Hyperopic Refraction Research Articles

Исходы самопроизвольного регресса ретинопатии недоношенных

Purpose. To analyze postnatal outcomes in children with spontaneous ROP regression. Material and methods. The study included 37 children (74 eyes) with spontaneous ROP regression. Gestational age was ranged from 23 to 32 weeks, body weight - from 493 to 1660 g at birth. Depending on the observation period, the children were divided into 2 age groups: 1 - from 1 month to 4 years old - 31 children (62 eyes), 2 - from 9 to 13 years old - 6 children (12 eyes). The diagnostics included standard ophthalmological examinations and additional methods. Results. In the first group, upon reaching the age of 1-year, complete retinal vascularization was observed in 26 (83%) cases (52 eyes). 5 children (10 eyes) had a narrow retinal avascular zone in the temporal segment. In the second group, in cases of postponed 3-rd stage of ROP, more severe disorders in the peripheral parts of the retina were revealed: compaction of the posterior hyaloid membrane with fixation and zones of traction retinoschisis of varying length. In the first years of life, all patients with ROP had a history of predominantly hyperopic refraction (94%). However, myopic refraction prevailed (82%) in the second group of children reaching school age. Conclusion. Considering the significant variability of the clinical manifestations of the cicatricial stage of ROP with spontaneous regression, long-term observation and a comprehensive ophthalmological examination of this group of patients are necessary for timely treatment. Key words: retinopathy of prematurity, spontaneous regression, cicatricial phase.

Эффективность лечения содружественного косоглазия у детей с гиперметропией методом хемоденервации ботулиническим токсином типа А

Purpose. Evaluation of the effectiveness of concomitant strabismus treatment in children with hyperopia by botulinum toxin type A chemodenervation. Materials and methods. The effectiveness of using botulinum toxin type A chemodenervation was studied in 115 children (230 eyes) from 8 months to 15 years old with concomitant convergent strabismus and hyperopic refraction. All patients were divided into 3 groups: group 1–17 patients with strabismus angle up to 15° according to Hirshberg, group 2–34 patients with strabismus angle from 15 to 25° according to Hirshberg, group 3–64 patients with strabismus angle more than 25° according to Hirshberg. All children received an injection of botulinum toxin type A into the horizontal oculomotor muscles at an average dosage of 3.4. Results. In most cases (68.70%), a positive effect was achieved after one injection. Two injections were given to 30 patients (26.09%), 6 patients were given 3 injections (5.22%). Repeated injections, most often (19.13%), were required in patients with a strabismus angle of more than 25 degrees. The effectiveness of strabismus treatment depends on the initial value of the angle and the adequately selected dose. Most often, a positive result of treatment was observed after one injection of botulinum toxin type A with a volume of 2 to 4. We did not find any complications when using the denervation method. Conclusion. The method of botulinum toxin type A chemodenervation is effective in the treatment of concomitant strabismus in children with hyperopia. Key words: botulinum toxin type A, concomitant strabismus, chemodenervation, children, hyperopia.

Difference of refractive status before and after cycloplegic refraction: the Lhasa Childhood Eye Study.

To compare the differences between cycloplegic and noncycloplegic refraction as well as associated factors in grade one students of primary schools, and explore the effectiveness of noncycloplegic refraction for refractive error screening. Cross-sectional study. A school-based study of 1856 students was conducted in Lhasa, Tibetan Plateau, China. Cycloplegia was achieved with two drops of 1% cyclopentolate and 1 drop of Mydrin P at a 5-min interval. Autorefraction was performed under both cycloplegic and noncycloplegic conditions. Bland-Altman analysis, receiver operating characteristic curve analysis, univariate and multiple linear regression models were used for analysis. Of the 1856 children enrolled, 1830 (98.60%) completed all procedures. The average age was 6.83 ± 0.46years. 965 (52.73%) children were boys and 1737 (94.92%) were Tibetan. Overall, there was a significant difference between cycloplegic and noncycloplegic SE of 0.90 ± 0.76D (P < 0.001). However, the intra-class coefficient correlation (ICC) for cylinder between these two methods was high (ICC = 0.941, 95% CI, 0.935-0.946). Larger differences between cycloplegic and noncycloplegic SE were associated with hyperopic RE and higher cylindrical value (P < 0.001). The prevalence of myopia, emmetropia and hyperopia with and without cycloplegia was (3.93% vs 14.59%), (9.95% vs 45.8%) and (86.21% vs 39.56%), respectively. Myopia, emmetropia and hyperopia based on noncycloplegic refraction was defined as SE ≤ -0.625D, -0.625 < SE ≤ 0D, and SE > 0D, respectively. Lack of cycloplegia leads to underestimation of hyperopia, with overestimation of myopia and emmetropia. Larger hyperopic refraction exhibited greater difference between cycloplegic and noncycloplegic refraction.

Effect of cyclopentolate versus tropicamide on anterior segment angle parameters in three refractive groups

ABSTRACT Clinical relevance Frequent clinical application of cycloplegia in clinical practice makes it essential to assess how this condition influences anterior segment angle parameters. Background This study aims to compare the effects of cyclopentolate and tropicamide on anterior segment angle parameters in three adult refractive groups. Methods Sixty healthy individuals were recruited and assigned into three refractive groups according to inclusion criteria. At baseline visit, anterior segment angle parameters were measured using anterior segment optical coherence tomography in the right eye. All measurements were repeated at two separate visits, one week apart, after administration of tropicamide 1% and cyclopentolate 1% at similar conditions. Main outcome measures were angle‐opening distance, trabecular iris angle, trabecular iris space area and anterior chamber depth. Anterior segment angle parameters were recorded at temporal areas (180 degrees). Results Sixty participants (29 men and 31 women, age: 27.82 ± 4.71-years) completed the experiment. Baseline mean spherical equivalents were +1.52 ± 1.20 D, −0.04 ± 0.33 D and −1.91 ± 0.91-D in hyperopic, emmetropic and myopic groups, respectively. No statistically significant differences were found between tropicamide and cyclopentolate for all angle parameters in three refractive groups. Both drops induced an increase in all parameters in three refractive groups. Analysis between refractive groups revealed that a more hyperopic refraction was associated with less trabecular iris angle, angle‐opening distance and anterior chamber depth parameters in baseline, after tropicamide and cyclopentolate instillations. Conclusions Topical application of cycloplegic eye drops in healthy individuals leads to small but significant changes in anterior chamber depth and anterior segment angle parameters, regardless of refractive status. Moreover, lower values of anterior chamber depth and anterior segment angle parameters in hyperopic individuals after administration of cycloplegic drops should be taken into account during biometric measurement and phakic intraocular lens implantation. Due to shorter effect and recovery time and less ocular/systemic reaction of tropicamide versus cyclopentolate, tropicamide could be a recommended cycloplegic agent for diagnostic and therapeutic procedures.

Association Between Medication-Taking and Refractive Error in a Large General Population-Based Cohort.

PurposeRefractive errors, particularly myopia, are common and a leading cause of blindness. This study aimed to explore associations between medications and refractive error in an aging adult cohort and to determine whether childhood-onset refractive errors predict future medication use to provide novel insights into disease mechanisms.MethodsThe study compared the spherical equivalent values measured in 102,318 UK Biobank participants taking the 960 most commonly used medications. The strengths of associations were evaluated against the self-reported age of spectacle wear. The causality of refractive error changes was inferred using sensitivity and Mendelian randomization analyses.ResultsAnti-glaucoma drugs were associated with 1 to 2 diopters greater myopic refraction, particularly in subjects who started wearing correction in the first two decades of life, potentially due to the association of higher intraocular pressure since early years with both myopia and, later in life, glaucoma. All classes of pain-control medications, including paracetamol, opiates, non-steroidal antiinflammatory drugs, and gabapentinoids, were associated with greater hyperopia (+0.68–1.15 diopters), after correction for deprivation, education, and polypharmacy and sensitivity analyses for common diagnoses. Oral hypoglycemics (metformin, gliburonide) were associated with myopia, as was allopurinol, and participants using bronchodilators (ipratropium and salbutamol) were more hyperopic.ConclusionsThis study finds for the first time, to our knowledge, that medication use is associated with refractive error in adults. The novel finding that analgesics are associated with hyperopic refraction, and the possibility that multisite chronic pain predisposes to hyperopia, deserves further research. Some drugs, such as antihyperglycemic or bronchodilators, may directly alter refractive error. Intraocular pressure appears causative for myopia.

Correlation analysis of some functional and anatomical parameters of the visual analyzer in nystagmus and amblyopia of various origins

Aim: To conduct a correlation analysis of the parameters of visual fixation, light sensitivity of the retina in the central region, and the thickness of the central region of the retina and choroid with the best corrected visual acuity (BCVA), refraction (SER), and axial length of the eye (AL) in nystagmus and amblyopia of various origins.&#x0D; Material and methods: The study included 45 patients aged 544 years (mean 11.26.14 years). All patients were divided into six groups depending on the type of amblyopia and associated conditions (with nystagmus). The retinal photosensitivity and fixation parameters were studied using an MP-3 Nidek microperimeter (Japan). Chorioretinal parameters were studied using an RS-3000 Advance 2 spectral optical coherence tomograph (Nidek, Japan). The axial length of the eye was measured using a Galilei G6 Scheimpflug analyzer. Correlation analysis was performed using the linear Pearson correlation coefficient (r).&#x0D; Results: In nystagmus, refractive and dysbinocular amblyopia, a strong direct correlation was found between the indicators of BCVA and the characteristics of fixation. In the groups associated with congenital myopia, relationships were found between BCVA, retinal thickness, and light sensitivity of the retina in the central region. There was no relationship between the subfoveal choroidal thickness and functional parameters of the eyes.&#x0D; Conclusions: In nystagmus and amblyopia associated with strabismus and hyperopic refraction, the primary amblyogenic factor is a decrease in the density and amplitude of fixation. In relative amblyopia due to congenital myopia, the decrease in visual acuity correlates with the photosensitivity of the retina and does not correlate with fixation parameters, which indicates the partially organic nature of relative amblyopia. No relationship was found between the choroidae thikness and the degree of amblyopia, which does not cofine its participation in the pathogenesis of the disease.

Effectiveness of chemodenervation with incobotulinumtoxinA in the treatment of concomitant strabismus in a group of children with hyperopic refraction

Effectiveness of chemodenervation with incobotulinumtoxinA in the treatment of concomitant strabismus in a group of children with hyperopic refraction

Особенности развития глаз и состояния рефракции у детей коренных малочисленных народов Севера, проживающих в Приамурье

Purpose. To study the anatomical and morphometric parameters of the eyes and the state of refraction in children of the indigenous and alien population living in the Khabarovsk krai of Russia. Material and methods. The study included 180 children living in the Nanai District of the Khabarovsk krai, aged from 3 months to 18 years. Two groups of children were formed, according to the criteria of belonging to the indigenous/alien population. 1st group – 84 children of the indigenous population – Nanai. 2nd group – 96 children of the alien population - peoples related to the Slavs. Both groups were matched for gender and age. In each of these groups, 5 age subgroups were formed. The comparison group is the average statistical indicators of the child population of Russia in the corresponding subgroups. Results. In comparative study, difference in the refractive index of the cornea was not found between the groups. A statistically significant delayed growth of the axial length of the eye was revealed in children of the indigenous population of the Khabarovsk krai in the age subgroups of 4–6, 7–10, 11–14 years old, in comparison with similar subgroups children of the newcoming population and with the average Russian indicators. Tendency to myopization was revealed in children of the 1st group from 7–10 years and older at retinoscopy on narrow pupil, in whom, after cycloplegia with 0,5–1% solutions of Cyclopentolate, a shift towards hyperopic refraction was revealed. Conclusion. The revealed features of the development of eyes in children of the indigenous population of the Khabarovsk krai must be taken into account, conducting them retinoscopy only in the conditions of achieving complete medical accommodation paresis, and, if necessary, to prescribe them adequate optical correction. This will allow timely prevention of the formation of complications associated with the peculiarities of the development of their refraction.

Signals for defocus arise from longitudinal chromatic aberration in chick

Chicks respond to two signals from longitudinal chromatic aberration (LCA): a wavelength defocus signal and a chromatic signal. Wavelength defocus predicts reduced axial eye growth in monochromatic short-wavelength light, compared to monochromatic long-wavelength light. Wavelength defocus may also influence growth in broadband light. In contrast, a chromatic signal predicts increased growth when short-wavelength contrast > long-wavelength contrast, but only when light is broadband. We aimed to investigate the influence of blue light, temporal frequency and contrast on these signals under broadband conditions. Starting at 12 to 13 days-old, 587 chicks were exposed to the experimental illumination conditions for three days for 8h/day and spent the remainder of their day in the dark. The stimuli were flickering lights, with a temporal frequency of 0.2 or 10 Hz, low (30%) or high contrast (80%), and a variety of ratios of cone contrast simulating the effects of defocus with LCA. There were two color conditions, with blue contrast (bPlus) and without (bMinus). Stimuli in the “bPlus” condition varied the amounts of long- (L), middle- (M_) and double (D-) cone contrast, relative to short- (S-) and (UV-) cone contrast, to simulate defocus. Stimuli in the “bMinus” condition only varied the relative modulations of the L + D vs. M cones. In all cases, the average of the stimuli was white, with an illuminance of 777 lux, with cone contrast created through temporal modulation. A Lenstar LS 900 and a Hartinger refractometer were used to measure ocular components and refraction. Wavelength defocus signals with relatively high S-cone contrast resulted in reduced axial growth, and more hyperopic refractions, under low-frequency conditions (p = 0.002), in response to the myopic defocus of blue light. Chromatic signals with relatively high S-cone contrast resulted in increased axial growth and more myopic refractions, under high frequency, low contrast, conditions (p < 0.001). We conclude that the chromatic signals from LCA are dependent on the temporal frequency, phase, and relative contrast of S-cone temporal modulation, and recommend broadband spectral and temporal environments, such as the outdoor environment, to optimize the signals-for-defocus in chick.

The Effects of High Lighting on the Development of Form-Deprivation Myopia in Guinea Pigs.

To investigate the effects of high ambient lighting on refraction and ocular biometry in guinea pig models of form-deprivation myopia (FDM). Forty 3-week-old guinea pigs were randomly assigned to groups exposed to either high light (HL, 10,000 lux) or normal light (NL, 500 lux) with normal vision or form deprivation. Throughout the 10-week rearing period, animals were exposed to high light or normal light for 12 hours with a 12-hour light/dark cycle. Refraction, axial length (AL), and radius of corneal curvature (CCR) were measured by cycloplegic retinoscopy, A-scan ultrasonography, and keratometer, respectively. At the end of treatment, form-deprived eyes under high ambient lighting exhibited more hyperopic refraction and shorter AL than those under normal ambient lighting (2.06 ± 1.68 diopters [D; mean ± SD] vs. -0.59 ± 1.56 D, P < 0.001; 8.36 ± 0.13 mm vs. 8.56 ± 0.16 mm, P < 0.001). Deprived eyes under high ambient lighting were relatively more myopic than their contralateral control eyes at the end of treatment (2.06 ± 1.68 D vs. 5.44 ± 0.66 D, P < 0.001). High lighting induced a significant hyperopic shift in normal eyes after 4 weeks of exposure. There were no significant differences in CCR between eyes exposed to high and normal light, nor between deprived eyes and contralateral eyes. High ambient lighting could retard, but not fully inhibit, the development of FDM. High light levels contributed to a greater hyperopic shift in normal eyes during the first 4 weeks of treatment. Corneal curvature was unaffected by either high ambient lighting or form deprivation.

The Impact of Parental Rural-to-urban Migration on Children’s Refractive Error in Rural China: A Propensity Score Matching Analysis

ABSTRACTPurpose: Parental rural-to-urban migration has a wide range of health effects on children’s but its impact on children’s refractive status remains unclear. We aim to examine whether parental rural-to-urban migration could influence the refractive status of their children in rural areas of China.Methods: Among the 2346 grade 7 students in the Mojiang Myopia Progression Study, information regarding parental migration was collected by questionnaires and was successfully obtained in 2105 participants. Refractive error was measured in diopters (D) with cycloplegia using an autorefractor and axial length (AL) was measured using an IOL Master. One-to-one nearest-neighbor matching techniques with a 0.01 caliper level were used to estimate the propensity score matching (PSM) models.Results: Among all the participants, 472 pairs (1 student with vs. 1 student without migrant parents) were successfully matched based on propensity scores. Students with migrant parents had a lower proportion of myopia (29.2% vs. 40.7%; P < .001) and more hyperopic refractions (−0.25D vs. −0.31D; P = .04) compared with those without. They also had shorter ALs (23.4 mm vs. 23.6 mm) but the difference was not significance (P = .18). In addition, students with migrant parents spent less time reading after school per day (0.87 vs. 1.01 hours; P = .01).Conclusions: Myopia is less prevalent among children with migrant parents compared with those without. This study indicated that living without parents might be a protect factor for myopia in Chinese school student via giving them less pressure on study.

Risk Factors for Incident Myopia among Teenaged Students of the Experimental Class of the Air Force in China.

Background In recent decades, the prevalence rate of myopia has markedly increased, especially among teenagers. Our purpose was to determine the incidence of myopia and identify the related risk factors among schoolchildren in the experimental classes of the Air Force in China. Methods In May 2015, this 3-year prospective cohort study enrolled 522 boys (age, 14–16 years) attending grade 10 in 16 high schools in 15 cities in China. Cycloplegic refraction was examined using retinoscopy in both eyes at the baseline and follow-up (3 years). A detailed questionnaire was completed by the students at the 3-year follow-up and included questions on parental myopia and on the total time spent doing near work and outdoor activities each week. Results The incidence of myopia at the 3-year follow-up was 27.01% (141/522, 95% confidence interval (CI): 23.38% to 30.98%). The refractive change was −0.46 D (95% CI: −0.49 to −0.42 D). More hyperopic or less myopic baseline refraction, outdoor activity time per week ≥14 h (odds ratio (OR) = 0.464, 95% CI: 0.227 to 0.950), and reading/writing distance ≥ 30 cm (OR = 0.505, 95% CI: 0.270 to 0.944) were significant protective factors against incident myopia. Near-work time ≥28 h per week was a significant risk factor (OR = 2.579, 95% CI: 1.314 to 5.061). Parental myopia, age at the start of primary school, continuous reading/writing for ≥1 h, sleep duration per week <49 h, and one or more dietary biases were not significant risk factors (P > 0.05). Conclusion A more hyperopic baseline refraction, more time spent outdoors, and longer writing/reading distance were protected against myopia onset, while more near-work time was a risk factor.

Longitudinal Changes in Spherical Equivalent of Moderate to High Hyperopia: 2- to 8-Year Follow-Up of Children at an Initial Age of 5.5 to 8.4 Years

Moderate to high hyperopia is associated with visual deficits. Currently, to our knowledge no study has reported its longitudinal refraction change in a large sample of schoolchildren. We investigated the longitudinal changes in spherical equivalent (SE) refractive error among schoolchildren with moderate to high hyperopia. Medical records of patients seeking refractions at Zhongshan Ophthalmic Center between 2009 and 2017 were reviewed retrospectively. Eligible criteria included hyperopia ≥+2.00 diopters (D) at an initial age of 6 to 8 years, at least three visits, and at least a 2-year follow-up. Individual pattern of refraction development was evaluated based on the mean rate of change in SE. Mixed-effect regression analysis was used to explore factors associated with the rate of change. A total of 1769 cases were identified. Median initial age was 6.4 (interquartile range [IQR], 5.9 to 7.1) years and median age at the final visit was 10.1 (IQR, 8.9 to 11.5) years. Median initial SE was +3.13 (IQR, +2.38 to +5.25) D. On average, participants experienced a myopic shift of -0.35 ± 0.27 D/year. A considerable number of eyes (721, 40.8%) demonstrated a longitudinal change of less than ±0.25 D/year and approximately 1 of 3 (611/1769) eyes demonstrated a change of >-0.50 and ≤-0.25 D/year. Children with greater initial hyperopia (β = -0.02, P < 0.001) experienced significantly faster reduction in hyperopic refraction. Age and sex had statistically significant but clinically insignificant impacts on the rate of hyperopia reduction. Variation exists in the refraction development of schoolchildren with moderate to high hyperopia. A considerable percentage of eyes demonstrates longitudinally stable refraction.

Frequencies of 4 Distinct Patterns of Glaucomatous Disc Appearance and Their Clinical Associations in Japanese Population-based Studies

To study the frequencies and factors associated with 4 disc patterns in primary open-angle glaucoma (POAG) identified in population-based studies: focal glaucomatous (FG type), generalized enlargement of cup (GE type), myopic glaucomatous (MG type), and senile sclerotic glaucomatous (SS type) patterns. In total, 270 disc photographs of acceptable quality were extracted from the records of 270 definitive POAG cases diagnosed according to the International Society of Geographical and Epidemiological Ophthalmology Criteria in 2 Japanese population-based glaucoma surveys. One randomly chosen eye from the bilateral POAG cases was included. Using a method of κ coefficient of reproducibility of classification of 0.80 according to a preliminary study, 143 discs were classified as FG, GE, MG, or SS types with respective frequencies of 57% (95% confidence interval [CI], 48-66), 33% (95% CI, 25-42), 7% (95% CI, 3-13), and 3% (95% CI, 0-7), and 127 discs as the miscellaneous type. Multinomial logistic regression analysis showed that the MG type was associated (P=0.052, 0.025, 0.019, and 0.018) with younger age, lower body mass index (BMI), and greater disc area and ovality, and the GE type was associated (P<0.001, 0.036, and 0.056) with greater disc area, corneal radius, and hyperopic refraction than the FG type. The FG type occurs most frequently in Japanese POAG followed by the GE type. The MG and SS types occurred much less often than previously reported in Japanese. Associations with age, BMI, disc area and ovality, refraction, and corneal radius differed among the FG, GE, and MG types.

Refractive Change and Incidence of Myopia Among A Group of Highly Selected Senior High School Students in China: A Prospective Study in An Aviation Cadet Prerecruitment Class.

To assess the incidence rate of myopia, refractive change, and the effects of influencing factors on a group of highly selected senior high school students in an Aviation Cadet prerecruitment class in China. A total of 800 nonmyopic, male, Grade 9 students aged 14- to 16-years old with cycloplegic refraction of -0.25 or greater diopters (D) to 1.75 D or less in both eyes were enrolled in May 2016. During their senior high school studies, students had one 20-minute physical training period a day, and they were encouraged to participate in outdoor activities during class recess without any time limits. The first follow-up was 8 months after enrollment when they were in Grade 10, and the second follow-up was 1 year after the first follow-up when they were in Grade 11. Comprehensive ocular examinations and a detailed questionnaire, which included questions about outdoor activity time, parental myopia, and near work, were completed at each follow-up. The average spherical equivalent refraction (SER) of the right eyes was 0.39 ± 0.44 D at baseline, 0.16 ± 0.41 D at the first follow-up, and -0.10 ± 0.38 D at the second follow-up. The cumulative refractive change was -0.50 D (95% confidence interval [CI], -0.53 to -0.47). The cumulative incidence rate of myopia was 15.5% (124/800). Incident myopia was significantly associated with outdoor activity for more than 1 versus less than 0.5 hr/d (odds ratio [OR] = 0.272, 95% CI, 0.132-0.560), baseline refraction (OR = 0.079, 95% CI, 0.041-0.153), maternal myopia (OR = 2.251, 95% CI, 1.160-4.368), longer class time (OR =3.215, 95% CI, 1.088-9.499), frequent, continuous, and long time reading/writing (OR = 1.620, 95% CI, 1.022-2.570), and shorter reading/writing distance (OR = 1.828, 95% CI, 1.065-3.140). In multiple linear regression model, having outdoor activity for more than 1 hr/d was protective from cumulative SER decrease. A higher baseline refraction together with longer reading/writing time, frequent, continuous, and longtime reading/writing, and shorter reading/writing distance were risk factors for SER decrease. In this cohort of highly selected, nonmyopic students, longer outdoor activity time was a protective factor for both incident myopia and refractive change of myopic shift. The risk factors for incident myopia included lower hyperopic baseline refraction, more near work, and maternal myopia. The risk factors for refractive change of myopic shift included more hyperopic baseline refraction and more near work.

Influence of severity and types of astigmatism on visual acuity in school-aged children in southern China.

To investigate the influence of astigmatism on visual acuity in school-aged children, and to define a cutoff for clinically significant astigmatism. This is a population-based, cross-sectional study. Among 5053 enumerated children aged 5-15y in Guangzhou, 3729 (73.8%) children aged 7-15 with successful cycloplegic auto-refraction (1% cyclopentolate) and a reliable visual acuity measurement were included. Ocular measurement included external eye, anterior segment, media and fundus and cycloplegic auto-refraction. Primary outcome measures included the relationship between severity and subtypes of astigmatism and the prevalence of visual impairment. Three criteria for visual impairment were adopted: best-corrected visual acuity (BCVA) ≤0.7, uncorrected visual acuity (UCVA) ≤0.5 or <0.7 in the right eye. Increases of cylinder power was significantly associated with worse visual acuity (UCVA: β=0.051, P<0.01; BCVA: β=0.025, P<0.001). A substantial increase in UCVI and BCVI was seen with astigmatism of 1.00 diopter (D) or more. Astigmatism ≥1.00 D had a greater BCVI prevalence than cylinder power less than 1.00 D (OR=4.20, 95%CI: 3.08-5.74), and this was also true for hyperopic, emmetropic and myopic refraction categories. Oblique astigmatism was associated with a higher risk of BCVI relative to with the rule astigmatism in myopic refractive category (OR=12.87, 95%CI: 2.20-75.38). Both magnitude and subtypes of astigmatism influence the prevalence of visual impairment in school children. Cylinder ≥1.00 D may be useful as a cutoff for clinically significant astigmatism.

Change in the Ophthalmobiometric Parameters in Myopia and Hyperopia under the Influence of Cycloplegia

Purpose: comparison of some ophthalmobiometric parameters in natural and cycloplegic conditions in myopia and hypermetropia. Material and methods: eyes biometric parameters were examined (the depth of the anterior chamber, the lens thickness and AL) before and after cycloplegia (1% Cyclopentolate hydrochloride — 2 times) in 244 eyes with myopic and hyperopic refraction in 122 patients aged 5–32 years. Biometric parameters were examined on the Galilei G6 optical system analyzer (Ziemer Ophthalmic Systems AG 6.0.6). The thickness of the choroid was measured with a spectral optical coherent tomograph (SD-OCT wavelength 800 nm) of Nidek RS-3000 Retina Scan Advance in 20 eyes of 10 patients aged 11 ± 1.3 years from the examined group before and 40 minutes after double injection of 1% Cyclopentolate hydrochloride. Results: the depth of anterior chamber and the axial, both in the narrow pupil and under the cycloplegia, are significantly higher in the myopic eyes than in the hyperopic eyes (p 0.05) and by 40 microns (0.04 mm) with hyperopia (p < 0.01). Conclusion: In cyclopegic condidions, as compared to the existing accommodation, increasing the depth of the anterior chamber decreased the thickness of the lens center of the lens somewhat extended posteriorly and decreases the axial length. The revealed changes in the AL can be associated with a change in the position of the pigment epithelium layer due to changes in the thickness of the choroid under different accommodation conditions. The significant changes in the thickness of the choroid the influence of cycloplegia was not proved in this study.

A NEW METHOD OF ASSESSMENT ZONULAR LENS

Purpose. To compare the wave front aberrations and their changes under the action of cycloplegia in eyes with myopia and hyperopia. Material and methods. We examined 46 patients: 20 (39 eyes) with myopic (average -5.2±1.5 D) and 26 patients (53 eyes) with hyperopic refraction (mean refraction +3,1±1,15 D) aged 5 - 17 years (average 11.6±0.6 years). All the patients underwent aberrometry in a darkened room before and after medical cycloplegia (instillations of 1% cyclopentolate dihydrochloride twice, with an interval of 10 minutes, aberrometry in 40 minutes after the first instillation) with the aberrometer divice OPD-ScanIII, Nidek. Result. Significant differences: horizontal trefoil (C8) and horizontal coma (C7) before cycloplegia in myopia was significantly higher, and their changes under cycloplegia significantly lower or absent. The difference of these aberrations, with are associated with the dislocation of the crystalline lens, decentration of the optical elements of the eye, provides the evidence of weak zonular tension in the eyes with myopia. The method of assessing zonular on the dynamics of the polynomias C8 and C7 in the background of cycloplegia was developed. Conclusion. The developed method of indirect assessment of the condition of the zonular lens according to the comparative aberrometry before and after cycloplegia recommended for prognosis of postnatal refraktogenesis and evaluation of progressive myopia treatment effectiveness.

High-Definition Optical Coherence Tomography of the Macula in Deprivational Amblyopia

This study evaluated macular thickness in deprivational amblyopia and compared it to matched controls. The authors present a cross-sectional study of patients with amblyopia from pediatric cataract and matched controls. Macular high-definition optical coherence tomography scans of each eye were acquired. Central macular thickness (CMT) and parafoveal thicknesses at 500 μm, 1,000 μm, and 1,500 μm in the nasal, temporal, inferior, and superior locations were measured. Thirty-four eyes were included: 14 eyes with deprivational amblyopia and 20 controls. In amblyopes, the mean age was 10.06 years ± 3.89 years and logMAR visual acuity (VA) was 0.41 ± 0.53, whereas in the control group, mean age was 8.96 years ± 1.89 years and mean logMAR VA was 0.03 ± 0.05. The macula in deprivational amblyopia was significantly thicker centrally compared to controls (P = .0013), but only tended to be thicker at 500 μm and thinner at 1,000 μm and 1,500 μm. Male gender, poorer VA, and hyperopic refraction positively correlated with CMT (P = .011, P = .018, and P = .038, respectively). Eyes with deprivational amblyopia had increased CMT compared to controls, and this correlated with the severity of amblyopia. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:198-204.].

Interocular Comparison of Anterior and Posterior Segment Findings and Laterality in Hyperopic Anisometropia

To investigate the laterality and the differences in anterior and posterior segment findings in hyperopic patients with anisometropia between their eyes using spectral domain optical coherence tomography and LenStar LS-900 device. This prospective institutional study included hyperopic anisometropic patients with and without amblyopia, aged between 6 and 40 years. The refractive error and the values of keratometry, axial length (AL), central corneal thickness (CCT), peripapillary retinal nerve fiber layer (RNFL) thickness, and central macular thickness (CMT) obtained using the RK-F1 autorefractor, LenStar LS-900, and Spectralis optical coherence tomography were compared between the higher hyperopic and fellow eyes. Eighty of the patients had hyperopic anisometropia with amblyopia and 30 of them had hyperopic anisometropia without amblyopia. The left eyes of the patients in this series were significantly more commonly affected. Axial length and CCT were significantly different between the higher hyperopic and the fellow eyes of all patients. In addition, the mean CMT and RNFL thickness of the higher hyperopic eyes were significantly higher than that of the fellow eyes. During the process of emmetropization and development of the retina, higher hyperopic eyes in hyperopic patients with anisometropia and amblyopic eyes may have blurred and abnormal vision, leading to under-development of vision, significantly higher CCT, CMT, and RNFL thickness, more hyperopic refraction, and shorter AL in the affected eye.