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1.
J Refract Surg ; 40(9): e595-e603, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39254246

RESUMO

PURPOSE: To report 12-month visual and refractive outcomes following topography-guided femtosecond laser-assisted laser in situ keratomileusis (LASIK) for myopia and compound myopic astigmatism correction. METHODS: This prospective, single-center observational study was conducted in an outpatient clinical practice at the Stanford University Byers Eye Institute in Palo Alto, California. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity, 5% and 25% contrast sensitivity CDVA, and manifest refraction following topography-guided femtosecond laser-assisted LASIK were assessed. Refractive measurements were used to perform a vector analysis. RESULTS: Sixty eyes of 30 patients (mean age: 32.8 ± 7.0 years; range: 23 to 52 years) undergoing topography-guided LASIK for the correction of myopia and compound myopic astigmatism were analyzed. Mean postoperative UDVA was -0.09 ± 0.10 logarithm of the minimum angle of resolution (logMAR) at 12 months. Mean preoperative CDVA was -0.09 ± 0.09 and -0.13 ± 0.08 logMAR at postoperative 12 months. At 12 months, 26.9% of eyes had gained one or more lines of postoperative UDVA compared to baseline CDVA. Mean pre-operative 5% contrast sensitivity CDVA was 0.68 ± 0.07 and 0.64 ± 0.12 logMAR at 12 months (P = .014) following LASIK. CONCLUSIONS: Topography-guided LASIK for myopia and myopic astigmatism correction provided excellent visual and refractive outcomes that were predictable, precise, and stable up to 12 months postoperatively. [J Refract Surg. 2024;40(9):e595-e603.].


Assuntos
Astigmatismo , Topografia da Córnea , Ceratomileuse Assistida por Excimer Laser In Situ , Lasers de Excimer , Miopia , Refração Ocular , Cirurgia Assistida por Computador , Acuidade Visual , Humanos , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Acuidade Visual/fisiologia , Astigmatismo/cirurgia , Astigmatismo/fisiopatologia , Estudos Prospectivos , Miopia/cirurgia , Miopia/fisiopatologia , Refração Ocular/fisiologia , Adulto , Masculino , Feminino , Adulto Jovem , Lasers de Excimer/uso terapêutico , Pessoa de Meia-Idade , Cirurgia Assistida por Computador/métodos , Sensibilidades de Contraste/fisiologia , Resultado do Tratamento , Seguimentos
2.
J Refract Surg ; 40(9): e635-e644, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39254245

RESUMO

PURPOSE: To investigate the impact of back-to-front corneal radius ratio (B/F ratio) and posterior keratometry (PK) on the accuracy of intraocular lens power calculation formulas in eyes after myopic laser in situ keratomileusis (LASIK)/photorefractive keratectomy (PRK) surgery. METHODS: A retrospective, consecutive case series study included 101 patients (132 eyes) with cataract after myopic LASIK/PRK. Mean prediction error (PE), mean absolute PE (MAE), median absolute error (MedAE), and the percentage of eyes within ±0.25, ±0.50, and ±1.00 diopters (D) of PE were determined. RESULTS: The Barrett True K-TK formula exhibited the lowest MAE (0.59 D) and MedAE (0.48 D) and the highest percentage of eyes within ±0.50 D of PE (54.55%) in total. In eyes with a B/F ratio of 0.70 or less and PK of -5.70 D or greater, the Potvin-Hill formula displayed the lowest MAE (0.46 to 0.67 D). CONCLUSIONS: The Barrett True-TK exhibited the highest prediction accuracy in eyes after myopic LASIK/PRK overall. However, for eyes with a low B/F ratio and flat PK, the Potvin-Hill performed best. [J Refract Surg. 2024;40(9):e635-e644.].


Assuntos
Biometria , Córnea , Ceratomileuse Assistida por Excimer Laser In Situ , Lasers de Excimer , Implante de Lente Intraocular , Lentes Intraoculares , Miopia , Ceratectomia Fotorrefrativa , Refração Ocular , Acuidade Visual , Humanos , Miopia/cirurgia , Miopia/fisiopatologia , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Estudos Retrospectivos , Ceratectomia Fotorrefrativa/métodos , Feminino , Masculino , Córnea/patologia , Córnea/cirurgia , Refração Ocular/fisiologia , Adulto , Pessoa de Meia-Idade , Lasers de Excimer/uso terapêutico , Acuidade Visual/fisiologia , Biometria/métodos , Óptica e Fotônica , Topografia da Córnea , Reprodutibilidade dos Testes , Adulto Jovem , Facoemulsificação
3.
J Refract Surg ; 40(9): e667-e671, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39254251

RESUMO

PURPOSE: To compare early visual quality of small incision lenticule extraction (SMILE) versus laser in situ keratomileusis (LASIK) in terms of low contrast acuity. METHODS: A secondary analysis was performed using a harmonized dataset derived from two completed prospective cohort studies on active-duty military service members undergoing either SMILE (n = 37), wavefront-guided (WFG) LASIK (n = 51), or wavefront-optimized (WFO) LASIK (n = 56). Night vision and photopic and mesopic low contrast visual acuity (LCVA) up to 3 months postoperatively were compared between groups. RESULTS: Compared to SMILE-treated eyes, WFG LASIK-treated eyes had significantly better night vision and photopic LCVA at 1 month postoperatively (beta = -0.039, P = .016; beta = -0.043, P = .007, respectively). WFO LASIK-treated eyes had significantly better photopic LCVA at 1 month postoperatively (beta = -0.039, P = .012) but had worse mesopic LCVA at 3 months postoperatively (beta = 0.033, P = .015) versus SMILE-treated eyes. CONCLUSIONS: SMILE and LASIK, on either a WFG or WFO laser platform, yielded excellent outcomes, but LCVA seemed to recover quicker following LASIK compared to SMILE. [J Refract Surg. 2024;40(9):e667-e671.].


Assuntos
Sensibilidades de Contraste , Substância Própria , Ceratomileuse Assistida por Excimer Laser In Situ , Lasers de Excimer , Miopia , Acuidade Visual , Humanos , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Acuidade Visual/fisiologia , Miopia/cirurgia , Miopia/fisiopatologia , Estudos Prospectivos , Adulto , Masculino , Lasers de Excimer/uso terapêutico , Feminino , Substância Própria/cirurgia , Sensibilidades de Contraste/fisiologia , Adulto Jovem , Refração Ocular/fisiologia , Cirurgia da Córnea a Laser/métodos , Visão Noturna/fisiologia , Militares , Resultado do Tratamento
4.
BMC Med Res Methodol ; 24(1): 194, 2024 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-39243025

RESUMO

BACKGROUND: Early identification of children at high risk of developing myopia is essential to prevent myopia progression by introducing timely interventions. However, missing data and measurement error (ME) are common challenges in risk prediction modelling that can introduce bias in myopia prediction. METHODS: We explore four imputation methods to address missing data and ME: single imputation (SI), multiple imputation under missing at random (MI-MAR), multiple imputation with calibration procedure (MI-ME), and multiple imputation under missing not at random (MI-MNAR). We compare four machine-learning models (Decision Tree, Naive Bayes, Random Forest, and Xgboost) and three statistical models (logistic regression, stepwise logistic regression, and least absolute shrinkage and selection operator logistic regression) in myopia risk prediction. We apply these models to the Shanghai Jinshan Myopia Cohort Study and also conduct a simulation study to investigate the impact of missing mechanisms, the degree of ME, and the importance of predictors on model performance. Model performance is evaluated using the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC). RESULTS: Our findings indicate that in scenarios with missing data and ME, using MI-ME in combination with logistic regression yields the best prediction results. In scenarios without ME, employing MI-MAR to handle missing data outperforms SI regardless of the missing mechanisms. When ME has a greater impact on prediction than missing data, the relative advantage of MI-MAR diminishes, and MI-ME becomes more superior. Furthermore, our results demonstrate that statistical models exhibit better prediction performance than machine-learning models. CONCLUSION: MI-ME emerges as a reliable method for handling missing data and ME in important predictors for early-onset myopia risk prediction.


Assuntos
Aprendizado de Máquina , Miopia , Humanos , Miopia/diagnóstico , Miopia/epidemiologia , Feminino , Criança , Masculino , Modelos Logísticos , Modelos Estatísticos , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Curva ROC , Teorema de Bayes , China/epidemiologia , Estudos de Coortes , Idade de Início
5.
Sci Rep ; 14(1): 20888, 2024 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-39244630

RESUMO

Refractive error is becoming a significant public health issue. Photorefractive Keratectomy (PRK) is a corneal surface surgical technique that removes the corneal epithelium before stromal photoablation by ultraviolet radiation from the Excimer laser. We designed a retrospective study to characterize corneal remodeling after myopic Photorefractive Keratectomy and assess the accuracy of laser-predicted ablation depth (AD). This study took place in 15-20 National Ophthalmology Hospital, Paris, France. 150 eyes with preoperative manifest spherical equivalent between - 10.00D and - 0.25D and cylinder < 3D, treated with the WaveLight® EX500 laser between 01/2019 and 01/2023, were followed for at least three months. The main outcome measurements were postoperative changes in epithelial (ET) and stromal (ST) thicknesses measured with spectral domain optical coherence tomography and mean simulated keratometry (SimK) assessed with corneal topography. The central ET significantly decreased at M1, increased over the preoperative value from M1 to M6, and stabilized after M6. The increase in central ET after M1 was associated with an increase in mean SimK (r = 0.34). The achieved AD was 7.9 ± 8.0 µm greater than the laser-predicted AD. Stromal over-ablation was significantly and independently associated with myopia > 6D preoperative mean SimK > 44D and transepithelial procedures.


Assuntos
Córnea , Lasers de Excimer , Miopia , Ceratectomia Fotorrefrativa , Tomografia de Coerência Óptica , Humanos , Ceratectomia Fotorrefrativa/métodos , Miopia/cirurgia , Feminino , Adulto , Masculino , Lasers de Excimer/uso terapêutico , Estudos Retrospectivos , Córnea/cirurgia , Córnea/patologia , Córnea/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Adulto Jovem , Topografia da Córnea , Pessoa de Meia-Idade , Substância Própria/cirurgia , Epitélio Corneano/cirurgia , Epitélio Corneano/patologia , Acuidade Visual
6.
Invest Ophthalmol Vis Sci ; 65(11): 8, 2024 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-39230992

RESUMO

Purpose: This study investigates alterations in intrinsically photosensitive retinal ganglion cells (ipRGCs) and dopaminergic amacrine cells (DACs) in lid suture myopia (LSM) rats. Methods: LSM was induced in rats by suturing the right eyes for 4 weeks. Double immunofluorescence staining of ipRGCs and DACs in whole-mount retinas was performed to analyze changes in the density and morphology of control, LSM, and fellow eyes. Real-time quantitative PCR and Western blotting were used to detect related genes and protein expression levels. Results: Significant myopia was induced in the lid-sutured eye, but the fellow eye was not different to control. Decreased ipRGC density with paradoxically increased overall melanopsin expression and enlarged dendritic beads was observed in both the LSM and fellow eyes of the LSM rat retinas. In contrast, DAC changes occurred only in the LSM eyes, with reduced DAC density and tyrosine hydroxylase (TH) expression, sparser dendritic processes, and fewer varicosities. Interestingly, contacts between ipRGCs and DACs in the inner plexiform layer (IPL) and the expression of pituitary adenylate cyclase-activating polypeptide (PACAP) and vesicular monoamine transporter protein 2 (VMAT2) mRNA were decreased in the LSM eyes. Conclusions: The ipRGCs and DACs in LSM rat retinas undergo multiple alterations in density, morphology, and related molecule expressions. However, the ipRGC changes alone appear not to be required for the development of myopia, given that myopia is only induced in the lid-sutured eye, and they are unlikely alone to drive the DAC changes. Reduced contacts between ipRGCs and DACs in the LSM eyes may be the structural foundation for the impaired signaling between them. PACAP and VMAT2, strongly associated with ipRGCs and DACs, may play important roles in LSM through complex mechanisms.


Assuntos
Células Amácrinas , Western Blotting , Modelos Animais de Doenças , Miopia , Células Ganglionares da Retina , Opsinas de Bastonetes , Animais , Células Ganglionares da Retina/patologia , Células Ganglionares da Retina/metabolismo , Ratos , Miopia/metabolismo , Células Amácrinas/metabolismo , Células Amácrinas/patologia , Opsinas de Bastonetes/metabolismo , Tirosina 3-Mono-Oxigenase/metabolismo , Reação em Cadeia da Polimerase em Tempo Real , Proteínas Vesiculares de Transporte de Monoamina/metabolismo , Proteínas Vesiculares de Transporte de Monoamina/genética , Masculino , Ratos Sprague-Dawley , Pálpebras/patologia , Polipeptídeo Hipofisário Ativador de Adenilato Ciclase/metabolismo , Contagem de Células , Proteína Vesicular 2 de Transporte de Glutamato
7.
Sci Rep ; 14(1): 20667, 2024 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-39237593

RESUMO

Myopia is a common ocular condition characterized by biomechanical weakening revealed by increasing creep rate, cyclic softening scleral thinning, change of collagen fibril crimping, and excessive elongation of the posterior sclera resulting in blurred vision. Animal studies support scleral crosslinking as a potential treatment for myopia control by strengthening the weakened sclera and slowing scleral expansion. While multiple studies investigated aspects of the biomechanical weakening and strengthening effects in myopia and after scleral crosslinking, a comprehensive analysis of the underlying mechanical changes including the effect of vehicle injections is still missing. The purpose of this study was to provide a comprehensive analysis of biomechanical changes by scleral inflation testing in experimental myopia, after retrobulbar vehicle injections and scleral crosslinking using genipin in tree shrews. Our results suggest that biomechanical weakening in myopia involves an increased creep rate and higher strain levels at which collagen fibers uncrimp. Both weakening effects were reduced after scleral crosslinking using genipin at doses that were effective in slowing myopia progression. Vehicle injections increased mechanical hysteresis and had a small but significant effect on slowing myopia progression. Also, our results support scleral crosslinking as a potential treatment modality that can prevent or counteract scleral weakening effects in myopia. Furthermore, vehicle solutions may cause independent biomechanical effects, which should be considered when developing and evaluating scleral crosslinking procedures.


Assuntos
Modelos Animais de Doenças , Iridoides , Miopia , Esclera , Tupaiidae , Animais , Esclera/efeitos dos fármacos , Esclera/metabolismo , Iridoides/farmacologia , Iridoides/administração & dosagem , Miopia/tratamento farmacológico , Miopia/fisiopatologia , Fenômenos Biomecânicos/efeitos dos fármacos , Reagentes de Ligações Cruzadas , Colágeno/metabolismo
8.
Sci Rep ; 14(1): 21549, 2024 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-39285196

RESUMO

To evaluate changes in dry eye-related parameters after posterior chamber phakic refractive lens (PC-PRL) implantation. This prospective study included 21 highly myopic patients (39 eyes) who underwent PC-PRL implantation at Lanzhou Huaxia Eye Hospital between January 2021 and June 2022, with a 3-month postoperative follow-up. In addition to routine preoperative examinations, dry eye assessments were conducted preoperatively and at 1 week, 1 month, and 3 months postoperatively. These assessments included the Ocular Surface Disease Index (OSDI) questionnaire score, non-invasive first tear break-up time (NIF-BUT), non-invasive average tear break-up time (NIA-BUT), tear meniscus height (TMH), meibomian gland loss (MGL) rate, and Schirmer I test (SIt). Repeated measures ANOVA was used to compare the differences in parameters across different time points, with pairwise comparisons conducted using the LSD-t test. After grouping, the Student's t-test was applied to compare normally distributed data, while the Mann-Whitney U test was used for non-normally distributed data. Categorical data were analyzed using the chi-square test. A total of 21 patients (39 eyes) were included, comprising 10 males (19 eyes) and 11 females (20 eyes), aged 19 to 49 years (33.76 ± 7.87). All patients completed the 3-month follow-up. Significant differences in OSDI scores were observed pre- and post-surgery (P = 0.008), with a peak at one week post-surgery (P < 0.001), then stabilizing at one and three months post-surgery. Postoperative NIF-BUT and NIA-BUT significantly decreased (P < 0.001 for both) but returned to preoperative levels within three months. There were no significant changes in TMH, MGL, or SIt postoperatively (P > 0.05). Significant differences in dry eye parameters were observed between the dry eye and control groups before and after surgery (P < 0.001). PC-PRL implantation impacts tear film stability on the ocular surface after surgery, leading to varying degrees of dry eye symptoms in patients. After surgery, all dry eye parameters return to their preoperative levels within three months.


Assuntos
Síndromes do Olho Seco , Implante de Lente Intraocular , Lentes Intraoculares Fácicas , Lágrimas , Humanos , Feminino , Masculino , Adulto , Lágrimas/metabolismo , Estudos Prospectivos , Implante de Lente Intraocular/métodos , Síndromes do Olho Seco/etiologia , Adulto Jovem , Miopia/cirurgia , Pessoa de Meia-Idade
9.
BMC Ophthalmol ; 24(1): 358, 2024 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-39278928

RESUMO

BACKGROUND: To assess the efficacy and safety of virtual reality-based visual training (VRVT) in myopia control among children. METHODS: The randomized, parallel-group, single-blind clinical trial conducted at the Department of Ophthalmology of Shanghai Tenth People's Hospital enrolled 65 low-myopic children (aged 8 to 13 years) with cycloplegic spherical equivalent (SE) between - 0.50 and - 3.00 diopters (D), astigmatism less than - 1.00 D, anisometropia less than 1.50D, and best corrected visual acuity (BCVA) more than 0.0 logarithm (LogMAR) of the minimum angle of resolution. The participants were enrolled in December 2020, and the follow-up of this study concluded on August 2021. Children were assigned randomly to the intervention group (VRVT plus single-vision spectacle [SVS]) and the control group (only SVS without receiving VRVT). The intervention group was administered for 20 min per day with VRVT under parental supervision at home. The primary outcome was changes in axial length (AL) at 3 months. Macular choroidal thickness (mCT) was regarded as a key secondary outcome. RESULTS: Among 65 participants (mean age: 10.8 years, 52.3% male), 60 children (92.3%) who completed the 3-month intervention and 6-month follow-up were included in the analysis (30 in the intervention group and 30 in the control group). The changes of AL were 0.063 ± 0.060 mm (95% confidence interval [CI], 0.074 to 0.119 mm) in the intervention group and 0.129 ± 0.060 mm (95% CI, 0.107 to 0.152 mm) and in the control group at 3 months (t = - 2.135, P = 0.037), and the mean difference between the two groups was 0.066 mm. The change of mCT were 22.633 ± 36.171 µm (95% CI, 9.127 to 36.140 µm) in the intervention group and - 3.000 ± 31.056 µm (95% CI, - 14.597 to 8.597 µm) in the control group at 3 months (t = 2.945, P = 0.005). VR vertigo was the most common adverse event which was occurred in two children (2/30, 6.67%) in the intervention group. CONCLUSIONS: VRVT is a promising method for myopia control in children with good user acceptability. Among children aged 8 to 13 years with low-myopia, nightly use of VRVT resulted in slowing myopia progression. TRIAL REGISTRATION: This protocol was registered with ClinicalTrials.gov (NCT06250920), retrospectively registered on 01 February 2024.


Assuntos
Miopia , Refração Ocular , Realidade Virtual , Acuidade Visual , Humanos , Masculino , Criança , Feminino , Miopia/fisiopatologia , Miopia/terapia , Método Simples-Cego , Acuidade Visual/fisiologia , Adolescente , Refração Ocular/fisiologia , Seguimentos , Resultado do Tratamento , Óculos , Comprimento Axial do Olho
10.
Sci Rep ; 14(1): 20514, 2024 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-39227639

RESUMO

To evaluate the changes of choroidal thickness (CT) and blood flow related to myopia, and its effects of vascular endothelial growth factor (VEGFA) on choroidal vessels in myopia. Subjects were included and divided into emmetropia (EM), non-high myopia (Non-HM) and high myopia (HM) groups. we measured choroidal thickness (CT), choriocapillaris vessel density (VD), and VEGFA content in tears in humans (137 subjects for CT, VD and 84 for tear) and detected the role of VEGFA in the choroid in form-deprivation myopia (FDM) in guinea pigs. Twenty-four guinea pigs were divided into control and FDM groups, and the expression changes of choroidal vessels and VEGFA were observed and compared using immunohistochemistry and Western blotting. Twenty-one guinea pigs were divided into control, FDM + Vehicle and FDM + Conbercept groups. The changes of diopter, axis length and choroidal vessels after intravitreal injection of Conbercept were observed. There were significant differences in CT and VD among the three groups (p < 0.05). VEGFA levels in tears were significantly lower in the myopic groups, with a decreasing trend from EM to Non-HM to HM. The choroidal vascular area fraction of FDM decreased compared to the control group. FDM guinea pigs exhibited reduced choroidal vasculature and significant downregulation of VEGFA expression. Following intravitreal injection of conbercept, the FDM + Conbercept group showed greater myopia, longer axial length, and lower choroidal vascular area fraction compared to the control group. VEGFA may participate in the regulation of choroidal blood vessels and blood flow in the progression of myopia. The reduction in VEGFA may accelerates the progression of myopia.


Assuntos
Corioide , Miopia , Fator A de Crescimento do Endotélio Vascular , Corioide/metabolismo , Corioide/irrigação sanguínea , Corioide/patologia , Fator A de Crescimento do Endotélio Vascular/metabolismo , Animais , Cobaias , Miopia/metabolismo , Miopia/patologia , Masculino , Humanos , Feminino , Adulto , Biomarcadores/metabolismo , Tomografia de Coerência Óptica , Densidade Microvascular , Modelos Animais de Doenças , Proteínas Recombinantes de Fusão
11.
BMC Ophthalmol ; 24(1): 388, 2024 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-39227793

RESUMO

BACKGROUND: Visual quality after corneal refractive surgery is linked to the postoperative effective optical zone (EOZ). This study aims to compare long-term changes in the EOZ following small incision lenticule extraction (SMILE) and femtosecond laser-assisted in-situ keratomileusis (FS-LASIK) for moderate and high myopia. METHODS: This study included 42 patients (72 eyes) who underwent either SMILE (36 eyes) or FS-LASIK (36 eyes). A custom software program based on the tangential curvature difference map of the Pentacam HR (Oculus Optikgeräte GmbH) was used to define the EOZ at 3 and 7 years postoperatively. The EOZ, its chronological changes compared to the programmed optical zone (POZ), and the corneal wavefront aberrations following SMILE and FS-LASIK were analyzed. Correlations between the EOZ changes and relevant parameters were evaluated. RESULTS: Three years postoperatively, EOZ following SMILE and FS-LASIK were 5.13 ± 0.27 mm and 4.70 ± 0.24 mm (P < 0.001), respectively. Seven years postoperatively, EOZ following SMILE and FS-LASIK decreased to 5.03 ± 0.28 mm and 4.63 ± 0.23 mm (P < 0.001), respectively. At postoperative 7 years, the percentages of EOZ/POZ were negatively correlated with Q-value changes (ß = -5.120, P = 0.009) following SMILE and positively correlated with the cylinder correction (ß = 1.184, P = 0.004) following FS-LASIK. The induced spherical aberrations in the SMILE group were less than those in the FS-LASIK group (P < 0.05) and were negatively correlated with the EOZ/POZ (ß = -16.653, P < 0.001). CONCLUSIONS: The EOZ following SMILE was larger than that following FS-LASIK in the long postoperative term for moderate and high myopia. Furthermore, a continual reduction in the EOZ was noted after both surgical modalities.


Assuntos
Topografia da Córnea , Ceratomileuse Assistida por Excimer Laser In Situ , Lasers de Excimer , Refração Ocular , Acuidade Visual , Humanos , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Feminino , Adulto , Masculino , Acuidade Visual/fisiologia , Refração Ocular/fisiologia , Lasers de Excimer/uso terapêutico , Adulto Jovem , Seguimentos , Estudos Retrospectivos , Miopia/cirurgia , Miopia/fisiopatologia , Substância Própria/cirurgia , Cirurgia da Córnea a Laser/métodos , Aberrações de Frente de Onda da Córnea/fisiopatologia , Córnea/cirurgia , Miopia Degenerativa/cirurgia , Miopia Degenerativa/fisiopatologia , Período Pós-Operatório
12.
Sci Rep ; 14(1): 20619, 2024 09 04.
Artigo em Inglês | MEDLINE | ID: mdl-39232029

RESUMO

Currently, the global prevalence of myopia is high and on the rise, seriously affecting the health of students. Studies have suggested that dietary factors may be associated with the occurrence and development of myopia, but the results are inconsistent. This survey aims to analyze the correlation between dietary factors and myopia while controlling for more confounding factors. A multi-stage stratified cluster sampling method was performed to select 10,619 primary and secondary school students in Shenyang for visual examination, and questionnaires were administered to 6974 of them. Logistic regression was performed with myopia as the dependent variable and the variables with p < 0.1 in the univariate analysis as independent variables. Sensitivity analysis was conducted using propensity score matching. The results showed that the overall prevalence of myopia among primary and secondary school students in Shenyang was 59.1%, with mild myopia predominating. Students who ate fresh fruits two or more times a day had a 0.69 times lower risk of myopia compared to those who did not eat fruits (95% CI 0.50-0.97). However, subgroup analysis demonstrated that this protective effect was only significant for male students, with an OR of 0.59 (95% CI 0.38-0.91). Moreover, female students who consumed sugary beverages once or more a day had a 1.8 times higher risk of myopia compared to those who did not consume sugary beverages (95% CI 1.03-3.15). Vegetable consumption, intake of fried foods, and breakfast habits were not significantly associated with myopia. In summary, excessive consumption of sugary beverages could increase the risk of myopia, especially in female students, whereas fruit intake contributed to reducing the risk of myopia, particularly in male students.


Assuntos
Dieta , Miopia , Estudantes , Humanos , Miopia/epidemiologia , Miopia/etiologia , Masculino , Feminino , China/epidemiologia , Estudantes/estatística & dados numéricos , Adolescente , Criança , Prevalência , Instituições Acadêmicas , Inquéritos e Questionários , Fatores de Risco , Comportamento Alimentar
13.
J Fr Ophtalmol ; 47(7): 104080, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39218721

RESUMO

PURPOSE: This study aimed to compare the differences between the Zeiss IOL Master and Oculus Pentacam in keratometry and central anterior chamber depth (ACD) measurements in patients with high myopia and cataracts. METHODS: Between January 2019 and December 2020, 89 patients (103 eyes) with cataracts and high myopia who underwent preoperative cataract evaluation at Nanchang First Hospital were selected for retrospective analysis. Keratometry (K1, K2) and ACD were measured with the IOL Master and Pentacam. Paired t-tests were performed to compare the differences, while the Bland-Altman method was used to evaluate the agreement. RESULTS: The K1 value was (43.15±2.44) D for the IOL Master and (42.98±2.47) D for the Pentacam, and the difference between the two instruments was statistically significant (P<0.01). The K2 value was (44.55±2.63) D for the IOL Master and (44.32±2.55) D for the Pentacam. The ACD was (3.44±0.33)mm for the IOL Master and (3.39±0.36)mm for the Pentacam. There were statistically significant differences between the two instruments in both keratometry and ACD (P<0.01). The absolute values of the maximum difference between the two instruments for K1 and K2 were 1.1 and 1.07; thus, the consistency of the two instruments with respect to this measurement was poor. However, the absolute value of the maximum difference between the two instruments for ACD was 0.34, so the consistency of the two instruments in relation to this measurement was good. CONCLUSIONS: Both the IOL Master and the Pentacam can be used in the measurement of keratometry and ACD in patients with high myopia and cataracts, but the keratometry measurements should be compared in clinical application.


Assuntos
Catarata , Miopia , Humanos , Catarata/diagnóstico , Catarata/patologia , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Idoso , Miopia/diagnóstico , Miopia/patologia , Adulto , Segmento Anterior do Olho/diagnóstico por imagem , Segmento Anterior do Olho/patologia , Câmara Anterior/patologia , Câmara Anterior/diagnóstico por imagem , Extração de Catarata , Idoso de 80 Anos ou mais
14.
Sci Rep ; 14(1): 21231, 2024 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-39261545

RESUMO

The study assessed selected parameters of redox status in the plasma of patients suffering from high myopia (HM). Thirty-five children with mean age 13.7 ± 2.7 years with HM and 40 healthy children were included. Plasma redox status parameters were determined using colorimetric kits. The levels of retinol, α-tocopherol and coenzyme Q10 were determined with a high-performance liquid chromatograph. Negative correlations were observed between the concentrations of retinol and the axial length of the eye (r = - 0.514 p < 0.001). Increased myeloperoxidase (MPO) activity (p < 0.018), and decreased concentrations of retinol (p < 0.001) and α-tocopherol (p < 0.023) in patients with HM and the axial length of the eye > 26 mm compared to controls were established. Significantly lower retinol and α-tocopherol concentrations were found in patients with the axial length of the eye > 26 mm compared to those with the axial length of the eye ≤ 26 mm (p < 0.001, p < 0.021, respectively). Increased MPO activity in advanced stages of HM may confirm an inflammatory process in HM patients. Reduced retinol and α-tocopherol concentrations and their link to disease progression indicate a need for monitoring their levels and supplementation in children with HM.


Assuntos
Miopia , Peroxidase , Vitamina A , alfa-Tocoferol , Humanos , alfa-Tocoferol/sangue , Peroxidase/sangue , Vitamina A/sangue , Masculino , Feminino , Criança , Adolescente , Miopia/sangue , Miopia/metabolismo , Estudos de Casos e Controles
15.
Zhonghua Yan Ke Za Zhi ; 60(9): 736-745, 2024 Sep 11.
Artigo em Chinês | MEDLINE | ID: mdl-39267552

RESUMO

Objective: To investigate the factors affecting the progression of visual field defects in patients with myopia and primary open-angle glaucoma (POAG), and to clarify whether the factors vary in patients with different degrees of myopia. Method: An ambispective cohort study was conducted among patients diagnosed with myopia and POAG from the glaucoma outpatient department at the Zhongshan Ophthalmic Center of Sun Yat-sen University between January 2006 and January 2024. Based on the criteria of functional visual field progression, patients were divided into the progression group and non-progression group, and further divided into the low to moderate myopia subgroup and high myopia subgroup according to the degree of myopia. The patient age, gender, type of glaucoma (high tension glaucoma and normal tension glaucoma), spherical equivalent refraction, best corrected visual acuity (BCVA, recorded as the logarithm of the minimum angle of resolution), intraocular pressure (IOP), central corneal thickness, baseline visual field, history of ophthalmic surgery (corneal refractive surgery and glaucoma surgery), and number of anti-glaucoma medications were summarized. The generalized estimation equation was used for comparison between groups, and the Cox proportional hazards model was used to analyze the factors affecting the progression of visual field defects. Results: A total of 182 eyes from 106 patients were included in this study. There were 57 eyes in the progression group and 125 eyes in the non-progression group. Compared with the non-progression group, the progression group had the older age [43 (29, 53) years old], worse BCVA [0.05 (0.00, 0.17)], greater IOP fluctuation [1.8 (1.3, 2.9)mmHg(1 mmHg=0.133 kPa)], more common baseline central defects [52.6%(30/57)], higher visual field pattern standard deviations [8.92 (5.32, 12.00)dB], lower visual field index [77% (67%, 88%)], and more anti-glaucoma medications [35.1% (20/57) patients used three medications] (all P<0.05). The Cox proportional hazards models showed that the baseline moderate visual field defects [hazard ratio (HR)=2.33, 95% confidence interval (CI): 1.25 to 4.36, P=0.008], baseline central defects (HR=2.09, 95%CI: 1.11 to 3.93, P=0.022), older age (Model A, HR=1.03, 95%CI: 1.00 to 1.05, P=0.017; Model B, HR=1.02, 95%CI: 1.00 to 1.05, P=0.019), and greater IOP fluctuation (Model A, HR=1.54, 95%CI: 1.32 to 1.81, P<0.001; Model B, HR=1.49, 95%CI: 1.26 to 1.75, P<0.001) were risk factors for visual field progression. In the low to moderate myopia subgroup, the increased risk of progression was associated with baseline central defects (HR=5.74, 95%CI: 1.72 to 19.20, P=0.005), worse BCVA (Model A, HR=15.80, 95%CI: 2.07 to 121.00, P=0.008; Model B, HR=12.50, 95%CI: 2.65 to 58.70, P=0.001), and older age (Model A, HR=1.05, 95%CI: 1.02 to 1.08, P=0.002; Model B, HR=1.07, 95%CI: 1.03 to 1.11, P<0.001). In the high myopia subgroup, the increased risk of progression was associated with baseline moderate visual field defects (HR=2.35, 95%CI: 1.12 to 4.92, P=0.024) and greater IOP fluctuation (Model A, HR=1.50, 95%CI: 1.24 to 1.82, P<0.001; Model B, HR=1.52, 95%CI: 1.26 to 1.83, P<0.001). Conclusions: Age, IOP fluctuation, baseline moderate visual field defects, and baseline central defects were the factors affecting the progression of visual field defects in patients with myopia and POAG. There were differences in the influencing factors of visual field progression in patients with different degrees of myopia.


Assuntos
Progressão da Doença , Glaucoma de Ângulo Aberto , Pressão Intraocular , Miopia , Campos Visuais , Humanos , Glaucoma de Ângulo Aberto/fisiopatologia , Fatores de Risco , Estudos de Coortes , Transtornos da Visão , Feminino , Masculino , Pessoa de Meia-Idade
16.
BMC Ophthalmol ; 24(1): 403, 2024 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-39266992

RESUMO

OBJECTIVES: This retrospective analysis evaluates the treatment success of "Defocus Incorporated Multiple Segments" (DIMS) spectacle lenses in a real-life clinical setting in Germany. MATERIALS AND METHODS: Axial length (AL) and objective refraction of 166 eyes treated with DIMS at baseline and 12-month follow-up were analyzed. Annual AL growth rate within the range of physiological growth rate was considered a successful treatment. Myopia progression of ≥ -0.5 D/yr accounted as treatment success. Differences in percentages of treatment success of subgroups depending on baseline AL and age against treatment success of the total population were investigated. RESULTS: Considering all eyes, treatment success regarding AL growth and myopia progression was achieved in 46% and 65%, respectively. Male eyes with moderate AL showed treatment success in a higher proportion (73%, p < 0.01; 89%, p < 0.01); eyes with high AL showed treatment success in a lower proportion (25%, p < 0.01; 51%, n.s.). Female eyes showed the same trend but without statistical significance (moderate AL: 49%; 68%; high AL: 40%; 62%). Younger children showed treatment success in a lower proportion (male: 11%, p < 0.01; 38%, p < 0.05; female: 25%, p < 0.01; 42%, p < 0.01). Older children showed treatment success in a higher proportion (male: 60%, p < 0.05; 78% p < 0.05; female: 53%, n.s.; 77% p < 0.05). CONCLUSIONS: Eyes with moderate baseline AL and of older children showed treatment success after 12 months of DIMS treatment. Eyes with a high baseline AL and of younger children showed treatment success in a smaller proportion, therefore combination treatment should be considered. In future studies, males and females should be assessed separately.


Assuntos
Comprimento Axial do Olho , Progressão da Doença , Óculos , Refração Ocular , Humanos , Estudos Retrospectivos , Masculino , Feminino , Criança , Refração Ocular/fisiologia , Alemanha/epidemiologia , Adolescente , Acuidade Visual/fisiologia , Miopia/fisiopatologia , Miopia/terapia , Seguimentos , Pré-Escolar
17.
BMC Public Health ; 24(1): 2490, 2024 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-39266991

RESUMO

BACKGROUND: Knowing the prevalence of myopia at school age is essential to implement preventive measures and appropriate interventions, ensure access to vision care, promote a healthier educational environment and improve academic performance. The purpose of this study was to determine the prevalence of myopia and its associated sociodemographic risk factors, as well as to estimate the coverage of myopia correction among adolescents in center of Portugal. METHODS: This cross-sectional study evaluated 1115 adolescents from the 5th to the 9th year of school, with an average of 12.9 years (SD = 1.5) ranging from 10.0 to 18.0 years. Optometric evaluations were carried out in a school environment and consisted of the evaluation of distance visual acuity, assessed using a logarithmic visual acuity chart (ETDRS charts 1 and 2) at 4 m, and measured by refractive error with a pediatric autorefractometer (Plusoptix), by non-cycloplegic. Myopia was defined as spherical equivalent (SE ≤ -0.50 diopter (D)) and uncorrected visual acuity (UVA ≤ 95VAR). Adjusted logistic regression analysis was applied to investigate risk factors. RESULTS: We found a myopia rate of 21.5% and a high myopia rate of 1.4%. Higher school level and attendance at urban schools were associated with myopia, but no association was found with age or sex. Only 34.6% of myopic adolescents use the best optical correction and 26.4% do not use any type of optical correction. CONCLUSIONS: Data on the prevalence of refractive problems in Portugal are scarce and heterogeneous. This study, although regional, provides a valuable contribution with a clear and reproducible methodology, following international guidelines and filling gaps in the existing literature. The results show that the rate of myopia in this age group is similar to reports from other European studies. The high rate of adolescents with uncorrected or under-corrected myopia in Portugal is a problem that deserves attention.


Assuntos
Miopia , Humanos , Portugal/epidemiologia , Adolescente , Miopia/epidemiologia , Masculino , Feminino , Estudos Transversais , Fatores de Risco , Prevalência , Criança , Estudantes/estatística & dados numéricos , Fatores Socioeconômicos , Fatores Sociodemográficos , Acuidade Visual
18.
Exp Eye Res ; 247: 110067, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39233303

RESUMO

Myopia has become a global public health problem, with a high incidence among adolescents. In recent years, the correlation between gut microbiota and various diseases has become a research hotspot. This paper analyzes the relationship between myopia and gut microbiota in adolescents based on 16S rRNA sequencing, opening up a new avenue for the prevention and control of myopia. 80 adolescents aged 6-15 years were included; fecal samples were collected to compare their diversity and species differences. There was no significant difference in α diversity when considering richness and evenness at the same time (P > 0.05). While the group difference in ß diversity reached a significant level (R2 = 0.022, P < 0.05). The absolute quantification and relative abundance of phylum level Firmicutes and Actinobacteriota are different; among the top 30 genera, myopic group only one genus decreased in absolute quantification, while 13 genera decreased in relative quantification; so LEfSe analysis was performed, and the result showed that microbial community composition changed under Linear discriminant analysis (LDA) score, the top ten changes are shown in the figure; the Wilcoxon Rank sum test also found some significant changes in the absolute abundance of differential microbiota among different groups, at the phylum level, one bacterial phylum decreased and three bacterial phyla increased; at the genus level, 2 bacteria genera decreased and 29 bacteria genera increased. Functional pathways prediction found many myopic-related pathways were functionally enhanced in myopic patients (P < 0.05). Multivariate logistic regression analysis results showed that the area under the curve (AUC) of myopic patients predicted was close to or equal to 1. In conclusion, adolescent myopia is closely related to the gut microbiota, and the characteristic gut microbiota can distinguish myopia from healthy controls to a large extent. Therefore, it can be considered to regulate these characteristic gut microbiota to prevent and control myopia.


Assuntos
Fezes , Microbioma Gastrointestinal , Miopia , RNA Ribossômico 16S , Humanos , RNA Ribossômico 16S/genética , Microbioma Gastrointestinal/genética , Adolescente , Masculino , Feminino , Miopia/microbiologia , Miopia/genética , Criança , Fezes/microbiologia , Bactérias/genética , Bactérias/isolamento & purificação , DNA Bacteriano/genética
19.
Optom Vis Sci ; 101(8): 497-507, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-39259699

RESUMO

PURPOSE: Axial elongation is the basis of progression in primary myopia and the preferred metric to monitor its evolution. We conducted a meta-regression to model axial elongation and its associated factors in children with low to moderate myopia. METHODS: A comprehensive electronic systematic search was performed using Ovid Medline, EMBASE, and Cochrane Central Register of Controlled Trials of studies conducted up until October 2021. The mean rate of axial elongation was analyzed using a multivariate linear mixed-effects meta-regression model, with backward stepwise elimination of nonsignificant covariates. The model included three levels of random effects, allowing both prediction and confidence intervals to be estimated. RESULTS: A total of 64 studies with 83 subpopulations and 142 evaluations of mean axial change from baseline met our inclusion criteria and had no missing significant covariates in the final model. A separate analysis including all populations with axial length data (202 evaluations) but missing variance or covariate data produced a similar model to that for the analysis with complete data. The mean axial elongation is 38% greater in Asian children (95% confidence interval, 19 to 61%; p<0.01) compared with non-Asians, but both groups show a 15% decline per year as age increases (95% confidence interval, 12 to 17% p<0.0001). Prediction intervals indicate substantial variability around the axial elongation estimates. CONCLUSIONS: This analysis provides mean values of axial elongation for evaluation of efficacy of myopia control. The broad prediction intervals emphasize the large range of individual axial elongation rates in the population, illustrating the challenge in managing individual children. Interpretation of the analysis is limited by the use of aggregated data rather than individual subject data.


Assuntos
Comprimento Axial do Olho , Miopia , Humanos , Criança , Miopia/fisiopatologia , Miopia/terapia , Progressão da Doença , Refração Ocular/fisiologia , Fatores Etários
20.
Invest Ophthalmol Vis Sci ; 65(11): 18, 2024 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-39250117

RESUMO

Purpose: To determine whether the Lrit3-/- mouse model of complete congenital stationary night blindness with an ON-pathway defect harbors myopic features and whether the genetic defect influences the recovery from lens-induced myopia. Methods: Retinal levels of dopamine (DA) and 3,4 dihydroxyphenylacetic acid (DOPAC) from adult isolated Lrit3-/- retinas were quantified using ultra performance liquid chromatography after light adaptation. Natural refractive development of Lrit3-/- mice was measured from three weeks to nine weeks of age using an infrared photorefractometer. Susceptibility to myopia induction was assessed using a lens-induced myopia protocol with -25 D lenses placed in front of the right eye of the animals for three weeks; the mean interocular shift was measured with an infrared photorefractometer after two and three weeks of goggling and after one and two weeks after removal of goggles. Results: Compared to wild-type littermates (Lrit3+/+), both DA and DOPAC were drastically reduced in Lrit3-/- retinas. Natural refractive development was normal but Lrit3-/- mice showed a higher myopic shift and a lower ability to recover from induced myopia. Conclusions: Our data consolidate the link between ON pathway defect altered dopaminergic signaling and myopia. We document for the first time the role of ON pathway on the recovery from myopia induction.


Assuntos
Ácido 3,4-Di-Hidroxifenilacético , Modelos Animais de Doenças , Dopamina , Camundongos Knockout , Miopia , Refração Ocular , Animais , Camundongos , Miopia/fisiopatologia , Miopia/metabolismo , Miopia/genética , Dopamina/metabolismo , Ácido 3,4-Di-Hidroxifenilacético/metabolismo , Refração Ocular/fisiologia , Camundongos Endogâmicos C57BL , Retina/metabolismo , Retina/fisiopatologia , Cegueira Noturna/fisiopatologia , Cegueira Noturna/genética , Cegueira Noturna/metabolismo , Doenças Genéticas Ligadas ao Cromossomo X/genética , Doenças Genéticas Ligadas ao Cromossomo X/fisiopatologia , Doenças Genéticas Ligadas ao Cromossomo X/metabolismo , Recuperação de Função Fisiológica/fisiologia , Masculino , Oftalmopatias Hereditárias
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