Effects of short-term use of atropine with different concentrations and frequencies on eye safety in children / 中华实验眼科杂志

Objective:To evaluate the effect of short-term topical administration of atropine eye drops with various concentrations and frequencies on eye safety in children.Methods:A double-blind randomized controlled trial was conducted.Sevevty-two children with ametropia or pre-myopia (72 eyes) were enrolled in Tianjin Medical University Eye Hospital from December 2020 to January 2022.The subjects were randomly divided into 0.01% atropine group, 0.02% atropine group and 0.04% atropine group according to a random number table, with 24 cases (24 eyes) in each group.Automatic refraction with an automatic computer optometry device, subjective refraction with a phoropter, intraocular pressure with a non-contact tonometer, axial length by optical biometrics, the amplitude of accommodation (AMP) by the push-up method, pupil diameter with pupilometer, near visual acuity at 33 cm with a standard logarithmic visual acuity chart, tear evaluation with Keratograph 5M and Ocular Surface Disease Index (OSDI) questionnaire survey were performed among all subjects.One drop of 0.01%, 0.02%, and 0.04% atropine was administrated to the study eye according to grouping, and the pupil diameter was measured every 10 minutes until the pupil did not enlarge three times, then the data after a single treatment of the three groups were recorded.After one-week application of the corresponding concentration of atropine eye drops once at night, the data after one-week treatment were recorded.For the next week, the application frequency of 0.01% and 0.02% atropine groups changed to once daily in the morning and evening, and 0.04% atropine group maintained once at night, then the data after two-week treatment were recorded.Data of the right eyes were analyzed.The changes in pupil diameter, AMP and other eye parameters before and after atropine eye drops of the three groups were compared.This study adhered to the Declaration of Helsinki and the study protocol was approved by the Ethics Committee of Tianjin Medical University Eye Hospital (No.2020KY[L]-51). All subjects and their guardians were fully informed of the method and purpose of this study before entering the cohort.Written informed consent was obtained from guardians.Results:Pupil diameters of 0.01%, 0.02% and 0.04% atropine groups were (5.59±0.48), (5.35±0.76) and (5.65±0.43)mm before treatment respectively, (7.00±0.68), (7.17±0.58) and (8.40±1.71)mm after a single treatment, (6.67±0.62), (6.56±0.65) and (7.60±0.69)mm after one-week treatment, (6.96±0.49), (7.04±0.53) and (7.60±0.36)mm after two-week treatment.There were significant differences in pupil diameter at different time points after treatment among the three groups ( Fgroup=9.430, P<0.001; Ftime=156.620, P<0.001). The AMP of 0.01%, 0.02% and 0.04% atropine groups were (12.94±3.02), (13.25±2.81) and (13.42±2.60)D before treatment respectively, (11.62±2.61), (11.53±2.06) and (9.64±1.93)D after a single treatment, (11.14±2.61), (11.33±2.33) and (8.30±1.18)D after one-week treatment, (9.99±1.81), (8.72±1.25) and (8.76±2.12)D after two-week treatment.There was no significant difference in the AMP among the three groups ( Fgroup=2.800, P=0.063). In the three groups, the AMP at different time points after treatment were significantly lower than that before treatment ( Ftime=61.400, P<0.001). There was no difference in spherical equivalent refraction, intraocular pressure, near visual acuity, axial length, first none-invasive tear break-up time, average none-invasive tear break-up time, tear meniscus height and OSDI score among the three groups ( Fgroup=0.030, 0.630, 1.420, 0.580, 0.140, 0.120, 0.340, 0.142; all at P>0.05). There were significant differences in spherical equivalent refraction, intraocular pressure, first none-invasive tear break-up time, average none-invasive tear break-up time, tear meniscus height and OSDI score at different time points between before and after medication among the three groups ( Ftime=12.560, 4.730, 4.720, 5.220, 3.720; all at P<0.05). Conclusions:Varying pupil dilation and AMP reduction occur after the use of different concentrations of atropine and are more severe at higher concentrations.Increased administration frequency of atropine is associated with more pupil dilation and AMP reduction, but there is no intolerable adverse effect.

Efficacy of 0.01% atropine in myopic children of different ages / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To valuate the efficacy of 0.01% atropine for controlling myopia in children of different ages.METHOD: A randomized, double-blind, placebo control and single-center study was conducted. A total of 295 myopic children, aged 6～13 years, with myopia of -0.5D～-6.00D and astigmatism ≤2.0D, who admitted to our hospital from May 2019 to May 2020 were randomly assigned to experimental group(197 cases)and control group(98 cases)in a 2:1 ratio. Two groups were further divided into three subgroups according to age, 6～8 years old group(40/26 cases), 9～10 years group(84/34 cases), and 11～13 years group(73/38 cases). 0.01% atropine was administrated in the experimental group and placebo was administrated in the control group once before sleep. The changes of parameters were compared before and at 2wk, 3, 6, 9 and 12mo after treatment. Intraocular pressure, accommodation amplitude, best corrected distance and near visual acuity, pupil diameter and tear film were tested at 2wk. Cycloplegic refraction was assessed before treatment, and at 6 and 12mo after treatment.RESULTS: The spherical equivalent and axial length progression at 12mo after administration was -0.37±0.69D and 0.29±0.24mm in the experimental group, and -0.59±0.65D and 0.37±0.23mm in the control group(P=0.008, 0.006). In 6～8 years group, spherical equivalent and axial length progression between experimental and control group were not statistically significant(t=0.054, P=0.957; t=-0.623, P=0.536). In 9～10 years group, spherical equivalent and axial length progression between groups were statistically significant(t=2.056, P=0.042; t=-2.057 P=0.042). In 11～13 years group, spherical equivalent and axial length progression between groups were statistically significant(t=2.33, P=0.022; t=-2.424, P=0.017). The pupil was slightly dilated and the accommodation amplitude was decreased in experimental group, and the mean pupil diameter of the two groups was 3.94±0.79 and 3.16±0.48 mm respectively at 12mo after treatment(P<0.001). Other parameters and adverse event noted between groups were not statistically significant.CONCLUSIONS: 0.01% atropine is helpful to control the progression of myopia in children, which is well tolerated by adolescents. However, the effect of 0.01% atropine on the control of myopia for children aged 6～8 years is not enough. The findings suggest that increased concentration of atropine can be tried for 6～8 years old.

Clinical observation of orthokeratology combined with 0.01% Atropine for controlling low to moderate myopia in adolescents / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the efficacy and safety of orthokeratology combined with 0.01% atropine in controlling low to moderate myopia in adolescents.<p>METHODS: A prospective non-randomized controlled study was conducted among 120 eyes of 120 adolescents with low to moderate myopia. 60 eyes in the control group were treated with orthokeratology, and 60 eyes in the combined group were treated with orthokeratology combined with 0.01% atropine. The best corrected distant visual acuity(BCDVA), best corrected near visual acuity(BCNVA), refraction, axial length, accommodative amplitude, photopic pupil diameter, mesopic pupil diameter, lipid layer thickness(LLT), tear film break up time(BUT)and complications were determined before treatment and at 1a after treatment. <p>RESULTS: There were no significant differences in BCDVA and BCNVA within and between the two groups before and after treatment(<i>P</i>>0.05). After treatment, the spherical equivalents of both groups progressed significantly(<i>P</i><0.01), and the average changes of spherical equivalent refractive error in the combined group and the control group were 0.21(0.03, 0.53)D and 0.40(0.15, 0.74)D respectively(<i>P</i><0.01). The axial lengths of both groups were increased significantly(<i>P</i><0.01), and the axial length elongations of the combined group and the control group were(0.13±0.19)mm and(0.22±0.21)mm respectively(<i>P</i><0.01). There were no significant differences in the accommodative amplitude, photopic and mesopic pupil diameters of the control group before and after treatment(<i>P</i>>0.05). After treatment, the accommodative amplitude of the combined group decreased significantly, while the photopic and mesopic pupil diameters significantly increased, respectively(<i>P</i><0.01). The accommodative amplitude of the combined group was smaller than that of the control group, while the photopic and mesopic pupil diameters were larger than those of the control group at 1a after treatment(<i>P</i><0.01). The LLT and BUT in both groups were significantly reduced from baseline(<i>P</i><0.01), but both showed no significant differences between the two groups at baseline and at 1a after treatment(<i>P</i>>0.05). During the treatment period, there was no difference in the incidence of total adverse reactions between the combined group and the control group(26.7% <i>vs</i> 15.0%, <i>P</i>>0.05). <p>CONCLUSION: Combined treatment with 0.01% atropine and orthokeratology would be a safe and more effective choice of treatment to control the development of myopia in adolescents.

Application of Eye Tracker in Lie Detection / 法医学杂志

Objective To investigate the application value of eye tracking in lie detection. Methods The 40 subjects were randomly divided into two groups. The pupil diameter, fixation duration, points of fixation and blink frequency of the subjects in the experimental group in observing target stimulation and non-target stimulation were recorded with eye tracker after they accomplished the mock crime. The eye movement parameters of subjects in the control group were directly collected. The differences in eye movement parameters of the experimental group and the control group in observing target stimulation and non-target stimulation were analyzed by t-test. Pearson coefficient analysis of correlation between eye movement parameters that had differences was conducted. The effectiveness of eye movement parameters to distinguish between the experimental group and the control group was calculated by the receiver operator characteristic （ROC） curve. Results Participants from the experimental group had shorter average pupil diameter, longer average fixation duration and fewer fixation points （P<0.05）, but the differences in blink frequency had no statistical significance. The differences in the above indicators of the control group in observing target stimulation and non-target stimulation had no statistical significance. The average fixation duration showed a negative correlation with fixation points （r=-0.255, P<0.05）; the average fixation duration showed a negative correlation with average pupil diameter （r=-0.218, P<0.05）; the fixation points showed a positive correlation with average pupil diameter （r=0.09, P<0.05）. The area under the curve of average pupil diameter, average fixation duration and fixation points was 0.603, 0.621 and 0.580, respectively. Conclusion The average pupil diameter, average fixation duration and fixation points obtained by the eye tracker under laboratory conditions can be used to detect lies.

Discrepancies between total and anterior corneal high-order aberrations at measured and theoretical pupil diameter / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the difference between total and anterior corneal high-order aberrations(HOA)calculated based on the pupil diameters of 4.0mm and the actual measurements in different age groups.<p>METHODS:<i> </i>A cross sectional study. A Total of 100 subjects between March, 31^th and May, 31^th in 2019 were included. Their total corneal high-order aberrations(THOA)and anterior corneal high-order aberrations(AHOA)were detected on the basis of different machine-provided pupil diameters(2.0-7.0mm)and their photopic pupil diameters were recorded as measured pupil diameters in the room with normal illumination. THOA and AHOA based on the machine-measured pupil diameter was calculated through fitting curves, and compared to the THOA and AHOA at a theoretical 4mm pupil diameter.<p>RESULTS: The measured pupil diameter was negatively correlated with age(<i>r</i>= -0.587, <i>P</i><0.001). THOA and AHOA based on measured pupil diameter were both negatively correlated with age(<i>r</i>= -0.191, <i>P=</i>0.002; <i>r</i>=-0.181, <i>P</i>=0.004). At 4mm pupil diameter, THOA was positively correlated with age(<i>r</i>=0.282, <i>P</i><0.001), while there was no obvious correlation between AHOA and age. In 40-49, 60-69 and 70-79 years old groups, their THOA and AHOA at the measured pupil diameters were significantly lower than those at 4mm pupil diameter(<i>P</i><0.05), while their THOA were significantly higher than AHOA at the measured pupil diameters(<i>P</i><0.05). At 4mm pupil diameter, THOA were significantly lower than AHOA in 20-29 years old groups(<i>P</i>=0.006), but higher than AHOA in 60-69 years old groups(<i>P</i>=0.039). In the aged group(include 60-69 and 70-79 years old groups), the proportion of observed value of THOA ≥0.3μm at the measured pupil diameters were significantly lower than those at 4mm pupil diameter(χ²=4.300, <i>P</i>=0.038).<p>CONCLUSION: THOA and AHOA at the measured pupil diameters in the old subjects are significantly lower than those at 4mm pupil diameter, which could be ascribed to their relatively small actual mean pupil sizes. Our study suggested that the THOA rather than AHOA should be used for the selection of multifocal intraocular lens for cataract patients at measured pupil diameter, so that more aged patients will satisfy the inclusion criteria.

Objective Verification of Physiologic Changes during Accommodation under Binocular, Monocular, and Pinhole Conditions

BACKGROUND: To objectively investigate accommodative response to various refractive stimuli in subjects with normal accommodation. METHODS: This prospective, non-randomized clinical trial included 64 eyes of 32 subjects with a mean spherical equivalent −1.4 diopters (D). We evaluated changes in accommodative power, pupil diameter, astigmatic value, and axis when visual stimuli were applied to binocular, monocular (dominant eye, non-dominant eye, ipsilateral, and contralateral), and pinhole conditions. Visual stimuli were given at 0.25 D (4 m), 2 D (50 cm), 3 D (33 cm), and 4 D (25 cm) and accommodative response was evaluated using open view binocular autorefractor/keratometer. RESULTS: The accommodative response to binocular stimulus was 90.9% of the actual refractive stimulus, while that of the monocular stimulus was 84.6%. The binocular stimulus induced a smaller pupil diameter than did the monocular stimulus. There was no difference in accommodative response between the dominant eye and non-dominant eye or between ipsilateral and contralateral stimuli. As the refractive stimuli became stronger, the absolute astigmatic value increased and the direction of the astigmatism axis became more horizontal. Pinhole glasses required 10%–15% less accommodative power compared with the monocular condition. CONCLUSION: Binocular stimuli enable more precise and effective accommodation than do monocular stimuli. Accommodative response is composed of 90% true accommodation and 10% pseudo-accommodation, and the refractive stimulus in one eye affects the contralateral eye to the same extent. This should be taken into account when developing guidelines for wearing smart glasses while driving, as visual stimulation is applied to only one eye, but far distance attention is constantly needed. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03557346

Changes of pupil diameter during PI operation in FLACS patients of different ages / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the related factors of pupil diameter changes in femtosecond laser-assisted cataract surgery in patients of different ages and their effects on the operation time and surgical efficacy of patient interface.<p>METHODS: One hundred and one patients(101 eyes)with femtosecond laser assisted cataract surgery were enrolled in this study from March 2017 to June 2018, the age group was divided into middle-aged group(46 cases)and old age group(55 cases). Routine mydriasis was carried out in every patient. The operation time of patient interface, docking time, nucleus radius and pupil diameter before, during and after interface operation, best corrected visual acuity before and after surgery were recorded. The state anxiety questionnaire was used to assess the state anxiety symptoms during interfacing operation and evaluate the clinical efficacy.<p>RESULTS: The age of patients with femtosecond laser assisted cataract surgery was significantly negatively correlated with the diameter of the pupil before, during and after the interface operation, the radius of the nucleus, and the state anxiety score. The interface operation time and the state anxiety score were significantly negative correlation. The pupil diameters of the middle-aged patients(8.89±0.57, 7.52±0.52, 8.96±0.54mm)were significantly greater than those of the elderly group(8.43±0.73, 7.14±0.55, 8.44±0.75mm)before, during and after the interface operation,and the state anxiety score(42.19±9.27)was significantly greater than that of the elderly group(39.80±9.15 points)(<i>P</i><0.01), however there was no difference in interface operation time, docking time and total effective rate of treatment between the two groups(<i>P</i>>0.05).<p>CONCLUSION: The pupillary changes in middle-aged femtosecond laser-assisted cataract patients are more sensitive and these patients are prone to anxiety, which has certain influence on the progress of the surgery.

Relationship between facial attractiveness and pupil diameter in young adults / Relação entre a atratividade facial e diâmetro pupilar em adultos jovens / Relación entre atratividad facial y diámetro de la pupila en adultos jóvenes

The objective of this study was to investigate whether there is a relationship between pupil diameter and facial attractiveness. Participated in the study 60 young adults (30 men and 30 women) between 18 and 26 years of age (M=20.65, SD=2.20). Ten different unfamiliar neutral faces (five men and five women) were used as stimuli. The pupil diameter of each face was manipulated with pupil diameters of 2, 3, 4, 5 and 6mm (10 faces x5 pupil diameters=50 stimuli). A two-step study was carried out with the same sample and the same sets of faces, seeking to understand the difference of responses between subjects of both sexes. In phase I, result indicated a significant difference in relation to the pupil diameter factor for both the men (ꭓ²=21.93, p<.05) and the women (ꭓ²=44.73, p<.05). In phase II, the results indicated significant differences in relation to the pupil size [F(1, 234)=19.06, p<0.05]. The post-hoc Tukey HSD test showed that both the men and the women differently judged the faces with a pupil diameter of 2mm in relation to the faces with pupil diameters of 3, 4, 5 and 6mm (p<.05). Also, a significant difference between the diameter of 5mm in relation to the diameter of 3mm (p<.05). In general, the results indicate that the pupil diameter is a structural component of the human face that plays an important role in the process of judging facial attractiveness.

O objetivo deste estudo foi investigar a relação entre o diâmetro da pupila e a atratividade facial. Participaram da pesquisa 60 jovens com idade entre 18 e 26 anos. Foram utilizadas dez faces de adultos jovens, manipulou-se o diâmetro de cada pupila com variações de 2, 3, 4, 5 e 6mm. Realizou-se um estudo em duas etapas: na fase I, o resultado indicou diferença significativa para o fator de diâmetro pupilar tanto para homens quanto para mulheres (p<0,05). Na fase II, os resultados indicaram diferenças significativas em relação ao tamanho da pupila (p<0,05). O teste post-hoc Tukey mostrou que tanto os homens quanto as mulheres avaliaram diferentemente as faces com diâmetro pupilar de 2mm (p<0,05). Em geral, os resultados indicam que o diâmetro da pupila é um componente da face humana que desempenha um importante função no processo de julgamento da atratividade facial.

El objetivo de este estudio fue investigar si existe una relación entre el diámetro pupilar y el atractivo facial. Participaron en la estudio 60 adultos jóvenes (30 hombres y 30 mujeres) entre 18 y 26 años de edad (M=20.65, DE=2.20). Se utilizaron como estímulos diez rostros neutrales desconocidos diferentes (cinco hombres y cinco mujeres). El diámetro de la pupila de cada cara se manipuló con diámetros de pupila de 2, 3, 4, 5 y 6mm (10 caras x5 diámetros de pupila=50 estímulos). Se realizó un estudio en dos etapas con la misma muestra y los mismos conjuntos de caras buscando entender la diferencia de respuestas entre sujetos de ambos sexos. En la fase I, el resultado indicó una diferencia significativa en relación al factor de diámetro de la pupila tanto para los hombres (ꭓ²=21.93, p <0.05) como para las mujeres (ꭓ²=44.73, p<0.05). En la fase II, los resultados indicaron diferencias significativas en relación al tamaño de la pupila [F(1, 234)=19,06, p<0,05]. La prueba post-hoc de Tukey HSD mostró que tanto los hombres como las mujeres evaluaron de manera diferente las caras con un diámetro pupilar de 2mm con respecto a las caras con diámetros pupilares de 3, 4, 5 y 6mm (p<0,05). Se observó una diferencia significativa entre el diámetro de 5mm en relación al diámetro de 3mm (p<0,05). En general, los resultados indican que el diámetro de la pupila es un componente estructural de la cara humana que desempeña una importante función en el proceso de juicio del atractivo facial.

Effects of 0.01％ and 0.02 ％ atropine eye drops on pupil diameter and accommodation amplitude in myopic children: one-year randomized, double blind, controlled trail / 中华实验眼科杂志

Objective To evaluate the effects of 0.0％ and 0.02％ atropine on pupil diameter (PD) and accommodation amplitude (AMP) in myopic children and analyze its relation factors.Methods A prospective randomized controlled trial design was adopted.One hundred and ninety-three myopia children were included from June to October,2016 in the First Affiliated Hospital of Zhengzhou University,all the children completed one-year follow-up.All the children were divided into three groups randomly,with 72,74 and 80 myopic children in 0.01％ atropine group,0.02％ atropine group and control group,respectively.The myopic children in 0.01％ atropine group and 0.02％ atropine group wore single-vision spectacle lenses and were treated with 0.01％ and 0.02％ atropine eye drops nightly,respectively.The myopic children in the control group wore spectacle lenses only.The PD and AMP were measured at baseline,and 4,8 and 12 months after treatment.Results There were no significant difference of baselinePD and AMP among the three groups (F=9.321,P=0.820;F=13.209,P=0.220).Compared with basline,after 12 months,the PD increased by 0.75,0.84 and 0.02 mm in 0.01％ atropine group,0.02％ atropine group and control group,respectively.There were statistically significant differences of PD among three groups at different time points (Fgroup =2.168,P=0.013;Ftime =2.139,P=0.015;Finteraction =2.148,P=0.001).Compared with baseline,the PD of 0.01％ atropine group and 0.02％ atropine group were increased 4,8 and 12 months after treatment,and the difference was statistically significant (all at P＜0.001).The PD was stable in control group.After 12 months,the AMP were reduced by 1.25,1.12 and 0.28 D in 0.01％ atropine group,0.02％ atropine group and control group,respectively.There were statistically significant differences of AMP among the three groups at the different time points (Fgroup =18.346,P =0.034;Ftime =1.823,P =0.002;Fintercation =3.239,P =0.023).Compared with baseline,the AMP of 0.01％ atropine group and 0.02％ atropine group were increased 4,8 and 12 months after treatment,and the differences were statistically significant (all at P＜0.05).The AMP remained stable in control group.The change of PD in 0.01％ atropine group and 0.02％ atropine group was correlated with age,baseline PD and baseline eye axis length,respectively (β =0.060,P =0.019;β =-0.440,P＜0.001;β =-0.37,P =0.045).The change in AMP of the atropine group was significantly correlated with the baseline adjustment range (β =-0.71,P＜0.001).Conclusions 0.01％ and 0.02％ atropine show similar effects on pupil diameter and accommodation amplitude after 12 months of treatment in myopic children.

Adverse effects of 0.01％ atropine sulfate eye drops on myopic children / 中华实验眼科杂志

Objective To observe the adverse effects of 0.01％ atropine sulfate eye drops on myopic children.Methods A prospective non-randomized controlled trial was conducted.Ninety-nine myopic children (99 right eyes) were randomly assigned to experimental group(55 cases) and control group(44 cases).Myopic children of experimental group wore completely corrected frame glasses,while 0.01％ atropine sulfate eye drop was dropped into each eye once a day before going to bed.Myopic children in control group only wore completely corrected frame glasses.The follow-up time was 4 months.Best corrected visual acuity (BCVA),intraocular pressure (IOP),change of pupil diameter (PD) and amplitude of accommodation,symptoms of discomfort after medication were observed.This study followed the Helsinki declaration and was approved by Ethic Committee of the First Affiliated Hospital of Zhengzhou University.Informed consent was signed by the parents of each patient.Results No significant differences were found in best corrected distance visual acuity (BCDVA),best corrected near visual acuity(BCNVA) and IOP between the two groups before and 4 months after treatment (BCDVA:Fgroup =3.880,P =0.112;Ftime =27.220,P =0.413;BCNVA:Fgroup =5.200,P =0.311;Ftime =38.200,P =0.116,IOP:Fgroup =12.350,P=0.214;Ftime =22.300,P =0.146).After 4 months treatment,the PD was (6.99 ±0.64) mm in the experimental group,which was significantly higher than that before treatment(P＜0.001).The PD of the experimental group was higher than that of the control group after 4 months treatment,and the difference was statistically significant (P＜0.01).The amplitude of accommodation in the experimental group was 14.01 ±3.98 after 4 months treatment.which was 1.20 D lower than that before treatment,the difference was statistically significant (P＜0.01).The amplitude of accommodation of the experimental group was lower than that of the control group after 4 months treatment,the difference was statistically significant (P ＜ 0.01).Four cases (8％) appeared photophobia symptoms.Two cases and 2 cases appeared photophobia for 1 week or 2 weeks,respectively.However this symptom would relieve after wear sunglasses or sunshade caps in outdoor activities.One case (2％) appeared ocular itching and swelling after 1 month treatment,but disappeared after withdrawal.There were no other uncomfortable symptoms such as near sight blurring.Conclusions In mainland of China,the BCDVA,BCNVA and IOP of myopic children are stable;the PD is dilated and the amplitude of accommodation is decreased slightly after 4 months treatment of 0.01％ atropine,and 10％ children appear photophobia,but do not affect their study and life.

Relation of pupil diameter with control effect of orthokeratology on myopia / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To observe the pupil diameter in different environment on myopia control effect of orthokeratology. ·METHODS: The optometry, pupil diameter and eye axial length were examined in 70 patients aged 8- to 13-year-old with low and moderate myopia, whom then were given night wear lenses, and we measured the length of eye axis and pupil diameter before wearing lenses,6, 12 and 24mo after wearing. In two different light environment groups, each group took the average pupil diameter as the dividing and divided into two subgroups; the pupil diameter higher than the mean group (19 cases, 17 cases respectively), the pupil diameter lower than the mean group (16 case, 18 cases respectively). The paired t-test, independent sample t-test, repeated measures ANOVA and Pearson correlation analysis were adopted to analyze. ·RESULTS: Whether in darkroom or exposed to natural light, the axial length of pupils whose diameter was lower than the mean diameter increased faster than that above the average diameter of pupils (P<0. 01). The initial pupil diameter was significantly negatively correlated with the growth of the eye axis at the end of the 24-month follow-up (r=-0.4267,P<0.05;r=-0.4925, P<0.01). · CONCLUSION: The myopia controlling effect of orthokeratology under two different illumination conditions showed that the effect of myopia control in children with larger pupils is better than that in children with smaller pupils, which may be that the larger pupil makes the orthokeratology maintain stronger intervention on peripheral retina myopic defocus.

Analysis of related parameters of ocular biometric values in children and adolescents / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To measure ocular biometric values with sexual and age and determine the relationship between the differences using the Lenstar 900.METHODS:Totally 413 myopes 826 eyes,200 males (400 eyes) and 213 females (426 eyes),were enrolled in this study and were divided into 3 groups:Group Ⅰ (＜ 5 years),Group Ⅱ (5-10 years),Group Ⅲ (＞10 years).Central corneal thickness (CCT),anterior chamber depth (ACD),lens thickness (LT),axial length (AL),white-to-white distance (WWD) and pupil diameter (PD) were measured by Lenstar 900.The differences between age groups and gender groups were compared using the LSD and SNKk methods in variance analysis.Pearson correlation coefficient to assess AL,CCT,ACD,LT,WWD,PD in children and adolescents.RESULTS:There were significant difference in CCT between ages groups (P＜0.05) which increased with the age.There were significant differences both in ACD and AL between sexual groups.With analysis of Person,CCT showed a significantly positive correlation with WWD and PD(r=0.208,0.167;P＜0.05) and ACD showed a significantly positive correlation with AL,WWD,PD(r=0.620,0.238,0.192;P＜0.05).LT showed a significantly negative correlation with ACD,AL and WWD (r=-0.271,-0.186,-0.227;P＜0.05).WWD showed a significantly positive correlation with PD (r=0.273,P＜0.05).CONCLUSION:CCT has gradually thickening trend with ages.Men are more than women in ACD and AL.CCT shows positive correlation with WWD and PD and ACD shows positive correlation with AL,WND,PD.LT shows negative correlation with ACD,AL and WWD.WWD showed positive correlation with PD.

Analysis of the point spread function in total corneal of normal population / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To explore relationship between the normal strehl ratio ( SR ) values of total aberrations/SR values of total higher-order aberrations and modulation transfer function ( MTF ) at total corneal at different pupil diameters in normal population. METHODS: To exam the SR values of total aberrations and SR values of total higher-order aberrations of total corneals in 200 people ( 400 eyes ) using SIRIUS 3D topography system and analysis the corresponding root-mean-square ( RMS) . RESULTS: The subjects with different pupil diameters (3. 0, 5. 0, 6. 0, 7. 0mm)'s exam results of total corneal were as following:SR value of total aberrations 100’(0. 45±0. 12), (0. 25±0. 06), (0. 17±0. 05), (0. 13±0. 04); SR value of total higher order ab cerrations 100’(0. 69±0. 14), (0. 34±0. 07), (0. 24±0. 05), (0. 16±0. 04);SR value of total aberrations 200’(0. 45±0. 12), (0. 24±0. 06), (0. 20±0. 04), (0. 16±0. 03); SR value of total higher order aberrations 200’(0.70±0. 13), (0. 35±0. 07), (0. 27±0. 06), (0. 20±0.04 ) . The SR values of each group decreases with the increases of pupil diameters. The SR values of total aberrations and SR values of total higher - order aberrations at total corneals are negatively correlated with corresponding RMS value. When the pupil diameter is small, the SR value of total aberrations is more related to higher frequency region of MTF. When the pupil diameter is big, the SR value of total aberrations is more related to lower frequency region of MTF. CONCLUSION: The visual performance of normal people can be well reflected by SR values of total aberrations and SR values of total higher - order aberrations at total corneal.

Clinical analysis on the pupil diameter changes of cataract patients during phacoemulsification / 国际眼科杂志(Guoji Yanke Zazhi)

To study the changes of pupil diameter and its effects during phacoemulsification. METHODS: Block design, prospective study. 60 cataract patients (60 eyes) were selected, which divided into two groups according to the age, young age group (group A, 20 eyes of 20 patients) and older age group (group B, 40 eyes of 40 patients). Two groups were all given compound tropicamide eye drops for fully mydriasis before operation, computer software to process images during operation, and according to the cornea amplification ratio measure pupil diameter during the operation phase: before the corneal tunnel incision ( t1 ) , after injection of sodium hyalurantae ( t2 ) , before artificial lens implantation (t3), at the end of the surgery ( t4 ). Statistical analysis of data using SPSS18. 0 software.RESULTS: The pupil diameter measurements of t1-t4 were followed respectively:group A were 8. 36 ± 0. 65, 8. 97±0. 50, 8. 67±0. 63, 8. 72±0. 96mm; group B were 7. 73± 0. 58, 8. 23 ± 0. 59, 7. 89 ± 0. 16, 7. 70 ± 0. 63mm. Overall comparisons between the two groups, the pupil diameter measurements had differences during the operation phase ( F = 26. 696, P0. 05). Comparisons in a group at different time points: the pupil diameter of t2 was larger than that in t1, with statistically differences ( P>0. 05), the pupil diameter of t3 and t4 were decreased in group B, with statistically differences (P<0. 05).CONCLUSlON: Compound tropicamide eye drops are given for mydriasis before operation, young patients with cataract and senile patients with cataract can achieve the effect of surgery for mydriasis, the pupil stability of phacoemulsification in senile patients with cataract are lower than that in young patients with cataract.

Influence of manual enlarging pupil to different diameters on clinical outcome of pupil atresia complicated cataract / 中华实验眼科杂志

Background Pupil atresia increases the difficulty of cataract surgery.The improper enlarging pupil will lead to many complications.The appropriate method of pupil dilation is very important to improve the postoperative effect.Objective This study was to evaluate the pupillary function after manually enlarged pupil to different sizes for pupil atresia complicated cataract.Methods A retrospective case-controlled study was designed.Thirty-eight eyes of 30 cases suffered from pupil atresia complicated cataract induced by chronic uveitis were enrolled in Shandong Eye Institute from May 2006 to May 2012.The eyes underwent pupil forming and phacoemulsification and assigned to the pupil enlarged to ≥6.0 mm group (15 eyes) and 4.5-5.5 mm group (23 eyes).The fibrosis membrane at pupil zone was removed,and the fibrosis strip at pupil collar was cut evenly by 23G intraocular microscissors as zigzag shape.Then the pupil was enlarged in multipoint by a pair of left and right iris hook from the main and lateral incisions.The pupils of 15 eyes in the pupil enlarged to ≥6.0 mm group were dilated above 6.0 mm and 23 pupils in the 4.5-5.5 mm group were dilated to 4.5-5.5 mm and followed by routine phacoemulsification and foldable intraocular lens implantation.Topical and systemic corticosteroids and nonsteroidal anti-inflammatory drugs combined topical mydriatic were applied before and after operation.The pupil diameter,light reflex and photophobia symptom in postoperation were compared between the two groups.The visual acuity before and after operation and intra-and post-operative complications were recorded.This study was approved by Ethic Committee of Shandong Eye Hospital,and written informed consent was obtined from each patient before operation.Results The pupil diameter in the pupil enlarged to ≥6.0 mm group was dilated to (6.9±0.4) mm and that of the 4.5-5.5 mm was dilated to (5.1 ±0.3) mm intraoperatively,with a statistical significance between them (t =16.100,P =0.000).Three months later,the pupil diameter in the pupil enlarged to ≥ 6.0 mm group was (4.9 ±0.4)mm,with different degrees of lacerated pupillary margins,and that in the pupil enlarged to 4.5-5.5 mm group was (3.5 ±0.5) mm,with rare lacerated pupillary margins,showing a statistically significant difference (t =9.820,P =0.000).The unresponsive or obtuse light reflex in the pupil enlarged to ≥6.0 mm group was significantly higher than in the pupil enlarged to 4.5-5.5 mm group(11 eyes vs.6 eyes) (x2 =8.200,P =0.005).The subjective photophobia symptom of 2-3 grades in the pupil enlarged to ≥6.0 mm group was in 12 eyes,which was higher than that in the pupil enlarged to 4.5-5.5 mm group (2 eyes) (H=19.840,P=0.000).The iris haemorrhage were seen in 3 eyes in the pupil enlarged to 4.5-5.5 mm group and 7 eyes in the pupil enlarged to ≥6.0 mm group (x2 =5.290,P=0.030).The visual acuities of the operated eyes in the two groups improved at different degrees.Conclusions Approximate physiological pupil and good visual quality can been obtained by manual releasing and enlarging pupil to less than 5.5 mm evenly during the surgery for pupil atresia complicated cataract induced by chronic uveitis.

A Case of Cataract Operation Using Iris Retractor in Congenital Microcoria

PURPOSE: To report an case regarding phacoemulsification and intraocularlens (IOL) implantation using an iris retractor in a congenital microcoria patient. CASE SUMMARY: A 53-year-old male patient visited the office with a complaint of gradual decrease of visual acuity. The patient's best corrected visual acuity (BCVA) was 0.3, and his refractive index could not be measured, as a very small pupil was observed in both eyes. After applying tropicamide and phenylephrine four times, the refractive index of both eyes remained immeasurable. In addition, on slit-lamp biomicroscopic examination, a nucleosclerotic cataract was observed in both eyes. Any signs of increased intraocular pressure or gonioscopic findings seen in glaucomatous patients was not detected in either eyes. Using an ultrasound biomicroscope and Pentacam, the pupil diameter were 0.31 mm in both eyes, and changed to 0.92 mm in the right eye, and 1.0 mm in the left eye, after applying mydriatics. Phacoemulsification and IOL implantation were performed one month apart from each other, using an iris retractor. On the follow-up examination 2 to 3 months postoperatively, BCVA was 0.7 in the right eye, and 1.0 in the left eye. After the operation, the pupil diameter was not changed before and after mydriasis, and measured 2.53 mm in the right eye, and 2.83 mm in the left eye. CONCLUSIONS: The authors have reported a case regarding visual acuity that improved in a congenital microcoria patient performing a phacoemulsification and IOL implantation operation using an iris retractor.

Change of Pupil Diameter after Cataract Surgery or After-Cataract Surgery

PURPOSE: To investigate the change of pupil diameter following cataract surgery or after-cataract surgery and the dependence of this change on the opacity at photopic and scotopic adaptation. METHODS: Thirty-five eyes with cataract and 32 eyes with after-cataract were evaluated prospectively. The pupil diameter was measured at 220 lux (photopic) and 0.05 lux (scotopic) using a pupillometer. Cataract patients were examined preoperatively, and at 1 week and 2 months postoperatively, and after-cataract patients were examined preoperatively, and at 1 week postoperatively. The lens opacity was classified as opacity degree and the after-cataract was divided into pearl and fibrosis type. RESULTS: Pupil diameter of cataract patients was reduced after surgery at photopic and scotopic adaptation (p<0.05). The pupil diameter of eyes with severe opacity degree was 4.3 +/- 1.1 mm and 5.0 +/- 1.1 mm at photopic and scotopic adaptation, respectively, and was larger than eyes with mild opacity degree (3.9 +/- 1.1 mm and 4.5 +/- 1.1 mm, respectively, p<0.05). At photopic and scotopic adaptation, pupil diameter of after-cataract patients was reduced by Nd: Yag laser (p<0.05). The pupil diameter of eyes with fibrosis type, 4.6 +/- 1.0 mm, was significantly smaller than that of eyes with pearls type (5.1 +/- 1.1 mm, p<0.05). CONCLUSIONS: The pupil diameter of eyes with severe opacity degree was larger that of eyes with mild opacity degree. In after-cataract patients, pupil diameter was significant different depending on opacification type at scotopic adaptation and it was reduced after Nd: Yag laser.

The Effect of 5HT(3) Receptor Agonist on Intraocular Pressure and Pupil Diameter in Rabbits

PURPOSE: The effects of 5HT3 receptor agonist and antagonist on rabbit intraocular pressure (IOP) and pupil size were evaluated. METHODS: A 5HT3 receptor agonist, I-Phenylbiguanide (PBG, 1%) and a 5HT3 receptor antagonist, 3-Tropanyl-indole-carboxylate methiodide (ICS-205,930) were applied topically to the rabbit eye, and intraocular pressure and pupil diameter were checked with a Tono-PenTM XL and a ruler. RESULTS: Topical application of 1% PBG significantly increased IOP by 4.6+/-1.2 mmHg (p<0.001) over a period of up to 2 hours, the IOP maximum reached at 1 hour and caused pupil dilatation by 3.3+/-0.3mm (p<0.001) over a period of up to 5 hours, the dilation maximum reached at 2 hour. Topical preadministration of 1% ICS-205,930 prevented a rise in IOP but did not counteract on the pupil dilatation brought about by 5HT3 receptor agonist. CONCLUSIONS: These findings indicate that topically applied 5HT3 receptor agonist could raise IOP and dilate pupil.

Effects of Electro Acupuncture on the Function of Autonomic Nervous System in the Pupillary Diameter / 全日本鍼灸学会雑誌

The effects of electro acupuncture on autonomic nerve functions associated with the pupil were examined by measuring the diameter of the iris (D1), the maximum rate of iris constriction (VC) and the maximum rate of iris dilation (VD) before, during and after electro acupuncture.<br>An iris recorder which can be used even in the supine position was used for measuring three parameters.<br>As a result, the change with the above stimulation was reflected in a diminution of D1, presumably influencing parasympathetic nerve. Besides, VC and VD tended to increase with light reflex, presumably improving pupillary reactivity.

Apparent Accommodation in Posterior Chamber IOL Implanted Eyes

In order to evaluate the cause of apparent accommodation in pseudophakia, we performed ECCE and implanted biconvex, monofocal I0L in the bag in 24 patients(32 eyes) and followed up for more than 2 months. We measured apparent accommodation, corneal astigmatism and near visual acuity. And we also measured apparent accommodation and the changes of anterior chamber depth according to the movement of I0L and apparent accommodation according to the changes of pupil diameter in normal state before drug instillation and after instillation of either 10% phenylephrine or 2% pilocarpine. The results were as follows: 1. The mean apparent accommodation was 1.36 +/- 0.52 diopters. 2. There was negative correlation between corneal astigmatism and apparent accommodation and between cornel astigmatism and near visual acuity. 3. There was negative correlation between anterior chamber depth and apparent accommodation measured in normal state before drug instillation. And also there was negative correlation between the changes of anterior chamber depth and the changes of apparent accommodation measured after instillation of either 10% phenylephrine or 2% pilocarpine. 4. There was positive correlation between reciprocal changes of pupil diameter and apparent accommodation. So we conclude that the apparent accommodation is seemed! to be a resultant changes according to the changes of the pupil diameter.