Myopic Adults Research Articles

Intraocular Straylight and Multifocal Soft Contact Lens Fit With a Myopia Control Approach.

Center-distance multifocal contact lenses (MFCLs) are used to slow myopia progression. We examined the effect of two MFCLs on intraocular straylight values in myopic individuals. Twenty-five young myopic adults were enrolled and were fit with three contact lenses (Biofinity sphere, Biofinity Multifocal, and NaturalVue Multifocal) in a random order over two study visits. Pupil size (NeurOptics VIP-300, Laguna Hills, CA) and contact lens centration were measured. Right eye intraocular straylight measurements were collected (OCULUS C-Quant; Wetzlar, Germany) and compared with a spectacle trial lens. Log straylight (LogSL) values and straylight residuals were analyzed using repeated-measures analyses of variance with Tukey-corrected post hoc t -tests. The mean participant age (±SD) was 24.1±1.5 years, and right eye spherical equivalent refractive error was -3.38±1.53 DS. There was no difference in mesopic pupil size between visits ( P =0.68) and no difference in contact lens centration between lenses ( P =0.99). LogSL values differed by lens type ( P =0.004). LogSL with the spectacle trial lens was significantly greater than with each contact lens type (all P <0.05), but there were no significant differences in LogSL between the three contact lenses (all P >0.05). There was no difference between the three contact lens designs for straylight residuals ( P =0.33). Measured intraocular straylight for both MFCLs was not different than with a spherical soft contact lens. A significant increase in intraocular straylight with spectacle trial lens correction was observed compared with all contact lenses.

COMPARISON OF NONCONTACT A-SCAN AND ULTRASOUND A-SCAN IN THE MEASUREMENT OF AXIAL LENGTH IN MYOPIC SUBJECTS

Introduction: Myopia, which is also known as nearsightedness, is a common type of refractive error among the majority of the population. It is characterized by clear vision up close but blurry vision at a distance. Myopia is caused by an eyeball that is abnormally longer than normal and cornea that is too steeply curved. In both cases, images are focused in front of the retina instead of on it. With abnormal axial length of the eyeball, myopia has developed into a condition that threatens eyesight. Methodology: In this study, we compared the axial length measurements between non-contact biometry, and ultrasound A-scan among young myopic adults in UKM Kuala Lumpur campus. A total of 90 healthy myopic subjects (14 male and 76 female) with mean age of 22.03 ± 1.14 years were enrolled in this cross-sectional study. Clinical investigations that included visual acuity, refraction and axial length measurement using optical and ultrasound biometry were carried out. Results: The mean spherical equivalent refractive error, axial length measured by optical biometry and ultrasound were found to be -3.04 ± 1.61 D, 24.74 ± 0.90 mm and 24.50 ± 0.86 mm respectively. Paired sample t-test showed that subjects’ axial length measured by ultrasound A-scan were significantly lower than optical biometry (p &lt; 0.05). Negative and strong correlations were found between degree of myopia and axial length (rs = -0.609, p &lt; 0.001). Regression showed that axial length measurement accounted for a significant 33.5% of the degree of myopia, R² = 0.335, adjusted R² = 0.328, F = (1, 88) = 44.38, p &lt; 0.01. Conclusion: The results of this study demonstrated a significant difference in measurements of axial length using non-contact A-scan and ultrasound A-scan in myopic subjects, which must be considered during management of myopic patients.

Association between weight-adjusted waist index and myopia in adolescents and young adults: results from NHANES 1999–2008

BackgroundPrevious studies have indicated a possible link between obesity and myopia, although the results have varied. The objective of this study was to investigate the correlation between a new measure of obesity, the weight-adjusted waist index (WWI), and myopia.MethodThis cross-sectional study included individuals between the ages of 12 and 25 who participated in a noncycloplegic vision examination as part of the National Health and Nutrition Examination Survey (NHANES) conducted from 1999 to 2008. WWI was calculated as waist circumference divided by the square root of body weight. Myopia was characterized by a spherical equivalent (SE) of ≤ − 0.5 diopters (D) and further categorized into mild (-3.00D < SE≤-0.50 D), moderate (-6.00D < SE ≤-3.00 D), or high (SE≤-6.00 D). We utilized a weighted multivariable logistic regression and a generalized additive model to evaluate the correlation between WWI and myopia. Threshold effects were analyzed, and we performed subgroup analysis and interaction tests.ResultsA grand total of 11,180 individuals were registered for the study. Decreased myopia severity was observed with higher WWI, as evidenced by elevated SE (β = 0.098, 95% CI: 0.028–0.167). Individuals in the top tertile of WWI experienced a 19.8% decrease in risk compared to those in the lowest group (OR = 0.802, 95% CI: 0.800-0.804; P for trend < 0.001). Similar associations were observed for high myopia. Gender-specific nonlinear associations were found, with different breakpoints for males (10.774) and females (10.025). In males, a significant positive association was found on the right side of the breakpoint (OR = 1.398, 95% CI: 1.038–1.884), while no significant association was found on the left side. Conversely, among females, a negative association was observed on the left side of the breakpoint (OR = 0.679, 95% CI: 0.512–0.899), whereas no notable correlation was detected on the right side.ConclusionIncreased WWI level was linked to a lower risk of myopia and high myopia in the overall sample, with gender-specific variations.

Electrophysiological response of myopic young adults with a novel ophthalmic lens for the control of myopia progression

Aims/Purpose: To evaluate the changes in the electrophysiological response of the retina induced by a novel perifocal ophthalmic lens designed for myopia control.Methods: This experimental cross‐sectional study, evaluated eleven myopic participants (24.9 ± 4.5 years) with refractive errors lower than 6.00 D (spherical equivalent of −2.40 ± 1.32 D in the right eye and − 2.24 ± 1.56 D in the left eye). Refraction, best‐corrected visual acuity, and axial length were obtained at baseline. The global flash multifocal electroretinogram (gf‐mfERG) was assessed for the sensorial dominant eye with the RETI‐port/scan21 (Roland Consult, Wiesbaden, Germany). The gf‐mfERG recordings were performed with a stimulus array pattern of 61‐scaled hexagons displayed on a 19‐inch RGB monitor at a 33 cm distance (optically corrected). The retina was divided into three groups ‐ the fovea (that included concentric ring 1), the parafovea (rings 2 and 3) and the peripheral retina (rings 4 and 5). The peak‐time (in milliseconds, ms), the amplitude (in nano‐volts, nV) and the mean response density (nV/deg2) of the direct and implicit components (DC and IC, respectively) were analysed and compared between control (monofocal contact lenses) and test conditions (perifocal lenses). These lenses have an add power of +2.50 D on the temporal side, and + 2.00 D on the nasal side, intended to change the peripheral refraction.Results: No differences were found in the DC and IC peak time between the control and test measurements, for the fovea, parafovea and peripheral retina. The mean response density of the DC was higher with the perifocal lens for the perifovea (p‐value = 0.033) and for the peripheral retina (p‐value = 0.026). For the IC, the mean response density was also higher with the perifocal lens, only for the parafovea (p‐value = 0.003).Conclusions: Perifocal lenses for myopia control upregulate the parafoveal and peripheral retinal electrical activity.

Rhegmatogenous retinal detachment: an analysis of 2315 eyes over a six-year period

Background: Rhegmatogenous retinal detachment (RRD) is a form of retinal detachment caused by passage of fluid from the vitreous cavity into the space between the neurosensory retina and the retinal pigment epithelium via a retinal break or full-thickness defect. At our tertiary referral center, we evaluated the clinical and epidemiological features of RRD, and we herein report the frequency of related risk factors.&#x0D; Methods: In this retrospective study, we reviewed the records of patients with a final diagnosis of RRD at an academic ophthalmological referral center in Isfahan, Iran, over a six-year period. We retrieved and reviewed data from the medical records of all eligible participants, including sex, age, laterality, lens status, macular status, type of RRD, location and number of breaks, type of surgery, rate of re-operation during the first year after initial surgery, and documented clinical risk factors for RRD. Clinical risk factors were categorized as the presence of myopic refractive error, ocular trauma, history of cataract surgery, history of other ocular surgeries, history of uveitis, or undetermined.&#x0D; Results: We included 2315 eyes of 2229 patients with a mean (standard deviation [SD]) age of 51.1 (16.9) years and a male-to-female ratio of 1.8:1. The most common quadrants containing retinal breaks were the superotemporal quadrant (34.1%), inferotemporal quadrant (23.4%), and superonasal quadrant (10.7%). Macula-involved RRD was seen in 90% of eyes (n=2083 eyes). The most frequently identified risk factors were cataract surgery (32.9%) and myopia (22.3%) in adults, and myopia (35.0%) and ocular trauma (27.4%) in the pediatric group. Most eyes underwent pars plana vitrectomy (51.3%), whereas pneumatic retinopexy (0.7%) was the least commonly selected.&#x0D; Conclusions: Our results indicate that cataract surgery and myopia are the most common risk factors for RRD in adults. Myopia and ocular trauma are the most common risk factors in pediatric patients. As observed in many studies, the characteristics of the study population, including middle age, male sex, myopia, and ocular trauma, may be associated with RRD at different rates. Further population-based longitudinal studies with larger sample sizes are required to verify these preliminary observations.

Visual Performance of Two Designs of Myopia Management Soft Contact Lenses Compared with a Monofocal One in Young Adults.

To compare the visual performance of two distinct types of soft contact lenses (CL) aimed at slowing down myopia progression with the performance of a monofocal soft CL. In a prospective double-masked, crossover trial, 18 myopic adults (aged 18-30 years old) were fitted in a randomized order with three types of disposable CL: MiSight (dual-focus), Mylo (extended depth of focus -EDOF-), and Clariti (single distance vision). Measurements were taken after wearing the CL for five days with five days off in between at two different optometry centers. High contrast distance visual acuity (VA) with spectacles and for each of the different CL, subjective refraction, slit lamp exam, aberrometry, stereopsis, monocular and binocular amplitude of accommodation and accommodative facility, and horizontal phorias were measured. The high contrast distance VAwas better for the single vision CL compared to the myopia control CL. No significant differences were observed between the r two myopia control CL. The overall root mean square (RMS) was higher for the double focus CL (RMS = 1.18 0.29 µm), followed by the EDOF CL (RMS = 0.76 0.35 µm) and then the single vision CL (RMS = 0.50 0.19 µm). The primary spherical aberration (SA) mean value was low for all of the three CL, without statistical differences among them. No other significant differences were detected. The overall RMS resulted in a higher value for the dual-focus than the EDOF CL, but no differences in high contrast distance VA and binocularity were detected between them. The monofocal CL's performance was better than the myopia control CL.

Effectiveness and the nomogram of small incision lenticule extraction in the correction of myopic anisometropia in adults.

To evaluate the safety, effectiveness, and predictability of small incision lenticule extraction (SMILE) for the treatment of anisometropia, and to explore the personalized design scheme of SMILE in correcting adult myopia anisometropia based on the nomogram. It's a prospective cohort study. Patients with anisometropic myopia of refractive difference ≥ 2.0 diopters (D) who underwent SMILE between September 2020 and March 2021 were enrolled. Clinical features and visual function were assessed preoperatively and at 1wk, 1, 3, and 6mo after the operation. The examination included tests for uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive errors, effectiveness index (preoperative CDVA/postoperative UDVA), safety index (postoperative CDVA/preoperative CDVA), nomogram and stereoscopic function. Paired t-test, Wilcoxon signed-rank test and repeated-measures analyses of variance were used for continuous variables, and Pearson Chi-squared test was used for categorical variables. The study involved 45 consecutive patients (average age: 25.0±6.9y; 82 out of 90 eyes underwent SMILE, while 8 eyes were not operated). The average preoperative spherical equivalent (SE) was -4.74±0.22 D. Six months after surgery, the effectiveness index was 1.05±0.12, and the safety index was 1.09±0.11. Seventy eyes (85.4%) exhibited SE correction error within ±0.5 D. The percentage of eyes with Titmus stereoscopic function equal to or less than 200″ significantly increased from 55.6% preoperatively to 88.9% postoperatively (P<0.05). There was statistically significant difference between higher myopia eyes and contralateral eyes in average nomogram value/spherical refraction ratio. SMILE is safe, effective and predictable in correcting myopic anisometropia, and it improves stereoscopic visual function of anisometropia patients. The precise and individualized design of the nomogram is a vital element to ensure the balance of both eyes after SMILE.

LncRNA-XR_002792574.1-mediated ceRNA network reveals potential biomarkers in myopia-induced retinal ganglion cell damage

BackgroundLong noncoding RNAs (lncRNAs) play a key role in the occurrence and progression of myopia. However, the function of lncRNAs in retinal ganglion cells (RGCs) in the pathogenesis of myopia is still unknown. The aim of our study was to explore the lncRNA-mediated competing endogenous RNA (ceRNA) network in RGCs during the development of myopia.MethodsRNA sequencing was performed to analyze lncRNA and mRNA expression profiles in RGCs between guinea pigs with form-deprived myopia (FDM) and normal control guinea pigs, and related ceRNA networks were constructed. Then, potentially important genes in ceRNA networks were verified by qRT‒PCR, and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed to explore biological functions in the RGCs of FDM guinea pigs. The important genes and related signaling pathways were further verified by qRT‒PCR, immunohistochemistry, immunofluorescence and Western blot in myopia in FDM guinea pigs, FDM mice, and highly myopic adults.ResultsThe distribution of RGCs was uneven, the number of RGCs was decreased, and RGC apoptosis was increased in FDM guinea pigs. In total, 873 lncRNAs and 2480 mRNAs were determined to be differentially expressed genes in RGCs from normal control and FDM guinea pigs. Via lncRNA-mediated ceRNA network construction and PCR verification, we found that lncRNA-XR_002792574.1 may be involved in the development of myopia through the miR-760-3p/Adcy1 pathway in RGCs. Further verification in FDM guinea pigs, FDM mice, and highly myopic adults demonstrated that the lncRNA-XR_002792574.1/miR-760-3p/Adcy1 axis in RGCs might be related to cGMP/PKG, the apelin signaling pathway and scleral remodeling.ConclusionWe demonstrated that the lncRNA-XR_002792574.1/miR-760-3p/Adcy1 axis in RGCs might be related to myopia. On the one hand, the lncRNA-XR_002792574.1/miR-760-3p/Adcy1 axis might inhibit the cGMP/PKG and apelin signaling pathways in RGCs, thereby causing RGC damage in myopia. On the other hand, the lncRNA-XR_002792574.1/miR-760-3p/Adcy1 axis may cause myopic scleral remodeling through the ERK-MMP-2 pathway. These findings may reveal novel potential targets in myopia and provide reference value for exploration and development of gene editing therapeutics for hereditary myopia.

Trends in Myopia and High Myopia from 1966 to 2019 in Olmsted County, Minnesota

PurposeTo investigate the prevalence of myopia and high myopia in Olmsted County, Minnesota from 1966-2019. DesignRetrospective cross-sectional, trend study using a random population-based sample in Olmsted County, Minnesota from 1966-2019. MethodsManifest refractions or lens prescription were converted to spherical equivalent (SE) to estimate prevalence of adult myopia and high myopia. Age, sex, race, and visual acuity were recorded. Subjects with SE ≤-0.5 diopters (D) were considered myopic; ≤-6.0 D were considered high myopia. Exclusion criteria included visually significant cataract, pseudophakia, prior refractive surgery, or age <18 years-old. ResultsAmong 81,706 sampled subjects, myopia prevalence increased from 33.9% (95% CI 31.1-36.8) in 1960s to 57.1% (95% CI, 56.6-57.6) in 2010s (p<0.001). High myopia prevalence increased from 2.8% (95% CI, 1.95-3.98) in 1960s to 8.3% (95% CI, 8.08-8.62) in 2010s (p<0.001). Both males (32.0%-55.1%, p<.001) and females (40.6%-58.5%, p<.001) experienced increasing myopia prevalence from 1960s-2010s while males (2.6%-7.4%, p<.001) and females (3.4%-9.1%, p<.001) also had higher high myopia prevalence rates from 1960s through 2010s. Increasing myopia and high myopia prevalence was detected by decade in nearly all age groups (excluding 18-24-year-old high myopia subjects). White and Asian subjects had the highest myopia prevalence while Black subjects had the lowest. From the 2000s-2010s, White (53.3%-57.0%, p<0.001) and Black (41.0%-47.0%, p=0.001) subjects had significant increases in myopia prevalence. Mean SE decreased from the 1960s (-0.42 D; 95% CI -0.59-+2.49) to 2010s (-1.85 D; 95% CI, -1.88-+2.96) (p<0.001). ConclusionsFrom 1966-2019 in Olmsted County, Minnesota, there was a 68% and 199% increase in myopia and high myopia prevalence, respectively.

Effects of posterior staphyloma on choroidal structure in myopic adults: a retrospective study

BackgroundStudies on the choroid of myopic eyes with posterior staphyloma have shown that choroidal thickness decreased. This retrospective study further analysed the effects of posterior scleral staphyloma on choroidal blood vessels and matrix components compared to non-pathological myopia.MethodsIn this cross-sectional study, ninety-one eyes were divided into pathological (posterior staphyloma) and non-pathological myopia. The latter was further divided into three groups (Group 1: 26 mm ≤ axial length; Group 2: 24 mm ≤ axial length < 26 mm; Group 3: 22 mm ≤ axial length < 24 mm). Choroidal thickness, total choroidal area, luminal area, stromal area, and choroidal vascularity index were calculated.ResultsThe CVI in N1, N2, I1, S2 of the posterior staphyloma group were lower than those of group 1 (both P < 0.05). The mean height of posterior staphyloma was associated with mean CT (Pearson correlation: r = -0.578, P = 0.039) but not with the mean CVI in posterior staphyloma group. In all groups, the mean choroidal thickness, total choroidal area, luminal area, and stromal area were significantly associated with axial length (P < 0.001), and the mean choroidal vascularity index was significantly associated with the mean choroidal thickness (P < 0.001).ConclusionThe choroidal structure of pathological myopia with posterior staphyloma and non-pathological myopia with longer axial length demonstrates alterations in which choroidal vessels are more impaired than the stroma. A lower choroidal vascularity index should be alert to pathological changes for myopia with axial length > 26 mm.

Factors influencing myopia stabilisation in young myopic adult Singaporeans

PurposeTo evaluate factors influencing stabilisation of myopia in the Singapore Cohort of Risk factors for Myopia.MethodsWe evaluated the longitudinal natural history of 424 myopic participants from 1999 to 2022. The...

Myopia Progression in Adults: A Retrospective Analysis.

Studies on adult myopia progression are limited. This retrospective analysis of a large data set of young adult myopes characterizes myopia progression during adulthood. This study aimed to determine the mean annual progression of myopia and to estimate the proportion of progressors in adult myopes. Longitudinal, noncycloplegic subjective refraction data for young adult myopes (spherical equivalent refractive error, -0.5 D or more), age ranging from 18 to 30 years, were retrospectively analyzed. The mean annual progression, as well as the proportion of progressors (at least -0.50 D shift between visits and annualized progression of -0.25 D or more), was estimated. A total of 354 myopes (230 females [64.7%]), with a mean (standard deviation) age of 22.2 (3.8) years, were considered. The mean (standard deviation) annualized progression was -0.10 (0.21), -0.08 (0.2), and -0.04 (0.21) D in the 18- to 21-year, 22- to 26-year, and 27- to 30-year age groups, respectively ( P = .003). The difference between 18- to 21- and 27- to 30-year age groups was significant ( P = .05), whereas all other pairwise comparisons were not significant. The proportion (95% confidence interval) of progressors in the 18- to 21-, >21- to 26-, and >26- to 30-year age groups was 18.3% (14.9 to 21.7%), 10.9% (7.1 to 14.7%), and 8.8% (4.4 to 13.1%), respectively. The proportion of progressors working or studying in a higher learning/academic environment was 16.2% with an odds ratio (95% confidence interval) for progression of 2.07 (1.15 to 3.74) compared with those in nonacademic environments ( P = .02), with no significant effect of sex or ethnicity. This study is consistent with other studies on myopia in young adults, which show that myopia does not progress by substantial amounts throughout the adult years, particularly after the age of 21 years. Although future studies may be challenged by the small rates of change and the small proportion of progressors, further research is needed to understand the implications of adult myopia progression on clinical management.

Impact of text contrast polarity on the retinal activity in myopes and emmetropes using modified pattern ERG

Environmental factors favoring myopia development are still being studied and there is accumulating evidence for a significant role of nearwork. Recently, reading standard black-on-white text was found to activate the retinal OFF pathway and induce choroidal thinning, which is associated with myopia onset. Contrarily, reading white-on-black text led to thicker choroids, being protective against myopia. Respective effects on retinal processing are yet unknown. Here, we exploratively assessed the impact of contrast polarity on the retinal activity and possible interactions with eccentricity and refractive error. We recorded pattern electroretinograms in myopic and emmetropic adults while presenting a dead leaves stimulus (DLS), overlaid by masks of different size in ring or circle shape, either filled with uniform gray or text of inverted or standard contrast. In myopes, retinal responses for DLS with standard and inverted contrast were larger when the perifovea was stimulated (6–12 deg), however, including the fovea resulted in smaller amplitudes for inverted contrast than in emmetropes. The retina of emmetropes was more sensitive to inverted contrast than to standard and gray within 12 deg, but most sensitive for gray in the perifovea. This demonstrates that the refractive error influences the sensitivity to text contrast polarity, with a special role of the peripheral retina, which is in line with previous studies about blur sensitivity. Defining whether the differences derive from retinal processing or anatomical features of a myopic eye requires further investigation. Our approach might be a first step to explain how nearwork promotes the eye’s elongation.

NO CHANGES IN THE ACCOMMODATIVE STIMULUS-RESPONSE CURVE BUT VARIED LAG OF ACCOMMODATION AFTER A 30-MIN ELECTRONIC NEAR TASK UNDER FOUR DIFFERENT LIGHTING CONDITIONS AMONG MYOPIC YOUNG ADULTS

The prevalence of myopia is increasing worldwide, mainly in Asian countries. Light-emitting Diodes (LED) and low light levels used for homework after school was thought to contribute to myopia development. This study explored how near work and lighting affect the accommodation response. 30 myopic young Malay adults (18-23 years old) were recruited. The ASRC was measured after performing a 30-min near the electronic task at 20 cm using a binocular open-field autorefraction (Grand Seiko, Shin-Nippon) at 6.0 m, 1.0 m, 0.5 m, 0.33 m, 0.25 m, and 0.20 m under four different lighting conditions (Fluorescent 6500K, Fluorescent 3000K, LED 6500K, LED 3000K). A significant flattening in the ASRC gradient was noted when comparing pre and post-measures following the near-vision task for all lighting conditions (p &lt; 0.01). ASRC gradient differences were not affected by lighting conditions (One-way repeated measure ANOVA F (3,87) = 0.84, p &gt; 0.05). ASRC gradient was affected only after 30 minutes of near work F (3,87) = 0.049, p &lt; 0.05). The increment in the accommodative inaccuracy was apparent following prolonged close work. Types of light were not imperative. This information on short-term exposure can be useful for interior light choice of buildings. The effect of long-term exposure requires further investigation.

Clinical Characteristics of Prescribing Orthokeratology Lenses in Adult

Orthokeratology lenses are specially designed rigid gas-permeable lenses that are similar to corneal refractive surgery, in that they flatten the central cornea, reducing corneal curvature and correcting myopic refractive errors. While there have been numerous studies on the prescription of orthokeratology lenses for children, there have been relatively few studies regarding prescribing orthokeratology lenses for adults. Properly prescribed orthokeratology lenses can help to slow down the progression of myopia in young adults and have the advantage of alleviating visual fatigue symptoms compared to soft contact lenses. This paper aims to summarize the various clinical characteristics of prescribing orthokeratology lenses in adults.

Impact of zone geometry on the introduction of myopic defocus in young adult eyes wearing multi-zone lenses.

Multizone contact lenses control myopia progression by proposed introduction of myopic defocus. This project investigated how much of the pupil area and how many dioptres of myopic defocus are introduced by different lens zone geometries with near- and off-axis viewing. Ten young myopic adults (18-25 years) binocularly wore four soft contact lenses including a single vision (SV), concentric-ring dual-focus (DF), centre-distance multifocal (MF) and a RingBoost™ (RB) multi-zone design containing a combination of coaxial and non-coaxial zones. A modified aberrometer captured aberrations and pupil sizes at four target vergences between -0.25 and -4.00 D (on-axis) and across the central ±30° of the horizontal retina (off-axis). Defocus was quantified as the difference between the measured refractive state and the target vergence within each zone of a multi-zone design within the pupil and compared with that of equivalent zone areas of the SV lens. The percentage of the pupil containing myopic defocused light for each lens was calculated. Defocus within the distance correction zones of multi-zone lenses was similar to that of the SV lens. When viewing on-axis at -0.25 D target vergence, on average 11% of the pupil was myopic with SV, whereas 62%, 84% and 50% of the pupil was myopic for the DF, MF and RB designs, respectively. At -4.00 D target vergence, all lenses exhibited a systematic decrease in the percentage of pupil area having myopic defocus (SV: 3%; DF: 18%; MF: 5% and RB: 26%). The off-axis proportions were similar across multi-zone lenses; however, multi-zone lenses retained approximately 1.25-3.0× more myopic defocus than the SV lens. Subjects accommodated using the distance-correction zones of multi-zone lenses. Multi-zone contact lenses introduced significant myopic defocus on-axis and across the central ±30° retina. However, the magnitude and proportion of defocus were influenced by zone geometry, add power and pupil size.

Quantitative assessment of the choroidal vasculature in myopic macular degeneration with optical coherence tomographic angiography.

To assess and compare choroidal morphometric vascular parameters, using optical coherence tomographic angiography (OCTA), in highly myopic adults with and without myopic macular degeneration (MMD). This is a clinic-based observational study of 148 eyes with axial length (AL) ≥25mm, enrolled from the high myopia clinic of the Singapore National Eye Centre. MMD was graded from fundus photographs. Swept source OCT (SS-OCT) and OCTA were performed and assessed for choroidal layer thickness (CT) and choroidal vasculature (choroidal vessel density (CVD), choroidal branch area (CBA) and mean choroidal vessel width (MCVW)) in the different choroidal layers (overall choroidal layer (CL), medium-vessel choroidal layer (MVCL), large-vessel choroidal layer (LVCL)). CTCL (r=-0.58, p<0.001), CTMVCL (r=-0.22, p=0.04), MCVWCL (r=-0.58, p<0.001), and CVDCL (r=-0.19, p=0.02) were negatively correlated with AL, while CBACL (r=0.61, p<0.001) was positively correlated. Compared to eyes with no MMD, eyes with MMD2 had lower CTCL (120.37±47.18µm vs 218.33±92.70µm, p<0.001), CTMVCL (70.57±15.28µm vs 85.32±23.71µm, p=0.04), CTLVCL (101.65±25.36µm vs 154.55±68.41µm, p=0.001) and greater CVDCL (71.10±3.97% vs 66.97±3.63%, p<0.001), CVDMVCL (66.96±2.35% vs 65.06±2.69%, p=0.002), CVDLVCL (68.36±2.56% vs 66.58±2.88%, p=0.012), MCVWMVCL (6.14±0.34µm vs 5.90±0.35µm, p=0.007), and CBACL (12.69±1.38% vs 11.34±1.18%, p<0.001). After adjusting for age, thicker CTCL (odds ratio (OR) 0.98, 95% confidence interval (CI) 0.97-0.99, p<0.001), CTMVCL (OR 0.97 (0.94-0.99), p=0.002) and CTLVCL (OR 0.97 (0.96-0.98, p<0.001) were significantly associated with lower odds of MMD2, while increased CVDCL (OR 1.37 (1.20-1.55), p<0.001), CVDMVCL (OR 1.39 (1.12-1.73), p=0.003), CVDLVCL (OR 1.31 (1.07-1.60), p=0.009), CBACL (OR 2.19 (1.55-3.08), p<0.001) and MCVWMVCL (OR 6.97 (1.59-30.51), p=0.01) was significantly associated with higher odds of MMD2. Decrease in choroidal vessel width, density and thickness, and an increase in vascular branching were observed in eyes with long AL. A thinner and denser choroid with greater branching area and vessel width, which may all be signs of hypoxia, were associated with greater odds of MMD2.

Особенности формирования и течения поздно приобретенной миопии

Introduction. In the modern world, the load on vision has significantly increased, the widespread introduction of computer technology has led to additional visual load, both during working hours and at home. Prolonged and strenuous visual work can lead to the emergence of professional ophthalmopathy, one of the leading manifestations of which is myopia, which develops in persons with visually strenuous work. Goal. To investigate the features of the formation and course of myopia in adults. Material and methods. A retrospective study was conducted based on ophthalmological examination data during the medical examination of the attached contingent in the period 2020-2023 (n=1506). Among them there were 1202 men (79.8%) and 304 women (20.2%). During the examination 416 people (27.6%) were found to be healthy. Refraction and accommodation disorders were detected in 1076 people (71.6%), other visual diseases – in 14 people (0.8%). Among the violations of refraction and accommodation, the leading (50.3%) were: myopia (29.9%), myopic astigmatism (17.6%) and mixed astigmatism (2.8%). The age at which myopia occurred, the degree of clinical refraction, the rate of progression, and the magnitude of anisometropia were evaluated. Results. In 153 people (20.2%), myopia manifested at the age of 34.3+7.2 years (18;52). At the time of examination, the duration of myopia was 7.3+5.9 years (0; 30). In the period 2020-2021, the proportion of late myopia left 14.0%, and in 2022-2023 – 28.8% (p&lt;0.001). Stationary course of late myopia was noted in 5.9% of cases, progression – in 90.2% (slow (0.5 dptr per year or less) – 77.8%; fast (more than 0.5 dptr per year – 7.2%). The proportion of mild myopia was 92.9%, medium – 6.5%, high – 0.7%. Isometropia was observed in 44.4% of cases, anisometropia up to 0.5 dpt – in 34.7% of cases, anisometropia with a degree of 0.75 dpt and more – in 20.9% of cases Conclusion. During the medical examination, 71.6% of the examined contingent revealed violations of refraction and accommodation, including 50.3% of individuals diagnosed with myopic refraction. Nearsightedness manifested at the age of 18 and older was observed in 20.2% of people with myopia. The data obtained confirm the need for therapeutic and preventive measures to prevent the formation and progression of myopia in adults. Keywords: myopia, adults, professional ophthalmopathy, refraction, accommodation

Meridional Attentional Asymmetries in Astigmatic Eyes.

To investigate the impact of attention orientation in young myopic adults with astigmatism. The effect of attention on foveal meridional performance and anisotropy was measured in corrected myopes with various levels of astigmatism (with-the-rule astigmatism ≤ -0.75D, Axis: 180 ± 20) using orientation-based attention. Attention was manipulated by instructing subjects to attend to either the horizontal or the vertical line of a central pre-stimulus (a pulsed cross) along separate blocks of trials. For each attention condition, meridional acuity and reaction times were measured via an annulus Gabor target situated remotely from the cross and presented at random horizontally and vertically in a two-alternative forced-choice employing two interleaved staircase procedures (one-up/one-down). Attention modulations were estimated by the difference in performance between horizontal and vertical attention. Foveal meridional performance and anisotropy were strongly affected by the orientation of attention, which appeared critical for the enhancement of reaction times and resolution. Under congruent orienting of attention, foveal meridional anisotropy was correlated with the amount of defocus for both reaction time and resolution, demonstrating greater vertical performance than horizontal performance as myopia increased. Compatible with an attentional compensation of blur through optimal orienting of attention, vertical attention enhanced reaction times compared to horizontal attention and was accompanied by an increase in overall acuity when myopia increased. Increased astigmatism was associated with smaller attention effects and asymmetry, suggesting potential deficits in the compensation of blur in astigmatic eyes. Collectively, attention to orientation plays a significant role in horizontal-vertical foveal meridional anisotropy and can modulate the asymmetry of foveal perception imposed by the optics of the eye in episodes of uncorrected vision. Further work is necessary to understand how attention and refractive errors interact during visual development. These results may have practical implications for methods to enhance vision with attention training in myopic astigmats.

Comparison of vision performance of spectacles prescribed to 0.05D versus 0.25D steps

ABSTRACT Clinical relevance Traditionally, refraction is performed, and spectacles are manufactured in in 0.25D-steps. Trial and spectacle lenses manufactured in smaller increments may allow for a more accurate refraction and prescribed spectacles. Background To determine whether refraction in 0.05D-steps improves the proportion of eyes achieving achieve duochrome equality, and whether spectacles prescribed in 0.05D-steps offer any vision benefits, compared to 0.25D-steps. Methods Myopic young adults were enrolled into two prospective studies conducted at different sites. Study 1 comprised 66 participants (refracted under cycloplegia) while Study 2 comprised 51 participants (not cyclopleged). A standard refraction was performed in both studies and a trial frame and trial lenses were used to determine the spherical endpoint of duochrome equality (0.25D-steps first then 0.05D-steps). In Study 2, the cylindrical component was refined in 0.05D-steps before the spherical endpoint in 0.05D-steps. Monocular high-contrast-visual-acuity (HCVA) was measured while wearing the final refractions. Participants in Study 2 wore spectacles manufactured in 0.25D and 0.05D-steps for 7 days each in a randomized, double-masked study. Both spectacles appeared identical. Outcome measures assessed on dispensing and after 7 days of wear comprised monocular acuity-based measurements (HCVA, low-contrast-visual-acuity, vanishing-optotype-acuity, contrast-sensitivity) and subjective ratings. The Quality-of-Vision questionnaire and subjective preference were assessed after 7 days. Results Both studies showed a higher proportion of eyes achieved duochrome equality (P < 0.001) and better average monocular HCVA (P ≤ 0.006) in 0.05D-steps. Study 2 showed 0.05D-step spectacles provided better average results for all monocular acuity-based measurements (P < 0.006) and were preferred by 65% (P = 0.04) of participants after 7 days (P = 0.04). There were no differences between spectacles for any other measures (P > 0.1). Conclusions Refraction performed, and spectacles manufactured in 0.05D-steps for this study improved average acuity-based outcomes and were preferred by most participants to spectacles in traditional 0.25D-steps.