the treatment period manifest abnormal refractive errors during the recovery period. All refractive changes were associated with alterations in vitreous chamber elongation rates. It appears that dim light is not a strong myopiagenic stimulus by itself, but it can impair the optical regulation of refractive development in primates.
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Affiliation(s)
- Zhihui She
- College of Optometry, University of Houston, Houston, TX, United States
| | - Li-Fang Hung
- College of Optometry, University of Houston, Houston, TX, United States; Brien Holden Vision Institute, Sydney, NSW, Australia
| | - Baskar Arumugam
- College of Optometry, University of Houston, Houston, TX, United States; Former employee of University of Houston, Houston, TX, United States
| | - Krista M Beach
- College of Optometry, University of Houston, Houston, TX, United States
| | - Earl L Smith
- College of Optometry, University of Houston, Houston, TX, United States; Brien Holden Vision Institute, Sydney, NSW, Australia.
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Gregory HR, Nti AN, Wolffsohn JS, Berntsen DA, Ritchey ER. Visual Performance of Center-distance Multifocal Contact Lenses Fit Using a Myopia Control Paradigm. Optom Vis Sci 2021; 98:272-279. [PMID: 33771957 PMCID: PMC8007064 DOI: 10.1097/opx.0000000000001665] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The purpose of this study was to examine the visual performance of center-distance MFCLs in nonpresbyopic adults under different illumination and contrast conditions compared with a single-vision contact lens (SVCL). METHODS Twenty-five adult subjects were fit with three different lenses (CooperVision Biofinity D MFCL +2.50 add, Visioneering Technologies NaturalVue MFCL, CooperVision Biofinity sphere). Acuity and reading performance were evaluated. RESULTS A statistically significant difference in high-contrast distance acuity was observed (Biofinity, -0.18 ± 0.06; Biofinity MFCL, -0.14 ± 0.08; NaturalVue MFCL, -0.15 ± 0.03; repeated-measures [RM] ANOVA, P = .02). Under mesopic, high-contrast conditions, MFCLs performed worse than SVCLs (Biofinity, -0.05 ± 0.091; Biofinity MFCL, +0.03 ± 0.09; NaturalVue MFCL, +0.05 ± 0.091; RM-ANOVA, P < .0001). Under low-contrast conditions, MFCLs performed one line worse in photopic lighting and two lines worse under mesopic conditions (RM-ANOVA, P < .0001). Glare reduced acuity by 0.5 logMAR for all lenses (RM-ANOVA, P < .001). A statistically significant difference in near acuity was observed (RM-ANOVA, P = .02), but all lenses achieved acuity better than -0.1 logMAR (Biofinity, -0.16 ± 0.06; Biofinity MFCL, -0.17 ± 0.04; NaturalVue MFCL, -0.13 ± 0.08). Reading performance in words per minute (wpm) was worse with MFCLs (Biofinity MFCL, 144 ± 22 wpm; NaturalVue MFCL, 150 ± 28 wpm) than with SVCLs (156 ± 23 wpm; RM-ANOVA, P = .02) regardless of letter size (RM-ANOVA, P = .13). No difference in acuity between the MFCLs was detected (RM-ANOVA: all, P > .05). CONCLUSIONS Multifocal contact lenses perform similarly to SVCLs for high-contrast targets and display reduced low-contrast acuity and reading speed. Practitioners should recognize that high-contrast acuity alone does not describe MFCL visual performance.
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Affiliation(s)
- Hannah R Gregory
- The Ocular Surface Institute, University of Houston College of Optometry, Houston, Texas
| | - Augustine N Nti
- The Ocular Surface Institute, University of Houston College of Optometry, Houston, Texas
| | - James S Wolffsohn
- Optometry and Vision Science Research Group, Department of Life and Health Sciences, Aston University, Birmingham, United Kingdom
| | - David A Berntsen
- The Ocular Surface Institute, University of Houston College of Optometry, Houston, Texas
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Andersen MKG, Kessel L. Ametropia and Emmetropization in CNGB3 Achromatopsia. Invest Ophthalmol Vis Sci 2021; 62:10. [PMID: 33560291 PMCID: PMC7873492 DOI: 10.1167/iovs.62.2.10] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 01/18/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose Emmetropization is the process of adjusting ocular growth to the focal plane in order to achieve a clear image. Chromatic light may be involved as a cue to guide this process. Achromats are color blind and lack normal cone function; they are often described as being hyperopic, indicating a failure to emmetropize. We aim to describe the refraction and refractive development in a population of genetically characterized achromats. Methods Refractive error data were collected retrospectively from 28 medical records of CNGB3 c.1148delC homozygous achromats. The distribution of spherical equivalent refractive error (SER) and spherical error was analyzed in adults. The refractive development in children was analyzed by documenting astigmatic refractive error and calculating median SER in 1-year age groups and by analyzing the individual development when possible. Results The distribution of SER and spherical error resembled a Gaussian distribution, indicating that emmetropization was disturbed in achromats, but we found indication of some decrease in SER during the first years of childhood. The prevalence of refractive errors was high and broadly distributed. Astigmatic refractive errors were frequent but did not seem to increase with age. Conclusions Refractive development in achromats is more complicated than a complete failure to emmetropize. The spread of refractive errors is larger than previously documented. Results presented here support the theory that chromatic cues and cone photoreceptors may play a role in emmetropization in humans but that it is not essential.
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Affiliation(s)
| | - Line Kessel
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet-Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Smith EL, Hung LF, She Z, Beach K, Ostrin LA, Jong M. Topically instilled caffeine selectively alters emmetropizing responses in infant rhesus monkeys. Exp Eye Res 2021; 203:108438. [PMID: 33428866 DOI: 10.1016/j.exer.2021.108438] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/30/2020] [Accepted: 01/02/2021] [Indexed: 11/30/2022]
Abstract
Oral administration of the adenosine receptor (ADOR) antagonist, 7-methylxanthine (7-MX), reduces both form-deprivation and lens-induced myopia in mammalian animal models. We investigated whether topically instilled caffeine, another non-selective ADOR antagonist, retards vision-induced axial elongation in monkeys. Beginning at 24 days of age, a 1.4% caffeine solution was instilled in both eyes of 14 rhesus monkeys twice each day until the age of 135 days. Concurrent with the caffeine regimen, the monkeys were fitted with helmets that held either -3 D (-3D/pl caffeine, n = 8) or +3 D spectacle lenses (+3D/pl caffeine, n = 6) in front of their lens-treated eyes and zero-powered lenses in front of their fellow-control eyes. Refractive errors and ocular dimensions were measured at baseline and periodically throughout the lens-rearing period. Control data were obtained from 8 vehicle-treated animals also reared with monocular -3 D spectacles (-3D/pl vehicle). In addition, historical comparison data were available for otherwise untreated lens-reared controls (-3D/pl controls, n = 20; +3D/pl controls, n = 9) and 41 normal monkeys. The vehicle controls and the untreated lens-reared controls consistently developed compensating axial anisometropias (-3D/pl vehicle = -1.44 ± 1.04 D; -3D/pl controls = -1.85 ± 1.20 D; +3D/pl controls = +1.92 ± 0.56 D). The caffeine regime did not interfere with hyperopic compensation in response to +3 D of anisometropia (+1.93 ± 0.82 D), however, it reduced the likelihood that animals would compensate for -3 D of anisometropia (+0.58 ± 1.82 D). The caffeine regimen also promoted hyperopic shifts in both the lens-treated and fellow-control eyes; 26 of the 28 caffeine-treated eyes became more hyperopic than the median normal monkey (mean (±SD) relative hyperopia = +2.27 ± 1.65 D; range = +0.31 to +6.37 D). The effects of topical caffeine on refractive development, which were qualitatively similar to those produced by oral administration of 7-MX, indicate that ADOR antagonists have potential in treatment strategies for preventing and/or reducing myopia progression.
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Affiliation(s)
- Earl L Smith
- College of Optometry, University of Houston, Houston, TX, United States; Brien Holden Vision Institute, Sydney, Australia.
| | - Li-Fang Hung
- College of Optometry, University of Houston, Houston, TX, United States; Brien Holden Vision Institute, Sydney, Australia
| | - Zhihui She
- College of Optometry, University of Houston, Houston, TX, United States
| | - Krista Beach
- College of Optometry, University of Houston, Houston, TX, United States
| | - Lisa A Ostrin
- College of Optometry, University of Houston, Houston, TX, United States
| | - Monica Jong
- Brien Holden Vision Institute, Sydney, Australia; Discipline of Optometry and Vision Science, University of Canberra, Canberra, Australia
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Wang S, Lin Z, Xi X, Lu Y, Pan L, Li X, Artal P, Lan W, Yang Z. Two-Dimensional, High-Resolution Peripheral Refraction in Adults with Isomyopia and Anisomyopia. Invest Ophthalmol Vis Sci 2021; 61:16. [PMID: 32511693 PMCID: PMC7415287 DOI: 10.1167/iovs.61.6.16] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose The purpose of this study was to investigate the two-dimensional peripheral refraction in fellow eyes of patients with isomyopia and anisomyopia. Methods Sixty-eight young adults were recruited, including 25 isomyopes with interocular differences (IODs) of foveal refraction < 1.00 D and 43 anisomyopes with IOD > 1.50 D. Peripheral refraction across an area of the visual field of 60° × 36° with a resolution of 1° was measured using a custom-made Hartmann-Shack wavefront sensor. The retinal area was divided into 3 × 3 zones for comparison between the fellow eyes. Results There was no difference of refraction in all corresponding zones between the fellow eyes in the isomyopic group (all P > 0.05). The IODs between more myopic (MM) eyes and less myopic (LM) eyes in the anisomyopic group ranged from −1.40 to approximately −2.46 D (all P <0.001), which was flagged in the center and attenuated in peripheral zones by varied magnitudes. In the stratification analysis for different levels of anisomyopia, the nasal retina first presented significant relative hyperopic shifts compared to the center, followed by the temporal retina. In contrast, the superior and inferior periphery only differed from the center when the central IOD was greater than 3.00 D. Conclusions The two-dimensional peripheral refraction patterns showed a mirror symmetry between the fellow eyes of a patient with isomyopia. However, in the anisomyopic group, peripheral refraction showed significantly relative hyperopic shift when compared with the center and developed with a varied rate in different areas. These findings may indicate an asymmetrical variation in the peripheral refraction patterns during myopia progression.
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Zhu Q, Xiao S, Hua Z, Yang D, Hu M, Zhu YT, Zhong H. Near Infrared (NIR) Light Therapy of Eye Diseases: A Review. Int J Med Sci 2021; 18:109-119. [PMID: 33390779 PMCID: PMC7738953 DOI: 10.7150/ijms.52980] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 10/15/2020] [Indexed: 12/18/2022] Open
Abstract
Near infrared (NIR) light therapy, or photobiomodulation therapy (PBMT), has gained persistent worldwide attention in recent years as a new novel scientific approach for therapeutic applications in ophthalmology. This ongoing therapeutic adoption of NIR therapy is largely propelled by significant advances in the fields of photobiology and bioenergetics, such as the discovery of photoneuromodulation by cytochrome c oxidase and the elucidation of therapeutic biochemical processes. Upon transcranial delivery, NIR light has been shown to significantly increase cytochrome oxidase and superoxide dismutase activities which suggests its role in inducing metabolic and antioxidant beneficial effects. Furthermore, NIR light may also boost cerebral blood flow and cognitive functions in humans without adverse effects. In this review, we highlight the value of NIR therapy as a novel paradigm for treatment of visual and neurological conditions, and provide scientific evidence to support the use of NIR therapy with emphasis on molecular and cellular mechanisms in eye diseases.
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Affiliation(s)
- Qin Zhu
- Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University, Kunming 650031, China
| | - Shuyuan Xiao
- Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University, Kunming 650031, China
| | - Zhijuan Hua
- Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University, Kunming 650031, China
| | - Dongmei Yang
- Department of Ophthalmology, the Second People's Hospital of Yunnan Province, Kunming 650021, China
| | - Min Hu
- Department of Ophthalmology, the Second People's Hospital of Yunnan Province, Kunming 650021, China
| | | | - Hua Zhong
- Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University, Kunming 650031, China
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She Z, Hung LF, Arumugam B, Beach KM, Smith EL. Effects of low intensity ambient lighting on refractive development in infant rhesus monkeys (Macaca mulatta). Vision Res 2020; 176:48-59. [PMID: 32777589 PMCID: PMC7487012 DOI: 10.1016/j.visres.2020.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 07/02/2020] [Accepted: 07/09/2020] [Indexed: 02/06/2023]
Abstract
Studies in chickens suggest low intensity ambient lighting causes myopia. The purpose of this experiment was to examine the effects of low intensity ambient lighting (dim light) on normal refractive development in macaque monkeys. Seven infant rhesus monkeys were reared under dim light (room illumination level: ~55 lx) from 24 to ~310 days of age with otherwise unrestricted vision. Refractive error, corneal power, ocular axial dimensions, and choroidal thickness were measured in anesthetized animals at the onset of the experiment and periodically throughout the dim-light-rearing period, and were compared with those of normal-light-reared monkeys. We found that dim light did not produce myopia; instead, dim-light monkeys were hyperopic relative to normal-light monkeys (median refractive errors at ~155 days, OD: +3.13 D vs. +2.31 D; OS: +3.31D vs. +2.44 D; at ~310 days, OD: +2.75D vs. +1.78D, OS: +3.00D vs. +1.75D). In addition, dim-light rearing caused sustained thickening in the choroid, but it did not alter corneal power development, nor did it change the axial nature of the refractive errors. These results showed that, for rhesus monkeys and possibly other primates, low ambient lighting by itself is not necessarily myopiagenic, but might compromise the efficiency of emmetropization.
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Affiliation(s)
- Zhihui She
- College of Optometry, University of Houston, Houston, TX, United States
| | - Li-Fang Hung
- College of Optometry, University of Houston, Houston, TX, United States; Brien Holden Vision Institute, Sydney, NSW, Australia
| | - Baskar Arumugam
- College of Optometry, University of Houston, Houston, TX, United States
| | - Krista M Beach
- College of Optometry, University of Houston, Houston, TX, United States
| | - Earl L Smith
- College of Optometry, University of Houston, Houston, TX, United States; Brien Holden Vision Institute, Sydney, NSW, Australia.
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Jonas JB, Wang YX, Dong L, Guo Y, Panda-Jonas S. Advances in myopia research anatomical findings in highly myopic eyes. EYE AND VISION (LONDON, ENGLAND) 2020; 7:45. [PMID: 32905133 PMCID: PMC7465809 DOI: 10.1186/s40662-020-00210-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 07/22/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The goal of this review is to summarize structural and anatomical changes associated with high myopia. MAIN TEXT Axial elongation in myopic eyes is associated with retinal thinning and a reduced density of retinal pigment epithelium (RPE) cells in the equatorial region. Thickness of the retina and choriocapillaris and RPE cell density in the macula are independent of axial length. Choroidal and scleral thickness decrease with longer axial length in the posterior hemisphere of the eye, most marked at the posterior pole. In any eye region, thickness of Bruch's membrane (BM) is independent of axial length. BM opening, as the inner layer of the optic nerve head layers, is shifted in temporal direction in moderately elongated eyes (axial length <26.5 mm). It leads to an overhanging of BM into the intrapapillary compartment at the nasal optic disc side, and to an absence of BM at the temporal disc border. The lack of BM at the temporal disc side is the histological equivalent of parapapillary gamma zone. Gamma zone is defined as the parapapillary region without BM. In highly myopic eyes (axial length >26.5 mm), BM opening enlarges with longer axial length. It leads to a circular gamma zone. In a parallel manner, the peripapillary scleral flange and the lamina cribrosa get longer and thinner with longer axial length in highly myopic eyes. The elongated peripapillary scleral flange forms the equivalent of parapapillary delta zone, and the elongated lamina cribrosa is the equivalent of the myopic secondary macrodisc. The prevalence of BM defects in the macular region increases with longer axial length in highly myopic eyes. Scleral staphylomas are characterized by marked scleral thinning and spatially correlated BM defects, while thickness and density of the choriocapillaris, RPE and BM do not differ markedly between staphylomatous versus non-staphylomatous eyes in the respective regions. CONCLUSIONS High axial myopia is associated with a thinning of the sclera and choroid posteriorly and thinning of the retina and RPE density in the equatorial region, while BM thickness is independent of axial length. The histological changes may point towards BM having a role in the process of axial elongation.
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Affiliation(s)
- Jost B. Jonas
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karis-University, Universitäts-Augenklinik, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Ya Xing Wang
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Li Dong
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yin Guo
- Tongren Eye Care Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Songhomitra Panda-Jonas
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karis-University, Universitäts-Augenklinik, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
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