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Martínez-Plaza E, López-de la Rosa A, Molina-Martín A, Piñero DP. Orthokeratology effect on the corneoscleral profile: Beyond the bull's eye. Ophthalmic Physiol Opt 2024; 44:757-768. [PMID: 38240175 DOI: 10.1111/opo.13279] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE To assess the impact of 3 months of orthokeratology (ortho-k) contact lenses (CLs) for myopia correction on the corneoscleral profile, as changes in scleral geometry could serve as indirect evidence of alteration in the corneal biomechanical properties. METHODS Twenty subjects (40 eyes) were recruited to wear ortho-k lenses overnight; however, after discontinuation (two CL fractures, one under-correction and two non-serious adverse events), 16 subjects (31 eyes) finished a 3-month follow-up. Corneoscleral topographies were acquired using the Eye Surface Profiler (ESP) system before and after 3 months of lens wear. Steep (SimKs) and flat (SimKf) simulated keratometry and scleral sagittal height measurements for 13-, 14- and 15-mm chord lengths were automatically calculated by the ESP software. Additionally, sagittal height and slope were calculated in polar format from 21 radii (0-10 mm from the corneal apex) at 12 angles (0-330°). Linear mixed models were fitted to determine the differences between visits. RESULTS SimKs and SimKf were increased significantly (p ≤ 0.02). The sagittal height in polar format increased significantly (p = 0.046) at a radius of 2.5 mm for 150°, 180°, 210° and 240° orientations and at a radius of 3.0 mm for 210°. Additionally, the slope in polar format significantly decreased (p ≤ 0.04) at radii ranges of 0.0-0.5, 0.5-1.0 and 1.0-1.5 mm for multiple angles and at a radii range of 5.0-5.5 mm for 90°. It also increased significantly (p ≤ 0.045) at a radii range of 1.5-2.0 mm for 30° and at radii ranges of 2.0-2.5, 2.5-3.0 and 3.0-3.5 mm for multiple angles. No significant changes were found for any parameter measured from the scleral area. CONCLUSIONS Three months of overnight ortho-k lens wear changed the central and mid-peripheral corneal geometry as expected, maintaining the peripheral cornea and the surrounding sclera stability.
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Affiliation(s)
- Elena Martínez-Plaza
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- University of Valladolid, Valladolid, Spain
| | - Alberto López-de la Rosa
- Department of Theoretical Physics, Atomic and Optics, University of Valladolid, Valladolid, Spain
- Instituto de Oftalmobiología Aplicada (IOBA), University of Valladolid, Valladolid, Spain
| | - Ainhoa Molina-Martín
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - David P Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
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Alfonso-Bartolozzi B, Fernández-Vega-Cueto L, Lisa C, Palacios A, Madrid-Costa D, Alfonso JF. Ten-year follow-up of posterior chamber phakic intraocular lens with central port design in patients with low and normal vault. J Cataract Refract Surg 2024; 50:441-447. [PMID: 38085219 DOI: 10.1097/j.jcrs.0000000000001379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 12/05/2023] [Indexed: 04/24/2024]
Abstract
PURPOSE To assess the clinical outcomes and postoperative complications of the implantable collamer lens (ICL) with a central port throughout 10 years of follow-up in patients with low and normal vault. SETTING Fernández-Vega Ophthalmological Institute, Oviedo, Spain. DESIGN Retrospective and comparative case series. METHODS This study included eyes that underwent a V4c ICL implantation with 10 years of follow-up. The eyes were divided into 2 groups according to the vault at 1 year postoperatively: vault <250 μm and between 250 μm and 800 μm. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell density (ECD), vault, complications, and secondary surgeries were analyzed. RESULTS 37 and 90 eyes were enrolled in the low and normal-vault groups, respectively. No differences in UDVA, CDVA, and refraction were found between the groups over 10 years of follow-up. No cases developed ICL-induced anterior subcapsular opacity over the follow-up period. 2 (5.4%) and 8 (8.9%) eyes in the low and normal-vault groups, respectively, required ICL exchange. 1 (2.8%) and 2 (2.2%) eyes in the low and normal-vault groups, respectively, required excimer laser to correct residual refractive error. The IOP remained stable throughout the 10-year follow-up. The loss in ECD from that preoperatively to 10 years postoperatively was 3.8% and 4.5% in the low and normal-vault groups, respectively ( P = .4). No pigment dispersion glaucoma or other vision-threatening complications were reported. CONCLUSIONS This study shows good long-term outcomes of the V4c ICL, supporting that the central hole provides safety to the procedure and prevents the potential risk associated with low vault.
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Affiliation(s)
- Belén Alfonso-Bartolozzi
- From the Fernández-Vega Ophthalmological Institute, Oviedo, Spain (Alfonso-Bartolozzi, Fernández-Vega-Cueto, Lisa, Palacios, Alfonso); Clinical and Experimental Eye Reseach Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain (Madrid-Costa)
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Cheng M, Chen X, Lei Y, Li B, Jiang Y, Xu Y, Zhou X, Wang X. Clinical Evaluation Of a 0.05 D-step Binocular Wavefront Optometer in Young Adults in China. Clin Exp Optom 2024; 107:395-401. [PMID: 36794379 DOI: 10.1080/08164622.2023.2175603] [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: 08/13/2022] [Revised: 01/13/2023] [Accepted: 01/28/2023] [Indexed: 02/17/2023] Open
Abstract
CLINICAL RELEVANCE Myopia has become a public health priority as its prevalence increases worldwide, and in clinical practice, the precise evaluation of refraction errors is necessary. BACKGROUND This study aimed to compare objective and subjective refraction measured by a binocular wavefront optometer (BWFOM) in adults with conventional objective and subjective refractions measured by an optometrist. METHODS This cross-sectional study included 119 eyes of 119 participants (34 men and 85 women; mean age:27.5 ± 6.3 years). Refractive errors were measured using BWFOM and conventional methods, with and without cycloplegia. The mean outcome measures were spherical power, cylindrical power, and spherical equivalence (SE). The agreement test was assessed using a two-tailed paired t-test and Bland - Altman plots. RESULTS Under noncycloplegic conditions, there were no significant differences in the objective SE between BWFOM and Nidek. Significant differences in subjective SE were observed between BWFOM and conventional subjective refraction (-5.79 ± 1.86 vs -5.65 ± 1.75 D, P < 0.01). Under cycloplegic conditions, the mean objective SE was significantly different between BWFOM and Nidek (-5.70 ± 1.76 vs -5.50 ± 1.83 D, P < 0.001); the mean subjective SE was significantly different between BWFOM and conventional subjective refractions (-5.52 ± 1.77 vs -5.62 ± 1.79 D, P < 0.001). The Bland - Altman plots revealed mean percentages of 95.38% and 95.17% for the points within the limits of agreement between BWFOM and conventional measurements and those between noncycloplegic and cycloplegic refractions, respectively. CONCLUSION The BWFOM is a new device that measures both objective and subjective refraction. It is more convenient and faster to obtain a proper prescription at a 0.05-D interval. The subjective refraction results of the BWFOM and the conventional subjective refraction were in good agreement.
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Affiliation(s)
- Mingrui Cheng
- Department of Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- Department of Ophthalmology, Jinshan Hospital Affiliated to Fudan University, Shanghai, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xun Chen
- Department of Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yadi Lei
- Department of Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Bailiang Li
- Department of Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yinjie Jiang
- Department of Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yilin Xu
- Department of Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaodong Zhou
- Department of Ophthalmology, Jinshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Xiaoying Wang
- Department of Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China
- National Health Commission Key Lab of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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Ma L, Li X, Hu J, Li Y, Wang S, Wang K, Zhao M. Influence of a long-distance optical imaging workbench on accommodation and choroidal response in myopic children. Clin Exp Optom 2024; 107:420-427. [PMID: 37406457 DOI: 10.1080/08164622.2023.2228810] [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: 12/02/2022] [Revised: 05/30/2023] [Accepted: 06/20/2023] [Indexed: 07/07/2023] Open
Abstract
CLINICAL RELEVANCE Optical approaches to modulating near work may be beneficial in arresting the progression of myopia. BACKGROUND To explore whether a long-distance optical image workbench (LOIW) can replace traditional near-distance reading and has beneficial influences on accommodation and choroidal parameters. METHODS This self-control study included two sessions. In session 1, an open-field autorefractor measured sustained accommodative response and pupil diameter when participants viewed virtual images from 3.42 m away through LOIW with + 0.50 D over-correction lenses (3.42 m/+0.50 D), LOIW with full-correction lenses (3.42 m/FC), or the visual target at a given distance of 0.33 m with + 0.50 D over-correction lenses (0.33 m/+0.50 D), with full-correction lenses (0.33 m/FC). In session 2, swept-source optical coherence tomography angiography assessed subfoveal choroidal thickness (SFChT), choroidal volume (CV), and choriocapillaris flow void percentage (FV%) at baseline and before and after reading via LOIW with + 0.50 D over-correction lenses (Far/+0.50 D) or in habitual near distance with full-correction (Near/FC) for a sustained 30-min period. RESULTS Thirty-five myopic (mean spherical equivalent refraction: -1.11 ± 0.78 D) children (median [range] age: 8.36 [8-10] years) were analysed. Children viewing virtual images in 3.42 m/+0.50 D exhibited mild-degree accommodative leads (-0.54 ± 0.17 D), much smaller pupil diameter (3.39 ± 0.63 mm) and microfluctuations (0.13 ± 0.04 D); accommodative lags (0.88 ± 0.04 D), larger pupil diameter (5.05 ± 0.75 mm) and microfluctuations (0.88 ± 0.16 D) were observed in 0.33 m/+0.50 D, and the microfluctuations were unstable (F = 2.185, p = 0.038). Compared with baseline data, SFChT, CV, and FV% changed by 13.40 ± 4.71 μm, 0.26 ± 0.21 mm3, and - 0.14%±3.66% in Far/+0.50 D, respectively, while changes under Near/FC were - 10.19 ± 7.48 μm, -0.15 ± 0.22 mm3 and 1.95%±2.92%, respectively. All changes differed significantly between these two conditions (all p < 0.001). CONCLUSION The long-distance working mode may exert beneficial effects on accommodative and choroidal parameters in myopic children compared with traditional near work.
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Affiliation(s)
- Lu Ma
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Xuewei Li
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Jie Hu
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Yan Li
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
| | - Shanshan Wang
- Beijing Key Laboratory for Precision Optoelectronic Measurement Instrument and Technology, School of Optics and Photonics, Beijing Institute of Technology, Beijing, China
| | - Kai Wang
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
| | - Mingwei Zhao
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
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Dang RM, Watt K, Kang P. Impact of age on measurement variability for axial length in myopic children. Clin Exp Optom 2024; 107:428-433. [PMID: 37674270 DOI: 10.1080/08164622.2023.2236124] [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: 12/06/2022] [Accepted: 07/10/2023] [Indexed: 09/08/2023] Open
Abstract
CLINICAL RELEVANCE Axial length is a primary outcome in the management of progressive myopia. However, young children may have difficulty fixating during these measurements compared to older children, which can result in higher measurement variability. This may affect perceived axial length progression, leading to inappropriate management. BACKGROUND This study assessed the impact of patient age on measurement variability for axial length measurements taken with the IOLMaster 700 and IOLMaster 500 in myopic children. METHODS A retrospective review of records was undertaken at a university optometry clinic. Five axial length measurements captured at the same visit were collected with the IOLMaster 700 and IOLMaster 500 for myopic patients ≤16 years. The within-subject standard deviation and R2 were calculated for each instrument to examine the effects of age on instrument variability. RESULTS Data was collected for 51 patients (30 female and 21 male), and the mean age was 10.98 ± 2.77 years. Mean axial length measured with the IOLMaster 700 was longer compared to the IOLMaster 500 (difference -0.02 ± 0.02 mm; p < 0.001). There was no effect of age on within-person variability for the measurement of axial lengths with either instrument, with R2 values of 0.021 (p = 0.305) and 0.13 (p = 0.420) for the IOLMaster 700 and IOLMaster 500, respectively. The within-subject variability of axial measurements with the IOLMaster 700 was significantly lower than that with the IOLMaster 500 (p < 0.001). CONCLUSION Measurement variability of axial length measurements with the IOLMaster 700 and IOLMaster 500 was not dependent on age. However, axial length measurements captured with the IOLMaster 700 were significantly longer and less variable than those with the IOLMaster 500. Eye health care practitioners should be aware of the differences between the two instruments and refrain from using them interchangeably, especially for myopia control where small changes in axial length can affect patient management.
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Affiliation(s)
- Rebecca M Dang
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Kathleen Watt
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Pauline Kang
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Omar WEW, Singh G, McBain AJ, Cruickshank F, Radhakrishnan H. Gut Microbiota Profiles in Myopes and Nonmyopes. Invest Ophthalmol Vis Sci 2024; 65:2. [PMID: 38691091 DOI: 10.1167/iovs.65.5.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024] Open
Abstract
Purpose To identify compositional differences in the gut microbiome of nonmyopes (NM) and myopes using 16S ribosomal RNA sequencing and to investigate whether the microbiome may contribute to the onset or progression of the condition. Methods Faecal samples were collected from 52 adult participants, of whom 23 were NM, 8 were progressive myopes (PM), and 21 were stable myopes (SM). The composition of the gut microbiota in each group was analysed using 16S ribosomal RNA gene sequencing. Results There were no significant differences in alpha and beta diversity between the three groups (NM, PM, and SM). However, the distributions of Bifidobacterium, Bacteroides, Megamonas, Faecalibacterium, Coprococcus, Dorea, Roseburia, and Blautia were significantly higher in the myopes (SM and PM combined) when compared with emmetropes. The myopes exhibited significantly greater abundance of bacteria that are linked to the regulation of dopaminergic signalling, such as Clostridium, Ruminococcus, Bifidobacterium, and Bacteroides. Individuals with stable myopia were found to have a significantly higher proportion of Prevotella copri than those with progressive myopia. Bifidobacterium adolescentis, a gamma-aminobutyric acid (GABA)-producing bacterium, was significantly higher in all myopes than in NM and, in the comparison between SM and PM, it is significantly higher in SM. B. uniformis and B. fragilis, both GABA-producing Bacteroides, were present in relatively high abundance in all myopes and in SM compared with PM, respectively. Conclusions The presence of bacteria related to dopamine effect and GABA-producing bacteria in the gut microbiome of myopes may suggest a role of these microorganisms in the onset and progression of myopia.
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Affiliation(s)
- Wan E W Omar
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Faculty of Health Sciences, Centre for Optometry Studies, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| | - Gurdeep Singh
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Andrew J McBain
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Fiona Cruickshank
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Hema Radhakrishnan
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
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Hira S, Klein Heffel K, Mehmood F, Sehgal K, Felix De Farias Santos AC, Steuernagel Del Valle G. Comparison of refractive surgeries (SMILE, LASIK, and PRK) with and without corneal crosslinking: systematic review and meta-analysis. J Cataract Refract Surg 2024; 50:523-533. [PMID: 38288954 DOI: 10.1097/j.jcrs.0000000000001405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/22/2024] [Indexed: 04/24/2024]
Abstract
Corneal crosslinking (CXL) is used for treating keratoconus and post-laser in situ keratomileusis ectasia. However, refractive surgery is not usually performed with prophylactic CXL. Therefore, we performed a meta-analysis comparing outcomes of refractive surgeries with vs without prophylactic CXL. We systematically searched databases for studies comparing refractive surgeries for myopic correction with vs without prophylactic corneal crosslinking. Review Manager 5.4.1 was used to perform statistical analysis. We included 2820 eyes from 28 studies. Compared with refractive surgery alone, surgery with prophylactic CXL resulted in decreased central corneal thickness, corrected distance visual acuity logMAR, and safety and efficacy indices. There were no significant differences in postoperative uncorrected distance visual acuity of 20/20 or better at ≥12 months and other visual outcomes among both groups. More randomized controlled trials with standard crosslinking protocols are needed to analyze the prophylactic use of crosslinking with refractive surgeries.
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Affiliation(s)
- Sara Hira
- From the FMH College of Medicine & Dentistry, Lahore, Pakistan (Hira); Federal University of Pelotas, Pelotas, Brazil (Klein Heffel); Department of Ophthalmology, Fatima Memorial Hospital, Lahore, Pakistan (Mehmood); Teerthanker Mahaveer University, Moradabad, UP, India (Sehgal); City University of São Paulo, São Paulo, Brazil (Felix De Farias Santos); University of Iowa, Iowa City, Iowa (Steuernagel Del Valle)
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Wan K, Wolffsohn JS, Cho P. Role of waveform signal parameters in the classification of children as relatively slow and fast myopia progressors. Clin Exp Optom 2024; 107:402-408. [PMID: 36797056 DOI: 10.1080/08164622.2023.2177098] [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: 11/17/2022] [Revised: 01/14/2023] [Accepted: 02/01/2023] [Indexed: 02/18/2023] Open
Abstract
CLINICAL RELEVANCE Identification of the baseline chracteristics for children undergoing orthokeratology with relatively fast myopia progression can allow a more accurate determination of the risk/benefit ratio. BACKGROUND This study aimed to investigate if baseline corneal biomechanics can classify relatively slow and fast myopia progression in children. METHODS Children aged six to 12 years with low myopia (0.50 to 4.00 D) and astigmatism (less than or equal to 1.25 D), were recruited. Participants were randomised to be fitted with orthokeratology contact lenses with a conventional compression factor (0.75 D, n = 29) or an increased compression factor (1.75 D, n = 33). Relatively fast progressors were defined as participants who had axial elongation of 0.34 mm or above per 2 years. A binomial logistic regression analysis and a classification and regression tree model were used in the data analysis. The corneal biomechanics were measured with a bidirectional applanation device. The axial length was measured by a masked examiner. RESULTS As there were no significant between-group differences in the baseline data (all p > 0.05), data were combined for analysis. The mean ± SD axial elongation for relatively slow (n = 27) and fast (n = 35) progressors were 0.18 ± 0.14 mm and 0.64 ± 0.23 mm per 2 years, respectively. The area under the curve (p2area1) was significantly higher in relatively fast progressors (p = 0.018). The binomial logistic regression and classification and regression tree model analysis showed that baseline age and p2area1 could differentiate between slow and fast progressors over 2 years. CONCLUSIONS Corneal biomechanics could be a potential predictor of axial elongation in orthokeratology contact lens-wearing children.
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Affiliation(s)
- Kin Wan
- School of Optometry, The Hong Kong Polytechnic University, HKSAR, Hong Kong, China
| | | | - Pauline Cho
- School of Optometry, The Hong Kong Polytechnic University, HKSAR, Hong Kong, China
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Qiu K, David C, Li Y, Lei Z, Tong L, Lin W. A retrospective study of cumulative absolute reduction in axial length after photobiomodulation therapy. BMC Ophthalmol 2024; 24:191. [PMID: 38664659 PMCID: PMC11044358 DOI: 10.1186/s12886-024-03427-4] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 04/03/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND To assess the age and timeline distribution of ocular axial length shortening among myopic children treated with photobiomodulation therapy in the real world situations. METHODS Retrospective study of photobiomodulation therapy in Chinese children aged 4 to 13 years old where axial length measurements were recorded and assessed to determine effectiveness at two age groups (4 ∼ 8 years old group and 9 ∼ 13 years old group). Data was collected from myopic children who received photobiomodulation therapy for 6 ∼ 12 months. Effectiveness of myopia control was defined as any follow-up axial length ≤ baseline axial length, confirming a reduction in axial length. Independent t-test was used to compare the effectiveness of the younger group and the older group with SPSS 22.0. RESULTS 342 myopic children were included with mean age 8.64 ± 2.20 years and baseline mean axial length of 24.41 ± 1.17 mm. There were 85.40%, 46.30%, 71.20% and 58.30% children with axial length shortening recorded at follow-up for 1 month, 3 months, 6 months and 12 months, respectively. With respect to the axial length shortened eyes, the mean axial length difference (standard deviation) was - 0.039 (0.11) mm, -0.032 (0.11) mm, -0.037 (0.12) mm, -0.028 (0.57) mm at 1, 3, 6, and 12-month follow-up, respectively. Greater AL shortening was observed among the older group who had longer baseline axial lengths than the younger group (P < 0.001). CONCLUSIONS Overall myopia control effectiveness using photobiomodulation therapy was shown to be age and time related, with the maximum absolute reduction in axial elongation being cumulative.
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Affiliation(s)
- Kaikai Qiu
- Fuzhou Southeast Institute of Visual Ophthalmology, Fuzhou (City), China.
| | - Coveney David
- Firstwest Innovations, 350007, Perth (City), Australia
| | - Ying Li
- The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou (City, China
| | - Zhou Lei
- Department of Optometry, Ningbo Eye Hospital of Wenzhou Medical University, 315000, Ningbo(City), China
| | - Liyang Tong
- Department of Optometry, Ningbo Eye Hospital of Wenzhou Medical University, 315000, Ningbo(City), China
| | - Wen Lin
- Fuzhou Southeast Institute of Visual Ophthalmology, Fuzhou (City), China.
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Wang H, Zhu LS, Pang CJ, Fan Q. Repeatability assessment of anterior segment measurements in myopic patients using an anterior segment OCT with placido corneal topography and agreement with a swept-source OCT. BMC Ophthalmol 2024; 24:182. [PMID: 38649848 PMCID: PMC11036772 DOI: 10.1186/s12886-024-03448-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/10/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND The precision of anterior segment biometric measurements in eyes has become increasingly important in refractive surgery. The purpose of this study is to assess the repeatability of the automatic measurements provided by a new spectral-domain optical coherence tomograph (SD-OCT)/Placido topographer (MS-39, CSO) and its agreement with a swept-source OCT (SS-OCT) biometer (CASIA SS-1000, Tomey) in patients with myopia. METHODS The right eye of 235 subjects was scanned 3 times with both devices. The evaluated parameters included central corneal radius of the steep meridian, central corneal radius of the flat meridian, mean central corneal radius, thinnest corneal thickness, central corneal thickness, anterior chamber depth, corneal volume and diameter. The intraobserver repeatability of the MS-39 measurements was calculated using intraclass correlation coefficient (ICC), within subject standard deviation, coefficient of repeatability, coefficient of variation and repeated-measures analysis of variance of the 3 repeated measurements. The agreement between the two devices was evaluated by 95% limits of agreement (LoA). RESULTS The majority of the parameters acquired from MS-39 showed high repeatability. The repeatability of corneal diameter was slightly lower than the other measurements, although the ICC remained high. Agreement with the CASIA SS-1000 was good, indicated by the Bland-Altman plots with narrow 95% LoA values for all parameters assessed. CONCLUSIONS The high repeatability of automatic measurements by the new device supports its clinical application in eyes with myopia, and the good agreement between the two devices indicates they could be used interchangeably for the parameters evaluated.
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Affiliation(s)
- Hao Wang
- Department of Refractive Surgery, Henan Provincial People's Hospital, Henan Eye Hospital, People's Hospital Affiliated to Zhengzhou University, People's Hospital Affiliated to Henan University, NO.7 Weiwu Road, 450003, Zhengzhou, China
| | - Li-Shuang Zhu
- Department of Blood Transfusion, Zhengzhou People's Hospital, NO.33 Huanghe Road, 450003, Zhengzhou, China
| | - Chen-Jiu Pang
- Department of Refractive Surgery, Henan Provincial People's Hospital, Henan Eye Hospital, People's Hospital Affiliated to Zhengzhou University, People's Hospital Affiliated to Henan University, NO.7 Weiwu Road, 450003, Zhengzhou, China.
| | - Qi Fan
- Department of Refractive Surgery, Henan Provincial People's Hospital, Henan Eye Hospital, People's Hospital Affiliated to Zhengzhou University, People's Hospital Affiliated to Henan University, NO.7 Weiwu Road, 450003, Zhengzhou, China
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11
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Wang X, Liu S, Chen Y, Gong J, Wu N, Yao Y. Extended depth of focus IOL in eyes with different axial myopia and targeted refraction. BMC Ophthalmol 2024; 24:183. [PMID: 38649861 PMCID: PMC11036644 DOI: 10.1186/s12886-024-03442-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 04/09/2024] [Indexed: 04/25/2024] Open
Abstract
AIM To evaluate the objective visual outcomes following implantation of extended depth of focus intraocular lens (EDOF IOL) in individuals with varying axial lengths (AL) and targeted refraction. METHODS This retrospective study comprised age-matched eyes that underwent implantation of the EDOF IOL. Eyes were categorized based on AL into groups: control group with AL < 26 mm; high myopia group with AL ≥ 26 mm. Each group was then subdivided based on postoperative spherical equivalent (SE). Follow-up at three months included assessment of uncorrected visual acuity at different distances, contrast sensitivity (CS), refractive outcomes, and spectacle independence. RESULTS Overall, this study included 100 eyes from 100 patients, comprising 50 males (50.00%) and 50 females (50.00%), with 20 eyes in each group. In the control group, the uncorrected distance visual acuity (UDVA) at 5 and 3 m (m) in the - 1.50 to -0.75 group was inferior to that of the - 0.75 to 0.00 group (P = 0.004). Conversely, the uncorrected near visual acuity (UNVA) at 33 cm in the - 1.50 to -0.75 group was superior to that of the - 0.75 to 0.00 group (P = 0.005). Within the high myopia group, the UDVA at 5 and 3 m in the - 2.25 to -1.50 group was worse than in the - 0.75 to 0.00 group (P = 0.009 and 0.008, respectively). However, the UNVA at 33 cm in the - 2.25 to -1.50 group was better than in the - 0.75 to 0.00 group (P = 0.020). No significant differences were observed among the groups for corrected distance visual acuity (CDVA) (P > 0.05). Additionally, in the high myopia group, the CS of the - 2.25 to -1.50 group was lower compared to that of the - 0.75 to 0.00 group (P = 0.017). Among high myopia patients, 90.00% with refraction ranging from - 1.50 to -0.75 reported achieving overall spectacle independence. CONCLUSIONS Implantation of extended depth of focus intraocular lenses (IOLs) yields satisfactory visual and refractive outcomes in eyes with axial myopia. Among high myopia patients, a refraction ranging from - 1.50 to -0.75 diopters achieves superior visual quality compared to other postoperative myopic diopters.
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Affiliation(s)
- Xiaohui Wang
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, 350005, Fujian, Fujian, China.
- Department of Ophthalmology, Binhai campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fujian, China.
- Fujian Institute of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
- Fujian Provincial Clinical Medical Research Center of Eye Diseases and Optometry, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
| | - Sinan Liu
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, 350005, Fujian, Fujian, China
- Department of Ophthalmology, Binhai campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fujian, China
- Fujian Institute of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Fujian Provincial Clinical Medical Research Center of Eye Diseases and Optometry, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Yinqi Chen
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, 350005, Fujian, Fujian, China
- Department of Ophthalmology, Binhai campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fujian, China
- Fujian Institute of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Fujian Provincial Clinical Medical Research Center of Eye Diseases and Optometry, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Jinping Gong
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, 350005, Fujian, Fujian, China
- Department of Ophthalmology, Binhai campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fujian, China
- Fujian Institute of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Fujian Provincial Clinical Medical Research Center of Eye Diseases and Optometry, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Nuozhou Wu
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, 350005, Fujian, Fujian, China
- Department of Ophthalmology, Binhai campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fujian, China
- Fujian Institute of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Fujian Provincial Clinical Medical Research Center of Eye Diseases and Optometry, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Yihua Yao
- Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, 350005, Fujian, Fujian, China
- Department of Ophthalmology, Binhai campus of the First Affiliated Hospital, National Regional Medical Center, Fujian Medical University, Fujian, China
- Fujian Institute of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Fujian Provincial Clinical Medical Research Center of Eye Diseases and Optometry, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
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12
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Fedtke C, Tilia D, Ehrmann K, Diec J, Lahav-Yacouel K, Falk D, Bakaraju RC. Visual performance of optical films utilizing Spatio-Temporal Optical Phase technology. Optom Vis Sci 2024; 101:195-203. [PMID: 38684062 DOI: 10.1097/opx.0000000000002121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Abstract
SIGNIFICANCE Spatio-Temporal Optical Phase technology utilizes film pairs containing optical elements applied to standard single-vision spectacle lenses. This technology provides a dynamic optical cue that may have efficacy in reducing the rate of myopia progression, but the visual performance of this technology is unknown. PURPOSE This study aimed to assess the visual performance of film pairs containing optical elements (tests) and a film pair with no optical elements (control). METHODS In this randomized, single-masked, bilateral wear study, 42 participants aged 18 to 40 years wore four test designs (E, F-1, G, and F-2) and the control. Subjective data (subjective ratings [1 to 10 scale]: clarity of vision [far-away, intermediate, near] and vision [at night, while walking, overall satisfaction], and willingness to purchase [yes/no response]) were collected after 3 days. Visual acuity (VA)-based measures (monocular high/low-contrast VA [6 m], contrast sensitivity [6 m], and binocular high-contrast VA [6 m and 40 cm]) were collected at dispensing. Visual acuity-based measures were also collected while wearing spectacles with no film. Analyses were performed using linear mixed models and the χ2 test. Significance was set at 5%. RESULTS The control performed better than any test for all subjective ratings (mean differences, 1.6 to 3.1 units: p<0.001), willingness to purchase (p<0.001), and designs F-1 and F-2 for binocular high-contrast VA at 40 cm (p=0.001 and p=0.01, respectively). Clarity of vision was significantly worse with F-2 compared with F-1 and G (p<0.001 and p=0.02, respectively). There were no differences between tests for any other subjective rating (p>0.1), willingness to purchase (p=0.11), or any VA-based measure (p>0.08). There were no differences between control and spectacles with no film for any VA-based measure (p>0.08). CONCLUSIONS All four test film pairs reduced visual performance compared with control to a degree comparable with other myopia management devices. There was no difference in visual performance between three of the four test film pairs.
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Affiliation(s)
| | | | | | - Jennie Diec
- nthalmic Pty Ltd, Sydney, New South Wales, Australia
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Mutti DO, Sinnott LT, Cotter SA, Jones-Jordan LA, Kleinstein RN, Manny RE, Twelker JD, Zadnik K. Predicting the onset of myopia in children by age, sex, and ethnicity: Results from the CLEERE Study. Optom Vis Sci 2024; 101:179-186. [PMID: 38684060 PMCID: PMC11060695 DOI: 10.1097/opx.0000000000002127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Abstract
SIGNIFICANCE Clinicians and researchers would benefit from being able to predict the onset of myopia for an individual child. This report provides a model for calculating the probability of myopia onset, year-by-year and cumulatively, based on results from the largest, most ethnically diverse study of myopia onset in the United States. PURPOSE This study aimed to model the probability of the onset of myopia in previously nonmyopic school-aged children. METHODS Children aged 6 years to less than 14 years of age at baseline participating in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study who were nonmyopic and less hyperopic than +3.00 D (spherical equivalent) were followed up for 1 to 7 years through eighth grade. Annual measurements included cycloplegic autorefraction, keratometry, ultrasound axial dimensions, and parental report of children's near work and time spent in outdoor and/or sports activities. The onset of myopia was defined as the first visit with at least -0.75 D of myopia in each principal meridian. The predictive model was built using discrete time survival analysis and evaluated with C statistics. RESULTS The model of the probability of the onset of myopia included cycloplegic spherical equivalent refractive error, the horizontal/vertical component of astigmatism (J0), age, sex, and race/ethnicity. Onset of myopia was more likely with lower amounts of hyperopia and less positive/more negative values of J0. Younger Asian American females had the highest eventual probability of onset, whereas older White males had the lowest. Model performance increased with older baseline age, with C statistics ranging from 0.83 at 6 years of age to 0.92 at 13 years. CONCLUSIONS The probability of the onset of myopia can be estimated for children in the major racial/ethnic groups within the United States on a year-by-year and cumulative basis up to age 14 years based on a simple set of refractive error and demographic variables.
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Affiliation(s)
| | | | - Susan A Cotter
- Southern California College of Optometry at Marshall B. Ketchum University, Fullerton, California
| | | | - Robert N Kleinstein
- School of Optometry, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Ruth E Manny
- University of Houston College of Optometry, Houston, Texas
| | - J Daniel Twelker
- Department of Ophthalmology and Vision Science, University of Arizona, Tucson, Arizona; for the CLEERE Study
| | - Karla Zadnik
- The Ohio State University College of Optometry, Columbus, Ohio
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Artemiev D, Todorova MG. A Case of Congenital Stationary Night Blindness in a Healthy Female Infant: Emphasis on Electroretinography. Klin Monbl Augenheilkd 2024; 241:529-532. [PMID: 38653284 DOI: 10.1055/a-2211-9248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Affiliation(s)
- Dmitri Artemiev
- Department of Ophthalmology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Margarita G Todorova
- Department of Ophthalmology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Department of Ophthalmology, University Hospital Basel, Basel, Switzerland
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Hong KE, Kim SA, Shin DY, Park CK, Park HYL. Ocular and Hemodynamic Factors Contributing to the Central Visual Function in Glaucoma Patients With Myopia. Invest Ophthalmol Vis Sci 2022; 63:26. [PMID: 35604665 PMCID: PMC9150826 DOI: 10.1167/iovs.63.5.26] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 04/28/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to investigate the ocular and hemodynamic factors contributing to the central visual function in glaucoma patients with myopia. Methods This study was a prospective observational study, which included 236 eyes of 140 patients with normal-tension glaucoma (NTG), which includes 114 eyes with mild myopia (axial length ≥24 and <26 mm) and 122 eyes with moderate-to-severe myopia (axial length ≥26 mm). Ocular characteristics were axial length and posterior pole profiles, including peripapillary atrophy (PPA) to disc area ratio, disc tilt ratio, disc torsion, and disc-foveal angle. Hemodynamic factors included standard deviation of the mean of qualified normal-to-normal intervals (SDNN) of a heart rate variability (HRV) test and vessel density (VD) parameters from optical coherence tomography angiography (OCTA). The root mean square error was estimated as a measure of the VD fluctuation. Association between ocular characteristics and VD parameters of the OCTA with the central sensitivity of the 10-degree visual field or the presence of central scotoma were analyzed. Results Deep layer VD of the peripapillary and macular areas showed significant differences between mild and moderate-to-severe myopia (P = 0.034 and P = 0.045, respectively). Structural parameters, especially PPA to disc area ratio, had significant correlation with peripapillary VD parameters in myopic eyes. Lower SDNN value (ß = 0.924, P = 0.011), lower deep VD of the macular area (ß = 0.845, P = 0.001), and greater fluctuation of deep VD in the peripapillary area (ß = 1.517, P = 0.005) were associated with the presence of central scotoma in patients with glaucoma with myopia in multivariate logistic regression analysis. Conclusions The structural changes by myopia, especially in the peripapillary region, affected VD parameters in myopic eyes. Lower deep VD and greater VD fluctuation in the peripapillary region showed association with central scotoma in patients with glaucoma with myopia, suggesting both structural and vascular changes by myopia may be related to central visual function in glaucoma patients with myopia.
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Affiliation(s)
- Kyung Euy Hong
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seong Ah Kim
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Da-Young Shin
- Department of Ophthalmology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chan Kee Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hae-Young Lopilly Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Tan Q, Zhu M, Du F, Jiang X, Huang X, Chen J, Peng H, Wang D. Changes in Retinal Vessel Flow after Small Incision Lenticule Extraction. Comput Math Methods Med 2022; 2022:8437066. [PMID: 35309847 PMCID: PMC8926514 DOI: 10.1155/2022/8437066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/14/2022] [Accepted: 01/20/2022] [Indexed: 11/18/2022]
Abstract
Objective In order to analyze changes in retinal vessel flow after small incision lenticule extraction (SMILE). Methods A total of 32 patients (62 eyes) who underwent SMILE were enrolled in this prospective study. Optical parameters, including vessel density (VD), and perfusion density (PD) of foveal, parafoveal, and perifoveal regions, respectively, were measured before surgery and at 1 day, 1 week, 1 month, and 3 months postoperation. Preoperative parameters and surgical parameters were recorded. Results Significant decreases in VD and PD on postoperative day 1 were detected in all quadrants, both in 3 mm and in 6 mm regions (P < 0.001). One month after surgery, VD returned to preoperative levels. None of the preoperative and surgical parameters were significantly correlated with the VD and PD fluctuations (all P > 0.05). Conclusion. VD may decrease significantly with regional disparity 1 day after SMILE while recovering at 1 month. Elevation of intraocular pressure due to suction may account for such changes.
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Affiliation(s)
- Qian Tan
- Department of Ophthalmology, Shenzhen People's Hospital, Shenzhen 518000, China
- Department of Ophthalmology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, China
| | - Minyi Zhu
- Department of Ophthalmology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, China
| | - Fangfang Du
- Department of Ophthalmology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, China
| | - Xianming Jiang
- Department of Ophthalmology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, China
| | - Xiaoshan Huang
- Department of Ophthalmology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, China
| | - Jingfang Chen
- Department of Ophthalmology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, China
| | - Hongjun Peng
- Department of Ophthalmology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, China
| | - Danyang Wang
- Department of Ophthalmology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518000, China
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Ha A, Kim SJ, Shim SR, Kim YK, Jung JH. Efficacy and Safety of 8 Atropine Concentrations for Myopia Control in Children: A Network Meta-Analysis. Ophthalmology 2022; 129:322-333. [PMID: 34688698 DOI: 10.1016/j.ophtha.2021.10.016] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [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: 06/12/2021] [Revised: 09/23/2021] [Accepted: 10/14/2021] [Indexed: 01/05/2023] Open
Abstract
TOPIC Comparative efficacy and safety of different concentrations of atropine for myopia control. CLINICAL RELEVANCE Atropine is known to be an effective intervention to delay myopia progression. Nonetheless, no well-supported evidence exists yet to rank the clinical outcomes of various concentrations of atropine. METHODS We searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials, the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov on April 14, 2021. We selected studies involving atropine treatment of at least 1 year's duration for myopia control in children. We performed a network meta-analysis (NMA) of randomized controlled trials (RCTs) and compared 8 atropine concentrations (1% to 0.01%). We ranked the atropine concentrations for the corresponding outcomes by P score (estimate of probability of being best treatment). Our primary outcomes were mean annual changes in refraction (diopters/year) and axial length (AXL; millimeters/year). We extracted data on the proportion of eyes showing myopia progression and safety outcomes (photopic and mesopic pupil diameter, accommodation amplitude, and distance and near best-corrected visual acuity [BCVA]). RESULTS Thirty pairwise comparisons from 16 RCTs (3272 participants) were obtained. Our NMA ranked the 1%, 0.5%, and 0.05% atropine concentrations as the 3 most beneficial for myopia control, as assessed for both primary outcomes: 1% atropine (mean differences compared with control: refraction, 0.81 [95% confidence interval (CI), 0.58-1.04]; AXL, -0.35 [-0.46 to -0.25]); 0.5% atropine (mean differences compared with control: refraction, 0.70 [95% CI, 0.40-1.00]; AXL, -0.23 [-0.38 to -0.07]); 0.05% atropine (mean differences compared with control: refraction, 0.62 [95% CI, 0.17-1.07]; AXL, -0.25 [-0.44 to -0.06]). In terms of myopia control as assessed by relative risk (RR) for overall myopia progression, 0.05% was ranked as the most beneficial concentration (RR, 0.39 [95% CI, 0.27-0.57]). The risk for adverse effects tended to rise as the atropine concentration was increased, although this tendency was not evident for distance BCVA. No valid network was formed for near BCVA. DISCUSSION The ranking probability for efficacy was not proportional to dose (i.e., 0.05% atropine was comparable with that of high-dose atropine [1% and 0.5%]), although those for pupil size and accommodation amplitude were dose related.
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Affiliation(s)
- Ahnul Ha
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea; Department of Ophthalmology, Jeju National University Hospital, Jeju-si, Korea; Department of Ophthalmology, Jeju National University School of Medicine, Jeju-si, Korea
| | - Seong Joon Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea; Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
| | - Sung Ryul Shim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Young Kook Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea; Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
| | - Jae Ho Jung
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea; Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
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Abstract
IMPORTANCE Myopia progression has been found to be worsening during the COVID-19 pandemic. It is important to control the rapid myopia progression in this period. OBJECTIVE To analyze the association of COVID-19-related lockdown measures with myopia progression in schoolchildren and to compare the performance of defocus incorporated multiple segments (DIMS) lens with that of single vision lens (SVL) treatment in reducing myopia progression. DESIGN, SETTING, AND PARTICIPANTS This cohort study involved an exploratory, prespecified, comparison of 2 independent longitudinal studies performed at the same institute beginning in 2019. Data from Hong Kong schoolchildren (aged 7-13 years) were gathered and analyzed. Data analysis was performed from June to July 2021. EXPOSURE Schoolchildren in study 1 wore a DIMS lens for 18 months, and those in study 2 wore a SVL for 24 months. MAIN OUTCOMES AND MEASURES Cycloplegic spherical equivalent refraction and axial length were measured. Studies 1 and 2 started before the start of lockdown measures and continued throughout the lockdown. In both studies, periods of fewer and more COVID-19-related lockdown measures were identified. Because COVID-19 lockdown caused deviations from the visit schedule, myopia progression was normalized to 12-month change, which were compared between DIMS and SVL groups, also during the periods with less and more lockdown time. RESULTS There were 115 participants (58 girls [50.4%]; mean [SD] age, 10.3 [1.5] years) in the DIMS group; their mean (SD) baseline refraction was -4.02 (1.46) D. There were 56 participants (29 girls [51.8%]; mean [SD] age, 10.8 [1.5] years) in the SVL group; their mean (SD) baseline refraction was -2.99 (1.06) D. After controlling for the covariates, DIMS treatment was significantly associated with 34% less axial elongation (0.19 mm [95% CI, 0.16 to 0.22 mm] vs 0.30 mm [95% CI, 0.25 to 0.35 mm]; P < .001) and 46% less myopic progression after 12 months (-0.31 D [95% CI, -0.39 to -0.23 D] vs -0.57 D [95% CI, -0.69 to -0.45 D]; P = .001) compared with SVL treatment. In both the DIMS and SVL groups, more lockdown time was associated with significantly more spherical equivalent refraction (-0.54 D [95% CI, -0.64 to 0.44 D] vs -0.34 D [95% CI, -0.44 to -0.25 D]; P = .01) and axial length (0.29 mm [95% CI, 0.25 to 0.32 mm] vs 0.20 mm [95% CI, 0.16 to 0.24 mm]; P = .001) compared with less lockdown time. No significant interaction between treatment type and lockdown time was observed. CONCLUSIONS AND RELEVANCE In this exploratory analysis, myopia progressed more rapidly in schoolchildren during the period when there were more COVID-19-related lockdown measures. However, optical treatment with DIMS was significantly associated with slower myopia progression compared with SVL treatment during the lockdown period.
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Affiliation(s)
- Kai Yip Choi
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
| | - Rachel Ka Man Chun
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Hong Kong
- Centre for Eye and Vision Research, Hong Kong
| | - Wing Chun Tang
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
| | - Chi Ho To
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Hong Kong
- Centre for Eye and Vision Research, Hong Kong
| | - Carly Siu-yin Lam
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Hong Kong
- Centre for Eye and Vision Research, Hong Kong
| | - Henry Ho-lung Chan
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Hong Kong
- Centre for Eye and Vision Research, Hong Kong
- University Research Facilities in Behavioral and Systems Neurosciences, The Hong Kong Polytechnic University, Hong Kong
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Abstract
PURPOSE To assess changes in the choroidal thickness (CT) after macular buckling in eyes with high myopia. METHODS Highly myopic eyes that underwent macular buckling surgery were retrospectively analyzed. Data of swept-source optical coherence tomography scanning at baseline and at 1, 3, 6, 12, and 18 months after macular buckling were collected. Subfoveal CT and CT at 750 µm superior, inferior, nasal, and temporal to the fovea were measured. The total choroidal area, vascular area, and stromal area were measured by the binarization method. The choroidal vascularity index was calculated by dividing the vascular area by the total choroidal area. RESULTS Forty-one eyes were included in the final analysis. The subfoveal CT increased from 49.85 ± 31.23 µm preoperatively to 75.74 ± 37.89 µm 1 month after macular buckling (P < 0.001), then decreased over time, coinciding with the trends of parafoveal CT, total choroidal area, vascular area, and stromal area. The subfoveal CT was restored to the preoperative level six months postoperatively (P = 0.202) and remained stable until the end of follow-up. The choroidal vascularity index increased at 1 and 3 months postoperatively (P = 0.001 and 0.005, respectively). CONCLUSION The choroid thickened in the early postoperative period. The compression force of the buckle implant might disturb microcirculatory drainage and contribute to the thickening. The choroid spontaneously recovered to the preoperative level over time.
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Affiliation(s)
- Ningning Tang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China ; and
- The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xiujuan Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China ; and
| | - Jing Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China ; and
| | - Bingqian Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China ; and
| | - Lin Lu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China ; and
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Haarman AEG, Enthoven CA, Tedja MS, Polling JR, Tideman JWL, Keunen JEE, Boon CJF, Felix JF, Raat H, Geerards AJM, Luyten GPM, van Rijn GA, Verhoeven VJM, Klaver CCW. Phenotypic Consequences of the GJD2 Risk Genotype in Myopia Development. Invest Ophthalmol Vis Sci 2021; 62:16. [PMID: 34406332 PMCID: PMC8375003 DOI: 10.1167/iovs.62.10.16] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/26/2021] [Indexed: 12/12/2022] Open
Abstract
Purpose To study the relatively high effect of the refractive error gene GJD2 in human myopia, and to assess its relationship with refractive error, ocular biometry and lifestyle in various age groups. Methods The population-based Rotterdam Study (RS), high myopia case-control study MYopia STudy, and the birth-cohort study Generation R were included in this study. Spherical equivalent (SER), axial length (AL), axial length/corneal radius (AL/CR), vitreous depth (VD), and anterior chamber depth (ACD) were measured using standard ophthalmologic procedures. Biometric measurements were compared between GJD2 (rs524952) genotype groups; education and environmental risk score (ERS) were calculated to estimate gene-environment interaction effects, using the Synergy index (SI). Results RS adults carrying two risk alleles had a lower SER and longer AL, ACD and VD (AA versus TT, 0.23D vs. 0.70D; 23.79 mm vs. 23.52 mm; 2.72 mm vs. 2.65 mm; 16.12 mm vs. 15.87 mm; all P < 0.001). Children carrying two risk alleles had larger AL/CR at ages 6 and 9 years (2.88 vs. 2.87 and 3.00 vs. 2.96; all P < 0.001). Education and ERS both negatively influenced myopia and the biometric outcomes, but gene-environment interactions did not reach statistical significance (SI 1.25 [95% confidence interval {CI}, 0.85-1.85] and 1.17 [95% CI, 0.55-2.50] in adults and children). Conclusions The elongation of the eye caused by the GJD2 risk genotype follows a dose-response pattern already visible at the age of 6 years. These early effects are an example of how a common myopia gene may drive myopia.
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Affiliation(s)
- Annechien E G Haarman
- Erasmus Medical Center, Department of Ophthalmology, Rotterdam, The Netherlands
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, The Netherlands
| | - Clair A Enthoven
- Erasmus Medical Center, Department of Ophthalmology, Rotterdam, The Netherlands
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, The Netherlands
- Erasmus Medical Center, the Generation R Study Group, Rotterdam, The Netherlands
| | - Milly S Tedja
- Erasmus Medical Center, Department of Ophthalmology, Rotterdam, The Netherlands
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, The Netherlands
| | - Jan R Polling
- Erasmus Medical Center, Department of Ophthalmology, Rotterdam, The Netherlands
- Department of Optometry and Orthoptics, Hogeschool Utrecht, University of Applied Science, Utrecht, The Netherlands
| | - J Willem L Tideman
- Erasmus Medical Center, Department of Ophthalmology, Rotterdam, The Netherlands
| | - Jan E E Keunen
- University Medical Center St Radboud, Department of Ophthalmology, Nijmegen, The Netherlands
| | - Camiel J F Boon
- Leiden University Medical Center, Department of Ophthalmology, The Netherlands
- Amsterdam University Medical Center, Department of Ophthalmology, University of Amsterdam, The Netherlands
| | - Janine F Felix
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, The Netherlands
- Erasmus Medical Center, the Generation R Study Group, Rotterdam, The Netherlands
- Erasmus Medical Center, Department of Pediatrics, Rotterdam, The Netherlands
| | - H Raat
- Erasmus University Medical Centre, Department of Public Health, Rotterdam, The Netherlands
| | | | | | - Gwyneth A van Rijn
- Leiden University Medical Center, Department of Ophthalmology, The Netherlands
| | - Virginie J M Verhoeven
- Erasmus Medical Center, Department of Ophthalmology, Rotterdam, The Netherlands
- Erasmus Medical Center, Department of Clinical Genetics, Rotterdam, The Netherlands
| | - Caroline C W Klaver
- Erasmus Medical Center, Department of Ophthalmology, Rotterdam, The Netherlands
- Erasmus Medical Center, Department of Epidemiology, Rotterdam, The Netherlands
- University Medical Center St Radboud, Department of Ophthalmology, Nijmegen, The Netherlands
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
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21
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Al Sayed ZR, Canac R, Cimarosti B, Bonnard C, Gourraud JB, Hamamy H, Kayserili H, Girardeau A, Jouni M, Jacob N, Gaignerie A, Chariau C, David L, Forest V, Marionneau C, Charpentier F, Loussouarn G, Lamirault G, Reversade B, Zibara K, Lemarchand P, Gaborit N. Human model of IRX5 mutations reveals key role for this transcription factor in ventricular conduction. Cardiovasc Res 2021; 117:2092-2107. [PMID: 32898233 DOI: 10.1093/cvr/cvaa259] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/15/2020] [Accepted: 08/28/2020] [Indexed: 01/02/2023] Open
Abstract
AIMS Several inherited arrhythmic diseases have been linked to single gene mutations in cardiac ion channels and interacting proteins. However, the mechanisms underlying most arrhythmias, are thought to involve altered regulation of the expression of multiple effectors. In this study, we aimed to examine the role of a transcription factor (TF) belonging to the Iroquois homeobox family, IRX5, in cardiac electrical function. METHODS AND RESULTS Using human cardiac tissues, transcriptomic correlative analyses between IRX5 and genes involved in cardiac electrical activity showed that in human ventricular compartment, IRX5 expression strongly correlated to the expression of major actors of cardiac conduction, including the sodium channel, Nav1.5, and Connexin 40 (Cx40). We then generated human-induced pluripotent stem cells (hiPSCs) derived from two Hamamy syndrome-affected patients carrying distinct homozygous loss-of-function mutations in IRX5 gene. Cardiomyocytes derived from these hiPSCs showed impaired cardiac gene expression programme, including misregulation in the control of Nav1.5 and Cx40 expression. In accordance with the prolonged QRS interval observed in Hamamy syndrome patients, a slower ventricular action potential depolarization due to sodium current reduction was observed on electrophysiological analyses performed on patient-derived cardiomyocytes, confirming the functional role of IRX5 in electrical conduction. Finally, a cardiac TF complex was newly identified, composed by IRX5 and GATA4, in which IRX5 potentiated GATA4-induction of SCN5A expression. CONCLUSION Altogether, this work unveils a key role for IRX5 in the regulation of human ventricular depolarization and cardiac electrical conduction, providing therefore new insights into our understanding of cardiac diseases.
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Affiliation(s)
- Zeina R Al Sayed
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Robin Canac
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Bastien Cimarosti
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Carine Bonnard
- Institute of Medical Biology, A*STAR, 8A Biomedical Grove, Singapore 138648, Singapore
| | - Jean-Baptiste Gourraud
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
- Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Hanan Hamamy
- Department of Genetic Medicine and Development, Geneva University, 1 rue Michel-Servet, Geneva 1211, Switzerland
| | - Hulya Kayserili
- Medical Genetics Department, Koç University School of Medicine(KUSOM), Rumelifeneri Yolu 34450, Istanbul, Turkey
| | - Aurore Girardeau
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Mariam Jouni
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Nicolas Jacob
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Anne Gaignerie
- Université de Nantes, CHU Nantes, Inserm, CNRS, SFR Santé, Inserm UMS 016, CNRS UMS 3556, 8 Quai Moncousu, F-44000 Nantes, France
| | - Caroline Chariau
- Université de Nantes, CHU Nantes, Inserm, CNRS, SFR Santé, Inserm UMS 016, CNRS UMS 3556, 8 Quai Moncousu, F-44000 Nantes, France
| | - Laurent David
- Université de Nantes, CHU Nantes, Inserm, CNRS, SFR Santé, Inserm UMS 016, CNRS UMS 3556, 8 Quai Moncousu, F-44000 Nantes, France
- Université de Nantes, INSERM, CRTI, 30 Bd Jean Monnet, F-44093 Nantes, France
- ITUN, CHU Nantes, 30 Bd Jean Monnet, F-44093 Nantes, France
| | - Virginie Forest
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Céline Marionneau
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Flavien Charpentier
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
- Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Gildas Loussouarn
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Guillaume Lamirault
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
- Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Bruno Reversade
- Institute of Medical Biology, A*STAR, 8A Biomedical Grove, Singapore 138648, Singapore
- Medical Genetics Department, Koç University School of Medicine(KUSOM), Rumelifeneri Yolu 34450, Istanbul, Turkey
- Department of Paediatrics, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore
- Institute of Molecular and Cellular Biology, A*STAR, 61 Biopolis Drive, Singapore 138673, Singapore
- Reproductive Biology Laboratory, Amsterdam UMC, Meibergdreef 9 1105, Amsterdam-Zuidoost, Netherlands
| | - Kazem Zibara
- ER045, Laboratory of stem cells, DSST, Biology department, Faculty of Sciences, Lebanese University, Rafic Hariri Campus - Hadath, Beirut 1700, Lebanon
| | - Patricia Lemarchand
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
- Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
| | - Nathalie Gaborit
- Université de Nantes, CNRS, INSERM, l'institut du thorax, 8 quai Moncousu, F-44000 Nantes, France
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22
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Enthoven CA, Polling JR, Verzijden T, Tideman JWL, Al-Jaffar N, Jansen PW, Raat H, Metz L, Verhoeven VJM, Klaver CCW. Smartphone Use Associated with Refractive Error in Teenagers: The Myopia App Study. Ophthalmology 2021; 128:1681-1688. [PMID: 34245754 DOI: 10.1016/j.ophtha.2021.06.016] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/18/2021] [Accepted: 06/29/2021] [Indexed: 02/08/2023] Open
Abstract
PURPOSE To investigate the association between smartphone use and refractive error in teenagers using the Myopia app. DESIGN Cross-sectional population-based study. PARTICIPANTS A total of 525 teenagers 12 to 16 years of age from 6 secondary schools and from the birth cohort study Generation R participated. METHODS A smartphone application (Myopia app; Innovattic) was designed to measure smartphone use and face-to-screen distance objectively and to pose questions about outdoor exposure. Participants underwent cycloplegic refractive error and ocular biometry measurements. Mean daily smartphone use was calculated in hours per day and continuous use as the number of episodes of 20 minutes on screen without breaks. Linear mixed models were conducted with smartphone use, continuous use, and face-to-screen distance as determinants and spherical equivalent of refraction (SER) and axial length-to-corneal radius (AL:CR) ratio as outcome measures stratified by median outdoor exposure. MAIN OUTCOME MEASURES Spherical equivalent of refraction in diopters and AL:CR ratio. RESULTS The teenagers on average were 13.7 ± 0.85 years of age, and myopia prevalence was 18.9%. During school days, total smartphone use on average was 3.71 ± 1.70 hours/day and was associated only borderline significantly with AL:CR ratio (β = 0.008; 95% confidence interval [CI], -0.001 to 0.017) and not with SER. Continuous use on average was 6.42 ± 4.36 episodes of 20-minute use without breaks per day and was associated significantly with SER and AL:CR ratio (β = -0.07 [95% CI, -0.13 to -0.01] and β = 0.004 [95% CI, 0.001-0.008], respectively). When stratifying for outdoor exposure, continuous use remained significant only for teenagers with low exposure (β = -0.10 [95% CI, -0.20 to -0.01] and β = 0.007 [95% CI, 0.001-0.013] for SER and AL:CR ratio, respectively). Smartphone use during weekends was not associated significantly with SER and AL:CR ratio, nor was face-to-screen distance. CONCLUSIONS Dutch teenagers spent almost 4 hours per day on their smartphones. Episodes of 20 minutes of continuous use were associated with more myopic refractive errors, particularly in those with low outdoor exposure. This study suggested that frequent breaks should become a recommendation for smartphone use in teenagers. Future large longitudinal studies will allow more detailed information on safe screen use in youth.
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Affiliation(s)
- Clair A Enthoven
- Department of Ophthalmology and Epidemiology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands; The Generation R Study Group, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Jan Roelof Polling
- Department of Ophthalmology and Epidemiology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands; Orthoptics and Optometry, University of Applied Sciences, Utrecht, Utrecht, The Netherlands
| | - Timo Verzijden
- Department of Ophthalmology and Epidemiology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - J Willem L Tideman
- Department of Ophthalmology and Epidemiology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Nora Al-Jaffar
- Department of Ophthalmology and Epidemiology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Pauline W Jansen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands; Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Zuid-Holland, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
| | | | - Virginie J M Verhoeven
- Department of Ophthalmology and Epidemiology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands; Clinical Genetics, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Caroline C W Klaver
- Department of Ophthalmology and Epidemiology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands; Department of Ophthalmology, Radboud University Medical Center, Nijmegen, Gelderland, The Netherlands; Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland.
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23
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Morningstar JE, Nieman A, Wang C, Beck T, Harvey A, Norris RA. Mitral Valve Prolapse and Its Motley Crew-Syndromic Prevalence, Pathophysiology, and Progression of a Common Heart Condition. J Am Heart Assoc 2021; 10:e020919. [PMID: 34155898 PMCID: PMC8403286 DOI: 10.1161/jaha.121.020919] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/21/2021] [Indexed: 01/01/2023]
Abstract
Mitral valve prolapse (MVP) is a commonly occurring heart condition defined by enlargement and superior displacement of the mitral valve leaflet(s) during systole. Although commonly seen as a standalone disorder, MVP has also been described in case reports and small studies of patients with various genetic syndromes. In this review, we analyzed the prevalence of MVP within syndromes where an association to MVP has previously been reported. We further discussed the shared biological pathways that cause MVP in these syndromes, as well as how MVP in turn causes a diverse array of cardiac and noncardiac complications. We found 105 studies that identified patients with mitral valve anomalies within 18 different genetic, developmental, and connective tissue diseases. We show that some disorders previously believed to have an increased prevalence of MVP, including osteogenesis imperfecta, fragile X syndrome, Down syndrome, and Pseudoxanthoma elasticum, have few to no studies that use up-to-date diagnostic criteria for the disease and therefore may be overestimating the prevalence of MVP within the syndrome. Additionally, we highlight that in contrast to early studies describing MVP as a benign entity, the clinical course experienced by patients can be heterogeneous and may cause significant cardiovascular morbidity and mortality. Currently only surgical correction of MVP is curative, but it is reserved for severe cases in which irreversible complications of MVP may already be established; therefore, a review of clinical guidelines to allow for earlier surgical intervention may be warranted to lower cardiovascular risk in patients with MVP.
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Affiliation(s)
- Jordan E. Morningstar
- Department of Regenerative Medicine and Cell BiologyMedical University of South CarolinaCharlestonSC
| | - Annah Nieman
- Department of Regenerative Medicine and Cell BiologyMedical University of South CarolinaCharlestonSC
| | - Christina Wang
- Department of Regenerative Medicine and Cell BiologyMedical University of South CarolinaCharlestonSC
| | - Tyler Beck
- Department of Regenerative Medicine and Cell BiologyMedical University of South CarolinaCharlestonSC
| | - Andrew Harvey
- Department of Regenerative Medicine and Cell BiologyMedical University of South CarolinaCharlestonSC
| | - Russell A. Norris
- Department of Regenerative Medicine and Cell BiologyMedical University of South CarolinaCharlestonSC
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24
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McCann P, Hogg R, Wright DM, Chakravarthy U, Peto T, Cruise S, McGuinness B, Young IS, Kee F, Azuara-Blanco A. Intraocular pressure and circumpapillary retinal nerve fibre layer thickness in the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA): distributions and associations. Br J Ophthalmol 2021; 105:948-956. [PMID: 32732345 DOI: 10.1136/bjophthalmol-2020-316499] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Received: 04/06/2020] [Revised: 06/03/2020] [Accepted: 06/25/2020] [Indexed: 11/03/2022]
Abstract
AIMS To describe the distributions of and associations with intraocular pressure (IOP) and circumpapillary retinal nerve fibre layer (cRNFL) thickness in a population-based study. METHODS Northern Ireland Cohort for the Longitudinal Study of Ageing participants underwent a computer-assisted personal interview, a self-completion questionnaire and a health assessment (HA). At the HA, participants underwent IOP measurement using Ocular Response Analyser and spectral-domain optical coherence tomography with Heidelberg Spectralis. Participants also underwent a range of anthropometric, ophthalmic, cardiovascular, cognition and blood tests. Participants who attended the HA and had a vertical cup-to-disc ratio (VCDR) measurement in at least one eye were eligible for the study. Participants without any IOP or cRNFL measurements were excluded from the respective analyses. RESULTS There were 3221 participants eligible for this study (5753 eyes included in the IOP analysis and 5461 eyes included in the cRNFL analysis). The mean (SD) Goldmann correlated IOP (IOPg) was 15.39 mm Hg (3.55 mm Hg). The mean (SD) average global cRNFL thickness was 94.39 µm (11.18 µm). Increased IOPg was associated with increased age, male sex, hypertension, refractive error (myopic decrease in spherical equivalent) and increased corneal resistance factor, while beta-blocker drug use was associated with lower IOPg in the fully adjusted multivariate analysis. Thinner average global cRNFL was associated with Alzheimer's disease in the age-adjusted and sex-adjusted model. In the fully adjusted multivariate analysis, increased age, male sex, left eyes, hypertension, increased VCDR, refractive error (myopic decrease in spherical equivalent) and increased IOPg were associated with thinner average global cRNFL, while Parkinson's disease and current (vs never) smoking status were associated with thicker average global cRNFL. CONCLUSIONS Increased IOP and reduced cRNFL were associated with increased age, myopic refractive error, male sex and hypertension. Alzheimer's disease was associated with thinner average global cRNFL, while Parkinson's disease was associated with thicker average global cRNFL.
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Affiliation(s)
- Paul McCann
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Ruth Hogg
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - David M Wright
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | | - Tunde Peto
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Sharon Cruise
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | | - Ian S Young
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Frank Kee
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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25
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Vingopoulos F, Nair A, See CW, Iyengar N, Haberman I, Sperber L, Lazzaro DR, Singh R, Ho A, Gupta O, Sharma S, Modi Y. POSITION OF IN-THE-BAG POSTERIOR CHAMBER INTRAOCULAR LENSES RELATIVE TO THE LIMBUS: Applications to Scleral-Sutured Lenses. Retina 2021; 41:1533-1540. [PMID: 33239547 DOI: 10.1097/iae.0000000000003044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To characterize the true position of in-the-bag intraocular lenses (IOLs) relative to the limbus using ultrasound biomicroscopy and estimate scleral-sutured IOL positioning. METHODS This prospective single-center study included 70 eyes of 41 patients with in-the-bag posterior chamber IOLs. Four vertical ultrasound biomicroscopy captures were performed in each eye in the superior, inferior, nasal, and temporal quadrants. Postoperative biometric data were collected. The primary outcome was the vertical distance of the in-the-bag IOL from the sclerocorneal limbus. Secondary outcomes included anterior shift and refractive change of a theoretical scleral-sutured IOL using sclerotomies at 2.5 mm and 3 mm posterior to the limbus. RESULTS A total of 265 ultrasound biomicroscopy images were analyzed, including 64 superior, 69 inferior, 66 nasal, and 66 temporal. The true in-the-bag IOL position measured as distance posterior to the sclerocorneal limbus was 4.23 ± 0.56 mm superiorly, 4.22 ± 0.46 mm inferiorly, 3.95 ± 0.48 mm nasally, and 3.86 ± 0.52 mm temporally. The anterior shift of a theoretical scleral-sutured IOL was 0.60 mm for a 3-mm sclerotomy and 0.93 mm for a 2.5-mm sclerotomy, resulting in a theoretical myopic shift of 0.45 diopter (D) and 0.79 D, respectively, assuming a 15-D IOL. Larger biometric measurements correlated with a more posterior in-the-bag position. CONCLUSION True in-the-bag IOL position was found to be more posterior than estimates of scleral-sutured IOLs. Additional corrections in scleral-sutured IOL calculations may improve refractive outcomes.
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Affiliation(s)
- Filippos Vingopoulos
- Department of Ophthalmology, NYU Langone Health, New York University, New York, New York
| | - Archana Nair
- Department of Ophthalmology, NYU Langone Health, New York University, New York, New York
| | - Craig W See
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio; and
| | - Nishanth Iyengar
- Department of Ophthalmology, NYU Langone Health, New York University, New York, New York
| | - Ilyse Haberman
- Department of Ophthalmology, NYU Langone Health, New York University, New York, New York
| | - Laurence Sperber
- Department of Ophthalmology, NYU Langone Health, New York University, New York, New York
| | - Douglas R Lazzaro
- Department of Ophthalmology, NYU Langone Health, New York University, New York, New York
| | - Rishi Singh
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio; and
| | - Allen Ho
- Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Omesh Gupta
- Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Sumit Sharma
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio; and
| | - Yasha Modi
- Department of Ophthalmology, NYU Langone Health, New York University, New York, New York
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26
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Simpson CL, Musolf AM, Cordero RY, Cordero JB, Portas L, Murgia F, Lewis DD, Middlebrooks CD, Ciner EB, Bailey-Wilson JE, Stambolian D. Myopia in African Americans Is Significantly Linked to Chromosome 7p15.2-14.2. Invest Ophthalmol Vis Sci 2021; 62:16. [PMID: 34241624 PMCID: PMC8287048 DOI: 10.1167/iovs.62.9.16] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 01/20/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to perform genetic linkage analysis and association analysis on exome genotyping from highly aggregated African American families with nonpathogenic myopia. African Americans are a particularly understudied population with respect to myopia. Methods One hundred six African American families from the Philadelphia area with a family history of myopia were genotyped using an Illumina ExomePlus array and merged with previous microsatellite data. Myopia was initially measured in mean spherical equivalent (MSE) and converted to a binary phenotype where individuals were identified as affected, unaffected, or unknown. Parametric linkage analysis was performed on both individual variants (single-nucleotide polymorphisms [SNPs] and microsatellites) as well as gene-based markers. Family-based association analysis and transmission disequilibrium test (TDT) analysis modified for rare variants was also performed. Results Genetic linkage analysis identified 2 genomewide significant variants at 7p15.2 and 7p14.2 (in the intergenic region between MIR148A and NFE2L3 and in the noncoding RNA LOC401324) and 2 genomewide significant genes (CRHR2 and AVL9) both at 7p14.3. No genomewide results were found in the association analyses. Conclusions This study identified a significant linkage peak in African American families for myopia at 7p15.2 to 7p14.2, the first potential risk locus for myopia in African Americans. Interesting candidate genes are located in the region, including PDE1C, which is highly expressed in the eyes, and known to be involved in retinal development. Further identification of the causal variants at this linkage peak will help elucidate the genetics of myopia in this understudied population.
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Affiliation(s)
- Claire L. Simpson
- Department of Genetics, Genomics and Informatics and Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee, United States
- Computational and Statistical Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Baltimore, Maryland, United States
| | - Anthony M. Musolf
- Computational and Statistical Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Baltimore, Maryland, United States
| | - Roberto Y. Cordero
- Department of Genetics, Genomics and Informatics and Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee, United States
| | - Jennifer B. Cordero
- Department of Genetics, Genomics and Informatics and Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee, United States
| | - Laura Portas
- Computational and Statistical Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Baltimore, Maryland, United States
| | - Federico Murgia
- Computational and Statistical Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Baltimore, Maryland, United States
| | - Deyana D. Lewis
- Computational and Statistical Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Baltimore, Maryland, United States
| | - Candace D. Middlebrooks
- Computational and Statistical Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Baltimore, Maryland, United States
| | - Elise B. Ciner
- The Pennsylvania College of Optometry at Salus University, Elkins Park, Pennsylvania, United States
| | - Joan E. Bailey-Wilson
- Department of Genetics, Genomics and Informatics and Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee, United States
| | - Dwight Stambolian
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
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Zhi Z, Xiang J, Fu Q, Pei X, Zhou D, Cao Y, Xie L, Zhang S, Chen S, Qu J, Zhou X. The Role of Retinal Connexins Cx36 and Horizontal Cell Coupling in Emmetropization in Guinea Pigs. Invest Ophthalmol Vis Sci 2021; 62:27. [PMID: 34283211 PMCID: PMC8300059 DOI: 10.1167/iovs.62.9.27] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 06/24/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to determine whether retinal gap junctions (GJs) via connexin 36 (Cx36, mediating coupling of many retinal cell types) and horizontal cell (HC-HC) coupling, are involved in emmetropization. Methods Guinea pigs (3 weeks old) were monocularly form deprived (FD) or raised without FD (in normal visual [NV] environment) for 2 days or 4 weeks; alternatively, they wore a -4 D lens (hyperopic defocus [HD]) or 0 D lens for 2 days or 1 week. FD and NV eyes received daily subconjunctival injections of a nonspecific GJ-uncoupling agent, 18-β-Glycyrrhetinic Acid (18-β-GA). The amounts of total Cx36 and of phosphorylated Cx36 (P-Cx36; activated state that increases cell-cell coupling), in the inner and outer plexiform layers (IPLs and OPLs), were evaluated by quantitative immunofluorescence (IF), and HC-HC coupling was evaluated by cut-loading with neurobiotin. Results FD per se (excluding effect of light-attenuation) increased HC-HC coupling in OPL, whereas HD did not affect it. HD for 2 days or 1 week had no significant effect on retinal content of Cx36 or P-Cx36. FD for 4 weeks decreased the total amounts of Cx36 and P-Cx36, and the P-Cx36/Cx36 ratio, in the IPL. Subconjunctival 18-β-GA induced myopia in NV eyes and increased the myopic shifts in FD eyes, while reducing the amounts of Cx36 and P-Cx36 in both the IPL and OPL. Conclusions These results suggest that cell-cell coupling via GJs containing Cx36 (particularly those in the IPL) plays a role in emmetropization and form deprivation myopia (FDM) in mammals. Although both FD and 18-β-GA induced myopia, they had opposite effects on HC-HC coupling. These findings suggest that HC-HC coupling in the OPL might not play a significant role in emmetropization and myopia development.
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Affiliation(s)
- Zhina Zhi
- School of Optometry and Ophthalmology, and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- State Key Laboratory and Key Laboratory of Vision Science, Ministry of Health People's Republic of China and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
| | - Jing Xiang
- School of Optometry and Ophthalmology, and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- State Key Laboratory and Key Laboratory of Vision Science, Ministry of Health People's Republic of China and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
| | - Qian Fu
- School of Optometry and Ophthalmology, and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- State Key Laboratory and Key Laboratory of Vision Science, Ministry of Health People's Republic of China and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
| | - Xiaomeng Pei
- School of Optometry and Ophthalmology, and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- State Key Laboratory and Key Laboratory of Vision Science, Ministry of Health People's Republic of China and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
| | - Dengke Zhou
- School of Optometry and Ophthalmology, and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- State Key Laboratory and Key Laboratory of Vision Science, Ministry of Health People's Republic of China and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
| | - Yuqing Cao
- School of Optometry and Ophthalmology, and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- State Key Laboratory and Key Laboratory of Vision Science, Ministry of Health People's Republic of China and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
| | - Liqin Xie
- School of Optometry and Ophthalmology, and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- State Key Laboratory and Key Laboratory of Vision Science, Ministry of Health People's Republic of China and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
| | - Sen Zhang
- School of Optometry and Ophthalmology, and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- State Key Laboratory and Key Laboratory of Vision Science, Ministry of Health People's Republic of China and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
| | - Si Chen
- School of Optometry and Ophthalmology, and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- State Key Laboratory and Key Laboratory of Vision Science, Ministry of Health People's Republic of China and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
| | - Jia Qu
- School of Optometry and Ophthalmology, and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- State Key Laboratory and Key Laboratory of Vision Science, Ministry of Health People's Republic of China and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
| | - Xiangtian Zhou
- School of Optometry and Ophthalmology, and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- State Key Laboratory and Key Laboratory of Vision Science, Ministry of Health People's Republic of China and Zhejiang Provincial Key Laboratory of Ophthalmology and Optometry, Wenzhou, Zhejiang, China
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Martínez-Plaza E, López-Miguel A, López-de la Rosa A, McAlinden C, Fernández I, Maldonado MJ. Effect of the EVO+ Visian Phakic Implantable Collamer Lens on Visual Performance and Quality of Vision and Life. Am J Ophthalmol 2021; 226:117-125. [PMID: 33577790 DOI: 10.1016/j.ajo.2021.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/25/2021] [Accepted: 02/03/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE To assess the effect of EVO+ (V5) Visian implantable collamer lens implantation on mesopic visual performance, quality of vision (QoV), and quality of life (QoL). DESIGN Prospective interventional case series. METHODS Thirty-six eyes of 36 participants who underwent EVO+ implantation for myopia were evaluated preoperatively and at postoperative visits at 1 week and 1, 3, and 6 months. Visual acuity (VA) and mesopic contrast sensitivity (CS) with and without halogen- and xenon-type glare sources were evaluated at each visit. Subjective QoV was assessed with the QoV questionnaire and QoL assessed with the Quality of Life Impact of Refractive Correction (QIRC) questionnaire at each visit. Ring-shaped dysphotopsia was also assessed at each postoperative visit. Linear, cumulative link and logit mixed models were fitted to analyze the effect of the EVO+. RESULTS Following EVO+ implantation, VA significantly (P ≤ .012) improved at the 4 postoperative visits. Mesopic CS progressively improved at 1, 3, and 6 months postoperatively (P ≤ .012). Halogen glare CS decreased at 1 week and halogen and xenon glare CS improved at 6 months (P ≤ .016). Photostress recovery time after halogen glare improved at 3 and 6 months (P ≤ .004). QoV scores improved at 1 week and 3 and 6 months (P ≤ .001). QIRC scores improved postoperatively (P < .001). Ring-shaped dysphotopsia decreased at 3 and 6 months (P ≤ .007). CONCLUSIONS EVO+ implantation provides good mesopic visual performance, QoV, and QoL during up to 6 months follow-up. Some activities performed under mesopic conditions with glare sources may be affected during the first postoperative week. Ring-shaped dysphotopsia is negligibly bothersome 6 months after surgery.
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Affiliation(s)
- Elena Martínez-Plaza
- From Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain
| | - Alberto López-Miguel
- From Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain.
| | | | - Colm McAlinden
- Department of Ophthalmology, Singleton Hospital, Swansea Bay University Health Board, Swansea, United Kingdom
| | - Itziar Fernández
- From Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Miguel J Maldonado
- From Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Red Temática de Investigación Colaborativa en Oftalmología (OftaRed), Instituto de Salud Carlos III, Madrid, Spain
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Liu CF, Chen SC, Chen KJ, Liu L, Chen YP, Kang EYC, Liu PK, Yeung L, Wu WC, Lai CC, Lo FS, Wang NK. Higher HbA1c may reduce axial length elongation in myopic children: a comparison cohort study. Acta Diabetol 2021; 58:779-786. [PMID: 33587176 PMCID: PMC8487071 DOI: 10.1007/s00592-020-01631-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/31/2020] [Indexed: 01/19/2023]
Abstract
AIMS To compare the annual axial length (AL) changes in myopic children with type 1 diabetes mellitus (T1DM) and those without diabetes. METHODS There are two groups of myopic children in this retrospective cohort study. Group 1 consisted of myopic children with T1DM (44 eyes of 22 patients). Group 2 comprised age-matched myopic children without diabetes (44 eyes of 22 children). These two groups were compared with regard to their baseline clinical characteristics. A generalized estimating equations (GEE) model was also used to determine the most likely factor that contributed to the results. RESULTS The average ages of group 1 and group 2 were 14.8 and 14.6 years, respectively. Children in group 1 had significantly slower annual AL changes (0.051 mm/year vs 0.103 mm/year; 50.5% slower, P = 0.011) and shorter baseline AL (23.97 vs 25.19 mm, P < 0.001) than those in group 2. GEE also showed that serum glycated hemoglobin (HbA1c) level (B = -0.023, P = 0.039) was the most important factor in reducing AL elongation in group 1 myopic children. CONCLUSIONS Long-term higher HbA1c level may reduce AL elongation. A strict blood sugar control strategy in clinical practice is warranted to axial myopia progression in T1DM children.
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Affiliation(s)
- Chun-Fu Liu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
- Program in Molecular Medicine, National Yang Ming University, Taipei, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shin-Chieh Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Kuan-Jen Chen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Laura Liu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yen-Po Chen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Ophthalmology, Tucheng Municipal Hospital, New Taipei City, Taiwan
| | - Eugene Yu-Chuan Kang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Pei-Kang Liu
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University, New York, New York, USA
| | - Ling Yeung
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Chi Wu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chi-Chun Lai
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Fu-Sung Lo
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.
- Division of Pediatric Endocrinology and Genetics, Chang Gung Memorial Hospital, Linkou, Taiwan.
| | - Nan-Kai Wang
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University, New York, New York, USA.
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Liu J, Zhang R, Sun L, Zheng Y, Chen S, Chen SL, Xu Y, Pang CP, Zhang M, Ng TK. Genotype-phenotype correlation and interaction of 4q25, 15q14 and MIPEP variants with myopia in southern Chinese population. Br J Ophthalmol 2021; 105:869-877. [PMID: 31604699 DOI: 10.1136/bjophthalmol-2019-314782] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 09/24/2019] [Accepted: 09/27/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND/AIMS To determine the association and interaction of genome-wide association study-reported variants for Asian populations with myopia and ocular biometric parameters in southern Chinese population. METHODS Totally, 1462 unrelated Han Chinese subjects were recruited with complete ophthalmic examinations, including 1196 myopia and 266 control subjects. A total of nine variants were selected for TaqMan genotyping. The genetic association, joint additive effect and genotype-phenotype correlation were investigated. RESULTS The 4q25 variant rs10034228 (p=0.002, OR=0.56) and MIPEP variant rs9318086 (p=0.004, OR=1.62) were found to be significantly associated with myopia as well as different severity of myopia. Moreover, 15q14 variant rs524952 (p=0.015, OR=1.49) also showed mild association with myopia and high myopia. However, there was no significant association of CTNND2, vasoactive intestinal peptide receptor 2 and syntrophin beta 1 variants with myopia. Joint additive analysis revealed that the subjects carrying 6 risk alleles of the 3 associated variants were 10-fold higher risk predisposed to high myopia. Genotype-phenotype correlation analysis revealed that high myopia subjects carrying 4q25 rs10034228 T allele showed thicker central corneal thickness, whereas high myopia subjects carrying 15q14 rs524952 A allele were associated with longer axial length and larger curvature ratio. CONCLUSION This study revealed significant association of 4q25, 15q14 and MIPEP variants with myopia and different severity of myopia in southern Chinese population, joint additively enhancing 10-fold of risk predisposing to high myopia. The correlation of these associated variants with axial length and corneal parameters suggests their contribution to the refractive status in high myopia subjects.
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Affiliation(s)
- Junbin Liu
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Riping Zhang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Lixia Sun
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Yuqian Zheng
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Shaowan Chen
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Shao-Lang Chen
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Yanxuan Xu
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Chi-Pui Pang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | - Mingzhi Zhang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Tsz Kin Ng
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
- Shantou University Medical College, Shantou, Guangdong, China
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Abstract
PURPOSE Both emmetropic and myopic eyes elongate throughout childhood. The goals of this study were to compare axial elongation among untreated progressing myopes, progressing myopes treated with a myopia control contact lens and emmetropes, in order to place axial elongation in the context of normal eye growth in emmetropic children, and to consider whether normal physiological eye growth places limits on what might be achieved with myopia control. METHODS Axial elongation data were taken from the 3-year randomised clinical trial of a myopia control dual-focus (MiSight® 1 day) contact lens. These were compared with data for myopic and emmetropic children in two large cohort studies: the Orinda Longitudinal Study of Myopia (OLSM) and the Singapore Cohort Study of the Risk Factors for Myopia (SCORM). Each study's published equations were used to calculate annual axial elongation. Four virtual cohorts-myopic and emmetropic for each model-were created, each with the same age distribution as the MiSight clinical trial subjects and the predicted cumulative elongation calculated at years 1, 2 and 3 for myopes and emmetropes using both the OLSM and SCORM models. RESULTS The untreated control myopes in the MiSight clinical trial showed mean axial elongation over 3 years (0.62 mm) similar to the virtual cohorts based on the OLSM (0.70 mm) and SCORM (0.65 mm) models. The predicted 3-year axial elongation for the virtual cohorts of emmetropes was 0.24 mm for both the OLSM and SCORM models-similar to the mean 3-year elongation in MiSight-treated myopes (0.30 mm). CONCLUSIONS The 3-year elongation in MiSight-treated myopes approached that of virtual cohorts of emmetropes with the same age distribution. It is hypothesised that myopic axial elongation is superimposed on an underlying physiological axial elongation observed in emmetropic eyes, which reflects increases in body stature. We speculate that optically based myopia control treatments may minimise the myopic axial elongation but retain the underlying physiological elongation observed in emmetropic eyes.
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Chen Q, Tan W, Lei X, Pan C, Jin L, Zeng Q, Wang Z. Clinical Prediction of Excessive Vault After Implantable Collamer Lens Implantation Using Ciliary Body Morphology. J Refract Surg 2021; 36:380-387. [PMID: 32521025 DOI: 10.3928/1081597x-20200513-02] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 05/13/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine the factors related to the ciliary body that are predictive of outcomes of excessive vault (> 1,000 µm) after Implantable Collamer Lens (ICL V4c; STAAR Surgical) implantation. METHODS In this retrospective case-control study, 27 eyes of 27 patients who presented with excessive vault (> 1,000 µm) following implantation of an ICL V4c were matched in a 1:2 ratio with those who presented with a normal vault (250 to 1,000 µm) on white-to-white distance, anterior chamber depth, and ICL size. The preoperative biometric parameters and clinical outcomes were compared between the two groups. The relationship between the postoperative vault and various variables was assessed by multiple linear regression analysis. Conditional logistic regression models were used to estimate odds ratios (ORs) and 95% CIs for excessive vault. RESULTS The vault value 1 month postoperatively was associated with preoperative anterior chamber volume, iris-ciliary angle, and crystalline lens rise (P < .05). In the conditional regression logistic analysis, every 1° reduction in iris-ciliary angle was associated with 4% increased odds of vault greater than 1,000 µm (OR = 0.96; 95% CI = 0.93 to 0.99; P < .001) and the anteriorly positioned ciliary body was associated with an increased risk of excessive vault after ICL implantation (OR = 3.57; 95% CI = 1.67 to 7.63; P < .001). In the excessive vault group, 1 eye underwent the ICL extraction and 3 eyes had an ICL exchange for a smaller ICL. After the ICL exchange, the mean value of postoperative vault decreased from 1,525.67 ± 468.22 to 810.33 ± 254.92 µm. CONCLUSIONS Eyes with an anteriorly positioned ciliary body were associated with a higher rate of excessive vault after ICL implantation, so the size of the ICL may need to be adjusted in these patients. Assessment of ciliary body characteristics adds significant information to the prediction of excessive vault after surgery. [J Refract Surg. 2020;36(6):380-387.].
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Liu J, Wang Y. Influence of Preoperative Keratometry on Refractive Outcomes for Myopia Correction With Small Incision Lenticule Extraction. J Refract Surg 2021; 36:374-379. [PMID: 32521024 DOI: 10.3928/1081597x-20200513-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 05/13/2020] [Indexed: 01/29/2023]
Abstract
PURPOSE To evaluate the effect of preoperative keratometry on refractive outcomes after small incision lenticule extraction (SMILE) for myopia. METHODS This retrospective study comprised 515 consecutive eyes that had SMILE to correct myopia. Pearson correlation and linear regression were used to determine the relationship between residual spherical equivalent and preoperative keratometry. The same analyses were repeated in the quartiles with the lowest and highest preoperative myopia. RESULTS Preoperatively, the mean spherical equivalent was -5.67 ± 1.87 diopters (D) (range: -1.63 to -9.75 D) and the mean keratometry was 43.10 ± 1.30 D (range: 38.90 to 47.00 D). Three months postoperatively, the mean spherical equivalent was -0.07 ± 0.18 D. After adjustment for age, sex, and preoperative spherical equivalent, greater postoperative undercorrection occurred in eyes with steeper corneas (P = .001). Each diopter of steeper keratometry resulted in 0.52% (0.03 D) more undercorrection. Correlation between the mean preoperative keratometry and residual spherical equivalent was significant in the lower preoperative myopia group (r = -0.24, P = .006), but not significant in the higher myopia group (r = -0.02, P = .809). CONCLUSIONS Preoperative keratometry affects refractive outcomes after SMILE. Steeper corneas have greater undercorrection, especially in eyes with low myopia. Knowledge of the correlation between refractive outcomes of SMILE and keratometry would help in modifying current treatment algorithms. [J Refract Surg. 2020;36(6):374-379.].
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Jong M, Jonas JB, Wolffsohn JS, Berntsen DA, Cho P, Clarkson-Townsend D, Flitcroft DI, Gifford KL, Haarman AEG, Pardue MT, Richdale K, Sankaridurg P, Tedja MS, Wildsoet CF, Bailey-Wilson JE, Guggenheim JA, Hammond CJ, Kaprio J, MacGregor S, Mackey DA, Musolf AM, Klaver CCW, Verhoeven VJM, Vitart V, Smith EL. IMI 2021 Yearly Digest. Invest Ophthalmol Vis Sci 2021; 62:7. [PMID: 33909031 PMCID: PMC8088231 DOI: 10.1167/iovs.62.5.7] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 01/24/2021] [Indexed: 12/17/2022] Open
Abstract
Purpose The International Myopia Institute (IMI) Yearly Digest highlights new research considered to be of importance since the publication of the first series of IMI white papers. Methods A literature search was conducted for articles on myopia between 2019 and mid-2020 to inform definitions and classifications, experimental models, genetics, interventions, clinical trials, and clinical management. Conference abstracts from key meetings in the same period were also considered. Results One thousand articles on myopia have been published between 2019 and mid-2020. Key advances include the use of the definition of premyopia in studies currently under way to test interventions in myopia, new definitions in the field of pathologic myopia, the role of new pharmacologic treatments in experimental models such as intraocular pressure-lowering latanoprost, a large meta-analysis of refractive error identifying 336 new genetic loci, new clinical interventions such as the defocus incorporated multisegment spectacles and combination therapy with low-dose atropine and orthokeratology (OK), normative standards in refractive error, the ethical dilemma of a placebo control group when myopia control treatments are established, reporting the physical metric of myopia reduction versus a percentage reduction, comparison of the risk of pediatric OK wear with risk of vision impairment in myopia, the justification of preventing myopic and axial length increase versus quality of life, and future vision loss. Conclusions Large amounts of research in myopia have been published since the IMI 2019 white papers were released. The yearly digest serves to highlight the latest research and advances in myopia.
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Affiliation(s)
- Monica Jong
- Discipline of Optometry and Vision Science, University of Canberra, Canberra, Australian Capital Territory, Australia
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Jost B. Jonas
- Department of Ophthalmology Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - James S. Wolffsohn
- Optometry and Vision Science Research Group, Aston University, Birmingham, United Kingdom
| | - David A. Berntsen
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, Texas, United States
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Danielle Clarkson-Townsend
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, Georgia, United States
- Gangarosa Department of Environmental Health, Emory University, Atlanta, Georgia, United States
| | - Daniel I. Flitcroft
- Department of Ophthalmology, Children's University Hospital, Dublin, Ireland
| | - Kate L. Gifford
- Myopia Profile Pty Ltd, Brisbane, Queensland, Australia
- Queensland University of Technology (QUT) School of Optometry and Vision Science, Kelvin Grove, Queensland, Australia
| | - Annechien E. G. Haarman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Machelle T. Pardue
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Healthcare System, Decatur, Georgia, United States
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, United States
| | - Kathryn Richdale
- College of Optometry, University of Houston, Houston, Texas, United States
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Milly S. Tedja
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Joan E. Bailey-Wilson
- Computational and Statistical Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Baltimore, Maryland, United States
| | - Jeremy A. Guggenheim
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom
| | - Christopher J. Hammond
- Section of Academic Ophthalmology, School of Life Course Sciences, King's College London, London, United Kingdom
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Stuart MacGregor
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - David A. Mackey
- Centre for Eye Research Australia, Ophthalmology, Department of Surgery, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- Department of Ophthalmology, Menzies Institute of Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Anthony M. Musolf
- Computational and Statistical Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Baltimore, Maryland, United States
| | - Caroline C. W. Klaver
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Virginie J. M. Verhoeven
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Veronique Vitart
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Earl L. Smith
- College of Optometry, University of Houston, Houston, Texas, United States
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Schmid KL, Brinkworth DR, Wallace KM. Emmetropisation responses when visual information is presented at only one or two near target planes in chick*. Clin Exp Optom 2021; 86:308-16. [PMID: 14558852 DOI: 10.1111/j.1444-0938.2003.tb03126.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2003] [Revised: 06/19/2003] [Accepted: 07/07/2003] [Indexed: 11/28/2022] Open
Abstract
PURPOSE When visual information is confined to one object plane and zero or hyperopic defocus is present, emmetropisation is directed towards this plane, when myopic defocus is present, emmetropisation processes fail. We investigated the effect of introducing information at a second nearer plane on emmetropisation responses under these conditions. METHODS The visual environment was controlled using lenses (+30 D, +40 D and +50 D) and cones with a Maltese cross target (MX) at one or two distances. Four different target configurations were used: 1. a single target was located at 3.3 cm, 2. a vertical hemi-field target was added at 2.5 cm, 3. a transparent target was added at 2.5 cm or 4. a single target was located at 2.5 cm. An additional cone length of 4.0 cm and nearer target distance of 3.3 cm was used with the +50 D lens. The imaging devices were applied monocularly to eight-day-old chicks and worn for four days. At the end of the treatment, refractive errors and eye growth were measured. Potential regional differences in growth were also assessed. RESULTS The configuration of the target and the interaction between target configuration and lens power had significant refractive and axial growth effects. With a single target plane, myopic and hyperopic defocus resulted in myopia. When defocus was experienced at two planes, refractive errors shifted towards the plane with the lower defocus and emmetropisation responses, although still not normal, were more consistent. CONCLUSIONS When visual information is provided at two distances, the target with the lesser incident defocus has the greater influence on the resultant refractive error. Emmetropisation responses are more accurate when information is presented at many distances.
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Affiliation(s)
- Katrina L Schmid
- Centre for Eye Research, School of Optometry, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
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Chen JC, Schmid KL, Brown B, Edwards MH, Yu BSY, Lew JKF. AC/A ratios in myopic and emmetropic Hong Kong children and the effect of timolol§. Clin Exp Optom 2021; 86:323-30. [PMID: 14558854 DOI: 10.1111/j.1444-0938.2003.tb03128.x] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2002] [Revised: 07/17/2003] [Accepted: 07/26/2003] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Caucasian children with myopia have elevated response accommodative vergence to accommodation (AC/A) ratios. The purpose of this study was twofold: to determine if response AC/A ratios vary with refractive error and with myopic progression rate in Hong Kong Chinese children, and to determine the effect of beta-adrenergic antagonism with topical timolol application on AC/A ratios. METHODS Thirty children aged eight to 12 years participated in the study. All refractive errors were corrected with spectacle lenses. Accommodative responses were measured using a Shin-Nippon autorefractor and concurrent changes in vergence were assessed using a vertical prism and a Howell-Dwyer card at three metres and 0.33 metre. Accommodative demand was altered using plus or minus two dioptre lenses and lens- and distance-induced response AC/A ratios were calculated. Measurements were repeated 30 minutes after the instillation of topical timolol maleate (0.5 per cent). RESULTS AC/A ratios appeared higher in progressing myopic children but the difference was not statistically significant. Timolol application reduced accommodative convergence (AC) in the stable myopes (reduction = -3 +/- 1.14 prism dioptres) but not in the emmetropes (0.69 +/- 0.96 prism dioptres) or progressing myopes (0.16 +/- 0.43 prism dioptres) and this difference between refractive groups was statistically significant (F(2, 27) = 3.766; P = 0.036). However, timolol did not produce a significant change in the accommodative response to positive or negative lenses or response AC/A ratios. CONCLUSIONS We did not find that AC/A ratios in myopic Chinese children were elevated and therefore, it is unlikely that elevated AC/A ratios are responsible for the high levels of myopia that occur in Hong Kong. The finding that timolol reduced AC in the stable myopes suggests that the autonomic control of accommodative convergence in these children may be different from that in emmetropic children and those with progressing myopia.
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Affiliation(s)
- Jennifer C Chen
- Centre for Eye Research, School of Optometry, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
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Jiang BC, Schatz S, Seger K. Myopic progression and dark focus variation in optometric students during the first academic year. Clin Exp Optom 2021; 88:153-9. [PMID: 15926878 DOI: 10.1111/j.1444-0938.2005.tb06688.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2003] [Revised: 01/17/2005] [Accepted: 01/29/2005] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The aim of this research was to investigate the change in refractive error (RE) of optometric students during their first academic year and whether these changes relate to changes in their dark focus (DF). METHOD The RE and DF of 64 students were measured objectively every three months during the first academic year, a total of four times, using a Canon R-1 infrared optometer. Thirty-five of the 64 students had an additional RE and DF measurement three weeks immediately after their Summer vacation. Students completed a survey regarding the near work demands they experienced during the Winter break and the teaching semesters. RESULTS Over nine months, the average RE of the students changed significantly from -2.22 +/- 1.93 (SD) D to -2.50 +/- 2.05 D (p = 0.0002). The rate of myopic progression averaged -0.37 dioptres per year. Inclusion of measurements taken on 35 students immediately after the Summer vacation showed that their change in RE during the Summer vacation was not significant (p = 0.79). For these subjects, the DF measured immediately after the vacation was significantly lower than the DF measured before the vacation (p = 0.007). The reduction in the DF after the vacations corresponded to a period of relative myopic stability in these subjects. CONCLUSIONS The results of this study suggest that optometric students performing extensive near work are at risk of developing myopia. The variation of their DF values indicates the changing demand for near work during different periods of the year. After Winter and Summer vacations, the DF was lower and the myopic progression was suspended. These findings further support the notion that myopic progression is related to high near work demands and suggest that this progression can be slowed by a period of reduced near work, for example, vacation periods.
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Affiliation(s)
- Bai-chuan Jiang
- College of Optometry, Nova Southeastern University, 3200 S University Drive, Fort Lauderdale, FL 33328, USA
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Min JS, Min BM. Comparison of outcomes of laser refractive surgery (LRS) alone and LRS with laser asymmetric keratectomy in patients with myopia: A retrospective study. Medicine (Baltimore) 2021; 100:e25366. [PMID: 33832118 PMCID: PMC8036046 DOI: 10.1097/md.0000000000025366] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 03/11/2021] [Indexed: 01/05/2023] Open
Abstract
To compare and analyze the postoperative 1-year outcomes of laser refractive surgery (LRS) alone vs LRS with laser asymmetric keratectomy (LAK), in patients with myopia, for preventing and resolving LRS complications.This retrospective study compared the preoperative and 1-year postoperative outcomes between the control and comparison groups using a sum of deviations in corneal thickness in 4 directions >80 μm. The control group included 41 patients with myopia (41 eyes) who underwent LRS. The comparison group included 33 patients (33 eyes) who received LAK-linked LRS. Age, spherical equivalent (SE), sphere, cylinder, uncorrected distance visual acuity (UDVA), pupil size, kappa angle, central corneal thickness, corneal irregularity in the 3.0 mm zone on Orbscan maps (SUM), distance between the maximum posterior elevation (best-fit-sphere) and the visual axis (DISTANCE), postoperative blurring scores, frequency of postoperative myopic regression, and efficiency index were compared.Preoperative age (P = .198), SE (P = .686), sphere (P = .562), cylinder (P = .883), UDVA (P = .139), pupil size (P = .162), kappa angle (P = .807), central corneal thickness (P = .738), corneal irregularity (P = .826), SUM (P = .774), and DISTANCE (P = .716) were similar between the 2 groups. The 1-year postoperative SE (P = .024), sphere (P = .022), corneal irregularity (P = .033), SUM (P = .000), DISTANCE (P = .04), blurring scores (P = .000), and frequency of postoperative myopic regression (P = .004) were significantly decreased in the comparison group compared to the control group. UDVA (P = .014) and the efficiency index (P = .035) were higher in the comparison group.LAK with LRS improved corneal symmetry by reducing the SUM and DISTANCE. UDVA and efficiency index were also improved and blurring and myopic regression were reduced postoperatively.
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Affiliation(s)
- Ji Sang Min
- Kim's Eye Hospital, Division of Cornea,Cataract, and Refractive Surgery. Konyang University School of Medicine. Youngdeungpo-gu, Seoul
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Ganesh S, Brar S, Gautam M, Sriprakash K. Visual and Refractive Outcomes Following Laser Blended Vision Using Non-linear Aspheric Micro-monovision. J Refract Surg 2021; 36:300-307. [PMID: 32396641 DOI: 10.3928/1081597x-20200407-02] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 04/02/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To report 1-year visual and refractive outcomes following PRESBYOND Laser Blended Vision using non-linear aspheric micro-monovision with the MEL 90 platform (Carl Zeiss Meditec GmbH). METHODS Data were collected retrospectively for all patients who underwent treatment for simultaneous correction of refractive error and presbyopia from June 2015 to June 2018. Only those patients who completed at least 6 months of follow-up were included in the study. RESULTS A total of 101 patients with a mean age of 51.05 ± 5.15 years (range: 40 to 65 years), of whom 38 patients had myopic and 63 patients had hyperopic refractive error with or without astigmatism, were included in the study. Mean preoperative spherical equivalent was -3.36 ± 1.86 diopters (D) in the myopia group and +1.75 ± 0.99 D in the hyperopia group. At 1 year, the mean spherical equivalent refraction was +0.13 ± 0.32 D in the distance eye and -1.42 ± 0.33 D (range: -0.88 to -2.50 D) in the near eye in the myopia group and -0.13 ± 0.24 D in the distance eye and -1.28 ± 0.31 D (range: -0.63 to -2.00 D) in the near eye in the hyperopia group. Two eyes in the hyperopia group underwent early enhancement for the near eye at 3 months. Ninety-seven percent of the patients in the myopia group and 96% in the hyperopia group were satisfied with their distance vision. Near vision satisfaction score was 95% for the myopia group and 89% for the hyperopia group. CONCLUSIONS At 1 year, the aspheric micro-monovision protocol resulted in satisfactory and fairly stable visual outcomes in both myopic and hyperopic individuals. [J Refract Surg. 2020;36(5):300-307.].
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Gregory HR, Nti AN, Wolffsohn JS, Berntsen DA, Ritchey ER. Visual Performance of Center-distance Multifocal Contact Lenses Fit Using a Myopia Control Paradigm. Optom Vis Sci 2021; 98:272-279. [PMID: 33771957 PMCID: PMC8007064 DOI: 10.1097/opx.0000000000001665] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The purpose of this study was to examine the visual performance of center-distance MFCLs in nonpresbyopic adults under different illumination and contrast conditions compared with a single-vision contact lens (SVCL). METHODS Twenty-five adult subjects were fit with three different lenses (CooperVision Biofinity D MFCL +2.50 add, Visioneering Technologies NaturalVue MFCL, CooperVision Biofinity sphere). Acuity and reading performance were evaluated. RESULTS A statistically significant difference in high-contrast distance acuity was observed (Biofinity, -0.18 ± 0.06; Biofinity MFCL, -0.14 ± 0.08; NaturalVue MFCL, -0.15 ± 0.03; repeated-measures [RM] ANOVA, P = .02). Under mesopic, high-contrast conditions, MFCLs performed worse than SVCLs (Biofinity, -0.05 ± 0.091; Biofinity MFCL, +0.03 ± 0.09; NaturalVue MFCL, +0.05 ± 0.091; RM-ANOVA, P < .0001). Under low-contrast conditions, MFCLs performed one line worse in photopic lighting and two lines worse under mesopic conditions (RM-ANOVA, P < .0001). Glare reduced acuity by 0.5 logMAR for all lenses (RM-ANOVA, P < .001). A statistically significant difference in near acuity was observed (RM-ANOVA, P = .02), but all lenses achieved acuity better than -0.1 logMAR (Biofinity, -0.16 ± 0.06; Biofinity MFCL, -0.17 ± 0.04; NaturalVue MFCL, -0.13 ± 0.08). Reading performance in words per minute (wpm) was worse with MFCLs (Biofinity MFCL, 144 ± 22 wpm; NaturalVue MFCL, 150 ± 28 wpm) than with SVCLs (156 ± 23 wpm; RM-ANOVA, P = .02) regardless of letter size (RM-ANOVA, P = .13). No difference in acuity between the MFCLs was detected (RM-ANOVA: all, P > .05). CONCLUSIONS Multifocal contact lenses perform similarly to SVCLs for high-contrast targets and display reduced low-contrast acuity and reading speed. Practitioners should recognize that high-contrast acuity alone does not describe MFCL visual performance.
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Affiliation(s)
- Hannah R Gregory
- The Ocular Surface Institute, University of Houston College of Optometry, Houston, Texas
| | - Augustine N Nti
- The Ocular Surface Institute, University of Houston College of Optometry, Houston, Texas
| | - James S Wolffsohn
- Optometry and Vision Science Research Group, Department of Life and Health Sciences, Aston University, Birmingham, United Kingdom
| | - David A Berntsen
- The Ocular Surface Institute, University of Houston College of Optometry, Houston, Texas
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Wong CW, Tsai A, Jonas JB, Ohno-Matsui K, Chen J, Ang M, Ting DSW. Digital Screen Time During the COVID-19 Pandemic: Risk for a Further Myopia Boom? Am J Ophthalmol 2021; 223:333-337. [PMID: 32738229 PMCID: PMC7390728 DOI: 10.1016/j.ajo.2020.07.034] [Citation(s) in RCA: 158] [Impact Index Per Article: 52.7] [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: 04/11/2020] [Revised: 07/21/2020] [Accepted: 07/21/2020] [Indexed: 11/02/2022]
Abstract
PURPOSE To review the impact of increased digital device usage arising from lockdown measures instituted during the COVID-19 pandemic on myopia and to make recommendations for mitigating potential detrimental effects on myopia control. DESIGN Perspective. METHODS We reviewed studies focused on digital device usage, near work, and outdoor time in relation to myopia onset and progression. Public health policies on myopia control, recommendations on screen time, and information pertaining to the impact of COVID-19 on increased digital device use were presented. Recommendations to minimize the impact of the pandemic on myopia onset and progression in children were made. RESULTS Increased digital screen time, near work, and limited outdoor activities were found to be associated with the onset and progression of myopia, and could potentially be aggravated during and beyond the COVID-19 pandemic outbreak period. While school closures may be short-lived, increased access to, adoption of, and dependence on digital devices could have a long-term negative impact on childhood development. Raising awareness among parents, children, and government agencies is key to mitigating myopigenic behaviors that may become entrenched during this period. CONCLUSION While it is important to adopt critical measures to slow or halt the spread of COVID-19, close collaboration between parents, schools, and ministries is necessary to assess and mitigate the long-term collateral impact of COVID-19 on myopia control policies.
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Affiliation(s)
- Chee Wai Wong
- Singapore National Eye Center, Duke-National University of Singapore Medical School, Singapore; Singapore Eye Research Institute, Singapore Health Service (SingHealth), Duke-National University of Singapore Medical School, Singapore
| | - Andrew Tsai
- Singapore National Eye Center, Duke-National University of Singapore Medical School, Singapore; Singapore Eye Research Institute, Singapore Health Service (SingHealth), Duke-National University of Singapore Medical School, Singapore
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Marcus Ang
- Singapore National Eye Center, Duke-National University of Singapore Medical School, Singapore; Singapore Eye Research Institute, Singapore Health Service (SingHealth), Duke-National University of Singapore Medical School, Singapore
| | - Daniel Shu Wei Ting
- Singapore National Eye Center, Duke-National University of Singapore Medical School, Singapore; Singapore Eye Research Institute, Singapore Health Service (SingHealth), Duke-National University of Singapore Medical School, Singapore.
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Abstract
Purpose To determine the effects of optically imposed astigmatism on myopia development in chickens. Methods Chicks were randomly assigned to wear either spherical (-10D, "LIM", n = 14) or sphero-cylindrical lenses (n ≥ 19 in each group) monocularly for a week from 5 days of age. All lenses imposed the same magnitude of spherical-equivalent hyperopic defocus (-10D), with the two astigmatic magnitudes (-8D or -4D) and four axes (45°, 90°, 135°, or 180°) altered to simulate four subtypes of clinical astigmatism. At the end of the treatment, refractive state was measured for all birds, whereas ocular axial dimensions and corneal curvature were measured for subsets of birds. Results Sphero-cylindrical lens wear produced significant impacts on nearly all refractive parameters (P < 0.001), resulting in myopic-astigmatic errors in the treated eyes. Compared to LIM, the presence of astigmatic blur induced lower myopic error (all except L180 group, P < 0.001) but with higher refractive astigmatism (all P < 0.001) in birds treated with sphero-cylindrical lenses. Distributions of the refractive, axial, and corneal shape parameters in the sphero-cylindrical lens-wear groups indicated that the astigmatic blur had directed the eye growth toward the least hyperopic image plane, with against-the-rule (ATR) and with-the-rule (WTR) astigmatisms typically inducing differential biometric changes. Conclusions The presence of early astigmatism predictably altered myopia development in chicks. Furthermore, the differential effects of WTR and ATR astigmatisms on anterior and posterior segment changes suggest that the eye growth mechanism is sensitive to the optical properties of astigmatism.
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Affiliation(s)
- Sonal Aswin Vyas
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Chea-su Kee
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Chen AM, Roberts TL, Cotter SA, Kulp MT, Sinnott LT, Borsting EJ, Tea YC, Jones-Jordan LA, Hertle R, Mitchell GL, Arnold LE, Chase C, Scheiman MM. Effectiveness of vergence/accommodative therapy for accommodative dysfunction in children with convergence insufficiency. Ophthalmic Physiol Opt 2021; 41:21-32. [PMID: 33119180 PMCID: PMC10545079 DOI: 10.1111/opo.12747] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Received: 06/25/2020] [Accepted: 09/04/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE To determine the effectiveness of office-based vergence/accommodative therapy for improving accommodative amplitude and accommodative facility in children with symptomatic convergence insufficiency and accommodative dysfunction. METHODS We report changes in accommodative function following therapy among participants in the Convergence Insufficiency Treatment Trial - Attention and Reading Trial with decreased accommodative amplitude (115 participants in vergence/accommodative therapy; 65 in placebo therapy) or decreased accommodative facility (71 participants in vergence/accommodative therapy; 37 in placebo therapy) at baseline. The primary analysis compared mean change in amplitude and facility between the vergence/accommodative and placebo therapy groups using analyses of variance models after 4, 8, 12 and 16 weeks of treatment. The proportions of participants with normal amplitude and facility at each time point were calculated. The average rate of change in amplitude and facility from baseline to week 4, and from weeks 4 to 16, were determined in the vergence/accommodative therapy group. RESULTS From baseline to 16 weeks, the mean improvement in amplitude was 8.6 dioptres (D) and 5.2 D in the vergence/accommodative and placebo therapy groups, respectively (mean difference = 3.5 D, 95% confidence interval (CI): 1.5 to 5.5 D; p = 0.01). The mean improvement in facility was 13.5 cycles per minute (cpm) and 7.6 cpm in the vergence/accommodative and placebo therapy groups, respectively (mean difference = 5.8 cpm, 95% CI: 3.8 to 7.9 cpm; p < 0.0001). Significantly greater proportions of participants treated with vergence/accommodative therapy achieved a normal amplitude (69% vs. 32%, difference = 37%, 95% CI: 22 to 51%; p < 0.0001) and facility (85% vs. 49%, difference = 36%, 95% CI: 18 to 55%; p < 0.0001) than those who received placebo therapy. In the vergence/accommodative therapy group, amplitude increased at an average rate of 1.5 D per week during the first 4 weeks (p < 0.0001), then slowed to 0.2 D per week (p = 0.002) from weeks 4 to 16. Similarly, facility increased at an average rate of 1.5 cpm per week during the first 4 weeks (p < 0.0001), then slowed to 0.6 cpm per week from weeks 4 to 16 (p < 0.0001). CONCLUSION Office-based vergence/accommodative therapy is effective for improving accommodative function in children with symptomatic convergence insufficiency and coexisting accommodative dysfunction.
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Affiliation(s)
- Angela M. Chen
- Southern California College of Optometry at Marshall B. Ketchum University, CA
| | - Tawna L. Roberts
- Department of Ophthalmology, Stanford University School of Medicine, CA
| | - Susan A. Cotter
- Southern California College of Optometry at Marshall B. Ketchum University, CA
| | | | | | - Eric J. Borsting
- Southern California College of Optometry at Marshall B. Ketchum University, CA
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Kleinstein RN, Mutti DO, Sinnott LT, Jones-Jordan LA, Cotter SA, Manny RE, Twelker JD, Zadnik K. Uncorrected Refractive Error and Distance Visual Acuity in Children Aged 6 to 14 Years. Optom Vis Sci 2021; 98:3-12. [PMID: 33394925 PMCID: PMC7789395 DOI: 10.1097/opx.0000000000001630] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE This study presents the relationship between distance visual acuity and a range of uncorrected refractive errors, a complex association that is fundamental to clinical eye care and the identification of children needing refractive correction. PURPOSE This study aimed to analyze data from the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error Study to describe the relationship between distance uncorrected refractive error and visual acuity in children. METHODS Subjects were 2212 children (51.2% female) 6 to 14 years of age (mean ± standard deviation, 10.2 ± 2.1 years) participating in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error Study between 2000 and 2010. Uncorrected distance visual acuity was measured using a high-contrast projected logMAR chart. Cycloplegic refractive error was measured using the Grand Seiko WR-5100K autorefractor. The ability of logMAR acuity to detect various categories of refractive error was examined using receiver operating characteristic curves. RESULTS Isoacuity curves show that increasing myopic spherical refractive errors, increasing astigmatic refractive errors, or a combination of both reduces distance visual acuity. Visual acuity was reduced by approximately 0.5 minutes of MAR per 0.30 to 0.40 D of spherical refractive error and by approximately 0.5 minutes of MAR per 0.60 to 0.90 D of astigmatism. Higher uncorrected hyperopic refractive error had little effect on distance visual acuity. Receiver operating characteristic curve analysis suggests that a logMAR distance acuity of 0.20 to 0.32 provides the best balance between sensitivity and specificity for detecting refractive errors other than hyperopia. Distance acuity alone was ineffective for detecting hyperopic refractive errors. CONCLUSIONS Higher myopic and/or astigmatic refractive errors were associated with predictable reductions in uncorrected distance visual acuity. The reduction in acuity per diopter of cylindrical error was about half that for spherical myopic error. Although distance acuity may be a useful adjunct to the detection of myopic spherocylindrical refractive errors, accommodation presumably prevents acuity from assisting in the detection of hyperopia. Alternate procedures need to be used to detect hyperopia.
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Affiliation(s)
- Robert N Kleinstein
- Department of Optometry and Vision Science, School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama
| | - Donald O Mutti
- College of Optometry, The Ohio State University, Columbus, Ohio
| | | | | | - Susan A Cotter
- Southern California College of Optometry, Marshall B. Ketchum University, Fullerton, California
| | - Ruth E Manny
- College of Optometry, University of Houston, Houston, Texas
| | - J Daniel Twelker
- Department of Ophthalmology and Vision Science, University of Arizona, Tucson, Arizona
| | - Karla Zadnik
- College of Optometry, The Ohio State University, Columbus, Ohio
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Gyldenkerne A, Aagaard N, Jakobsen M, Toftelund C, Hjortdal J. Changes in accommodative function following small-incision lenticule extraction for high myopia. PLoS One 2020; 15:e0244602. [PMID: 33378342 PMCID: PMC7773189 DOI: 10.1371/journal.pone.0244602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 06/26/2020] [Accepted: 12/12/2020] [Indexed: 12/02/2022] Open
Abstract
Purpose To examine whether the amplitude of accommodation, the accommodative response, and the accommodative facility is affected and correlated with changes in higher-order aberrations for patients with high myopia surgically treated with small-incision lenticule extraction (SMILE). Methods 35 highly myopic eyes (myopic spherical equivalent of at least 6 diopters) of 35 patients treated with SMILE were included. Assessments were made before and 3 months after surgery. Donders push-up-method was used to measure the amplitude of accommodation. The accommodative response was assessed using an open-field autorefractor”Grand Seiko WAM-5500” (Grand Seiko Co. Ltd., Hiroshima, Japan) in combination with a Badal optometer and stimuli of accommodation at 0.0, 0.5, 1.25, 2.0, 3.0, and 4.0 D, respectively. Accommodative facility was measured at 40 cm with ±2,00D flipper lenses. All measurements of accommodation were performed monocularly with the refractive error corrected with soft contact lenses. Results The amplitude of accommodation did not change statistically significantly (mean difference -0.24 D (SD 0.98), 95% CI of mean difference -0.58 D to 0.11 D, paired-sample t(34) = -1.39; P = 0.17). The accommodative responses at 0.0, 0.5, 1.25, 2.0, 3.0, and 4.0 D did not statistically significantly change either (F(6,29) = 1.15; P = .36). Finally, the accommodative facility was also unchanged with a mean difference of 1.11 cycles per minute (SD 5.11, 95% CI of mean difference -0.64 to 2.87, paired-sample t(34) = 1.29; P = 0.21). No clinically significant associations between changes in accommodation and higher-order aberrations were found. Conclusions SMILE does not alter the amplitude of accommodation, the accommodative response, nor the accommodative facility for highly myopic patients, and the surgically induced corneal higher-order aberrations do not affect the accommodative function.
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Affiliation(s)
- Anders Gyldenkerne
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
- * E-mail:
| | - Nicolaj Aagaard
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Malene Jakobsen
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Carina Toftelund
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Jesper Hjortdal
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
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Wu D, Liu C, Li B, Wang D, Fang X. Influence of Cap Thickness on Corneal Curvature and Corneal Biomechanics After SMILE: A Prospective, Contralateral Eye Study. J Refract Surg 2020; 36:82-88. [PMID: 32032428 DOI: 10.3928/1081597x-20191216-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 12/16/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the impact of cap thickness for small incision lenticule extraction (SMILE) on changes in corneal curvature and biomechanics. METHODS One hundred eyes (50 patients) were enrolled in this prospective contralateral eye study. The difference in manifest refraction spherical equivalent (MRSE) in the same patient was less than 0.50 diopters. SMILE was performed with a randomized cap thickness of 110 µm in one eye and 140 µm in the other eye. MRSE, uncorrected distance visual acuity (UDVA), and corneal curvature and biomechanics were evaluated. The anterior and posterior surfaces of the corneal curvature (mean keratometry [Km] values 2, 4, and 6 mm from the pupil center) were measured by Pentacam HR (Oculus Optikgeräte, Wetzlar, Germany) and changes in corneal biomechanics at 6 months postoperatively by Scheimpflug technology. RESULTS There was no significant between-group difference in UDVA or MRSE postoperatively. Postoperative changes in Km at the anterior surface (ΔKm-ant) in the 4-mm zone were significantly higher in the 110-µm group than in the 140-µm group at 1 day and 1, 3, and 6 months postoperatively (P = .043, .045, .003, and .049, respectively); at 3 months, the ΔKm-ant in the 6-mm zone was higher in the 110-µm group (P = .035). The changes in second appla-nation time, deformation amplitude, and integrated radius were significantly less in the 110-µm group (P = .031, .049, and < .001, respectively). CONCLUSIONS A thicker corneal cap caused less change in anterior surface curvature after SMILE for moderate or low myopia, with no significant difference in UDVA and MRSE. [J Refract Surg. 2020;36(2):82-88.].
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Ross M, Ofri R, Aizenberg I, Abu-Siam M, Pe'er O, Arad D, Rosov A, Gootwine E, Dvir H, Honig H, Obolensky A, Averbukh E, Banin E, Gantz L. Naturally-occurring myopia and loss of cone function in a sheep model of achromatopsia. Sci Rep 2020; 10:19314. [PMID: 33168939 PMCID: PMC7653946 DOI: 10.1038/s41598-020-76205-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 10/23/2020] [Indexed: 01/01/2023] Open
Abstract
Achromatopsia is an inherited retinal disease characterized by loss of cone photoreceptor function. Day blind CNGA3 mutant Improved Awassi sheep provide a large animal model for achromatopsia. This study measured refractive error and axial length parameters of the eye in this model and evaluated chromatic pupillary light reflex (cPLR) testing as a potential screening test for loss of cone function. Twenty-one CNGA3 mutant, Improved Awassi, 12 control Afec-Assaf and 12 control breed-matched wild-type (WT) Awassi sheep were examined using streak retinoscopy and B-mode ocular ultrasonography. Four CNGA3 mutant and four Afec-Assaf control sheep underwent cPLR testing. Statistical tests showed that day-blind sheep are significantly more myopic than both Afec-Assaf and WT Awassi controls. Day-blind sheep had significantly longer vitreous axial length compared to WT Awassi (1.43 ± 0.13 and 1.23 ± 0.06 cm, respectively, p < 0.0002) and no response to bright red light compared to both controls. Lack of response to bright red light is consistent with cone dysfunction, demonstrating that cPLR can be used to diagnose day blindness in sheep. Day-blind sheep were found to exhibit myopia and increased vitreous chamber depth, providing a naturally occurring large animal model of myopia.
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Affiliation(s)
- Maya Ross
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Ron Ofri
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Itzhak Aizenberg
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | | | - Oren Pe'er
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Dikla Arad
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Alexander Rosov
- Institute of Animal Science, Agricultural Research Organization, Volcani Center, Rishon LeZion, Israel
| | - Elisha Gootwine
- Institute of Animal Science, Agricultural Research Organization, Volcani Center, Rishon LeZion, Israel
| | - Hay Dvir
- Institute of Animal Science, Agricultural Research Organization, Volcani Center, Rishon LeZion, Israel
| | - Hen Honig
- Institute of Animal Science, Agricultural Research Organization, Volcani Center, Rishon LeZion, Israel
| | - Alexey Obolensky
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Edward Averbukh
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Eyal Banin
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Liat Gantz
- Department of Optometry and Vision Science, Hadassah Academic College, 37 Haneviim St., Jerusalem, 9101001, Israel.
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Jonker SMR, Berendschot TTJM, Ronden AE, Saelens IEY, Bauer NJC, Nuijts RMMA. Long-term changes in visual outcomes and ocular morphometrics after myopic and toric phakic intraocular lens implantation: Five- and 10-year results. J Cataract Refract Surg 2020; 45:1470-1479. [PMID: 31564321 DOI: 10.1016/j.jcrs.2019.05.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 05/28/2019] [Accepted: 05/31/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate the long-term refractive and visual, anterior chamber depth, and axial length (AL) changes and complications after rigid iris-fixated phakic intraocular lens (pIOL) implantation to treat myopia or astigmatism. SETTING University Eye Clinic Maastricht, Maastricht UMC+, the Netherlands. DESIGN Prospective case series. METHODS The study evaluated patients who had implantation of an Artisan myopic or toric iris-fixated pIOL as of January 1998. Changes were measured annually and reported after 1, 5, and 10 years postoperatively. RESULTS The study comprised 460 eyes (250 patients; mean age 41.1 years ± 10.7 [SD]). Over 10 years, the mean myopization was -0.79 diopters (D) (P < .001), with 52% of eyes within ±1.0 D of target. The mean increase in the logarithm of the minimum angle of resolution (logMAR) corrected distance visual acuity (CDVA) over 10 years was 0.05 (P < .001); 95% of eyes had a CDVA of 20/40 or more and 7% lost 2 or more lines of CDVA. The mean logMAR uncorrected visual acuity (UDVA) increased by 0.14 over 10 years (P < .001); 96% had a UDVA 20/40 or better. The AL increased by 1.14 mm over 10 years (P = .009). Ten percent of pIOLs were explanted because of cataract formation after a mean of 97.9 ± 34.9 months. A higher preoperative age (hazard ratio [HR], 1.08; P < .001) and longer AL (HR, 1.34; P < .001) were risk factors for shorter survival because of cataract formation. CONCLUSION Ten years after rigid iris-fixated pIOL implantation, the CDVA and UDVA decreased significantly as a result of significant myopization caused by an increased AL unrelated to the pIOL.
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Affiliation(s)
- Soraya M R Jonker
- University Eye Clinic Maastricht, Maastricht University Medical Center, Heerlen, the Netherlands.
| | - Tos T J M Berendschot
- University Eye Clinic Maastricht, Maastricht University Medical Center, Heerlen, the Netherlands
| | - Annick E Ronden
- University Eye Clinic Maastricht, Maastricht University Medical Center, Heerlen, the Netherlands
| | - Isabelle E Y Saelens
- University Eye Clinic Maastricht, Maastricht University Medical Center, Heerlen, the Netherlands
| | - Noël J C Bauer
- University Eye Clinic Maastricht, Maastricht University Medical Center, Heerlen, the Netherlands; Department of Ophthalmology, Zuyderland Medical Center, Heerlen, the Netherlands
| | - Rudy M M A Nuijts
- University Eye Clinic Maastricht, Maastricht University Medical Center, Heerlen, the Netherlands; Department of Ophthalmology, Zuyderland Medical Center, Heerlen, the Netherlands
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Hayashi K, Yoshida M, Hayashi S, Yoshimura K. Short-Term Changes in Prediction Error after Cataract Surgery in Eyes Receiving 1 of 3 Types of Single-Piece Acrylic Intraocular Lenses. Am J Ophthalmol 2020; 219:12-20. [PMID: 32479807 DOI: 10.1016/j.ajo.2020.05.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 05/15/2020] [Accepted: 05/21/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE To compare short-term changes in refractive prediction error (PE) after phacoemulsification among eyes receiving different types of single-piece acrylic intraocular lenses (IOLs). DESIGN Randomized clinical trial. METHODS A total of 195 eyes of 195 patients scheduled for implantation of a single-piece acrylic IOL were randomly assigned to receive 1 of 3 IOLs: 1) an Alcon model SN60WF, 2) a Hoya model XY-1, or 3) an AMO model ZCB00V. Manifest spherical equivalent (MRSE) value, PE, and changes in PE were examined at 1 day and at 1 and 2 months postoperatively and were compared among groups. RESULTS The mean MRSE and PE significantly changed toward myopia between 1 day and 2 months postoperatively in all groups (P < .0001). The MRSE and PE did not differ significantly among groups at 1 day and 1 month postoperatively and were significantly smaller in the SN60WF group than in the XY-1 and ZCB00V groups at 2 months (P ≤ .0006). The PE change between 1 day and 2 months postoperatively was significantly smaller in the SN60WF group than in the other groups (P = .0062). IOL type and changes in anterior chamber depth and corneal curvature independently correlated with PE changes. CONCLUSIONS The MRSE and PE showed a significant myopic change for 2 months postoperatively in eyes implanted with 1 of 3 types of single-piece acrylic IOLs and were significantly smaller in the SN60WF than in the XY-1 and ZCB00V groups. Changes in PE during the 2 postoperative months were smaller in the SN60WF IOLs than in the other IOLs, suggesting that postoperative refractive stability differs among single-piece acrylic IOLs.
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Affiliation(s)
| | | | - Shunsuke Hayashi
- Department of Ophthalmology, National Hospital Organization Saitama Hospital, Saitama, Japan; Department of Ophthalmology, Keio University Faculty of Medicine, Keio University School of Medicine, Tokyo, Japan
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Hainsworth DP, Gao X, Bebu I, Das A, Olmos de Koo L, Barkmeier AJ, Tamborlane W, Lachin JM, Aiello LP. Refractive Error and Retinopathy Outcomes in Type 1 Diabetes: The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study. Ophthalmology 2020; 128:554-560. [PMID: 32941962 DOI: 10.1016/j.ophtha.2020.09.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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] [Received: 04/14/2020] [Revised: 08/18/2020] [Accepted: 09/09/2020] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To determine the relationship between refractive error and diabetic retinopathy (DR). DESIGN Clinical trial. PARTICIPANTS Type I diabetes individuals with serial refractive error and DR stage measurements over 30 years in the Diabetes Control and Complications Trial (DCCT) and Epidemiology of Diabetes Interventions and Complications (EDIC) follow-up study. METHODS Stage of DR was measured every 6 months from standard fundus photographs, and refractive error was measured annually during the 6.5 years of DCCT; then, both were staggered every fourth year during EDIC with the full cohort measured at EDIC years 4 and 10. Outcomes of DR were 2- or 3-step progression, presence of proliferative DR (PDR), clinically significant macular edema (CSME), diabetic macular edema (DME), or ocular surgery. Myopia, emmetropia, and hyperopia were defined as a spherical equivalent of ≤-0.5, >-0.5 and <0.5, and ≥0.5, respectively. MAIN OUTCOME MEASURES For each outcome separately, Cox proportional hazard (PH) models assessed the association between the refractive error status and the subsequent risk of that outcome, both without and with adjustment for potential risk factors. RESULTS Hyperopia was associated with a higher risk of 2-step progression (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.05-1.59), 3-step progression (HR, 1.35; 95% CI, 1.05-1.73), and PDR (HR, 1.40; 95% CI, 1.02-1.92) compared with emmetropia in unadjusted models. These associations remained significant after adjustment for DCCT treatment group, cohort, age, sex, smoking, duration of diabetes, systolic and diastolic blood pressures, pulse, low-density lipoprotein, high-density lipoprotein, triglycerides, albumin excretion rate, and DCCT/EDIC mean updated hemoglobin A1c (HbA1c) (2-step progression: HR, 1.28; 95% CI, 1.03-1.58; 3-step progression: HR, 1.30; 95% CI, 1.00-1.68; PDR: HR, 1.38; 95% CI, 1.00-1.90). Myopia was not associated with any of the 5 DR outcomes in the unadjusted models and only marginally associated with 2-step progression (HR, 1.11; 95% CI, 1.00-1.24) in the adjusted models. CONCLUSIONS Myopia is not associated with DR progression risk. Hyperopia is an independent risk factor for 2-step and 3-step DR progression and PDR.
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Affiliation(s)
| | - Xiaoyu Gao
- The Biostatistics Center, The George Washington University, Rockville, Maryland
| | - Ionut Bebu
- The Biostatistics Center, The George Washington University, Rockville, Maryland.
| | - Arup Das
- University of New Mexico School of Medicine, Albuquerque, New Mexico
| | | | | | | | - John M Lachin
- The Biostatistics Center, The George Washington University, Rockville, Maryland
| | - Lloyd Paul Aiello
- Department of Ophthalmology, Harvard Medical School and Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts
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