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Kulmaganbetov M, Leung M, Alsweiler JM, Black J, Bloomfield FH, Gamble GD, Harding JE, Jiang Y, Poppe T, Tottman AC, Wouldes TA, Thompson B. Associations between neonatal nutrition and visual outcomes in 7-year-old children born very preterm. Ophthalmic Physiol Opt 2024; 44:347-355. [PMID: 38069619 DOI: 10.1111/opo.13260] [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: 05/25/2023] [Revised: 11/10/2023] [Accepted: 11/25/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE There is uncertainty about the effect of increased neonatal protein intake on neurodevelopmental outcomes following preterm birth. The aim of this study was to assess the effect of a change in neonatal nutrition protocol at a major tertiary neonatal intensive care unit intended to increase protein intake on ophthalmic and visual development in school-age children born very preterm. METHODS The study cohort comprised children (n = 128) with birthweight <1500 g or gestational age < 30 weeks born at Auckland City Hospital before (OldPro group, n = 55) and after (NewPro group, n = 73) a reformulation of parenteral nutrition that resulted in increased total protein intake during the first postnatal week and decreased carbohydrate, total parenteral fluid and sodium intake. Clinical and psychophysical vision assessments were completed at 7 years' corrected age, including visual acuity, global motion perception (a measure of dorsal stream function), stereoacuity, ocular motility and ocular health. Composite measures of favourable overall visual, binocular and functional visual outcomes along with individual vision measures were compared between the groups using logistic and linear regression models. RESULTS Favourable overall visual outcome did not differ between the two groups. However, global motion perception was better in the NewPro group (p = 0.04), whereas the OldPro group were more likely to have favourable binocular visual outcomes (60% vs. 36%, p = 0.02) and passing stereoacuity (p = 0.02). CONCLUSIONS These results indicate subtle but complex associations between early neonatal nutrition after very preterm birth and visual development at school age.
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Affiliation(s)
- Mukhit Kulmaganbetov
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong, Hong Kong
- Kazakh Eye Research Institute, Almaty, Kazakhstan
| | - Myra Leung
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
- Discipline of Optometry and Vision Science, University of Canberra, Canberra, Australian Capital Territory, Australia
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Jane M Alsweiler
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
- Newborn Services, National Women's Health, Auckland City Hospital, Auckland, New Zealand
| | - Joanna Black
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | | | - Greg D Gamble
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Jane E Harding
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Yannan Jiang
- Department of Statistics, Faculty of Science, University of Auckland, Auckland, New Zealand
| | - Tanya Poppe
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Anna C Tottman
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Trecia A Wouldes
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Benjamin Thompson
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong, Hong Kong
- Liggins Institute, University of Auckland, Auckland, New Zealand
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
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Kapahi C, Silva AE, Cory DG, Kulmaganbetov M, Mungalsingh MA, Pushin DA, Singh T, Thompson B, Sarenac D. Measuring the visual angle of polarization-related entoptic phenomena using structured light. Biomed Opt Express 2024; 15:1278-1287. [PMID: 38404299 PMCID: PMC10890886 DOI: 10.1364/boe.507519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 02/27/2024]
Abstract
The ability to perceive polarization-related entoptic phenomena arises from the dichroism of macular pigments held in Henle's fiber layer of the retina and can be inhibited by retinal diseases, such as age-related macular degeneration, which alters the structure of the macula. Structured light tools enable the direct probing of macular pigment density and retinal structure through the perception of polarization-dependent entoptic patterns. Here, we directly measure the visual angle of an entoptic pattern created through the illumination of the retina with a structured state of light and a perception task that is insensitive to corneal birefringence. The central region of the structured light stimuli was obstructed, with the size of the obstruction varying according to a psychophysical staircase. Two stimuli, one producing 11 azimuthal fringes and the other three azimuthal fringes, were presented to 24 healthy participants. The pattern with 11 azimuthal fringes produced an average visual angle threshold of 10° ± 1° and a 95% confidence interval (C.I.) of [6°, 14°]. For the pattern with three azimuthal fringes, a threshold extent of 3.6° ± 0.3° C.I. = [1.3°, 5.8°] was measured, a value similar to the published extent of Haidinger's brush (4°). The increase in apparent size and clarity of entoptic phenomena produced by the presented structured light stimuli offers the potential to detect the early signs of macular disease over perception tasks using uniform polarization stimuli.
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Affiliation(s)
- C Kapahi
- Institute for Quantum Computing, University of Waterloo, Waterloo, ON, N2L3G1, Canada
- Department of Physics, University of Waterloo, Waterloo, ON, N2L3G1, Canada
| | - A E Silva
- School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, N2L3G1, Canada
| | - D G Cory
- Institute for Quantum Computing, University of Waterloo, Waterloo, ON, N2L3G1, Canada
- Department of Chemistry, University of Waterloo, Waterloo, ON, N2L3G1, Canada
| | | | - M A Mungalsingh
- School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, N2L3G1, Canada
| | - D A Pushin
- Institute for Quantum Computing, University of Waterloo, Waterloo, ON, N2L3G1, Canada
- Department of Physics, University of Waterloo, Waterloo, ON, N2L3G1, Canada
- Centre for Eye and Vision Research, Hong Kong, SAR, China
| | - T Singh
- Centre for Eye and Vision Research, Hong Kong, SAR, China
| | - B Thompson
- School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, N2L3G1, Canada
- Centre for Eye and Vision Research, Hong Kong, SAR, China
| | - D Sarenac
- Institute for Quantum Computing, University of Waterloo, Waterloo, ON, N2L3G1, Canada
- Centre for Eye and Vision Research, Hong Kong, SAR, China
- Department of Physics, University at Buffalo, State University of New York, Buffalo, New York 14260, USA
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Pushin DA, Cory DG, Kapahi C, Kulmaganbetov M, Mungalsingh M, Silva AE, Singh T, Thompson B, Sarenac D. Structured light enhanced entoptic stimuli for vision science applications. Front Neurosci 2023; 17:1232532. [PMID: 37559704 PMCID: PMC10407105 DOI: 10.3389/fnins.2023.1232532] [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: 05/31/2023] [Accepted: 07/11/2023] [Indexed: 08/11/2023] Open
Abstract
The dichroic macular pigment in the Henle fiber layer in the fovea enables humans to perceive entoptic phenomena when viewing polarized blue light. In the standard case of linearly polarized stimuli, a faint bowtie-like pattern known as the Haidinger's brush appears in the central point of fixation. As the shape and clarity of the perceived signal is directly related to the health of the macula, Haidinger's brush has been used as a diagnostic marker in studies of early stage macular degeneration and central field visual dysfunction. However, due to the weak nature of the perceived signal the perception of the Haidinger's brush has not been integrated with modern clinical methods. Recent attempts have been made to increase the strength of the perceived signal by employing structured light with spatially varying polarization profiles. Here we review the advancements with the structured light stimuli and describe the current challenges and future prospects.
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Affiliation(s)
- Dmitry A. Pushin
- Department of Physics, University of Waterloo, Waterloo, ON, Canada
- Centre for Eye and Vision Research, Hong Kong, Hong Kong SAR, China
- Institute for Quantum Computing, University of Waterloo, Waterloo, ON, Canada
| | - David G. Cory
- Institute for Quantum Computing, University of Waterloo, Waterloo, ON, Canada
- Department of Chemistry, University of Waterloo, Waterloo, ON, Canada
| | - Connor Kapahi
- Department of Physics, University of Waterloo, Waterloo, ON, Canada
- Institute for Quantum Computing, University of Waterloo, Waterloo, ON, Canada
| | | | - Melanie Mungalsingh
- School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada
| | - Andrew E. Silva
- School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada
| | - Taranjit Singh
- Centre for Eye and Vision Research, Hong Kong, Hong Kong SAR, China
| | - Benjamin Thompson
- Centre for Eye and Vision Research, Hong Kong, Hong Kong SAR, China
- School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada
| | - Dusan Sarenac
- Centre for Eye and Vision Research, Hong Kong, Hong Kong SAR, China
- Institute for Quantum Computing, University of Waterloo, Waterloo, ON, Canada
- Department of Physics, University at Buffalo, State University of New York, Buffalo, NY, United States
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