Evaluation of interpupillary distance in the Turkish population

Prescription eyeglasses as a forensic physical evidence: Prediction of age based on refractive error measures using machine learning algorithm

Refractive errors (RE) are commonly reported visual impairment problems worldwide. Previous clinical studies demonstrated age-related changes in human eyes. We hypothesized that the binocular RE metrics including sphere and cylinder power, axis orientation, and interpupillary distance (IPD) can be used for forensic age estimation of an unknown individual. RE data of both eyes were collected from the clinical optometric exams and prescription glasses of 2027 Egyptian individuals aged between 2 to 93 years. The differences between age groups as well as sides, and sexual dimorphism were explored. Two modeling methods were compared: multiple and stepwise linear regression (LR) versus machine learning Regression Forest (RFM). Data were apportioned into training and test datasets with a ratio of 80/20. The results showed significant differences among the age groups in each eye for all variables. Stepwise LR improved the results over models based on the one-sided lens due to selection of IPD in addition to the left and right axis, and left sphere as independent variables. For the RFM, the left axis and IPD were the most important features. RFM outperformed LR in terms of accuracy and root mean squared error (RMSE). The estimated age within ±10 years showed 81.4% accuracy rate and RMSE = 8.9 years versus 38.5% accuracy rate and RMSE = 17.99 years using RFM and stepwise LR, respectively, in the test set. The current study upholds the significance of the age-related changes of refractive error in formulating alternative forensic age estimation models when standard methods are unavailable.

Normal periocular anthropometric measurements in an Australian population

PURPOSE

To report the normative ocular and periocular anthropometric measurements in an Australian cohort and investigate how these may be affected age, gender, and ethnicity.

METHODS

Prospective study of patients presenting to the Royal Adelaide Hospital. Patient with orbital or eyelid disease, previous surgery, craniofacial abnormalities, pupil abnormalities, strabismus, and poor image quality was excluded. Standardised photographs were taken in a well-illuminated room. A green dot with a diameter of 24 mm was placed on the participant's foreheads for calibration between pixels and millimetres. Ocular and periocular landmarks were segmented to calculate the periorbital measurements. Independent sample t test was used to compare male and female subjects, Pearson's correlation was used to correlate periocular dimensions with age, and ANOVA with Bonferroni was used to compare periocular dimension between ethnic groups.

RESULTS

Seven hundred and sixty eyes from 380 participants (215 female, mean age 58 ± 18 years) were included. The mean marginal reflex distance (MRD) 1 was 3.5 mm and decreased with increasing age (r =  - 0.09, p = 0.01) and MRD 2 was 5.2 mm. Compared to Caucasians, African subjects had a significantly larger interpupillary distance and outer intercanthal distance, whereas East Asians had a significantly larger inner intercanthal distance (p < 0.05). The values of marginal reflex distance 2, palpebral fissure height, horizontal palpebral aperture, inner intercanthal distance, interpupillary distance and outer intercanthal distance were significantly higher in male subjects than female subjects (p < 0.05).

CONCLUSIONS

Normative periocular dimensions may vary according to age, gender, and ethnicity. An understanding of normal periocular dimensions is important in the evaluation of orbital disease across different ethnic groups and may serve as reference points for oculoplastic surgery and industry.

Comparing the Effectiveness of Smartphone Applications in the Measurement of Interpupillary Distance

Purpose To determine the accuracy of three smartphone applications in the measurement of interpupillary distance (IPD). Methods This study compared measurements from three smartphone applications to measurements obtained by a single trained examiner using a digital pupilometer in 44 subjects. The mean absolute error (MAE) of IPD prediction by each application was compared. Additionally, the frequency at which each application measured IPD within ± 0.05 mm, ± 0.10 mm, ± 0.25 mm, ± 0.50 mm, ± 0.75 mm, and ± 1.00 mm of the digital pupilometer measurement was determined. Results The Eye Measure (Dotty Digital, Sydney, New South Wales, Australia) and Warby Parker (Warby Parker, New York, New York) applications had significantly lower MAE of IPD measurements (0.511364 mm) compared to the PDCheck AR (EyeQue Corp., Newark, California) application (1.375 mm). The Warby Parker application most frequently obtained accurate IPD measurements within the following ranges: ± 0.05 mm, ± 0.10 mm, ± 0.25 mm, ± 0.50 mm, ± 0.75 mm, and ± 1.00 mm. Conclusion Of the three smartphone applications compared in this study, the Warby Parker application performed to the highest degree of accuracy and may serve as an adequate alternative when conventional IPD measurement methods are either unavailable or unable to be performed accurately.

Comparison of Interpupillary Distance, Pupillary Diameter and Corneal Reflex Measured with Plusoptix A09 in Normally Developing Children and Autism

Aim: Autism Spectrum Disorder (ASD) is a developmental disorder that can present with an abnormality of the autonomic nervous system (ANS symptoms).Method: In this study, 38 eyes of 19 ASD were included with 19 healthy children (control group). Participants were analyzed according to their characteristics. Here, used the Plusoptix A09 devices to measure the difference in pupil size, corneal reflex, and interpupillary distance (IPD) between ASD and healthy children.Results: The mean age±standard deviation (SD) for the autism group was 4,6±2,5 years (range 2-11 years). In the group of normally developing children, the mean age was±SD 5,02±2,6 years (range 2-11 years). The size of the right pupil (p=0,006) and left pupil (p=0,007) was found to be significantly different in the control and experimental groups. IPD (p=0,000) was statistically significant between groups unlike the corneal reflex was not (p=0,173). The p-value is less than 0,05 in all statistical results.Conclusion: As a result, pupil diameter and IPD of children with autism were found to be larger than the control group, but there was no significant difference in corneal reflex. Pupillary measurements reveal differences between people with ASD.  

A Novel Technique for Measuring Ocular Duction Ranges

Purpose

To report a novel technique for measuring ocular ductions and evaluate its performance in normal participants.

Methods

We developed a laser pointer technique (LPT), a novel technique for quantitative measurement of ocular ductions. The device consists of a screen and headset with a laser pointer. Participants rotate their head while wearing the headset maintaining fixation on an optotype in the center of the screen until the target becomes blurry. Twenty-eight healthy volunteers were enrolled. The ocular ductions were measured with the LPT and compared to those of the Goldmann perimeter technique (GPT).

Results

The mean horizontal and vertical duction ranges were 95.2° ± 10.1° and 84.1° ± 10.8° using the LPT, respectively, and 113.2° ± 14.1° and 105.8° ± 12.5° using the GPT, respectively; both were significantly greater in the GPT than LPT (both P < 0.05). The total time required for testing was shorter with the LPT compared to the GPT (56.1 ± 4.5 seconds and 92.3 ± 11.6 seconds, P = 0.003). Both the LPT and GPT measurements showed excellent intraobserver repeatability, and LPT showed better interobserver repeatability.

Conclusions

Considering its reproducibility, accuracy, and simplicity, the LPT is expected to be useful for evaluating patients with ocular motility disorders as a first-order evaluation in the absence of sophisticated examination devices.

Translational Relevance

The laser pointer technique, the new method for measuring ocular ductions, could be useful for evaluating patients with ocular motility disorders in clinical practice.

Agreement and inter-session repeatability of manual and automatic interpupillary distance measurements

BACKGROUND

Interpupillary distance (IPD) is important in developmental anatomy, genetics, design of optical instrumentation, ocular diagnostics, and optical prescribing. IPD frequently is measured on different days, and by either automatic pupillometers (physiological measurement) or manual ruler (anatomical measurement). Therefore, there is importance in the agreement and inter-session repeatability of manual and automatic IPD measurements.

METHODS

Monocular distance from the bridge of the nose and binocular distance and near binocular IPD were randomly measured, using a millimeter ruler and the Essilor Pupillon pupillometer. Gender effects were assessed using Wilcoxon and Mann-Whitney tests, respectively. Agreement was assessed using Spearman correlation and Bland-Altman (B&A) plots. Thirty additional participants were tested within 1-2 weeks to determine the inter-session repeatability.

RESULTS

The agreement study included 199 participants (mean age: 24.1 ± 5.0 range: 19-53, 58 male, 141 female) and the repeatability sub- study included 30 (mean age: 27.9 ± 4.5, range: 23-39, 6 male, 24 female). Males and females significantly differed in age (<2 year mean difference (md)) and IPD (monocular md: < 1 mm, binocular md: < 2 mm). Manual vs. automatic measurements were significantly different for all conditions (md: <1 mm for all) except for distance left eye male PD. There was no significant difference between the session for both methods.

CONCLUSIONS

Binocular and monocular manual and automatic measurements were significantly different statistically, but not clinically. Distance binocular IPD was approximately 3 mm wider than near IPD. Male binocular IPD was approximately 2 mm wider than the female IPD. Both methods had good inter-session repeatability.

Comparison of physiognomy and frame angle parameters using different devices to prescribe progressive addition lenses

Clinical relevance: Accurate measurement of several physiognomy parameters (interpupillary, nasopupillary and fitting height distances) and frame angles (pantoscopic and frame wrap angles) is essential for prescribing progressive addition lenses for presbyopic patients.Background: Few reports have described the repeatability of different devices commonly used to conduct essential measurements for prescribing progressive addition lenses.Methods: Interpupillary, nasopupillary (at far and near distances) and fitting point heights were measured three consecutive times in 21 healthy volunteers with four devices (traditional frame ruler, PD-5 interpupilometer, OptiCenter, and VisiOffice). Pantoscopic and wrap frame angles were also measured three times with Essilor standard pantoscopic ruler, Opticenter and VisiOffice.Results: The frame ruler, PD-5 and Opticenter showed better repeatability for interpupillary and nasopupillary distance (co-efficient of variation close to 1%, within-subject standard deviation or Sw < 0.50 mm) measurements at far and near distances than Visioffice (co-efficient of variation > 2%, Sw > 0.50 mm). Fitting point heights measurements showed worse repeatability with all devices (frame ruler: co-efficient of variation close to 5%, Sw = 0.46 mm; Opticenter co-efficient of variation > 5%, Sw > 0.80 mm; Visioffice co-efficient of variation > 10%, Sw > 1.50 mm). Pantoscopic angle measurements showed very low repeatability with the ruler and Opticenter (co-efficient of variation > 25%, Sw > 1.90 mm). The frame wrap angle showed unacceptable repeatability values with the ruler (co-efficient of variation > 10%, Sw = 0.49º) and Visioffice (co-efficient of variation > 60%, Sw > 2.50º), but acceptable repeatability with Opticenter (co-efficient of variation < 1%, Sw = 0.05º).Conclusions: Interpupillary and nasopupillary distance measurement showed acceptable repeatability with all the assessed methods; however, these measurements alone are no longer sufficient for free-form progressive addition lens prescription, which requires fitting point heights and pantoscopic and frame wrap angle measurement. Such measures display a lack of repeatability that could induce centration errors and could affect vision and/or adaptation of the user.

Craniofacial Anthropometry of Healthy Turkish Young Adults: Outer Canthal, Inner Canthal, Palpebral Fissure, and Interpupillary Distances

ABSTRACT

This study aims to examine the values of the orbital region in Turkish young adults by the two-dimensional photogrammetry. Anthropometric measurements of the eye and eyelid-related parameters were taken from 100 female and 100 male volunteer Turkish young adults, ranging in age from 18 to 25 years. Endocanthion (en), exocanthion (ex), and pupil (p) were identified on the photograph and the distances between these points were measured with the ImageJ program. The average values of the en-en, ex-en (R), ex-en (L), p-p, and ex-ex were found as 32.92 ± 2.84, 32.48 ± 2.06, 32.22 ± 2.01, 65.32 ± 3.77, and 97.75 ± 5.09 mm, respectively. There were statistically significant differences between the genders in all parameters. Although there are many studies examining these parameters, comprehensive studies are needed in different populations and in many cases. In this study, we believe that the results obtained for Turkish young adults can be used as reference values.

Shortening of Interpupillary Distance after Instillation of Topical Prostaglandin Analog Eye Drops

PURPOSE

To investigate changes in the interpupillary distance (IPD) after continual instillation of topical prostaglandin analogs (PGAs) in glaucoma patients as an objective indicator of prostaglandin-associated periorbitopathy (PAP).

DESIGN

Retrospective, comparative case series.

METHODS

A total of 152 institutional patients with glaucoma were enrolled in this study. Inclusion criteria were visual acuities exceeding 10/20 bilaterally and no intraocular surgery during observation. Intervention/observation procedures: First-time bilateral instillation of bimatoprost, travoprost, latanoprost, or tafluprost and IPDs measured by automatic refractometry. IPDs, intraocular pressures (IOPs), and refractive errors were measured before and after continual drug administration (treatment, 2-24 months).

MAIN OUTCOME MEASUREMENTS

Post-treatment changes in IPDs. A total of 61 untreated patients served as controls.

RESULTS

The IPDs shortened significantly (P < 0.001) after treatment (-0.80 ± 2.1 mm); the IPDs of control subjects remained unchanged (0.05 ± 0.96 mm; P = 0.69). The IPD change after bimatoprost instillation (-2.20 ± 0.97 mm) was significantly (P < 0.001) greater than with other PGAs (-0.65 ± 2.09 mm). The IOPs decreased significantly (P < 0.001) (-3.7 ± 4.3 mm Hg); the refractive errors did not change significantly (P < 0.099) (-0.07 ± 0.69 diopter) post-treatment. The percentages of subjects with 2-mm or greater decreases in IPD after bimatoprost, travoprost, latanoprost, or tafluprost were 85.7%, 20.0%, 18.2%, and 17.2%, respectively, and with 3-mm or greater decreases in IPD 35.7%, 12.0%, 14.5%, and 12.1%, respectively. The specificities were 93.4% and 100% in the control group, respectively, with IPD threshold changes of 2 and 3 mm or more, respectively.

CONCLUSIONS

The IPD decreased significantly after topical PGAs within 24 months. The effect was significantly greater with bimatoprost than with other PGAs. The noninvasive, immediate automatic refractometry measurement may be an objective numerical indicator of PAP.

Bi-allelic TMEM94 Truncating Variants Are Associated with Neurodevelopmental Delay, Congenital Heart Defects, and Distinct Facial Dysmorphism

Neurodevelopmental disorders (NDD) are genetically and phenotypically heterogeneous conditions due to defects in genes involved in development and function of the nervous system. Individuals with NDD, in addition to their primary neurodevelopmental phenotype, may also have accompanying syndromic features that can be very helpful diagnostically especially those with recognizable facial appearance. In this study, we describe ten similarly affected individuals from six unrelated families of different ethnic origins having bi-allelic truncating variants in TMEM94, which encodes for an uncharacterized transmembrane nuclear protein that is highly conserved across mammals. The affected individuals manifested with global developmental delay/intellectual disability, and dysmorphic facial features including triangular face, deep set eyes, broad nasal root and tip and anteverted nostrils, thick arched eye brows, hypertrichosis, pointed chin, and hypertelorism. Birthweight in the upper normal range was observed in most, and all but one had congenital heart defects (CHD). Gene expression analysis in available cells from affected individuals showed reduced expression of TMEM94. Global transcriptome profiling using microarray and RNA sequencing revealed several dysregulated genes essential for cell growth, proliferation and survival that are predicted to have an impact on cardiotoxicity hematological system and neurodevelopment. Loss of Tmem94 in mouse model generated by CRISPR/Cas9 was embryonic lethal and led to craniofacial and cardiac abnormalities and abnormal neuronal migration pattern, suggesting that this gene is important in craniofacial, cardiovascular, and nervous system development. Our study suggests the genetic etiology of a recognizable dysmorphic syndrome with NDD and CHD and highlights the role of TMEM94 in early development.

Periorbital Soft Tissue Anthropometric Analysis of Young Adults

The authors aim to determine the periorbital soft tissue anthropometric norms for Turkish young adults for right and left eyes using a noninvasive two-dimensional photogrammetric analysis. Anthropometric measurements of the periorbital soft tissue were taken from 172 female and 56 male Turkish adults aged between 18 and 24 years. The periorbital soft tissue profiles (ocular and palpebral) for males and females were digitally analyzed using linear measurements made with standardized photographic records, taken in a natural head position. Statistically significant differences were found for ocular soft tissue measurements according to gender except inner intercanthal distance (P = 0.125) and right horizontal palpebral aperture (P = 0.240). Statistically significant differences were found for palpebral soft tissue measurements according to gender except right pretarsal skin height (P = 0.112) and left pretarsal skin height (P = 0.056). Results were compared with other ethnic groups. Normal periorbital soft tissue measurements are fundamental anatomical parameters utilized in ophthalmology, optometry, ophthalmic industry, oculoplastic surgery, clinical genetics, dermatocosmetology. Further, normal anthropometric measurements generate reference data for studies in craniofacial dysmorphology, oculoplastic surgery, dermatocosmetology, and comparative physical anthropology.