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Kinori M, Nitzan I, Szyper NS, Achiron A, Spierer O. Correlation of Refractive Error with Anisometropia Development in Early Childhood. Am J Ophthalmol 2024; 264:145-153. [PMID: 38552933 DOI: 10.1016/j.ajo.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/08/2024] [Accepted: 03/11/2024] [Indexed: 05/04/2024]
Abstract
PURPOSE This study aims to investigate the relationship between the type and severity of refractive error and anisometropia development in preschool children. DESIGN Retrospective cohort study. METHODS Data from Maccabi Healthcare Services, Israel's second-largest Health Maintenance Organization (HMO), were analyzed. The study included all isometropic children aged 1 to 6 years, re-examined for refraction at least 2 years following their initial examination between 2012 and 2022. Anisometropia was defined as a ≥1 diopter interocular difference in spherical equivalent. Relationships were assessed using logistic regression models adjusted for key sociodemographic factors. RESULTS Among 33,496 isometropic children (51.2% male, mean age 3.2 ± 1.5 years), the prevalences of emmetropia, myopia, and hyperopia were 26.7% (n = 8944), 4.2% (n = 1397), and 69.1% (n = 23,155), respectively. Over a mean follow-up period of 5.1 ± 2.4 years, 2593 children (7.7%) were diagnosed with anisometropia. Adjusted odds ratios (ORs) for anisometropia gradually increased with baseline refractive error severity, reaching 13.90 (5.32-36.34) in severe myopia and 4.19 (3.42-5.15) in severe hyperopia. This pattern was also evident in cylindrical anisometropia, where ORs increased with greater baseline astigmatism, peaking at 12.10 (9.19-15.92) in children with high astigmatism (≥3 D). Associations remained consistent in sensitivity and subgroup analyses including across both sexes and when using a stricter anisometropia criterion. CONCLUSIONS Children aged 1 to 6 years, initially without anisometropia but showing increasing severity of myopia, hyperopia, or astigmatism, are more likely to develop anisometropia. This underscores the importance of follow-up refractive measurements within this population to promptly diagnose and treat anisometropia and prevent potential visual complications.
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Affiliation(s)
- Michael Kinori
- Department of Ophthalmology (M.K.), Assuta Medical Center Ashdod, Israel and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Itay Nitzan
- Department of Ophthalmology (I.N.), Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Department of Military Medicine, Faculty of Medicine (I.N.), Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Asaf Achiron
- Department of Ophthalmology (A.A.), Tel Aviv Medical Center, Tel Aviv, Israel; Faculty of Medicine (A.A., O.S.), Tel Aviv University, Tel Aviv, Israel
| | - Oriel Spierer
- Faculty of Medicine (A.A., O.S.), Tel Aviv University, Tel Aviv, Israel; Department of Ophthalmology (O.S.), E. Wolfson Medical Center, Holon, Israel
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Chan K, O T, Broude C, Waner S, Ceisler E, Fay A, Pacicco L, Waner M. Advantages of Early Surgical Management of Periorbital Infantile Hemangiomas. Facial Plast Surg Aesthet Med 2024. [PMID: 38946543 DOI: 10.1089/fpsam.2023.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024] Open
Abstract
Background: Early evaluation and treatment of periorbital infantile hemangiomas (POIH) were associated with lower rates of ophthalmological complications. Objective: To evaluate age and characteristics associated with improved anisometropic astigmatism (anisoastigmatism) and eye symmetry measured by diopters and a 5-point scale, respectively, in patients with POIH treated with surgical excision. Methods: A retrospective study was performed on patients with POIH. Patient characteristics and eye symmetry were analyzed between patients with resolved and unresolved anisoastigmatism after surgery. Statistical analyses included the Mann-Whitney U tests, chi-square tests, and linear regression models. Results: In total, 54 patients were included (male: 20, female: 34). Upper medial eyelid was the most commonly affected site (resolved: 45%, unresolved: 43%), followed by upper lateral and upper central. Fifty-six percent (31/55) had postoperative resolution of anisoastigmatism, whereas 44% (24/55) did not. Earlier surgical evaluation (median: 4.5 vs. 6.0 months, p = 0.047) and excision (median: 5.0 vs. 12.0 months, p = 0.005) were associated with reversible anisoastigmatism. Good and suboptimal eye symmetry were not associated with earlier surgical excision (median: 6 vs. 6.5 months, p = 0.87). Follow-up ranged from 1 month to 12 years. Conclusion: Earlier surgical excision was associated with reversing anisoastigmatism but was not significant for improving eye symmetry.
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Affiliation(s)
- Kimberly Chan
- Vascular Birthmark Institute of New York, New York, New York, USA
- Department of Otolaryngology-Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA
| | - Teresa O
- Vascular Birthmark Institute of New York, New York, New York, USA
- Department of Otolaryngology-Lenox Hill Hospital & Manhattan Eye, Ear and Throat Hospital, New York, New York, USA
| | - Caroline Broude
- Vascular Birthmark Institute of New York, New York, New York, USA
| | - Stefan Waner
- Department of Mathematics, Hofstra University, Hempstead, New York, USA
| | - Emily Ceisler
- Department of Ophthalmology, New York University Grossman School of Medicine, New York, New York, USA
| | - Aaron Fay
- Vascular Birthmark Institute of New York, New York, New York, USA
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Lauren Pacicco
- Vascular Birthmark Institute of New York, New York, New York, USA
| | - Milton Waner
- Vascular Birthmark Institute of New York, New York, New York, USA
- Department of Otolaryngology-Lenox Hill Hospital & Manhattan Eye, Ear and Throat Hospital, New York, New York, USA
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Hashemi H, Khabazkhoob M, Lança C, Emamian MH, Fotouhi A. Prevalence of anisometropia and its associated factors in school-age children. Strabismus 2024; 32:1-10. [PMID: 38230509 DOI: 10.1080/09273972.2023.2293883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
PURPOSE To determine the prevalence of anisometropia and the associated demographic and biometric risk factors in children. METHODS This cross-sectional study was conducted on the elementary school children of Shahroud, east of Iran, in 2015. All rural students were recruited, while multistage cluster sampling was used to select the students in urban areas. All children underwent optometric examinations including the measurement of uncorrected and corrected visual acuity, autorefraction, and subjective refraction with cycloplegia. Biometric components were measured using the Allegro Biograph. Myopia and hyperopia were defined as a spherical equivalent ≤-0.5 and ≥ +2.00 diopter, respectively. Students with a history of ocular trauma or lack of cycloplegic refraction at least in one eye were excluded from the study. RESULTS Of 6624 selected children, 5620 participated in the study. After applying the exclusion criteria, the data of 5357 students (boys: 52.8%, n = 2834) were analyzed. The mean age of the subjects was 9.2 ± 1.7 years (range: 6-12 years). The prevalence of anisometropia ≥ 1 D was 1.1% (95% CI: 0.8 to 1.4) in all children, 1.0% (95% CI: 0.7-1.3) in boys, 1.3% (95% CI: 0.8-1.7) in girls, 1.1% (95% CI: 0.8-1.4) in urban children, and 1.4% (95% CI: 0.5-2.3) in rural children. The prevalence of anisometropia was 8.8% (95% CI: 5.3-12.2) in myopic and 5.7% (95% CI: 2.8-8.5) in hyperopic children. Axial length asymmetry (OR = 40.9; 95%CI: 10.2-164.1), myopia (OR = 17.9; 95% CI: 9.4-33.9), and hyperopia (OR = 10.1; 95% CI: (5.1-19.7) were associated with anisometropia in multiple logistic regression model. More anisometropia was associated with more severe amblyopia. The odds of amblyopia (OR = 82.3: 38.2-177-3) and strabismus (OR = 17.6: 5.5-56.4) were significantly higher in anisometropic children. The prevalence of amblyopia was 21.7% in children with myopic anisometropia ≥ 3D, 66.7% in children with hyperopic anisometropia ≥ 3D, and 100% in cases with antimetropia ≥ 3D. CONCLUSION The prevalence of anisometropia was low in Iranian school children. However, a high percentage of anisometropic students had amblyopia and strabismus. Axial length was the most important biometric component associated with anisometropia.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Carla Lança
- Escola Superior de Tecnologia da Saúde de Lisboa (ESTeSL), Instituto Politécnico de Lisboa, Lisboa, Portugal
- Comprehensive Health Research Center (CHRC), Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Gong W, Zhu Z, Bulloch G, Wang J, Chen J, Du L, Yang J, Zhang B, He X, Zou H, Xu X, Deng J, Huang J. Anisometropia and its association with refraction development in highly myopic children. Clin Exp Optom 2024; 107:58-65. [PMID: 37078165 DOI: 10.1080/08164622.2023.2198635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/30/2023] [Indexed: 04/21/2023] Open
Abstract
CLINICAL RELEVANCE Anisometropia can affect visual development in children. Investigations of anisometropia in high myopes would explore potential causes related to anisometropia, highlighting the management of anisometropia in high myopia. BACKGROUND The prevalence of anisometropia ranged from 0.6% to 4.3% in general paediatric population and from 7% to 14% in myopes. Anisometropia is regarded as an associated factor for myopia development, while myopia progression is a stimulus driving anisometropic development. The purpose of this study was to investigate the prevalence of anisometropia and its association with refraction development in Chinese children with high myopia. METHODS In the cohort study, a total of 1,577 highly myopic (spherical equivalent ≤-5.0D) children aged 4-18 years were included. Refractive parameters (dioptre of sphere, dioptre of cylinder, corneal curvature radius, and axial length) of both eyes were measured after cycloplegia. The prevalence and degree of anisometropia were compared among refractive groups (non-parametric tests or chi-square tests), and regression analyses were used to determine associated factors of anisometropia. The statistical significance was set to P < 0.05 (two-tailed). RESULTS In highly myopic children with a mean (standard deviation) age of 13.06 (2.80) years, the proportions of spherical equivalent anisometropia, cylindrical anisometropia and spherical anisometropia ≥1.00 D were 34.5%, 21.9% and 39.9%, respectively. There was more spherical equivalent anisometropia associated with more severe astigmatism (P for trend <0.001). In the multivariate regression analysis, more spherical equivalent anisometropia, cylindrical anisometropia and spherical anisometropia were associated with higher degrees of astigmatism (standard beta = -0.175, -0.148 and -0.191, respectively). More spherical anisometropia was associated with better spherical power (standard beta = 0.116). CONCLUSION The proportion of anisometropia in highly myopic children was high, compared with previously reported general population, and more severe anisometropia was associated with higher degree of cylindrical power, but not spherical power.
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Affiliation(s)
- Wei Gong
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Zhuoting Zhu
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Gabriella Bulloch
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
| | - Jingjing Wang
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Jun Chen
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Linlin Du
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Jinliuxing Yang
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Bo Zhang
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Xiangui He
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Haidong Zou
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xun Xu
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Junjie Deng
- Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jiannan Huang
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
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Qin J, Qing H, Ji N, Lyu T, Ma H, Shi M, Yu S, Ma C, Fu A. Changes in axial length in anisometropic children wearing orthokeratology lenses. Front Med (Lausanne) 2023; 10:1266354. [PMID: 38020088 PMCID: PMC10656815 DOI: 10.3389/fmed.2023.1266354] [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: 07/24/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose There is a particular anisometropia occurring in one eye with myopia, while the other eye has very low myopia, emmetropia, or very low hyperopia. It is unclear how the binocular axial length changes when these children wear unilateral OK lenses only in the more myopic eyes. This study investigates the changes in the axial elongation of both eyes. Methods This is a 1-year retrospective study. In total, 148 children with myopic anisometropia were included. The more myopic eyes were wearing orthokeratology lenses (treated eyes), whereas the contralateral eyes were not indicated for visual correction (untreated eyes). The untreated eyes were classified into three subgroups based on the spherical equivalent refraction (SER): low myopia (≤ -0.50 D, n = 37), emmetropia (+0.49 to -0.49 D, n = 76), and low hyperopia (≥0.50 D, n = 35). Changes in the axial length (AL) were compared between the untreated and treated eyes and among the three subgroups. Results The axial elongation was 0.14 ± 0.18 mm and 0.39 ± 0.27 mm in all treated and untreated eyes, respectively (p < 0.001). The interocular AL difference decreased significantly from 1.09 ± 0.45 mm at the baseline to 0.84 ± 0.52 mm at 1 year (p < 0.001). The baseline median (Q1, Q3) SER of the untreated eyes were -0.75 D (-0.56, -0.88 D), 0.00 D (0.00, -0.25 D), and +0.75 D (+1.00, +0.62 D) in low myopia, emmetropia, and low hyperopia subgroups, respectively. The axial elongation was 0.14 ± 0.18 mm, 0.15 ± 0.17 mm, and 0.13 ± 0.21 mm (p = 0.92) in the treated eyes and 0.44 ± 0.25 mm, 0.35 ± 0.24 mm, and 0.41 ± 0.33 mm in the untreated eyes (p = 0.11) after 1 year. Multivariate linear regression analyses only showed significant differences in axial elongation between the emmetropia and low myopia subgroups of untreated eyes (p = 0.04; p > 0.05 between other subgroups). Conclusion Unilateral orthokeratology lenses effectively reduced axial elongation in the more myopic eyes and reduced interocular AL differences in children with myopic anisometropia. The refractive state of the untreated eyes did not affect the axial elongation of the more myopic eye wearing the orthokeratology lens. In the untreated eyes, AL increased faster in the low myopia subgroup than in the emmetropia subgroup.
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Affiliation(s)
- Jian Qin
- Department of Ophthalmology, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Huiling Qing
- Department of Ophthalmology, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Na Ji
- Department of Ophthalmology, The Affiliated Eye Hospital of Suzhou Vocational Health College, Suzhou, China
| | - Tianbin Lyu
- Department of Ophthalmology, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Ma
- Department of Ophthalmology, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Menghai Shi
- Department of Ophthalmology, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Shiao Yu
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Conghui Ma
- Department of Ophthalmology, Henan Provincial People's Hospital, Henan Eye Hospital, Henan Eye Institute, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Aicun Fu
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Morrison AM, Kulp MT, Ciner EB, Mitchell GL, McDaniel CE, Hertle RW, Candy TR, Roberts TL, Peterseim MM, Granet DB, Robbins SL, Srinivasan G, Allison CL, Ying GS, Orel-Bixler D, Block SS, Moore BR. Prescribing patterns for paediatric hyperopia among paediatric eye care providers. Ophthalmic Physiol Opt 2023; 43:972-984. [PMID: 37334937 DOI: 10.1111/opo.13184] [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: 04/03/2023] [Revised: 05/18/2023] [Accepted: 05/31/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE To survey paediatric eye care providers to identify current patterns of prescribing for hyperopia. METHODS Paediatric eye care providers were invited, via email, to participate in a survey to evaluate current age-based refractive error prescribing practices. Questions were designed to determine which factors may influence the survey participant's prescribing pattern (e.g., patient's age, magnitude of hyperopia, patient's symptoms, heterophoria and stereopsis) and if the providers were to prescribe, how much hyperopic correction would they prescribe (e.g., full or partial prescription). The response distributions by profession (optometry and ophthalmology) were compared using the Kolmogorov-Smirnov cumulative distribution function test. RESULTS Responses were submitted by 738 participants regarding how they prescribe for their hyperopic patients. Most providers within each profession considered similar clinical factors when prescribing. The percentages of optometrists and ophthalmologists who reported considering the factor often differed significantly. Factors considered similarly by both optometrists and ophthalmologists were the presence of symptoms (98.0%, p = 0.14), presence of astigmatism and/or anisometropia (97.5%, p = 0.06) and the possibility of teasing (8.3%, p = 0.49). A wide range of prescribing was observed within each profession, with some providers reporting that they would prescribe for low levels of hyperopia while others reported that they would never prescribe. When prescribing for bilateral hyperopia in children with age-normal visual acuity and no manifest deviation or symptoms, the threshold for prescribing decreased with age for both professions, with ophthalmologists typically prescribing 1.5-2 D less than optometrists. The threshold for prescribing also decreased for both optometrists and ophthalmologists when children had associated clinical factors (e.g., esophoria or reduced near visual function). Optometrists and ophthalmologists most commonly prescribed based on cycloplegic refraction, although optometrists most commonly prescribed based on both the manifest and cycloplegic refraction for children ≥7 years. CONCLUSION Prescribing patterns for paediatric hyperopia vary significantly among eye care providers.
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Affiliation(s)
- Ann M Morrison
- The Ohio State University College of Optometry, Columbus, Ohio, USA
| | - Marjean T Kulp
- The Ohio State University College of Optometry, Columbus, Ohio, USA
| | - Elise B Ciner
- Pennsylvania College of Optometry, Salus University, Elkins Park, Pennsylvania, USA
| | - G Lynn Mitchell
- The Ohio State University College of Optometry, Columbus, Ohio, USA
| | | | | | - T Rowan Candy
- Indiana University Bloomington, Bloomington, Indiana, USA
| | - Tawna L Roberts
- Spencer Center for Vision Research, Byers Eye Institute at Stanford University, Palo Alto, California, USA
| | - M Millicent Peterseim
- Medical University of South Carolina Albert Florens Storm Eye Institute, Charleston, South Carolina, USA
| | - David B Granet
- Viterbi Family Department of Ophthalmology, Ratner Children's Eye Center, University of California San Diego, La Jolla, California, USA
| | - Shira L Robbins
- Viterbi Family Department of Ophthalmology, Ratner Children's Eye Center, University of California San Diego, La Jolla, California, USA
| | - Gayathri Srinivasan
- Spencer Center for Vision Research, Byers Eye Institute at Stanford University, Palo Alto, California, USA
| | | | - Gui-Shuang Ying
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Deborah Orel-Bixler
- Berkeley School of Optometry, University of California, Berkeley, California, USA
| | | | - Bruce R Moore
- New England College of Optometry, Boston, Massachusetts, USA
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Zhou Y, Zhang XF, Chen XJ, Wang M, Cai JR, Xiong YJ, Song Y, Sun ZM. Prevalence of anisometropia and influencing factors among school-age children in Nantong, China: a cross-sectional study. Front Public Health 2023; 11:1190285. [PMID: 37397717 PMCID: PMC10307961 DOI: 10.3389/fpubh.2023.1190285] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/25/2023] [Indexed: 07/04/2023] Open
Abstract
Objective To investigate the prevalence of anisometropia and associated parameters among school-aged children in Nantong, China. Methods This school-based, cross-sectional study examined students from primary schools, junior high schools, and senior high schools in an urban area of Nantong, China. Univariate and multivariate logistic regression analyses were used to investigate the specific correlations between anisometropia and related parameters. Non-cycloplegic autorefraction was assessed for each student. Anisometropia was defined as the spherical equivalent refraction (SE) difference ≥ 1.0 D between eyes. Results A total of 9,501 participants were validated for analyses, of which 53.2% (n = 5,054) were male, and 46.8% (n = 4,447) were female. The mean of age was 13.32 ± 3.49 years, ranging from 7-19 years. The overall prevalence of anisometropia was 25.6%. Factors such as myopia, scoliosis screening positive, hyperopia, female sex, older age, and higher weight had a significantly higher risk of anisometropia (p < 0.05). Conclusion There was a high prevalence of anisometropia in school-age children. Some physical examination parameters are closely related to children's anisometropia, especially myopia and scoliosis. Preventing myopia and controlling its progression may be the most important ways to reduce the prevalence of anisometropia. Correcting scoliosis may be an important factor in controlling the prevalence of anisometropia, and maintaining good reading and writing posture may be helpful in controlling the prevalence of anisometropia.
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Affiliation(s)
- Yue Zhou
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Xiao Fang Zhang
- Department of Nantong Fifth People’s Hospital, Nantong, Jiangsu, China
| | - Xiao Juan Chen
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Min Wang
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Jian Ru Cai
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Yao Jia Xiong
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Yu Song
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Zhi Min Sun
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
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Controlling anisomyopia in children by orthokeratology: A one-year randomised clinical trial. Cont Lens Anterior Eye 2023; 46:101537. [PMID: 34785153 DOI: 10.1016/j.clae.2021.101537] [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: 06/25/2021] [Revised: 11/03/2021] [Accepted: 11/06/2021] [Indexed: 01/18/2023]
Abstract
PURPOSE To investigate the effects of overnight orthokeratology (OK) lenses wear on the interocular axial length (AL) difference in anisomyopic children. METHODS Sixty anisomyopic children (8-14 years old) were enrolled in this one-year prospective, randomised controlled study. Subjects were randomly assigned to wear OK lenses (OK group) or single-vision spectacles (control group). AL was monitored at baseline and every six months using an IOL Master biometer, and axial elongation and interocular AL differences were compared between the groups. RESULTS In the control group, the more myopic eyes had similar axial elongation (0.36 ± 0.17 mm) to the less myopic eyes (0.37 ± 0.17 mm) at the one-year follow-up (P > 0.05). In the OK group, the less myopic eyes exhibited significantly greater axial elongation (0.24 ± 0.17 mm) than the more myopic eyes (0.13 ± 0.13 mm) at the one-year follow-up (P < 0.05). The mean interocular AL difference significantly decreased in the OK group over one year, from 0.47 ± 0.24 mm to 0.35 ± 0.22 mm (P < 0.05). However, the mean interocular AL difference decreased only slightly in the control group, from 0.56 ± 0.28 mm to 0.55 ± 0.28 mm (P > 0.05). CONCLUSION This randomised, controlled study demonstrated that OK reduces the interocular AL difference in anisomyopic children due to stronger myopic control of the more myopic eye.
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Hashem O, Sheha H. Ten-Year Outcomes of LASIK for Pediatric Myopic Anisometropia. Clin Ophthalmol 2022; 16:4293-4301. [PMID: 36578667 PMCID: PMC9792104 DOI: 10.2147/opth.s387302] [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: 08/24/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose To evaluate long-term safety, effectiveness, and stability of unilateral LASIK in pediatric myopic anisometropic amblyopia. Methods This retrospective study included children who received unilateral LASIK for myopic anisometropia of >6 D, after mandatory 6-month occlusion/penalization therapy. They were evaluated at 6 months, 1 year, 2 years and biannually until 10 years. Outcome measures included visual acuity, refraction, ocular alignment, stereopsis, corneal clarity, and corneal topography. Results 32 patients (16 girls) with mean age of 8.6 ± 2.3 years completed 10 years of follow up after unilateral LASIK. Mean preoperative spherical equivalent refraction (SER) was -10.3D ±2.0D in the affected eye, with anisometropic difference of -9.5D ±1.7D. Mean post-LASIK SER was -1.3D±0.8D (p<0.001). Anisometropia significantly decreased to 0.3D±0.8D, 0.4D±1.0D, and 1.0±2.5D at 6 months, 1 year and 10 years respectively (p<0.001). 11 patients (34%) who had preoperative intermittent exotropia (< 15°) regained orthophoria in all gazes, while 5 of 10 who had constant exotropia with large angle (>30°) required strabismus surgery for ocular alignment. BCVA improved from 0.04±0.6 Decimal at baseline to 0.6 ±0.2 after LASIK and occlusion therapy (p< 0.001). Despite insignificant refractive regression in both eyes, patients have maintained orthophoria, improved stereopsis, clear cornea, and the topography showed no evidence of post-LASIK ectasia. Conclusion LASIK appears safe, effective, and stable for correcting refractory pediatric myopic anisometropia, in which conventional measures fail or endanger normal visual development. Eliminating anisometropic aniseikonia consequently restores binocular vision and stereopsis which, along with amblyopia therapy, would reverse amblyopia and prevent recurrence.
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Affiliation(s)
- Omar Hashem
- Cornea and Refractive Department, Research Institute of Ophthalmology, Giza, Cairo, Egypt,Correspondence: Omar Hashem, Research Institute of Ophthalmology, 2 Al Ahram Street, Giza, Cairo, Egypt, Tel +201222422032, Email
| | - Hosam Sheha
- Department of Ophthalmology, Florida International University, Herbert Wertheim College of Medicine & Glaucoma Research Organization, Miami, FL, USA,Department of Ophthalmology, Manhattan Eye, Ear and Throat Hospital, Hofstra Northwell School of Medicine, New York, NY, USA
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10
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Xu Z, Wu Z, Wen Y, Ding M, Sun W, Wang Y, Shao Z, Liu Y, Yu M, Liu G, Hu Y, Bi H. Prevalence of anisometropia and associated factors in Shandong school-aged children. Front Public Health 2022; 10:1072574. [PMID: 36620276 PMCID: PMC9815018 DOI: 10.3389/fpubh.2022.1072574] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
Objective To investigate anisometropia's prevalence and associated factors in school-aged children. Methods A cross-sectional school-based study was conducted in Shandong Province, China, including children aged 4 to 17 from 9 schools. Anisometropia was defined as the differences between the two eyes in spherical equivalent (SE) or cylinder degree of 1.00 diopter (D) or more [SE or cylindrical (CYL) difference ≥ 1.00 D] after cycloplegic autorefraction. The Generalized Linear Model (GLM) was used to analyze the effects of ocular parameters [the differences between eyes in axial length (AL), habitual visual acuity (HVA), and corneal astigmatism (CA)] and lifestyle parameters (time spent indoor near work and outdoor activities) on anisometropia. Results Total 4,198 (93.4%) of the 4,494 children were included in the statistical analysis. The mean difference in inter-eye SE was 0.42 ± 0.61 D. The prevalence of anisometropia was 13.2% (95%CI: 12.1 to 14.2%) (SE anisometropia's prevalence:10.3%; CYL anisometropia's prevalence: 4.1%), increased with older age (OR = 1.10, P = 0.002), the worse myopic eye (myopia vs. premyopia, OR = 1.87, P = 0.002), the worse hyperopic eye (hyperopia vs. premyopia, OR = 1.77, P = 0.013), larger difference in inter-eye AL (0.1-0.3 vs. ≤ 0.1, OR = 1.67, P = 0.008; >0.3 vs. ≤ 0.1, OR = 28.61, P < 0.001), HVA (>0.2 vs. ≤ 0.2, OR = 3.01, P < 0.001), CA (OR = 6.24, P < 0.001), the worse stereoacuity (>100 vs. ≤ 100, OR = 1.59, P = 0.001), longer indoor near work time per day on weekends (4-8 vs. <4, OR = 1.41, P = 0.038; ≥8 vs. <4, OR = 1.40, P = 0.131), and shorter outdoor activity time per day on weekdays (≥1 vs. <1, OR = 0.75, P = 0.046) in multivariable analysis. In the SE anisometropia group, the difference in inter-eye AL (>0.3 vs. ≤ 0.1, β: 0.556, 95%CI: 0.050 to 1.063), HVA (>0.2 vs. ≤ 0.2, β: 0.511, 95%CI: 0.312 to 0.710), and CA (β: 0.488, 95%CI: 0.289 to 0.688), stereoacuity (>100 vs. ≤ 100, β: 0.299, 95%CI: 0.110 to 0.488) had a positive impact on the difference in inter-eye SE. Conclusions Ocular parameters and lifestyle parameters are associated with the occurrence of anisometropia in children aged 4 to 17 years, including the difference in inter-eye AL, HVA, CA, stereoacuity, indoor near work time, and outdoor activity time. Preventing myopia and early treating anisometropic amblyopia may be effective ways to reduce the prevalence of anisometropia.
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Affiliation(s)
- Zihang Xu
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Jinan, China,Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China
| | - Ziyun Wu
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Jinan, China,Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China
| | - Ying Wen
- Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Meihua Ding
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Wei Sun
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Jinan, China,Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yirong Wang
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhen Shao
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yi Liu
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Mingkun Yu
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Jinan, China,Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China
| | - Guoyong Liu
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Jinan, China,Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China
| | - Yuanyuan Hu
- Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China,Yuanyuan Hu ✉
| | - Hongsheng Bi
- Ophthalmology and Optometry Medical School, Shandong University of Traditional Chinese Medicine, Jinan, China,Shandong Academy of Eye Disease Prevention and Therapy, Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, China,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China,*Correspondence: Hongsheng Bi ✉
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11
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Khan N, Zaka-ur-Rab S, Ashraf M, Mishra A. Comparison of stereoacuity in patients of anisometropia, isometropia and emmetropia. Indian J Ophthalmol 2022; 70:4405-4409. [PMID: 36453354 PMCID: PMC9940589 DOI: 10.4103/ijo.ijo_658_22] [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] [Indexed: 12/12/2022] Open
Abstract
Purpose To compare the stereoacuity in patients with anisometropia, isometropia, and emmetropia. Methods A cross-sectional study was conducted on 1403 subjects (range: 5-45 years) divided into anisometropes (n = 403), isometropes (n = 500), and emmetropes (n = 500). There were 258 amblyopic eyes among anisometropes and 156 amblyopic eyes among isometropes. Stereoacuity was measured using the Titmus stereo test consisting of a combination of contour targets. Results There were 675 males and 728 females. A significant (P < 0.001) reduction in stereoacuity was found in anisometropes as compared to isometropes and emmetropes. The stereoacuity was even worse in amblyopes as compared to non-amblyopes. Most patients with anisometropia of <3.0 D had fair stereoacuity. However, as the degree of anisometropia increased to >3.0 D, stereoacuity deteriorated gradually. Marked reduction of stereoacuity was observed in severe degree of anisometropia (>6.0 D). Overall, an anisometropia of ≥2.12 D was associated with reduced stereoacuity. Among the anisometropes, it was found to be the poorest in myopia, followed by myopia with astigmatism, hypermetropia with astigmatism, and hypermetropia. Conclusion The level of stereoacuity was worse in anisometropes as compared to isometropes and emmetropes. Amblyopes had a greater reduction in stereoacuity than non-amblyopes. Stereoacuity decreased as the degree of anisometropia increased. Among the anisometropes, myopes had worst stereoacuity than hypermetropes.
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Affiliation(s)
- Nida Khan
- Retina Service, Institute of Ophthalmology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Simi Zaka-ur-Rab
- Retina Service, Institute of Ophthalmology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India,Correspondence to: Prof. Simi Zaka-ur-Rab, Retina Service, Institute of Ophthalmology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh - 202 002, Uttar Pradesh, India. E-mail:
| | - Mohammad Ashraf
- Retina Service, Institute of Ophthalmology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Aradhna Mishra
- Retina Service, Institute of Ophthalmology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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12
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Wang X, Chen Y, Wang Z, Li H, He Q, Rong H, Wei R. Assessment of macular structures and vascular characteristics in highly myopic anisometropia using swept-source optical coherence tomography angiography. Front Physiol 2022; 13:918393. [PMID: 36045745 PMCID: PMC9421159 DOI: 10.3389/fphys.2022.918393] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose: This study aimed to explore the macular structures and vascular characteristics of more myopic (MM) and contralateral eyes with highly myopic anisometropia.Methods: Comprehensive ophthalmic examinations were performed for 33 patients with highly myopic anisometropia. Macular structures (total retinal layer [TRL], ganglion cell and inner plexiform layer [GCIPL], inner nuclear layer [INL], outer retinal layer [ORL], nerve fiber layer [NFL], choroidal layer [CHL]) and vascular characteristics (superficial vascular complex density [SVD], deep vascular complex density [DVD], choriocapillaris perfusion area [CCPA]) were assessed using swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCTA). Macular structures and vascular characteristics of each subregion were compared to those of the Early Treatment of Diabetic Retinopathy Study (ETDRS).Results: With highly myopic anisometropia, the thicknesses of the TRL, GCIPL, INL, and ORL in MM eyes were smaller than those in contralateral eyes in at least one quadrant of the perifoveal and parafoveal circles (all p < 0.05), with no changes in the foveal and temporal quadrants of perifoveal regions (all p > 0.05). A thicker NFL (p = 0.018) was found in MM eyes than in contralateral eyes in the superior perifoveal quadrant. The CHL (all p < 0.05) in MM eyes was thinner in all regions than in the contralateral eyes according to the ETDRS. There were no statistical differences in the SVD, DVD, and CCPA of MM and contralateral eyes (all p > 0.05).Conclusion: All retinal layers, except the NFL, tended to be thinner in all subregions, except the temporal perifoveal and foveal quadrants in MM eyes, and choroidal thickness was thinned in all areas.
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13
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Liu F, Niu L, Guo J, Jian W, Shang J, Zhao J, Xue K, Zhou X. Quantitative evaluation of retinal and choroidal vascularity and retrobulbar blood flow in patients with myopic anisometropia by CDI and OCTA. Br J Ophthalmol 2022:bjophthalmol-2021-320597. [PMID: 35443997 DOI: 10.1136/bjophthalmol-2021-320597] [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: 10/12/2021] [Accepted: 04/01/2022] [Indexed: 11/04/2022]
Abstract
AIMS To investigate the association between the myopic severity and retinal microvascular density, choroidal vascularity and retrobulbar blood flow in adult anisomyopes. METHODS This study comprised 90 eyes of 45 myopic anisomyopes who were recruited for Colour Doppler imaging (CDI) and optical coherence tomography angiography (OCTA). The superficial vessel density (SVD), deep vessel density (DVD), choroidal thickness (ChT) and choroidal vascularity, including total choroidal area (TCA), luminal area (LA), stromal area (SA) and Choroidal Vascularity Index (CVI), were measured using OCTA. Moreover, the Pulsatile Index, peak systolic velocity (PSV) and end diastolic velocity (EDV) of posterior ciliary artery (PCA), central retinal artery (CRA) and ophthalmic artery (OA) were quantified by CDI, and all parameters were compared between two eyes and the correlations among parameters were analysed. RESULTS The mean difference of spherical equivalent (SE) and axial lengths (AL) between eyes were -6.00±2.94 D and 2.48±1.31 mm, respectively. The SVD, DVD, ChT, TCA, LA, SA and CVI were significantly lower in more myopic eyes compared with the contralateral eyes. In more myopic eyes, CDI parameters of CRA and PSV and EDV of PCA were also significantly lower. After adjusting for age and sex, the binocular asymmetry in LA and ChT was independent risk factor affecting interocular difference in both AL and SE. CONCLUSION Retinal microvascular density, choroidal vascularity and retrobulbar blood flow were simultaneously lower in adult myopic anisomyopes with more myopic eyes and disturbed choroid circulation was related to the severity of myopia. Further longitudinal study was helped to identify the effect of choroidal parameters for myopic progression.
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Affiliation(s)
- Fang Liu
- Department of Ophthalmology and Optometry, Eye and Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Fudan University, Shanghai, China
| | - Lingling Niu
- Department of Ophthalmology and Optometry, Eye and Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Fudan University, Shanghai, China
| | - Jie Guo
- Department of Ophthalmology and Optometry, Eye and Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Department of Ophthalmology and Shanghai Key Laboratory of Visual Impairment and Restoration, Eye and Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Weijun Jian
- Department of Ophthalmology and Optometry, Eye and Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Fudan University, Shanghai, China
| | - Jianmin Shang
- Department of Ophthalmology and Optometry, Eye and Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Fudan University, Shanghai, China
| | - Jing Zhao
- Department of Ophthalmology and Optometry, Eye and Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Fudan University, Shanghai, China
| | - Kang Xue
- Department of Ophthalmology and Optometry, Eye and Ear, Nose and Throat Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Department of Ophthalmology and Shanghai Key Laboratory of Visual Impairment and Restoration, Eye and Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology and Optometry, Eye and Ear, Nose and Throat Hospital, Fudan University, Shanghai, China .,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Fudan University, Shanghai, China
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14
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Guillon-Rolf R, Grammatico-Guillon L, Leveziel N, Pelen F, Durbant E, Chammas J, Khanna RK. Refractive errors in a large dataset of French children: the ANJO study. Sci Rep 2022; 12:4069. [PMID: 35260753 PMCID: PMC8904779 DOI: 10.1038/s41598-022-08149-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 03/02/2022] [Indexed: 11/25/2022] Open
Abstract
Undetected refractive errors (REs) in children can lead to irreversible vision loss. This study aimed to show the proportions of REs in French children using cycloplegic refraction. Multicentre cross-sectional retrospective study including children with cycloplegic refraction and without associated ocular conditions from 2015 to 2018 in French eye clinics. The following data were collected: age, symptoms of eye strain, best-corrected visual acuity (BCVA), cycloplegic refraction. The analysis included 48,163 children (mean age: 7.75 years, range: 2 to 12 years). The proportion of each RE was as follows: emmetropia (− 0.50 < Spherical Equivalent (SE) ≤ + 2.0; 58.3%), hyperopia (+ 2.0 \documentclass[12pt]{minimal}
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\begin{document}$$\le$$\end{document}≤− 0.50; 15.5%), high myopia (SE < − 6; 0.5%), high hyperopia (SE > + 5; 3.6%), mixed astigmatism (4.9%). Anisometropia (SE difference ≥ 1.5) was found in 5.0%. Functional amblyopia in children attending primary school (aged over 6 years) was encountered in 2.7%. Symptoms of eye strain were frequent (70%) but not specific to any RE. REs are frequently found in French children and may remain undetected in the absence of symptoms of eye strain. Few studies have investigated REs in children using cycloplegic refraction, which has been shown to be the gold standard for RE assessment.
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Affiliation(s)
- Rébecca Guillon-Rolf
- Department of Ophthalmology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.,ANJO, Association Nationale Des Jeunes Ophtalmologistes, Centre Hospitalier National des 15-20, 28, Rue de Charenton, 75012, Paris, France
| | - Leslie Grammatico-Guillon
- Department of Medical Information, Centre Hospitalier Régional Universitaire, Bretonneau Hospital, Tours, France
| | - Nicolas Leveziel
- Department of Ophthalmology, Centre Hospitalier Universitaire, Poitiers, France
| | | | - Eve Durbant
- ANJO, Association Nationale Des Jeunes Ophtalmologistes, Centre Hospitalier National des 15-20, 28, Rue de Charenton, 75012, Paris, France.,Department of Ophthalmology, Centre Hospitalier Universitaire, Reims, France
| | - Jimmy Chammas
- ANJO, Association Nationale Des Jeunes Ophtalmologistes, Centre Hospitalier National des 15-20, 28, Rue de Charenton, 75012, Paris, France.,Department of Ophthalmology, Centre Hospitalier Universitaire, Reims, France
| | - Raoul K Khanna
- ANJO, Association Nationale Des Jeunes Ophtalmologistes, Centre Hospitalier National des 15-20, 28, Rue de Charenton, 75012, Paris, France. .,Neurogénétique et Physiopathologie Neuronale, iBrain, INSERM, U1253, Université de Tours, Tours, France. .,Department of Ophthalmology, Centre Hospitalier Régional Universitaire, Bretonneau Hospital, Tours, France.
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15
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Metsing TI, Jacobs WE, Hansraj R. Vision screening as part of the school health policy in South Africa from the perspective of school health nurses. Afr J Prim Health Care Fam Med 2022; 14:e1-e8. [PMID: 35144447 PMCID: PMC8905394 DOI: 10.4102/phcfm.v14i1.3172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/12/2021] [Accepted: 11/19/2021] [Indexed: 11/05/2022] Open
Abstract
Background Vision screenings of school-going children are essential in the early detection of visual anomalies common in different age categories, which may negatively affect their academic ability and social development. Hence, their inclusion in school health policies is imperative. The aim of this study was to assess the implementation of vision screening protocols in the current Integrated School Health Screening policy of South Africa from the perspective of school health personnel. Aim The study sought to explore the perceptions, experiences and attitudes of the school health nurses on vision screenings included as part of the school health screenings in Gauteng province (South Africa). Setting This study was located across three public healthcare facilities across Gauteng at primary healthcare levels. Methods Three teams of 13 school health personnel from three primary healthcare facilities in the district of Ekurhuleni were invited to participate in the study. Focus group interviews were conducted for generating information on collective opinions and the rationale behind their views. Results Results of the collected qualitative data revealed challenges related to training, vision screening tests, referral criteria and follow-ups or referral pathways. In addition, further challenges reported were related to communication, time, space and consent forms not signed by the parents. Conclusion Improved cohesion and communication between all role players will enable reasonable and professional provision of validated vision screening services that have the best chance of early detection of children with vision anomalies to negate possible adverse effects on their scholarly performance.
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Affiliation(s)
- Thokozile I Metsing
- Discipline of Optometry, Faculty of Health Sciences, University of Johannesburg, Johannesburg.
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Factors Associated with Changes in Peripapillary Retinal Nerve Fibre Layer Thickness in Healthy Myopic Eyes. J Ophthalmol 2022; 2021:3462004. [PMID: 34987866 PMCID: PMC8723879 DOI: 10.1155/2021/3462004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 12/06/2021] [Indexed: 12/23/2022] Open
Abstract
Myopic people face an elevated risk of primary open angle glaucoma. Changes in the fundus in people with high myopia often lead to misdiagnosis of glaucoma, as this condition has many clinical signs in common with myopia, making the diagnosis of glaucoma more challenging. Compared to reduction of the visual field, a decrease in retinal nerve fibre layer (RNFL) thickness occurs earlier in glaucoma, which is widely considered useful for distinguishing between these conditions. With the development of optical coherence tomography (OCT), RNFL thickness can be measured with good reproducibility. According to previous studies, this variable is not only affected by axial length but also related to the patient's age, gender, ethnicity, optic disc area, and retinal blood flow in myopia. Herein, we intend to summarize the factors relevant to the RNFL in myopia to reduce the false-positive rate of glaucoma diagnosis and facilitate early prevention of myopia.
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Ji N, Niu Y, Qin J, Fu AC, Cui C. Orthokeratology Lenses Versus Administration of 0.01% Atropine Eye Drops for Axial Length Elongation in Children With Myopic Anisometropia. Eye Contact Lens 2022; 48:45-50. [PMID: 34924543 DOI: 10.1097/icl.0000000000000848] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the effect of orthokeratology (OK) lenses and that of 0.01% atropine eye drops on axial length (AL) elongation in children with myopic anisometropia. METHODS Ninety-five children with myopic anisometropia who used OK lenses (N=49) or 0.01% atropine eye drops (N=46) were enrolled in this retrospective 1-year study. For all children, the eyes with higher spherical equivalent refractive error (SER) were assigned to the H-eye subgroup, whereas the fellow eyes with lower SER were assigned to the L-eye subgroup. RESULTS After 1-year treatment, the mean change in the AL of H eyes and L eyes in the OK lenses group was 0.18±0.16 mm and 0.24±0.15 mm, respectively (P=0.15), and 0.28±0.20 mm and 0.25±0.18 mm, respectively (P=0.48), in the 0.01% atropine group. Multivariate regression analyses showed significant differences in AL change between H and L eyes after treatment with OK lens (P=0.03), whereas no significant difference in the 0.01% atropine (P=0.22). The change in the AL in the H-eye group was less with OK lenses than with 0.01% atropine (P=0.04), whereas there was no significant difference between the change in AL in the L-eye group between treatment with OK lens and 0.01% atropine (P=0.89). CONCLUSIONS In myopic anisometropic children, AL differences between 2 eyes decrease by wearing OK lenses but do not change after administration of 0.01% atropine eye drops. The increased effect of OK lenses, but not 0.01% atropine, in reducing axial elongation at 1 year in the eye with higher SER in anisometropic children warrants further investigation.
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Affiliation(s)
- Na Ji
- From the The Affiliated Eye Hospital of Suzhou Vocational Health College; Suzhou, China
- Henan Provincial People's Hospital, Henan Eye Hospital, Zhengzhou, China ; and
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan Niu
- From the The Affiliated Eye Hospital of Suzhou Vocational Health College; Suzhou, China
- Henan Provincial People's Hospital, Henan Eye Hospital, Zhengzhou, China ; and
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jian Qin
- From the The Affiliated Eye Hospital of Suzhou Vocational Health College; Suzhou, China
- Henan Provincial People's Hospital, Henan Eye Hospital, Zhengzhou, China ; and
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ai-Cun Fu
- From the The Affiliated Eye Hospital of Suzhou Vocational Health College; Suzhou, China
- Henan Provincial People's Hospital, Henan Eye Hospital, Zhengzhou, China ; and
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Can Cui
- From the The Affiliated Eye Hospital of Suzhou Vocational Health College; Suzhou, China
- Henan Provincial People's Hospital, Henan Eye Hospital, Zhengzhou, China ; and
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Interocular Symmetry Analysis of Corneal Elevation Using the Fellow Eye as the Reference Surface and Machine Learning. Healthcare (Basel) 2021; 9:healthcare9121738. [PMID: 34946464 PMCID: PMC8702115 DOI: 10.3390/healthcare9121738] [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: 11/30/2021] [Revised: 12/12/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
Abstract
Unilateral corneal indices and topography maps are routinely used in practice, however, although there is consensus that fellow-eye asymmetry can be clinically significant, symmetry studies are limited to local curvature and single-point thickness or elevation measures. To improve our current practices, there is a need to devise algorithms for generating symmetry colormaps, study and categorize their patterns, and develop reference ranges for new global discriminative indices for identifying abnormal corneas. In this work, we test the feasibility of using the fellow eye as the reference surface for studying elevation symmetry throughout the entire corneal surface using 9230 raw Pentacam files from a population-based cohort of 4613 middle-aged adults. The 140 × 140 matrix of anterior elevation data in these files were handled with Python to subtract matrices, create color-coded maps, and engineer features for machine learning. The most common pattern was a monochrome circle (“flat”) denoting excellent mirror symmetry. Other discernible patterns were named “tilt”, “cone”, and “four-leaf”. Clustering was done with different combinations of features and various algorithms using Waikato Environment for Knowledge Analysis (WEKA). Our proposed approach can identify cases that may appear normal in each eye individually but need further testing. This work will be enhanced by including data of posterior elevation, thickness, and common diagnostic indices.
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Vincent SJ, Collins MJ, Read SA, Carney LG. Myopic anisometropia: ocular characteristics and aetiological considerations. Clin Exp Optom 2021; 97:291-307. [DOI: 10.1111/cxo.12171] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 02/14/2014] [Indexed: 12/20/2022] Open
Affiliation(s)
- Stephen J Vincent
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Leo G Carney
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
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20
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Xu G, Hu Y, Zhu S, Guo Y, Xiong L, Fang X, Liu J, Zhang Q, Huang N, Zhou J, Li F, Lei X, Jiang L, Wang Z. A multicenter study of interocular symmetry of corneal biometrics in Chinese myopic patients. Sci Rep 2021; 11:5536. [PMID: 33692402 PMCID: PMC7946893 DOI: 10.1038/s41598-021-84937-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/20/2021] [Indexed: 12/26/2022] Open
Abstract
It is essential to know the normal range of the interocular symmetry of the cornea (ISC) for keratoconus diagnosis and corneal substitutes design. In the present study we investigated the interocular symmetry of corneal biometrics in 6,644 Chinese myopic patients from multiple ophthalmic centers. Corneal biometrics of both eyes were exported from the Pentacam instrument. Interocular symmetry of the corneal biometrics was analyzed by Spearman's correlation test, intraclass correlation coefficient (ICC) analysis and Bland-Altman plot. Significantly strong interocular correlations were found in anterior and posterior corneal curvatures, corneal diameter, corneal thickness, corneal volume, corneal eccentricity, and corneal asphericity (r = 0.87-0.98, all P < 0.001). Moderate interocular correlations were observed in whole corneal astigmatism (r = 0.78) and posterior corneal astigmatism (r = 0.73). ICC between the right and left eyes was 0.94-0.98 for anterior and posterior corneal curvatures, corneal diameter, corneal thickness and corneal volume, 0.80-0.88 for corneal eccentricity and asphericity, and 0.73-0.79 for corneal astigmatism (all P < 0.001). Bland-Altman plot showed that the 95% limit of agreement between both eyes was narrow and symmetric in most of the corneal biometrics, suggesting strong interocular agreements in these corneal biometrics. In conclusion, significant interocular symmetry of corneal biometrics is observed in Chinese myopia patients. Extra attention should be paid to patients with interocular corneal asymmetry.
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Affiliation(s)
- Guihua Xu
- Department of Ophthalmology, Huizhou Municipal Central Hospital, Huizhou, China.,Aier Institute of Refractive Surgery, Refractive Surgery Center, Guangzhou Aier Eye Hospital, Guangzhou, China
| | - Yijun Hu
- Aier Institute of Refractive Surgery, Refractive Surgery Center, Guangzhou Aier Eye Hospital, Guangzhou, China. .,Aier School of Ophthalmology, Central South University, Fourth Floor, New Century Mansion, 198 Middle Furong Road, Changsha, 410015, China.
| | - Shanqing Zhu
- Aier Institute of Refractive Surgery, Refractive Surgery Center, Guangzhou Aier Eye Hospital, Guangzhou, China
| | - Yunxiang Guo
- Aier Institute of Refractive Surgery, Refractive Surgery Center, Guangzhou Aier Eye Hospital, Guangzhou, China
| | - Lu Xiong
- Aier Institute of Refractive Surgery, Refractive Surgery Center, Guangzhou Aier Eye Hospital, Guangzhou, China
| | - Xuejun Fang
- Aier School of Ophthalmology, Central South University, Fourth Floor, New Century Mansion, 198 Middle Furong Road, Changsha, 410015, China.,Refractive Surgery Center, Shenyang Aier Eye Hospital, Shenyang, China
| | - Jia Liu
- Refractive Surgery Center, Shenyang Aier Eye Hospital, Shenyang, China
| | - Qingsong Zhang
- Refractive Surgery Center, Wuhan Aier Eye Hospital, Wuhan, China
| | - Na Huang
- Refractive Surgery Center, Wuhan Aier Eye Hospital, Wuhan, China
| | - Jin Zhou
- Refractive Surgery Center, Chengdu Aier Eye Hospital, Chengdu, China
| | - Fangfang Li
- Refractive Surgery Center, Chengdu Aier Eye Hospital, Chengdu, China
| | - Xiaohua Lei
- Refractive Surgery Center, Hankou Aier Eye Hospital, Hainan, China
| | - Li Jiang
- Refractive Surgery Center, Hankou Aier Eye Hospital, Hainan, China
| | - Zheng Wang
- Aier Institute of Refractive Surgery, Refractive Surgery Center, Guangzhou Aier Eye Hospital, Guangzhou, China.,Aier School of Ophthalmology, Central South University, Fourth Floor, New Century Mansion, 198 Middle Furong Road, Changsha, 410015, China
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21
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Tong H, Hao Q, Wang Z, Wang Y, Li R, Zhao X, Sun Q, Zhang X, Chen X, Zhu H, Huang D, Liu H. The biometric parameters of aniso-astigmatism and its risk factor in Chinese preschool children: the Nanjing eye study. BMC Ophthalmol 2021; 21:67. [PMID: 33535994 PMCID: PMC7860027 DOI: 10.1186/s12886-021-01808-7] [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: 06/01/2020] [Accepted: 01/07/2021] [Indexed: 11/15/2022] Open
Abstract
Backgrounds Aniso-astigmatism may hinder normal visual development in preschool children. Knowing its prevalence, biometric parameters and risk factors is fundamental to children eye care. The purpose of this study was to determine the biometric components of aniso-astigmatism and associated maternal risk factors in Chinese preschool children. Methods In the population-based, prospective cohort Nanjing Eye Study, children were measured for noncycloplegic refractive error using an autorefractor and for biometric parameters using an optical low-coherent reflectometry. The difference of total astigmatism (TA) between both eyes was calculated using cylinder power (non-vectorial aniso-TA was defined as ≥1.00 Dioptre Cylinder [DC] between both eyes) and by vector analysis (vectorial aniso-TA was defined as a difference of ≥0.5 in J0 or J45 between both eyes which is equivalent to 1.00 DC). The prevalence of aniso-TA was presented. Interocular biometric parameters were compared between with vs. without aniso-astigmatism group. In addition, risk factors were determined using multivariate logistic regression model. Results Of 1131 children (66.90 ± 3.38 months, 53.31% male), the prevalence of non-vectorial aniso-TA was 1.95% (95% Confidence Interval (CI) = 1.14–2.75%), while the prevalence of vectorial aniso-TA was twice as common as non-vectorial aniso-TA, neither varying with sex or age. With aniso-TA eyes were more asymmetric in axial length and corneal curvature radius than without aniso-TA eyes. In multivariate logistic regression model, 5-min Apgar score less than 7 was significantly associated with higher risk of aniso-TA (vectorial aniso-TA: Odds Ratio (OR) = 6.42, 95%CI = 2.63–15.69, P < 0.001; non-vectorial aniso-TA: OR = 4.99, 95%CI = 1.41–17.68, P = 0.01). Being twin or triple was significantly associated with higher risk of vectorial aniso-CA (OR = 2.43, 95%CI = 1.05–5.60, P = 0.04). Pre-term delivery (OR = 2.60, 95%CI = 1.09–6.15, P = 0.03) and post-term delivery (OR = 3.61, 95%CI = 1.31–9.96, P = 0.01) were significantly associated with higher risk of vectorial aniso-CA. Conclusions Both corneal curvature radius and axial length asymmetry were correlated with aniso-TA. Children with 5-min Apgar score < 7 were more likely to have aniso-TA, while twin or triple, pre-term or post-term delivery were more likely to have vectorial aniso-CA. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-01808-7.
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Affiliation(s)
- Haohai Tong
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Qingfeng Hao
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Zijin Wang
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Yue Wang
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Rui Li
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xiaoyan Zhao
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Qigang Sun
- Department of Ophthalmology, Maternal and Child Healthcare Hospital of Yuhuatai District, Nanjing, China
| | - Xiaohan Zhang
- Department of Ophthalmology, Wuxi Children's Hospital, Wuxi, China
| | - Xuejuan Chen
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Hui Zhu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Dan Huang
- Department of Child Healthcare, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
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22
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Eyes of Aniso-Axial Length Individuals Share Generally Similar Corneal Biometrics with Normal Eyes in Cataract Population. J Ophthalmol 2020; 2020:4760978. [PMID: 33178451 PMCID: PMC7648247 DOI: 10.1155/2020/4760978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/01/2020] [Accepted: 10/14/2020] [Indexed: 11/17/2022] Open
Abstract
AIMS To determine the characteristics of corneal biometrics in eyes from aniso-axial length cataract patients compared with eyes from non-aniso-axial length individuals. METHODS This is a retrospective case series. Cataract patients with preoperative binocular measurements were recruited. A binocular axial difference of ≥1 mm was considered to indicate aniso-axial length. The anterior segmental biometrics were measured using Pentacam HR (Oculus, Wetzlar, Germany) and IOLMaster 500 (Carl Zeiss Meditec, Jena, Germany). Comparisons of biometrics were made among 4 eye conditions: the longer eyes from aniso-axial length patients, the shorter eyes from aniso-axial length patients, the longer eyes from non-aniso-axial length patients, and the shorter eyes from non-aniso-axial length patients. The aniso-axial length eyes were also stratified into 8 subgroups with axial length (AL) increments of 1 mm, and the biometrics of the subgroups were compared. RESULTS There was smaller anterior corneal astigmatism in the shorter aniso-axial length group than those in the longer aniso-axial length group (1.01 ± 0.70 D vs 1.12 ± 0.76 D, P=0.031). The longer aniso-axial length eyes had greater anterior corneal steep curvature (44.13 ± 1.69 D vs 43.87 ± 1.69 D, P=0.009) and anterior corneal astigmatism (1.12 ± 0.76 D vs 1.02 ± 0.69 D, P=0.023) compared with longer non-aniso-axial length subjects. Other corneal biometrics were similar between the aniso-axial length eyes and the non-aniso-axial length eyes. In the longer aniso-axial length group, the posterior corneal aberrations of eyes in the ≥5 mm subgroups were greater than those in the <5 mm subgroups (0.879 ± 0.183 μm vs 0.768 ± 0.178 μm for total aberrations, P < 0.001; 0.228 ± 0.086 μm vs 0.196 ± 0.043 μm for high-order aberrations, P=0.036; 0.847 ± 0.173 μm vs 0.741 ± 0.179 μm for low-order aberrations, P=0.001). CONCLUSION Eyes of aniso-axial length individuals share generally similar corneal biometrics with normal eyes in cataract population. Anterior corneal astigmatism of the longer eyes from the aniso-axial length cataract patients was higher than that of the longer eyes from the non-aniso-axial length individuals. Total posterior corneal aberrations of the longer aniso-axial length eyes increased when the binocular axial difference was over 5 mm.
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Does anisometropia affect the ciliary muscle thickness? An ultrasound biomicroscopy study. Int Ophthalmol 2020; 40:3393-3402. [PMID: 33083933 DOI: 10.1007/s10792-020-01625-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 07/17/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To compare the ciliary muscle thickness (CMT) of the normal fellow eye to that of the amblyopic eye using ultrasound biomicroscopy (UBM) in patients with unilateral anisometropic amblyopia. METHODS Thirty patients with unilateral anisometropic amblyopia were involved. The patients were divided into two groups: 19 hyperopic and 11 myopic. Axial length (AL) was measured with optic biometry and anterior chamber depth (ACD), iris area, and CMT were measured with UBM. RESULTS The mean age was 34.10 ± 6.61 years. The mean spherical difference between two eyes was 2.59 diopter (D) in hyperopic patients and 3.77D in myopic patients. In the hyperopic patients, nasal CMT1(nCMT), temporal CMT1(tCMT), tCMT2, and tCMT3 values were statistically thinner in amblyopic eyes than healthy eyes (p = 0.036, p = 0.003, p = 0.023, p = 0.005, respectively). ACD values were statistically lower in amblyopic eyes (2.78 ± 0.26 mm) than healthy eyes (2.90 ± 0.21 mm) (p < 0.001). In the myopic patients, nCMT1, nCMT2, nCMT3, tCMT1, tCMT2, and tCMT3 values were statistically thicker in amblyopic eyes than healthy eyes (p = 0.003, p = 0.003, p = 0.005, p = 0.003, p = 0.003, p = 0.019, respectively). ACD values were statistically higher in amblyopic eyes (3.20 ± 0.30 mm) than healthy eyes (3.06 ± 0.29 mm) (p = 0.004). Also, there was no significant difference in the iris area between the amblyopic and normal eyes of the myopic and hyperopic patients (p > 0.05). CONCLUSIONS Amblyopic eyes in patients with unilateral myopic anisometropia have thicker CMT and deeper ACD than healthy eyes. Conversely, amblyopic eyes in patients with unilateral hyperopic anisometropia have thinner CMT and shorter ACD than healthy eyes. There is a positive correlation between AL and CMT.
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24
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Flitcroft I, Mccullough S, Saunders K. What can anisometropia tell us about eye growth? Br J Ophthalmol 2020; 105:1211-1215. [PMID: 32855163 DOI: 10.1136/bjophthalmol-2020-316406] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/25/2020] [Accepted: 08/03/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS Both eyes of one individual share the same environment and genes. We examined interocular differences in biometry to determine the potential role of other factors in refractive development. METHODS 362 subjects (6-7 years) from the Northern Ireland Childhood Errors of Refraction study were studied. Cycloplegic autorefraction was measured with a Shin-Nippon open-field autorefractor. Axial length and corneal curvature were measured with a Zeiss IOLMaster. RESULTS 257 subjects had an interocular difference of <0.50 D (ISO group) and 105 (29%) a difference of ≥0.50 D (ANISO group). Twenty-five subjects (6.9%) had anisometropia ≥1.00 D and 9 (2.5%) had anisometropia ≥1.50 D. The two groups, ISO and ANISO, showed different refractive distributions (p=0.001) with the ISO group showing a nearly Gaussian distribution and the ANISO group showing positive skew, a hyperopic shift and a bi-Gaussian distribution. A marker of emmetropisation is the poor correlation between refraction and corneal curvature seen in older children. There was no significant correlation between refraction and corneal curvature of each eye in the ISO group (r=0.09, p=0.19), but these parameters were significantly correlated in the ANISO group (r=0.28, p=0.004). CONCLUSION In young children, small degrees of anisometropia (≥0.5 D) are associated with impaired emmetropisation. This suggests that anisometropia is a marker for poorly regulated eye growth, indicating that, in addition to environmental and genetic influences on eye growth, stochastic processes contribute to refractive outcomes.
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Affiliation(s)
- Ian Flitcroft
- Ophthalmology, Children's University Hospital, Dublin, Ireland
| | - Sara Mccullough
- Centre for Optometry and Vision Science Research, University of Ulster, Coleraine, Londonderry, UK
| | - Kathryn Saunders
- Centre for Optometry and Vision Science Research, University of Ulster, Coleraine, Londonderry, UK
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Metsing TI, Hansraj R, Jacobs W. Comparison of the Snellen and Spectrum LogMAR visual acuity charts in schoolgoing children. AFRICAN VISION AND EYE HEALTH 2020. [DOI: 10.4102/aveh.v79i1.531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Lingham G, Mackey DA, Sanfilippo PG, Mountain J, Hewitt AW, Newnham JP, Yazar S. Influence of prenatal environment and birth parameters on amblyopia, strabismus, and anisometropia. J AAPOS 2020; 24:74.e1-74.e7. [PMID: 32151573 DOI: 10.1016/j.jaapos.2019.12.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/09/2019] [Accepted: 12/31/2019] [Indexed: 10/24/2022]
Abstract
PURPOSE To report the prevalence of amblyopia, strabismus, and anisometropia in a young adult population at a single center in Australia and to investigate the underlying prenatal and early-life risk factors. METHODS Participants in the Raine Study have been followed from mid-gestation (n = 2,868 newborns) to young adulthood. At age 20 years, 1,344 participants had a comprehensive eye examination, including visual acuity and a detailed orthoptic assessment. Risk factors were determined from medical records and questionnaires completed by the mothers at 18 weeks' gestation. The main outcome measures were the proportions of participants with amblyopia, esotropia, exotropia, or anisometropia (defined as >1 D difference). RESULTS Of the 1,125 white participants, 12 (1.1%) had amblyopia, 39 (3.5%) had strabismus, and 33 (2.9%) had anisometropia. In multivariable logistic regression, amblyopia was associated with a maternal history of pregnancy-induced hypertension (OR = 3.80; 95% CI, 1.19-12.13); esotropia, with lower gestational age (OR = 0.97; 95% CI, 0.95-0.97) and a heavier placenta (OR = 1.02; 95% CI, 1.00-1.04); exotropia, with a maternal history of previously treated hypertension (OR = 4.00; 95% CI, 1.06-15.03) and maternal use of recreational drugs during early pregnancy (OR = 3.61; 95% CI, 1.06-15.03); and anisometropia, with older maternal age (OR = 1.07; 95% CI, 1.01-1.14) and an abnormal umbilical cord (OR = 2.39; 95% CI, 1.04-5.47). CONCLUSIONS The prevalence of amblyopia, strabismus, and anisometropia in this cohort was similar to that in other studies. Preterm birth and maternal health may have adverse effects on eye development.
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Affiliation(s)
- Gareth Lingham
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth
| | - David A Mackey
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth.
| | - Paul G Sanfilippo
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth; Centre for Eye Research Australia, University of Melbourne, Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Jenny Mountain
- School of Population Health, University of Western Australia, Perth
| | - Alex W Hewitt
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth; Centre for Eye Research Australia, University of Melbourne, Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, Melbourne, Australia; School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia
| | - John P Newnham
- School of Women and Infants Health, University of Western Australia, King Edward Memorial Hospital, Perth
| | - Seyhan Yazar
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth
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Abstract
SIGNIFICANCE Anisomyopia is a natural experimental paradigm that compares dose response between fellow eyes. This study is the first to explore whether orthokeratology (ortho-k) has a dose-response effect on axial length growth and reduces the interocular difference in axial length in anisomyopic children. PURPOSE The purpose of this study was to compare the effect of ortho-k on axial length elongation between the fellow eyes of anisomyopic children. METHODS In this retrospective study, 49 anisomyopic children who wore ortho-k lenses were assigned to the anisomyopic ortho-k group. Based on the one-to-one match principle (same age and proximate spherical equivalent), high-isomyopic and low-isomyopic groups each enrolled 49 isomyopic children who wore ortho-k lenses with spherical equivalent similar to that of the more myopic eye and the less myopic eye in the anisomyopic ortho-k group, respectively. Forty-nine anisomyopic children who wore spectacles were enrolled in the anisomyopic spectacle group. At baseline and at 1- and 2-year visits, axial length was measured. Axial length elongation and interocular difference in axial length were compared. RESULTS In the anisomyopic ortho-k group, the less myopic eyes exhibited more axial length elongation than did the more myopic eyes during 1- and 2-year treatment periods (P < .01). However, there was no significant difference in axial length elongation between the fellow eyes in the isomyopic groups and anisomyopic spectacle group. At the 2-year visit, the interocular difference in axial length of children in the anisomyopic ortho-k group significantly decreased from 0.72 ± 0.34 to 0.56 ± 0.38 mm (P < .05). In contrast, ortho-k lens-wearing isomyopic children or spectacle-wearing anisomyopic children did not show a significant change in interocular difference in axial length. CONCLUSIONS Orthokeratology could reduce the amount of anisomyopia in children primarily through stronger myopia control in the more myopic eye.
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Fu AC, Qin J, Rong JB, Ji N, Wang WQ, Zhao BX, Lyu Y. Effects of orthokeratology lens on axial length elongation in unilateral myopia and bilateral myopia with anisometropia children. Cont Lens Anterior Eye 2019; 43:73-77. [PMID: 31862203 DOI: 10.1016/j.clae.2019.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/29/2019] [Accepted: 12/02/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE To investigate the effect of orthokeratology (OK) lens on axial length (AL) elongation in unilateral myopia and bilateral myopia with anisometropia children. METHODS Twenty-seven unilateral myopia (group 1) and 25 bilateral myopia with anisometropia children (group 2) were involved in this 1-year retrospective study. The eyes with higher spherical equivalent refractive error (SER) were assigned to the H eyes subgroup and the fellow eyes with lower SER to the L eyes subgroup in the two groups. RESULTS The mean change in AL of H eyes and L eyes were 0.11 ± 0.19 mm, 0.30 ± 0.28 mm in group 1 (P = 0.04) and 0.09± 0.14mm, 0.13± 0.16mm in group 2 (P = 0.36), respectively. Multivariate regression analyses showed that significant difference of change in AL was found between H eyes and L eyes in group1 (β=0.25, P = 0.03), but no difference in group 2 (β=0.09, P = 0.12). The AL of H eyes in group 1 and group 2, H eyes in group 1 and L eyes in group 2 had the same increased rate (β= -0.04, P = 0.43; β = 0.02, P = 0.56). CONCLUSIONS Monocular OK lens is effective on suppression AL elongation of the myopic eyes and reduce anisometropia value in unilateral myopic children. The OK lens can control the AL elongation in both eyes at the same rate, but it cannot reduce anisometropia value in bilateral myopia with anisometropia children after 1-year follow-up.
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Affiliation(s)
- Ai-Cun Fu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Jian Qin
- Provincial People's Hospital, Henan Eye Hospital, Zhengzhou 450000, China
| | - Jun-Bo Rong
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Na Ji
- The Affiliated Eye Hospital of Suzhou Vocational Health College, Suzhou, 215000, China
| | - Wei-Qun Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Bing-Xin Zhao
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Yong Lyu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China.
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Jiang S, Chen Z, Bi H, Xia R, Shen T, Zhou L, Jiang J, Zhang B, Lu F. Elucidation of the more myopic eye in anisometropia: the interplay of laterality, ocular dominance, and anisometropic magnitude. Sci Rep 2019; 9:9598. [PMID: 31270453 PMCID: PMC6610619 DOI: 10.1038/s41598-019-45996-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 06/19/2019] [Indexed: 12/12/2022] Open
Abstract
This study reveals how, in a myopic anisometrope, the odds of an eye being more myopic are related to laterality, ocular dominance, and magnitude of anisometropia. In 193 subjects, objective refraction was performed with cycloplegia. Sighting, motor, and sensory dominance were determined with the hole-in-the-card test, convergence near-point test, continuous flashing technique, respectively. Multiple logistic regression was used for probability analysis. Seventy percent of the subjects had a right eye that was more myopic, while 30% of them had a more myopic left eye. When the right eye was the sensory dominant eye, the probability of the right eye being more myopic increased to 80% if the anisometropia was less than 3.0 D, and decreased below 70% if anisometropia was beyond 3.0 D. When the left eye was the sensory dominant eye, the probability of the left eye being more myopic increased to above 40% if the anisometropia was less than 4.0 D and decreased below 30% if the anisometropia was beyond 4.0 D. Therefore, between the two eyes of anisometropes, laterality tilts the chance of being more myopic to the right. Being the sensory dominant eye increases an eye’s probability of being more myopic by another 10% if the magnitude of anisometropia is moderate.
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Affiliation(s)
- Siyu Jiang
- Wenzhou Medical University, School of Ophthalmology and Optometry, Wenzhou, Zhejiang, 325027, China
| | - Zheyi Chen
- Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Hua Bi
- Nova Southeastern University, College of Optometry, Fort Lauderdale, FL, 33314, USA
| | - Ruijing Xia
- Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China.,Nova Southeastern University, College of Optometry, Fort Lauderdale, FL, 33314, USA
| | - Ting Shen
- Wenzhou Medical University, School of Ophthalmology and Optometry, Wenzhou, Zhejiang, 325027, China
| | - Ling Zhou
- Wenzhou Medical University, School of Ophthalmology and Optometry, Wenzhou, Zhejiang, 325027, China
| | - Jun Jiang
- Wenzhou Medical University, School of Ophthalmology and Optometry, Wenzhou, Zhejiang, 325027, China.,Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Bin Zhang
- Nova Southeastern University, College of Optometry, Fort Lauderdale, FL, 33314, USA.
| | - Fan Lu
- Wenzhou Medical University, School of Ophthalmology and Optometry, Wenzhou, Zhejiang, 325027, China.
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Metsing IT, Hansraj R, Jacobs W, Nel EW. Review of school vision screening guidelines. AFRICAN VISION AND EYE HEALTH 2018. [DOI: 10.4102/aveh.v77i1.444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Vision screenings are important in identifying visual anomalies likely to disrupt the physical, intellectual, social and emotional development of children. School health services globally include vision screenings, complementing a variety of associated screening services.Aim: This review article provides evidence for content, provision and efficacy of the vision screening services for children of school-going age and reports on the current practice of children’s vision screenings worldwide including in South Africa.Methods: Studies were identified from PubMed, Ebscohost and Science Direct with the search terms utilised during the selection of electronic articles and journals for the review. The target population includes children of school-going age from 6 to 19 years without previously known conditions associated with visual anomalies and learning-related problems. The quality of vision screening programmes and policies for the school-going age children in different countries were evaluated using Wilson and Jungner criteria.1Results: Vision screening programmes worldwide appear to support comprehensive vision screening methods among pre-schoolers (from birth to ≤ 6 years vs. children of school-going age). The development of vision screening procedures in some countries in the United States of America (USA) was found to be grounded on epidemiologic findings and principles. These may have contributed towards the formulation of national vision screening guidelines for pre-schoolers that supported the detection of amblyopia and its associated conditions such as strabismus, anisometropia and myopia. School-going children’s vision screenings are not supported worldwide as research has shown that there is lack of benefits for detecting other visual anomalies such as vergence and accommodative dysfunctions. This is despite evidence provided by the literature reviewed that an association exists between prevalent accommodation and vergence dysfunctions including poor ocular motilities and poor near-vision, among children of school-going age with poor academic performance.Conclusion: The guidelines worldwide support school vision screenings, especially for the pre-schoolers by the school health nurses, with other programs having considered the teachers, optometrists or orthoptists as the appropriate personnel to conduct the school vision screenings. There is still a need for the effectiveness of the school vision-screening programmes to be investigated related to the importance of detecting convergence and accommodative dysfunctions for the school going age children.
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Effects of astigmatic defocus on binocular contrast sensitivity. PLoS One 2018; 13:e0202340. [PMID: 30106991 PMCID: PMC6091947 DOI: 10.1371/journal.pone.0202340] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 08/01/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine the effects of astigmatism on contrast sensitivity (CS). Methods Eighteen normal volunteers (30.5 ± 6.0 [mean ± SD] years) were recruited. After correcting each refractive error by spectacles, against-the-rule (ATR) or with-the-rule (WTR) astigmatism of +1.00, +2.00 and +3.00 D was intentionally produced in both eyes, and then binocular CS was measured. The cylindrical addition of different powers (+1.00–+3.00 D) was compensated with spherical lenses so that the spherical equivalent refraction became zero in each eye. Subsequently, the above cylindrical addition was monocularly induced, and binocular CS was measured again. The relation between CS and astigmatic power, axis, and monocular or binocular astigmatism was investigated. Results With binocular ATR and WTR astigmatism, increases in astigmatic power significantly correlated with decreases in the area under the log contrast sensitivity function (AULCSF). With monocular astigmatic defocus, astigmatic power addition did not affect AULCSF. With binocular astigmatic defocus of high-power (+2.00 and +3.00 D), ATR astigmatism deteriorated AULCSF more than WTR astigmatism. In a comparison between binocular and monocular astigmatic defocus, CS was significantly worse with binocular astigmatic defocus than with monocular astigmatic defocus at higher spatial frequencies regardless of astigmatic power. Conclusions Binocular astigmatic defocus deteriorates CS depending on the amount of astigmatic power. ATR astigmatism reduces CS more than WTR astigmatism dose. In addition, binocular astigmatic defocus affects CS more severely than monocular astigmatic defocus especially at high spatial frequencies.
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Yang C, Li X, Zhang G, Lan J, Zhang Y, Chu H, Li J, Xie W, Wang S, Yan L, Zeng J. Comparison of perceptual eye positions among patients with different degrees of anisometropia. Medicine (Baltimore) 2017; 96:e8119. [PMID: 28953639 PMCID: PMC5626282 DOI: 10.1097/md.0000000000008119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study is to compare the perceptual eye positions (PEPs) among patients with different degrees of anisometropia.A total of 157 patients were recruited into this retrospective study. A detailed ophthalmic examination was conducted on each patient. The degree of refractive errors in the presence of astigmatism was converted into the degree of spherical equivalent (SE). Patients were divided into 3 groups according to the interocular SE difference: severe anisometropia group with interocular SE difference ≥2.50D, mild anisometropia group with interocular SE difference ≥1.00D and <2.50D, and non-anisometropia group with interocular SE difference <1.00D. The vertical and horizontal PEP were measured by a computer-controlled perceptual examination evaluation system. The results obtained from the 3 groups were compared and analyzed.A total of 157 patients were enrolled including 32 patients in the severe anisometropia group, 37 patients in the mild anisometropia group, and 88 patients in the non-anisometropia group. The quartiles of vertical PEP pixels were as follows: 7.50 (5.00, 16.75) in the severe anisometropia group, 5.00 (2.00, 7.50) in the mild anisometropia group, and 5.00 (3.00, 9.00) in the non-anisometropia group, respectively. The vertical PEP pixel was much higher in the severe anisometropia group than that in the other two groups (P < .05). The quartiles of horizontal PEP pixels were as follows: 27.50 (10.75, 67.50) in the severe anisometropia group, 17.00 (7.00, 54.50) in the mild anisometropia group, and 21.50 (11.00, 60.75) in the non-anisometropia group. There were no statistically significant differences among the 3 groups (P > .05).There was an obvious deviation of vertical PEP in patients with anisometropia ≥2.50D, indicating that the instability of vertical PEP might be associated with the development of severe anisometropia.
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Affiliation(s)
- Cheng Yang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences
| | - Xue Li
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences
| | - Guanrong Zhang
- Health Management Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences
| | - Jianqing Lan
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences
| | - Yan Zhang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences
| | - Hang Chu
- National Engineering Research Center for Healthcare Devices, Guangzhou, China
| | - Juan Li
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences
| | - Wenjuan Xie
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences
| | - Shujun Wang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences
| | - Li Yan
- National Engineering Research Center for Healthcare Devices, Guangzhou, China
| | - Jin Zeng
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences
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Singh N, Rohatgi J, Kumar V. A Prospective Study of Anterior Segment Ocular Parameters in Anisometropia. KOREAN JOURNAL OF OPHTHALMOLOGY 2017; 31:165-171. [PMID: 28367046 PMCID: PMC5368091 DOI: 10.3341/kjo.2017.31.2.165] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 12/07/2016] [Indexed: 12/27/2022] Open
Abstract
Purpose The aim of this study was to investigate the differences in anterior segment ocular parameters in anisometropia >1 D. Methods This study included 202 eyes of 101 subjects ranging from 10 to 40 years of age with anisometropia of 1 D or more. The subjects were divided into groups according to anisomyopia, anisoastigmatism, and anisohypermetropia. After providing informed consent, each patient underwent a detailed ophthalmological examination including cycloplegic refraction, best-corrected visual acuity, cover test, axial length (AL) measurement using A-scan ultrasound biometer, keratometry, anterior chamber depth, and central corneal thickness measurement. For each participant, the eye with greater refractive error was compared to the fellow eye via paired t-tests. Correlations between parameters were studied using the Pearson correlation coefficient. Results The average age of subjects was 21.7 ± 9.3 years. Of 101 subjects, 31 had anisomyopia; 42 had anisohypermetropia; and 28 had anisoastigmatism. A predisposition toward greater myopia in right eyes was noted in anisomyopia (24 of 31 subjects, 77%). The inter-ocular acuity difference was significant in all three groups (p < 0.01). As the degree of anisometropia increased, there was significant positive correlation in the difference in AL in myopes (r = 0.863, p < 0.01) and hypermetropes (r = 0.669, p < 0.01) and the difference in corneal curvature in anisoastigmatism (r = 0.564, p = 0.002) and hypermetropes (r = 0.376, p = 0.014). A significant positive correlation was also present between the anterior chamber depth difference and refractive difference in hypermetropes (r = 0.359, p = 0.020). Conclusions This study showed that anisomyopia is correlated only with anterior chamber differences. Anisohypermetropia is correlated with AL differences as well as corneal curvature difference and anterior chamber depth difference. The amount of anisoastigmatism correlates only with corneal curvature difference.
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Affiliation(s)
- Neha Singh
- Department of Ophthalmology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Jolly Rohatgi
- Department of Ophthalmology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Vinod Kumar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Lee CW, Fang SY, Tsai DC, Huang N, Hsu CC, Chen SY, Chiu AWH, Liu CJL. Prevalence and association of refractive anisometropia with near work habits among young schoolchildren: The evidence from a population-based study. PLoS One 2017; 12:e0173519. [PMID: 28273153 PMCID: PMC5342266 DOI: 10.1371/journal.pone.0173519] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 02/21/2017] [Indexed: 12/15/2022] Open
Abstract
Background Lifestyle behaviour may play a role in refractive error among children, but the association between near work habits and refractive anisometropia remains unclear. Methods We estimated the prevalence of refractive anisometropia and examined its association with near work activities among 23,114 children in the Myopia Investigation Study in Taipei who were grade 2 elementary school students at baseline in 2013 and 2014. Baseline data on demographics, medical history, parental history and near work habits were collected by parent-administered questionnaire survey. Refractive status was determined by cycloplegic autorefraction. Refractive anisometropia was defined as the spherical equivalent difference ≥ 1.0 diopter between eyes. Results The prevalence of refractive anisometropia was 5.3% (95% confidence interval [CI], 5.0% to 5.6%). The prevalence and severity of refractive anisometropia increased with both myopic and hyperopic refractive error. Multivariate logistic regression analysis revealed that refractive anisometropia was significantly associated with myopia (odds ratio [OR], 2.98; 95% CI, 2.53–3.51), hyperopia (OR, 2.37; 95% CI, 1.98–2.83), degree of astigmatism (OR, 1.005; 95% CI, 1.005–1.006), amblyopia (OR, 2.54; 95% CI, 2.06–3.12), male gender (OR, 0.88; 95% CI, 0.78–0.99) and senior high school level of maternal education (OR, 0.69; 95% CI, 0.52–0.92). Though anisometropic children were more likely to spend more time on near work (crude OR, 1.15; 95% CI, 1.02–1.29) and to have less eye-to-object distance in doing near work (crude OR, 1.15; 95% CI, 1.01–1.30), these associations became insignificant after additional adjustment for ocular, demographic and parental factors. Conclusions The present study provides large-scale, population-based evidence showing no independent association between refractive anisometropia and near work habits, though myopia is associated with refractive anisometropia.
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Affiliation(s)
- Chia-Wei Lee
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shao-You Fang
- Children and Family Research Center, National Taiwan University, Taipei, Taiwan
| | - Der-Chong Tsai
- National Yang-Ming University School of Medicine, Taipei, Taiwan
- Department of Ophthalmology, National Yang-Ming University Hospital, Yilan, Taiwan
- * E-mail: (CJLL); (DCT)
| | - Nicole Huang
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Chih-Chien Hsu
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shing-Yi Chen
- Department of Health, Taipei City Government, Taipei, Taiwan
| | | | - Catherine Jui-Ling Liu
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
- National Yang-Ming University School of Medicine, Taipei, Taiwan
- * E-mail: (CJLL); (DCT)
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Singh N, Rohatgi J, Gupta VP, Kumar V. Measurement of peripapillary retinal nerve fiber layer thickness and macular thickness in anisometropia using spectral domain optical coherence tomography: a prospective study. Clin Ophthalmol 2017; 11:429-434. [PMID: 28260856 PMCID: PMC5328294 DOI: 10.2147/opth.s123273] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Purpose To study whether there is a difference in central macular thickness (CMT) and peripapillary retinal nerve fiber layer (RNFL) thickness between the two eyes of individuals having anisometropia >1 diopter (D) using spectral domain optical coherence tomography (OCT). Material and methods One hundred and one subjects, 31 with myopic anisometropia, 28 with astigmatic anisometropia, and 42 with hypermetropic anisometropia, were enrolled in the study. After informed consent, detailed ophthalmological examination was performed for every patient including cycloplegic refraction, best corrected visual acuity, slit lamp, and fundus examination. After routine ophthalmic examination peripapillary RNFL and CMT were measured using spectral domain OCT and the values of the two eyes were compared in the three types of anisometropia. Axial length was measured using an A Scan ultrasound biometer (Appa Scan-2000). Results The average age of subjects was 21.7±9.3 years. The mean anisometropia was 3.11±1.7 D in myopia; 2±0.99 D in astigmatism; and 3.68±1.85 D in hypermetropia. There was a statistically significant difference in axial length of the worse and better eye in both myopic and hypermetropic anisometropia (P=0.00). There was no significant difference between CMT of better and worse eyes in anisomyopia (P=0.79), anisohypermetropia (P=0.09), or anisoastigmatism (P=0.16). In anisohypermetropia only inferior quadrant RNFL was found to be significantly thicker (P=0.011) in eyes with greater refractive error. Conclusion There does not appear to be a significant difference in CMT and peripapillary RNFL thickness in anisomyopia and anisoastigmatism. However, in anisohypermetropia inferior quadrant RNFL was found to be significantly thicker.
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Affiliation(s)
- Neha Singh
- Department of Ophthalmology, University College of Medical Sciences, Delhi, India
| | - Jolly Rohatgi
- Department of Ophthalmology, University College of Medical Sciences, Delhi, India
| | - Ved Prakash Gupta
- Department of Ophthalmology, University College of Medical Sciences, Delhi, India
| | - Vinod Kumar
- Department of Ophthalmology, University College of Medical Sciences, Delhi, India
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Pärssinen O, Kauppinen M, Kaprio J, Rantanen T. Anisometropia of ocular refractive and biometric measures among 66- to 79-year-old female twins. Acta Ophthalmol 2016; 94:768-774. [PMID: 27273930 DOI: 10.1111/aos.13125] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 04/15/2016] [Indexed: 12/17/2022]
Abstract
PURPOSE To examine the prevalence of anisometropia of spherical refraction (AnisoSR), astigmatism (AnisoAST) and spherical equivalent (AnisoSE) and their associations with spherical refraction (SR), refractive astigmatism (AST), spherical equivalent (SE) and interocular differences of ocular biometric parameters among elderly female twins. METHODS Refraction of 117 monozygotic (MZ) and 116 dizygotic (DZ) female twin subjects aged 66-79 years was assessed with an auto-refractor (Topcon AT) and controlled by subjective refraction. Corneal refraction, anterior chamber depth and axial length were measured with a Zeiss IOL Master. Participants with eyes operated for cataract or glaucoma were excluded, but the grade of nuclear opacity was not recorded. The associations between the absolute values of AnisoSR, AnisoAST and AnisoSE with SR, AST, SE, corneal refractive power (CR), corneal astigmatism (CAST), anterior chamber depth (ACD) and axial length (AL) and with their interocular differences were calculated. When calculating the interdependencies of the differences, the real and absolute differences between the right and left eye were used. RESULTS Means ± standard deviations for AnisoSR, AnisoAST and AnisoSE were 0.67 ± 0.92 D, 0.42 ± 0.41 D and 0.65 ± 0.71 D, respectively. AnisoSR, AnisoAST and AnisoSE >1.0 D were present in 14.7%, 4.2% and 17.7% of cases, respectively. Anisometropia of spherical refraction (AnisoSR), AnisoAST and AnisoSE were higher the more negative the values of SR or SE. Hyperopic ametropia did not increase these anisometropia values. The correlations of AnisoSR and AnisoSE with the absolute values of interocular differences in CR and AL were non-significant. Using the real values of the interocular differences, the respective correlations were significant. The correlation between the real interocular differences in CR and AL was negative (r = -0.258, p < 0.001). Thus, the combined effect of the real interocular differences in CR and AL was a decrease in AnisoSR and AnisoSE (emmetropization). CONCLUSION Higher AnisoSR and AnisoSE were associated with more myopic refraction and longer AL. Higher AnisoAST was associated with more negative SR and higher AST and CAST. The negative correlation between real interocular differences in CR and AL indicated their influence of emmetropization in AnisoSR and AnisoSE.
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Affiliation(s)
- Olavi Pärssinen
- Department of Ophthalmology; Central Hospital of Central Finland; Jyväskylä Finland
- Gerontology Research Center and Department of Health Sciences; University of Jyväskylä; Jyväskylä Finland
| | - Markku Kauppinen
- Gerontology Research Center and Department of Health Sciences; University of Jyväskylä; Jyväskylä Finland
| | - Jaakko Kaprio
- Gerontology Research Center and Department of Health Sciences; University of Jyväskylä; Jyväskylä Finland
- Department of Public Health; University of Helsinki; Helsinki Finland
- Institute for Molecular Medicine; University of Helsinki; Helsinki Finland
- Department of Health; National Institute for Health and Welfare; Helsinki Finland
| | - Taina Rantanen
- Gerontology Research Center and Department of Health Sciences; University of Jyväskylä; Jyväskylä Finland
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Dohvoma VA, Epée E, Ebana Mvogo SR, Lietcheu NS, Ebana Mvogo C. Correlation between Hertel exophthalmometric value and refraction in young Cameroonian adults aged 20 to 40 years. Clin Ophthalmol 2016; 10:1447-51. [PMID: 27536057 PMCID: PMC4975139 DOI: 10.2147/opth.s111915] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To study the relationship between exophthalmometric value (EV) and refractive error in Cameroonian young adults. Patients and methods A prospective descriptive study was carried out in the ophthalmic unit of the Yaoundé Central Hospital from March to May 2015. Consenting patients aged 20–40 years with no intraocular pathology who were seen for refractive errors were included. Ocular protrusion was measured using the Hertel exophthalmometer. Automatic refraction was done following cycloplegia with cyclopentolate and tropicamide. Results A total of 200 patients were included (68% females and 32% males). The mean age was 27.2±6 years. Hyperopia was the most common refractive error (51%), followed by hyperopic astigmatism (19.3%). EV varied between 9 mm and 23 mm, with a mean of 14.8±2.5 mm in the right eye and 15.0±2.5 mm in the left eye. The mean EVs were 17.10±2.80 mm in myopia, 14.24±1.92 mm in hyperopia, 16.72±2.58 mm in myopic astigmatism, 14.07±2.19 mm in hyperopic astigmatism, and 14.77±2.40 mm in mixed astigmatism. The spherical value had a negative correlation with EV (P=0.0000). Conclusion The mean EV of this Cameroonian population is smaller than that of other populations and is consistent with the known characteristic hyperopic status of the population. A study on a larger sample will determine the normative data of absolute and relative EV in our setting.
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Affiliation(s)
- Viola A Dohvoma
- Department of Ophthalmology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Emilienne Epée
- Department of Ophthalmology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Stève R Ebana Mvogo
- Department of Ophthalmology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - N Sandra Lietcheu
- Department of Ophthalmology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Côme Ebana Mvogo
- Department of Ophthalmology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
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Effect of myopic anisometropia on anterior and posterior ocular segment parameters. Int Ophthalmol 2016; 37:377-384. [PMID: 27262559 DOI: 10.1007/s10792-016-0272-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 05/27/2016] [Indexed: 12/12/2022]
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Abstract
PURPOSE To demonstrate the refractive changes of amblyopic children attributed to high anisometropia in the myopia endemic in Taiwan. METHODS Amblyopic children younger than 10 years with myopic or hyperopic anisometropia 3 diopters (D) or more who had follow-up for more than 2 years and had final visual acuity of 20/30 or better in the amblyopic eye were included. RESULTS The average age on the first visit was similar for the 13 myopic children (5.5 years) and 17 hyperopic children (5.3 years). Initially, the mean anisometropia was significantly different (myopic, 7.25 D vs. hyperopic, 3.89 D), but the visual acuity of the amblyopic eye (logarithm of the minimum angle of resolution) was similar between both groups at baseline (0.50 vs. 0.57). Myopization of the sound eye surpassed that of the amblyopic eye in the myopic group, which resulted in a yearly reduction of anisometropia of 0.51 D. However, hyperopia decreased synchronously in both eyes of the hyperopic children. The final degree of anisometropia was not significantly different between the two groups (4.07 D vs. 3.62 D). CONCLUSIONS Growing up in a country with a high prevalence of myopia, children with myopic and hyperopic anisometropia in this study inevitably had myopization in both eyes. Myopic anisometropia decreases significantly over time, but hyperopic anisometropia remains constant.
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Kulp MT, Ying GS, Huang J, Maguire M, Quinn G, Ciner EB, Cyert LA, Orel-Bixler DA, Moore BD. Associations between hyperopia and other vision and refractive error characteristics. Optom Vis Sci 2014; 91:383-9. [PMID: 24637486 DOI: 10.1097/opx.0000000000000223] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To investigate the association of hyperopia greater than +3.25 diopters (D) with amblyopia, strabismus, anisometropia, astigmatism, and reduced stereoacuity in preschoolers. METHODS Three- to five-year-old Head Start preschoolers (N = 4040) underwent vision examination including monocular visual acuity (VA), cover testing, and cycloplegic refraction during the Vision in Preschoolers Study. Visual acuity was tested with habitual correction and was retested with full cycloplegic correction when VA was reduced below age norms in the presence of significant refractive error. Stereoacuity testing (Stereo Smile II) was performed on 2898 children during study years 2 and 3. Hyperopia was classified into three levels of severity (based on the most positive meridian on cycloplegic refraction): group 1: greater than or equal to +5.00 D, group 2: greater than +3.25 D to less than +5.00 D with interocular difference in spherical equivalent greater than or equal to 0.50 D, and group 3: greater than +3.25 D to less than +5.00 D with interocular difference in spherical equivalent less than 0.50 D. "Without" hyperopia was defined as refractive error of +3.25 D or less in the most positive meridian in both eyes. Standard definitions were applied for amblyopia, strabismus, anisometropia, and astigmatism. RESULTS Relative to children without hyperopia, children with hyperopia greater than +3.25 D (n = 472, groups 1, 2, and 3) had a higher proportion of amblyopia (34.5 vs. 2.8%, p < 0.0001) and strabismus (17.0 vs. 2.2%, p < 0.0001). More severe levels of hyperopia were associated with higher proportions of amblyopia (51.5% in group 1 vs. 13.2% in group 3) and strabismus (32.9% in group 1 vs. 8.4% in group 3; trend p < 0.0001 for both). The presence of hyperopia greater than +3.25 D was also associated with a higher proportion of anisometropia (26.9 vs. 5.1%, p < 0.0001) and astigmatism (29.4 vs. 10.3%, p < 0.0001). Median stereoacuity of nonstrabismic, nonamblyopic children with hyperopia (n = 206) (120 arcsec) was worse than that of children without hyperopia (60 arcsec) (p < 0.0001), and more severe levels of hyperopia were associated with worse stereoacuity (480 arcsec for group 1 and 120 arcsec for groups 2 and 3, p < 0.0001). CONCLUSIONS The presence and magnitude of hyperopia among preschoolers were associated with higher proportions of amblyopia, strabismus, anisometropia, and astigmatism and with worse stereoacuity even among nonstrabismic, nonamblyopic children.
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Affiliation(s)
- Marjean Taylor Kulp
- *OD, MS, FAAO †PhD ‡MS §MD, MSCE ∥OD, FAAO **PhD, OD, FAAO ††OD, PhD, FAAO The Ohio State University College of Optometry, Columbus, Ohio (MTK); University of Pennsylvania, Philadelphia, Pennsylvania (G-sY, JH, MM); Children's Hospital of Pennsylvania, Philadelphia, Pennsylvania (GQ); Pennsylvania College of Optometry at Salus University, Philadelphia, Pennsylvania (EBC); Northeastern State University Oklahoma College of Optometry, Tahlequah, Oklahoma (LAC); University of California, Berkeley School of Optometry, Berkeley, California (DAO-B); New England College of Optometry, Boston, Massachusetts (BDM)
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Deng L, Gwiazda J, Manny RE, Scheiman M, Weissberg E, Fern KD, Weise K. Limited change in anisometropia and aniso-axial length over 13 years in myopic children enrolled in the Correction of Myopia Evaluation Trial. Invest Ophthalmol Vis Sci 2014; 55:2097-105. [PMID: 24576881 DOI: 10.1167/iovs.13-13675] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We investigated changes in anisometropia and aniso-axial length with myopia progression in the Correction of Myopia Evaluation Trial (COMET) cohort. METHODS Of 469 myopic children, 6 to <12 years old, enrolled in COMET, 358 were followed for 13 years. Cycloplegic autorefraction and axial length (AL) in each eye were measured annually. The COMET eligibility required anisometropia (interocular difference in spherical equivalent refraction) of ≤ 1.00 diopter (D). For each child, a linear regression line was fit to anisometropia data by visit, and the regression slope b was used as the rate of change. Logistic regression was applied to identify factors for significant changes in anisometropia (b ≥ 0.05 D/y, or a cumulative increase in anisometropia ≥ 0.50 D over 10 years). Similar analyses were applied to aniso-AL. RESULTS A total of 358/469 (76.3%) children had refractions at baseline and the 13-year visit. The mean (SD) amount of anisometropia increased from 0.24 D (0.22 D) at baseline to 0.49 D (0.46 D) at the 13-year visit. A total of 319/358 (89.1%) had slopes |b| < 0.05 D/y and 39 (10.9%) had slopes |b| ≥ 0.05 D/y, with only one negative slope. Similarly, 334/358 (93.3%) children had little change in aniso-AL over time. The correlation between changes in anisometropia and aniso-AL over 13 years was 0.39 (P < 0.001). The correlation between changes in anisometropia and myopia progression was significant (r = -0.36, P < 0.001). No correlation was found between baseline anisometropia and myopia progression (r = -0.02, P = 0.68). CONCLUSIONS Myopia and axial length progressed at a similar rate in both eyes for most children in COMET during the period of fast progression and eventual stabilization. These results may be more generalizable to school-aged myopic children with limited anisometropia at baseline. (ClinicalTrials.gov number, NCT00000113.).
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Affiliation(s)
- Li Deng
- New England College of Optometry, Boston, Massachusetts, United States
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Kulp MT, Ying GS, Huang J, Maguire M, Quinn G, Ciner EB, Cyert LA, Orel-Bixler DA, Moore BD. Accuracy of noncycloplegic retinoscopy, retinomax autorefractor, and SureSight vision screener for detecting significant refractive errors. Invest Ophthalmol Vis Sci 2014; 55:1378-85. [PMID: 24481262 DOI: 10.1167/iovs.13-13433] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate, by receiver operating characteristic (ROC) analysis, the ability of noncycloplegic retinoscopy (NCR), Retinomax Autorefractor (Retinomax), and SureSight Vision Screener (SureSight) to detect significant refractive errors (RE) among preschoolers. METHODS Refraction results of eye care professionals using NCR, Retinomax, and SureSight (n = 2588) and of nurse and lay screeners using Retinomax and SureSight (n = 1452) were compared with masked cycloplegic retinoscopy results. Significant RE was defined as hyperopia greater than +3.25 diopters (D), myopia greater than 2.00 D, astigmatism greater than 1.50 D, and anisometropia greater than 1.00 D interocular difference in hyperopia, greater than 3.00 D interocular difference in myopia, or greater than 1.50 D interocular difference in astigmatism. The ability of each screening test to identify presence, type, and/or severity of significant RE was summarized by the area under the ROC curve (AUC) and calculated from weighted logistic regression models. RESULTS For detection of each type of significant RE, AUC of each test was high; AUC was better for detecting the most severe levels of RE than for all REs considered important to detect (AUC 0.97-1.00 vs. 0.92-0.93). The area under the curve of each screening test was high for myopia (AUC 0.97-0.99). Noncycloplegic retinoscopy and Retinomax performed better than SureSight for hyperopia (AUC 0.92-0.99 and 0.90-0.98 vs. 0.85-0.94, P ≤ 0.02), Retinomax performed better than NCR for astigmatism greater than 1.50 D (AUC 0.95 vs. 0.90, P = 0.01), and SureSight performed better than Retinomax for anisometropia (AUC 0.85-1.00 vs. 0.76-0.96, P ≤ 0.07). Performance was similar for nurse and lay screeners in detecting any significant RE (AUC 0.92-1.00 vs. 0.92-0.99). CONCLUSIONS Each test had a very high discriminatory power for detecting children with any significant RE.
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Wu JF, Bi HS, Wang SM, Hu YY, Wu H, Sun W, Lu TL, Wang XR, Jonas JB. Refractive error, visual acuity and causes of vision loss in children in Shandong, China. The Shandong Children Eye Study. PLoS One 2013; 8:e82763. [PMID: 24376575 PMCID: PMC3871613 DOI: 10.1371/journal.pone.0082763] [Citation(s) in RCA: 173] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 11/05/2013] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To examine the prevalence of refractive errors and prevalence and causes of vision loss among preschool and school children in East China. METHODS Using a random cluster sampling in a cross-sectional school-based study design, children with an age of 4-18 years were selected from kindergartens, primary schools, and junior and senior high schools in the rural Guanxian County and the city of Weihai. All children underwent a complete ocular examination including measurement of uncorrected (UCVA) and best corrected visual acuity (BCVA) and auto-refractometry under cycloplegia. Myopia was defined as refractive error of ≤-0.5 diopters (D), high myopia as ≤ -6.0D, and amblyopia as BCVA ≤ 20/32 without any obvious reason for vision reduction and with strabismus or refractive errors as potential reasons. RESULTS Out of 6364 eligible children, 6026 (94.7%) children participated. Prevalence of myopia (overall: 36.9 ± 0.6%;95% confidence interval (CI):36.0,38.0) increased (P<0.001) from 1.7 ± 1.2% (95%CI:0.0,4.0) in the 4-years olds to 84.6 ± 3.2% (95%CI:78.0,91.0) in 17-years olds. Myopia was associated with older age (OR:1.56;95%CI:1.52,1.60;P<0.001), female gender (OR:1.22;95%CI:1.08,1.39;P = 0.002) and urban region (OR:2.88;95%CI:2.53,3.29;P<0.001). Prevalence of high myopia (2.0 ± 0.2%) increased from 0.7 ± 0.3% (95%CI:0.1,1.3) in 10-years olds to 13.9 ± 3.0 (95%CI:7.8,19.9) in 17-years olds. It was associated with older age (OR:1.50;95%CI:1.41,1.60;P<0.001) and urban region (OR:3.11;95%CI:2.08,4.66);P<0.001). Astigmatism (≥ 0.75D) (36.3 ± 0.6%;95%CI:35.0,38.0) was associated with older age (P<0.001;OR:1.06;95%CI:1.04,1.09), more myopic refractive error (P<0.001;OR:0.94;95%CI:0.91,0.97) and urban region (P<0.001;OR:1.47;95%CI:1.31,1.64). BCVA was ≤ 20/40 in the better eye in 19 (0.32%) children. UCVA ≤ 20/40 in at least one eye was found in 2046 (34.05%) children, with undercorrected refractive error as cause in 1975 (32.9%) children. Amblyopia (BCVA ≤ 20/32) was detected in 44 (0.7%) children (11 children with bilateral amblyopia). CONCLUSIONS In coastal East China, about 14% of the 17-years olds were highly myopic, and 80% were myopic. Prevalence of myopia increased with older age, female gender and urban region. About 0.7% of pre-school children and school children were amblyopic.
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Affiliation(s)
- Jian Feng Wu
- Department of Ophthalmology, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Hong Sheng Bi
- Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
- * E-mail: (HSB); (JBJ)
| | - Shu Mei Wang
- School of Public Health, Shandong University, Jinan, Shandong, China
| | - Yuan Yuan Hu
- The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Hui Wu
- Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Wei Sun
- The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Tai Liang Lu
- The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Xing Rong Wang
- Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Jost B. Jonas
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Heidelberg, Germany
- * E-mail: (HSB); (JBJ)
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Barrett BT, Bradley A, Candy TR. The relationship between anisometropia and amblyopia. Prog Retin Eye Res 2013; 36:120-58. [PMID: 23773832 DOI: 10.1016/j.preteyeres.2013.05.001] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 05/17/2013] [Accepted: 05/23/2013] [Indexed: 01/28/2023]
Abstract
This review aims to disentangle cause and effect in the relationship between anisometropia and amblyopia. Specifically, we examine the literature for evidence to support different possible developmental sequences that could ultimately lead to the presentation of both conditions. The prevalence of anisometropia is around 20% for an inter-ocular difference of 0.5D or greater in spherical equivalent refraction, falling to 2-3%, for an inter-ocular difference of 3D or above. Anisometropia prevalence is relatively high in the weeks following birth, in the teenage years coinciding with the onset of myopia and, most notably, in older adults starting after the onset of presbyopia. It has about one-third the prevalence of bilateral refractive errors of the same magnitude. Importantly, the prevalence of anisometropia is higher in highly ametropic groups, suggesting that emmetropization failures underlying ametropia and anisometropia may be similar. Amblyopia is present in 1-3% of humans and around one-half to two-thirds of amblyopes have anisometropia either alone or in combination with strabismus. The frequent co-existence of amblyopia and anisometropia at a child's first clinical examination promotes the belief that the anisometropia has caused the amblyopia, as has been demonstrated in animal models of the condition. In reviewing the human and monkey literature however it is clear that there are additional paths beyond this classic hypothesis to the co-occurrence of anisometropia and amblyopia. For example, after the emergence of amblyopia secondary to either deprivation or strabismus, anisometropia often follows. In cases of anisometropia with no apparent deprivation or strabismus, questions remain about the failure of the emmetropization mechanism that routinely eliminates infantile anisometropia. Also, the chronology of amblyopia development is poorly documented in cases of 'pure' anisometropic amblyopia. Although indirect, the therapeutic impact of refractive correction on anisometropic amblyopia provides strong support for the hypothesis that the anisometropia caused the amblyopia. Direct evidence for the aetiology of anisometropic amblyopia will require longitudinal tracking of at-risk infants, which poses numerous methodological and ethical challenges. However, if we are to prevent this condition, we must understand the factors that cause it to develop.
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Affiliation(s)
- Brendan T Barrett
- School of Optometry & Vision Science, University of Bradford, Richmond Road, Bradford BD7 1DP, United Kingdom.
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