Characteristics of Refractive Errors in a Population of Adults in the Central Region of Poland

Biometric Risk Factors for Central Serous Chorioretinopathy

INTRODUCTION

Central serous chorioretinopathy (CSCR) is a common disease that in chronic form can lead to significant visual impairment. Hence, the systemic and local risk factors of CSCR have been analyzed to possibly prevent its onset. The goal of the present study was to find the biometric parameters characteristic for CSCR.

METHODS

The study included 66 eyes of 60 consecutive patients who were diagnosed with acute or chronic CSCR between January 01 2021 and June 30 2021. There were 46 males and 14 females with a mean age of 48.8 ± 10.0 years in the study cohort. Six patients had symptomatic binocular disease. The axial length and retinal parameters of all patients were measured with spectral domain optical coherence tomography (SD-OCT), and refraction error was tested after cycloplegia. The results of the affected eyes were compared with those of healthy fellow eyes (with exclusion of eyes previously affected by CSCR or with any other ocular disorder) (39 eyes) and the control group (75 eyes), and correlated to the duration of the disease.

RESULTS

No significant differences were revealed in axial length between the affected eyes, healthy fellow eyes, and controls (23.31 ± 1.06 mm versus 23.59 ± 1.20 mm versus 23.33 ± 1.19 mm, respectively). The distribution of refraction errors was similar in the three analyzed groups. A hypermetropic shift was noted in the affected eyes versus controls (p = 0.030); however, no difference was noted in refraction error between the healthy fellow CSCR eyes and controls (p = 0.418). Both acute and chronic CSCR cases, as well as their fellow eyes, demonstrated significantly greater choroidal thickness compared with healthy individuals (p < 0.001). Longer disease duration was correlated with a significant deficit in macular volume and average central retinal thickness (p < 0.05).

CONCLUSIONS

CSCR is a clinical entity that can occur in patients with every type of refraction error. A shorter axial length of the eyeball is not associated with the diagnosis of CSCR; however, increased choroidal thickness is typical of this entity. Longer disease duration is correlated with the loss of retinal thickness and volume.

The Incidence and Severity of Myopia in the Population of Medical Students and Its Dependence on Various Demographic Factors and Vision Hygiene Habits

(1) Background: Myopia is one of the leading causes of visual impairment. Visual work and usage of electronic devices are known risk factors of myopia. Many education systems were forced to apply online and hybrid teaching methods, to reduce the number of new cases of COVID-19. Medical students are a population well-known for intense visual work in the form of learning; (2) Methods: Visual acuity and refractive error were measured in the population of medical students. Participants also filled out the survey that included their population characteristic and their habits related to the hygiene of vision; (3) Results: We found a correlation between the age of the first diagnosis of myopia and current values of refractive error. The majority of participants believe that the COVID-19 pandemic had an impact on the health of their vision. Among methods of studying, usage of the computer screen was less preferred by myopic students; (4) Conclusions: In the population of medical school students in Eastern Poland, visual acuity was lower than 1.0 in 232 (52.97%) in the right eye and 234 (53.42%) in the left eye. Early recognition of refractive error has influenced its current values. Among methods of studying, usage of the computer screen was less preferred by myopic students. More population-based studies should focus on the impact of the COVID-19 pandemic on the health of vision.

Refractive errors in mixed breed dogs of different ages

The purpose of the study was to evaluate the occurrence and range of refractive errors in dogs of different ages. A total of 99 clinically healthy, mixed-breed mesocephalic dogs were included in the study and divided into three different age groups according to the current human/pet analogy chart: 40 adults (23 males, 17 females, 1-8 years old, 3-70 kg), 21 seniors (14 males, 7 females, 6-11 years old, 7-42 kg), and 38 geriatrics (22 males, 16 females, 8-13 years old, 5-45 kg). All the dogs underwent an ophthalmic examination, including Schirmer tear test, tonometry, biomicroscopy, and ophthalmoscopy. Neither eye drops nor pharmacological sedatives were administered before the autorefractometry. The refractive states were assessed bilaterally using a hand-held Retinomax 3 (Righton) autorefractor. The results underwent statistical analysis using Statistica v12 software (ANOVA and t-test). A P-value < 0.05 was considered as significant. Emmetropia, defined as a refractive state > -0.5 D and < +0.5 D, was found in 36% of the adult, 43% of the senior, and 38% of the geriatric patients. Anisometropia was found in 1% of the adult, 9.5% of the senior and 5.5% of the geriatric dogs when the refractive power of the two eyes differed ≥ 1.0 myopia ≤ -0.5 D and hyperopia ≥ +0.5 D were found in 23% and 41% of the adult eye globes as well as 24% and 33% in the senior dogs and 15% and 47% in the geriatric dogs, respectively. The maximal values of the myopia in the adult and geriatric dogs were -2.5 D and -2.75 D, respectively. The maximal values of the hyperopia in the adult and geriatric dogs were 1.75 D and 2.5 D, respectively. No statistically significant correlation was found between the groups. Ametropia is a common refractive state for dogs of different ages. The most frequent refractive state in ametropic mixed-bed dogs in all age groups is hyperopia.

Using electronic medical record data to establish and monitor the distribution of refractive errors. JOURNAL OF OPTOMETRY 2022;15 Suppl 1:S32-S42. [PMID: 36220741 PMCID: PMC9732486 DOI: 10.1016/j.optom.2022.09.001]

OBJECTIVE

To establish the baseline distribution of refractive errors and associated factors amongst a population that attended primary care optometry clinics.

DESIGN

Retrospective cross sectional cohort study of electronic medical records (EMR).

METHODS

Electronic medical record data was extracted from forty optometry clinics, representing a mix of urban and rural areas in Ireland. The analysis was confined to demographic and clinical data gathered over a sixty-month period between 2015 and 2019. Distribution rates were calculated using the absolute and relative frequencies of refractive error in the dataset, stratified for age and gender using the following definitions: high myopia ≤ -6.00 D, myopia ≤ -0.50 D, hyperopia ≥ +0.50 D, astigmatism ≤ -0.75 DC and anisometropia ≥ 1.00 D. Visual acuity data was used to explore vision impairment rates in the population. Further analysis was carried out on a gender and age-adjusted subset of the EMR data, to match the proportion of patients in each age grouping to the population distribution in the most recent (2016) Irish census.

RESULTS

153,598 clinic records were eligible for analysis. Refractive errors ranged from -26.00 to +18.50 D. Myopia was present in 32.7%, of which high myopia represented 2.4%, hyperopia in 40.1%, astigmatism in 38.3% and anisometropia in 13.4% of participants. The clinic distribution of hyperopia, astigmatism and anisometropia peaked in older age groups, whilst the myopia burden was highest amongst people in their twenties. A higher proportion of females were myopic, whilst a higher proportion of males were hyperopic and astigmatic. Vision impairment (LogMAR > 0.3) was present in 2.4% of participants. In the gender and age- adjusted distribution model, myopia was the most common refractive state, affecting 38.8% of patients.

CONCLUSION

Although EMR data is not representative of the population as a whole, it is likely to provide a reasonable representation of the distribution of clinically significant (symptomatic) refractive errors. In the absence of any ongoing traditional epidemiological studies of refractive error in Ireland, this study establishes, for the first time, the distribution of refractive errors observed in clinical practice settings. This will serve as a baseline for future temporal trend analysis of the changing pattern of the distribution of refractive error in EMR data. This methodology could be deployed as a useful epidemiological resource in similar settings where primary eyecare coverage for the management of refractive error is well established.

Patterns of Blindness in the Navajo Nation: A 9-Year Study

The Navajo Nation is the largest Native American reservation by area and citizenship. The study sought to provide the first large-scale examination of ocular pathology within this population. A retrospective review of all Navajo patients seen at Moran Eye Center Navajo Nation Outreach Clinics from 2013 to 2021 for demographics, visual acuity, refractive, and eye pressure data was undergone. Further variables included comorbidity and eye diagnoses among patients at these clinics. Results: First-time patient visits totaled 2251 from 2013 to 2021. The median age was 53 (range, 18 to 92), and clinics had a predominance of female patients (1387:864). Among patients presenting without glasses, 20.67% (198/958), 9.71% (93/958), and 3.13% (30/958) had mild visual impairment (VI), moderate to severe VI, and blindness, respectively. Cataracts were the most common cause of blindness in these patients (40%, 12/30) and the need for glasses was the second most common cause (33%, 10/30). From 2016 to 2021, 17.71% (48/271) of diabetic patients were diagnosed with diabetic retinopathy (DR). Within the subset of Navajo patients that presented without any correction, 73% of bilateral blindness was preventable via glasses prescription or cataract surgery. This study comments on questions of equitable care for Navajo patients.

Impact of Refractive Errors on the Academic Performance of High School Children of Lahore

Introduction

The process of learning begins in childhood and accurate vision can greatly affects a child's learning capacity. It is documented that visual impairment in children can have a significant impact on their performance at school as well as their social interaction and development.

Objective

This research aimed to study the impact of refractive corrections on the academic performance of high school children in Lahore.

Methodology

A total of 2,000 students with equal distribution of gender, public, private school, and locality were included in the study. All students were screened for defective vision. The academic performance before and after corrections was recorded on the prescribed proforma.

Results

The prevalence of refractive error was high among the public high schools 244 (59.2%) as compared to the private schools 168 (40.8%). The area-based prevalence was higher among the students in urban settings 255 (62%) while in rural it was 157 (38%). It was found that in the public sector, the average score of academic results before the intervention was 56.39 ± 13.24 which was increased to 60.27 ± 14.94 after the intervention while in the private sector, before the intervention, the average score was 63.53 ± 17.50 which was improved to 67.12 ± 18.48. It was found to be statistically significant at p-value &lt; 0.05.

Conclusion

A significant impact was observed in the average academic scores of the results after refractive corrections.

Gender and age distribution of refractive errors in an optometric clinical population

AIM

To determine the patterns of distribution of refractive errors in a clinical sample of patients examined in an optometry practice.

METHOD

In this retrospective study, the clinic records of 6687 patients aged 6 to 85 years comprising 2168 (32.2%) males and 4519 (67.5%) females were reviewed. Refractive error were analysed according to gender, age, as well as types and categories including axis of astigmatism using the vector power analysis method where the traditional sphero-cylinder was transformed into J0 (primary) and J45 (oblique) astigmatic components.

RESULTS

Only the analysis for right eye was reported as right and left spherical equivalent were similar. The mean with standard deviations for refractive errors were: Myopia: -1.95 ± 2.6, hyperopia: 1.04  ± 0.9, astigmatism: -1.22 ± 0.71 and anisometropia: -0.01 ± 2.5 DS. The distributions with significant changes included males that were significantly more myopic and astigmatic, while females were more hyperopic across the age groups. Furthermore, myopia decreased, while hyperopia, astigmatism and anisometropia increased with increasing age. Unique findings from this study include: myopia peaked earlier, second hyperopic shift commenced after age 82 years and the distribution of severity of astigmatism contrasts with previous understanding.

CONCLUSION

Although the patterns of distribution of refractive errors in patients aged 6 to 85 years corroborates previous findings, myopia and hyperopia peak, as well as severity of astigmatism were unique to the present study. Results from non-clinic populations will be useful to confirm trends reported in this study.

Design, methodology, and baseline of whole city-million scale children and adolescents myopia survey (CAMS) in Wenzhou, China

Background

Myopia is the most common visual impairment in children and adolescents worldwide. This study described an economical and effective population-based screening pipeline and performed the project of a million scale children and adolescents myopia survey (CAMS), which will shed light on the further study of myopia from the level of epidemiology and precision medicine.

Methods

We developed a novel population-based screening pattern, an intelligent screening process and internet-based information transmission and analysis system to carry out the survey consisting of school children in Wenzhou, China. The examination items include unaided distance visual acuity, presenting distance visual acuity, and non-cycloplegic autorefraction. Myopia and high myopia were defined as spherical equivalent (SE) ≤ − 1.00 diopters (D) and SE ≤ − 6.00 D, respectively. Next, the reports of the vision checking were automatically sent to parents and the related departments. The CAMS project will be done two to four times annually with the support of the government. An online eyesight status information management system (OESIMS) was developed to construct comprehensive and efficient electronic vision health records (EVHRs) for myopia information inquiry, risk pre-warning, and further study.

Results

The CAMS completed the first-round of screening within 30 days for 99.41% of Wenzhou students from districts and counties, in June 2019. A total of 1,060,925 participants were eligible for CAMS and 1,054,251 (99.37% participation rate) were selected through data quality control, which comprised 1305 schools, and 580,609, 251,050 and 170,967 elementary, middle, and high school students. The mean age of participants was 12.21 ± 3.32 years (6–20 years), the female-to-male ratio was 0.82. The prevalence of myopia in elementary, middle, and high school students was 38.16%, 77.52%, and 84.00%, respectively, and the high myopia incidence was 0.95%, 6.90%, and 12.98%.

Conclusions

The CAMS standardized myopia screening model involves automating large-scale information collection, data transmission, data analysis and early warning, thereby supporting myopia prevention and control. The entire survey reduced 90% of staff, cost, and time consumption compared with previous surveys. This will provide new insights for decision support for public health intervention.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40662-021-00255-1.

Prevalence and characteristics of peripheral myopic retinopathy in Guangzhou office workers

AIM

To determine the prevalence and characteristics of peripheral myopic retinopathy among a sample of Guangzhou office workers.

METHODS

A cross-sectional study of Guangzhou Chinese office works in different departments and units of the Guangzhou Power Supply Bureau, China, in 2016. Myopic retinopathy was recorded and analyzed with a scanning laser ophthalmoscope and by slit-lamp microscopy combined with a three-mirror contact lens.

RESULTS

In total, 1910 eyes of 955 subjects (508 females and 447 males) aged 21-59y were included; 69.6% of these eyes were myopic. The myopia group had a younger age and worse uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) when compared with hyperopia and emmetropia groups (P<0.001). The axial length (AL) was significantly longer, the spherical equivalent (SE) was more serious, and the optic nerve crescent was significantly larger in subjects with myopia than with hyperopia and emmetropia. Subjects with myopia, and especially high myopia, had the highest frequency of myopic retinal 18 changes (49.4%, P<0.001) [white-without-pressure (43.8%, P<0.001), lattice degeneration (4.5%, P=0.044)] among the three groups. Logistic regression confirmed that any myopia (OR: 3.41, P<0.001) [mild myopia (OR: 1.93, P=0.001), moderate myopia (OR:3.64, P<0.001), and high myopia (OR:10.58, P<0.001)], a greater AL (OR: 1.55, P<0.001) and a much higher SE (OR: 0.77, P<0.001) increased the risk for peripheral retinal changes.

CONCLUSION

Myopia-related retinal changes are positively associated with greater AL, higher SE, and myopia.