Ophthalmic and Physiological Optics最新文献

Purpose: To investigate the change in subfoveal choroidal thickness (SFChT) in bilateral anisomyopic children undergoing orthokeratology (ortho-k) over 2 years and the association with axial elongation (AE).

Methods: SFChT, axial length and refractive data from 26 bilateral anisomyopic subjects (aged 7-12 years) who participated in a 2-year prospective orthokeratology study were analysed using generalised estimating equations and linear mixed models.

Results: SFChT in the more myopic eyes (MME) (at least 1.50 D more myopia than the fellow eye) became thicker (mean ± standard deviation change, 25 ± 20 μm) after 6 months of ortho-k lens wear (p < 0.001) and remained stable thereafter (p ≥ 0.13), but no such change was observed in the less myopic eyes (LME) (p ≥ 0.07). Combining data from both eyes, the baseline SFChT and SFChT change after 2 years of ortho-k treatment were associated with 2-year AE [generalised estimating equation (accounting for the inclusion of both eyes): β = 0.002, p = 0.03 and β = -0.005, p < 0.001, respectively].

Conclusions: After 2 years of ortho-k treatment, the increase in the SFChT occurred exclusively in the MME. Considering both eyes, greater SFChT thickening was associated with less eye growth.

Purpose: To investigate the correlation between dry eye disease (DED) symptoms and academic performance in young adults aged 21-30 years, as well as to determine the relationship between screen time and DED symptoms.

Methods: A total of 454 young adults, between 21 and 30 years of age, were initially enrolled in the study. Data collected included age, sex, grade point average (GPA), hours of contact lens wear, degree of compliance with the 20-20-20 rule, response to the Ocular Surface Disease Index (OSDI) questionnaire, as well as screen time for studying and engaging in social media activities. Spearman correlation analysis was conducted to investigate the relationship between DED symptoms and academic performance, screen time and contact lens usage.

Results: A total of 445 participants were included in the analysis, with 99.3% (n = 442) exhibiting DED symptoms (OSDI ≥13). The mean (standard deviation) OSDI score was 76.91 (17.89). Additionally, only 17.0% of participants adhered to the recommended 20-20-20 rule during screen usage. Mean daily screen time was 9.84 (3.73) h, with 2.97 (2.34) h for social media and 6.93 (3.48) h for study. OSDI scores were significantly correlated with study screen time (r_s = 0.12, p = 0.01) and social media usage (r_s = 0.13, p = 0.01), but not with GPA (r_s = -0.07, p = 0.16) or contact lens daily wearing time (r_s = 0.05, p = 0.43).

Conclusions: The prevalence of DED symptoms was found to be high amongst young adults. This study revealed a significant association between the duration of screen time and DED symptoms in this population. Prolonged screen exposure, both for academic purposes and social media engagement, was linked with more severe manifestations of DED. Notably, no significant correlation was observed between academic performance and DED symptoms in young adults.

Purpose: Some individuals with central vision impairment can obtain or maintain driving privileges using bioptic telescopes. Previous work has often demonstrated an increased collision risk for bioptic drivers, but some on-road studies find similar safety to that of normally sighted drivers. The purpose of this study was to compare exposure-controlled hard braking and speeding events measured with naturalistic recording in visually impaired bioptic drivers and normally sighted control drivers.

Methods: Visual acuity was measured for each eye individually and through the bioptic when indicated. Contrast sensitivity was measured binocularly with the Mars chart. Binocular integrated visual fields were constructed from monocular 24-2C SITA Faster plots. A commercially available GPS recorder was installed into drivers' personal vehicles for at least 6 weeks. Total mileage, instances of hard braking, travel over 65 miles per hour (mph) and posted speed limit violations were counted. Exposure-controlled rates were calculated for each of these safety events. Driver characteristics and hard braking events were compared using median tests, and Spearman correlation was used to assess the relationships among vision measurements and driving safety events.

Results: Twenty licensed bioptic drivers and 20 control drivers were enrolled. Bioptic drivers were significantly more likely to perform hard braking manoeuvres than controls. Among bioptic drivers, hard braking frequency was not predicted by visual acuity, contrast sensitivity or binocular integrated visual field deviation. Bioptic drivers with poorer contrast sensitivity were more likely to travel above 65 mph. Speeding events were not related to hard braking.

Conclusions: Bioptic drivers demonstrated nearly three times as many hard braking events per 1000 miles driven, but vision measurements did not predict hard braking. Bioptic drivers with poorer contrast sensitivity were more likely to drive faster than 65 mph. Further work exploring relationships among vision and driving safety in bioptic drivers is warranted.

Purpose: Myopia is highly prevalent among children and adolescents and results from abnormal refractive development. Less outdoor time as well as more near work have been recognised as major risk factors for myopia. This study analysed the major environmental factors related to myopia, such as outdoor activities and near work, and reviewed the potential mechanisms of myopia development.

Methods: A systematic search was conducted across PubMed, Web of Science, Cochrane Library and Ovid databases within the last two decades up to November 2024. This review followed the recommendations of the PRISMA Statement and only full-text review articles in English were included.

Results: Summarising the findings from 13 review articles, the environmental risk factors for myopia included lighting features such as low illumination and monochromatic light as well as aspects of the visual scene, for example, the presence of low spatial frequencies and hyperopic defocus. These particular visual stimuli may contribute to the onset and progression of myopia and increase the risk of retinal disorders by reducing choroidal blood flow, leading to scleral hypoxia and remodelling. When analysing environmental risk factors, it is challenging to isolate the individual contributions of outdoor time and near work. Furthermore, previous studies used different definitions of environmental exposures.

Conclusions: Future research needs quantitative, objective and standardised measures to improve the comparability and consistency between studies. In addition, work should focus on different ethnic populations and gene-environment studies, so as to determine the influence of environmental risk factors on myopia.

Background: Glaucoma is the leading cause of irreversible blindness globally, posing a significant public health challenge in Australia, particularly among individuals aged 55 years and older. As primary health care providers, optometrists play a crucial role in the early diagnosis and management of glaucoma, making them central to efforts aimed at reducing the burden of this sight-threatening condition. This study investigates the practice patterns of Australian optometrists in diagnosing and managing glaucoma, focusing on test utilisation, diagnostic confidence, referral practices and intra- and inter-observer variabilities in grading glaucomatous optic neuropathy (GON).

Methods: A mixed-method cross-sectional design was conducted, involving 50 Australian optometrists who graded 120 colour digital retinal photographs for GON and completed an online survey regarding their diagnostic methods and confidence levels. Statistical analyses assessed inter- and intra-observer agreement in GON grading.

Results: The results showed that 82% of optometrists surveyed possessed optical coherence tomography (OCT) instruments and 96% had visual field analysers. Despite a majority expressing confidence in glaucoma detection, only 8% felt capable of independently diagnosing the disease and initiating treatment. Inter-observer agreement for glaucoma detection from retinal photographs was moderate (kappa = 0.53, 95% CI 0.50-0.54), while intra-observer agreement was substantial (kappa = 0.73, 95% CI 0.70-0.77). Inter-observer agreement of optometrists was similar to that of ophthalmologists.

Conclusion: Most optometrists have access to advanced diagnostic tools, know how to appropriately diagnose and manage glaucoma and have similar inter-observer variability when assessing fundus photographs to that of glaucoma sub-specialists, but few feel confident in independently diagnosing and managing glaucoma.

Purpose: Keratoconus causes progressive myopia and irregular astigmatism, leading to vision impairment. This study investigated choroidal and retinal variations and their influence in participants with keratoconus.

Methods: This case-control study assessed 33 keratoconic and 33 axial length-matched healthy myopic eyes. Choroidal and retinal parameters between the two groups were compared using general linear models. Correlations between keratoconus choroidal/retinal parameters and ABCD grading or tomographic keratoconus classification (TKC) staging were assessed. Multivariable linear regression models were used to investigate the factors affecting changes in keratoconus choroidal/retinal thickness and blood flow.

Results: Keratoconus participants exhibited 2.3% lower macular inner retinal thickness (mean difference: -4.97 μm, p = 0.02), along with 8.0% and 2.3% higher superior and mean retinal vessel (mean difference: 2.71%, p = 0.03; mean difference: 3.22%, p = 0.01) densities, respectively, compared with controls. The blood flow density of the choroidal capillaries was 15.5% higher (mean difference: 5.72%, p = 0.01), while the large choroidal vessel density was 4.8% lower (mean difference: -3.38%, p = 0.03) at the macula in the keratoconus group. In the keratoconus group, higher deep retinal vessel density correlated with more severe A grading (r = 0.49, p = 0.006), while lower large choroidal vessel density correlated with more severe B grading (r = -0.48, p = 0.006); notably, higher deep retinal vessel density was positively correlated with more severe TKC staging (r = 0.50, p = 0.004). Furthermore, superior retinal vessel density was associated with the index of vertical asymmetry (IVA) (slope coefficient: 3.55%, p = 0.03) and the index of height asymmetry (slope coefficient: 0.07%, p = 0.04). Mean retinal vessel density was associated with IVA (slope coefficient: 4.82%, p = 0.01). Choroidal capillary density was associated with the keratoconus index (slope coefficient: 21.89%, p = 0.01). Large choroidal vessel density was associated with the steepest keratometry (slope coefficient: -0.61%/D, p = 0.009).

Conclusion: Participants with keratoconus exhibited choroidal and retinal parameter alterations associated with keratoconus severity, as well as corneal keratometry and irregularity, suggesting the potential pathophysiological mechanisms.

Purpose: To evaluate the rangefinding and light sensing capabilities of a novel wearable sensor, the Visual Environment Evaluation Tool (VEET) developed for myopia research.

Methods: The VEET 1.0 (Meta, LLC) is a temple-integrated system mounted on a spectacle frame. Both the left and right temples house four sensors each, angled straight ahead and 20° downward/4° nasal, respectively. For validation, VEET-mounted spectacles were placed on a mannequin head. An infrared camera was used to capture the spatial characteristics of the rangefinding beam. Distance measurements were collected against a wall for 5-400 cm. The accuracy of distance measurements for different target types, sizes and tilt was assessed. Ambient illumination was captured in different indoor and outdoor settings and compared to a lux meter.

Results: All devices (N = 20) were capable of capturing distances for the full range evaluated, 5-400 cm, against a wall. There was a strong relationship between the actual and measured distances, with a slope of 1.01 ± 0.003 and 0.95 ± 0.007, for the left and right temples, respectively. Distance measurements were repeatable across different target types, including paper and tablet. Mean beam diameter of five tested devices was 52.2° ± 7.5°. The VEET effectively measured distances across different target sizes, ranging from 2 × 2 cm and larger and target tilt ±60°. Illumination measurements across different indoor and outdoor settings demonstrated a strong linear relationship with lux meter readings (R² = 0.99 and 0.78 for the left and right temples, respectively), effectively distinguishing indoor (<1000 lux) and outdoor (≥1000 lux) illumination levels.

Conclusion: The VEET provides accurate quantification of real-time distances across different target types and sizes and is capable of effectively distinguishing indoor and outdoor illumination levels. The VEET will be valuable in studies evaluating risk factors for myopia to gain a better understanding of the role of near work and light exposure.