Ophthalmic and Physiological Optics最新文献

Purpose: The purpose of this study was to compare the perception and understanding of the information provided by ChatGPT regarding myopia among optometry students, optometrists undertaking a Master degree and practicing optometrists.

Methods: This was a cross-sectional descriptive study using a structured questionnaire distributed via Wooclap to 225 participants (125 optometry students, 21 Masters students and 79 practicing optometrists). All participants evaluated the responses generated by ChatGPT Version 4.0 using a five-point scale: very poor, poor, acceptable, good and very good. Data were analysed using SPSS, applying descriptive analysis and chi-squared tests to assess the significance of differences observed between the groups.

Results: Practicing optometrists, with an average age of 39.7 ± 11.0 and 15.2 ± 7.5 years of professional experience, rated the information provided by ChatGPT on myopia complications more positively than the optometry and Masters students, highlighting the importance of clinical experience (p < 0.001). Alternatively, this may indicate a difference in awareness, knowledge and training, with younger students potentially being more speculative in their evaluations. The perceptions about myopia prevention among the groups were similar (p = 0.28). At the same time, the perceptions of the effectiveness of treatments such as contact lenses and pharmaceutical agents showed differences, with optometrists rating these treatments more positively (p < 0.001 and p = 0.004, respectively).

Conclusions: This study showed differences in the perception and interpretation of the information provided by ChatGPT about myopia depending on the level of education. While AI plays an important role in education, practicing optometrists trust the information extracted by ChatGPT more than optometry students.

Introduction: Tear exchange during contact lens wear is essential for ocular surface integrity, facilitating debris removal, and maintaining corneal metabolism. Fluorophotometry and fluorogram methods are typically used to measure tear exchange, which require hardware modifications to a slit lamp biomicroscope. This manuscript introduces an alternative method using a corneoscleral profilometer, the Eye Surface Profiler (ESP), to quantify tear exchange during corneal and scleral rigid lens wear by assessing fluorescence intensity changes over time.

Methods: As a proof of concept, a healthy participant wore a corneal and a scleral rigid lens on separate days. After lens application, 2% sodium fluorescein was instilled, and ESP images were captured at intervals over a 30-min period for corneal and a 90-min period for the scleral lens. Fluorescence intensity data were extracted and analysed using MATLAB, restricted to a region of interest centred on the contact lens. The fluorescence intensity was fitted with an exponential decay curve to quantify tear exchange.

Results: Fluorescence intensity decreased over time for both lenses, with a faster decay rate being observed for the corneal lens. The scleral lens showed an initial ingress of fluorescein into the fluid reservoir, then a slow decay in fluorescence intensity due to limited tear exchange. The decay rate for the corneal lens was approximately four times faster than the scleral lens, with the time to reach 50% decay of ~42 min for the corneal lens compared to ~157 min for the scleral lens.

Conclusion: A new method was developed to quantify tear exchange using a commercially available corneoscleral profilometer, offering a wider field of view than existing techniques. This approach has clinical potential in scleral lens practice for identifying landing zone misalignment and improving the understanding of post-lens tear dynamics, particularly in cases involving scleral lens modifications or patients experiencing midday fogging.

Purpose: To assess the repeatability of lipid layer thickness (LLT) measurement using the LipiView® interferometer after daily disposable contact lens (CL) wear and correlation with ocular comfort in soft contact lens wearers.

Methods: A prospective study was conducted over two consecutive months, wherein CL wearers (n = 20) wore either Somofilcon A or Verofilcon A daily disposable CLs in a crossover design, switching lenses after 1 month. The pre-corneal tear film LLT was measured at the end of each month after CLs had been worn for at least 6 h. Using the LipiView® interferometer, three measurements of the LLT (average, maximum and minimum) were recorded. Subjects' symptoms were evaluated with the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) and correlations sought between post-lens pre-corneal tear film LLT and symptoms.

Results: The average, maximum and minimum intraclass correlation coefficients (ICC) of LLT measurements at baseline were 0.57, 0.39 and 0.66, respectively, indicating poor (ICC < 0.4) to moderate (≥0.4, <0.75) repeatability. Coefficients of repeatability (CR) were 20.4, 24.8 and 20.8, respectively. After daily disposable CL wear, the ICC values were 0.66, 0.72 and 0.63 (indicating moderate repeatability), with CR values of 25.7, 32.0 and 23.3, respectively. Although all the ICC values of the pre-corneal LLT increased after daily disposable lens wear indicating improved repeatability, the CR values also increased, indicating larger spread of data. However, in both cases, these increases were not significantly different from baseline. There were no significant differences in pre-corneal LLT between the two lens types and no significant correlation with comfort scores (baseline: r = -0.11, p = 0.67; Verofilcon A lenses: r = 0.19, p = 0.45; Somofilcon A lenses r = 0.13, p = 0.62) for either lens.

Conclusions: The repeatability of average, maximum and minimum LLT measurements performed by LipiView remained stable during CL wear. There was no significant correlation between LLT and comfort scores.

Purpose: To investigate the repeatability of optical coherence tomography angiography (OCTA) parameters in participants with different severities of glaucoma.

Methods: Subjects with open-angle glaucoma were enrolled prospectively and categorised into mild (mean deviation [MD] of 24-2 visual field test ≥ -6 dB), moderate to advanced (-6 > MD ≥ -20 dB) and severe glaucoma groups (MD < -20 dB). OCTA was performed three times within a single visit to obtain superficial and deep macular vessel density (VD) and peripapillary vessel and capillary density. The association between the coefficient of variation (CoV) and intraclass correlation coefficient (ICC) of these OCTA parameters and glaucoma severity (MD, the thickness of the retinal nerve fibre layer and the ganglion cell complex) was analysed, along with factors associated with the CoV of OCTA parameters.

Results: A total of 57 mild, 92 moderate to advanced and 39 severe glaucomatous eyes were included. CoV for superficial (p < 0.001) and deep macular VD (p < 0.001) and peripapillary VD (p = 0.004) increased with glaucoma severity. Greater CoV for superficial and deep macular VD and peripapillary VD was associated with worse MD and scan quality index in multivariable analysis. The association between a higher CoV of superficial and deep macular VD and worse MD was only noticeable in participants with a scan quality index <7. The relationship between the CoV of peripapillary VD and MD was consistent across varying image qualities.

Conclusion: The intrasession variability of OCTA parameters was greater in glaucoma participants with advanced disease, especially in those with suboptimal scan quality.

Purpose: To investigate the influence of axial length on different ocular parameters and create a predictive tool for refractive error progression.

Methods: Two eye models were used to simulate refractive errors, namely the Liou-Brennan and the Goncharov-Dainty. Both models were simulated using Zemax OpticStudio. Simulations were made by varying axial length and central corneal radii of curvature, with values ranging from 21.5 to 28.5 mm and 7.0 to 8.5 mm, respectively. Additionally, simulations of different lens parameters were included.

Results: Refractive error maps were produced for different ethnicities and a comparison with experimental results was undertaken. These showed the relationships between axial length and crystalline lens thickness, refractive index and curvatures of the cornea and lens.

Conclusions: The concept of refractive error maps may provide more insight into the refractive state of individuals and groups with provision for a comparative analysis. With further experimental data added, such refractive error maps could be used as a predictive tool.

Purpose: This study evaluated the effects of orthokeratology and 0.01% atropine on corneal biomechanical properties (CBPs) and myopia progression in children, focusing on their association with axial length (AL) changes and treatment outcomes.

Methods: In this 1-year prospective study, 53 children (aged 8-17 years) were enrolled, with 30 undergoing orthokeratology and 23 receiving 0.01% atropine. CBP parameters, including the Corvis Biomechanical Index (CBI), central corneal thickness (CCT), biomechanically corrected intraocular pressure (bIOP) and stress-strain index (SSI), were assessed at baseline and during follow-ups at 1, 3, 6, 9 and 12 months. The orthokeratology group was further stratified into good and poor responders based on early myopia reduction.

Results: The orthokeratology group exhibited a significant increase in CBI over time, particularly among good responders, while CCT, bIOP and SSI remained stable. In contrast, no significant changes in CBPs were observed in the atropine group. AL elongation showed no significant correlation with CBP changes in either group. The orthokeratology group achieved superior control of myopia progression compared to the atropine group at 12 months, with poor responders exhibiting better long-term AL control.

Conclusions: Both orthokeratology and 0.01% atropine were effective in controlling myopia. While atropine had no impact on CBPs, the increase in CBI with orthokeratology may predict early treatment outcomes. However, the initial response to orthokeratology did not guarantee long-term effectiveness, highlighting the need for individualised treatment monitoring.

Purpose: To investigate changes in fluid reservoir turbidity parameters over time and its influence on visual performance in eyes with ocular surface disorders (OSD) wearing scleral contact lenses (SL).

Methods: Thirteen eyes with OSD were assessed for corrected distance visual acuity, contrast sensitivity (CS) and fluid reservoir turbidity using anterior segment optical coherence tomography at baseline, after 5 min and 0.5, 1, 2, 3 and 4 h of SL wear on day 1 and after 1 month.

Results: A significant reduction in CS was noted at 0.5, 1, 2, 3 and 4 h of SL wear compared to 5 min (p < 0.001) and a similar trend was noted after 1 month (p < 0.001). The average number of particles on day 1 showed a significant increase over 4 h of SL wear (p < 0.001), with a same trend noted at 1 month (p = 0.001). However, the percentage of particles decreased from 88% ± 4% to 75% ± 12% (p = 0.004) after 1 month of SL wear. Average particle size showed a significant increase at all time points over 4 h compared with 5 min of SL wear (p < 0.003) and after 1 month (p < 0.001). The percentage of average particle size decreased from 73% ± 9% to 67% ± 8% after 1 month of lens wear (p = 0.003). The mean percentage turbid area increased from 0.6% ± 0.5% to 24% ± 16% over 4 h of lens wear on day 1 (p < 0.006) and from 0.7% ± 0.5% to 11% ± 8% at 1 month (p = 0.001). The mean difference in percentage turbid area at the first and follow-up visits decreased from 96% ± 3% to 89% ± 9% (p = 0.01).

Conclusions: A gradual increase in fluid reservoir turbidity parameters was noted with the reduction in CS; however, all these parameters improved after 1 month of SL wear.

Purpose: Reliable assessment is critical for diagnosing and managing meibomian gland dysfunction. Multi-functional diagnostic devices, such as meibographers, streamline clinical workflows by integrating multiple ocular assessments. Ensuring reproducibility across examiners is vital for accurate diagnosis and monitoring of treatment. This prospective study determined the inter-examiner reproducibility (IER), inter-rater reproducibility (IRR) and within-subject variability (WSV) of the Huvitz HRK-9000A meibographer.

Methods: Meibomian glands (MGs) of both eyelids of healthy participants were captured during the same session by Examiner 1 (E1) and Examiner 2 (E2) in a counter-balanced design. The images were rated offline by E1, E2 and an Independent rater (R1). The inter-examiner reproducibility (IER between E1 vs. E2) and inter-rater reproducibility (IRR between E1 vs. R1 and E2 vs. R1) were determined based on non-parametric Bland-Altman plots, intraclass correlation coefficients (ICCs) and weighted Kappa (κ) values. Within-subject variability (WSV) was determined using ICCs.

Results: Mean MG loss of the upper (E1: 1.0 ± 0.8 vs. R1: 0.9 ± 0.8, E2: 1.2 ± 0.8 vs. R1: 0.9 ± 0.7) and lower eyelids (E1: 1.9 ± 0.9 vs. R1: 2.1 ± 1.1, E2: 1.5 ± 1.0 vs. R1: 1.8 ± 1.0) of 35 participants (mean age 22 ± 3 years, range 19-30) was significantly correlated (p < 0.001) for all pairs of examiners (E1-E2, E1-R1 and E2-R1), but was significantly different for the upper eyelids of E2 vs. E1 (p < 0.002) and E2 vs. R1 (p < 0.003). Median differences between pairs of raters for both eyelids were close to zero, with >74% of comparisons falling within the interquartile range, except for the upper eyelids of E2 vs. E1 and E2 vs. R1 (63% and 66%, respectively). IRR demonstrated moderate agreement (0.43-0.57) with good reliability (ICC range 0.76-0.86) for the upper eyelids and good agreement (0.60-0.65) with good reliability (ICC range 0.85-0.88) for the lower eyelids. The WSV was excellent (ICCs for repeated measurements > 0.90).

Conclusions: The HRK-9000A meibographer demonstrated excellent reliability, with good inter-examiner and inter-rater reproducibility. It is suitable for meibographic assessment, follow-up or treatment.

Purpose: To explore the longitudinal changes in retinal and choroidal thickness and their relation with the onset of type 1 diabetes mellitus (T1DM) in children.

Methods: Thirty-eight children with T1DM and 71 healthy controls were included in this 3-year longitudinal study. Ophthalmic and systemic examinations were conducted on each participant. Retinal and choroidal thickness were measured by optical coherence tomography. Baseline values and changes in retinal and choroidal thickness were compared with DR onset, diabetics without DR and healthy controls. Logistic regression was used to explore the association with DR development.

Results: Six children developed DR during the follow-up period (15.79%) and five of them developed microaneurysms in the parapapillary temporal quadrant. During follow-up, greater retinal thickening occurred in subjects with DR compared with diabetic participants without DR (p = 0.03) and healthy controls (p = 0.02) in the parapapillary outer temporal section. Compared with the control group, greater retinal thickening was observed in DR subjects in the averaged parapapillary outer ring (p = 0.01), the macular inner temporal section (p = 0.03) and several macular sections (all p < 0.05). Additionally, greater retinal thickening was observed in several parapapillary regions in non-DR T1DM participants compared with healthy controls (all p < 0.05). The thickness change in the outer temporal parapapillary section was independently associated with DR onset (OR = 1.33, 95% CI 1.01-1.73, p = 0.04).

Conclusion: Children with T1DM showed a significant or a trend of increasing retinal and choroidal thickness compared with normal controls over a 3-year period. The change of retinal thickness in the parapapillary outer temporal section was associated with the development of DR in children with T1DM, suggesting that it could serve as a biomarker for predicting and screening DR in these individuals.