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Read SA, Alonso-Caneiro D, Hoseini-Yazdi H, Lin YK, Pham TTM, Sy RI, Tran A, Xu Y, Zainudin R, Jaiprakash AT, Tran H, Collins MJ. Objective Measures of Gaze Behaviors and the Visual Environment during Near-Work Tasks in Young Adult Myopes and Emmetropes. Transl Vis Sci Technol 2023; 12:18. [PMID: 37962538 PMCID: PMC10653255 DOI: 10.1167/tvst.12.11.18] [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: 04/28/2023] [Accepted: 10/16/2023] [Indexed: 11/15/2023] Open
Abstract
Purpose To objectively quantify near-work gaze behaviors and the visual environment during reading tasks performed on a smartphone and on paper in both indoor and outdoor environments in myopes and emmetropes. Methods A novel wearable gaze and viewing distance tracking device was used to quantify near-work gaze behaviors (focusing demand) and the visual environment (20° peripheral scene relative defocus) during a series of reading tasks. Data from nine myopes (mean age, 21 ± 1.4 years) and 10 emmetropes (21 ± 0.8 years) were analyzed. Five-minute reading tasks (matched for font type and size) were performed under four conditions: reading from a smartphone indoors, paper indoors, smartphone outdoors, and paper outdoors. Results A significantly greater focusing demand (closer viewing distance) was found with smartphone-based reading (mean, 3.15 ± 0.74 D) compared to paper-based reading (2.67 ± 0.48 D) (P < 0.001), with the differences being greatest for myopic participants (P = 0.04). Smartphone reading was also associated with greater peripheral scene relative myopic defocus (P < 0.001). Although near-work behaviors were similar between environments, significantly more relative myopic defocus was found at the start of the paper-based task when performed outdoors compared to indoors (P = 0.02). Conclusions Significant differences in focusing demand and scene relative defocus within a 20° field were found to be associated with reading tasks performed on a smartphone and paper in indoor and outdoor environments. Translational Relevance These findings highlight the complex interaction between near-work behaviors and the visual environment and demonstrate that factors of potential importance to myopia development vary between paper-based and smartphone-based near tasks.
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Affiliation(s)
- Scott A. Read
- Centre for Vision and Eye Research, School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - David Alonso-Caneiro
- Centre for Vision and Eye Research, School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
- School of Science, Technology and Engineering, University of Sunshine Coast, Queensland, Australia
| | - Hosein Hoseini-Yazdi
- Centre for Vision and Eye Research, School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Yan Ki Lin
- Centre for Vision and Eye Research, School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Trang T. M. Pham
- Centre for Vision and Eye Research, School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Rafael I. Sy
- Centre for Vision and Eye Research, School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Alysha Tran
- Centre for Vision and Eye Research, School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Yiming Xu
- Centre for Vision and Eye Research, School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Rina Zainudin
- Centre for Vision and Eye Research, School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Anjali T. Jaiprakash
- Centre for Biomedical Technologies, School of Clinical Sciences, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Hoang Tran
- Centre for Vision and Eye Research, School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Michael J. Collins
- Centre for Vision and Eye Research, School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
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Wagner P, Ho A, Kim J. Objective Quantification and Topographic Dioptric Demand of Near-Work. Transl Vis Sci Technol 2023; 12:28. [PMID: 36799872 PMCID: PMC9942781 DOI: 10.1167/tvst.12.2.28] [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: 02/18/2023] Open
Abstract
Purpose The assessment of myopigenic environmental risk factors such as near-work relies on subjective data. Although diaries and questionnaires on near-work show correlation to some degree, it remains unknown how they may correspond to ground truth. This is an important consideration because valid estimates of near-work have great utility for understanding the mechanisms by which dioptric demand drives excessive eye-growth, which is not yet entirely understood. To this end, we assessed a novel eye-tracking system to quantify near-work. Method We compared subjective entries from diaries to objective data on accommodative demand acquired with a three-dimensional eye-tracker in 20 participants. Each test involved approximately one-hour exposure to ecological near-work environments. Furthermore, topographical dioptric demand maps were computed in retinal coordinates. Results Our study suggests a frequent mismatch between objectively and subjectively labeled data of near-work tasks (concordance 74.6%). Objective and subjective estimates of dioptric demand showed a moderate correlation and were not significantly different (R2 = 0.59, P = .35). Instead, accommodative demand with an agreement between objective and subjective near-work labels showed a high correlation and were significantly different (R2 = 0.79, P = .016). The accumulated topographical dioptric demand of ecological near-work environments did not present myopigenic defocus stimuli to the retina periphery. Thus extreme close-up near-work presented peripheral defocus stimuli that have been proposed to curb excessive eye growth. Conclusions The proposed objective measurement method may provide improvements over subjective methods for estimating near-work parameters. Translational Relevance The topographic dioptric demand maps highlight a possible conflict of causal mechanisms of the two myopia models: "excessive near-work" and "peripheral optical defocus."
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Affiliation(s)
- Peter Wagner
- Brien Holden Vision Institute Limited, Sydney, NSW, Australia,School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia
| | - Arthur Ho
- Brien Holden Vision Institute Limited, Sydney, NSW, Australia,School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia
| | - Juno Kim
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia
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Maldoddi R, Thakur S, Verkicharla PK. Near work, light levels and dioptric profile - Which factor dominates and influences the short-term changes in axial length? Ophthalmic Physiol Opt 2023; 43:426-434. [PMID: 36734816 DOI: 10.1111/opo.13103] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 01/14/2023] [Accepted: 01/18/2023] [Indexed: 02/04/2023]
Abstract
PURPOSE Given the agonistic nature of near work to promote axial elongation and the antagonistic nature of time outdoors to prevent myopia, we aimed to investigate the following: (a) how the short-term effect of near work performed outdoors (Experiment 1) influences axial length and (b) how near work performed in two different dioptric profiles (uncluttered and cluttered) alters the changes in central axial length (Experiment 2). METHODS Forty-six adults (age range: 19-32 years) participated in the study. In Experiment 1, 22 participants completed a 15-min distance task and a reading task in both the outdoor (~30,000 lux) and indoor (~70 lux) locations. In Experiment 2, 24 participants performed the same reading task at a study desk in uncluttered and cluttered reading environments. Pre- and post-task ocular biometry measurements were performed for each session using a non-contact biometer. RESULTS In Experiment 1, a significant increase in axial length from baseline was found after performing reading tasks in both outdoor (mean ± SEM: +12.3 ± 3.4 μm, p = 0.001) and indoor locations (+11.9 ± 3.1 μm, p = 0.001). In Experiment 2, axial length increased significantly from baseline to post reading task, in both uncluttered (+17.9 ± 3.5 μm, p < 0.001) and cluttered reading environments (+19.2 ± 2.9 μm, p < 0.001). No significant changes in axial length were observed either between outdoor and indoor locations (p = 0.92) or between the uncluttered and cluttered reading environment (p = 0.75). CONCLUSION Independent of light intensity (outdoor or indoor location) and dioptric profile of the near-work environment (uncluttered or cluttered), a 15-min reading task led to a significant increase in axial length. While the long-term effects of these findings need to be evaluated, practitioners should emphasise how near work can reduce the beneficial effects of time outdoors, while providing recommendations related to time outdoors for myopia control.
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Affiliation(s)
- Rakesh Maldoddi
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Swapnil Thakur
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Pavan K Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India.,Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Wagner P, Ho A, Kim J. Estimating 3D spatiotemporal point of regard: a device evaluation. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2022; 39:1343-1351. [PMID: 36215577 DOI: 10.1364/josaa.457663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/10/2022] [Indexed: 06/16/2023]
Abstract
This paper presents and evaluates a system and method that record spatiotemporal scene information and location of the center of visual attention, i.e., spatiotemporal point of regard (PoR) in ecological environments. A primary research application of the proposed system and method is for enhancing current 2D visual attention models. Current eye-tracking approaches collapse a scene's depth structures to a 2D image, omitting visual cues that trigger important functions of the human visual system (e.g., accommodation and vergence). We combined head-mounted eye-tracking with a miniature time-of-flight camera to produce a system that could be used to estimate the spatiotemporal location of the PoR-the point of highest visual attention-within 3D scene layouts. Maintaining calibration accuracy is a primary challenge for gaze mapping; hence, we measured accuracy repeatedly by matching the PoR to fixated targets arranged within a range of working distances in depth. Accuracy was estimated as the deviation from estimated PoR relative to known locations of scene targets. We found that estimates of 3D PoR had an overall accuracy of approximately 2° omnidirectional mean average error (OMAE) with variation over a 1 h recording maintained within 3.6° OMAE. This method can be used to determine accommodation and vergence cues of the human visual system continuously within habitual environments, including everyday applications (e.g., use of hand-held devices).
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Gajjar S, Ostrin LA. A systematic review of near work and myopia: measurement, relationships, mechanisms and clinical corollaries. Acta Ophthalmol 2022; 100:376-387. [PMID: 34622560 DOI: 10.1111/aos.15043] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 09/02/2021] [Accepted: 09/22/2021] [Indexed: 12/17/2022]
Abstract
After decades of investigation, the role of near work in myopia remains unresolved, with some studies reporting no relationship and others finding the opposite. This systematic review is intended to summarize classic and recent literature investigating near work and the onset and progression of myopia, potential mechanisms and pertinent clinical recommendations. The impact of electronic device use is considered. PubMed and Medline were used to find peer-reviewed cross-sectional and longitudinal studies related to near work and myopia from 1980 to July 2020 using the PRISMA checklist. Studies were chosen using the Joanna Briggs Institute checklist, with a focus on studies with a sample size greater than 50. Studies were independently evaluated; conclusions were drawn per these evaluations. Numerous cross-sectional studies found increased odds ratio of myopia with increased near work. While early longitudinal studies failed to find this relationship, more recent longitudinal studies have found a relationship between myopia and near work. Rather than daily duration of near work, interest has increased regarding absolute working distance and duration of continuous near viewing. Several reports have found that shorter working distances (<30 cm) and continuous near-work activity (>30 min) are risk factors for myopia onset and progression. Novel objective continuously measuring rangefinding devices have been developed to better address these questions. The literature is conflicting, likely due to the subjective and variable nature in which near work has been quantified and a paucity of longitudinal studies. We conclude that more precise objective measures of near viewing behaviour are necessary to make definitive conclusions regarding the relationship between myopia and near work. Focus should shift to utilizing objective and continuously measuring instruments to quantify near-work behaviours in children, followed longitudinally, to understand the complex factors related to near work. A better understanding of the roles of absolute working distance, temporal properties, viewing breaks and electronic device use on myopia development and progression will aid in the development of evidence-based clinical recommendations for behavioural modifications to prevent and slow myopia.
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Affiliation(s)
- Shail Gajjar
- University of Houston College of Optometry Houston TX USA
| | - Lisa A. Ostrin
- University of Houston College of Optometry Houston TX USA
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Romashchenko D, Papadogiannis P, Unsbo P, Lundström L. Simultaneous measurements of foveal and peripheral aberrations with accommodation in myopic and emmetropic eyes. BIOMEDICAL OPTICS EXPRESS 2021; 12:7422-7433. [PMID: 35003843 PMCID: PMC8713693 DOI: 10.1364/boe.438400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 06/14/2023]
Abstract
The difference in peripheral retinal image quality between myopic and emmetropic eyes plays a major role in the design of the optical myopia interventions. Knowing this difference under accommodation can help to understand the limitations of the currently available optical solutions for myopia control. A newly developed dual-angle open-field sensor was used to assess the simultaneous foveal and peripheral ( 20 ∘ nasal visual field) wavefront aberrations for five target vergences from -0.31 D to -4.0 D in six myopic and five emmetropic participants. With accommodation, the myopic eyes showed myopic shifts, and the emmetropic eyes showed no change in RPR. Furthermore, RPR calculated from simultaneous measurements showed lower intra-subject variability compared to the RPR calculated from peripheral measurements and target vergence. Other aberrations, as well as modulation transfer functions for natural pupils, were similar between the groups and the accommodation levels, foveally and peripherally. Results from viewing the same nearby target with and without spectacles by myopic participants suggest that the accommodative response is not the leading factor controlling the amplitude of accommodation microfluctuations.
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Affiliation(s)
- Dmitry Romashchenko
- Department of Applied Physics, Royal Institute of Technology, Stockholm, 11421, Sweden
- Current address: R&D, Johnson & Johnson Vision, Groningen, 9728 NX, The Netherlands
| | - Petros Papadogiannis
- Department of Applied Physics, Royal Institute of Technology, Stockholm, 11421, Sweden
| | - Peter Unsbo
- Department of Applied Physics, Royal Institute of Technology, Stockholm, 11421, Sweden
| | - Linda Lundström
- Department of Applied Physics, Royal Institute of Technology, Stockholm, 11421, Sweden
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Choi KY, Chan SSH, Chan HHL. The effect of spatially-related environmental risk factors in visual scenes on myopia. Clin Exp Optom 2021; 105:353-361. [PMID: 34612803 DOI: 10.1080/08164622.2021.1983400] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Myopia, the most common refractive error, is estimated to affect over two billion people worldwide, especially children from East Asian regions. Children with early onset myopia have an increased risk of developing sight threatening complications in later life. In addition to the contribution of genetic factors, of which expression is controversially suggested to be subject to environmental regulation, various environmental factors, such as near-work, outdoor, and living environment, have also been determined to play significant roles in the development of refractive error, especially juvenile myopia. Cues from daily visual scenes, including lighting, spatial frequency, and optical defocus over the field of visual stimuli, are suggested to influence emmetropisation, thereby affecting myopia development and progression. These risk factors in visual scenes of the everyday life may explain the relationship between urbanicity and myopia prevalence. This review first summarises the previously reported associations between myopia development and everyday-life environments, including schooling, urban settings, and outdoors. Then, there is a discussion of the mechanisms hypothesised in the literature about the cues from different visual scenes of urbanicity in relation to myopia development.
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Affiliation(s)
- Kai Yip Choi
- The Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Sonia Seen-Hang Chan
- The Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Henry Ho-Lung Chan
- The Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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8
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Delshad S, Collins MJ, Read SA, Vincent SJ. The human axial length and choroidal thickness responses to continuous and alternating episodes of myopic and hyperopic blur. PLoS One 2020; 15:e0243076. [PMID: 33264356 PMCID: PMC7710071 DOI: 10.1371/journal.pone.0243076] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 11/14/2020] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To investigate the change in axial length (AxL) and choroidal thickness (ChT) in response to continuous and alternating episodes of monocular myopic and hyperopic defocus. METHODS The right eye of sixteen young adults was exposed to 60 minute episodes of either continuous or alternating myopic and hyperopic defocus (+3 DS & -3 DS) over six separate days, with the left eye optimally corrected for distance. During alternating defocus conditions, the eye was exposed to either 30 or 15 minute cycles of myopic and hyperopic defocus, with the order of defocus reversed in separate sessions. The AxL and ChT of the right eye were measured before, during and after each defocus condition. RESULTS Significant changes in AxL were observed over time, dependent upon the defocus condition (p < 0.0001). In general, AxL exhibited a greater magnitude of change during continuous than alternating defocus conditions. The maximum AxL elongation was +7 ± 7 μm (p = 0.010) in response to continuous hyperopic defocus and the maximum AxL reduction was -8 ± 10 μm of (p = 0.046) in response to continuous myopic defocus. During both 30 and 15 minute cycles of alternating myopic and hyperopic defocus of equal duration, the effect of opposing blur sessions cancelled each other and the AxL was near baseline levels following the final defocus session (mean change from baseline across all alternating defocus conditions was +2 ± 10 μm, p > 0.05). Similar, but smaller magnitude, changes were observed for ChT. CONCLUSIONS The human eye appears capable of temporal averaging of visual cues from alternating myopic and hyperopic defocus. In the short term, this integration appears to be a cancellation of the effects of the preceding defocus condition of opposite sign.
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Affiliation(s)
- Samaneh Delshad
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Kelvin Grove, Queensland, Australia
- * E-mail:
| | - Michael John Collins
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Kelvin Grove, Queensland, Australia
| | - Scott Andrew Read
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Kelvin Grove, Queensland, Australia
| | - Stephen James Vincent
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Kelvin Grove, Queensland, Australia
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Choi KY, Mok AYT, Do CW, Lee PH, Chan HHL. The diversified defocus profile of the near-work environment and myopia development. Ophthalmic Physiol Opt 2020; 40:463-471. [PMID: 32519412 PMCID: PMC7497190 DOI: 10.1111/opo.12698] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 05/04/2020] [Indexed: 12/16/2022]
Abstract
Purpose To quantify the defocus characteristics in the near‐work environment at home and investigate the relationship with subsequent myopia progression. Methods Fifty subjects (aged 7–12 years) were recruited and followed for 1 year. The home near‐work environment (writing desk) was measured at a baseline home‐visit using the Kinect‐for‐Windows to capture a 3‐dimensional image. The depth values of the image were then converted into scene defocus with respect to the subject’s viewpoint. The defocus characteristics were quantified as the dioptric volume (the total amount of net defocus, or DV) and standard deviation of the defocus values (SDD). Information on home size, time spent outdoors, and in front of a desk were also obtained. Univariate correlation, and multivariate regression were used to assess the association between myopia progression, defocus characteristics, and other co‐variates. Results The baseline spherical equivalent refraction (M) and refraction change over 1 year (∆M) were − 1.51 ± 2.02 D and − 0.56 ± 0.45 D respectively. DV was not significantly correlated with ∆M (Spearman’s ρ = −0.25, p = 0.08), while SDD was negatively correlated to ∆M (Spearman’s ρ = −0.42, p = 0.003). Although SDD was not a significant predictor in multivariate analysis, the regional DV at 15°–20° eccentricity was significant (p = 0.001). Home size (F2,50 = 7.01, p = 0.002) and time spent outdoors (Independent t = −2.13, p = 0.04) were also associated with ∆M, but not time spent in front of desk (Independent t = 0.78, p = 0.44). Conclusion The defocus profile in the home environment within the para‐central field of view is associated with childhood refractive error development.
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Affiliation(s)
- Kai Yip Choi
- The Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Angela Yuen-Ting Mok
- The Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Chi-Wai Do
- The Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Paul Hong Lee
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Henry Ho-Lung Chan
- The Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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10
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Accommodation responses following contrast adaptation. Vision Res 2020; 170:12-17. [PMID: 32217367 DOI: 10.1016/j.visres.2020.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/03/2020] [Accepted: 03/03/2020] [Indexed: 11/21/2022]
Abstract
The current study explored the effects of contrast adaptation on the accommodation response (AR), using low- and high-pass filtered video clips as stimuli. Ten young myopic (mean ± standard deviation: -2.91 ± 1.36D) and 10 near emmetropic subjects (-0.19 ± 0.14D) participated in the study. The AR was monitored under monocular viewing conditions using an eccentric infrared photorefractor. A 2-stage procedure was used: (1) the minimum spatial frequency content necessary to produce a proper individual AR; and (2) the AR was compared before and after adaptation to low-pass (s = -0.5), control (s = 0) and high-pass (s = +0.5) filtered videos. We found that (1) the average threshold Sinc-blur of both myopes and emmetropes necessary to evoke accommodation was (mean ± standard deviation) λ = 7.40 ± 4.05 cpd. Myopes required a higher Sinc blur (average, 10.00 ± 4.05 cpd) compared to emmetropes (average, 4.80 ± 1.60 cpd). (2) Adaptation to low-pass filtered videos increased the AR by 0.41 ± 0.33D in the myopic group and reduced it in the emmetropic group by 0.31 ± 0.25D. Adaptation to high pass-filtered videos induced similar changes in both refractive groups (an increase of 0.41 ± 0.40D and 0.46 ± 0.29D for myopes and emmetropes, respectively). Our measurements show that the human AR can be modified by spatial frequency selective contrast adaptation although these were short-term effects. The perhaps most striking finding was that adaptation to low pass filtered videos had opposite effects on the AR in emmetropes and myopes. It remains to be studied whether these differences were a consequence of myopia or a contributing factor in myopia development.
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Lingham G, Mackey DA, Lucas R, Yazar S. How does spending time outdoors protect against myopia? A review. Br J Ophthalmol 2019; 104:593-599. [PMID: 31722876 DOI: 10.1136/bjophthalmol-2019-314675] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 10/07/2019] [Accepted: 10/30/2019] [Indexed: 01/12/2023]
Abstract
Myopia is an increasingly common condition that is associated with significant costs to individuals and society. Moreover, myopia is associated with increased risk of glaucoma, retinal detachment and myopic maculopathy, which in turn can lead to blindness. It is now well established that spending more time outdoors during childhood lowers the risk of developing myopia and may delay progression of myopia. There has been great interest in further exploring this relationship and exploiting it as a public health intervention aimed at preventing myopia in children. However, spending more time outdoors can have detrimental effects, such as increased risk of melanoma, cataract and pterygium. Understanding how spending more time outdoors prevents myopia could advance development of more targeted interventions for myopia. We reviewed the evidence for and against eight facets of spending time outdoors that may protect against myopia: brighter light, reduced peripheral defocus, higher vitamin D levels, differing chromatic spectrum of light, higher physical activity, entrained circadian rhythms, less near work and greater high spatial frequency (SF) energies. There is solid evidence that exposure to brighter light can reduce risk of myopia. Peripheral defocus is able to regulate eye growth but whether spending time outdoors substantially changes peripheral defocus patterns and how this could affect myopia risk is unclear. Spectrum of light, circadian rhythms and SF characteristics are plausible factors, but there is a lack of solid evidence from human studies. Vitamin D, physical activity and near work appear unlikely to mediate the relationship between time spent outdoors and myopia.
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Affiliation(s)
- Gareth Lingham
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, Western Australia, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Robyn Lucas
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, Western Australia, Australia.,National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Seyhan Yazar
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, Western Australia, Australia .,Single Cell and Computational Genomics, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
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Wolffsohn JS, Kollbaum PS, Berntsen DA, Atchison DA, Benavente A, Bradley A, Buckhurst H, Collins M, Fujikado T, Hiraoka T, Hirota M, Jones D, Logan NS, Lundström L, Torii H, Read SA, Naidoo K. IMI - Clinical Myopia Control Trials and Instrumentation Report. Invest Ophthalmol Vis Sci 2019; 60:M132-M160. [PMID: 30817830 DOI: 10.1167/iovs.18-25955] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The evidence-basis based on existing myopia control trials along with the supporting academic literature were reviewed; this informed recommendations on the outcomes suggested from clinical trials aimed at slowing myopia progression to show the effectiveness of treatments and the impact on patients. These outcomes were classified as primary (refractive error and/or axial length), secondary (patient reported outcomes and treatment compliance), and exploratory (peripheral refraction, accommodative changes, ocular alignment, pupil size, outdoor activity/lighting levels, anterior and posterior segment imaging, and tissue biomechanics). The currently available instrumentation, which the literature has shown to best achieve the primary and secondary outcomes, was reviewed and critiqued. Issues relating to study design and patient selection were also identified. These findings and consensus from the International Myopia Institute members led to final recommendations to inform future instrumentation development and to guide clinical trial protocols.
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Affiliation(s)
- James S Wolffsohn
- Ophthalmic Research Group, Aston University, Birmingham, United Kingdom
| | - Pete S Kollbaum
- Indiana University, School of Optometry, Bloomington, Indiana, United States
| | - David A Berntsen
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, Texas, United States
| | - David A Atchison
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | | | - Arthur Bradley
- Indiana University, School of Optometry, Bloomington, Indiana, United States
| | - Hetal Buckhurst
- School of Health Professions, Peninsula Allied Health Centre, Plymouth University, Plymouth, United Kingdom
| | - Michael Collins
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | - Takashi Fujikado
- Department of Applied Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takahiro Hiraoka
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masakazu Hirota
- Department of Applied Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Debbie Jones
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Nicola S Logan
- Ophthalmic Research Group, Aston University, Birmingham, United Kingdom
| | | | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Scott A Read
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | - Kovin Naidoo
- African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa
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13
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García García M, Pusti D, Wahl S, Ohlendorf A. A global approach to describe retinal defocus patterns. PLoS One 2019; 14:e0213574. [PMID: 30939130 PMCID: PMC6445412 DOI: 10.1371/journal.pone.0213574] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 02/25/2019] [Indexed: 12/26/2022] Open
Abstract
The popularity of myopia treatments based on the peripheral defocus theory has risen. So far, little evidence has emerged around the questions which of these treatments are effective and why. In order to establish a framework that enables clinicians and researchers to acknowledge the possible interactions of different defocus patterns across the retina, different peripheral refractive errors (PRX) of subjects and different designs of optical treatments were evaluated. Dioptric defocus patterns on the retinal level have been obtained by merging the matrices of dioptric defocus maps of the visual field of different scenarios with individual peripheral refractive errors and different optical designs of multifocal contact lenses. The newly obtained matrices were statistically compared using a non-parametric test with familywise error algorithms and multi-comparison tests. Results show that asymmetric peripheral refractive error profiles (temporal or nasal positively skewed) appear to be less prone to be changed by the defocus imposition of multifocal contact lenses than those presenting symmetric patterns (relative peripheral myopia or hyperopia).
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Affiliation(s)
- Miguel García García
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Baden-Wuerttemberg, Germany
- Carl Zeiss Vision International GmbH, Aalen, Baden-Wuerttemberg, Germany
| | - Dibyendu Pusti
- Laboratorio de Óptica, Universidad de Murcia, Murcia, Spain
| | - Siegfried Wahl
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Baden-Wuerttemberg, Germany
- Carl Zeiss Vision International GmbH, Aalen, Baden-Wuerttemberg, Germany
| | - Arne Ohlendorf
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Baden-Wuerttemberg, Germany
- Carl Zeiss Vision International GmbH, Aalen, Baden-Wuerttemberg, Germany
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14
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Schaeffel F. All about restraining eye growth: the 16th International Myopia Conference in Birmingham, UK. Ophthalmic Physiol Opt 2018; 38:210-214. [PMID: 29691926 DOI: 10.1111/opo.12458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Frank Schaeffel
- Section of Neurobiology of the Eye, Ophthalmic Research Institute, Tübingen, Germany
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