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Huang Y, Li X, Wu J, Huo J, Zhou F, Zhang J, Yang A, Spiegel DP, Chen H, Bao J. Effect of spectacle lenses with aspherical lenslets on choroidal thickness in myopic children: a 2-year randomised clinical trial. Br J Ophthalmol 2023; 107:1806-1811. [PMID: 36167484 DOI: 10.1136/bjo-2022-321815] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 09/07/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Spectacle lenses with highly aspherical lenslets (HAL) and slightly aspherical lenslets (SAL) showed effective myopia control. This study was to investigate their effects on macular choroidal thickness (ChT) in myopic children. METHODS Exploratory analysis from a 2-year, double-masked, randomised trial. 170 children aged 8-13 years with myopia between -0.75D and -4.75D, astigmatism of 1.50D or less, and anisometropia of 1.00D or less were recruited. Participants were randomly assigned in a 1:1:1 ratio to receive HAL, SAL or single vision spectacle lenses (SVL). The subfoveal, parafoveal and perifoveal ChT were evaluated every 6 months. RESULTS 154 participants completed all examinations. The ChT showed significant changes over time in all three groups in all regions (all p<0.05). The ChTs continuously decreased in the SVL group (ranging from -20.75 (SD 22.34) μm to -12.18 (22.57) μm after 2 years in different regions). Compared with the SVL group, ChT in the SAL group decreased less (ranging from -16.49 (21.27) μm to -5.29 (18.15) μm). In the HAL group, ChT increased in the first year and then decreased in the second year (ranging from -0.30 (27.54) μm to 8.92 (23.97) μm after two years). The perifoveal ChT decreased less than the parafoveal ChT, and the superior region decreased the least. CONCLUSIONS The ChT of the macula decreased after 2 years of myopia progression with SVL. Wearing spectacle lenses with aspherical lenslets reduced or abolished the ChT thinning and HAL had a more pronounced effect. TRIAL REGISTRATION NUMBER ChiCTR1800017683.
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Affiliation(s)
- Yingying Huang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, China
| | - Xue Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, China
| | - Junqian Wu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jiawen Huo
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Fengchao Zhou
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jiali Zhang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Adeline Yang
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, China
- Essilor International SA, Singapore
| | - Daniel P Spiegel
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, China
- Essilor International SA, Singapore
| | - Hao Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jinhua Bao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, China
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Huang Y, Zhang J, Yin Z, Yang A, Spiegel DP, Drobe B, Chen H, Bao J, Li X. Effects of Spectacle Lenses With Aspherical Lenslets on Peripheral Eye Length and Peripheral Refraction in Myopic Children: A 2-Year Randomized Clinical Trial. Transl Vis Sci Technol 2023; 12:15. [PMID: 37955608 PMCID: PMC10653269 DOI: 10.1167/tvst.12.11.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/27/2023] [Indexed: 11/14/2023] Open
Abstract
Purpose To investigate changes in peripheral eye length (PEL) and peripheral refraction (PR) in myopic children after wearing spectacle lenses with highly or slightly aspherical lenslets (HAL or SAL) for 2 years. Methods We recruited 170 children aged 8 to 13 years with myopia between -0.75 diopters (D) and -4.75 D. Participants were randomized to wear HAL, SAL, or single vision spectacle lenses (SVL). PEL and PR were measured at 0° central and 15° and 30° in the nasal and temporal retina every 6 months for 2 years. The relative PR (RPR) was calculated by subtracting central from peripheral values. Results PELs significantly increased with time (all P < 0.001), with the greatest elongation in the SVL group and the least in the HAL group. In the SVL and SAL groups, axial length elongated faster than the periphery. Whereas in the HAL group, N30 elongated faster than other PELs, axial length elongated less than the periphery. With time, the PR became more negative (all P < 0.001), with the most negative changes in the SVL group and the least negative changes in the HAL group. RPR became more hyperopic in the SVL and SAL groups, but less hyperopic in the HAL group (all P < 0.001). Conclusions Over the 2-year myopia progression, steeper retina and greater peripheral hyperopic defocus were found in the SVL group. In the SAL group, changes were attenuated. In the HAL group, the retina flattened and peripheral defocus became less hyperopic. Translational Relevance HAL and SAL lenses had little impact on PEL elongation.
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Affiliation(s)
- Yingying Huang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jiali Zhang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ziang Yin
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Adeline Yang
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
- R&D Singapore, Essilor International, Singapore, Singapore
| | - Daniel P. Spiegel
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
- R&D Singapore, Essilor International, Singapore, Singapore
| | - Björn Drobe
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
- R&D Singapore, Essilor International, Singapore, Singapore
| | - Hao Chen
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jinhua Bao
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xue Li
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Wenzhou Medical University–Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
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Gao Y, Spiegel DP, Muzahid IAI, Lim EW, Drobe B. Spectacles with highly aspherical lenslets for myopia control do not change visual sensitivity in automated static perimetry. Front Neurosci 2022; 16:996908. [PMID: 36507344 PMCID: PMC9733526 DOI: 10.3389/fnins.2022.996908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/08/2022] [Indexed: 11/27/2022] Open
Abstract
Purpose Spectacle lenses with arrays of lenslets have gained popularity in myopia control due to their high efficacy, low impact on visual performance, and non-invasiveness. One of the questions regarding their impact on visual performance that still remain is that: do the lenslets impact visual field sensitivity? The current study aims to investigate the impact of wearing spectacle lenses with highly aspherical lenslets (HAL) on the visual field sensitivity. Methods An automated static perimetry test (Goldman perimeter target III) was employed to measure the detection sensitivity in the visual field. Targets were white light dots of various luminance levels and size 0.43°, randomly appearing at 76 locations within 30° eccentricity. Twenty-one adult subjects (age 23-61, spherical equivalent refractive error (SER) -8.75 D to +0.88 D) participated in the study. Sensitivities through two lenses, HAL and a single vision lens (SVL) as the control condition, were measured in random order. Results The mean sensitivity differences between HAL and SVL across the 76 tested locations ranged between -1.14 decibels (dB) and 1.28 dB. Only one location at 30° in the temporal visual field reached statistical significance (p < 0.00065) whereby the sensitivity increased by 1.1 dB with HAL. No significant correlation was found between the difference in sensitivity and age or SER. Such a difference is unlikely to be clinically relevant. Conclusion Compared to the SVL, the HAL did not change detection sensitivity to static targets in the whole visual field within 30° eccentricity.
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Chen J, Zhuo R, Chen J, Yang A, Lim EW, Bao J, Drobe B, Spiegel DP, Chen H, Hou L. Spectacle lenses with slightly aspherical lenslets for myopia control: clinical trial design and baseline data. BMC Ophthalmol 2022; 22:345. [PMID: 35974312 PMCID: PMC9382742 DOI: 10.1186/s12886-022-02562-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 08/01/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives Myopia is a major public health problem and it is essential to find safe and effective means to control its progression. The study design and baseline data are presented for a one-year prospective, double-masked, crossover, randomized clinical trial evaluating the efficacy of single vision spectacle lenses with concentric rings of slightly aspherical contiguous lenslets technology (SAL) on myopia control. Methods One hundred 8- to 13-year old Chinese children with a refractive error of -0.75 D to -4.75 D were assigned to two groups. In Group 1, SAL and single vision lenses were each worn for 6 months, and Group 2 wore the lenses in the reversed order. Primary outcomes are axial length and spherical equivalent of cycloplegic refractive error. Secondary outcomes included corneal thickness, anterior chamber depth, lens thickness, visual acuity, and lens adaptation. Results No significant differences in baseline parameters (cycloplegic spherical equivalent, axial length, age) were found between groups (0.49 < p < 0.94). All children adapted well to the test lenses and there was no significant difference in visual acuity between the SAL and single vision lenses (p = 0.27). Conclusions The children in the two well balanced groups had comparable visual acuity and adapted well to the test lenses. These results imply that visual acuity can be well improved by SAL lenses. Clear visual acuity provides the assurance for good compliance in this longitudinal study. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-022-02562-0.
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Affiliation(s)
- Junhong Chen
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, 270 Xueyuan West RoadZhejiang Province, Wenzhou, 310020, China.,Department of Optometry Center, Affiliated Eye Hospital of Wenzhou Medical University, Zhejiang Province, Hangzhou, China
| | - Ran Zhuo
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, 270 Xueyuan West RoadZhejiang Province, Wenzhou, 310020, China.,Department of Optometry Center, Affiliated Eye Hospital of Wenzhou Medical University, Zhejiang Province, Hangzhou, China
| | - Jiayan Chen
- Department of Optometry Center, Affiliated Eye Hospital of Wenzhou Medical University, Zhejiang Province, Hangzhou, China
| | - Adeline Yang
- Essilor International Research Center (WEIRC), Wenzhou Medical University, Zhejiang Province, Wenzhou, China.,R&D AMERA, Essilor International, Singapore, Singapore
| | - Ee Woon Lim
- Essilor International Research Center (WEIRC), Wenzhou Medical University, Zhejiang Province, Wenzhou, China.,R&D AMERA, Essilor International, Singapore, Singapore
| | - Jinhua Bao
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, 270 Xueyuan West RoadZhejiang Province, Wenzhou, 310020, China.,Essilor International Research Center (WEIRC), Wenzhou Medical University, Zhejiang Province, Wenzhou, China
| | - Björn Drobe
- Essilor International Research Center (WEIRC), Wenzhou Medical University, Zhejiang Province, Wenzhou, China.,R&D AMERA, Essilor International, Singapore, Singapore
| | - Daniel P Spiegel
- Essilor International Research Center (WEIRC), Wenzhou Medical University, Zhejiang Province, Wenzhou, China.,R&D AMERA, Essilor International, Singapore, Singapore
| | - Hao Chen
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, 270 Xueyuan West RoadZhejiang Province, Wenzhou, 310020, China. .,Essilor International Research Center (WEIRC), Wenzhou Medical University, Zhejiang Province, Wenzhou, China.
| | - Lijie Hou
- Hangzhou Branch of Zhejiang Eye Hospital Affiliated to Wenzhou Medical University, 618 Fengqi East Road, Hangzhou, Zhejiang, 310020, China.
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Bao J, Huang Y, Li X, Yang A, Zhou F, Wu J, Wang C, Li Y, Lim EW, Spiegel DP, Drobe B, Chen H. Spectacle Lenses With Aspherical Lenslets for Myopia Control vs Single-Vision Spectacle Lenses: A Randomized Clinical Trial. JAMA Ophthalmol 2022; 140:472-478. [PMID: 35357402 PMCID: PMC8972151 DOI: 10.1001/jamaophthalmol.2022.0401] [Citation(s) in RCA: 65] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance Reducing myopia progression can reduce the risk of associated ocular pathologies. Objective To evaluate whether spectacle lenses with higher lenslet asphericity have a higher myopia control efficacy throughout 2 years. Design, Setting, and Participants This double-masked randomized clinical trial was conducted between July 2018 and October 2020 at the Eye Hospital of Wenzhou Medical University in Wenzhou, China. Children aged 8 to 13 years with a cycloplegic spherical equivalent refraction (SER) of -0.75 D to -4.75 D and astigmatism with less than -1.50 D were recruited. A data and safety monitoring committee reviewed findings from a planned interim analysis in 2019. Interventions Participants were randomly assigned in a 1:1:1 ratio to receive spectacle lenses with highly aspherical lenslets (HAL), spectacle lenses with slightly aspherical lenslets (SAL), or single-vision spectacle lenses (SVL). Main Outcome and Measures Two-year changes in SER and axial length and their differences between groups. Results Of 157 participants who completed each visit (mean [SD] age, 10.4 [1.2] years), 54 were analyzed in the HAL group, 53 in the SAL group, and 50 in the SVL group. Mean (SE) 2-year myopia progression in the SVL group was 1.46 (0.09) D. Compared with SVL, the mean (SE) change in SER was less for HAL (by 0.80 [0.11] D) and SAL (by 0.42 [0.11] D; P ≤ .001). The mean (SE) increase in axial length was 0.69 (0.04) mm for SVL. Compared with SVL, increase in axial length was slowed by a mean (SE) of 0.35 (0.05) mm for HAL and 0.18 (0.05) mm for SAL (P ≤ .001). Compared with SVL, for children who wore HAL at least 12 hours every day, the mean (SE) change in SER was slowed by 0.99 (0.12) D, and increase in axial length slowed by 0.41 (0.05) mm. Conclusions and Relevance In this study, HAL and SAL reduced the rate of myopia progression and axial elongation throughout 2 years, with higher efficacy for HAL. Longer wearing hours resulted in better myopia control efficacy for HAL. Trial Registration Chinese Clinical Trial Registry Identifier: ChiCTR1800017683.
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Affiliation(s)
- Jinhua Bao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China.,Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yingying Huang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China.,Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xue Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China.,Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Adeline Yang
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China.,R&D AMERA, Essilor International, Singapore, Singapore
| | - Fengchao Zhou
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Junqian Wu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chu Wang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuhao Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ee Woon Lim
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China.,R&D AMERA, Essilor International, Singapore, Singapore
| | - Daniel P Spiegel
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China.,R&D AMERA, Essilor International, Singapore, Singapore
| | - Björn Drobe
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China.,R&D AMERA, Essilor International, Singapore, Singapore
| | - Hao Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
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Bao J, Yang A, Huang Y, Li X, Pan Y, Ding C, Lim EW, Zheng J, Spiegel DP, Drobe B, Lu F, Chen H. One-year myopia control efficacy of spectacle lenses with aspherical lenslets. Br J Ophthalmol 2021; 106:1171-1176. [PMID: 33811039 PMCID: PMC9340037 DOI: 10.1136/bjophthalmol-2020-318367] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 02/28/2021] [Accepted: 03/01/2021] [Indexed: 01/23/2023]
Abstract
Aims To evaluate the 1-year efficacy of two new myopia control spectacle lenses with lenslets of different asphericity. Methods One hundred seventy schoolchildren aged 8–13 years with myopia of −0.75 D to −4.75 D were randomised to receive spectacle lenses with highly aspherical lenslets (HAL), spectacle lenses with slightly aspherical lenslets (SAL), or single-vision spectacle lenses (SVL). Cycloplegic autorefraction (spherical equivalent refraction (SER)), axial length (AL) and best-corrected visual acuity (BCVA) were measured at baseline and 6-month intervals. Adaptation and compliance questionnaires were administered during all visits. Results After 1 year, the mean changes in the SER (±SE) and AL (±SE) in the SVL group were −0.81±0.06 D and 0.36±0.02 mm. Compared with SVL, the myopia control efficacy measured using SER was 67% (difference of 0.53 D) for HAL and 41% (difference of 0.33 D) for SAL, and the efficacy measured using AL was 64% (difference of 0.23 mm) for HAL and 31% (difference of 0.11 mm) for SAL (all p<0.01). HAL resulted in significantly greater myopia control than SAL for SER (difference of 0.21 D, p<0.001) and AL (difference of 0.12 mm, p<0.001). The mean BCVA (−0.01±0.1 logMAR, p=0.22) and mean daily wearing time (13.2±2.6 hours, p=0.26) were similar among the three groups. All groups adapted to their lenses with no reported adverse events, complaints or discomfort. Conclusions Spectacle lenses with aspherical lenslets effectively slow myopia progression and axial elongation compared with SVL. Myopia control efficacy increased with lenslet asphericity. Trial registration number ChiCTR1800017683.
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Affiliation(s)
- Jinhua Bao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Adeline Yang
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China.,R&D AMERA, Essilor International, Singapore
| | - Yingying Huang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xue Li
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yiguo Pan
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chenglu Ding
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ee Woon Lim
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China.,R&D AMERA, Essilor International, Singapore
| | - Jingwei Zheng
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Daniel P Spiegel
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China.,R&D AMERA, Essilor International, Singapore
| | - Björn Drobe
- Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China.,R&D AMERA, Essilor International, Singapore
| | - Fan Lu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China .,Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hao Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China .,Wenzhou Medical University-Essilor International Research Center (WEIRC), Wenzhou Medical University, Wenzhou, Zhejiang, China
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Li S, Pan Y, Xu J, Li X, Spiegel DP, Bao J, Chen H. Effects of physical exercise on macular vessel density and choroidal thickness in children. Sci Rep 2021; 11:2015. [PMID: 33479470 PMCID: PMC7820247 DOI: 10.1038/s41598-021-81770-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 01/11/2021] [Indexed: 11/09/2022] Open
Abstract
We used swept-source (SS) optical coherence tomography (OCT) and OCT angiography (OCTA) to investigate the effects of moderate physical exercise on retinal and choroidal vessel densities (VDs) and thicknesses in children. One eye in each of 40 myopic children (mean age, 11.70 years) and 18 emmetropic children (mean age, 11.06 years) were included. SS-OCT 6 × 6-mm radial scans and SS-OCTA 3 × 3-mm images were centered on the macula. Heart rate (HR), systolic and diastolic blood pressure, and intraocular pressure (IOP) were recorded before and immediately after a 20-min stationary cycling exercise and after a 30-min rest. The subfoveal choroidal thickness (SFCT), choroidal thickness (CT), and VD at the superficial and deep retinal layers, choriocapillaris, and deeper choroidal vessels were determined. SFCT and CT were significantly lower at all locations immediately after exercise (p < 0.001) and did not fully recover after rest (p < 0.05). VD was lower in the deep retinal layer after exercise (p = 0.02) and higher in the superficial layer after rest (p = 0.03) in myopic eyes while it was higher in the superficial (p < 0.01) and deep layer (p < 0.01) after rest in emmetropic eyes. No significant exercise-related changes in the superficial retinal VD, choroidal VD, or IOP were observed. ΔCT% and ΔSFCT% were significantly correlated with increases in HR in myopic group (p = 0.04 and p = 0.03, respectively). Exercise increased retinal VD after rest in emmetropic eyes, and caused significant CT thinning that lasted for at least 30 min in both emmetropic and myopic eyes.
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Affiliation(s)
- Shufeng Li
- Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027, Zhejiang, China
| | - Yiguo Pan
- Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027, Zhejiang, China
| | - Jingjing Xu
- Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027, Zhejiang, China
| | - Xue Li
- Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027, Zhejiang, China
| | - Daniel P Spiegel
- R&D Vision Sciences AMERA, Essilor International, Singapore, Singapore
| | - Jinhua Bao
- Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027, Zhejiang, China.
| | - Hao Chen
- Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027, Zhejiang, China.
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Searchfield GD, Spiegel DP, Poppe TNER, Durai M, Jensen M, Kobayashi K, Park J, Russell BR, Shekhawat GS, Sundram F, Thompson BB, Wise KJ. A proof-of-concept study comparing tinnitus and neural connectivity changes following multisensory perceptual training with and without a low-dose of fluoxetine. Int J Neurosci 2020; 131:433-444. [PMID: 32281466 DOI: 10.1080/00207454.2020.1746310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background. This proof-of-concept study investigated a method of multisensory perceptual training for tinnitus, and whether a short, low-dose administration of fluoxetine enhanced training effects and changed neural connectivity.Methods. A double-blind, randomized placebo controlled design with 20 participants (17 male, 3 female, mean age = 57.1 years) involved 30 min daily computer-based, multisensory training (matching visual, auditory and tactile stimuli to perception of tinnitus) for 20 days, and random allocation to take 20 mg fluoxetine or placebo daily. Behavioral measures of tinnitus and correlations between pairs of a priori regions of interest (ROIs), obtained using resting-state functional magnetic resonance imaging (rs-fMRI), were performed before and after the training.Results. Significant changes in ratings of tinnitus loudness, annoyance, and problem were observed with training. No statistically significant changes in Tinnitus Functional Index, Tinnitus Handicap Inventory or Depression Anxiety Stress Scales were found with training. Fluoxetine did not alter any of the behavioural outcomes of training compared to placebo. Significant changes in connectivity between ROIs were identified with training; sensory and attention neural network ROI changes correlated with significant tinnitus rating changes. Rs-fMRI results suggested that the direction of functional connectivity changes between auditory and non-auditory networks, with training and fluoxetine, were opposite to the direction of those changes with multisensory training and placebo.Conclusions. Improvements in tinnitus measures were correlated with changes in sensory and attention networks. The results provide preliminary evidence for changes in rs-fMRI accompanying a multisensory training method in persons with tinnitus.
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Affiliation(s)
- G D Searchfield
- Eisdell Moore Centre & Audiology Section, The University of Auckland, Auckland, New Zealand.,Centre for Brain Research, The University of Auckland, Auckland, New Zealand.,Brain Research New Zealand, New Zealand
| | - D P Spiegel
- Essilor Research and Development, Singapore, Singapore
| | - T N E R Poppe
- Biomedical Engineering and Imaging Sciences, Kings College London, London, UK
| | - M Durai
- Eisdell Moore Centre & Audiology Section, The University of Auckland, Auckland, New Zealand.,Centre for Brain Research, The University of Auckland, Auckland, New Zealand
| | - M Jensen
- Bay of Plenty and School of Pharmacy, Pharmacy, Whakatane Hospital, University of Auckland, Auckland, New Zealand
| | - K Kobayashi
- Eisdell Moore Centre & Audiology Section, The University of Auckland, Auckland, New Zealand.,Acoustics Centre, Mechanical Engineering, The University of Auckland, Auckland, New Zealand
| | - J Park
- Eisdell Moore Centre & Audiology Section, The University of Auckland, Auckland, New Zealand
| | - B R Russell
- School of Pharmacy, Otago University, Dunedin, New Zealand
| | | | - F Sundram
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - B B Thompson
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
| | - K J Wise
- Eisdell Moore Centre & Speech Science, The University of Auckland, Auckland, New Zealand
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9
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Ruiz T, Baldwin AS, Spiegel DP, Hess R, Farivar R. Increased Noise in Cortico-Cortical Integration After Mild TBI Measured With the Equivalent Noise Technique. Front Neurol 2019; 10:767. [PMID: 31428031 PMCID: PMC6689961 DOI: 10.3389/fneur.2019.00767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 07/02/2019] [Indexed: 11/13/2022] Open
Abstract
The bulk of deficits accompanying mild traumatic brain injury (mTBI) is understood in terms of cortical integration—mnemonic, attentional, and cognitive disturbances are believed to involve integrative action across brain regions. Independent of integrative disturbances, mTBI may increase cortical noise, and this has not been previously considered. High-level integrative deficits are exceedingly difficult to measure and model, motivating us to utilize a tightly-controlled task within an established quantitative model to separately estimate internal noise and integration efficiency. First, we utilized a contour integration task modeled as a cortical-integration process involving multiple adjacent cortical columns in early visual areas. Second, we estimated internal noise and integration efficiency using the linear amplifier model (LAM). Fifty-seven mTBI patients and 24 normal controls performed a 4AFC task where they had to identify a valid contour amongst three invalid contours. Thresholds for contour amplitude were measured adaptively across three levels of added external orientation noise. Using the LAM, we found that mTBI increased internal noise without affecting integration efficiency. mTBI also caused hemifield bias differences, and efficiency was related to a change of visual habits. Using a controlled task reflecting cortical integration within the equivalent noise framework empowered us to detect increased computational noise that may be at the heart of mTBI deficits. Our approach is highly sensitive and translatable to rehabilitative efforts for the mTBI population, while also implicating a novel hypothesis of mTBI effects on basic visual processing—namely that cortical integration is maintained at the cost of increased internal noise.
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Affiliation(s)
- Tatiana Ruiz
- Research Institute of the McGill University Health Center, Montreal, QC, Canada
| | - Alex S Baldwin
- Research Institute of the McGill University Health Center, Montreal, QC, Canada
| | - Daniel P Spiegel
- Vision Sciences, Essilor R&D, Center for Innovation and Technology, Singapore, Singapore
| | - Robert Hess
- Research Institute of the McGill University Health Center, Montreal, QC, Canada
| | - Reza Farivar
- Research Institute of the McGill University Health Center, Montreal, QC, Canada
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10
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Lanca C, Teo A, Vivagandan A, Htoon HM, Najjar RP, Spiegel DP, Pu SH, Saw SM. The Effects of Different Outdoor Environments, Sunglasses and Hats on Light Levels: Implications for Myopia Prevention. Transl Vis Sci Technol 2019; 8:7. [PMID: 31360613 DOI: 10.1167/tvst.8.4.7] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 05/27/2019] [Indexed: 02/05/2023] Open
Abstract
Purpose Lack of outdoor time is a known risk factor for myopia. Knowledge of the light levels reaching the eye and exposure settings, including sun-protective measures, is essential for outdoor programs and myopia. We evaluated the impact of sun-protective strategies (hat and sunglasses) on maintaining high illuminance levels to prevent myopia. Methods A child-sized mannequin head was developed to measure light illuminance levels with and without sun-protective equipment, across a wide range of environments in Singapore, outdoors (open park, under a tree, street) and indoors (under a fluorescent illumination with window, under white LED-based lighting without window). A comparison was made between indoor and outdoor light levels that are experienced while children are involved in day-to-day activities. Results Outdoor light levels were much higher (11,080-18,176 lux) than indoors (112-156 lux). The higher lux levels protective of myopia (>1000 lux) were measured at the tree shade (5556-7876 lux) and with hat (4112-8156 lux). Sunglasses showed lux levels between 1792 and 6800 lux. Although with sunglasses readings were lower than tree shade and hat, light levels were still 11 to 43 times higher than indoors. Conclusions Recommendations on spending time outdoors for myopia prevention with adequate sun protection should be provided while partaking in outdoor activities, including protection under shaded areas, wearing a hat or sunglasses, sunscreen, and adequate hydration. Translational Relevance Light levels outdoors were higher than indoors and above the threshold illuminance for myopia prevention even with adequate sun-protective measures.
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Affiliation(s)
| | - Aaron Teo
- University of Southampton Malaysia (UoSM), Johor, Malaysia
| | | | - Hla M Htoon
- Singapore Eye Research Institute, Singapore.,Duke-NUS Medical School, Eye ACP, Singapore
| | - Raymond P Najjar
- Singapore Eye Research Institute, Singapore.,Duke-NUS Medical School, Eye ACP, Singapore
| | - Daniel P Spiegel
- Vision Sciences, Essilor R&D, Center for Innovation and Technology, Singapore
| | - Suan-Hui Pu
- University of Southampton Malaysia (UoSM), Johor, Malaysia
| | - Seang-Mei Saw
- Singapore Eye Research Institute, Singapore.,Duke-NUS Medical School, Eye ACP, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
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11
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Wang Y, He Z, Liang Y, Chen Y, Gong L, Mao Y, Chen X, Yao Z, Spiegel DP, Qu J, Lu F, Zhou J, Hess RF. Corrigendum: The Binocular Balance at High Spatial Frequencies as Revealed by the Binocular Orientation Combination Task. Front Hum Neurosci 2019; 13:196. [PMID: 31249518 PMCID: PMC6582770 DOI: 10.3389/fnhum.2019.00196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 05/24/2019] [Indexed: 12/03/2022] Open
Affiliation(s)
- Yonghua Wang
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Zhifen He
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Yunjie Liang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Yiya Chen
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Ling Gong
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Yu Mao
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Xiaoxin Chen
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Zhimo Yao
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Daniel P Spiegel
- Vision Sciences, Essilor R&D, Center for Innovation and Technology, Singapore, Singapore
| | - Jia Qu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Fan Lu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Jiawei Zhou
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Robert F Hess
- McGill Vision Research, Department of Ophthalmology, McGill University, Montreal, QC, Canada
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12
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Wang Y, He Z, Liang Y, Chen Y, Gong L, Mao Y, Chen X, Yao Z, Spiegel DP, Qu J, Lu F, Zhou J, Hess RF. The Binocular Balance at High Spatial Frequencies as Revealed by the Binocular Orientation Combination Task. Front Hum Neurosci 2019; 13:106. [PMID: 31001096 PMCID: PMC6454030 DOI: 10.3389/fnhum.2019.00106] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 03/11/2019] [Indexed: 11/13/2022] Open
Abstract
How to precisely quantify the binocular eye balance (i.e., the contribution that each eye makes to the binocular percept) across a range of spatial frequencies using a binocular combination task, is an important issue in both clinical and basic research. In this study, we aimed to compare the precision of a binocular orientation combination paradigm with that of the standard binocular phase combination paradigm in measuring the binocular eye balance at low to high spatial frequencies. Nine normal adults (average age: 24.6 ± 2.0 years old) participated. Subjects viewed an LED screen dichoptically with polarized glasses in a dark room. The method of constant stimuli was used to quantitatively assess the point of subjective equality (PSE), i.e., the interocular contrast ratio when two eyes are balanced in binocular combination, for stimulus spatial frequencies from 0.5 to 8 cycles/degree. Precision was quantified by the variance [i.e., standard error (SE), obtained from 100 bootstrap estimates] associated to the PSE. Using stimuli whose interocular phase difference at the edge of the gratings was matched at 45°, we found that the orientation paradigm provides more precision than the standard binocular phase combination paradigm, especially at high frequencies (Experiment 1). Such differences remained when using stimuli that had three times larger interocular phase difference (Experiment 2) or displayed at four times higher stimuli resolution (Experiment 3). Our results indicate that a binocular combination tasked based on orientation rather than phase, provides a more precise estimate of binocular eye balance in human adults at high spatial frequencies, thus allowing a binocular balance to be assessed within the spatial region where amblyopes are most defective (i.e., high spatial frequencies).
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Affiliation(s)
- Yonghua Wang
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of Ophthalmology and Optometry and Eye hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Zhifen He
- School of Ophthalmology and Optometry and Eye hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Yunjie Liang
- School of Ophthalmology and Optometry and Eye hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Yiya Chen
- School of Ophthalmology and Optometry and Eye hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Ling Gong
- School of Ophthalmology and Optometry and Eye hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Yu Mao
- School of Ophthalmology and Optometry and Eye hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Xiaoxin Chen
- School of Ophthalmology and Optometry and Eye hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Zhimo Yao
- School of Ophthalmology and Optometry and Eye hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Daniel P Spiegel
- Vision Sciences, Essilor R&D, Center for Innovation and Technology, Singapore, Singapore
| | - Jia Qu
- School of Ophthalmology and Optometry and Eye hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Fan Lu
- School of Ophthalmology and Optometry and Eye hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Jiawei Zhou
- School of Ophthalmology and Optometry and Eye hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, China
| | - Robert F Hess
- McGill Vision Research, Department of Ophthalmology, McGill University, Montreal, QC, Canada
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13
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Schmidtmann G, Ruiz T, Reynaud A, Spiegel DP, Laguë-Beauvais M, Hess RF, Farivar R. Sensitivity to Binocular Disparity is Reduced by Mild Traumatic Brain Injury. Invest Ophthalmol Vis Sci 2017; 58:2630-2635. [PMID: 28494496 DOI: 10.1167/iovs.17-21845] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The impairment of visual functions is one of the most common complaints following mild traumatic brain injury (mTBI). Traumatic brain injury-associated visual deficits include blurred vision, reading problems, and eye strain. In addition, previous studies have found evidence that TBI can diminish early cortical visual processing, particularly for second-order stimuli. We investigated whether cortical processing of binocular disparity is also affected by mTBI. Methods In order to investigate the influence of mTBI on global stereopsis, we measured the quick Disparity Sensitivity Function (qDSF) in 22 patients with mTBI. Patients with manifest strabismus and double vision were excluded. Compared with standard clinical tests, the qDSF is unique in that it offers a quick and accurate estimate of thresholds across the whole spatial frequency range. Results Results show that disparity sensitivity in the mTBI patients were significantly reduced compared with the normative dataset (n = 61). The peak spatial frequency was not affected. Conclusions Our results suggest that the reduced disparity sensitivity in patients with mTBI is more likely caused by cortical changes (e.g., axonal shearing, or reduced interhemispheric communication) rather than oculomotor dysfunction.
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Affiliation(s)
- Gunnar Schmidtmann
- Traumatic Brain Injury Program, The Research Institute of the McGill University Health Centre, Montreal, Canada 2McGill Vision Research Unit, Department of Ophthalmology, McGill University, Montreal, Canada
| | - Tatiana Ruiz
- Traumatic Brain Injury Program, The Research Institute of the McGill University Health Centre, Montreal, Canada 2McGill Vision Research Unit, Department of Ophthalmology, McGill University, Montreal, Canada
| | - Alexandre Reynaud
- McGill Vision Research Unit, Department of Ophthalmology, McGill University, Montreal, Canada
| | - Daniel P Spiegel
- Traumatic Brain Injury Program, The Research Institute of the McGill University Health Centre, Montreal, Canada 2McGill Vision Research Unit, Department of Ophthalmology, McGill University, Montreal, Canada
| | - Maude Laguë-Beauvais
- Traumatic Brain Injury Program, The Research Institute of the McGill University Health Centre, Montreal, Canada 3Department of Neurology and Neurosurgery, McGill University, Montréal, Canada
| | - Robert F Hess
- McGill Vision Research Unit, Department of Ophthalmology, McGill University, Montreal, Canada
| | - Reza Farivar
- Traumatic Brain Injury Program, The Research Institute of the McGill University Health Centre, Montreal, Canada 2McGill Vision Research Unit, Department of Ophthalmology, McGill University, Montreal, Canada
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14
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Spiegel DP, Baldwin AS, Hess RF. The Relationship Between Fusion, Suppression, and Diplopia in Normal and Amblyopic Vision. Invest Ophthalmol Vis Sci 2017; 57:5810-5817. [PMID: 27802486 DOI: 10.1167/iovs.16-20438] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Single vision occurs through a combination of fusion and suppression. When neither mechanism takes place, we experience diplopia. Under normal viewing conditions, the perceptual state depends on the spatial scale and interocular disparity. The purpose of this study was to examine the three perceptual states in human participants with normal and amblyopic vision. Methods Participants viewed two dichoptically separated horizontal blurred edges with an opposite tilt (2.35°) and indicated their binocular percept: "one flat edge," "one tilted edge," or "two edges." The edges varied with scale (fine 4 min arc and coarse 32 min arc), disparity, and interocular contrast. We investigated how the binocular interactions vary in amblyopic (visual acuity [VA] > 0.2 logMAR, n = 4) and normal vision (VA ≤ 0 logMAR, n = 4) under interocular variations in stimulus contrast and luminance. Results In amblyopia, despite the established sensory dominance of the fellow eye, fusion prevails at the coarse scale and small disparities (75%). We also show that increasing the relative contrast to the amblyopic eye enhances the probability of fusion at the fine scale (from 18% to 38%), and leads to a reversal of the sensory dominance at coarse scale. In normal vision we found that interocular luminance imbalances disturbed binocular combination only at the fine scale in a way similar to that seen in amblyopia. Conclusions Our results build upon the growing evidence that the amblyopic visual system is binocular and further show that the suppressive mechanisms rendering the amblyopic system functionally monocular are scale dependent.
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Affiliation(s)
- Daniel P Spiegel
- McGill Vision Research Unit, Department of Ophthalmology, McGill University, Montréal, Québec, Canada 2Traumatic Brain Injury Program, The Research Institute of the McGill University Health Center, Montréal, Québec, Canada
| | - Alex S Baldwin
- McGill Vision Research Unit, Department of Ophthalmology, McGill University, Montréal, Québec, Canada
| | - Robert F Hess
- McGill Vision Research Unit, Department of Ophthalmology, McGill University, Montréal, Québec, Canada
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15
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Li J, Spiegel DP, Hess RF, Chen Z, Chan LYL, Deng D, Yu M, Thompson B. Dichoptic training improves contrast sensitivity in adults with amblyopia. Vision Res 2015; 114:161-72. [PMID: 25676883 DOI: 10.1016/j.visres.2015.01.017] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 01/18/2015] [Accepted: 01/24/2015] [Indexed: 11/27/2022]
Abstract
Dichoptic training is designed to promote binocular vision in patients with amblyopia. Initial studies have found that the training effects transfer to both binocular (stereopsis) and monocular (recognition acuity) visual functions. The aim of this study was to assess whether dichoptic training effects also transfer to contrast sensitivity (CS) in adults with amblyopia. We analyzed CS data from 30 adults who had taken part in one of two previous dichoptic training studies and assessed whether the changes in CS exceeded the 95% confidence intervals for change based on test-retest data from a separate group of observers with amblyopia. CS was measured using Gabor patches (0.5, 3 and 10cpd) before and after 10days of dichoptic training. Training was delivered using a dichoptic video game viewed through video goggles (n=15) or on an iPod touch equipped with a lenticular overlay screen (n=15). In the iPod touch study, training was combined with anodal transcranial direct current stimulation of the visual cortex. We found that dichoptic training significantly improved CS across all spatial frequencies tested for both groups. These results suggest that dichoptic training modifies the sensitivity of the neural systems that underpin monocular CS.
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Affiliation(s)
- Jinrong Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Daniel P Spiegel
- Department of Optometry and Vision Science, Faculty of Science, The University of Auckland, New Zealand; McGill Vision Research, McGill University, Canada
| | | | - Zidong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Lily Y L Chan
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region
| | - Daming Deng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Minbin Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
| | - Benjamin Thompson
- Department of Optometry and Vision Science, Faculty of Science, The University of Auckland, New Zealand; School of Optometry and Vision Science, University of Waterloo, Canada.
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16
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Spiegel DP, Li J, Hess RF, Byblow WD, Deng D, Yu M, Thompson B. Transcranial direct current stimulation enhances recovery of stereopsis in adults with amblyopia. Neurotherapeutics 2013; 10:831-9. [PMID: 23857313 PMCID: PMC3805870 DOI: 10.1007/s13311-013-0200-y] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Amblyopia is a neurodevelopmental disorder of vision caused by abnormal visual experience during early childhood that is often considered to be untreatable in adulthood. Recently, it has been shown that a novel dichoptic videogame-based treatment for amblyopia can improve visual function in adult patients, at least in part, by reducing inhibition of inputs from the amblyopic eye to the visual cortex. Non-invasive anodal transcranial direct current stimulation has been shown to reduce the activity of inhibitory cortical interneurons when applied to the primary motor or visual cortex. In this double-blind, sham-controlled cross-over study we tested the hypothesis that anodal transcranial direct current stimulation of the visual cortex would enhance the therapeutic effects of dichoptic videogame-based treatment. A homogeneous group of 16 young adults (mean age 22.1 ± 1.1 years) with amblyopia were studied to compare the effect of dichoptic treatment alone and dichoptic treatment combined with visual cortex direct current stimulation on measures of binocular (stereopsis) and monocular (visual acuity) visual function. The combined treatment led to greater improvements in stereoacuity than dichoptic treatment alone, indicating that direct current stimulation of the visual cortex boosts the efficacy of dichoptic videogame-based treatment. This intervention warrants further evaluation as a novel therapeutic approach for adults with amblyopia.
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Affiliation(s)
- Daniel P. Spiegel
- />State Key Laboratory of Ophthalmology, Zhongshan, Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060 China
- />Department of Optometry and Vision Science, The University of Auckland, Auckland, 1142 New Zealand
- />Centre for Brain Research, The University of Auckland, Auckland, 1142 New Zealand
| | - Jinrong Li
- />State Key Laboratory of Ophthalmology, Zhongshan, Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060 China
| | - Robert F. Hess
- />Department of Ophthalmology, McGill University, Montreal, QC Canada
| | - Winston D. Byblow
- />Centre for Brain Research, The University of Auckland, Auckland, 1142 New Zealand
- />Department of Sport & Exercise Science, The University of Auckland, Auckland, 1142 New Zealand
| | - Daming Deng
- />State Key Laboratory of Ophthalmology, Zhongshan, Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060 China
| | - Minbin Yu
- />State Key Laboratory of Ophthalmology, Zhongshan, Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060 China
| | - Benjamin Thompson
- />Department of Optometry and Vision Science, The University of Auckland, Auckland, 1142 New Zealand
- />Centre for Brain Research, The University of Auckland, Auckland, 1142 New Zealand
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17
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Spiegel DP, Byblow WD, Hess RF, Thompson B. Anodal Transcranial Direct Current Stimulation Transiently Improves Contrast Sensitivity and Normalizes Visual Cortex Activation in Individuals With Amblyopia. Neurorehabil Neural Repair 2013; 27:760-9. [DOI: 10.1177/1545968313491006] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background. Amblyopia is a neurodevelopmental disorder of vision that is associated with abnormal patterns of neural inhibition within the visual cortex. This disorder is often considered to be untreatable in adulthood because of insufficient visual cortex plasticity. There is increasing evidence that interventions that target inhibitory interactions within the visual cortex, including certain types of noninvasive brain stimulation, can improve visual function in adults with amblyopia. Objective. We tested the hypothesis that anodal transcranial direct current stimulation (a-tDCS) would improve visual function in adults with amblyopia by enhancing the neural response to inputs from the amblyopic eye. Methods. Thirteen adults with amblyopia participated and contrast sensitivity in the amblyopic and fellow fixing eye was assessed before, during and after a-tDCS or cathodal tDCS (c-tDCS). Five participants also completed a functional magnetic resonance imaging (fMRI) study designed to investigate the effect of a-tDCS on the blood oxygen level–dependent response within the visual cortex to inputs from the amblyopic versus the fellow fixing eye. Results. A subgroup of 8/13 participants showed a transient improvement in amblyopic eye contrast sensitivity for at least 30 minutes after a-tDCS. fMRI measurements indicated that the characteristic cortical response asymmetry in amblyopes, which favors the fellow eye, was reduced by a-tDCS. Conclusions. These preliminary results suggest that a-tDCS deserves further investigation as a potential tool to enhance amblyopia treatment outcomes in adults.
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Spiegel DP, Hansen BC, Byblow WD, Thompson B. Anodal transcranial direct current stimulation reduces psychophysically measured surround suppression in the human visual cortex. PLoS One 2012; 7:e36220. [PMID: 22563485 PMCID: PMC3341359 DOI: 10.1371/journal.pone.0036220] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Accepted: 03/30/2012] [Indexed: 02/01/2023] Open
Abstract
Transcranial direct current stimulation (tDCS) is a safe, non-invasive technique for transiently modulating the balance of excitation and inhibition within the human brain. It has been reported that anodal tDCS can reduce both GABA mediated inhibition and GABA concentration within the human motor cortex. As GABA mediated inhibition is thought to be a key modulator of plasticity within the adult brain, these findings have broad implications for the future use of tDCS. It is important, therefore, to establish whether tDCS can exert similar effects within non-motor brain areas. The aim of this study was to assess whether anodal tDCS could reduce inhibitory interactions within the human visual cortex. Psychophysical measures of surround suppression were used as an index of inhibition within V1. Overlay suppression, which is thought to originate within the lateral geniculate nucleus (LGN), was also measured as a control. Anodal stimulation of the occipital poles significantly reduced psychophysical surround suppression, but had no effect on overlay suppression. This effect was specific to anodal stimulation as cathodal stimulation had no effect on either measure. These psychophysical results provide the first evidence for tDCS-induced reductions of intracortical inhibition within the human visual cortex.
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Affiliation(s)
- Daniel P. Spiegel
- Department of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Bruce C. Hansen
- Department of Psychology & Neuroscience Program, Colgate University, Hamilton, New York, United States of America
| | - Winston D. Byblow
- Department of Sport and Exercise Science, University of Auckland, Auckland, New Zealand
| | - Benjamin Thompson
- Department of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
- * E-mail:
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