Spherical Equivalent Refractive Error Research Articles

A new polygenic score for refractive error improves detection of children at risk of high myopia but not the prediction of those at risk of myopic macular degeneration

High myopia (HM), defined as a spherical equivalent refractive error (SER) ≤-6.00 diopters (D), is a leading cause of sight impairment, through myopic macular degeneration (MMD). We aimed to derive an improved polygenic score (PGS) for predicting children at risk of HM and to test if a PGS is predictive of MMD after accounting for SER. The PGS was derived from genome-wide association studies in participants of UK Biobank, CREAM Consortium, and Genetic Epidemiology Research on Adult Health and Aging. MMD severity was quantified by a deep learning algorithm. Prediction of HM was quantified as the area under the receiver operating curve (AUROC). Prediction of severe MMD was assessed by logistic regression. In independent samples of European, African, South Asian and East Asian ancestry, the PGS explained 19% (95% confidence interval 17-21%), 2% (1-3%), 8% (7-10%) and 6% (3-9%) of the variation in SER, respectively. The AUROC for HM in these samples was 0.78 (0.75-0.81), 0.58 (0.53-0.64), 0.71 (0.69-0.74) and 0.67 (0.62-0.72), respectively. The PGS was not associated with the risk of MMD after accounting for SER: OR=1.07 (0.92-1.24). Performance of the PGS approached the level required for clinical utility in Europeans but not in other ancestries. A PGS for refractive error was not predictive of MMD risk once SER was accounted for. Supported by the Welsh Government and Fight for Sight (24WG201).

Comparison of Ocular Biomery in Primary Open Angle Glaucoma and Non-glaucoma in South West Nigeria.

Glaucoma is a public health problem in Nigeria. The number of individuals affected by glaucoma in Nigeria is much higher than the individuals known to have the disease. Ocular parameters such as intraocular pressure, central cornea thickness, axial length and refractive error have all been documented as risk factors of glaucoma especially among Caucasians and African Americans, with little documentation in Africa where there's an alarming rate of blindness. To compare central cornea thickness (CCT), intraocular pressure (IOP), axial length (AL) and refractive state in participants with primary open angle glaucoma (POAG) and non-glaucoma in South-West Nigeria. This hospital-based case-control study was carried out among 184 newly diagnosed POAG and non-glaucoma adult participants attending the outpatient clinic of Eleta eye institute. The CCT, IOP, AL and refractive state were measured in each participant. Test of significance between proportions in categorical variables were assessed using chi square test (χ2) in both groups. The means were compared using independent t-test while correlation between parameters were analyzed using Pearson correlation coefficient. The mean age of the POAG participants was 57.16 + 13.3 years and the mean age of the non-glaucoma participants was 54.15 + 13.4 years. The mean IOP in the POAG group was 30.2 + 8.9mmHg while non- glaucoma group was 14.2 + 2.6mmHg (P < 0.001), other ocular parameters were not significantly different in both groups. In the POAG group, decreased spherical equivalent refractive error (i.e increasing myopia) was significantly associated with increased axial length (r= -0.252, P = 0.01), but not significant in the non- glaucoma group. However, in the non-glaucoma group, central cornea thickness increased with increasing intraocular pressure (r= 0.305, P = 0.003), which was not significant in the glaucoma group. Patients with POAG had much higher IOP and thus, IOP remains a significant risk factor in its development. There was a significant relationship between refractive state and axial length in the POAG group while a significant relationship was identified between central cornea thickness and intraocular pressure in the non- glaucoma group.

Modelling changes in the prevalence of childhood myopia.

To re-examine the changes with time in the underlying patterns of individual refraction at different ages, which have led to an increased prevalence of myopia in a population of Asian children. Using published cross-sectional longitudinal data, the frequency distributions of spherical equivalent refractive error (SE) in yearly cohorts of 6- and 12-year-old Japanese children during the period 1984-1996 were modelled in terms of ex- and bi-Gaussian distributions. Both models suggested that over the period of the study, little change occurred in the SE frequency distributions for 6-year-olds, with most children having SEs near emmetropia. In contrast, in each annual cohort of 12-year-olds, although the SE of some children remained near-emmetropic, a sub-set failed to maintain emmetropia. Most of this group became more myopic between 6 and 12 years of age. The proportion of children showing myopic progression increased over the period of study. The observed increase in mean levels of myopia in older Japanese children in the late 20th century is due to a greater proportion of children failing to maintain emmetropisation between the ages of 6 and 12, rather than to myopic shifts in all children. Some children, with small SE changes between 6 and 12 years of age, would not have benefitted from any treatment intended to slow myopia progression.

Evaluation of a Pilot Protocol for Detecting Infant Hyperopia.

Highly hyperopic children are at greater risk for developing conditions such as strabismus, amblyopia, and early literacy and reading problems. High hyperopia is a common finding in infants in a pediatric medical practice, and early detection can be done effectively in that setting with tropicamide autorefraction. This study aimed to evaluate the effectiveness of a pilot screening program to detect high hyperopia in 2-month-old infants in a pediatric medical practice in Columbus, Ohio. Cycloplegic refractive error (1% tropicamide) was measured by retinoscopy and autorefraction with the Welch Allyn SureSight (Welch Allyn/Hillrom, Skaneateles Falls, NY) in 473 infants (55.4% female) who were undergoing their 2-month well-baby visit at their pediatrician's medical practice. Cycloplegic retinoscopy (1% cyclopentolate) was repeated at a subsequent visit in 35 infants with ≥+5.00 D hyperopia in the most hyperopic meridian during the screening. Twenty-eight infants (5.9%) had high hyperopia (spherical equivalent, ≥+5.00 D), and 61 (12.9%) had high hyperopia (≥+5.00 D in at least one meridian of at least one eye) by retinoscopy with 1% tropicamide. The mean ± standard deviation spherical equivalent tropicamide cycloplegic refractive error measured with retinoscopy was +2.54 ± 1.54 D (range, -3.25 to +7.00 D) and with SureSight was +2.29 ± 1.64 D (range, -2.90 to +7.53 D). Retinoscopy done using 1% cyclopentolate was 0.44 ± 0.54 D more hyperopic in spherical equivalent than with 1% tropicamide ( P < .001). High hyperopia was a common finding in 2-month-old infants in a pediatric medical setting that could be detected effectively by cycloplegic autorefraction using tropicamide. Greater cooperation between pediatric primary vision and medical care could lead to effective vision screenings designed to detect high hyperopia in infants.

Prevalence of refractive errors in children of Puerto Rico.

To determine the prevalence of refractive error in 5- to 17-year-old schoolchildren in Puerto Rico. A quantitative descriptive study of 2867 children aged 5 to 17y from all seven educational regions of Puerto Rico was conducted from 2016-2019. Refractive error was determined via static and subjective refraction. Children with distance acuity ≤20/40 or near visual acuity ≤20/32 had a cycloplegic refraction. Data analysis included descriptive statistics, correlation coefficient, Kruskal-Wallis, Chi-square, and t test calculations. Twenty percent of the children had a spherical equivalent refractive error ≤ -0.50 D, 3.2% had a spherical equivalent ≥ +2.00 D, and 10.4% had astigmatism ≥1 D. There was a statistically (but non-clinically) significant myopic change in spherical equivalent refractive error with age (P<0.001). The prevalence of myopia increased with age (P<0.001) but not hyperopia (P=0.59) or astigmatism (P=0.51). Males had a significantly higher hyperopic spherical equivalent than females (P<0.001). Females had a higher prevalence of myopia (P<0.001) than males, but there was no difference in the hyperopia (P=0.74) or astigmatism prevalence (P=0.87). The prevalence of a spherical equivalent equal to or less than -0.50 D (myopia, 20.7%) is one of the highest among similar-aged children worldwide. Further studies should explore the rate of myopia progression in children in Puerto Rico. Individual children must be monitored to examine the need for treatment of myopia progression.

Retrospective review of the effectiveness of orthokeratology versus soft peripheral defocus contact lenses for myopia management in an academic setting

To evaluate the relative efficacy of peripheral defocus contact lenses (PDCLs) and orthokeratology (OK) in a real-world clinical population, and compare these results with previous randomised controlled clinical trials. Records from a university practice were reviewed to identify children who were treated with OK or PDCLs. The analysed sample contained 273 visits from 77 patients. Annualised rates of axial length (AL) progression were calculated and used as the response variable in both linear mixed-effects (LME) and nonlinear regression models. On average, children were 10.7 years of age at baseline (p=0.14 between treatments), and most patients were female. More Asian children wore OK lenses compared with PDCLs (p < 0.01). At baseline, children had ~3.00 D of myopia and 0.75 D of astigmatism in both treatment groups (p > 0.20 between treatments). LME regression models using only baseline covariates showed no evidence that the annualised change in AL differed between treatments, with or without the inclusion of age, race, sex, baseline AL or spherical equivalent refractive error. Across all possible subsets of models, age at baseline was the best predictor of annualised AL change. There was no statistical difference between parameters of an exponential decay model fitted within treatment using follow-up age as a time-varying predictor, indicating that the rate of annualised change in AL was similar for OK and PDCL. Retrospective analysis of real-world clinical data found no difference in annualised AL growth between PDCL and OK. Importantly, the AL progression from this clinical setting is consistent with that reported in randomised clinical trials. Therefore, continued research of real-world performance is warranted to understand the safety and efficacy of modern myopia control treatments in the broader population.

Reduced contrast sensitivity function correlated with superficial retinal capillary plexus impairment in early stage of dysthyroid optic neuropathy

BackgroundTo assess the accuracy of contrast sensitivity function (CSF) in detecting dysthyroid optic neuropathy (DON) at an early stage in thyroid-associated ophthalmopathy (TAO) patients and to examine potential factors that may be linked to early visual impairments in these individuals.MethodsA total of 81 TAO patients (50 non-DON and 31 DON), and 24 control subjects participated in the study. CSF was measured with the quick CSF (qCSF) method. Optical coherence tomography angiography (OCTA) images of the ganglion cell complex layer (GCCL), superficial and deep retinal capillary plexuses (SRCP and DRCP) in a 3 mm diameter area around the macula were evaluated.ResultsCompared with the controls, the area under the log contrast sensitivity function (AULCSF) and SRCP density were significantly reduced in non-DON and DON patients (all P < 0.05). The GCCL thickness of the DON patients was thinner than that of the controls and non-DON patients (all P < 0.05). The AULCSF was significantly correlated with spherical equivalent refractive error, muscle index, SRCP density and GCCL thickness in TAO patients, respectively (all P < 0.05). However, stepwise multi-regression analysis showed that the AULCSF was only significantly correlated with SRCP density (P < 0.001). Receiver operating characteristic curve analysis showed that the AULCSF produced the most accurate discrimination between non-DON and DON patients from the controls (AUC = 0.831, 0.987, respectively; all P < 0.001).ConclusionsCSF change in the early stage of DON is related to SRCP density. It can be an early indicator of visual impairments associated with DON in TAO patients.

Comparing ocular biometry and autorefraction measurements from the Myopia Master with the IOLMaster 700 and the Huvitz HRK-8000A autorefractor.

To compare axial length (AL) and corneal radius (CR) measured with the Oculus Myopia Master and the Zeiss IOLMaster 700, and cycloplegic refractive error measured with the Myopia Master and the Huvitz Auto Ref/Keratometer (HRK-8000A). The study included both eyes of 74 participants (16 male), with a mean (SD) age of 22.8 (3.7) years. The parameters indicated were measured under cycloplegia with these instruments: Myopia Master (AL, CR and refractive error), IOLMaster 700 (AL and CR) and HRK-8000A (refractive error and CR). Bland-Altman plots with mixed effects 95% limits of agreement (LoA) and corresponding 95% confidence intervals were used to assess the agreement in ocular biometry between the Myopia Master and the IOLMaster 700, and for refractive error between the Myopia Master and the HRK-8000A. The analysis included 139 eyes, of which 52 were myopic (spherical equivalent refractive error, SER ≤ -0.50 D), 32 emmetropic and 55 hyperopic (SER ≥ 0.50 D). The 95% LoA for AL between the Myopia Master and IOLMaster 700 was -0.097 to 0.089 mm. There was no mean difference in AL [mean (SD)=-0.004 (0.047) mm, p=0.34]. There was a significant difference in mean CR, with that measured with the Myopia Master being flatter than that found with the IOLMaster 700 [0.035 (0.028) mm, p < 0.001]. The 95% LoA for CR was -0.02 to 0.09 mm. Compared with HRK-8000A, the Myopia Master measured a significantly more negative SER [-0.19 (0.33)D, p < 0.001], with 95% LoA of -0.86 to 0.46 D. The LoA for measurements of SER, CR and AL when comparing the Myopia Master with the HRK-8000A and the IOLMaster 700 were wider than deemed acceptable for making direct comparisons. This indicates that the instruments cannot be used interchangeably in clinical practice or research.

Refractive changes after strabismus surgery in patients with intermittent exotropia.

To evaluate the long-term refractive changes after horizontal muscle surgery in patients with intermittent exotropia and investigate the correlation between changes in the postoperative refractive error and clinical factors. We retrospectively reviewed the clinical data of patients aged < 15 years who underwent unilateral strabismus surgery (lateral rectus recession and medial rectus resection [RR, n = 47], lateral rectus recession and medial rectus plication [RP, n = 81], or lateral rectus recession [LRc, n = 68]). Preoperative and postoperative refractive errors up to four years after surgery were recorded. A mixed model was applied to compare the refractive error between the operated and fellow eyes and identify the factors associated with postoperative refractive changes. The mean age at surgery was 7.5±2.4years, and girls accounted for 56.1% of the study population. There was no significant difference in the change in the spherical equivalent of refractive error between both eyes throughout the postoperative period. In contrast, the operated eyes consistently and significantly showed higher cylindrical power in with-the-rule astigmatism by 0.25D than in fellow eyes. Age, sex, and preoperative refractive error were not correlated with changes in postoperative astigmatism. Meanwhile, the type of surgery showed a significant interaction with the astigmatism changes. RP had less effect on the changes in astigmatism than RR and LRc (p = 0.001 and p = 0.022, respectively). Horizontal muscle surgery has no long-term effect on the change in the spherical equivalent. However, mild with-the-rule astigmatism is induced and sustained after surgery, and the type of surgery affects the postoperative change of astigmatism.

Evaluation of aberrometry changes following strabismus surgery in patients with horizontal strabismus.

The aim is to investigate the change in aberrations following strabismus surgery in patients with horizontal strabismus. This prospective study included patients who underwent surgery for horizontal strabismus. The patients were assessed preoperatively and 1 month and 3 months after the surgery, in terms of logMAR best-corrected visual acuity, eye deviation, spherical equivalent refractive error, tomographic and aberrometric corneal changes. Corneal tomography was performed using Orbscan II device. Wavefront analyses were performed using Bausch and Lomb Zywave II. A total of 25 patients (48 eyes) with exotropia or esotropia were entered in this study. Mean values of exotropia in the distance and near deviations were reported as 31.42 ± 7.13 and 28.82 ± 6.96 prism diopters (PD), respectively. Mean scores of esotropia in the distance and near deviations were 25.22 ± 5.41 and 30.45 ± 9.4 PD, respectively. Evaluation of irregularity in 5 mm zone, horizontal coma, spherical aberration changes, and root mean square of higher-order aberrations (HOAs) in 6 mm, and HOA w/o Z 400 changes showed that there was a significant difference before the intervention and 1 month after the surgery (P < 0.05). However, no difference was observed in the aforementioned variables before and 3 months after the intervention (P > 0.05). Results of the present study indicated a transient increase in HOAs and corneal irregularity following strabismus surgery on horizontal eye muscles that returned to the baseline after 3 months.

The Relationship between Axis Length Difference and Refractive Error in Unilateral Myopic Anisometropic Children Treated with Orthokeratology.

To explore the correlation between the axial length (AL) difference (myopic and nonmyopic eye) and the refractive error in children with unilateral myopia anisometropia (UMA) and to elucidate its clinical application in the process of Ortho-K lenses review following nonstop wearing. This study retrospectively analyzed the data of 70 children with UMA (age, 8-15 years) whose myopic eyes were treated with Ortho-K lenses. The spherical equivalent refractive errors (SERE) of the myopic eye ranged from -0.75 D to -4.25 D, and astigmatism was no less than -1.50 D. In addition, SERE of nonmyopic eyes were no less than -0.50 D. AL, and the refractive data of both eyes were measured at baseline. A multivariate linear regression was used to analyze the relationship between the AL difference and refractive error, and paired t-test was used to analyze the changes in AL in both eyes. Every 1 mm axial length change corresponds to -1.627 D (95% CI: -1.921 D, -1.333 D; P < 0.001) change in refractive error in children. The association between the AL change and the degree of myopia did not change with age (P=0.751). Among the 70 subjects, 51 (72.86%) had myopia in the right eye, and the 95% confidence interval (CI) for myopia occurring in the right eye was 62.4%-83.3%. The paired t-test showed that the average AL growth was significantly slower in myopic eyes treated with Ortho-K lenses than in nonmyopic eyes (t = 9.805, P < 0.001). Every 1 mm AL change would cause an average refractive error increase. Age did not influence the association between AL changes and the degree of myopia. The right eye is more likely to be affected in children with UMA. The Ortho-K lens treatment slowed down the growth of AL in the myopic eye in children with UMA.

SubFoveal Choroidal Imaging in High Myopic Nepalese Cohort.

Evidence suggests that choroid is thinner in myopes as compared to nonmyopes. However, choroidal thickness varies with the refractive error, age, axial length, and ethnicity. The purpose of this study was to determine the subfoveal choroidal thickness (SFCT) in high myopic Nepalese subjects and to investigate its association with the mean spherical equivalent refractive error (MSE), axial length, and age. Ninety-two eyes of 92 high myopic subjects (MSE ≤ -6 diopters) and 83 eyes of 83 emmetropic subjects (MSE: 0.00 Diopters) were included in the study. SFCT was assessed using spectral domain optical coherence tomography, and the axial length was measured using partial coherence interferometry. SFCT was measured manually using the inbuilt tool within the imaging software. SFCT in the high myopic subjects was significantly thinner (mean ± SD: 224.17 ± 68.91 μm) as compared to the emmetropic subjects (353.24 ± 65.63 μm) (mean difference, 127.76 ± 130.80 μm, and p < 0.001). In high myopic subjects, there was a significant negative correlation of choroidal thickness with the axial length (rho = -0.75; p < 0.001) and MSE (rho = -0.404; p < 0.01). Regression analysis demonstrated a decrease of choroidal thickness by 40.32 μm (p < 0.001) for every 1 millimeter increase in the axial length and by 11.65 μm (p < 0.001) for every 1 diopter increase in the MSE. High myopic Nepalese subjects had significantly thinner choroid as compared to emmetropes. The MSE and axial length were inversely correlated with the SFCT. Age had no effect on SFCT in this study. These findings may have implications in interpreting choroidal thickness values in clinical and epidemiological studies in myopes, especially in the south Asian population.

The effect of sustained eye rotation upon eye length in healthy myopic adults.

The aim of the study was to determine whether ocular movement can affect the shape of the globe and lead to measurable change in axial and peripheral eye length. Ten subjects aged 18-30 years (6 M/4 F) participated with informed consent. The mean spherical equivalent refractive error was ≤-1.00 DS with cylindrical refraction <-1.25 DC. One drop of tropicamide hydrochloride 1% was instilled 20 min before measurement to induce mydriasis and mild cycloplegia. Using IOLMaster, eye length was measured centrally and temporally (25° off-axis) in four different positions. Subjects then rotated their eyes 25° in the temporal direction to fixate on a target for 10 min. After that, the same measurements were repeated. Before rotation, the group mean peripheral eye length was significantly shorter than the central eye length (P < 0.05). There was no significant variation in central or peripheral eye length due to off-axis fixation, either after the initial eye rotation or after fixation for 10 min at the off-axis point. The difference between central and peripheral eye lengths was maintained after 10 min of temporal fixation (P < 0.05). Peripheral eye length was shorter than central eye length showing the prolate shape associated with myopia. The action of the extraocular muscles on the globe has no significant effect upon the retinal shape assessed by off-axis eye length measurement in myopic subjects.

Refractive and Binocular Vision Status and Associated Asthenopia among Clinical Microscopists

Background Clinical microscopists are at a greater risk of developing binocular vision anomalies and asthenopia.&#x0D; Objective To assess the refractive and binocular vision status and to explore the association between the presence of asthenopic symptoms and microscopy work among clinical microscopists working at medical laboratory department.&#x0D; Method This cross-sectional study involved 37 clinical microscopists working at medical laboratory department of Dhulikhel Hospital, Nepal. The study was conducted from January to December 2013. Only those participants who had been using microscope for at least a year were enrolled in this study. Each participant underwent distance visual acuity (VA) assessment, refractions, and orthoptic evaluation, including measurement of distance and near phoria, near point of convergence (NPC), near point of accommodation (NPA), positive fusional vergence (PFV), adduction, and calculation of accommodation convergence/accommodation (AC/A) ratio. The tear test was also carried out in each subject. Information about use of glasses, microscopy work (duration, and time spent per day in microscope), and visual symptoms associated with the use of microscope such as eye strain, headache, double vision, and near vision were collected.&#x0D; Result The mean age of the clinical microscopists was 29 ± 5.7 years. The prevalence of refractive error was 56.76% and the mean spherical equivalent (SE) refractive error was -0.77 ± 0.86 D. Refractive error had neither correlation with microscopy work and asthenopic symptoms associated with it, and nor with binocular vision parameters- NPC, AA and AC/A ratio. However, there was a positive association between asthenopic symptoms and microscopy work. There was statistically significant difference between symptomatic and asymptomatic subjects for binocular vision parameters, including NPC, AA and positive fusional vergence (PFV) for near.&#x0D; Conclusion Microscopy work has an impact on near binocular vision. Asthenopic symptoms bear a positive association with microscopy work. Refractive error has no significant correlation with either microscopy works or associated asthenopic symptoms.

Non-cycloplegic refraction cannot replace cycloplegic refraction in primary school children.

The purpose was to assess the differences in spherical equivalent refractive error (SER) between cycloplegic autorefraction (1% cyclopentolate), non-cycloplegic autorefraction, and non-cycloplegic retinoscopy measured by experienced optometrists in a population with a high prevalence of hyperopia. Refractive error was measured with the three methods in 111 children aged 7–8 and 10–11 years. Bland-Altman analysis was used to assess the mean of the differences (MD) and the 95% limits of agreement (LoA) between cycloplegic autorefraction and the two non-cycloplegic methods. A mixed effects model was used to investigate the differences between methods by refractive group. Cycloplegic autorefraction gave a significantly more positive SER than both non-cycloplegic retinoscopy (MD = 0.47 D, LoA = -0.59–1.53 D) and non-cycloplegic autorefraction (MD = 0.92 D, LoA of -1.12 to 2.95 D). The mean differences in SER increased with increasing degree of hyperopia [F(4, 215) = 12.6, p &lt; .001], both when comparing cycloplegic refraction with non-cycloplegic retinoscopy and non-cycloplegic autorefraction.&#x0D; Non-cycloplegic retinoscopy and autorefraction result in significantly less positive SER than cycloplegic autorefraction. The wide confidence intervals for the mean difference and limits of agreement are clinically unacceptable and the methods cannot be used interchangeably. Consequently, refraction without cycloplegia would cause misdiagnosis in some children. Even if non-cycloplegic retinoscopy results in narrower limits of agreement, the risk of misdiagnosis is not eliminated by being experienced in carrying out retinoscopy. We show that it is essential to use cycloplegia when refracting children, and in particular to ensure that no hyperope goes undetected.

Ocular biometry measures and their correlation with refractive error in Aboriginal and Torres Strait Islander children

ABSTRACT Clinical relevance The ocular biometry measures of the eye determine the refractive status, and while most refractive error develops during childhood, the ocular biometry measures of Aboriginal and Torres Strait Islander children have not previously been reported. Background To investigate the ocular biometry of Aboriginal and Torres Strait Islander children, including measures important in determining refractive error and those which relate to the risk of ocular disease. Methods Participants included 252 primary and secondary school children (Aboriginal and Torres Strait Islander: 101; non-Indigenous: 151), aged between 4 and 18 years. Habitual monocular distance visual acuity, cycloplegic autorefraction, and ocular optical biometry were measured in all participants and intraocular pressure measured in secondary school children using rebound tonometry. Results The mean (±SD) spherical equivalent refractive error of Aboriginal and Torres Strait Islander children was significantly less hyperopic than non-Indigenous children (Aboriginal and Torres Strait Islander: +0.52 ± 0.80 D; non-Indigenous: +0.86 D ±0.58 D; p < 0.001). There were no differences in axial length or axial length/corneal radius ratio between the two groups, however the mean lens power of Aboriginal and Torres Strait Islander children was significantly greater than that of non-Indigenous children (Aboriginal and Torres Strait Islander: 23.62 D; non-Indigenous: 22.51 D; p < 0.001). Aboriginal and Torres Strait Islander children had a thinner central corneal thickness (Aboriginal and Torres Strait Islander: 534 ± 37 µm; non-Indigenous: 543 ± 35 µm; p = 0.04), and lower intraocular pressure compared with non-Indigenous children (Aboriginal and Torres Strait Islander: 14.7 ± 3.8 mmHg; non-Indigenous: 16.0 ± 3.7; p = 0.02). Conclusion Differences exist in the refractive error, lens power, central corneal thickness, and intraocular pressure of Aboriginal and Torres Strait Islander children compared to non-Indigenous Australian children which have potential implications for the development of refractive error and ocular disease later in life.

Absorbable suture for band tightening of scleral buckling in pseudophakic rhegmatogenous retinal detachment: a modified surgical technique and a 6-month follow-up.

Rhegmatogenous retinal detachment (RRD) is a separation of the neurosensory retina from the retinal pigment epithelium as a result of liquid vitreous passing through a retinal break. Scleral buckling surgery (SB) is a conventional treatment for RRD. In SB, a silicon explant is used to indent the sclera, reduce vitreous traction, and close the retinal break, and an encircling band is used circumferentially, leading to myopia. This study aimed to evaluate the functional and biometric outcomes after SB with absorbable band-tightening sutures in patients with pseudophakic RRD. In this prospective interventional study, we included pseudophakic eyes with RRD treated surgically with SB and a temporary encircling band using a 6-0 absorbable Vicryl suture to tighten the band, instead of conventional permanent suture tightening. Anterior chamber depth (ACD), axial length (AL), intraocular pressure (IOP), spherical equivalent refractive error (SER), and best-corrected distance visual acuity (BCDVA) were measured preoperatively and at 1 day, 2 weeks, 3 months, and 6 months postoperatively. We included 30 eyes of 30 patients with a mean (standard deviation [SD]) age of 66.1 (10.5) years who underwent SB with an absorbable band-tightening suture for pseudophakic RRD. Significant increases in AL and ACD were observed at 2 weeks after surgery, with a significant decline in values thereafter; however, at the 6-month follow-up, the values were significantly higher than those at baseline (all P < 0.05). Based on the Vicryl tension and its hydrolysis, mean (SD) SER at 2 weeks postoperatively was significantly more myopic than at baseline (-5.8 [1.6] D versus +1.3 [1.8] D). However, the mean (SD) SER decreased significantly throughout the 6-month follow-up (all P < 0.05), and it reached -1.8 (0.9) D, which was comparable with the mean baseline SER (P = 0.140). The participants experienced significant improvement in BCDVA throughout the follow-up period (all P < 0.05). Using an absorbable suture to tighten the encircling band in patients with pseudophakic RRD can reduce postoperative myopia without adversely affecting the anatomical or functional outcomes. Future comparative studies with larger sample sizes and longer postoperative follow-up are needed to verify these findings.

Effect of topical latanoprost on choroidal thickness and vessel area in Guinea pigs.

The aim of this study was to investigate the effect of latanoprost, an ocular hypotensive agent and prostaglandin analog, on choroidal thickness and structure in young adult guinea pigs. Young (three-month-old) guinea pigs (n=10) underwent daily monocular treatment with topical 0.005% latanoprost for 2 weeks, followed by a washout period of 2 weeks. Tonometry (iCare) and retinoscopy were undertaken to monitor intraocular pressure (IOP) and refractive error (recorded as spherical equivalent refractive error; SER), respectively. Axial length (AL) and choroidal thickness (ChT) were measured using high frequency A-scan ultrasonography, with additional ChT data, as well as choroidal vessel (ChV) areas obtained from posterior segment imaging using Spectral Domain-Optical Coherence Tomography (SD-OCT). Image J was used to analyze SD-OCT images. As expected, latanoprost significantly reduced IOP in treated eyes. Mean interocular IOP difference (±SE) changed from -0.40±0.31mmHg at baseline to -2.23±0.43mmHg after 2 weeks of treatment (p=0.05). However, SER and AL were unaffected; interocular difference changed from 0.41±0.58 to 0.38±0.43 D and from -0.002±0.02mm to -0.007±0.01mm (p>0.05), respectively. Latanoprost had minimal effect on ChT. Interocular ChT differences were 0.01±0.06μmat baseline and 0.04±0.06μm after 2 weeks of treatment (SD-OCT; p>0.05). However, treated eyes had significant increased ChV areas; interocular differences changed from -0.76±69.2 to 100.78±66.9μm2 after treatment (p=0.04). While this study was limited to otherwise untreated young adult guinea pigs, the possibility that choroidal vessel enlargement contributes to the previously reported inhibitory effect of topical latanoprost on myopia progression in young guinea pigs warrants investigation.

Spectacles with highly aspherical lenslets for myopia control do not change visual sensitivity in automated static perimetry.

Spectacle lenses with arrays of lenslets have gained popularity in myopia control due to their high efficacy, low impact on visual performance, and non-invasiveness. One of the questions regarding their impact on visual performance that still remain is that: do the lenslets impact visual field sensitivity? The current study aims to investigate the impact of wearing spectacle lenses with highly aspherical lenslets (HAL) on the visual field sensitivity. An automated static perimetry test (Goldman perimeter target III) was employed to measure the detection sensitivity in the visual field. Targets were white light dots of various luminance levels and size 0.43°, randomly appearing at 76 locations within 30° eccentricity. Twenty-one adult subjects (age 23-61, spherical equivalent refractive error (SER) -8.75 D to +0.88 D) participated in the study. Sensitivities through two lenses, HAL and a single vision lens (SVL) as the control condition, were measured in random order. The mean sensitivity differences between HAL and SVL across the 76 tested locations ranged between -1.14 decibels (dB) and 1.28 dB. Only one location at 30° in the temporal visual field reached statistical significance (p < 0.00065) whereby the sensitivity increased by 1.1 dB with HAL. No significant correlation was found between the difference in sensitivity and age or SER. Such a difference is unlikely to be clinically relevant. Compared to the SVL, the HAL did not change detection sensitivity to static targets in the whole visual field within 30° eccentricity.

Spectacle Lenses With Highly Aspherical Lenslets for Slowing Myopia: A Randomized, Double-Blind, Cross-Over Clinical Trial: Parts of these data were presented as a poster at the Annual Research in Vision and Ophthalmology meeting, 2022.

To evaluate myopia progression with highly aspherical lenslet (HAL) spectacles vs conventional single vision (SV) spectacles. Prospective, double-blind, single-center, randomized, cross-over trial. A total of 119 Vietnamese children (7-13 years of age, spherical equivalent refractive error [SE]=-0.75 to -4.75D) were randomized to wear either HAL or SV, and after 6 months (stage 1) crossed over to the other lens for another 6 months (stage 2). At the end of stage 2, both groups wore HAL for a further 6 months. In the order that lenses were worn at each stage, group 1 was designated HSH (HAL-SV-HAL) and group 2 SHH (SV-HAL-HAL). The main outcome measures were a comparison between HAL and SV for change (Δ) in SE and axial length (AL) during each stage; and a comparison of ΔSE/AL with SV between HSH and SHH groups to determine whether myopia rebounded when switched from HAL to SV (HSH group). Myopia progressed more slowly with HAL than with SV during stages 1 and 2 (SEΔ stage 1: -0.21 vs -0.27D, P=.317, stage 2: -0.05 vs -0.32D, P < .001; ALΔ stage 1: 0.07 vs 0.14 mm, P=.004; stage 2: 0.04 vs 0.17 mm, P < .001). ΔSE/AL with SV was not different between the HSH and SHH groups (ΔSE -0.33 ± 0.27D vs -0.27 ± 0.42D, P=.208; ΔAL 0.17 ± 0.13mm vs 0.13 ± 0.15 mm, P=.092). An average of 14 hours per day of lens wear was reported with both lenses. In this cross-over trial, intergroup and intragroup comparisons indicate that HAL slows myopia. Children were compliant with lens wear, and data were not suggestive of rebound when patients were switched from HAL to SV.