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Thakur S, Maldoddi R, Vangipuram M, Kalivemula M, Ch SNSH, Karthikesh A, Verkicharla PK. Peripheral Refraction Using Ancillary Retinoscope Component (P-ARC). Transl Vis Sci Technol 2024; 13:7. [PMID: 38568607 PMCID: PMC10996980 DOI: 10.1167/tvst.13.4.7] [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: 08/22/2023] [Accepted: 02/19/2024] [Indexed: 04/05/2024] Open
Abstract
Purpose To assess the agreement of retinoscope-based peripheral refraction techniques with the criterion standard open-field autorefractor. Methods Fifty young adults (mean age, 24 ± 3 years) participated in this study. Two masked, experienced senior examiners carried out central refraction and peripheral refraction at the temporal 22° (T22°) and nasal 22° (N22°) eccentricities. Peripheral refraction techniques were (a) peripheral refraction using ancillary retinoscope component (P-ARC), (b) retinoscopy with eye rotation, and (c) open-field autorefractor. Peripheral refraction with retinoscopy values was compared with an open-field autorefractor (Shinn Nippon NVision-K) to assess the agreement. All measurements were taken from the right eye under noncycloplegic conditions. Results The mean difference ±95% limits of agreement of peripheral refraction values obtained using P-ARC from T22° (+0.11 diopters [D] ± 1.20 D; P = 0.20) or N22° (+0.13 D ± 1.16 D; P = 0.13) were comparable with open-field autorefractor. The eye rotation technique compared to autorefractor showed a significant difference for T22° (+0.30 D ± 1.26 D; P = 0.002); however, there was an agreement for N22° (+0.14 D ± 1.16 D; P = 0.10). With respect to the identification of peripheral refraction patterns, examiners were able to identify relative peripheral hyperopia in most of the participants (77%). Conclusions Peripheral refraction with P-ARC was comparable with open-field autorefractor at T22° and N22° eccentricities. Peripheral retinoscopy techniques can be another approache for estimating and identifying peripheral refraction and its patterns in a regular clinical setting. Translational Relevance Retinoscope with P-ARC has high potential to guide and enable eye care practitioners to perform peripheral refraction and identify peripheral refraction patterns for effective myopia management.
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Affiliation(s)
- Swapnil Thakur
- Myopia Research Lab - Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, LV Prasad Eye Institute, Hyderabad, India
| | - Rakesh Maldoddi
- Myopia Research Lab - Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, LV Prasad Eye Institute, Hyderabad, India
| | - Manogna Vangipuram
- Center for Technology Innovation, LV Prasad Eye Institute, Hyderabad, India
| | - Manasa Kalivemula
- Center for Technology Innovation, LV Prasad Eye Institute, Hyderabad, India
| | | | - Anche Karthikesh
- Center for Technology Innovation, LV Prasad Eye Institute, Hyderabad, India
| | - Pavan K Verkicharla
- Myopia Research Lab - Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, LV Prasad Eye Institute, Hyderabad, India
- Infor Myopia Centre (prevention & control), LV Prasad Eye Institute, Hyderabad, India
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Chen X, Li M, Li J, Wu M, Liu X, Yu C, Guo X, Wang Y, Wang Y, Lu W, Li L, Wang Y. One-year efficacy of myopia control by the defocus distributed multipoint lens: a multicentric randomised controlled trial. Br J Ophthalmol 2024:bjo-2023-324243. [PMID: 38503477 DOI: 10.1136/bjo-2023-324243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 02/29/2024] [Indexed: 03/21/2024]
Abstract
AIMS To report the 1-year results of the efficacy of a defocus distributed multipoint (DDM) lens in controlling myopia progression in a multicentre, randomised controlled trial. METHODS Overall, 168 children aged 6-13 years were recruited and randomly assigned to wear a DDM lens (n=84) or single-vision (SV) lens (n=84) in three centres. Cycloplegic autorefraction (spherical equivalent refraction (SER)) and axial length (AL) were measured. Linear mixed model analysis was performed to compare between-group SER and AL changes. Logistic regression analysis was used to analyse the between-group difference in rapid myopia progression (SER increase≥0.75 D per year or AL growth≥0.40 mm per year). RESULTS After 1 year, mean changes in SER were significantly lower in the DDM group (-0.47±0.37 D) than in the SV group (-0.71±0.42 D) (p<0.001). Similarly, mean changes in AL were significantly lower in the DDM group (0.21±0.17 mm) than in the SV group (0.34±0.16 mm) (p<0.001). After adjusting for age, sex, daily wearing time and parental myopia, rapid myopia progression risk was higher in the SV group than in the DDM group (OR=3.51, 95% CI: 1.77 to 6.99), especially for children who wore a lens for >12 hours per day, boys and younger children (6-9 years) with ORs (95% CIs) of 10.82 (3.22 to 36.37), 5.34 (1.93 to 14.78) and 8.73 (2.6 to 29.33), respectively. CONCLUSIONS After 1 year, DDM lenses effectively retarded myopia progression in children. Longer daily wearing time of DDM lens improved the efficacy of myopia control. Future long-term studies are needed for validation. TRIAL REGISTRATION NUMBER NCT05340699.
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Affiliation(s)
- Xiaoqin Chen
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Nankai University affiliated Eye Institute, Tianjin, China
- Tianjin Eye Hospital Optometric Center, Tianjin, China
| | - Mengdi Li
- Tianjin Eye Hospital Optometric Center, Tianjin, China
| | - Jun Li
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Eye Hospital Optometric Center, Tianjin, China
| | - Min Wu
- Tongren Eye Care Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | | | - Cui Yu
- He Eye Specialist Hospital, Shenyang, China
| | - Xingyi Guo
- Tianjin Eye Hospital Optometric Center, Tianjin, China
| | - Yanbo Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | | | - Wenli Lu
- Department of Epidemiology and Health Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Lihua Li
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Nankai University affiliated Eye Institute, Tianjin, China
- Tianjin Eye Hospital Optometric Center, Tianjin, China
| | - Yan Wang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Nankai University affiliated Eye Institute, Tianjin, China
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Perdziak M, Prymula K, Przekoracka-Krawczyk A. Utility of retinoscopy to examine peripheral refraction. JOURNAL OF OPTOMETRY 2023; 17:100505. [PMID: 38128435 PMCID: PMC10777112 DOI: 10.1016/j.optom.2023.100505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/09/2023] [Accepted: 11/04/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE This study explored whether retinoscopy (RET) provides comparable results of relative peripheral refraction (RPR) to open-field autorefractometry (AR) in myopic subjects. METHODS Peripheral refraction was measured in 20 myopic and 20 control adult subjects. Both central and peripheral refraction (20° nasal and temporal eccentricity) were measured using RET and open-field AR. Differences in the median central spherical equivalent (SE), median RPR, and median J45/J180 power vectors between the RET and AR techniques were analyzed. Moreover, Bland - Altman plots were used to assess the agreement between RET and AR methods for RPR measurements in MG. RESULTS For MG, the median RPR values were positive (hyperopic shift), and no significant differences were observed between the RET and AR techniques with respect to RPR measurement. In addition, we did not observe any significant differences in the RPR values between the nasal and temporal eccentricities for either the RET or AR technique for myopic subjects. There was also a significant correlation and agreement between the RET and AR technique for RPR measurements. With respect to central refraction, the median SE was slightly more positive for the RET than for the AR technique. Inside the CG, we also found significant correlation between the RET and AR technique for RPR measurements, and we observed a myopic shift in peripheral eccentricities. CONCLUSION Our results show that retinoscopy may be a useful tool for objective measurements of RPR in myopic subjects and may be used interchangeably with the open-field AR method in everyday clinical practice.
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Affiliation(s)
- Maciej Perdziak
- Department of Optometry, Chair of Ophthalmology and Optometry, Poznan University of Medical Sciences, Poznan, Poland.
| | - Krystian Prymula
- Laboratory of Vision Science, Faculty of Physics, Adam Mickiewicz University, Poznan, Poland
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Noya-Padin V, Nores-Palmas N, Giraldez MJ, Yebra-Pimentel E, Pena-Verdeal H. Comparison Between Ocular Biometric Parameters and Intraocular Pressure With and Without Contact Lenses. Eye Contact Lens 2023; 49:464-470. [PMID: 37713633 DOI: 10.1097/icl.0000000000001030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVES To compare the values of central corneal thickness, anterior chamber depth (ACD), lens thickness (LT), vitreous length (VL), axial length (AL), and corneal-compensated intraocular pressure performed with and without contact lenses (CL). METHODS Forty volunteer participants (16 men and 24 women, 24.2±2.9 years) were recruited. In a single visit, participants underwent autorefraction, keratometry, biometry, topography, pachymetry, and tonometry with the naked eye (without CL). Then, biometry, pachymetry, and tonometry were repeated twice wearing two CL (somofilcon A and nesofilcon A) fitted in a random order. RESULTS Many of the ocular biometric values were affected by the use of CL during measurements (paired t test; all P ≤0.003), except for LT and VL (Wilcoxon test; both P ≥0.272). Corneal-compensated intraocular pressure was also affected by contact lens wear during measurements, obtaining lower values when wearing them (Wilcoxon test; all P ≤0.001). CONCLUSIONS Central corneal thickness, ACD, AL, and corneal-compensated intraocular pressure measurements cannot be performed while wearing CL. However, LT and VL measurements were not affected by any contact lens use. In addition, it was observed that ACD results from both devices are not interchangeable either when measured with the naked eye or using any contact lens.
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Affiliation(s)
- Veronica Noya-Padin
- Applied Physics Department (Optometry Area) (V.N.-P., N.N.-P., M.J.G., E.Y.-P., H.P.-V.), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela; and Optometry Group (M.J.G., E.Y.-P., H.P.-V.), Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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Ramírez-Ortiz MA, Amato-Almanza M, Romero-Bautista I, Klunder-Klunder M, Aguirre-Luna O, Kuzhda I, Resnikoff S, Eckert KA, Lansingh VC. A large-scale analysis of refractive errors in students attending public primary schools in Mexico. Sci Rep 2023; 13:13509. [PMID: 37598286 PMCID: PMC10439951 DOI: 10.1038/s41598-023-40810-5] [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: 04/13/2023] [Accepted: 08/16/2023] [Indexed: 08/21/2023] Open
Abstract
A cross-sectional, retrospective study was conducted from September 2013 through July 2014 to determine the prevalence of refractive errors among students attending public primary schools in Mexico. Among 3,861,156 students at 14,566 public primary schools in all 32 states of Mexico, teachers identified reduced visual acuity in 1,253,589 (32.5%) using visual acuity measurement. Optometrists confirmed 391,498 [31.2%, mean (SD) age: 8.8 (1.9) years; 204,110 girls (52.9%)] had refractive errors using visual acuity measurement and noncycloplegic static retinoscopy. Among 288,537 (72.4%) of children with previous eyeglasses usage data reported, 241,505 (83.7%) had uncorrected refractive errors. Before prescription eyeglasses were provided, 281,891 students (72%) had logMAR visual acuity ≤ 0.2; eyeglasses corrected vision loss in 85.6% (n = 241,352) of them. Simple myopic astigmatism was the most frequent refractive error (25.7%, n = 100,545). Astigmatism > - 1.00 diopters was present in 54.6% of all students with ametropia. The anisometropia rate based on spherical equivalent difference between right and left eye ≥ 1.50 diopters was 3.9% (n = 15,402). Uncorrected refractive errors are an important issue in primary school students in Mexico. An updated study is needed to analyze the evolving trends over the past decade.
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Affiliation(s)
| | - Mónica Amato-Almanza
- Ophthalmology Department, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | | | | | - Oswaldo Aguirre-Luna
- Ophthalmology Department, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Iryna Kuzhda
- Ophthalmology Department, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Serge Resnikoff
- Brien Holden Vision Institute, Sydney, NSW, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia
| | | | - Van Charles Lansingh
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
- HelpMeSee, New York, NY, USA.
- See Better to Learn Better Foundation, Mexico City, Mexico.
- Instituto Mexicano de Oftalmología, Av. Armando Birlain Shaffler S/N, Centro Sur, 76090, Santiago de Querétaro, QRO, Mexico.
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Noya-Padin V, Garcia-Queiruga J, Iacubitchii M, Giraldez MJ, Yebra-Pimentel E, Pena-Verdeal H. Lenstar LS900 vs EchoScan US-800: comparison between optical and ultrasound biometry with and without contact lenses and its relationship with other biometric parameters. Expert Rev Med Devices 2023. [PMID: 37402231 DOI: 10.1080/17434440.2023.2233410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/23/2023] [Accepted: 06/15/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND Due to the increasing use of contact lenses (CL) and the interest in ocular and body size relationships, this study aimed to compare measurements from two biometers (contact ultrasonic EchoScan US-800 and non-contact optical Lenstar LS900) with and without CL and to explore the relationship between ocular and body biometric parameters. DESIGN AND METHODS This cross-sectional study measured ocular biometry using two biometers along with their body height and right foot length in 50 participants. Differences between biometry data from the two devices were compared and correlations between ocular and body biometric values were analyzed. RESULTS All parameters showed interbiometric differences (p ≤ 0.030), except crystalline lens thickness during CL wear (p = 0.159). Comparing measurements with and without CL, differences were observed in axial length (p < 0.001), vitreous length measured by optical biometer (p = 0.016), and anterior chamber depth by ultrasonic biometer (p < 0.016). Lens thickness remained unaffected (p ≥ 0.190). Body height and foot length were correlated with anterior chamber depth, vitreous length, and axial length (p ≤ 0.019, r ≥ 0.330). Most biometric parameters were correlated among them using both devices (p ≤ 0.037, r ≥ 0.296). CONCLUSIONS These biometers are not interchangeable and CL affects measurements. Body height and foot length correlate with ocular dimensions, and most ocular biometric values correlate positively.
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Affiliation(s)
- Veronica Noya-Padin
- Departamento de Física Aplicada (Área de Optometría), Santiago de Compostela, Galicia, Spain
| | - Jacobo Garcia-Queiruga
- Departamento de Física Aplicada (Área de Optometría), Santiago de Compostela, Galicia, Spain
| | - Maria Iacubitchii
- Ophthalmology Department, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova
| | - Maria J Giraldez
- Departamento de Física Aplicada (Área de Optometría), Santiago de Compostela, Galicia, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Eva Yebra-Pimentel
- Departamento de Física Aplicada (Área de Optometría), Santiago de Compostela, Galicia, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Hugo Pena-Verdeal
- Departamento de Física Aplicada (Área de Optometría), Santiago de Compostela, Galicia, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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Gopalakrishnan A, Hussaindeen JR, Chaudhary R, Ramakrishnan B, Arunachalam S, Balakrishnan AC, Sri J S D, Sahoo M, S R, M V, S V, Narayanan A. Results of the School Children Ocular Biometry and Refractive Error Study in South India. Turk J Ophthalmol 2022; 52:412-420. [PMID: 36578223 PMCID: PMC9811226 DOI: 10.4274/tjo.galenos.2021.90008] [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] [Indexed: 12/29/2022] Open
Abstract
Objectives Axial length (AL) is an important contributor to refraction, and growth curves are gaining importance in the prediction of myopia. This study aimed to profile the distribution of ocular biometry parameters and to identify correlates of spherical equivalent refraction (SE) among school children in South India. Materials and Methods The School Children Ocular Biometry and Refractive Error study was conducted as part of a school screening program in southern India. The enrolled children underwent tests that included vison check, refraction, binocular vision assessment, and biometry measurements. Results The study included 1382 children whose mean (standard deviation [SD]) age was 10.18 (2.88) years (range: 5-16 years). The sample was divided into 4 groups (grades 1-2, grades 3-5, grades 6-9, and grade 10) based on significant differences in right AL (p<0.001). The mean (SD) AL (range: 20.33-27.27 mm) among the four groups was 22.50 (0.64) mm, 22.88 (0.69) mm, 23.30 (0.82) mm, and 23.58 (0.87) mm, respectively. The mean SE (range: +1.86 to -6.56 D) was 0.08 (0.65 D) in class 1 and decreased with increasing grade to -0.39 (1.20 D) in grade 10. There was a significant difference in all biometry parameters between boys and girls (p<0.001). Age, AL, and mean corneal curvature were the main predictors of SE. Conclusion This study provides a profile of ocular biometry parameters among school children in South India for comparison against profiles from other regions across the country. The study data will form a reference for future studies assessing myopia in this ethnicity.
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Affiliation(s)
- Aparna Gopalakrishnan
- *Srimathi Sundari Subramanian Department of Visual Psychophysics, Unit of Medical Research Foundation, Myopia Clinic, Chennai, India
| | - Jameel Rizwana Hussaindeen
- *Srimathi Sundari Subramanian Department of Visual Psychophysics, Unit of Medical Research Foundation, Myopia Clinic, Chennai, India,* Address for Correspondence: Srimathi Sundari Subramanian Department of Visual Psychophysics, Unit of Medical Research Foundation, Myopia Clinic, Chennai, India E-mail:
| | - Romans Chaudhary
- The Sankara Nethralaya Academy, Unit of Medical Research Foundation, Chennai, India
| | - Bhavatharini Ramakrishnan
- *Srimathi Sundari Subramanian Department of Visual Psychophysics, Unit of Medical Research Foundation, Myopia Clinic, Chennai, India
| | - Sushil Arunachalam
- *Srimathi Sundari Subramanian Department of Visual Psychophysics, Unit of Medical Research Foundation, Myopia Clinic, Chennai, India
| | | | - Deepika Sri J S
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
| | - Manaswini Sahoo
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
| | - Robin S
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
| | - Varsaharinya M
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
| | - Vishnupriya S
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
| | - Anuradha Narayanan
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
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Gehring AM, Haensel JX, Curtiss MK, Roberts TL. Validation of the PowerRef 3 for Measuring Accommodation: Comparison With the Grand Seiko WAM-5500A Autorefractor. Transl Vis Sci Technol 2022; 11:25. [PMID: 36255360 PMCID: PMC9587467 DOI: 10.1167/tvst.11.10.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/08/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose This validation study examines the PowerRef 3 as a method for measuring accommodation objectively. We assess agreement with refractive measurements obtained simultaneously by the Grand Seiko WAM-5500A autorefractor. Methods Refractive measurements were recorded simultaneously using the PowerRef 3 and WAM-5500A in 32 noncyclopleged participants aged 15 to 46 years. Accommodative states were recorded for 10 seconds at six accommodative demands (5 diopters [D], 4 D, 3 D, 2.5 D, 2 D, and 0 D) while participants fixated a high-contrast Maltese cross. WAM-5500A measurements were converted to power in the vertical meridian for comparison with PowerRef 3 data. Dioptric difference values were computed, and agreement was assessed using Bland-Altman plots with 95% limits of agreement (LOA) and intraclass correlation coefficient analyses. Results The mean absolute dioptric differences measured 0.14 D or less across accommodative demands. Analyses showed an excellent intraclass correlation coefficient across the tested demands (0.93). Bland-Altman plots indicated a bias of -0.02 D with 95% LOA of -1.03 D to 0.99 D. The 95% LOA was smallest for the 3 D demand (-0.71 D to 0.64 D), and largest at 5 D demand (-1.51 D to 1.30 D). Conclusions The mean dioptric differences between the PowerRef 3 and WAM-5500A autorefractor were small and not clinically significant. While some variability in agreement was observed depending on the tested demand, the PowerRef 3 demonstrated good agreement with the WAM-5500A. Translational Relevance The PowerRef 3 may be used to obtain objective measures of accommodation both monocularly and binocularly and provides a more flexible method, especially in pediatric populations.
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Affiliation(s)
| | - Jennifer X. Haensel
- Spencer Center for Vision Research, Byers Eye Institute at Stanford University, Palo Alto, CA, USA
| | - Molly K. Curtiss
- Children's Vision Center, Akron Children's Hospital, Akron, OH, USA
| | - Tawna L. Roberts
- Children's Vision Center, Akron Children's Hospital, Akron, OH, USA
- Spencer Center for Vision Research, Byers Eye Institute at Stanford University, Palo Alto, CA, USA
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High Prevalence of Astigmatism in Children after School Suspension during the COVID-19 Pandemic Is Associated with Axial Elongation. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9060919. [PMID: 35740857 PMCID: PMC9245603 DOI: 10.3390/children9060919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/08/2022] [Accepted: 06/16/2022] [Indexed: 11/17/2022]
Abstract
During the COVID-19 pandemic, the Hong Kong Government enforced a “school from home” policy between February and September 2020. This cross-sectional epidemiological study was conducted to investigate the prevalence of astigmatism and visual habits after the home confinement period. Vision screenings were conducted at three local government-funded primary schools in Hong Kong from October 2020 to December 2020. A total of 418 ethnically Chinese primary school children completed the eye examination and returned questionnaires concerning demographic information and visual habits. It was found that 46.5% (95% CI, 41.7−61.4%) of the children aged 8 to 11 years had astigmatism ≥ 0.75 D, which was predominately With-The-Rule astigmatism. The prevalence of astigmatism reported in these children is generally higher than that of studies conducted before COVID. Compared to their non-astigmatic peers, astigmatic children had a longer axial length (p < 0.001) and engaged in fewer outdoor activities (p = 0.04). Multiple linear regression analyses also revealed significant relationships between axial length and both cylindrical error and J0 astigmatism. Due to the high astigmatism prevalence, there is a pressing need for further studies on the long-term impact of the pandemic on children’s vision.
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Guo R, Shi L, Xu K, Hong D. Clinical evaluation of autorefraction and subjective refraction with and without cycloplegia in Chinese school-aged children: a cross-sectional study. Transl Pediatr 2022; 11:933-946. [PMID: 35800271 PMCID: PMC9253959 DOI: 10.21037/tp-22-226] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/16/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The accuracy of open-field autorefractors is important for vision screening, clinical care, and vision research, especially in patients with childhood myopia. TOPCON KR3000 autorefractor was conventional autorefractor and subjective refraction after cycloplegia was gold criteria for assessing the refraction. Results of refractive error in Chinese school-aged children obtained by three methods were evaluated and compared. METHODS A cross-sectional study was conducted. A total of 89 patients (with a total of 177 eyes) diagnosed as refractive error in the Affiliated Hospital of Nanjing University of Chinese Medicine from July 2020 to September 2020 were sequentially enrolled in this study. All subjects underwent routine ophthalmic examination to exclude other ocular diseases and had a best corrected visual acuity no less than 0.1 The spherical diopter (SD), spherical equivalence (SE), and astigmatism (J0 and J45) were determined in patients before cycloplegia using two autorefractors, and again after cycloplegia. Subjective refraction results were obtained simultaneously after cycloplegia as gold criteria for comparison. A comparison of data between three methods was performed using paired t-tests and presented graphically using Bland-Altman plots. RESULTS Before cycloplegia, the SD and SE results from WAM were 0.14 D and 0.12 D more positive than the reading from TOPCON (P=0.011 and P=0.021, respectively). The SD measured by WAM and TOPCON was 0.31 D and 0.45 D more negative than the values obtained by subjective refraction after cycloplegia, respectively (P<0.001 and P<0.001, respectively). The SE readings also showed a similar trend (P<0.001, P<0.001). After cycloplegia, the SD and SE measurement obtained with WAM were 0.13 D and 0.12 D more positive than those measured by TOPCON (P<0.001 and P<0.001, respectively), and this was not significantly different to the results obtained using subjective refraction. However, the results of SD, SE, and J0 measured by the TOPCON were significantly different from the results obtained using subjective refraction (P<0.001, P<0.001, and P=0.002, respectively). CONCLUSIONS In clinical application, the measurements obtained with the WAM-5500 autorefractor were more reliable than those of the TOPCON KR3000 autorefractor in patients with or without cycloplegia. The WAM-5500 Autorefractor represents a reliable and valid objective refraction tool for optometric practice.
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Affiliation(s)
- Rui Guo
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Li Shi
- Department of Ophthalmology, Nanjing Jiangning District Hospital of TCM, Nanjing, China
| | - Ke Xu
- Department of Optometry, Nanjing University of Chinese Medicine, Nanjing, China
| | - Dejian Hong
- Department of Ophthalmology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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Gopalakrishnan A, Hussaindeen JR, Sivaraman V, Swaminathan M, Wong YL, Armitage JA, Gentle A, Backhouse S. The Sankara Nethralaya Tamil Nadu Essilor Myopia (STEM) Study-Defining a Threshold for Non-Cycloplegic Myopia Prevalence in Children. J Clin Med 2021; 10:jcm10061215. [PMID: 33804031 PMCID: PMC8001787 DOI: 10.3390/jcm10061215] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/19/2021] [Accepted: 02/21/2021] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to investigate the agreement between cycloplegic and non-cycloplegic autorefraction with an open-field auto refractor in a school vision screening set up, and to define a threshold for myopia that agrees with the standard cycloplegic refraction threshold. The study was conducted as part of the Sankara Nethralaya Tamil Nadu Essilor Myopia (STEM) study, which investigated the prevalence, incidence, and risk factors for myopia among children in South India. Children from two schools aged 5 to 15 years, with no ocular abnormalities and whose parents gave informed consent for cycloplegic refraction were included in the study. All the children underwent visual acuity assessment (Pocket Vision Screener, Elite school of Optometry, India), followed by non-cycloplegic and cycloplegic (1% tropicamide) open-field autorefraction (Grand Seiko, WAM-5500). A total of 387 children were included in the study, of whom 201 were boys. The mean (SD) age of the children was 12.2 (±2.1) years. Overall, the mean difference between cycloplegic and non-cycloplegic spherical equivalent (SE) open-field autorefraction measures was 0.34 D (limits of agreement (LOA), 1.06 D to −0.38 D). For myopes, the mean difference between cycloplegic and non-cycloplegic SE was 0.13 D (LOA, 0.63D to −0.36D). The prevalence of myopia was 12% (95% CI, 8% to 15%) using the threshold of cycloplegic SE ≤ −0.50 D, and was 14% (95% CI, 11% to 17%) with SE ≤ −0.50 D using non-cycloplegic refraction. When myopia was defined as SE of ≤−0.75 D under non-cycloplegic conditions, there was no difference between cycloplegic and non-cycloplegic open-field autorefraction prevalence estimates (12%; 95% CI, 8% to 15%; p = 1.00). Overall, non-cycloplegic refraction underestimates hyperopia and overestimates myopia; but for subjects with myopia, this difference is minimal and not clinically significant. A threshold of SE ≤ −0.75 D agrees well for the estimation of myopia prevalence among children when using non-cycloplegic refraction and is comparable with the standard definition of cycloplegic myopic refraction of SE ≤ −0.50 D.
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Affiliation(s)
- Aparna Gopalakrishnan
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai 600 006, India; (J.R.H.); (V.S.); (M.S.)
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, VIC 3216, Australia; (J.A.A.); (A.G.); (S.B.)
- Correspondence:
| | - Jameel Rizwana Hussaindeen
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai 600 006, India; (J.R.H.); (V.S.); (M.S.)
| | - Viswanathan Sivaraman
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai 600 006, India; (J.R.H.); (V.S.); (M.S.)
| | - Meenakshi Swaminathan
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai 600 006, India; (J.R.H.); (V.S.); (M.S.)
| | - Yee Ling Wong
- R&D AMERA, Essilor International Singapore, Singapore 339346, Singapore;
| | - James Andrew Armitage
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, VIC 3216, Australia; (J.A.A.); (A.G.); (S.B.)
| | - Alex Gentle
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, VIC 3216, Australia; (J.A.A.); (A.G.); (S.B.)
| | - Simon Backhouse
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, VIC 3216, Australia; (J.A.A.); (A.G.); (S.B.)
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Tong H, Hao Q, Wang Z, Wang Y, Li R, Zhao X, Sun Q, Zhang X, Chen X, Zhu H, Huang D, Liu H. The biometric parameters of aniso-astigmatism and its risk factor in Chinese preschool children: the Nanjing eye study. BMC Ophthalmol 2021; 21:67. [PMID: 33535994 PMCID: PMC7860027 DOI: 10.1186/s12886-021-01808-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 01/07/2021] [Indexed: 11/15/2022] Open
Abstract
Backgrounds Aniso-astigmatism may hinder normal visual development in preschool children. Knowing its prevalence, biometric parameters and risk factors is fundamental to children eye care. The purpose of this study was to determine the biometric components of aniso-astigmatism and associated maternal risk factors in Chinese preschool children. Methods In the population-based, prospective cohort Nanjing Eye Study, children were measured for noncycloplegic refractive error using an autorefractor and for biometric parameters using an optical low-coherent reflectometry. The difference of total astigmatism (TA) between both eyes was calculated using cylinder power (non-vectorial aniso-TA was defined as ≥1.00 Dioptre Cylinder [DC] between both eyes) and by vector analysis (vectorial aniso-TA was defined as a difference of ≥0.5 in J0 or J45 between both eyes which is equivalent to 1.00 DC). The prevalence of aniso-TA was presented. Interocular biometric parameters were compared between with vs. without aniso-astigmatism group. In addition, risk factors were determined using multivariate logistic regression model. Results Of 1131 children (66.90 ± 3.38 months, 53.31% male), the prevalence of non-vectorial aniso-TA was 1.95% (95% Confidence Interval (CI) = 1.14–2.75%), while the prevalence of vectorial aniso-TA was twice as common as non-vectorial aniso-TA, neither varying with sex or age. With aniso-TA eyes were more asymmetric in axial length and corneal curvature radius than without aniso-TA eyes. In multivariate logistic regression model, 5-min Apgar score less than 7 was significantly associated with higher risk of aniso-TA (vectorial aniso-TA: Odds Ratio (OR) = 6.42, 95%CI = 2.63–15.69, P < 0.001; non-vectorial aniso-TA: OR = 4.99, 95%CI = 1.41–17.68, P = 0.01). Being twin or triple was significantly associated with higher risk of vectorial aniso-CA (OR = 2.43, 95%CI = 1.05–5.60, P = 0.04). Pre-term delivery (OR = 2.60, 95%CI = 1.09–6.15, P = 0.03) and post-term delivery (OR = 3.61, 95%CI = 1.31–9.96, P = 0.01) were significantly associated with higher risk of vectorial aniso-CA. Conclusions Both corneal curvature radius and axial length asymmetry were correlated with aniso-TA. Children with 5-min Apgar score < 7 were more likely to have aniso-TA, while twin or triple, pre-term or post-term delivery were more likely to have vectorial aniso-CA. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-01808-7.
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Affiliation(s)
- Haohai Tong
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Qingfeng Hao
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Zijin Wang
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Yue Wang
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Rui Li
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xiaoyan Zhao
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Qigang Sun
- Department of Ophthalmology, Maternal and Child Healthcare Hospital of Yuhuatai District, Nanjing, China
| | - Xiaohan Zhang
- Department of Ophthalmology, Wuxi Children's Hospital, Wuxi, China
| | - Xuejuan Chen
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Hui Zhu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Dan Huang
- Department of Child Healthcare, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
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