Ultrasound Assessment of Gaze-induced Posterior Eyewall Deformation in Highly Myopic Eyes

Purpose

To establish a quantitative metric of posterior eyewall deformability in different directions of gaze in highly myopic eyes with and without posterior staphyloma.

Methods

A prospective study was performed on 53 highly myopic patients (106 eyes). Ultrasound scans were acquired in primary, up, downward, nasal, and temporal gazes. A validated intensity-based segmentation algorithm was used to quantify the posterior eyewall geometry on digitalized B-scan images. Posterior eyewall local curvature (K) and distance (L) to the transducer were calculated. The associations between directions of gaze, axial length (AL), and presence of staphyloma with the K and L parameters were assessed.

Results

A total of 53 participants (106 eyes) were studied. Multivariate regression analysis demonstrated that, after accounting for longer AL, and presence of staphyloma, eccentric gaze was often independently associated with various K and L parameters. Specifically, downward gaze was associated with increased posterior eyewall concavity as reflected in the maximum of K (KMax) (β = 0.050, P < 0.001) and absolute value of KMax (β = 0.041, P = 0.011). Both downward gaze and upgaze were independently associated with increase in the derivative of absolute KMax (which is consistent with more apparent, steeper staphyloma ridges), local KMax (which detects KMax at smaller intervals), and Kstd (which represents likelihood of staphyloma presence) and decrease in maximum of L (which represents movement of the staphyloma apex) with all P < 0.05. The β coefficients for downward gaze were consistently greater in magnitude compared with those in upgaze. After accounting for AL and presence of staphyloma, horizontal gazes were independently associated only with decrease in the standard deviation of L (which also represents likelihood of staphyloma presence) and maximum of L.

Conclusions

Downward gaze results in a significant increase in posterior eyewall concavity in highly myopic eyes after accounting for AL and staphyloma presence. In comparison with downward gaze, upgaze resulted in a lower magnitude, but significant changes in staphyloma ridge steepness and the likelihood of staphyloma presence. Horizontal gazes seemed to be associated with less posterior eyewall geometric parameters. Studies are required to further assess the association between downward gaze during near work on posterior eyewall concavity and possible effects on myopia development and progression.

Lighting a Path for Autonomous Vehicle Communication: The Effect of Light Projection on the Detection of Reversing Vehicles by Older Adult Pedestrians

Pedestrian understanding of driver intent is key to pedestrian safety on the road and in parking lots. With the development of autonomous vehicles (AVs), the human driver will be removed, and with it, the exchange that occurs between drivers and pedestrians (e.g., head nods, hand gestures). One possible solution for augmenting that communication is an array of high-intensity light-emitting diodes (LEDs) to project vehicle-to-pedestrian (V2P) messages on the ground plane behind a reversing vehicle. This would be particularly beneficial to elderly pedestrians, who are at particular risk of being struck by reversing cars in parking lots. Their downward gaze and slower reaction time make them particularly vulnerable. A survey was conducted to generate designs, and a simulator experiment was conducted to measure detection and reaction times. The study found that elderly pedestrians are significantly more likely to detect an additional projected message on the ground than detect the existing brake light alone when walking in a parking lot.