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BMJ Open Ophthalmology Nov 2023To investigate repeatability of refractive state using a smartphone-based assessment tool, the Near Eye Tool for Refractive Assessment (NETRA).
OBJECTIVE
To investigate repeatability of refractive state using a smartphone-based assessment tool, the Near Eye Tool for Refractive Assessment (NETRA).
METHODS AND ANALYSIS
This study included 279 participants, predominantly female (66.7%) of African descent (49.1%). The age range was 9-63 years with mean age () 22.6 (8.9) years. Two consecutive measurements per eye with the NETRA were measured for both eyes of all participants. However, analyses for the right eyes only are included here. Multivariate statistical analysis included stereo-pair comets and scatterplots with 95% surfaces of constant probability density. Correlation coefficients for repeated samples were determined. Repeatability and agreement for NETRA were assessed with Bland-Altman plots, coefficients of repeatability ([Formula: see text] ; [Formula: see text] is the SD of differences) and intraclass correlation coefficients (ICCs).
RESULTS
Bland-Altman plots, within-subject SD ( ), coefficients of repeatability and ICC indicated that repeated measurements were similar for many but not all eyes and there was good agreement (ICC=0.96) for the spherical coefficient ( =) but less so for antistigmatic coefficients ( = and = ) of power. Although mean differences for repeated samples were almost zero, 95% limits of agreement widths were larger for the stigmatic coefficients. Without cycloplegia, repeatability (2.77 ) was 1.63 D, 0.58 D and 0.56 D for the stigmatic and antistigmatic coefficients, respectively.
CONCLUSION
NETRA is a potentially useful and inexpensive portable method in clinical and primary health settings, and especially in less-developed regions of the world. The subjective nature of the self-refraction task can be challenging for younger individuals, and cycloplegia is recommended for NETRA with such patients.
Topics: Humans; Female; Child; Adolescent; Young Adult; Adult; Middle Aged; Male; Refraction, Ocular; Vision Tests; Cornea; Face; Presbyopia
PubMed: 38007230
DOI: 10.1136/bmjophth-2023-001458 -
Indian Journal of Ophthalmology Dec 2023Cycloplegic refraction is mandatory for children to know the eye's refractive status. In this study, we compared cycloplegia induced by cyclopentolate 1% to that induced...
PURPOSE
Cycloplegic refraction is mandatory for children to know the eye's refractive status. In this study, we compared cycloplegia induced by cyclopentolate 1% to that induced by atropine 1% by means of retinoscopy.
METHODS
In this parallel-designed interventional study, we included 67 children aged between 4 and 17 years. After the initial retinoscopy under cyclopentolate 1% (used twice in each eye), we repeated it a week later under atropine ointment 1% (used twice a day for 3 days); both were done by the same trained optometrist masked to the drug. Each eye's refraction was converted to spherical equivalents (SEs), and the values averaged between the two eyes of each child under each drug. We compared SE with paired t-test (JASP 16.4). In addition, we performed correlational analysis, and looked for agreement using the Bland-Altman plot. Significance was set at P < 0.05. Wherever possible, 95% confidence intervals (CIs) are quoted.
RESULTS
The mean SE with atropine was +1.93 ± 2.0 D, compared to +1.75 ± 1.95 D under cyclopentolate. On average, atropine induced greater cycloplegia by a mere 0.18 D (95% CI: 0.07 to 0.29 D, P value 0.002). The two cycloplegic refractions correlated significantly (Pearson's r: 0.975, P < 0.001). The Bland-Altman plot revealed the limits of agreement as 1.06 and -0.71 D.
CONCLUSION
Our study suggests that cyclopentolate works for the most part as well as atropine to attain cycloplegia. Atropine may be considered for children less than 15 years of age with greater than 5.0 D of hyperopia. Cycloplentolate, with its advantages of quick action and short duration, should form the first go-to topical cycloplegic in busy outpatient clinics.
Topics: Child; Humans; Child, Preschool; Adolescent; Cyclopentolate; Mydriatics; Atropine; Refraction, Ocular; Pupil; Presbyopia; Pupil Disorders; Refractive Errors
PubMed: 37991295
DOI: 10.4103/IJO.IJO_1159_23 -
BMC Ophthalmology Nov 2023To compare the visual outcomes, spectacle independent rate and stereopsis in patients who underwent bilateral implantation of extended depth of focus (EDOF) intraocular... (Clinical Trial)
Clinical Trial
BACKGROUND
To compare the visual outcomes, spectacle independent rate and stereopsis in patients who underwent bilateral implantation of extended depth of focus (EDOF) intraocular lens (IOL), or a blend approach of EDOF and bifocal IOL.
METHODS
A total of 60 cataract patients, who were scheduled for phacoemulsification and intraocular lens implantation in both eyes in West China Hospital of Sichuan University, were enrolled and divided into Micro monovision group(-0.5D~-1.0D), Non-micro monovision group (< 0.5D) with Symfony IOL, and Mixed group with Symfony and ZMB00 IOLs. Three months postoperatively, we compared the visual acuity, modulation transfer function (MTF), defocus curve, stereopsis, spectacle independence, and photic phenomena among the three groups.
RESULTS
Compared to the Non-micro monovision group (UNVA: 0.07 ± 0.04), Micro monovision group (UNVA: 0.00 ± 0.07, P < 0.001) and Mixed group (UNVA: -0.02 ± 0.06, P < 0.001) showed improvement in binocular uncorrected near visual acuity (UNVA). Additionally, Mixed group exhibited lower MTF10 (MTF10: 0.38 ± 0.24) and point spread function (PSF: 0.192 ± 0.269) results in their non-dominant eye compared to both Micro monovision group (MTF10: 0.56 ± 0.21, P = 0.027; PSF: 0.417 ± 0.282, P = 0.034) and Non-micro monovision group (MTF10: 0.55 ± 0.19, P = 0.038; PSF: 0.408 ± 0.285, P = 0.003). Spectacle independence for near vision were higher in both the Micro monovision (45%) and Mixed (55%) group compared to the Non-micro monovision group (40%). The Mixed group also reported higher incidence of photic phenomena (25%). However, there were no significant differences in stereoscopic function among the three groups.
CONCLUSION
Both micro monovision and mix-and-match methods can help patients to obtain better visual outcomes at different distances. Mix-and-match method has better near visual acuity, while micro monovision method has better intermediate visual acuity. Non-micro monovision methods will affect patients' near vision outcomes. Binocularly implanted EDOF IOL has better contrast sensitivity.
CLINICAL TRIAL REGISTRATION
Registration date:11/07/2023.
TRIAL REGISTRATION NUMBER
ChiCTR2300073433.
TRIAL REGISTRY
West China Hospital of Sichuan University retrospectively registered.
Topics: Humans; Cataract; Eyeglasses; Lens Implantation, Intraocular; Lenses, Intraocular; Patient Satisfaction; Phacoemulsification; Prosthesis Design; Refraction, Ocular; Vision, Binocular
PubMed: 37990306
DOI: 10.1186/s12886-023-03228-1 -
BMC Ophthalmology Nov 2023To prospectively evaluate visual functions and patient satisfaction after bilateral implantation of diffractive continuous depth-of-focus intraocular lens (CDF IOL)... (Clinical Trial)
Clinical Trial
BACKGROUND
To prospectively evaluate visual functions and patient satisfaction after bilateral implantation of diffractive continuous depth-of-focus intraocular lens (CDF IOL) compared with trifocal IOLs.
METHODS
This investigator-initiated study was approved by a certified local review board (registered: jRCTs032210305). CDF IOL (Synergy, J&J, group S) and trifocal IOL (AcrySof PanOptix, Alcon, group P) were implanted bilaterally in 30 patients each. Three months postoperatively, binocular outcomes of uncorrected (BUCVA) and distance-corrected (BDCVA) visual acuities at distances of 0.3, 0.4, 0.5, 0.7, and 5 m were measured. Contrast sensitivities were binocularly measured using CSV-1000 (2.5 m) and Pelli-Robson charts at distances of 0.4 and 1 m. Symptoms of glare, halo, starburst, and waxy vision, and satisfaction for near, intermediate, and far visions were assessed with questionnaires. Differences between the two groups were examined.
RESULTS
Twenty-seven patients each completed the follow-up. The mean age of the group S was lower than that of the group P (P < 0.001). The BUCVA at 0.4 m was better in the S group, while the mean manifest refraction of the P group showed a significant hyperopic shift (P < 0.001). BDCVA was significantly better in the S group. The contrast sensitivity results at three distances showed no discernible differences. Although more patients in the S group reported significant glare and halo, their satisfaction with near vision was higher.
CONCLUSIONS
The binocular visual function of patients with CDF IOLs was comparable to or better than that of patients with trifocal IOLs. The patients were satisfied with near vision, despite the enhanced glare and halo. Understanding the differences between the two types of presbyopia-correcting IOLs is important to ensure patient satisfaction.
TRIAL REGISTRATION
This clinical trial was registered in the Japan Registry for Clinical Research (identifier: jRCTs032210305) on September 13, 2021.
Topics: Humans; Contrast Sensitivity; Lenses, Intraocular; Myopia; Patient Satisfaction; Prospective Studies; Prosthesis Design; Pseudophakia; Refraction, Ocular; Vision, Binocular; Visual Acuity
PubMed: 37990206
DOI: 10.1186/s12886-023-03207-6 -
Experimental Eye Research Dec 2023Presbyopia is caused by age-related lenticular hardening, resulting in near vision loss, and it occurs in almost every individual aged ≥50 years. The lens experiences...
Presbyopia is caused by age-related lenticular hardening, resulting in near vision loss, and it occurs in almost every individual aged ≥50 years. The lens experiences mechanical pressure during for focal adjustment to change its thickness. As lenticular stiffening results in incomplete thickness changes, near vision is reduced, which is known as presbyopia. Piezo1 is a mechanosensitive channel that constantly senses pressure changes during the regulation of visual acuity, and changes in Piezo1 channel activity may contribute to presbyopia. However, no studies have reported on Piezo1 activation or the onset of presbyopia. To elucidate the relevance of Piezo1 activation and cross-linking in the development of presbyopia, we analysed the function of Piezo1 in the lens. The addition of Yoda1, a Piezo1 activator, induced an increase in transglutaminase 2 (TGM2) mRNA expression and activity through the extra-cellular signal-regulated kinase (ERK) 1/2 and c-Jun-NH2-terminal kinase1/2 pathways. In ex vivo lenses, Yoda1 treatment induced γ-crystallin cross-linking via TMG2 activation. Furthermore, Yoda1 eye-drops in mice led to lenticular hardening via TGM2 induction and activation in vivo, suggesting that Yoda1-treated animals could serve as a model for presbyopia. Our findings indicate that this presbyopia-animal model could be useful for screening drugs for lens-stiffening inhibition.
Topics: Mice; Animals; Ion Channels; Presbyopia; Protein Glutamine gamma Glutamyltransferase 2; Sclerosis; Biological Transport
PubMed: 37951336
DOI: 10.1016/j.exer.2023.109719 -
Ophthalmology and Therapy Jan 2024Presbyopia-correcting intraocular lens (PCIOL) implantation is a popular treatment option for cataract surgery patients who desire spectacle independence. This study...
INTRODUCTION
Presbyopia-correcting intraocular lens (PCIOL) implantation is a popular treatment option for cataract surgery patients who desire spectacle independence. This study aimed to understand patient perception and outcomes with PCIOLs by analyzing patient social media posts.
METHODS
This was a non-interventional retrospective study that used predefined search strings to identify publicly available social media data discussing patient perceptions and outcomes with seven PCIOLs (three trifocal, one multifocal with continuous range of vision, and three extended depth-of-focus [EDOF] PCIOLs). Relevant posts were searched from Reddit, YouTube, and Facebook and patient forums Patient.info, Medicine.net, Optiker-Forum, and Medizin Forum from September 2020 to October 2022 in four languages (English, German, French, and Spanish).
RESULTS
A total of 2237 posts were included, all in English, with 68% of posts identified on Patient.info. The themes most discussed by patients were quality of vision (69% of total posts), patient experience after PCIOL implantation (30%), patient perception before PCIOL implantation (26%), and visual disturbances (24%). Most discussed PCIOLs were Vivity® (58% of total posts), PanOptix® (38%), Synergy® (26%), and Symfony® (13%). Patient perception of PCIOLs was most frequently influenced by healthcare professionals, online reading, and online videos (31%, 18%, and 15% of posts, respectively). A total of 215 posts (10% of total) discussed glasses use after PCIOL surgery: for EDOF and trifocal/multifocal PCIOLs, 37% and 56% of posts discussing glasses use stated being glasses free, respectively. A total of 537 posts discussed visual disturbances: halos/rings (66%) and starbursts (36%) were the most discussed visual disturbances for all lens types. Being glasses free after PCIOL implantation appeared to be a key driver of patient satisfaction.
CONCLUSION
Social media provides a rich source of information on patient perception, experience, and overall satisfaction of PCIOLs that can be used to complement and guide the collection of further evidence generated through controlled trials.
PubMed: 37948016
DOI: 10.1007/s40123-023-00840-8 -
Scientific Reports Nov 2023This study investigated the influence of large-diameter multifocal contact lenses on the ocular surface, visual quality, and visual function for presbyopic adults with... (Randomized Controlled Trial)
Randomized Controlled Trial
This study investigated the influence of large-diameter multifocal contact lenses on the ocular surface, visual quality, and visual function for presbyopic adults with dry eye syndromes. The study enrolled 40-55-year-old adults with presbyopia and dry eye syndromes (DES). The subjects were randomly assigned to three groups wearing different designs of contact lenses (Proclear, SMR, and Optimum) for 6-8 h a day for two weeks. Ocular surface health, tear quality, visual quality, and visual function were measured before and after lens wear. No significant difference was observed across all three groups for the amount of conjunctival redness, blink frequency (lens on), and stereopsis vision before and after wearing. Although there seemed to be a significant declining trend for corneal staining and limbal redness, non-invasive tear break-up time (TBUT), and lipid layer thickness while lens wear, the measured values were all within the normal range. Vice-versa after lens removal, results also showed significant improvement on lipid layer thickness, blink frequency (lens off), and contact TBUT. A significant improvement was observed in the modulation transfer function (MTF) of the total area ratio after wearing contact lenses. In contrast, the MTF of the high-order aberration area ratio resulting from lens wear was lower than that of the baseline measurement. There are also significant improvements observed for SMR and Optimum regarding near visual acuity, near point of accommodation, and the subjective questionnaire (OSDI and VBP) scores. Although it is difficult to avoid a specific negative impact on the ocular surface and tear film, visual function and visual quality can still be positively improved, especially shown on larger diameter and distance-center designed multifocal contact lenses.
Topics: Humans; Adult; Middle Aged; Vision, Ocular; Contact Lenses; Dry Eye Syndromes; Presbyopia; Lipids; Tears
PubMed: 37945680
DOI: 10.1038/s41598-023-46732-6 -
Case Reports in Ophthalmology 2023Visual difficulties can negatively impact life quality. Our purpose was to report the refractive surgical planning and outcomes of a young patient with mixed astigmatism...
Visual difficulties can negatively impact life quality. Our purpose was to report the refractive surgical planning and outcomes of a young patient with mixed astigmatism and phacoemulsification-induced presbyopia due to congenital cataracts who was unsatisfied with her vision-related quality of life. A 32-year-old woman, submitted to phacoemulsification with implantation of a monofocal intraocular lens (IOL) and Nd:YAG laser posterior capsulotomy 3 years before, due to congenital cataracts, was referred to the Refractive Surgery Unit of Centro Hospitalar Universitário de Santo António. She had mixed astigmatism (+1.00-4.00 × 10° in the right eye [RE] and +0.50-1.75 × 180° in the left eye [LE]) and surgical-induced presbyopia, was intolerant to contact lenses, and felt that her vision significantly impaired her life quality. A trifocal Sulcoflex (Rayner) IOL was implanted to correct the spherical and near refractive errors. In a second surgical time, a photorefractive keratectomy was performed to correct the residual astigmatism (-3.50 × 10° in the RE and -1.50 × 170° in the LE). In the last visit, distance and near uncorrected visual acuity were 20/20 (Snellen) and Jaeger 1, respectively, in both eyes, and the patient was very satisfied. When assessing the surgical options of young, working-age patients, clinicians should, when possible, consider alternative solutions to monofocal IOLs. In this patient, the combination of corneal and intraocular procedures allowed the correction of both the distance and near refractive errors, with a subsequent significant improvement in the patient's quality of life.
PubMed: 37942232
DOI: 10.1159/000534431 -
Metabolites Oct 2023Protein aggregation is the etiopathogenesis of the three most profound vision-threatening eye diseases: age-related cataract, presbyopia, and age-related macular...
Protein aggregation is the etiopathogenesis of the three most profound vision-threatening eye diseases: age-related cataract, presbyopia, and age-related macular degeneration. This perspective organizes known information on ATP and protein aggregation with a fundamental unrecognized function of ATP. With recognition that maintenance of protein solubility is related to the high intracellular concentration of ATP in cells, tissues, and organs, we hypothesize that (1) ATP serves a critical molecular function for organismal homeostasis of proteins and (2) the hydrotropic feature of ATP prevents pathological protein aggregation while assisting in the maintenance of protein solubility and cellular, tissue, and organismal function. As such, the metabolite ATP plays an extraordinarily important role in the prevention of protein aggregation in the leading causes of vision loss or blindness worldwide.
PubMed: 37887425
DOI: 10.3390/metabo13101100 -
PloS One 2023To assess public awareness, interest, and concerns regarding Vuity (1.25% pilocarpine hydrochloride ophthalmic solution), an eye drop for the treatment of presbyopia,...
PURPOSE
To assess public awareness, interest, and concerns regarding Vuity (1.25% pilocarpine hydrochloride ophthalmic solution), an eye drop for the treatment of presbyopia, based on Google Trends.
METHODS
We used Google Trends that provides a relative search volume for queried terms, to evaluate searches for Vuity from June 30, 2021, to June 30, 2022, in the United States. The data for this study were downloaded on June 30, 2022. Main outcome measures were changes in relative search volumes for the terms "Vuity," "Eye drops for reading," "Eye drops for near vision," "Presbyopia," "Pilocarpine," and related popular search terms, such as "Vuity side effects," and "Vuity retinal detachment".
RESULTS
Since the approval of Vuity on October 29, 2021, notable increases in the relative search volumes occurred for Vuity in October 2021, December 2021, and from March to April 2022, which coincided with its approval, availability, and subsequent direct-to-consumer advertising based on positive results of clinical trials. The direct-to-consumer advertising had the greatest impact on the search volume for Vuity. Specific interests included Vuity cost, where to buy it, and its side effects. Retinal detachment was the most highly searched Vuity side effect. Geographic variation was evident, with the relative search volumes highest for "Vuity" in Wyoming, followed by North Dakota.
CONCLUSION
Google Trends is a useful tool for monitoring increases in public interest in Vuity for presbyopia. Public concerns regarding side effects warrant further real-world investigations of the causal relationship between Vuity and retinal detachment.
Topics: United States; Humans; Search Engine; Presbyopia; Retinal Detachment; Ophthalmic Solutions; Wyoming
PubMed: 37883338
DOI: 10.1371/journal.pone.0293066