Spherical Equivalent Research Articles

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.

Ocular Biometric and Optical Coherence Tomography Parameters in Former Preterm Children: A Cohort Study.

To compare biometric and optical coherence tomography parameters as well as refractive status in preterm children aged 4-8 years with or without retinopathy of prematurity (ROP), and evaluate their correlations with age and gender-matched full-term children. Retrospective comparative cohort study of four groups of children. Children with a history of preterm birth, including ROP who received intravitreal bevacizumab (IVB) treatment, children with a history of ROP that regressed without treatment and those with no history of ROP were compared to age and gender-matched full-term children as a control group. Best corrected visual acuity (BCVA), spherical equivalent of refraction (SE), macular and choroidal thickness, as well as biometric parameters was measured. A total of 120 eyes of 120 children (30 children in each group) were included. There was no significant difference in BCVA, SE, and subjective cylinder between groups (p=0.05, p=0.3, p=0.6, respectively). Axial length was significantly shorter, and the cornea was steeper in both ROP groups than in other groups (p=0.001, p < 0.001, respectively). The central macular thickness was significantly thicker in the treated, regressed ROP and preterm groups than in full-term children (p < 0.001). The gestational age was negatively correlated with macular thickness in both treated and regressed ROP groups (r = -0.517; p=0.003, r = - 0.490; p=0.006, respectively). Children with a history of ROP had a shorter axial length, steeper cornea, and thicker macula that correlated with lower gestational age.

Performance evaluation and parameter optimization of a walnut shell–kernel winnowing device

AbstractTo design a walnut shell–kernel winnowing device, the aerodynamic characteristics of walnut shells and kernels were studied by combining theoretical computation and empirical tests. A winnowing method was developed for shell–kernel separation based on an analysis of suspending velocity. The performance of the walnut shell–kernel winnowing device was evaluated based on the screening rate and loss rate. Influences of feeding rate, wind speed, and vibration frequency on the performance of the device were simulated, and the optimal operating parameters were acquired. Research results demonstrated that the suspending velocity ranges of walnut shells and kernels were 8.96–13.89 and 11.81–20.78 m/s, respectively. Vibration frequency was the primary factor that influenced the screening rate of the device, followed by wind speed and then feeding rate. Feeding rate was the primary factor influencing the loss rate of the device, followed by vibration frequency and then wind speed. The optimal operating parameters were as follows: feeding rate = 246.61 g/s, wind speed = 19.77 m/s, and vibration frequency = 41.17 Hz. Under these conditions, the winnowing device's screening rate and loss rate were 79.22% and 7.38%, respectively. The performance of the designed walnut shell–kernel winnowing device conforms to practical operational requirements. This study provides a potential reference for future investigation into the optimization of shell–kernel winnowing devices for other agricultural products.Practical applicationsIn order to explore the influence of each factor on the performance of the device, the windward area of the crushed materials was obtained by Image Processing. Meanwhile the “3σ criterion” was used to establish an equivalent sphere of equal windward area to replace the real shape of the walnut particles, and the range of the suspending velocity of the walnut crushed material was explored. Based on the Computational Fluid Dynamics Discrete Eement Method (CFD‐DEM) coupling method, and taking the screening rate and loss rate as the evaluation indicators, the effects of feed flow, wind speed, and vibration frequency on the performance of the device were simulated and analyzed, and the optimal operating parameter combination was obtained. The performance of the walnut shell–kernel winnowing device designed in this paper meets the actual operation requirements, and the research method can provide a reference for the development and optimization of other agricultural product separation equipments.

Temperature digital twins model for blueberry pre-cooling based on micro-cluster method

Abstract Objectives In order to improve the prediction accuracy of forced-air pre-cooling for blueberries, a mathematical model of forced-air pre-cooling for blueberries based on the micro-cluster method was established. Materials and Methods In order to determine the optimal micro-cluster model parameters suitable for forced air pre-cooling of blueberries, three factors controlling the micro-cluster geometry parameters were evaluated by 7/8 pre-cooling time, uniformity, and convective heat transfer coefficient. Results It was found that the optimal values of the number of micro-clusters (n3), the distance between individual units within a micro-cluster (a) and the distance between micro-clusters (c) were 3, 0.75, and 0.2, respectively. Under these optimal values, the temperature error of the micro-cluster method remained below 1 °C, achieving highly accurate temperature predictions during the blueberry pre-cooling process. The results showed that the micro-cluster method effectively solved the challenges of complex configuration, long simulation time, and low accuracy compared to the porous medium and equivalent sphere methods. Conclusion Based on the above analysis, it can be concluded that the micro-cluster method provids a theoretical basis for optimizing forced-air pre-cooling processes and making informed control decisions.

Outcomes of the Q value-based nomogram in managing pediatric versus adult keratoconus: a prospective interventional study.

Keratoconus (KCN) is an ectatic disorder of the cornea characterized by stromal weakness and apical protrusion of the cornea, and is associated with a gradual and painless reduction in visual acuity. KCN in pediatric patients has certain important characteristics, such as a progressive and aggressive nature. We aimed to analyze the visual, refractive, and topographic outcomes of implanting a single 210° arc-length Keraring segment according to a novel, objective, Q value-based nomogram (Q-N) for the treatment of pediatric versus adult KCN. This prospective, multicenter, non-randomized, open-label trial included 47 eyes of 47 patients who were allocated to one of two groups. The adult group included 33 eyes of patients ≥ 18 years of age, whereas the pediatric group included 14 eyes of patients aged 14 - 17 years. All patients underwent femtosecond laser-assisted implantation of a single 210° arc-length Keraring segment according to the Q-N and were followed up for 6 months. All eyes underwent visual acuity measurement, cycloplegic refraction, and corneal topography at baseline and 6 months after surgery. The study groups were comparable in terms of sex proportions and KCN grades (both P > 0.05). The adult group exhibited significant postoperative improvements in mean uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), sphere, cylinder, spherical equivalent (SE), and Kmax (all P < 0.001) with a mean change of -0.56 logarithm of the minimal angle of resolution (logMAR), - 0.40 logMAR, 3.07 diopters (D), 0.70 D, 3.42 D, and - 5.26 D, respectively. The pediatric group exhibited significant postoperative improvements in mean UDVA, CDVA, sphere, SE, and Kmax (all P < 0.05) with a mean change of - 0.62 logMAR, - 0.34 logMAR, 3.18 D, 3.67 D, and - 5.37 D, respectively. There were no significant differences between the groups in terms of the mean change in visual, refractive, and topographic variables (all P > 0.05). No postoperative complications were observed in either group. Use of the objective Q-N was efficient in the treatment of pediatric KCN, with postoperative improvements in the mean visual, refractive, and topographic parameters, comparable to outcomes in adult keratoconus. Q-N achieved good corneal remodeling with subsequent improvements in visual, refractive, and topographic outcomes in both adult and pediatric patients with keratoconus. To verify our preliminary findings, we recommend further multicenter randomized clinical trials using the Q-N nomogram in a larger sample of pediatric patients with KCN as an adjunct treatment before or after CXL.

Safety and Efficacy of Low Dose Atropine in Nepalese Children with Progressive Myopia.

Myopia is emerging as a public health emergency worldwide. Low dose atropine has been proven to be safe and efficacious in halting the progression of myopia. Aim of this study was to evaluate safety and efficacy of low dose atropine in Nepalese children with progressive myopia. It is a prospective non randomized interventional study. Children with myopia progression of >0.5D in the last six months with baseline myopia of -1.5 to -8 Diopter and astigmatism of 3 D or less were prescribed 0.01% atropine daily at bedtime for two years. Demography including age, gender, race, and examinations including anterior and posterior segment, axial length, near point of accommodation and near vision were recorded in all the children. Ocular and systemic side effects were documented. A total of 200 children were enrolled in the study. Mean age was 11.9±2.97 years with 41% female. Baseline mean axial length was 24.47±1 and mean spherical equivalent was 3.69±1.33. Average increase in axial length was 0.18(±0.02), 0.17(±0.02), and 0.19(±0.04) mm in six months, one year, and two years respectively. The increase in spherical equivalence was 0.2 (±0.01), 0.3(±0.02), and 0.3(±0.02)) diopter in six months, one year, and two years respectively. The myopia progression was found more in the Mongolian race compared to the Aryan race. No ocular or systemic side effects were documented. Topical low dose atropine appears to be safe and efficacious in halting the progression of myopia in a cohort of Nepalese children. Further randomized control trial on various doses of atropine are recommended.

Eye Size and Shape in Relation to Refractive Error in Children: A Magnetic Resonance Imaging Study.

The purpose of this study was to determine the association between eye shape and volume measured with magnetic resonance imaging (MRI) and optical biometry and with spherical equivalent (SE) in children. For this study, there were 3637 10-year-old children from a population-based birth-cohort study that underwent optical biometry (IOL-master 500) and T2-weighted MRI scanning (height, width, and volume). Cycloplegic refractive error was determined by automated refraction. The MRI images of the eyes were segmented using an automated algorithm combining atlas registration with voxel classification. Associations among optical biometry, anthropometry, MRI measurements, and RE were tested using Pearson correlation. Differences between refractive error groups were tested using ANOVA. The mean volume of the posterior segment was 6350 (±680) mm3. Myopic eyes (SE ≤ -0.5 diopters [D]) had 470mm3 (P < 0.001) and 970mm3 (P < 0.001) larger posterior segment volume than emmetropic and hyperopic eyes (SE ≥ +2.0D), respectively. The majority of eyes (77.1%) had an oblate shape, but 47.4% of myopic eyes had a prolate shape versus 3.9% of hyperopic eyes. The correlation between SE and MRI-derived posterior segment length (r -0.51, P < 0.001) was stronger than the correlation with height (r -0.30, P < 0.001) or width of the eye (r -0.10, P < 0.001). In this study, eye shape at 10 years of age was predominantly oblate, even in eyes with myopia. Of all MRI measurements, posterior segment length was most prominently associated with SE. Whether eye shape predicts future myopia development or progression should be investigated in longitudinal studies.

Assessment of Peripapillary Retinal Nerve Fiber Layer Optical Density Ratios in Healthy Eyes Using Optical Coherence Tomography with Different Analytical Radii

Purpose To explore the characteristics and determinants of peripapillary retinal nerve fiber layer (RNFL) optical density (OD) by optical coherence tomography (OCT) in healthy eyes with varied analytical radii. Methods Peripapillary OCT scans centered at the optic disc of 150 eyes from 150 healthy subjects (64 males and 86 females) were included. Under 5 analytical circles with different radii (1.45 mm, 1.7 mm, 1.95 mm, 2.2 mm and 2.45 mm), the circumpapillary circular cross-sectional images were exported for further analysis using Image J. Peripapillary RNFL and retinal pigment epithelium (RPE) OD in different quadrants and clock-hours were obtained. RNFL optical density ratio (ODR) was then calculated as RNFL OD divided by RPE OD. A linear mixed-effects model analysis was performed to assess the relationship between RNFL ODR and analytical radius, accounting for axial length, age, spherical equivalent, thickness and image score. Results The RNFL ODRs had a double-hump pattern with peaks in the superior and inferior quadrants and troughs in the temporal and nasal areas. In the linear mixed-effects model analysis, a trend of decreasing mean RNFL ODR with increasing analytical radius was found (0.9227 ± 0.0689, 0.9063 ± 0.0620, 0.8916 ± 0.0552, 0.8729 ± 0.0553 and 0.8575 ± 0.0564 respectively, p = 0.034). RNFL ODR values was negatively correlated with age (p < 0.001), positively correlated with corresponding RNFL thickness (p < 0.001). No significant correlation was found between RFNL ODR and image score, axial length and spherical equivalent. Conclusions RNFL ODR profile showed a comparable double-hump configuration with RNFL thickness. RNFL ODR values tended to decrease with larger analytical circles and older age, and increase with corresponding RNFL thickness. These factors should be considered when interpreting RNFL ODR in glaucoma assessment.

Shape Matters: Long-Range Transport of Microplastic Fibers in the Atmosphere.

The deposition of airborne microplastic particles, including those exceeding 1000 μm in the longest dimension, has been observed in the most remote places on earth. However, their deposition patterns are difficult to reproduce using current atmospheric transport models. These models usually treat particles as perfect spheres, whereas the real shapes of microplastic particles are often far from spherical. Such particles experience lower settling velocities compared to volume equivalent spheres, leading to longer atmospheric transport. Here, we present novel laboratory experiments on the gravitational settling of microplastic fibers in air and find that their settling velocities are reduced by up to 76% compared to those of the spheres of the same volume. An atmospheric transport model constrained with the experimental data shows that shape-corrected settling velocities significantly increase the horizontal and vertical transport of particles. Our model results show that microplastic fibers of about 1 mm length emitted in populated areas are more likely to reach extremely remote regions of the globe, including the high Arctic, which is not the case for spheres of equivalent volume. We also calculate that fibers with lengths of up to 100 μm settle slowly enough to be lifted high into the stratosphere, where degradation by ultraviolet radiation may release chlorine and bromine, thus potentially damaging the stratospheric ozone layer. These findings suggest that the growing environmental burden and still increasing emissions of plastic pose multiple threats to life on earth.

DeepGraFT: A novel semantic segmentation auxiliary ROI-based deep learning framework for effective fundus tessellation classification

Fundus tessellation (FT) is a prevalent clinical feature associated with myopia and has implications in the development of myopic maculopathy, which causes irreversible visual impairment. Accurate classification of FT in color fundus photo can help predict the disease progression and prognosis. However, the lack of precise detection and classification tools has created an unmet medical need, underscoring the importance of exploring the clinical utility of FT. Thus, to address this gap, we introduce an automatic FT grading system (called DeepGraFT) using classification-and-segmentation co-decision models by deep learning. ConvNeXt, utilizing transfer learning from pretrained ImageNet weights, was employed for the classification algorithm, aligning with a region of interest based on the ETDRS grading system to boost performance. A segmentation model was developed to detect FT exits, complementing the classification for improved grading accuracy. The training set of DeepGraFT was from our in-house cohort (MAGIC), and the validation sets consisted of the rest part of in-house cohort and an independent public cohort (UK Biobank). DeepGraFT demonstrated a high performance in the training stage and achieved an impressive accuracy in validation phase (in-house cohort: 86.85 %; public cohort: 81.50 %). Furthermore, our findings demonstrated that DeepGraFT surpasses machine learning-based classification models in FT classification, achieving a 5.57 % increase in accuracy. Ablation analysis revealed that the introduced modules significantly enhanced classification effectiveness and elevated accuracy from 79.85 % to 86.85 %. Further analysis using the results provided by DeepGraFT unveiled a significant negative association between FT and spherical equivalent (SE) in the UK Biobank cohort. In conclusion, DeepGraFT accentuates potential benefits of the deep learning model in automating the grading of FT and allows for potential utility as a clinical-decision support tool for predicting progression of pathological myopia.

Efficacy of Multifocal Soft Contact Lenses in Reducing Myopia Progression Among Taiwanese Schoolchildren: A Randomized Paired-Eye Clinical Trial.

To evaluate the efficacy and safety of myopia control using a multifocal soft contact lens designed with high peripheral add power in schoolchildren. This 1-year multi-center, prospective, randomized, double-blind, controlled study enrolled myopic schoolchildren aged 6-15years with refractive errors between - 1.0 D and - 10.0 D. Each participant was randomly allocated to wear a daily disposable multifocal soft contact lens as the treatment in one eye and a single-vision soft contact lens as the control in the other eye. The primary endpoints were changes in the cycloplegic spherical equivalent (SE) and axial length at 1year. Fifty-two of the 59 participants (88.1%) completed the study protocol. The mean change in SE was - 0.73 ± 0.40 D in the treatment group. and - 0.85 ± 0.51 D in the control group (mean difference: - 0.12 ± 0.34 D, p = 0.012). The mean change in axial length was 0.25 ± 0.14mm in the treatment group, and 0.33 ± 0.17mm in the control group (mean difference: 0.08 ± 0.10mm, p < 0.001). The treatment was well tolerated, and no serious adverse events were observed. Treatment with multifocal soft contact lenses with high peripheral add power was effective in controlling the progression of myopia and axial length elongation in myopic schoolchildren.

Progression of Myopic Maculopathy Based on the ATN Classification System

Introduction: Myopic maculopathy is a sight-threatening disease, which causes irreversible vision faults and central vision loss. The purpose of this study is evaluating the risk factors of the myopic maculopathy progression according to the ATN classification system. Methods: Clinic data of 69 high myopia patients aged older than 40 years with a follow-up time of more than 2 years, who underwent fundus photography and OCT examination were retrospectively collected. Fundus changes were evaluated with ATN classification at the first and last follow-up times. The related factors affecting progress including axial length (AL), spherical equivalence (SE), subfoveal choroidal thickness (SFCT), disc-foveal distance (DFD), optic disc tilt, and parapapillary atrophy (PPA) were analyzed. Results: This study included 69 high-myopia patients with mean age 54.29 ± 10.41 years. The progression rate of myopic maculopathy (MM) was approximately 25.56%. Elongated DFD (5.37 ± 0.11 mm vs. 4.86 ± 0.37 mm; p < 0.001) and thinner SFCT (138.52 ± 29.38 μm vs. 184.87 ± 48.72 μm; p = 0.008) at baseline were linked with MM progression. In multiple logistic regression analysis, DFD was a substantial hazard risk factor (adjusted OR = 1.672, 95% CI: 1.135–2.498, p < 0.05) after adjusting for age, AL and SFCT. Receiver operating characteristic curve showed that DFD might serve as a predictor to discriminate the MM progression with a cut-off value of 5.15 mm and a substantial receiver operating characteristic curve area (AUC: 0.794). Compared with the non-progression group, the progression group had older age (p < 0.001), longer AL (p = 0.001), higher optic disc tilt rate (p < 0.001), and higher proportion of pre-existing PPA (p = 0.038) at baseline, the differences were statistically significant. Conclusion: Based on the ATN classification system, we found that the progression of MM was related to older age, longer AL, high disc tilt, pre-existing PPA, thinner SFCT, and longer DFD. The parameter of DFD was an important factor affecting the progression of MM, which is considered to have a higher probability of progression when the length is beyond 5.15 mm.

Utility of retinoscopy to examine peripheral refraction

PurposeThis study explored whether retinoscopy (RET) provides comparable results of relative peripheral refraction (RPR) to open–field autorefractometry (AR) in myopic subjects. MethodsPeripheral refraction was measured in 20 myopic and 20 control adult subjects. Both central and peripheral refraction (20° nasal and temporal eccentricity) were measured using RET and open-field AR. Differences in the median central spherical equivalent (SE), median RPR, and median J45/J180 power vectors between the RET and AR techniques were analyzed. Moreover, Bland – Altman plots were used to assess the agreement between RET and AR methods for RPR measurements in MG. ResultsFor MG, the median RPR values were positive (hyperopic shift), and no significant differences were observed between the RET and AR techniques with respect to RPR measurement. In addition, we did not observe any significant differences in the RPR values between the nasal and temporal eccentricities for either the RET or AR technique for myopic subjects. There was also a significant correlation and agreement between the RET and AR technique for RPR measurements. With respect to central refraction, the median SE was slightly more positive for the RET than for the AR technique. Inside the CG, we also found significant correlation between the RET and AR technique for RPR measurements, and we observed a myopic shift in peripheral eccentricities. ConclusionOur results show that retinoscopy may be a useful tool for objective measurements of RPR in myopic subjects and may be used interchangeably with the open-field AR method in everyday clinical practice.

Myopic Progression of Children in RSUP Dr M Djamil During COVID-19 Pandemic

Background: Myopia (nearsightedness) is an eye condition when a far object reflection is focused in front of the retina without accommodation, so far object cannot be seen clearly. The elongation of the eye's axial length primarily causes myopia. Lack of outdoor activities and excessive near work (screentime) during home confinement duringthe COVID-19 pandemic have increased the risk of myopia development, primarily in school children.&#x0D; Objective: This study aims to see children's myopic progression during the COVID-19 pandemic.&#x0D; Methods: This research was an observational analytic study by a retrospective cohort about children's myopic progression based on the difference between the spherical equivalent (SE) of 34 patients in RSUP Dr. M. Djamil from before (September 2019–February 2020) followed up to late (September 2021–February 2022) of COVID-19 pandemic from their medical records.&#x0D; Results: The results showed that myopic progression majorly occurredin children who were females (47.0%), had myopic parents (67.6%), ≥ 2 hours of outdoor activity (61.7%), &gt; 5 hours of screentime (79.4%); with slow annualized myopic progression (61.7%). The median of SE from before and late the COVID-19 pandemic are -4.00 (-16.00 – -0.25) D and -4.62 (-17.00 – -0.25) D respectively; p&lt;0.001.&#x0D; Conclusion: Children did have myopia worsening during the COVID-19 pandemic.&#x0D; Keywords: Myopia, Progression, COVID-19, Children, Spherical Equivalent

Effective Decrease in Myopia Progression With Two Mechanisms of Management.

To ascertain the effectiveness of 0.01% atropine treatment to inhibit myopia progression and the possible additive potency with peripheral defocus contact lenses over 3 years and the rebound effect 1 year after cessation of treatment. This prospective study included 127 children aged 8 to 5 years, divided into three treatment groups: 0.01% atropine and single-vision spectacles (At+SV, n = 36), 0.01% atropine and peripheral defocus contact lens (At+PDCL, n = 30), and 0.01% atropine and dual-focus contact lens (At+DF, n = 25). A control group was prescribed single-vision spectacles (n = 36). Cycloplegic spherical equivalence refraction was measured every 6 months during 3 years of treatment and 1 year after cessation. Myopia progression decreased over 3 years of treatment, more during the second and third years than the first year, to a statistically significant degree in the atropine groups (P < .01): in the first, second, and third years, respectively, -0.42 ± 0.34, -0.19 ± 0.18, -0.22 ± 0.19 diopters (D) in the At+SV group, -0.26 ± 0.21, -0.14 ± 0.37, and -0.15 ± 0.31 D in the At+PDCL group, and -0.22 ± 0.15, -0.15 ± 0.22, and -0.11 ± 0.14 D in the At+DF group. Myopia progressed 1 year after cessation of treatment: -0.29 ± 0.28 D in the At+SV group, -0.13 ± 0.28 D in the At+PDCL group, and -0.09 ± 0.18 D in the At+DF group. After 3 years, there was no statistically significant difference in myopia progression between the At+SV and At+PDCL or At+DF groups (P < .05). Low-dose atropine has been substantiated in this cohort as an effective treatment to decelerate myopia progression over 3 years, more effective in the second and third years of treatment. The combination treatment did not exhibit a statistically significant advantage over monotherapy in this cohort. The At+DF group exhibited a statistically lower rebound effect than the At+SV group. [J Pediatr Ophthalmol Strabismus. 2024;61(3):204-210.].

Correlation of angle kappa with biometry and higher-order aberrations of cataract patients at Prof. Ngoerah Hospital Ophthalmology Clinic

Background Advancements in ophthalmic surgery now hinge on intricate interplays among ocular parameters. Angle kappa, measuring deviation between visual and pupillary axes, is crucial, especially in refractive procedures with multifocal intraocular lens implants. The research aimed to correlate angle kappa with biometry and higher-order aberrations (HOA) to enhance surgical outcomes among adult cataract patients at Prof. Ngoerah Hospital Ophthalmology Clinic, Denpasar, Bali. MethodsThis cross-sectional study included 29 male and female cataract patients aged 18-80 years, without prior treatment. All patients had a basic examination that included testing of visual acuity using Snellen chart, autorefractometer, measurement of ocular pressure using non-contact tonometry, and slit-lamp examination for cataract grading. Patients who met the inclusion criteria were then examined for biometry (axial length, spherical equivalent, white-to-white distance, anterior chamber depth) using Nidek AL Scan and for angle kappa and HOA using OPD scan III. ResultsData from 50 eyes of 29 subjects (15 females and 14 males) were analyzed. The mean age of the subjects was 60.6 ± 12.5 years. Age and spherical equivalent had positive correlation with angle kappa (r =0.104, r=0.213), but the correlation was not statistically significant. In this study, interestingly angle kappa was not significantly correlated with HOA, AXL, WTW, and ACD (r = -0.050, r = -0.192, r = -0.104, r = -0.195, p &gt;0.05). ConclusionIn conclusion, angle kappa may increase with age and spherical equivalent. Further study with larger sample size is required.

Longitudinal analysis of refraction and ocular biometrics in preschool children with early-onset high myopia

We investigated changes in refraction and ocular biometrics in preschool children with early-onset high myopia. Sixty eyes of 60 children with a mean follow-up time of 58.5 months were included in this study. At baseline, mean age of children was 55.6 ± 13.1 months, mean spherical equivalent (SE) was − 8.59 ± 2.66 D, and 25.64 ± 1.16 mm for axial length (AL). The total annual rate of myopic progression and axial elongation were − 0.37 ± 0.39 D/year and 0.33 ± 0.18 mm/year, respectively. During follow-up period, there was a trend toward less myopic progression and axial elongation over time. Of the total participants, 24 children (40%) were in the myopia progression group and the remaining 36 children (60%) were in the myopia stability group. In multiple linear regression analysis, baseline SE and AL were independently associated with myopic progression, while age, sex, and baseline AL-to-CR ratio were not related to myopic progression. According to the model, more myopic SE (β = − 0.186, P = 0.035) and longer AL (β = − 0.391, P = 0.008) at baseline were significantly associated with myopic progression. Myopia progression in preschoolers with high myopia tended to be relatively modest, with 60% of subjects exhibited myopic stability. Higher myopic SE, and longer AL at baseline were associated with myopic progression in preschool children with high myopia.

Observation of peripheral refraction in myopic anisometropia in young adults.

To investigate the differences in retinal refraction difference values (RDVs) of adult patients with myopic anisometropia compared with those without myopic anisometropia, and to investigate the relationship between ocular biometric measurements and relative peripheral refraction. This clinical observation study included 130 patients with myopia (-0.25 to -10.00 D) between October 2022 and January 2023 aged between 18 and 40y. The patients were divided into anisometropia (n=63; difference in binocular anisometropia ≥1.00 D) and non-anisometropia (n=67; difference in binocular anisometropia <1.00 D) groups accordingly. Ocular biometric measurements were performed by optical biometrics and corneal topography to assess the steep keratometry (Ks), flap keratometry (Kf), axial length (AL), corneal astigmatism (CYL; Ks-Kf), surface regularity index (SRI), surface asymmetry index (SAI), and central corneal thickness (CCT). The RDV was measured at five retinal areas from the fovea to 53 degrees (RDV-0-10, RDV-10-20, RDV-20-30, RDV-30-40, and RDV-40-53), the total RDV (TRDV) of 53 degrees, and four regions, including RDV-superior, RDV-inferior, RDV-temporal, and RDV-nasal. An analysis of Spearman correlation was carried out to examine the correlation between RDV and the spherical equivalent (SE) and ocular biological parameters. Within RDV-20-53, both groups showed relative hyperopic defocus, and the increase in RDV corresponds to the increase in eccentricity. In the myopic anisometropia group, the TRDV, RDV-20-53, RDV-superior, and more myopic eyes had significantly higher RDV-temporal values than less myopic eyes. (P<0.05). In the non-anisometropia group, there was no significant difference in the RDV between the more and less myopic eyes at different eccentricities (P>0.05). There was a negative correlation between SE and TRDV (r=-0.205, P=0.001), RDV-20-53 (r=-0.281, -0.183, -0.176, P<0.05), RDV-superior (r=-0.251, P<0.001), and RDV-temporal (r=-0.230, P<0.001), a negative correlation between CYL and RDV-10-30 (r=-0.147, -0.180, P<0.05), and a negative correlation between SRI and RDV-0-20 (r=-0.190, -0.170, P<0.05). AL had a positive correlation with RDV-20-30 (r=0.164, P=0.008) and RDV-temporal (r=0.160, P=0.010). More myopic eyes in patients with myopic anisometropia show more peripheral hyperopic defocus. Diopter and corneal morphology may affect peripheral retinal defocus.

Clinical outcomes with a novel extended depth of focus intraocular lens Tecnis Symfony

Relevance. Some of the most current intraocular lenses (IOL) are lenses with an extended depth of focus. Lenses of this type allow you to reduce dependence on glasses by distributing light energy to long-range and focus at medium distance, without losing the quality of vision. Studies that analyze the results of implantation of this type of lens are few. Purpose: to evaluate the clinical outcomes of extended depth of focus (EDOF) intraocular lens (IOL) implantation. Materials and methods. Prospective randomized study enrolled 61 patients of 79 eyes (18 to 86 years) undergone uncomplicated phacoemulsifi cation with EDOF IOL Tecnis Symfony (USA) implantation. The study was conducted from November 2020 through November 2022. Uncorrected near visual acuity (UNVA); corrected near visual acuity (CNVA) and uncorrected and corrected distance visual acuity (UDVA and CDVA), monocular defocus curve and refractive outcomes were evaluated during a 3-month period. When calculating the IOL, the target spherical equivalent was –0.35 ± 0.11 D. Results. In the postoperative period 3 months, visual acuity were 0.7 or better in 82.4% UCDVA, 100% CDVA and 50% UCNVA. 3 months after surgery, UDVA and UNVA at 40 cm averaged 0.85 ± 0.15 and 0.69 ± 0.18, respectively. CDVA and CNVA at 40 cm was 0.98 ± 0.04 and 0.8 ± 0.14, respectively. A total of 85.7% of eyes achieved postoperative visual acuity about 0.5 for the range of defocus levels between +1.00 and −1.50 D. Conclusions. Cataract surgery with Tecnis Symfony EDOF IOL implantation provide functional levels of visual acuity in distance, intermediate zones. The near visual performance with this IOL might be signifi cantly enhanced using a micro-monovision approach

Dietary intake and its association with myopia in children in Goa

Myopia is a multifactorial condition. Myopia is largely influenced by hereditary and environmental variables. Vitamins D, E, and C, omega-3 fatty acids, and antioxidants have been noted as essential for preserving healthy eye function and possibly reducing the development of myopia. : This study was conducted to compare dietary consumption between myopes and emmetropes.: A cross-sectional study was conducted in the outpatient department of ophthalmology in the state of Goa, India. Children aged between 7 and 15 years were included. Children with visual acuity of less than 0.1 logMAR later underwent objective evaluation using retinoscopy and subjective refraction. The spherical equivalent (SE), and myopia were defined as SE 0.5 D in at least one eye. Children with logMAR visual acuity of 0.1 in both eyes, no glasses, or an ophthalmic history were classified as emmetropic (SE&amp;#60; 0.50D). A daily intake interview was taken using a 24-hour dietary recall, and a detailed interview of the subject's food consumption was taken.: A total of 60 children who visited the outpatient department of ophthalmology were included in the analysis. The sample consisted of 31 emmetropes and 29 myopes The mean age of the sample was 10 ± 2.29 years. Almost half the population was male (32 children [53.33%]). The mean refractive error in myopic children was -2.02 ± 1.449 D. The mean axial length in emmetrope children was 22.84 ± 0.972 mm, and in myopic children it was 23.81 ± 0.91mm (P = 0.629). Emmetropes showed higher dietary nutritional consumption than myopes in all dietary components, but the results were not statistically significant. In our study, we could not link Diet and myopia statistically. Although there is a clear indication that emmetropes demonstrated better dietary consumption compared to myopes.