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Klevens AM, Taylor ML, Wescott DL, Gamlin PD, Franzen PL, Hasler BP, Siegle G, Roecklein KA. The role of retinal irradiance estimates in melanopsin-driven retinal responsivity: a reanalysis of the post-illumination pupil response in seasonal affective disorder. Sleep 2024; 47:zsae109. [PMID: 38877879 PMCID: PMC11381569 DOI: 10.1093/sleep/zsae109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 04/24/2024] [Indexed: 09/10/2024] Open
Abstract
To isolate melanopsin contributions to retinal sensitivity measured by the post-illumination pupil response (PIPR), controlling for individual differences in non-melanopsin contributions including retinal irradiance is required. When methodologies to negate such differences present barriers, statistical controls have included age, baseline diameter, iris pigmentation, and circadian time of testing. Alternatively, the pupil light reflex (PLR) and calculations estimating retinal irradiance both reflect retinal irradiance, while the PLR also reflects downstream pathways. We reanalyzed data from an observational, correlational study comparing the PIPR across seasons in seasonal affective disorder (SAD) and controls. The PIPR was measured in 47 adults in Pittsburgh, Pennsylvania (25 SAD) over 50 seconds after 1 second of red and blue stimuli of 15.3 log photons/cm2/s. The PLR was within 1 second while PIPR was averaged over 10-40 seconds post-stimulus. Two raters ranked iris pigmentation using a published scale. We evaluated model fit using Akaike's Information Criterion (AIC) across different covariate sets. The best-fitting models included either estimated retinal irradiance or PLR, and circadian time of testing. The PLR is collected contemporaneously in PIPR studies and is an individually specific measure of nonspecific effects, while being minimally burdensome. This work extends the prior publication by introducing theoretically grounded covariates that improved analytic model fits based on AIC specific to the present methods and sample. Such quantitative methods could be helpful in studies which must balance participant and researcher burden against tighter methodological controls of individual differences in retinal irradiance.
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Affiliation(s)
- Alison M Klevens
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Maddison L Taylor
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Paul D Gamlin
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Peter L Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Greg Siegle
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kathryn A Roecklein
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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2
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Sparks S, Hayes G, Pinto J, Bulte D. Characterising cerebrovascular reactivity and the pupillary light response-a comparative study. Front Physiol 2024; 15:1384113. [PMID: 39175613 PMCID: PMC11338921 DOI: 10.3389/fphys.2024.1384113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 07/29/2024] [Indexed: 08/24/2024] Open
Abstract
Introduction Smooth muscle is integral to multiple autonomic systems, including cerebrovascular dynamics through vascular smooth muscle cells and in ocular muscle dynamics, by regulating pupil size. In the brain, smooth muscle function plays a role in cerebrovascular reactivity (CVR) that describes changes in blood vessel calibre in response to vasoactive stimuli. Similarly, pupil size regulation can be measured using the pupillary light response (PLR), the pupil's reaction to changes in light levels. The primary aim of this study was to explore the interplay between cerebral blood flow and pupil dynamics, evaluated using CVR and PLR, respectively. Methods A total of 20 healthy adults took part in a CVR gas stimulus protocol and a light and dark flash PLR protocol. CVR was calculated as the blood flow velocity change in the middle cerebral artery, measured using transcranial Doppler ultrasound in response to a 5% increase in CO2. Multiple PLR metrics were evaluated with a clinical pupillometer. Results CVR and PLR metrics were all within the expected physiological ranges for healthy adults. Nine different PLR metrics, assessed through the light and dark flash protocols, were compared against CVR. A significant negative relationship was observed between the latency of the PLR in the dark flash protocol and CVR. No statistically significant relationships were found between CVR and other PLR metrics. Conclusion This is the first study to investigate the relationship between cerebral blood flow and pupil dynamics. A significant relationship between dark flash latency and CVR was observed. Future work includes evaluating these relationships using more robust CVR and PLR measurement techniques in a larger, more diverse cohort. Notably, more research is warranted into the PLR using a dark flash protocol and its connection to cerebrovascular function.
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Affiliation(s)
| | | | | | - Daniel Bulte
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom
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Hartmann EV, Reichert CF, Spitschan M. Effects of caffeine intake on pupillary parameters in humans: a systematic review and meta-analysis. BEHAVIORAL AND BRAIN FUNCTIONS : BBF 2024; 20:19. [PMID: 39103929 DOI: 10.1186/s12993-024-00245-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 07/18/2024] [Indexed: 08/07/2024]
Abstract
Caffeine is a widely used drug that broadly affects human cognition and brain function. Caffeine acts as an antagonist to the adenosine receptors in the brain. Previous anecdotal reports have also linked caffeine intake with changes in pupil diameter. By modifying the retinal irradiance, pupil diameter modulates all ocular light exposure relevant for visual (i.e., perception, detection and discrimination of visual stimuli) and non-visual (i.e., circadian) functions. To date, the extent of the influence of caffeine on pupillary outcomes, including pupil diameter, has not been examined in a systematic review. We implemented a systematic review laid out in a pre-registered protocol following PRISMA-P guidelines. We only included original research articles written in English reporting studies with human participants, in which caffeine was administered, and pupil diameter was measured using objective methods. Using broad search strategies, we consulted various databases (PsycINFO, Medline, Embase, Cochrane Library, bioRxiv and medRxiv) and used the Covidence platform to screen, review and extract data from studies. After importing studies identified through database search (n = 517 imported, n = 46 duplicates), we screened the title and abstracts (n = 471), finding 14 studies meeting our eligibility criteria. After full-text review, we excluded seven studies, leaving only a very modest number of included studies (n = 7). Extraction of information revealed that the existing literature on the effect of caffeine on pupil parameters is very heterogeneous, differing in pupil assessment methods, time of day of caffeine administration, dose, and protocol timing and design. The evidence available in the literature does not provide consistent results but studies rated as valid by quality assessment suggest a small effect of caffeine on pupil parameters. We summarize the numeric results as both differences in absolute pupil diameter and in terms of effect sizes. More studies are needed using modern pupil assessment methods, robust study design, and caffeine dose-response methodology.
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Affiliation(s)
- Elias Vincent Hartmann
- Centre for Chronobiology, University Psychiatric Clinics Basel (UPK), Basel, Switzerland
| | - Carolin Franziska Reichert
- Centre for Chronobiology, University Psychiatric Clinics Basel (UPK), Basel, Switzerland.
- Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland.
| | - Manuel Spitschan
- Max Planck Institute for Biological Cybernetics, Translational Sensory & Circadian Neuroscience, Tübingen, Germany.
- TUM School of Medicine & Health, Technical University of Munich, Munich, Germany.
- TUM Institute for Advanced Study (TUM-IAS), Technical University of Munich, Garching, Germany.
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Klerman EB, Brager A, Carskadon MA, Depner CM, Foster R, Goel N, Harrington M, Holloway PM, Knauert MP, LeBourgeois MK, Lipton J, Merrow M, Montagnese S, Ning M, Ray D, Scheer FAJL, Shea SA, Skene DJ, Spies C, Staels B, St‐Onge M, Tiedt S, Zee PC, Burgess HJ. Keeping an eye on circadian time in clinical research and medicine. Clin Transl Med 2022; 12:e1131. [PMID: 36567263 PMCID: PMC9790849 DOI: 10.1002/ctm2.1131] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Daily rhythms are observed in humans and almost all other organisms. Most of these observed rhythms reflect both underlying endogenous circadian rhythms and evoked responses from behaviours such as sleep/wake, eating/fasting, rest/activity, posture changes and exercise. For many research and clinical purposes, it is important to understand the contribution of the endogenous circadian component to these observed rhythms. CONTENT The goal of this manuscript is to provide guidance on best practices in measuring metrics of endogenous circadian rhythms in humans and promote the inclusion of circadian rhythms assessments in studies of health and disease. Circadian rhythms affect all aspects of physiology. By specifying minimal experimental conditions for studies, we aim to improve the quality, reliability and interpretability of research into circadian and daily (i.e., time-of-day) rhythms and facilitate the interpretation of clinical and translational findings within the context of human circadian rhythms. We describe protocols, variables and analyses commonly used for studying human daily rhythms, including how to assess the relative contributions of the endogenous circadian system and other daily patterns in behaviours or the environment. We conclude with recommendations for protocols, variables, analyses, definitions and examples of circadian terminology. CONCLUSION Although circadian rhythms and daily effects on health outcomes can be challenging to distinguish in practice, this distinction may be important in many clinical settings. Identifying and targeting the appropriate underlying (patho)physiology is a medical goal. This review provides methods for identifying circadian effects to aid in the interpretation of published work and the inclusion of circadian factors in clinical research and practice.
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Affiliation(s)
- Elizabeth B. Klerman
- Department of NeurologyMassachusetts General Hospital, Brigham and Women's HospitalBostonMassachusettsUSA
- Division of Sleep MedicineHarvard Medical SchoolBostonMassachusettsUSA
| | - Allison Brager
- PlansAnalysis, and FuturesJohn F. Kennedy Special Warfare Center and SchoolFort BraggNorth CarolinaUSA
| | - Mary A. Carskadon
- Alpert Medical School of Brown UniversityDepartment of Psychiatry and Human BehaviorEP Bradley HospitalChronobiology and Sleep ResearchProvidenceRhode IslandUSA
| | | | - Russell Foster
- Sir Jules Thorn Sleep and Circadian Neuroscience InstituteNuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - Namni Goel
- Biological Rhythms Research LaboratoryDepartment of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIllinoisUSA
| | - Mary Harrington
- Neuroscience ProgramSmith CollegeNorthamptonMassachusettsUSA
| | | | - Melissa P. Knauert
- Section of PulmonaryCritical Care, and Sleep MedicineDepartment of Internal MedicineYale School of MedicineNew HavenConnecticutUSA
| | - Monique K. LeBourgeois
- Sleep and Development LaboratoryDepartment of Integrative PhysiologyUniversity of Colorado BoulderBoulderColoradoUSA
| | - Jonathan Lipton
- Boston Children's Hospital and Kirby Neurobiology CenterBostonMassachusettsUSA
| | - Martha Merrow
- Institute of Medical PsychologyFaculty of MedicineLMUMunichGermany
| | - Sara Montagnese
- Department of MedicineUniversity of PadovaPadovaItaly
- ChronobiologyFaculty of Health and Medical SciencesUniversity of SurreyGuildfordUK
| | - Mingming Ning
- Clinical Proteomics Research Center and Cardio‐Neurology DivisionMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - David Ray
- NIHR Oxford Biomedical Research CentreJohn Radcliffe HospitalOxfordUK
- Oxford Centre for DiabetesEndocrinology and MetabolismUniversity of OxfordOxfordUK
| | - Frank A. J. L. Scheer
- Division of Sleep MedicineHarvard Medical SchoolBostonMassachusettsUSA
- Medical Chronobiology ProgramDivision of Sleep and Circadian DisordersDepartments of Medicine and NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
| | - Steven A. Shea
- Oregon Institute of Occupational Health SciencesOregon Health and Science UniversityPortlandOregonUSA
| | - Debra J. Skene
- ChronobiologyFaculty of Health and Medical SciencesUniversity of SurreyGuildfordUK
| | - Claudia Spies
- Department of Anesthesiology and Intensive Care MedicineCharité – Universitaetsmedizin BerlinBerlinGermany
| | - Bart Staels
- UnivLilleInsermCHU LilleInstitut Pasteur de LilleU1011‐EGIDLilleFrance
| | - Marie‐Pierre St‐Onge
- Division of General Medicine and Center of Excellence for Sleep and Circadian ResearchDepartment of MedicineColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Steffen Tiedt
- Institute for Stroke and Dementia ResearchUniversity HospitalLMUMunichGermany
| | - Phyllis C. Zee
- Center for Circadian and Sleep MedicineDivision of Sleep MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Helen J. Burgess
- Sleep and Circadian Research LaboratoryDepartment of PsychiatryUniversity of MichiganAnn ArborMichiganUSA
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Bufo MR, Guidotti M, De Faria C, Mofid Y, Bonnet-Brilhault F, Wardak C, Aguillon-Hernandez N. Autonomic tone in children and adults: Pupillary, electrodermal and cardiac activity at rest. Int J Psychophysiol 2022; 180:68-78. [PMID: 35914548 DOI: 10.1016/j.ijpsycho.2022.07.009] [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: 03/14/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022]
Abstract
Considering the suspected involvement of the autonomic nervous system (ANS) in several neurodevelopmental disorders, a description of its tonus in typical populations and of its maturation between childhood and adulthood is necessary. We aimed to arrive at a better understanding of the maturation of the sympathetic (SNS) and parasympathetic (PNS) tonus by comparing children and adults at rest, via recordings of multiple ANS indices. We recorded simultaneously pupil diameter, electrodermal activity (EDA) and cardiac activity (RR interval and HRV: heart rate variability) in 29 children (6-12 years old) and 30 adults (20-42 years old) during a 5-min rest period. Children exhibited lower RR intervals, higher LF peak frequencies, and lower LF/HF (low frequency/high frequency) ratios compared to adults. Children also produced more spontaneous EDA peaks, reflected in a larger EDA AUC (area under the curve), in comparison with adults. Finally, children displayed a larger median pupil diameter and a higher pupillary hippus frequency than adults. Our results converged towards higher SNS and PNS tones in children compared to adults. Childhood would thus be characterized by a high autonomic tone, possibly reflecting a physiological state compatible with developmental acquisitions.
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Affiliation(s)
- Maria Rosa Bufo
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Marco Guidotti
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; Centre universitaire de pédopsychiatrie, CHRU de Tours, Tours, France; Centre Hospitalier du Chinonais, Saint-Benoît-la-Forêt, France
| | - Cindie De Faria
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Yassine Mofid
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Frédérique Bonnet-Brilhault
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; Centre universitaire de pédopsychiatrie, CHRU de Tours, Tours, France
| | - Claire Wardak
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
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Lee YS, Kim HJ, Lim DK, Kim MH, Lee KJ. Age-specific influences of refractive error and illuminance on pupil diameter. Medicine (Baltimore) 2022; 101:e29859. [PMID: 35801739 PMCID: PMC9259156 DOI: 10.1097/md.0000000000029859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To assess the most influential factor for pupil diameter changes among age, illuminance, and refractive state and reestablish the optimal procedures for clinical applications based on refractive state and illuminance for different age groups. The study was an observational study (repeated measure study). Participants included 219 Korean adults aged 20 to 69 years. Pupil diameters were measured using a pupilometer under scotopic, mesopic-low, and mesopic-high lighting conditions. Factor interactions among age, illuminance, and refractive state were evaluated using mixed linear model and chi-square automated interaction detection. Illuminance mainly contributed to variations in pupil diameter of participants over 50 years, whereas the refractive state was the dominant controlling factor for the pupil variation in participants below 50 years. For more generalized application, the pupil diameter decreased with older age and brighter illuminance (P < .001, inverse correlation, all comparisons). The mean pupil diameter was significantly higher in myopes and emmetropes than in hyperopes (P < .001). Pupil diameter variation modeled using the mixed model confirmed age, illuminance, and refractive error as significant factors (P < .001). Accounting for the interactions among age, illuminance, and refractive error and establishing their hierarchical dominance can be generalized using the chi-square automated interaction detection method and mixed model. Promoting age-dependent consideration for both illuminance and refractive state is necessary when pupil diameters play significant roles in clinical and manufacturing circumstances.
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Affiliation(s)
- Yong-Sik Lee
- Department of Optometry, Eulji University, Seongnam-si, Gyeonggi-do, Korea
| | - Hui-June Kim
- Department of Optometry, GM St. Mary’s Eye Clinic 2, Saessak-ro, Busanjin-gu, Busan-si, Korea
| | - Dong-Kyu Lim
- Department of Optometry, Eulji University, Seongnam-si, Gyeonggi-do, Korea
| | - Myoung-Hee Kim
- Department of Dental Hygiene, College of Health Science, Eulji University, Seongnam-si, Gyeonggi-do, Korea
| | - Koon-Ja Lee
- Department of Optometry, Eulji University, Seongnam-si, Gyeonggi-do, Korea
- *Correspondence: Koon-Ja Lee, Department of Optometry, Eulji University, Seongnam-si, Gyeonggi-do 13135, Korea (e-mail: )
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7
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Lynch GTF, James SM, Cardon TA, McPherson SM. Sensitivity and specificity of pupillary light reflex measures for ASD using monocular pupillometry. Neurol Sci 2022; 43:4537-4545. [DOI: 10.1007/s10072-022-05976-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 02/23/2022] [Indexed: 10/19/2022]
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8
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Baker J, Putnam N, Kozlowski RE, Anderson M, Bird Z, Chmielewski J, Meske J, Steinshouer N, Kozlowski MR. Effects of chronic, daily exposures to low intensity blue light on human retinal pigment epithelial cells: Implications for the use of personal electronic devices. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY 2022. [DOI: 10.1016/j.jpap.2022.100118] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Martínez-Plaza E, Ruiz-Fortes P, Soto-Negro R, Hernández-Rodríguez CJ, Molina-Martín A, Arias-Puente A, Piñero DP. Characterization of Dysfunctional Lens Index and Opacity Grade in a Healthy Population. Diagnostics (Basel) 2022; 12:diagnostics12051167. [PMID: 35626322 PMCID: PMC9140515 DOI: 10.3390/diagnostics12051167] [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: 04/04/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 11/28/2022] Open
Abstract
This study enrolled 61 volunteers (102 eyes) classified into subjects < 50 years (group 1) and subjects ≥ 50 years (group 2). Dysfunctional Lens Index (DLI); opacity grade; pupil diameter; and corneal, internal, and ocular higher order aberrations (HOAs) were measured with the i-Trace system (Tracey Technologies). Mean DLI was 8.89 ± 2.00 and 6.71 ± 2.97 in groups 1 and 2, respectively, being significantly higher in group 1 in all and right eyes (both p < 0.001). DLI correlated significantly with age (Rho = −0.41, p < 0.001) and pupil diameter (Rho = 0.20, p = 0.043) for all eyes, and numerous internal and ocular root-mean square HOAs for right, left, and all eyes (Rho ≤ −0.25, p ≤ 0.001). Mean opacity grade was 1.21 ± 0.63 and 1.48 ± 1.15 in groups 1 and 2, respectively, with no significant differences between groups (p ≥ 0.29). Opacity grade significantly correlated with pupil diameter for right and all eyes (Rho ≤ 0.33, p ≤ 0.013), and with some ocular root-mean square HOAs for right and all eyes (Rho ≥ 0.23, p ≤ 0.020). DLI correlates with age and might be used complementary to other diagnostic measurements for assessing the dysfunctional lens syndrome. Both DLI and opacity grade maintain a relationship with pupil diameter and internal and ocular HOAs, supporting that the algorithms used by the device may be based, in part, on these parameters.
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Affiliation(s)
- Elena Martínez-Plaza
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 Alicante, Spain; (E.M.-P.); (C.J.H.-R.); (A.M.-M.)
- University of Valladolid, 47002 Valladolid, Spain
| | - Pedro Ruiz-Fortes
- Department of Ophthalmology, Vithas Medimar International Hospital, 03016 Alicante, Spain; (P.R.-F.); (R.S.-N.); (A.A.-P.)
| | - Roberto Soto-Negro
- Department of Ophthalmology, Vithas Medimar International Hospital, 03016 Alicante, Spain; (P.R.-F.); (R.S.-N.); (A.A.-P.)
| | - Carlos J. Hernández-Rodríguez
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 Alicante, Spain; (E.M.-P.); (C.J.H.-R.); (A.M.-M.)
- Department of Ophthalmology, Vithas Medimar International Hospital, 03016 Alicante, Spain; (P.R.-F.); (R.S.-N.); (A.A.-P.)
| | - Ainhoa Molina-Martín
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 Alicante, Spain; (E.M.-P.); (C.J.H.-R.); (A.M.-M.)
| | - Alfonso Arias-Puente
- Department of Ophthalmology, Vithas Medimar International Hospital, 03016 Alicante, Spain; (P.R.-F.); (R.S.-N.); (A.A.-P.)
| | - David P. Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 Alicante, Spain; (E.M.-P.); (C.J.H.-R.); (A.M.-M.)
- Department of Ophthalmology, Vithas Medimar International Hospital, 03016 Alicante, Spain; (P.R.-F.); (R.S.-N.); (A.A.-P.)
- Correspondence: ; Tel.: +34-965-903400
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Mostafa J, Porter J, Queener HM, Ostrin LA. Intrinsically photosensitive retinal ganglion cell-driven pupil responses in patients with traumatic brain injury. Vision Res 2021; 188:174-183. [PMID: 34352476 DOI: 10.1016/j.visres.2021.07.007] [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: 10/31/2020] [Revised: 05/25/2021] [Accepted: 07/14/2021] [Indexed: 10/20/2022]
Abstract
Previous findings regarding intrinsically photosensitive retinal ganglion cell (ipRGC) function after traumatic brain injury (TBI) are conflicting. We examined ipRGC-driven pupil responses in civilian TBI and control participants using two pupillography protocols that assessed transient and adaptive properties: (1) a one second (s) long wavelength "red" stimulus (651 nm, 133 cd/m2) and 10 increasing intensities of 1 s short wavelength "blue" stimuli (456 nm, 0.167 to 167 cd/m2) with a 60 s interstimulus interval, and (2) two minutes of 0.1 Hz red stimuli (33 cd/m2), followed by two minutes of 0.1 Hz blue stimuli (16 cd/m2). For Protocol 1, constriction amplitude and the 6 s post illumination pupil response (PIPR) were calculated. For Protocol 2, amplitudes and peak velocities of pupil constriction and redilation were calculated. For Protocol 1, constriction amplitude and the 6 s PIPR were not significantly different between TBI patients and control subjects for red or blue stimuli. For Protocol 2, pupil constriction amplitude attenuated over time for red stimuli and potentiated over time for blue stimuli across all subjects. Constriction and redilation velocities were similar between groups. Pupil constriction amplitude was significantly less in TBI patients compared to control subjects for red and blue stimuli, which can be attributed to age-related differences in baseline pupil size. While TBI, in addition to age, may have contributed to decreased baseline pupil diameter and constriction amplitude, responses to blue stimulation suggest no selective damage to ipRGCs.
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Affiliation(s)
- Jakaria Mostafa
- University of Houston College of Optometry, 4901 Calhoun Rd, Houston, TX 77004, United States
| | - Jason Porter
- University of Houston College of Optometry, 4901 Calhoun Rd, Houston, TX 77004, United States
| | - Hope M Queener
- University of Houston College of Optometry, 4901 Calhoun Rd, Houston, TX 77004, United States
| | - Lisa A Ostrin
- University of Houston College of Optometry, 4901 Calhoun Rd, Houston, TX 77004, United States.
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Using Anterior Segment Optical Coherence Tomography (ASOCT) Parameters to Determine Pupillary Block Versus Plateau Iris Configuration. J Glaucoma 2021; 29:1036-1042. [PMID: 32976290 DOI: 10.1097/ijg.0000000000001664] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PRéCIS:: The potential parameters for differentiating pupillary block (PB) from plateau iris configuration (PIC) on anterior segment optical coherence tomography (ASOCT) are lens/pupil size parameters and angles. Further study is needed to determine a landmark peripheral to the centroid of the iris. PURPOSE Investigate anterior segment parameters to distinguish between 2 mechanisms of angle closure, PB and PIC, using swept-source Fourier domain ASOCT. PATIENTS AND METHODS Retrospective ASOCT images from narrow angle eyes were reviewed. PIC was defined either by ultrasound biomicroscopy and/or clinically when an iridoplasty was performed. Images were read by a masked reader using Anterior Chamber Analysis and Interpretation software to identify scleral spur landmarks and calculate anterior chamber, peripheral angle, iris size, iris shape, and lens/pupil size parameters. ASOCT parameters were summarized and compared using the 2-sample t test. Thresholds and area under receiver operating characteristic curve were calculated using logistic regression analysis. RESULTS One hundred eyes (66 PB and 34 PIC) of 100 participants were reviewed. Of all ASOCT parameters, iris length in each quadrant, pupil arc, lens/pupil parameters (pupil arc, lens vault, and pupil diameter), all pupillary margin-center point-scleral spur landmark (PM-C-SSL) parameters, and all except superior central iris vault parameters were significantly different between PB and PIC. On threshold evaluation, lens/pupil parameters had the greatest area under receiver operating characteristic curve values (0.77 to 0.80), followed by PM-C-SSL angles (0.71 to 0.75). CONCLUSIONS We propose that the pupil size parameters and PM-C-SSL angle are the most reliable novel ASOCT parameters to distinguish between PB and PIC eyes. These parameters do not rely on the visibility of the posterior iris surface, which is difficult to identify with ASOCT, but may be ambient lighting dependent.
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12
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Is accommodation a confounder in pupillometry research? Biol Psychol 2021; 160:108046. [PMID: 33581231 DOI: 10.1016/j.biopsycho.2021.108046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 02/07/2021] [Accepted: 02/07/2021] [Indexed: 11/24/2022]
Abstract
Much psychological research uses pupil diameter measurements to investigate the cognitive and emotional effects of visual stimuli. A potential problem is that accommodating at a nearby point causes the pupil to constrict. This study examined to what extent accommodation is a confounder in pupillometry research. Participants solved multiplication problems at different distances (Experiment 1) and looked at line drawings with different monocular depth cues (Experiment 2) while their pupil diameter, refraction, and vergence angle were recorded using a photorefractor. Experiment 1 showed that the pupils dilated while performing the multiplications, for all presentation distances. Pupillary constriction due to accommodation was not strong enough to override pupil dilation due to cognitive load. Experiment 2 showed that monocular depth cues caused a small shift in refraction in the expected direction. We conclude that, for the young student sample we used, pupil diameter measurements are not substantially affected by accommodation.
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Winston M, Zhou A, Rand CM, Dunne EC, Warner JJ, Volpe LJ, Pigneri BA, Simon D, Bielawiec T, Gordon SC, Vitez SF, Charnay A, Joza S, Kelly K, Panicker C, Rizvydeen S, Niewijk G, Coleman C, Scher BJ, Reed DW, Hockney SM, Buniao G, Stewart T, Trojanowski L, Brogadir C, Price M, Kenny AS, Bradley A, Volpe NJ, Weese-Mayer DE. Pupillometry measures of autonomic nervous system regulation with advancing age in a healthy pediatric cohort. Clin Auton Res 2019; 30:43-51. [DOI: 10.1007/s10286-019-00639-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/13/2019] [Indexed: 02/03/2023]
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Tekin K, Sekeroglu MA, Kiziltoprak H, Doguizi S, Inanc M, Yilmazbas P. Static and dynamic pupillometry data of healthy individuals. Clin Exp Optom 2018; 101:659-665. [PMID: 29356077 DOI: 10.1111/cxo.12659] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 12/17/2017] [Accepted: 12/18/2017] [Indexed: 08/30/2023] Open
Affiliation(s)
- Kemal Tekin
- Ophthalmology Department, Kars State Hospital, Kars, Turkey,
| | - Mehmet Ali Sekeroglu
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey,
| | - Hasan Kiziltoprak
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey,
| | - Sibel Doguizi
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey,
| | - Merve Inanc
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey,
| | - Pelin Yilmazbas
- Ophthalmology Department, Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey,
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Huang D, Zhang X, Wang Y, Zhu H, Ding H, Bai J, Chen J, Fu Z, Wang Z, Chen X, Liu H. Pupillary measurements and anisocoria in Chinese preschoolers 3-4 years of age screened using the plusoptiX A12C. J AAPOS 2017; 21:262.e1-262.e5. [PMID: 28716735 DOI: 10.1016/j.jaapos.2017.04.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 04/19/2017] [Accepted: 04/19/2017] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate the distribution of the pupil diameter and distance and the incidence of anisocoria in a screening setting for Chinese preschoolers 3-4 years of age. METHODS This was a cross-sectional, population-based study conducted in children aged 3-4 years in Nanjing, China. Plusoptix photoscreening was conducted without cycloplegia. Additional assessments were conducted, including light reaction test, reevaluation for anisocoria (in dim and bright light), swinging-flashlight test, and cocaine test, if necessary. RESULTS A total of 1,818 children were screened. Pupillary measurements were conducted successfully in nearly all children (99.3% for the pupil diameter; 98.4% for the interpupillary distance). The pupil diameters of both eyes of each individual were highly correlated (5.9 ± 0.7 mm in both eyes; P < 0.0001; r = 0.93). The mean interpupillary distance was 50.1 ± 3.1 mm. The pupil diameters (6.0 mm in boys; 5.8 mm in girls) and interpupillary distance (50.6 mm in boys; 49.5 mm in girls) were correlated with sex (all P < 0.0001) but not age (P = 0.22; P = 0.68). General anisocoria of 0.5-0.9 mm in 7.8% of children and 1.0-1.2 mm in 0.4% of children was found. No child was diagnosed with pathological anisocoria, craniofacial trauma, or congenital malformation syndrome. CONCLUSIONS The Plusoptix photoscreener is a useful tool for obtaining pupillary measurements and detecting anisocoria in a screening setting. For Chinese preschoolers 3-4 years of age the mean pupil diameter and distance were 5.9 and 50.1 mm, respectively, with sex-related difference; anisocoria of 0.5-0.9 mm is present in 7.8% of children.
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Affiliation(s)
- Dan Huang
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Xiaohan Zhang
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Yue Wang
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Hui Zhu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Hui Ding
- Maternal and Child Healthcare Hospital of Yuhuatai District, Nanjing, China
| | - Jing Bai
- Maternal and Child Healthcare Hospital of Yuhuatai District, Nanjing, China
| | - Ji Chen
- Maternal and Child Healthcare Hospital of Yuhuatai District, Nanjing, China
| | - Zhujun Fu
- Nanjing Children's Hospital, Nanjing, China
| | - Zijin Wang
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Xuejuan Chen
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
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Otero C, Aldaba M, Ferrer O, Gascón A, Ondategui-Parra JC, Pujol J. Suitability of open-field autorefractors as pupillometers and instrument design effects. Int J Ophthalmol 2017; 10:567-572. [PMID: 28503429 DOI: 10.18240/ijo.2017.04.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 02/14/2017] [Indexed: 11/23/2022] Open
Abstract
AIM To determine the agreement and repeatability of the pupil measurement obtained with VIP-200 (Neuroptics), PowerRef II (Plusoptix), WAM-5500 (Grand Seiko) and study the effects of instrument design on pupillometry. METHODS Forty patients were measured twice in low, mid and high mesopic. Repeatability was analyzed with the within-subject standard deviation (Sw) and paired t-tests. Agreement was studied with Bland-Altman plots and repeated measures ANOVA. Instrument design analysis consisted on measuring pupil size with PowerRef II simulating monocular and binocular conditions as well as with proximity cues and without proximity cues. RESULTS The mean difference (±standard deviation) between test-retest for low, mid and high mesopic conditions were, respectively: -0.09 (±0.16), -0.05 (±0.18) and -0.08 (±0.23) mm for Neuroptics, -0.05 (±0.17), -0.12 (±0.23) and -0.17 (±0.34) mm for WAM-5500, -0.04 (±0.27), -0.13 (±0.37) and -0.11 (±0.28) mm for PowerRef II. Regarding agreement with Neuroptics, the mean difference for low, mid and high mesopic conditions were, respectively: -0.48 (±0.35), -0.83 (±0.52) and -0.38 (±0.56) mm for WAM-5500, -0.28 (±0.56), -0.70 (±0.55) and -0.61 (±0.54) mm for PowerRef II. The mean difference of binocular minus monocular pupil measurements was: -0.83 (±0.87) mm; and with proximity cues minus without proximity cues was: -0.30 (±0.77) mm. CONCLUSION All the instruments show similar repeat-ability. In all illumination conditions, agreement of Neuroptics with WAM-5500 and PowerRef II is not good enough, which can be partially induced due to their open field design.
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Affiliation(s)
- Carles Otero
- Davalor Research Center, Technical University of Catalonia, Terrassa 08222, Spain
| | - Mikel Aldaba
- Davalor Research Center, Technical University of Catalonia, Terrassa 08222, Spain
| | - Oriol Ferrer
- Davalor Research Center, Technical University of Catalonia, Terrassa 08222, Spain
| | - Andrea Gascón
- Davalor Research Center, Technical University of Catalonia, Terrassa 08222, Spain
| | | | - Jaume Pujol
- Davalor Research Center, Technical University of Catalonia, Terrassa 08222, Spain
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Exfoliation Syndrome and Solar Exposure: New Epidemiological Insights Into the Pathophysiology of the Disease. Int Ophthalmol Clin 2016; 55:13-22. [PMID: 26322422 DOI: 10.1097/iio.0000000000000092] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Pasquale LR, Jiwani AZ, Zehavi-Dorin T, Majd A, Rhee DJ, Chen T, Turalba A, Shen L, Brauner S, Grosskreutz C, Gardiner M, Chen S, Borboli-Gerogiannis S, Greenstein SH, Chang K, Ritch R, Loomis S, Kang JH, Wiggs JL, Levkovitch-Verbin H. Solar exposure and residential geographic history in relation to exfoliation syndrome in the United States and Israel. JAMA Ophthalmol 2015; 132:1439-45. [PMID: 25188364 DOI: 10.1001/jamaophthalmol.2014.3326] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
IMPORTANCE Residential (geographic) history and extent of solar exposure may be important risk factors for exfoliation syndrome (XFS) but, to our knowledge, detailed lifetime solar exposure has not been previously evaluated in XFS. OBJECTIVE To assess the relation between residential history, solar exposure, and XFS. DESIGN, SETTING, AND PARTICIPANTS This clinic-based case-control study was conducted in the United States and Israel. It involved XFS cases and control individuals (all ≥ 60-year-old white individuals) enrolled from 2010 to 2012 (United States: 118 cases and 106 control participants; Israel: 67 cases and 72 control participants). MAIN OUTCOMES AND MEASURES Weighted lifetime average latitude of residence and average number of hours per week spent outdoors as determined by validated questionnaires. RESULTS In multivariable analyses, each degree of weighted lifetime average residential latitude away from the equator was associated with 11% increased odds of XFS (pooled odds ratio [OR], 1.11; 95% CI, 1.05-1.17; P < .001). Furthermore, every hour per week spent outdoors during the summer, averaged over a lifetime, was associated with 4% increased odds of XFS (pooled OR, 1.04; 95% CI, 1.00-1.07; P = .03). For every 1% of average lifetime summer time between 10 am and 4 pm that sunglasses were worn, the odds of XFS decreased by 2% (OR, 0.98; 95% CI, 0.97-0.99; P < .001) in the United States but not in Israel (OR, 1.00; 95% CI, 0.99-1.01; P = .92; P for heterogeneity = .005). In the United States, after controlling for important environmental covariates, history of work over water or snow was associated with increased odds of XFS (OR, 3.86; 95% CI, 1.36-10.9); in Israel, there were too few people with such history for analysis. We did not identify an association between brimmed hat wear and XFS (P > .57). CONCLUSIONS AND RELEVANCE Lifetime outdoor activities may contribute to XFS. The association with work over snow or water and the lack of association with brimmed hat wear suggests that ocular exposure to light from reflective surfaces may be an important type of exposure in XFS etiology.
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Affiliation(s)
- Louis R Pasquale
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts2Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston
| | - Aliya Z Jiwani
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston
| | - Tzukit Zehavi-Dorin
- Goldschleger Eye Institute, Chaim Sheba Medical Center, Tel Aviv University, Tel Hashomer, Israel
| | - Arow Majd
- Goldschleger Eye Institute, Chaim Sheba Medical Center, Tel Aviv University, Tel Hashomer, Israel
| | - Douglas J Rhee
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston4Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Teresa Chen
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston
| | - Angela Turalba
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston
| | - Lucy Shen
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston
| | - Stacey Brauner
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston
| | - Cynthia Grosskreutz
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston5currently withNovartis Institute for BioMedical Research, Cambridge, Massachusetts
| | - Matthew Gardiner
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston
| | - Sherleen Chen
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston
| | | | - Scott H Greenstein
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston
| | - Kenneth Chang
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston
| | - Robert Ritch
- Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York
| | - Stephanie Loomis
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jae H Kang
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts
| | - Janey L Wiggs
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston
| | - Hani Levkovitch-Verbin
- Goldschleger Eye Institute, Chaim Sheba Medical Center, Tel Aviv University, Tel Hashomer, Israel
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Kang JH, Wiggs JL, Pasquale LR. Relation between time spent outdoors and exfoliation glaucoma or exfoliation glaucoma suspect. Am J Ophthalmol 2014; 158:605-14.e1. [PMID: 24857689 PMCID: PMC4138242 DOI: 10.1016/j.ajo.2014.05.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 05/13/2014] [Accepted: 05/14/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the relation between time spent outdoors at various life periods and risk of exfoliation glaucoma or exfoliation glaucoma suspect. DESIGN Retrospective cohort study in the United States. METHODS Participants (49 033 women in the Nurses Health Study and 20 066 men in the Health Professionals Follow-up Study) were 60+ years old, were free of glaucoma and cataract, reported eye examinations, and completed questions about time spent outdoors in direct sunlight at midday at 3 life periods: high school to age 24 years, age 25-35 years, and age 36-59 years (asked in 2006 in women and 2008 in men). Participants were followed biennially with mailed questionnaires from 1980 women/1986 men to 2010. Incident cases (223 women and 38 men) were confirmed with medical records. Cohort-specific multivariable-adjusted rate ratios from Cox proportional hazards models were estimated and pooled with meta-analysis. RESULTS Although no association was observed with greater time spent outdoors in the ages of 25-35 or ages 36-59 years, the pooled multivariable-adjusted rate ratios for ≥11 hours per week spent outdoors in high school to age 24 years compared with ≤5 hours per week was 2.00 (95% confidence interval = 1.30, 3.08; P for linear trend = .001). In women, this association was stronger in those who resided in the southern geographic tier in young adulthood (P for interaction = .07). CONCLUSIONS Greater time spent outdoors in young adulthood was associated with risk of exfoliation glaucoma or exfoliation glaucoma suspect, supporting an etiologic role of early exposures to climatic factors.
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Affiliation(s)
- Jae H Kang
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School and Brigham & Women's Hospital, Boston, Massachusetts.
| | - Janey L Wiggs
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts
| | - Louis R Pasquale
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School and Brigham & Women's Hospital, Boston, Massachusetts; Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear, Boston, Massachusetts
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Muñoz Negrete FJ, Rebolleda G. Automated evaluation of the pupil. ACTA ACUST UNITED AC 2014; 88:125-6. [PMID: 23597639 DOI: 10.1016/j.oftal.2013.02.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Accepted: 02/11/2013] [Indexed: 11/29/2022]
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Behar-Cohen F, Baillet G, de Ayguavives T, Garcia PO, Krutmann J, Peña-García P, Reme C, Wolffsohn JS. Ultraviolet damage to the eye revisited: eye-sun protection factor (E-SPF®), a new ultraviolet protection label for eyewear. Clin Ophthalmol 2013; 8:87-104. [PMID: 24379652 PMCID: PMC3872277 DOI: 10.2147/opth.s46189] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Ultraviolet (UV) radiation potentially damages the skin, the immune system, and structures of the eye. A useful UV sun protection for the skin has been established. Since a remarkable body of evidence shows an association between UV radiation and damage to structures of the eye, eye protection is important, but a reliable and practical tool to assess and compare the UV-protective properties of lenses has been lacking. Among the general lay public, misconceptions on eye-sun protection have been identified. For example, sun protection is mainly ascribed to sunglasses, but less so to clear lenses. Skin malignancies in the periorbital region are frequent, but usual topical skin protection does not include the lids. Recent research utilized exact dosimetry and demonstrated relevant differences in UV burden to the eye and skin at a given ambient irradiation. Chronic UV effects on the cornea and lens are cumulative, so effective UV protection of the eyes is important for all age groups and should be used systematically. Protection of children's eyes is especially important, because UV transmittance is higher at a very young age, allowing higher levels of UV radiation to reach the crystalline lens and even the retina. Sunglasses as well as clear lenses (plano and prescription) effectively reduce transmittance of UV radiation. However, an important share of the UV burden to the eye is explained by back reflection of radiation from lenses to the eye. UV radiation incident from an angle of 135°-150° behind a lens wearer is reflected from the back side of lenses. The usual antireflective coatings considerably increase reflection of UV radiation. To provide reliable labeling of the protective potential of lenses, an eye-sun protection factor (E-SPF®) has been developed. It integrates UV transmission as well as UV reflectance of lenses. The E-SPF® compares well with established skin-sun protection factors and provides clear messages to eye health care providers and to lay consumers.
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Affiliation(s)
- Francine Behar-Cohen
- French Institute of Health and Medical Research, Team 17, Centre de Recherche des Cordeliers, France
| | - Gilles Baillet
- Research and Development Center, Essilor International, Saint Maur des Fossés, France
| | - Tito de Ayguavives
- Research and Development Center, Essilor International, Saint Maur des Fossés, France
| | | | - Jean Krutmann
- IUF Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Pablo Peña-García
- Department of Research, Fundacion Jorge Alio, Alicante, Spain
- Division of Ophthalmology, University Miguel Hernández, Alicante, Spain
| | - Charlotte Reme
- Laboratory of Retinal Cell Biology, Department of Ophthalmology, University of Zurich, Switzerland
| | - James S Wolffsohn
- Life and Health Sciences, Aston University, Aston Triangle, Birmingham, UK
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Tran K, Mendel TA, Holbrook KL, Yates PA. Construction of an inexpensive, hand-held fundus camera through modification of a consumer "point-and-shoot" camera. Invest Ophthalmol Vis Sci 2012; 53:7600-7. [PMID: 23049089 DOI: 10.1167/iovs.12-10449] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To construct a low-cost, easy-to-use, high-image-quality mydriatic fundus camera with "point-and-shoot" operation, and to evaluate the efficacy of this camera to accurately document retinal disease. METHODS A prototype portable fundus camera was designed by interfacing a novel optical module with a Panasonic Lumix G2 consumer camera. Low-cost, commercially available optics were used to create even illumination of the fundus, providing a 50° retinal field of view. A comparative study assessing the image quality of the prototype camera against a traditional tabletop fundus camera was conducted under an Institutional Review Board (IRB)-approved study. RESULTS A stand-alone, mydriatic camera prototype was successfully developed at a parts cost of less than $1000. The prototype camera was capable of operating in a point-and-shoot manner with automated image focusing and exposure, and the image quality of fundus photos was comparable to that of existing commercial cameras. Pathology related to both nonproliferative and proliferative diabetic retinopathy and age-related macular degeneration was easily identified from fundus images obtained from the low-cost camera. CONCLUSIONS Early prototype development and clinical testing have shown that a consumer digital camera can be inexpensively modified to image the fundus with professional diagnostic quality. The combination of low cost, portability, point-and-shoot operation, and high image quality provides a foundational platform on which one can design an accessible fundus camera to screen for eye disease.
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Affiliation(s)
- Kenneth Tran
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
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Herbst K, Sander B, Lund-Andersen H, Broendsted AE, Kessel L, Hansen MS, Kawasaki A. Intrinsically photosensitive retinal ganglion cell function in relation to age: a pupillometric study in humans with special reference to the age-related optic properties of the lens. BMC Ophthalmol 2012; 12:4. [PMID: 22471313 PMCID: PMC3411473 DOI: 10.1186/1471-2415-12-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Accepted: 04/03/2012] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The activity of melanopsin containing intrinsically photosensitive ganglion retinal cells (ipRGC) can be assessed by a means of pupil responses to bright blue (appr.480 nm) light. Due to age related factors in the eye, particularly, structural changes of the lens, less light reaches retina. The aim of this study was to examine how age and in vivo measured lens transmission of blue light might affect pupil light responses, in particular, mediated by the ipRGC. METHODS Consensual pupil responses were explored in 44 healthy subjects aged between 26 and 68 years. A pupil response was recorded to a continuous 20 s light stimulus of 660 nm (red) or 470 nm (blue) both at 300 cd/m2 intensity (14.9 and 14.8 log photons/cm2/s, respectively). Additional recordings were performed using four 470 nm stimulus intensities of 3, 30, 100 and 300 cd/m2. The baseline pupil size was measured in darkness and results were adjusted for the baseline pupil and gender. The main outcome parameters were maximal and sustained pupil contraction amplitudes and the postillumination response assessed as area under the curve (AUC) over two time-windows: early (0-10 s after light termination) and late (10-30 s after light termination). Lens transmission was measured with an ocular fluorometer. RESULTS The sustained pupil contraction and the early poststimulus AUC correlated positively with age (p=0.02, p=0.0014, respectively) for the blue light stimulus condition only.The maximal pupil contraction amplitude did not correlate to age either for bright blue or red light stimulus conditions.Lens transmission decreased linearly with age (p<0.0001). The pupil response was stable or increased with decreasing transmission, though only significantly for the early poststimulus AUC to 300 cd/m2 light (p=0.02). CONCLUSIONS Age did not reduce, but rather enhance pupil responses mediated by ipRGC. The age related decrease of blue light transmission led to similar results, however, the effect of age was greater on these pupil responses than that of the lens transmission. Thus there must be other age related factors such as lens scatter and/or adaptive processes influencing the ipRGC mediated pupil response enhancement observed with advancing age.
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Affiliation(s)
- Kristina Herbst
- Department of Ophthalmology, Glostrup Hospital, Ndr. Ringvej 57, 2600 Glostrup, Copenhagen, Denmark
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Brown S. Preoperative pupil size and LASIK. Ophthalmology 2011; 118:2525-6; author reply 2526-7. [PMID: 22136680 DOI: 10.1016/j.ophtha.2011.08.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Accepted: 08/09/2011] [Indexed: 11/29/2022] Open
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Manche E, Chan A. Author reply. Ophthalmology 2011. [DOI: 10.1016/j.ophtha.2011.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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