RESUMEN
Many animals use Earth's magnetic field (also known as the geomagnetic field) for navigation1. The favoured mechanism for magnetosensitivity involves a blue-light-activated electron-transfer reaction between flavin adenine dinucleotide (FAD) and a chain of tryptophan residues within the photoreceptor protein CRYPTOCHROME (CRY). The spin-state of the resultant radical pair, and therefore the concentration of CRY in its active state, is influenced by the geomagnetic field2. However, the canonical CRY-centric radical-pair mechanism does not explain many physiological and behavioural observations2-8. Here, using electrophysiology and behavioural analyses, we assay magnetic-field responses at the single-neuron and organismal levels. We show that the 52 C-terminal amino acid residues of Drosophila melanogaster CRY, lacking the canonical FAD-binding domain and tryptophan chain, are sufficient to facilitate magnetoreception. We also show that increasing intracellular FAD potentiates both blue-light-induced and magnetic-field-dependent effects on the activity mediated by the C terminus. High levels of FAD alone are sufficient to cause blue-light neuronal sensitivity and, notably, the potentiation of this response in the co-presence of a magnetic field. These results reveal the essential components of a primary magnetoreceptor in flies, providing strong evidence that non-canonical (that is, non-CRY-dependent) radical pairs can elicit magnetic-field responses in cells.
Asunto(s)
Criptocromos , Drosophila melanogaster , Campos Magnéticos , Animales , Criptocromos/química , Criptocromos/metabolismo , Drosophila melanogaster/química , Drosophila melanogaster/citología , Drosophila melanogaster/metabolismo , Drosophila melanogaster/fisiología , Flavina-Adenina Dinucleótido/metabolismo , Triptófano/metabolismo , Electrofisiología , Conducta Animal , Análisis de la Célula Individual , Neuronas/citología , Neuronas/metabolismoRESUMEN
A large intronic hexanucleotide repeat expansion (GGGGCC) within the C9orf72 (C9orf72-SMCR8 Complex Subunit) locus is the most prevalent genetic cause of both Frontotemporal Dementia (FTD) and Motor Neuron Disease (MND). In patients this expansion is typically hundreds to thousands of repeat units in length. Repeat associated non-AUG translation of the expansion leads to the formation of toxic, pathological Dipeptide-Repeat Proteins (DPRs). To date there remains a lack of in vivo models expressing C9orf72 related DPRs with a repeat length of more than a few hundred repeats. As such our understanding of how physiologically relevant repeat length DPRs effect the nervous system in an ageing in vivo system remains limited. In this study we generated Drosophila models expressing DPRs over 1000 repeat units in length, a known pathological length in humans. Using these models, we demonstrate each DPR exhibits a unique, age-dependent, phenotypic and pathological profile. Furthermore, we show co-expression of specific DPR combinations leads to distinct, age-dependent, phenotypes not observed through expression of single DPRs. We propose these models represent a unique, in vivo, tool for dissecting the molecular mechanisms implicated in disease pathology, opening up new avenues in the study of both MND and FTD.
Asunto(s)
Expansión de las Repeticiones de ADN/genética , Dipéptidos/genética , Modelos Animales de Enfermedad , Demencia Frontotemporal , Enfermedad de la Neurona Motora , Animales , Proteína C9orf72/genética , Drosophila , FenotipoRESUMEN
PURPOSE: To assess the association of specific newborn and maternal factors with indicators of increased blood-forming capacity in umbilical cord blood to inform strategic collection strategies that could augment the quality of units in public cord blood banks. METHODS: Data regarding 268 consecutive cord blood units (CBUs) banked by Canadian Blood Services were analyzed. Multivariate analysis was performed to identify factors associated with markers of hematopoietic potency and likelihood of utilization. RESULTS: Delayed clamping of the cord beyond 60 s was associated with reduced volume collected. Any delay in clamping of the cord was associated with reduced total nucleated cell counts. Newborn weight >4,000 g was also associated with greater blood volume in the collection but not with other measures of hematopoietic potency. Cord blood acidosis at birth (pH.
Asunto(s)
Bancos de Sangre , Sangre Fetal , Canadá , Femenino , Células Madre Hematopoyéticas , Humanos , Hipertensión Inducida en el Embarazo , Recién Nacido , Embarazo , Factores de TiempoRESUMEN
Purpose: To compare the visual performance of prototype contact lenses designed via deliberate manipulation of higher-order spherical aberrations to extend-depth-of-focus with two commercial multifocals, after 1 week of lens wear. Methods: In a prospective, participant-masked, cross-over, randomized, 1-week dispensing clinical-trial, 43 presbyopes [age: 42-63 years] each wore AIROPTIX Aqua multifocal (AOMF), ACUVUE OASYS for presbyopia (AOP) and extended-depth-of-focus prototypes (EDOF) appropriate to their add requirements. Measurements comprised high-contrast-visual-acuity (HCVA) at 6 m, 70 cm, 50 cm and 40 cm; low-contrast-visual-acuity (LCVA) and contrast-sensitivity (CS) at 6 m and stereopsis at 40 cm. A self-administered questionnaire on a numeric-rating-scale (1-10) assessed subjective visual performance comprising clarity-of-vision and lack-of-ghosting at various distances during day/night-viewing conditions and overall-vision-satisfaction. Results: EDOF was significantly better than AOMF and AOP for HCVA averaged across distances (p ≤ 0.038); significantly worse than AOMF for LCVA (p = 0.021) and significantly worse than AOMF for CS in medium and high add-groups (p = 0.006). None of these differences were clinically significant (≤2 letters). EDOF was significantly better than AOMF and AOP for mean stereoacuity (36 and 13 seconds-of-arc, respectively: p ≤ 0.05). For clarity-of-vision, EDOF was significantly better than AOP at all distances and AOMF at intermediate and near (p ≤ 0.028). For lackof-ghosting averaged across distances, EDOF was significantly better than AOP (p < 0.001) but not AOMF (p = 0.186). EDOF was significantly better than AOMF and AOP for overall-vision satisfaction (p ≤ 0.024). Conclusions: EDOF provides better intermediate and near vision performance than either AOMF or AOP with no difference for distance vision after 1 week of lens wear (AU)
Objetivo: Comparar el rendimiento visual de un prototipo de lentes de contacto diseñadas mediante manipulación deliberada de aberraciones esféricas de alto orden, para ampliar la profundidad de campo con dos lentes multifocales comerciales, tras una semana de uso. Métodos: En un ensayo clínico prospectivo, ciego para los participantes, transversal, aleatorizado, con uso de lentes durante una semana, 43 présbitas [Edad: 42-63 años] utilizaron lentes AIROPTIX Aqua multifocal (AOMF), ACUVUE OASYS para presbicia (AOP) y de profundidad de foco extendido (EDOF) adecuados a sus requisitos de adición. Las mediciones incluyeron agudeza visual de alto contraste (HCVA) a 6 m, 70 cm, 50 cm y 40 cm, agudeza visual de bajo contraste (LCVA), sensibilidad de contraste (CS) a 6 m, y estereopsis a 40 cm. Un cuestionario auto-administrado sobre una escala de evaluación numérica (1-10) valoró el rendimiento visual subjetivo incluyendo la nitidez de visión y la ausencia de imágenes fantasma a diversas distancias en condiciones de visión diurna/nocturna, así como la satisfacción sobre la visión general. Resultados: EDOF fue considerablemente mejor que AOMF y AOP para la media de las distancias HCVA (p ≤ 0,038); considerablemente peor que AOMF para LCVA (p = 0,021) y considerablemente peor que AOMF para CS en los grupos de adición media y elevada (p = 0,006). Ninguna de estas diferencias fueron clínicamente significativas (≤ 2 letras). EDOF fue considerablemente mejor que AOMF y AOP para la estereoagudeza media (36 y 13 segundos de arco, respectivamente: p ≤ 0,05). Para la claridad de visión, EDOF fue considerablemente mejor que AOP en todas las distancias, y AOMF para las distancias intermedia y cercana (p ≤ 0,028). Para la falta de imágenes fantasma promediada a las diferentes distancias, EDOF fue considerablemente mejor que AOP (p < 0,001) pero no así AOMF (p = 0,186). EDOF fue considerablemente mejor que AOMF y AOP en cuanto a satisfacción sobre la visión general (p ≤ 0,024). Conclusiones: EDOF aporta un mejor desempeño de visión intermedia y cercana que AOMF o AOP, sin diferencia de visión lejana tras una semana de uso de lentes de contacto multifocales (AU)
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Lentes de Contacto/clasificación , Lentes de Contacto , Lentes de Contacto de Uso Prolongado , Presbiopía/terapia , Miopía , Pruebas del Campo Visual/métodos , Pruebas del Campo Visual , Estudios Prospectivos , 28599 , Encuestas y CuestionariosRESUMEN
PURPOSE: To compare the visual performance of prototype contact lenses designed via deliberate manipulation of higher-order spherical aberrations to extend-depth-of-focus with two commercial multifocals, after 1 week of lens wear. METHODS: In a prospective, participant-masked, cross-over, randomized, 1-week dispensing clinical-trial, 43 presbyopes [age: 42-63 years] each wore AIROPTIX Aqua multifocal (AOMF), ACUVUE OASYS for presbyopia (AOP) and extended-depth-of-focus prototypes (EDOF) appropriate to their add requirements. Measurements comprised high-contrast-visual-acuity (HCVA) at 6m, 70cm, 50cm and 40cm; low-contrast-visual-acuity (LCVA) and contrast-sensitivity (CS) at 6m and stereopsis at 40cm. A self-administered questionnaire on a numeric-rating-scale (1-10) assessed subjective visual performance comprising clarity-of-vision and lack-of-ghosting at various distances during day/night-viewing conditions and overall-vision-satisfaction. RESULTS: EDOF was significantly better than AOMF and AOP for HCVA averaged across distances (p≤0.038); significantly worse than AOMF for LCVA (p=0.021) and significantly worse than AOMF for CS in medium and high add-groups (p=0.006). None of these differences were clinically significant (≤2 letters). EDOF was significantly better than AOMF and AOP for mean stereoacuity (36 and 13 seconds-of-arc, respectively: p≤0.05). For clarity-of-vision, EDOF was significantly better than AOP at all distances and AOMF at intermediate and near (p≤0.028). For lack-of-ghosting averaged across distances, EDOF was significantly better than AOP (p<0.001) but not AOMF (p=0.186). EDOF was significantly better than AOMF and AOP for overall-vision-satisfaction (p≤0.024). CONCLUSIONS: EDOF provides better intermediate and near vision performance than either AOMF or AOP with no difference for distance vision after 1 week of lens wear.
Asunto(s)
Lentes de Contacto Hidrofílicos , Percepción de Profundidad/fisiología , Presbiopía/terapia , Agudeza Visual/fisiología , Adulto , Sensibilidad de Contraste , Estudios Cruzados , Diseño de Equipo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Presbiopía/fisiopatología , Estudios Prospectivos , Encuestas y CuestionariosRESUMEN
Purpose: To compare the visual performance of prototype contact lenses which extend depthof-focus (EDOF) by deliberate manipulation of multiple higher-order spherical aberration terms and a commercially-available center-near lens (AIR OPTIX Aqua Multifocal, AOMF). Methods: This was a prospective, cross-over, randomized, single-masked (participant), shortterm clinical trial where 52 participants (age 45-70 years) were stratified as low, medium or high presbyopes and wore EDOF and AOMF on different days. Objective measures comprised high and low contrast visual acuity (HCVA/LCVA, log MAR), and contrast sensitivity (log units) at 6 m; HCVA at 70 cm, 50 cm and 40 cm and stereopsis (seconds of arc) at 40 cm. HCVA at 70 cm, 50 cm and 40 cm were measured as «comfortable acuity» rather than conventional resolution acuity. Subjective measures comprised clarity-of-vision and ghosting at distance, intermediate and near, overall vision satisfaction and ocular comfort (1-10 numeric rating scale) and lens purchase (yes/no response). Statistical analysis included repeated measures ANOVA, paired t-tests and McNemars test. Results: Significant differences between lens types were independent of strata (p ≥ 0.119). EDOF was significantly better than AOMF for HCVA at 40 cm (0.42 ± 0.18 vs. 0.48 ± 0.22, p = 0.024), stereopsis (98 ± 88 vs. 141 ± 114, p < 0.001), clarity-of-vision at intermediate (8.5 ± 1.6 vs. 7.7 ± 1.9, p = 0.006) and near (7.3 ± 2.5 vs. 6.2 ± 2.5, p = 0.005), lack-of-ghosting (p = 0.012), overall vision satisfaction (7.5 ± 1.7 vs. 6.4 ± 2.2, p < 0.001) and ocular comfort (9.0 ± 1.0 vs. 8.3 ± 1.7, p = 0.002). Significantly more participants chose to only-purchase EDOF (33% vs. 6%, p = 0.003).). There were no significant differences between lens types for any objective measure at 6 m or clarity-of-vision at distance (p ≥ 0.356). Conclusions: EDOF provides better intermediate and near vision performance in presbyopes than AOMF with no difference for distance vision during short-term wear (AU)
Objetivo: Comparar el rendimiento visual de prototipos de lentes de contacto con las de profundidad de campo extendida (EDOF), mediante la manipulación deliberada de múltiples aberraciones esféricas de alto orden y las lentes de visión simultánea centro-cerca comercialmente disponibles (AIR OPTIX Aqua Multifocal, AOMF). Métodos: Ensayo clínico prospectivo, transversal, aleatorizado, con máscara única (participante), y a corto plazo, en el que se estratificó la presbicia de 52 participantes (de edades comprendidas entre 45 y 70 años) como baja, media o alta; dichos participantes utilizaron lentes EDOF y AOMF en días diferentes. Las mediciones objetivas incluyeron la agudeza visual de alto y bajo contraste (HCVA/LCVA, log MAR), y la sensibilidad al contraste (unidades log) a 6 m, HCVA a 70 cm, 50 cm y 40 cm, y estereopsis (segundos de arco) a 40 cm. La HCVA a 70 cm, 50 cm y 40 cm se midió como «agudeza de confort» en lugar de la agudeza de resolución convencional. Las mediciones subjetivas incluyeron la claridad de visión y la visión fantasma (ghosting) a distancia, la satisfacción con la visión general intermedia y lejana, el confort ocular (escala de clasificación numérica de 1a 10) y la adquisición de lentes de contacto (respuesta sí/no). El análisis estadístico incluyó la prueba ANOVA con medidas repetidas, la prueba de t pareada, y la prueba de McNemar. Resultados: La significación de las diferencias entre los tipos de lentes fue independiente de los estratos (p ≥ 0,119). Los resultados de EDOF fueron considerablemente mejores que los de AOMF en cuanto a HCVA a 40 cm (0,42 ± 0,18 frente a 0,48 ± 0,22, p = 0,024), estereopsis (98 ± 88 frente a 141 ± 114, p < 0,001), claridad de visión intermedia (8,5 ± 16 frente a 7,7 ± 1,9, p = 0,006) y próxima (7,3 ± 2,5 frente a 6,2 ± 2,5, p = 0,005), ausencia de visión fantasma (p = 0,012), satisfacción con la visión general (7,5 ± 1,7 frente a 6,4 ± 2,2, p < 0,001) y confort ocular (9,0 ± 1,0 frente a 8,3 ± 1,7, p = 0,002). Un número considerable de participantes optó por adquirir únicamente EDOF (33% frente al 6%, p = 0,003). No se produjeron diferencias significativas entre los dos tipos de lentes en relación a las mediciones objetivas a 6 m, ni a la claridad de visión lejana (p ≥ 0,356). Conclusiones: Las lentes EDOF proporcionaron un mejor rendimiento de la visión intermedia y próxima en pacientes con presbicia que las lentes AOMF, sin que se produjeran diferencias en cuanto a visión lejana con el uso a corto plazo (AU)
Asunto(s)
Humanos , Masculino , Femenino , Lentes/provisión & distribución , Trastornos de la Visión/diagnóstico , Análisis de Varianza , Presbiopía/metabolismo , Presbiopía/patología , Lentes/clasificación , Trastornos de la Visión/complicaciones , Estudios Prospectivos , Presbiopía/complicaciones , Presbiopía/diagnóstico , Lentes de ContactoRESUMEN
PURPOSE: To compare the visual performance of prototype contact lenses which extend depth-of-focus (EDOF) by deliberate manipulation of multiple higher-order spherical aberration terms and a commercially-available center-near lens (AIR OPTIX Aqua Multifocal, AOMF). METHODS: This was a prospective, cross-over, randomized, single-masked (participant), short-term clinical trial where 52 participants (age 45-70 years) were stratified as low, medium or high presbyopes and wore EDOF and AOMF on different days. Objective measures comprised high and low contrast visual acuity (HCVA/LCVA, logMAR), and contrast sensitivity (log units) at 6m; HCVA at 70cm, 50cm and 40cm and stereopsis (seconds of arc) at 40cm. HCVA at 70cm, 50cm and 40cm were measured as "comfortable acuity" rather than conventional resolution acuity. Subjective measures comprised clarity-of-vision and ghosting at distance, intermediate and near, overall vision satisfaction and ocular comfort (1-10 numeric rating scale) and lens purchase (yes/no response). Statistical analysis included repeated measures ANOVA, paired t-tests and McNemar's test. RESULTS: Significant differences between lens types were independent of strata (p≥0.119). EDOF was significantly better than AOMF for HCVA at 40cm (0.42±0.18 vs. 0.48±0.22, p=0.024), stereopsis (98±88 vs. 141±114, p<0.001), clarity-of-vision at intermediate (8.5±1.6 vs. 7.7±1.9, p=0.006) and near (7.3±2.5 vs. 6.2±2.5, p=0.005), lack-of-ghosting (p=0.012), overall vision satisfaction (7.5±1.7 vs. 6.4±2.2, p<0.001) and ocular comfort (9.0±1.0 vs. 8.3±1.7, p=0.002). Significantly more participants chose to only-purchase EDOF (33% vs. 6%, p=0.003).). There were no significant differences between lens types for any objective measure at 6m or clarity-of-vision at distance (p≥0.356). CONCLUSIONS: EDOF provides better intermediate and near vision performance in presbyopes than AOMF with no difference for distance vision during short-term wear.
Asunto(s)
Lentes de Contacto Hidrofílicos , Percepción de Profundidad/fisiología , Presbiopía/rehabilitación , Anciano , Análisis de Varianza , Sensibilidad de Contraste/fisiología , Estudios Cruzados , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Diseño de Prótesis , Refracción Ocular/fisiología , Agudeza Visual/fisiologíaRESUMEN
PURPOSE: To compare visual acuity (VA), contrast sensitivity, stereopsis, and subjective visual performance of Acuvue® Oasys® for Presbyopia (AOP), Air Optix® Aqua Multifocal (AOMF), and Air Optix® Aqua Single Vision (AOSV) lenses in patients with presbyopia. METHODS: A single-blinded crossover trial was conducted. Twenty patients with mild presbyopia (add ≤+1.25 D) and 22 with moderate/severe presbyopia (add ≥+1.50 D) who wore lenses bilaterally for 1 h, with a minimum overnight washout period between the use of each lens. Measurements included high- and low-contrast visual acuity (HCVA and LCVA, respectively) at a distance, contrast sensitivity (CS) at a distance, HCVA at intermediate (70 cm) and near (50 cm & 40 cm) distances, stereopsis, and subjective questionnaires regarding vision clarity, ghosting, overall vision satisfaction, and comfort. The test variables were compared among the lens types using repeated-measures ANOVA. RESULTS: Distance variables (HCVA, LCVA, and CS) were significantly worse with multifocal lens than with AOSV lens (p≤0.008), except for AOMF lens in the mild presbyopia group in which no significant difference was observed (p>0.05). Multifocal lenses had significantly greater HCVA at 40 cm than AOSV lens (p≤0.026). AOMF lens had greater intermediate HCVA than AOP lens (p<0.03). AOP lens demonstrated greater improvements in stereopsis than AOMF and AOSV lens in the moderate/severe presbyopia group (p≤0.03). Few significant differences in subjective variables were observed, with no significant difference in the overall vision satisfaction observed between lens types (p>0.05). The proportions of patients willing to buy AOSV, AOMF, and AOP lenses were 20%, 40%, and 50%, respectively, in the mild presbyopia group and 14%, 32%, and 23%, respectively, in the moderate/severe presbyopia group; however, these differences were not statistically significant (p≥0.159). CONCLUSIONS: Further development of multifocal lenses is required before significant advantages of multifocal lenses over single vision lens are observed in patients with presbyopia.
Asunto(s)
Lentes de Contacto Hidrofílicos , Diseño de Equipo , Presbiopía/rehabilitación , Anciano , Sensibilidad de Contraste/fisiología , Estudios Cruzados , Percepción de Profundidad/fisiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Presbiopía/clasificación , Estudios Prospectivos , Método Simple Ciego , Encuestas y Cuestionarios , Pruebas de Visión , Agudeza Visual/fisiologíaRESUMEN
ABSTRACT Purpose: To compare visual acuity (VA), contrast sensitivity, stereopsis, and subjective visual performance of Acuvue® Oasys® for Presbyopia (AOP), Air Optix® Aqua Multifocal (AOMF), and Air Optix® Aqua Single Vision (AOSV) lenses in patients with presbyopia. Methods: A single-blinded crossover trial was conducted. Twenty patients with mild presbyopia (add ≤+1.25 D) and 22 with moderate/severe presbyopia (add ≥+1.50 D) who wore lenses bilaterally for 1 h, with a minimum overnight washout period between the use of each lens. Measurements included high- and low-contrast visual acuity (HCVA and LCVA, respectively) at a distance, contrast sensitivity (CS) at a distance, HCVA at intermediate (70 cm) and near (50 cm & 40 cm) distances, stereopsis, and subjective questionnaires regarding vision clarity, ghosting, overall vision satisfaction, and comfort. The test variables were compared among the lens types using repeated-measures ANOVA. Results: Distance variables (HCVA, LCVA, and CS) were significantly worse with multifocal lens than with AOSV lens (p≤0.008), except for AOMF lens in the mild presbyopia group in which no significant difference was observed (p>0.05). Multifocal lenses had significantly greater HCVA at 40 cm than AOSV lens (p≤0.026). AOMF lens had greater intermediate HCVA than AOP lens (p<0.03). AOP lens demonstrated greater improvements in stereopsis than AOMF and AOSV lens in the moderate/severe presbyopia group (p≤0.03). Few significant differences in subjective variables were observed, with no significant difference in the overall vision satisfaction observed between lens types (p>0.05). The proportions of patients willing to buy AOSV, AOMF, and AOP lenses were 20%, 40%, and 50%, respectively, in the mild presbyopia group and 14%, 32%, and 23%, respectively, in the moderate/severe presbyopia group; however, these differences were not statistically significant (p≥0.159). Conclusions: Further development of multifocal lenses is required before significant advantages of multifocal lenses over single vision lens are observed in patients with presbyopia.
RESUMO Objetivo: Comparar a acuidade visual, sensibilidade ao contraste, estereopsia e desempenho visual subjetivo de présbitas usando lentes de contato Acuvue Oasys para presbiopia (AOP), Air Optix Aqua Multifocal (AOMF) e Air Optix Aqua Single Vision (AOSV). Método: Foi realizado estudo mascarado simples, cruzado. Vinte pacientes com presbiopia baixa (adição ≤+1,25 D) e 22 com presbiopia média/alta (adição ≥+1,50 D) usaram cada lente bilateralmente durante 1 hora, com descanso mínimo de uma noite entre as diferentes lentes. As medições incluíram acuidade visual para distância em alto e baixo contraste (HCVA, LCVA), sensibilidade ao contraste para distância (CS), HCVA para distância intermediária (70 cm) e para perto (50 cm e 40 cm), estereopsia e questionários subjetivos sobre nitidez visual, fantasmas, satisfação visão geral e conforto. As variáveis foram comparadas entre os tipos de lentes, utilizando medidas repetidas ANOVA. Resultados: As variáveis para distância (HCVA, LCVA, CS) foram significativamente piores com as multifocais em relação a AOSV (p≤0,008), exceto para AOMF no grupo de baixa adição, que não foi significativamente diferente (p>0,05). As multifocais foram significativamente melhores do que a AOSV para HCVA em 40 cm (p≤0,026). AOMF superou AOP para HCVA intermediária (p<0,03). AOP superou AOMF e AOSV em relação à estereopsia no grupo de presbiopia médio/alto (p≤0,03). Houve poucas diferenças significativas nas variáveis subjetivas, mas a satisfação visual global não foi significativamente diferente entre as lentes (p>0,05). A disposição para comprar lentes AOSV, AOMF e AOP foi: 20%, 40%, 50%, respectivamente, no grupo de presbiopia baixa; 14%, 32%, 23% no grupo de presbiopia média/alto, mas essas diferenças não foram estatisticamente significativas (p≥0,159). Conclusões: Melhorias futuras parecem ser necessárias para produção de uma lente multifocal que forneça aos présbitas uma vantagem significativa sobre a lente de visão única.
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Presbiopía/rehabilitación , Lentes de Contacto Hidrofílicos , Diseño de Equipo , Presbiopía/clasificación , Pruebas de Visión , Sensibilidad de Contraste/fisiología , Agudeza Visual/fisiología , Método Simple Ciego , Estudios Prospectivos , Encuestas y Cuestionarios , Satisfacción del Paciente , Estudios Cruzados , Percepción de Profundidad/fisiologíaRESUMEN
PURPOSE: To compare the objective and subjective visual performance of a novel contact lens which extends depth of focus by deliberate manipulation of higher-order spherical aberrations and a commercially available zonal-refractive multifocal lens. METHODS: A prospective, cross-over, randomized, single-masked, short-term clinical trial comprising 41 presbyopes (age 45 to 70 years) wearing novel Extended Depth of Focus lenses (EDOF) and ACUVUE OAYS for Presbyopia (AOP). Each design was assessed on different days with a minimum overnight wash-out. Objective measures comprised high-contrast visual acuity (HCVA, logMAR) at 6 m, 70 cm, 50 cm, and 40 cm; low-contrast visual acuity (LCVA, logMAR) and contrast sensitivity (log units) at 6 m; and stereopsis (seconds of arc) at 40 cm. HCVA at 70 cm, 50 cm, and 40 cm were measured as "comfortable acuity" rather than conventional resolution acuity. Subjective performance was assessed on a 1-10 numeric rating scale for clarity of vision and ghosting at distance, intermediate and near, overall vision satisfaction, ocular comfort, and lens purchase. Statistical analysis included repeated measures ANOVA and paired t tests. RESULTS: HCVA, clarity of vision, and ghosting with EDOF were significantly better than AOP (p < 0.01); however, differences were dependent on testing distances and add groups. Post hoc analysis showed EDOF was significantly better than AOP for HCVA at 70 cm (0.11 ± 0.11 vs. 0.21 ± 0.16, p < 0.001), 50 cm (0.26 ± 0.17 vs. 0.36 ± 0.18, p = 0.003), 40 cm (0.42 ± 0.17 vs. 0.52 ± 0.21, p = 0.001), and LCVA at 6 m (0.22 ± 0.08 vs. 0.27 ± 0.12, p = 0.024). EDOF was significantly better than AOP for clarity of vision at distance (7.7 ± 1.6 vs. 6.8 ± 2.3, p = 0.029), intermediate (8.8 ± 1.4 vs. 7.0 ± 2.2, p < 0.001), and near (7.4 ± 2.4 vs. 5.2 ± 2.7, p < 0.001), ghosting at distance (9.1 ± 1.2 vs. 8.1 ± 2.5, p = 0.005), and overall vision satisfaction (7.6 ± 1.6 vs. 6.0 ± 2.6, p < 0.001). More participants chose to purchase EDOF compared to AOP (61 vs. 39%) and significantly more chose to only-purchase EDOF compared to only-purchase AOP (27 vs. 5%, p = 0.022). CONCLUSIONS: When compared with AOP, EDOF lenses provide better intermediate and near vision performance in presbyopic participants without compromising distance vision.