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Life (Basel, Switzerland) Oct 2023To evaluate residual refractive astigmatism using the Panacea and enVista toric calculators, compared to the gold-standard Barrett toric calculator.
PURPOSE
To evaluate residual refractive astigmatism using the Panacea and enVista toric calculators, compared to the gold-standard Barrett toric calculator.
DESIGN
A retrospective and comparative study was conducted in one center.
METHODS
We reviewed the medical records of all patients with a diagnosis of senile cataracts and regular corneal astigmatism, without previous corneal or intraocular surgery, who underwent phacoemulsification with implantation of a toric intraocular lens, who had pre- and postoperative corneal topography, biometry, and refraction measurements.
RESULTS
The frequency of preoperative astigmatism according to the axis was 70 (84%) eyes showing with-the-rule (WTR) astigmatism, 9 (14%) eyes with against-the-rule (ATR) astigmatism, and 1 (2%) eye with oblique astigmatism. Regarding astigmatism prediction errors, there were statistically significant differences between the enVista and Panacea calculators (median of 0.39, 0.18, and 0.52 for Barrett, enVista, and Panacea, respectively). The residual astigmatism prediction error centroid was similar for the Barrett and enVista toric calculators, and both were lower compared to the Panacea calculator (x-component < 0.001).
CONCLUSIONS
The enVista toric calculator incorporating the Emmetropia Verifying Optical (EVO) toric calculator provides similar results to the gold-standard Barrett calculator.
PubMed: 37895391
DOI: 10.3390/life13102009 -
Investigative Ophthalmology & Visual... Jul 2023Usher syndrome (USH) is a genetically heterogeneous group of autosomal recessive (AR) syndromic inherited retinal degenerations (IRDs) representing 50% of...
PURPOSE
Usher syndrome (USH) is a genetically heterogeneous group of autosomal recessive (AR) syndromic inherited retinal degenerations (IRDs) representing 50% of deaf-blindness. All subtypes include retinitis pigmentosa, sensorineural hearing loss, and vestibular abnormalities. Thorough phenotyping may facilitate genetic diagnosis and intervention. Here we report the clinical/genetic features of an Irish USH cohort.
METHODS
USH patients were selected from the Irish IRD registry (Target 5000). Patients were examined clinically (deep-phenotyping) and genetically using a 254 IRD-associated gene target capture sequencing panel, USH2A exon, and whole genome sequencing.
RESULTS
The study identified 145 patients (24.1% USH1 [n = 35], 73.8% USH2 [n = 107], 1.4% USH3 [n = 2], and 0.7% USH4 [n = 1]). A genetic diagnosis was reached in 82.1%, the majority (80.7%) being MYO7A or USH2A genotypes. Mean visual acuity and visual field (VF) were 0.47 ± 0.58 LogMAR and 31.3° ± 32.8°, respectively, at a mean age of 43 years. Legal blindness criteria were met in 40.7%. Cataract was present in 77.4%. ADGRV1 genotypes had the most VF loss, whereas USH2A patients had greater myopia and CDH23 had the most astigmatism. Variants absent from gnomAD non-Finnish Europeans and ClinVar represented more than 20% of the variants identified and were detected in ADGRV1, ARSG, CDH23, MYO7A, and USH2A.
CONCLUSIONS
USH is a genetically diverse group of AR IRDs that have a profound impact on affected individuals and their families. The prevalence and phenotype/genotype characteristics of USH in Ireland have, as yet, gone unreported. Understanding the genotype of Irish USH patients may guide clinical and genetic characterization facilitating access to existing/novel therapeutics.
Topics: Humans; Usher Syndromes; Ireland; Mutation; Genotype; Retinal Degeneration; Phenotype; Extracellular Matrix Proteins; Pedigree
PubMed: 37466950
DOI: 10.1167/iovs.64.10.23 -
Plastic and Reconstructive Surgery.... Oct 2023Metopic synostosis patients have a high prevalence of orthoptic anomalies, including hyperopia, astigmatism, and amblyopia. We hypothesized altered orbital anatomy...
BACKGROUND
Metopic synostosis patients have a high prevalence of orthoptic anomalies, including hyperopia, astigmatism, and amblyopia. We hypothesized altered orbital anatomy contributes to suboptimal visual outcomes by adversely affecting eye anatomy and growth from early life onward. Therefore, we aimed to investigate eye and orbital anatomy in metopic synostosis.
METHODS
We conducted a retrospective study in nonsyndromic metopic synostosis patients (n = 134, median age 0.43 years [IQR 0.45]) with nonsyndromic sagittal synostosis patients (n = 134, median age 0.27 years [IQR 0.23]) as controls. Primary analyses focused on eye dimensions (axial length, width, and globe height) and orbital dimensions, correcting for sex and age. Measurements were obtained from preoperative computed tomography scans.
RESULTS
Axial length and width in metopic synostosis patients did not differ from sagittal synostosis patients, but globe height was significantly smaller ( = 0.0002). Lateral wall interorbital length, lateral orbital wall length, anterior medial interorbital length, and maximal medial interorbital length were significantly smaller, and anterior vertical orbital height and maximal vertical orbital height were significantly larger ( < 0.001). The central orbital axis and interorbital angle were significantly narrower, and medial-to-lateral orbital wall angle was wider ( < 0.001).
CONCLUSIONS
Metopic synostosis patients have more shallow, wider, and higher orbits. Eye dimensions are similar in sagittal synostosis patients, although globe height was smaller. Altered orbital and eye dimensions in metopic synostosis probably have a causal relation with an unknown order of development. How these dimensions relate to future orthoptic anomalies (eg, refractive error) needs further investigation.
PubMed: 37823032
DOI: 10.1097/GOX.0000000000005303 -
Biomedical Optics Express Feb 2024Adaptive optics visual simulation is a powerful tool for vision testing and evaluation. However, the existing instruments either have fixed tabletop configurations or,...
Adaptive optics visual simulation is a powerful tool for vision testing and evaluation. However, the existing instruments either have fixed tabletop configurations or, being wearable, only offer the correction of defocus. This paper proposes a novel head-mounted adaptive optics visual simulator that can measure and modify complex ocular aberrations in real-time. The prototype is composed of two optical modules, one for the objective assessment of aberrations and the second for wavefront modulation, all of which are integrated into a wearable headset. The device incorporates a microdisplay for stimulus generation, a liquid crystal on silicon (LCoS) spatial light modulator for wavefront manipulation, and a Hartmann-Shack wavefront sensor. Miniature optical components and optical path folding structures, together with in-house 3D printed mounts and housing, were adapted to realize the compact size. The system was calibrated by characterizing and compensating the internal aberrations of the visual relay. The performance of the prototype was analyzed by evaluating the measurement and compensation of low-order and higher-order aberrations induced through trial lenses and phase masks in an artificial eye. The defocus curves for a simulated bifocal diffractive lens were evaluated in real eyes. The results show high accuracy while measuring and compensating for the induced defocus, astigmatism, and higher-order aberrations, whereas the MTF analysis shows post-correction resolution of up to 37.5 cycles/degree (VA 1.25). Moreover, the subjective test results show the defocus curves closely matched to a commercial desktop visual simulator.
PubMed: 38404335
DOI: 10.1364/BOE.506858 -
BMC Ophthalmology Nov 2023To investigate the prevalence and risk factors of refractive astigmatism (RA) and corneal astigmatism (CA) in preschool children and school-aged children in Shanghai,...
BACKGROUND
To investigate the prevalence and risk factors of refractive astigmatism (RA) and corneal astigmatism (CA) in preschool children and school-aged children in Shanghai, China.
METHODS
In this school-based, cross-sectional study, 4-15 years old children across three learning stages of kindergarten, primary school, and junior high school underwent noncycloplegic autorefraction and completed comprehensive questionnaires involving time spent on daily homework and outdoor activities. Data from the right eyes were analysed.
RESULTS
Overall, 7084 children (mean ± standard deviation (SD) of age: 8.08 ± 3.11 years) were included, and the prevalence rates of RA/CA ( ≤ - 1.0 D) in children were 15.8%/64% in kindergartens, 16.5%/65% in primary schools, and 32.8%/76.9% in junior high schools. The magnitude and prevalence of RA and CA all increased with age or with learning stage (all P < 0.001). The presence of RA was associated with more myopic spherical power (odds ratio (OR) 0.956, P = 0.021), junior high school (OR 1.973, P < 0.001), longer homework time on weekdays (OR 1.074, P = 0.029), and shorter outdoor activity time on weekends (odds ratio 0.929, P = 0.013).
CONCLUSION
In the wide age range of 4 to 15 years, the magnitude and prevalence of RA and CA increased with the learning stage, and these increases mainly began at the primary school stage. Factors, including longer homework time and shorter outdoor time were correlated with the presence of RA.
Topics: Child, Preschool; Humans; Child; Adolescent; Astigmatism; Prevalence; Cross-Sectional Studies; East Asian People; China; Refraction, Ocular; Corneal Diseases; Risk Factors
PubMed: 37950161
DOI: 10.1186/s12886-023-03201-y -
Revista Brasileira de Psiquiatria (Sao... 2023The present study analyzed the reciprocal relationships between four common pediatric ophthalmic diseases (i.e., hyperopia, myopia, astigmatism, and strabismus) and...
Bidirectional associations between hyperopia, myopia, astigmatism, and strabismus, and attention-deficit/hyperactivity disorder in children: a national population-based cohort study.
OBJECTIVES
The present study analyzed the reciprocal relationships between four common pediatric ophthalmic diseases (i.e., hyperopia, myopia, astigmatism, and strabismus) and attention-deficit/hyperactivity disorder (ADHD) in children.
METHODS
This study enrolled 86,028 children with ADHD and 1,798,673 children without ADHD in the Taiwan Maternal and Child Health Database who were born at any time from 2004 to 2017. Cox proportional hazards regression models were used to estimate the bidirectional relationships of the four ophthalmic diseases with ADHD in children after adjusting for age, sex, and gestational age at birth. Survival curves for time-to-event variables were estimated using the Kaplan-Meier method, and the log-rank test was used to compare the curves.
RESULTS
The results indicated that ADHD significantly predicted the occurrence of hyperopia, myopia, astigmatism, and strabismus. Furthermore, hyperopia, myopia, astigmatism, and strabismus significantly predicted the occurrence of ADHD. The time between enrollment and ADHD diagnosis was shorter for patients with ophthalmic diseases than for the control group, and the time between enrollment and ophthalmic disease diagnosis was also shorter for ADHD patients than for the control group. Sex differences were found in the associations between ADHD and ophthalmic diseases.
CONCLUSION
Clinicians should monitor children with ADHD for hyperopia, myopia, astigmatism, and strabismus to ensure appropriate treatment, and vice versa.
Topics: Infant, Newborn; Humans; Child; Female; Male; Astigmatism; Hyperopia; Attention Deficit Disorder with Hyperactivity; Cohort Studies; Myopia; Strabismus
PubMed: 37718319
DOI: 10.47626/1516-4446-2023-3156 -
BMJ Open Aug 2023Glaucoma, a major cause of irreversible blindness, is a highly heritable human disease. Currently, the majority of the risk genes for glaucoma are unknown. We...
PURPOSE
Glaucoma, a major cause of irreversible blindness, is a highly heritable human disease. Currently, the majority of the risk genes for glaucoma are unknown. We established the Genetics of Glaucoma Study (GOGS) to identify disease genes and improve genetic prediction of glaucoma risk and response to treatment.
PARTICIPANTS
More than 5700 participants with glaucoma or a family history of glaucoma were recruited through a media campaign and the Australian Government healthcare service provider, Services Australia, making GOGS one of the largest genetic studies of glaucoma globally. The mean age of the participants was 65.30±9.36 years, and 62% were female. Participants completed a questionnaire obtaining information about their glaucoma-related medical history such as family history, glaucoma status and subtypes, surgical procedures, and prescriptions. The questionnaire also obtained information about other eye and systemic diseases. Approximately 80% of the participants provided a DNA sample and ~70% consented to data linkage to their Australian Government Medicare and Pharmaceutical Benefits Scheme schedules.
FINDINGS TO DATE
4336 GOGS participants reported that an optometrist or ophthalmologist has diagnosed them with glaucoma and 3639 participants reported having a family history of glaucoma. The vast majority of the participants (N=4393) had used at least one glaucoma-related medication; latanoprost was the most commonly prescribed drug (54% of the participants who had a glaucoma prescription). A subset of the participants reported a surgical treatment for glaucoma including a laser surgery in 2008 participants and a non-laser operation in 803 participants. Several comorbid eye and systemic diseases were also observed; the most common reports were ocular hypertension (53% of the participants), cataract (48%), hypertension (40%), nearsightedness (31%), astigmatism (22%), farsightedness (16%), diabetes (12%), sleep apnoea (11%) and migraines (10%).
FUTURE PLANS
GOGS will contribute to the global gene-mapping efforts as one of the largest genetic studies for glaucoma. We will also use GOGS to develop or validate genetic risk prediction models to stratify glaucoma risk, particularly in individuals with a family history of glaucoma, and to predict clinical outcomes (eg, which medication works better for an individual and whether glaucoma surgery is required). GOGS will also help us answer various research questions about genetic overlap and causal relationships between glaucoma and its comorbidities.
Topics: Aged; Humans; Female; Middle Aged; Male; Antihypertensive Agents; Australia; National Health Programs; Glaucoma; Ocular Hypertension; Intraocular Pressure
PubMed: 37536973
DOI: 10.1136/bmjopen-2022-068811 -
BMC Ophthalmology Jun 2024To comparatively analyze the surgically induced astigmatism (SIA) of the anterior, posterior, and total corneas of eyes undertaking implantable collamer lens (ICL)... (Comparative Study)
Comparative Study
Analysis of surgically induced astigmatism of the anterior, posterior, and total cornea after implantable collamer lens implantation: a comparative study between temporal and superior clear corneal incisions.
BACKGROUND
To comparatively analyze the surgically induced astigmatism (SIA) of the anterior, posterior, and total corneas of eyes undertaking implantable collamer lens (ICL) implantation with temporal or superior corneal incisions.
METHODS
One hundred and nine eyes of 109 patients who received ICL implantation were recruited: 40 eyes had temporal incisions and 69 eyes had superior incisions. Total corneal refractive power (TCRP); simulated keratometry of the anterior (Sim-K) and posterior (Sim-K) corneal curvature; and astigmatism of the anterior (CA), posterior (CA), and total (CA) cornea were recorded through a Pentacam preoperatively and 3 months postoperatively. The SIA of the anterior, posterior, and total cornea were also compared between the two groups.
RESULTS
There were no significant intergroup differences for TCRP, Sim-K, Sim-K, CA, CA, or CA, preoperatively. However, values of CA, CA, and CA with temporal incision were significantly higher than those parameters with superior incision postoperatively. All of the SIA of the anterior, posterior, and total cornea were significantly lower for temporal incision than those with a superior incision (p < 0.001, p = 0.006 and p = 0.001 respectively). Meanwhile, the superior incisions created against-the-rule (ATR) astigmatism, and temporal incisions always induce with-the-rule (WTR) astigmatism in total cornea.
CONCLUSIONS
A superior incision may be suitable for correcting WTR astigmatism, while a temporal incision for correcting ATR astigmatism when using a non-toric ICL. Meanwhile, temporal incision could be a better choice with little preoperative astigmatism or that preoperative astigmatism would be corrected with toric ICLs.
TRIAL REGISTRATION
Registration number: ChiCTR2100051739. Prospectively registered: 01 October 2021.
Topics: Humans; Astigmatism; Female; Male; Adult; Cornea; Lens Implantation, Intraocular; Visual Acuity; Refraction, Ocular; Young Adult; Phakic Intraocular Lenses; Myopia; Middle Aged; Corneal Topography; Retrospective Studies; Postoperative Complications; Prospective Studies
PubMed: 38867207
DOI: 10.1186/s12886-024-03501-x -
Therapeutic Advances in Ophthalmology 2024New developments in artificial intelligence, particularly with promising results in early detection and management of keratoconus, have favorably altered the natural... (Review)
Review
BACKGROUND
New developments in artificial intelligence, particularly with promising results in early detection and management of keratoconus, have favorably altered the natural history of the disease over the last few decades. Features of artificial intelligence in different machine such as anterior segment optical coherence tomography, and femtosecond laser technique have improved safety, precision, effectiveness, and predictability of treatment modalities of keratoconus (from contact lenses to keratoplasty techniques). These options ingrained in artificial intelligence are already underway and allow ophthalmologist to approach disease in the most non-invasive way.
OBJECTIVES
This study comprehensively describes all of the treatment modalities of keratoconus considering machine learning strategies.
DESIGN
A multidimensional comprehensive systematic narrative review.
DATA SOURCES AND METHODS
A comprehensive search was done in the five main electronic databases (PubMed, Scopus, Web of Science, Embase, and Cochrane), without language and time or type of study restrictions. Afterward, eligible articles were selected by screening the titles and abstracts based on main mesh keywords. For potentially eligible articles, the full text was also reviewed.
RESULTS
Artificial intelligence demonstrates promise in keratoconus diagnosis and clinical management, spanning early detection (especially in subclinical cases), preoperative screening, postoperative ectasia prediction after keratorefractive surgery, and guiding surgical decisions. The majority of studies employed a solitary machine learning algorithm, whereas minor studies assessed multiple algorithms that evaluated the association of various keratoconus staging and management strategies. Last but not least, AI has proven effective in guiding the implantation of intracorneal ring segments in keratoconus corneas and predicting surgical outcomes.
CONCLUSION
The efficient and widespread clinical translation of machine learning models in keratoconus management is a crucial goal of potential future approaches to better visual performance in keratoconus patients.
TRIAL REGISTRATION
The article has been registered through PROSPERO, an international database of prospectively registered systematic reviews, with the ID: CRD42022319338.
PubMed: 38516169
DOI: 10.1177/25158414241232258