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Ophthalmic Epidemiology Feb 2024We conducted a scoping review of studies examining ambient air pollution as a risk factor for chronic eye disease influencing the lens, retina, and intraocular pressure... (Review)
Review
PURPOSE
We conducted a scoping review of studies examining ambient air pollution as a risk factor for chronic eye disease influencing the lens, retina, and intraocular pressure in adults.
METHODS
Terms related to air pollution and eye disease outcomes were used to search for publications on Embase, Web of Science Core Collection, Global Health, PubMed, and the Cochrane Central Register of Controlled Trials from January 1, 2010, through April 11, 2022.
RESULTS
We identified 27 articles, focusing on the following non-mutually exclusive outcomes: cataract (n = 9), presbyopia (n = 1), retinal vein occlusion or central retinal arteriolar and venular equivalents (n = 5), intraocular pressure (IOP) (n = 3), glaucoma (n = 5), age-related macular degeneration (AMD) (n = 5), diabetic retinopathy (n = 2), and measures of retinal morphology (n = 3). Study designs included cross-sectional (n = 16), case-control (n = 4), and longitudinal (n = 7). Air pollutants were measured in 50% and 95% of the studies on lens and retina or IOP, respectively, and these exposures were assigned to geographic locations. Most research was conducted in global regions with high exposure to air pollution. Consistent associations suggested a possibly increased risk of cataract and retina-associated chronic eye disease with increasing exposure to particulate matter (PM-PM), NO, NO, and SO. Associations with O were less consistent.
CONCLUSIONS
Accumulating research suggests air pollution may be a modifiable risk factor for chronic eye diseases of the lens and retina. The number of studies on each specific lens- or retina-related outcome is limited. Guidelines regarding the role of air pollution in chronic eye disease do not exist.
Topics: Adult; Humans; Air Pollutants; Air Pollution; Cataract; Cross-Sectional Studies; Environmental Exposure; Eye Diseases
PubMed: 36864662
DOI: 10.1080/09286586.2023.2183513 -
Ophthalmic Epidemiology Nov 2023Uncorrected presbyopia has been shown to reduce Zanzibari women's quality of life. In this mixed-methods study, we examined the subjective wellbeing and self-reported...
PURPOSE
Uncorrected presbyopia has been shown to reduce Zanzibari women's quality of life. In this mixed-methods study, we examined the subjective wellbeing and self-reported work performance among older women entrepreneurs with functional presbyopia before and shortly after correction, and how poor vision at close distance affected their daily lives.
METHODS
Women entrepreneurs underwent eye examination to identify those with uncorrected functional presbyopia. Their subjective wellbeing and work performance were both measured in Cantril's ladder. Ready-made glasses were then provided and 30 minutes to an hour later, their subjective wellbeing and work performance was remeasured. Twenty women entrepreneurs were interviewed to understand their lived experience with uncorrected presbyopia.
RESULTS
Two-hundred-seventeen women entrepreneurs were included in the survey (mean age 51.6 years, SD 8.64). Women entrepreneurs had a mean subjective wellbeing score of 3.32 (SD 1.10) pre-correction and 5.99 (SD 1.13) post-correction ( < .001), and a mean self-rated current work performance score of 4.62 (SD 1.36) before correction and 5.47 (SD 1.35) post-correction ( < .001). One-hundred-and-ninety (87.6%) and 121 women entrepreneurs (55.8%) rated their current subjective wellbeing and work performance scores < 5, respectively. Around 1/4 of women entrepreneurs reported having severe difficulties with near tasks.
CONCLUSION
Poor vision at a close distance caused by uncorrected functional presbyopia negatively affected economic, physical and psychosocial aspects of women entrepreneurs' lives. Subjective wellbeing and self-reported work productivity scores improved significantly shortly after presbyopia was corrected. More research with longer follow-up is needed to understand the full benefits of correcting presbyopia.
PubMed: 37933957
DOI: 10.1080/09286586.2023.2279102 -
Investigative Ophthalmology & Visual... Aug 2023The mechanical properties of the crystalline lens are related to its optical function of accommodation, and their changes with age are one of the potential causes for...
PURPOSE
The mechanical properties of the crystalline lens are related to its optical function of accommodation, and their changes with age are one of the potential causes for presbyopia. We estimated the mechanical parameters of the crystalline lens using quantitative optical coherence tomography (OCT) imaging and wavefront sensing data from accommodating participants and computer modeling.
METHODS
Full-lens shape data (from quantitative swept-source OCT and eigenlens representation) and optical power data (from Hartmann-Shack wavefront sensor) were obtained from 11 participants (22-30 years old) for relaxed accommodation at infinity and -4.5 D accommodative demand. Finite element models of lens, capsular bag, zonulae, and ciliary body were constructed using measured lens geometry and literature data, assuming a 60-mN radial force. An inverse modeling scheme was used to determine the shear moduli of the nucleus and cortex of the lens, such that the simulated deformed (maximally stretched) lens matched the participant's lens at -4.5 D.
RESULTS
The shear moduli of the nucleus and cortex were 1.62 ± 1.32 and 8.18 ± 5.63 kPa, on average, respectively. The shear modulus of the nucleus was lower than that of the cortex for all participants evaluated. The average of the two moduli per participant was statistically significantly correlated with age (R2 = 0.76, P = 0.0049).
CONCLUSIONS
In vivo imaging and mechanical modeling of the crystalline lens allow estimations of the crystalline lens' mechanical properties. Differences between nuclear and cortical moduli and their dependency with age appear to be critical in accommodative function and likely in its impairment in presbyopia.
Topics: Humans; Male; Female; Lens, Crystalline; Accommodation, Ocular; Finite Element Analysis; Presbyopia; Tomography, Optical Coherence; Computer Simulation; Healthy Volunteers; Adult
PubMed: 37639248
DOI: 10.1167/iovs.64.11.31 -
Clinical Ophthalmology (Auckland, N.Z.) 2023To obtain consensus on the key areas of burden associated with existing devices and to understand the requirements for a comprehensive next-generation diagnostic device...
PURPOSE
To obtain consensus on the key areas of burden associated with existing devices and to understand the requirements for a comprehensive next-generation diagnostic device to be able to solve current challenges and provide more accurate prediction of intraocular lens (IOL) power and presbyopia correction IOL success.
PATIENTS AND METHODS
Thirteen expert refractive cataract surgeons including three steering committee (SC) members constituted the voting panel. Three rounds of voting included a Round 1 structured electronic questionnaire, Round 2 virtual face-to-face meeting, and Round 3 electronic questionnaire to obtain consensus on topics related to current limitations and future solutions for preoperative cataract-refractive diagnostic devices.
RESULTS
Forty statements reached consensus including current limitations (n = 17) and potential solutions (n = 23) associated with preoperative diagnostic devices. Consistent with existing evidence, the panel reported unmet needs in measurement accuracy and validation, IOL power prediction, workflow, training, and surgical planning. A device that facilitates more accurate corneal measurement, effective IOL power prediction formulas for atypical eyes, simplified staff training, and improved decision-making process for surgeons regarding IOL selection is expected to help alleviate current burdens.
CONCLUSION
Using a modified Delphi process, consensus was achieved on key unmet needs of existing preoperative diagnostic devices and requirements for a comprehensive next-generation device to provide better objective and subjective outcomes for surgeons, technicians, and patients.
PubMed: 37521152
DOI: 10.2147/OPTH.S412847 -
Journal of Refractive Surgery... Oct 2023To evaluate the visual outcome, light distortion index (LDI), and quality of life (QoL) of patients implanted with two complementary intraocular lenses (IOLs) to treat...
PURPOSE
To evaluate the visual outcome, light distortion index (LDI), and quality of life (QoL) of patients implanted with two complementary intraocular lenses (IOLs) to treat cataract and presbyopia.
METHODS
Twenty-seven consecutive patients with cataract were treated with the implantation of the Artis Symbiose Mid (Mid) IOL (Cristalens Industrie) in the distance-dominant eye and the Artis Symbiose Plus (Plus) IOL (Cristalens Industrie) in the contralateral eye following phacoemulsification. The primary objective was to ascertain the monocular and binocular defocus curves. Secondary endpoints included uncorrected distance visual acuity, corrected distance visual acuity, uncorrected intermediate visual acuity, and distance-corrected intermediate visual acuity at 90 and 70 cm, uncorrected near visual acuity and distance-corrected visual acuity at 40 cm, contrast sensitivity, LDI with a halometer, stereopsis, and patients' QoL with the validated Visual Function Index (VF-14) questionnaire. These measurements were collected in two visits, at 4.14 ± 3.13 and 10.30 ± 3.14 months postoperatively.
RESULTS
Statistically significant differences in the monocular defocus curves were found at the defocus steps of -1.00, -1.25, -1.50, -1.75, -2.50, -2.75, -3.00, -3.50 diopters and the -4.00 diopters ( < .050). The mean binocular defocus curve was 0 logMAR or better from the +0.50 to the -2.50 D defocus steps. Contrast sensitivity was within normal values. The LDI was 12.57 (6.61)% for the Mid eyes, 14.99 ± 5.70% for the Plus eyes, and 10.36 ± 4.42% binocularly. The patients' stereopsis was 40.0 (12.5) arc-seconds. The QoL score was 95.99 (7.14) at 10 months.
CONCLUSIONS
The implantation of the Artis Symbiose IOLs was a safe and effective treatment for presbyopia compensation in patients with cataract. Both IOLs are complementary and may produce a binocular depth-of-field of 3.00 diopters over 0 logMAR when used together. .
Topics: Humans; Quality of Life; Lens Implantation, Intraocular; Presbyopia; Vision, Binocular; Prospective Studies; Lenses, Intraocular; Depth Perception; Phacoemulsification; Cataract; Prosthesis Design; Patient Satisfaction; Refraction, Ocular
PubMed: 37824303
DOI: 10.3928/1081597X-20230908-01 -
Ophthalmology and Therapy Jun 2024The phase 3, randomized, vehicle-controlled, 14-day VIRGO study evaluated the efficacy and safety of twice-daily dosing of pilocarpine hydrochloride ophthalmic solution...
INTRODUCTION
The phase 3, randomized, vehicle-controlled, 14-day VIRGO study evaluated the efficacy and safety of twice-daily dosing of pilocarpine hydrochloride ophthalmic solution 1.25% (Pilo) in presbyopia. On VIRGO exit, a companion study was conducted to assess the patient experience with presbyopia and satisfaction with Pilo.
METHODS
Recruited individuals completed the Presbyopia Patient Satisfaction Questionnaire (PPSQ) plus a three-part exit survey, or a live interview. The PPSQ evaluated respondents' experience with Pilo. Survey parts 1 and 2 evaluated experience managing presbyopia before and during VIRGO, respectively; part 3 assessed future possibilities of using Pilo in real-world situations. The interview further informed the interviewees' experience with presbyopia and Pilo. The primary endpoint was responders (%) in each rating category of the PPSQ items 1-7; the secondary endpoints were summary of categorical (survey) and qualitative (interviews) responses.
RESULTS
The PPSQ and survey included 62 participants who received Pilo (N = 28) or vehicle (N = 34) in VIRGO; the interview included ten participants (Pilo, N = 4; vehicle, N = 6). Per the PPSQ, 64.3% of Pilo users reported vision improvement, including 17.9% with complete improvement; ≥ 46.4% were satisfied/very satisfied with their ability to perform daily activities, see up close unaided, and read in dim light. Among vehicle users, these percentages were 35.3%, 0%, and ≤ 23.5%, respectively. In both subgroups, ≥ 67.9% were interested in using Pilo or Pilo and eyeglasses/contact lenses in the future. Per the interview, vehicle users (n = 6/6) found the eyedrop easy to use but none experienced meaningful near-vision improvements, stopped using other correction method(s) part of the day, were satisfied with the eyedrop, preferred it over their previous correction method(s), or would continue using it if prescribed. Conversely, 75% (n = 3/4) of Pilo users responded positively to each of these six criteria.
CONCLUSIONS
Findings validate the VIRGO results and improve our understanding of the patient experience, demonstrating improved vision and satisfaction with Pilo (vs. vehicle) when performing daily activities.
PubMed: 38662193
DOI: 10.1007/s40123-024-00935-w -
Canadian Journal of Ophthalmology.... Oct 2023To compare the visual and patient reported outcomes of 2 presbyopia-correcting intraocular lenses (IOLs).
OBJECTIVE
To compare the visual and patient reported outcomes of 2 presbyopia-correcting intraocular lenses (IOLs).
METHODS
A total of 134 eyes (67 patients) that underwent cataract surgery with either a trifocal IOL or an extended depth of focus (EDOF) IOL bilaterally and were assessed 3 months after surgery. Outcome measures were binocular distance-corrected visual acuity at near (40 cm), intermediate (60 cm), and distance (6 m); Akman modified Quality of Life (QOL) Questionnaire-14; and 10% contrast visual acuity at distance and near, with and without glare.
RESULTS
Mean binocular logMAR visual acuity (VA) for the PanOptix compared with the Symfony lenses: distance-corrected near VA, 0.054 versus 0.228; distance-corrected intermediate VA, 0.019 versus 0.063; and distance-corrected distance VA, -0.016 versus -0.021. The QOL questionnaire showed that 62% of the PanOptix group and 48% of the Symfony group had little or no difficulty with all QOL-related tasks. In a multivariable model controlling for pupil size and angle kappa (chord mu distance, right eyes), the differences were -0.005 (range, -0.03-0.02) and 0.165 (range, 0.12-0.21), respectively. Also, 10% contrast acuity was comparable in the 2 different lenses and was unaffected by glare.
CONCLUSIONS
Binocular distance-corrected near VA was significantly better in the PanOptix group (p < 0.0001). This result remained statistically significant after controlling for pupil size and chord mu distance (p < 0.001). Intermediate and distance VAs were similar between the 2 groups. QOL scores were higher in the PanOptix group.
Topics: Humans; Refraction, Ocular; Quality of Life; Prospective Studies; Cataract Extraction; Lenses, Intraocular; Patient Satisfaction; Cataract; Prosthesis Design; Phacoemulsification; Pseudophakia
PubMed: 35661646
DOI: 10.1016/j.jcjo.2022.05.005 -
Journal of Cataract and Refractive... Aug 2023To assess the inter-observer agreement and reliability of central topography (CT) of IOL Master 700 with that of Pentacam HR, as a screening tool for determining the...
PURPOSE
To assess the inter-observer agreement and reliability of central topography (CT) of IOL Master 700 with that of Pentacam HR, as a screening tool for determining the suitability for premium (toric, monofocal and presbyopia correcting) intraocular lens (IOL) implants.
SETTING
Nethradhama Superspeciality Eye Hospital, Bangalore, India.
METHOD
200 eyes of eligible patients undergoing unilateral or bilateral phacoemulsification with premium IOL's were included in the study. Preoperatively, IOL Master 700 CT and Pentacam scans were performed for corneal topography evaluation. 2 experienced clinicians were randomised to interpret the axial map of either of the scans at a time and their responses were then enclosed in an envelope, and forwarded to a third observer for analysis. If there was a conflict, final decision was based on the interpretation of the Pentacam scan.
RESULTS
Of the total scans interpreted by the 2 observers, 77.5% (n = 155) showed agreement whereas 22.5% (n = 45) showed disagreement. The sensitivity, specificity, positive predictive value and negative predictive value (NPV) of IOL Master 700 CT in diagnosing irregular corneas when compared with Pentacam HR, was 72.73%, 78.09%, 29.09% and 95.86% respectively. The Cohen's κ inter-observer agreement value was 0.44, signifying a moderate degree of agreement, which was statistically significant (P < .00).
CONCLUSIONS
High NPV of IOL Master CT suggested that the device efficiently ruled out irregular corneas, while any suspicious scan should be confirmed with Pentacam HR or a similar device for appropriate decision-making regarding premium IOL selection.
TRIAL REGISTRATION NUMBER
CTRI/2021/11/038053.
Topics: Humans; Lens Implantation, Intraocular; Reproducibility of Results; Observer Variation; India; Lenses, Intraocular; Cornea; Phacoemulsification; Tomography; Astigmatism
PubMed: 37482665
DOI: 10.1097/j.jcrs.0000000000001193 -
Journal of Optometry 2023To assess the agreement between the Eye Refract, an instrument to perform subjective automated refraction, and the traditional subjective refraction, as the gold...
PURPOSE
To assess the agreement between the Eye Refract, an instrument to perform subjective automated refraction, and the traditional subjective refraction, as the gold standard, in young hyperopes under noncycloplegic and cycloplegic conditions.
METHODS
A cross-section and randomized study was carried out, involving 42 participants (18.2 ± 7.7 years, range 6 to 31 years). Only one eye was chosen for the analysis, randomly. An optometrist conducted the refraction with the Eye Refract, while another different optometrist conducted the traditional subjective refraction. Spherical equivalent (M), cylindrical components (J0 and J45), and corrected distance visual acuity (CDVA) were compared between both refraction methods under noncycloplegic and cycloplegic conditions. A Bland-Altman analysis was performed to assess the agreement (accuracy and precision) between both refraction methods.
RESULTS
Without cycloplegia, the Eye Refract showed significantly lower values of hyperopia than the traditional subjective refraction (p < 0.009), the mean difference (accuracy) and its 95% limits of agreement (precision) being -0.31 (+0.85, -1.47) D. Conversely, there were no statistical differences between both refraction methods under cycloplegic conditions (p ≥ 0.05). Regarding J0 and J45, both refraction methods manifested no significant differences between them under noncycloplegic and cycloplegic conditions (p ≥ 0.05). Finally, the Eye Refract significantly improved CDVA (0.04 ± 0.01 logMAR) compared with the traditional subjective refraction without cycloplegia (p = 0.01).
CONCLUSIONS
The Eye Refract is presented as a useful instrument to determine the refractive error in young hyperopes, the use of cycloplegia being necessary to obtain accurate and precise spherical refraction.
Topics: Humans; Hyperopia; Mydriatics; Vision Tests; Refraction, Ocular; Refractive Errors; Presbyopia
PubMed: 37019707
DOI: 10.1016/j.optom.2023.03.001 -
Clinical Ophthalmology (Auckland, N.Z.) 2024To determine if the changes in stereoacuity and aniseikonia, following bilateral implantation of presbyopia correcting intraocular lenses could be predicted from...
Stereoacuity and Aniseikonia: Evaluation Before and After Bilateral Implantation of Three Types of Presbyopia-Correcting Intraocular Lenses in Uncomplicated Phacoemulsification with Due Consideration of Interocular Differences in Higher Order Aberrations, Axial Lengths, Refractive Errors, and...
PURPOSE
To determine if the changes in stereoacuity and aniseikonia, following bilateral implantation of presbyopia correcting intraocular lenses could be predicted from preoperative measurements of higher order aberrations (HOAs), axial lengths (AL), refractive errors (RE) and corrected visual acuities (CVAs).
PATIENTS AND METHODS
Stereoacuity (Randot tests, @6m & 40cm, in steps of 20 arcsecs") vertical and horizontal aniseikonia (Awaya test @6m, in steps of 1%) with best correction and HOAs (Shack-Hartmann aberrometer) were measured before, 3 and 6 months after uncomplicated bilateral phacoemulsification. Twenty patients (I) underwent a mix-and-match procedure (Tecnis MF, ZKB00 in one eye and ZLB00 in the other), 17 (II) were implanted with a trifocal (AT LISA 839 triMP) and 18 (III) with a one-piece diffractive (Synergy OU) intraocular lens. The resultant aniseikonia (A) of vertical and horizontal pairs of aniseikonia measurements was calculated using the Pythagorean theorem. Twenty untreated age/gender matched cases were recruited as controls (IV).
RESULTS
The key results (p < 0.001) were a) stereoacuity at distance (SAD) and near (SAN) improved, A reduced in groups I, II & III remaining unchanged in group IV; b) some significant intergroup differences in SAD, SAN & A were detected at postop; c) at 6 months postop, changes (Δ=pre- minus postoperative value) correlated with preoperative values (x). Linear regression revealed, I ΔSAD=0.66x-57.47 [0.832, ±66.4], ΔSAN=0.96x-34.59 [0.821, ±16.9], ΔA=0.93A-2.12 [0.795, ±1.4] II ΔSAD=0.79x-62.91 [0.916, ±38.1], ΔSAN=0.96x-31.49 [0.892, ±8.0], ΔA=0.91A-0.91 [0.839, ±1.3] III ΔSAD=0.67x-35.50 [0.991, ±23.7], ΔSAN=0.88x-38.51[0.988, ±10.6], ΔA=0.86A-0.96 [0.900, ±1.3]. Figures in parentheses are the corresponding and ±limits of agreement between actual and estimated values. Definitive overarching associations connecting interocular differences in HOAs, AL, RE, and CVAs with SAD, SAN and A were not found.
CONCLUSION
Changes in stereoacuity and aniseikonia can be predicted using preoperative values. ΔSAN can be predicted within ±1, and ΔA within ±2, scale divisions. In group III ΔSAD can be predicted within ±1, and in group I ±3, scale divisions.
PubMed: 38855012
DOI: 10.2147/OPTH.S459684