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1.
Sci Rep ; 12(1): 18644, 2022 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-36333404

RESUMO

The study is to evaluate the performance of ocular biometric measures and uncorrected visual acuity (UCVA) for detecting myopia among Chinese students. Among 5- to 18-year-old Chinese students from two cities of China, trained eye-care professionals performed assessment of ocular biometrics (axial length (AL), corneal curvature radius (CR), anterior chamber depth) under noncycloplegic conditions using NIDEK Optical Biometer AL-Scan, distance visual acuity using retro-illuminated logMAR chart with tumbling-E optotypes, and cycloplegic refractive error using NIDEK autorefractor with administration of 0.5% tropicamide. Spherical equivalent (SER) in diopters (D) was calculated as sphere plus half cylinder, and myopia was defined as SER ≤ - 0.5 D. Performances of ocular biometrics and UCVA (individually and in combination) for detecting myopia were evaluated using sensitivity and specificity, predictive values, and area under ROC curve (AUC) in both development dataset and validation dataset. Among 3436 students (mean age 9.7 years, 51% female), the mean (SD) cycloplegic SER was - 0.20 (2.18) D, and 1269 (36.9%) had myopia. Cycloplegic SER was significantly correlated with AL (Pearson Correlation coefficient r = - 0.82), AL/CR ratio (r = - 0.90), and UCVA (r = 0.79), but was not correlated with CR (r = 0.02, p = 0.15). The AL/CR ratio detected myopia with AUC 0.963 (95% CI 0.957-0.969) and combination with UCVA improved the AUC to 0.976 (95% CI 0.971-0.981). Using age-specific AL/CR cutoff (> 3.00 for age < 10 years, > 3.06 for 10-14 years, > 3.08 for ≥ 15 years) as myopia positive, the sensitivity and specificity were 87.0% (95% CI 84.4-89.6%) and 87.8% (86.0-89.6%), respectively, in the development dataset and 86.4% (95% CI 83.7-89.1%) and 89.4% (95% CI 87.3-91.4%), respectively, in the validation dataset. Combining AL/CR and UCVA (worse than 20/32 for age < 10 years, and 20/25 for ≥ 10 years) provided 91.9% (95% CI 90.4-93.4%) sensitivity and 87.0% (95% CI 85.6-88.4%) specificity, positive value of 80.6% (95% CI 78.5-82.6%) and negative value of 94.8% (95% CI 93.8-95.8%). These results suggest that AL/CR ratio is highly correlated with cycloplegic refractive error and detects myopia with high sensitivity and specificity,  AL/CR ratio alone or in combination with UCVA can be used as a tool for myopia screening or for estimating myopia prevalence in large epidemiological studies with limited resources for cycloplegic refraction.


Assuntos
Miopia , Erros de Refração , Humanos , Feminino , Criança , Pré-Escolar , Adolescente , Masculino , Midriáticos , Miopia/diagnóstico , Miopia/epidemiologia , Refração Ocular , Acuidade Visual , Biometria , Erros de Refração/diagnóstico , Córnea , Estudantes , China/epidemiologia
2.
Am J Health Behav ; 46(5): 567-575, 2022 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-36333827

RESUMO

OBJECTIVES: In this study, we compare the visual acuity levels and physical activity participation of Chinese and Japanese children. METHODS: We collected data on static visual acuity, kinetic visual acuity, axial length, intensity, frequency, duration, amount, and physical activity items of 431 children aged 6-12 years from Chinese and Japanese schools in the same city. Our analysis examined the relationships involving age, visual function indicators, ocular biometric parameters, and extracurricular physical activity. RESULTS: We found the myopia rate higher in Chinese children than in Japanese children, increasing with age except in grade 4; kinetic visual acuity in Chinese children was lower than in Japanese children (p<.01). The axial length becomes longer with age in both groups, with Chinese children having a longer axial length than Japanese children. The amount of physical activity in Chinese and Japanese children aged 6-12 years fluctuates. The frequency, duration, and physical activity items are lower in Chinese children than Japanese (p<.01). CONCLUSIONS: Chinese and Japanese children's overall static visual acuity development level shows a decreasing trend, and Japanese children have better kinetic visual acuity and physical activity participation than Chinese children. Physical activity could have an impact on visual acuity.


Assuntos
Miopia , Criança , Humanos , Japão , Acuidade Visual , Exercício Físico , China
3.
BMC Res Notes ; 15(1): 342, 2022 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-36335388

RESUMO

OBJECTIVE: As low-dose atropine eye-drops for myopia progression control prepared in-house by diluting the commercial 0.1% atropine eye-drop with sterile water or normal saline has been a common practice whereas atropine injection is readily available and could be a more feasible alternative, this study aimed to assess the properties of the in-house low-dose atropine eye-drops prepared by diluting the atropine injection in two solvents and tested in two temperature conditions. RESULTS: The 0.01% atropine eye-drops contains no bacteria, fungi, or particulate matter. The levels of atropine sulfate on all samples were comparable to the freshly prepared samples at the 12th week, regardless of the solvents used or storage conditions. The low-dose atropine eye-drops prepared from readily available atropine sulfate injection at healthcare facilities could be an alternative to commercial products.


Assuntos
Atropina , Miopia , Humanos , Soluções Oftálmicas , Solução Salina , Midriáticos , Lubrificantes , Hospitais , Solventes
4.
Zhonghua Yan Ke Za Zhi ; 58(11): 979-983, 2022 Nov 11.
Artigo em Chinês | MEDLINE | ID: mdl-36348545

RESUMO

The capsular tension ring (CTR) can stabilize the capsule, support the lax zonules, and inhibit the proliferation and migration of lens epithelial cells. Clinically, CTR is mostly used in patients with zonular weakness, which can improve the stability of intraocular lens (IOL) and reduce the incidence of posterior capsular opacity (PCO). The relatively large capsular bag volume, zonular weakness in cataract patients with high myopia may increase the instability of IOL and PCO. Therefore, many clinicians have implanted CTR in cataract patients with high myopia. In this review, we summarized the application of CTR in cataract patients with high myopia.


Assuntos
Catarata , Cápsula do Cristalino , Lentes Intraoculares , Miopia , Facoemulsificação , Humanos , Implante de Lente Intraocular , Catarata/complicações , Catarata/terapia
5.
BMC Ophthalmol ; 22(1): 451, 2022 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-36418970

RESUMO

BACKGROUND: Changes in the retina and choroid blood vessels are regularly observed in myopia. However, if the retinal glial cells, which directly contact blood vessels, play a role in mammalian myopia is unknown. We aimed to explore the potential role and mechanism of retinal glial cells in form deprived myopia. METHODS: We adapted the mice form-deprivation myopia model by covering the right eye and left the left eye open for control, measured the ocular structure with anterior segment optical coherence tomography, evaluated changes in the morphology and distribution of retinal glial cells by fluorescence staining and western blotting; we also searched the online GEO databases to obtain relative gene lists and confirmed them in the form-deprivation myopia mouse retina at mRNA and protein level. RESULTS: Compared with the open eye, the ocular axial length (3.54 ± 0.006 mm v.s. 3.48 ± 0.004 mm, p = 0.027) and vitreous chamber depth (3.07 ± 0.005 mm v.s. 2.98 ± 0.006 mm, p = 0.007) in the covered eye became longer. Both glial fibrillary acidic protein and excitatory amino acid transporters 4 elevated. There were 12 common pathways in human myopia and anoxic astrocytes. The key proteins were also highly relevant to atropine target proteins. In mice, two common pathways were found in myopia and anoxic Müller cells. Seven main genes and four key proteins were significantly changed in the mice form-deprivation myopia retinas. CONCLUSION: Retinal astrocytes and Müller cells were activated in myopia. They may response to stimuli and secretory acting factors, and might be a valid target for atropine.


Assuntos
Células Ependimogliais , Miopia , Humanos , Camundongos , Animais , Astrócitos , Neuroglia , Atropina , Retina , Modelos Animais de Doenças , Hipóxia , Mamíferos
6.
BMC Ophthalmol ; 22(1): 444, 2022 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-36401229

RESUMO

BACKGROUND: Vitrectomy and peeling of the internal limiting membrane (ILM) was an effective therapeutic approach for myopic foveoschisis with progressive visual loss. This study investigated the anatomical and visual outcomes of fovea-sparing ILM peeling with or without the inverted flap technique for patients with symptomatic myopic foveoschisis (MF). METHODS: We retrospectively reviewed the clinical data of patients with MF. Vitrectomy with fovea-sparing ILM peeling and air tamponade was performed in all patients. The primary outcome measures included best-corrected visual acuity (BCVA), mean macular thickness (MMT), and central foveal thickness (CFT). Depending on whether an inverted ILM flap technique was utilized, further subgroup comparisons between the inverted flap group and the non-inverted flap group were conducted. RESULTS: Twenty-six eyes of 22 patients were included. Fifteen eyes were underwent fovea-sparing ILM peeling without inverted ILM flap and 11 of the 26 eyes were treated with fovea-sparing ILM peeling and an inverted ILM flap technique. In the mean follow-up period of 10.74 ± 4.58 months, a significant improvement in BCVA was observed from 0.97 ± 0.45 logMAR to 0.58 ± 0.51 logMAR (P < 0.01), during which the BCVA of 20 eyes (76.92%) improved and remained stable in 5 eyes (19.23%). Moreover, a positive correlation was also found between the preoperative BCVA and the postoperative BCVA (r = 0.50, P = 0.01). At the last visit, the final MMT decreased from 492.69 ± 209.62 µm to 234.73 ± 86.09 µm, and the CFT reduced from 296.08 ± 209.22 µm to 138.31 ± 73.92 µm (all P < 0.01). A subgroup analysis found no significant differences in BCVA, MMT, or CFT between the inverted and non-inverted flap groups (all P > 0.05). CONCLUSION: Fovea-sparing ILM peeling with or without inverted flap technique resulted in favorable visual and anatomical outcomes for the treatment of MF. An important factor affecting the postoperative visual outcome was the preoperative visual acuity. Our study found no significant difference between the presence and absence of the inverted ILM flap.


Assuntos
Miopia , Perfurações Retinianas , Retinosquise , Humanos , Membrana Basal/cirurgia , Miopia/cirurgia , Perfurações Retinianas/cirurgia , Retinosquise/cirurgia , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos
7.
PLoS One ; 17(11): e0277703, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36409673

RESUMO

PURPOSE: To measure angle-to-angle (ATA) and spur-to-spur (STS) distances along six meridians using swept-source optical coherence tomography (SS-OCT) and compare with horizontal white-to-white (WTW) distance in different refractive error. METHODS: Overall, 126 eyes were assessed with the Anterion SS-OCT (Heidelberg Engineering, Heidelberg, Germany). ATA and STS distances were obtained using SS-OCT at 0, 30, 60, 90, 120, and 150 degrees. WTW was measured at 0 degree with built-in infrared camera. One way ANOVA test, pearson correlation coefficient, and stepwise multivariate regression analysis were used to compare ATA and STS distances with age, anterior chamber depth (ACD), axial length (AL), and simulated keratometric values (Sim K) in different refractive error groups. RESULTS: The mean MRSE refraction was +0.05 ± 0.23 D in the emmetropic group (41 eyes), -3.42 ± 3.04 D in the myopic group (44 eyes), and +1.33 ± 0.64 D in the hyperopic group (31 eyes). There was no statistical difference in the WTW of the emmetropic (11.62 ± 0.44 mm), myopic (11.79 ± 0.46 mm), and hyperopic groups (11.80 ± 0.49 mm) using one-way ANOVA (p = 0.007). ATA and STS were vertically oval in all groups. The correlation between ATA, STS and age, ACD, AL, and K values showed different significance for each meridian according to the refractive error. ATA increased as the horizontal WTW, ACD, and AL increased and Sim K decreased. STS shows relatively smaller explanatory power than ATA in the stepwise multivariate regression analysis. CONCLUSIONS: This study is the first to analyze the relationship between ATA and STS compared to WTW by different refractive error. The difference between the horizontally oval WTW and vertically oval anterior chamber can be large, especially in myopia. ATA showed a greater positive correlation than STS with AL and ACD.


Assuntos
Hiperopia , Miopia , Humanos , Tomografia de Coerência Óptica/métodos , Câmara Anterior/diagnóstico por imagem , Miopia/diagnóstico por imagem , Refração Ocular , Emetropia
8.
Invest Ophthalmol Vis Sci ; 63(12): 11, 2022 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-36350621

RESUMO

Purpose: We previously reported miR-328-3p as a novel risk factor for myopia through a genetic association study of the PAX6 gene. In the present study, we first explored the effects of miR-328-3p on other myopia-related genes, and then tested whether anti-miR-328-3p may be used for myopia control. Methods: The luciferase report assay and transient transfection were used to confirm miR-328-3p target genes. The chromatin immunoprecipitation (ChIP) assay was used to investigate retinoic acid receptor on the miR-328-3p promoter. Mice and pigmented rabbits were induced to have myopia by the form deprivation method, and then anti-miR-328-3p oligonucleotide was topically instilled to the myopic eyes. The axial length was measured to assess the therapeutic effect of anti-miR-328-3p. A toxicity study using much higher doses was conducted to assess the safety and ocular irritation of anti-miR-328-3p. Results: The report assay and transfection of miR-328-3p mimic confirmed that miR-328-3p dose-dependently decreased both mRNA and protein expression of fibromodulin (FMOD) and collagen1A1 (COL1A1). We subsequently showed that FMOD promoted TGF-ß1 expression, and overexpression of FMOD increased the phosphorylation levels of p38-MAPK and JNK. The ChIP study showed that retinoic acid binds to miR-328-3p promoter and up-regulates miR-328-3p expression. In myopic animal studies, anti-miR-328-3p was as effective as 1% atropine and had a dose-dependent effect on suppressing axial elongation. In the toxicity study, anti-miR-328-3p did not cause any unwanted effects in the eyes or other organs. Conclusions: Micro (mi)R-328-3p affects myopia development via multiple routes. anti-miR-328-3p possesses a potential as a novel therapy for myopia control.


Assuntos
MicroRNAs , Miopia , Camundongos , Animais , Coelhos , Antagomirs/uso terapêutico , MicroRNAs/genética , MicroRNAs/metabolismo , Miopia/genética , Miopia/tratamento farmacológico , Atropina/uso terapêutico , RNA Mensageiro , Fibromodulina
9.
J Fr Ophtalmol ; 45(10): 1177-1183, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36357250

RESUMO

PURPOSE: To investigate the relationship between levels of transforming growth factor beta (TGF-beta), matrix metalloproteinase (MMP) and tissue inhibitors of MMP (TIMP) in the aqueous humor (AH) and plasma (PL) of myopic patients. METHODS: Aqueous humor and plasma were collected intraoperatively from 37 myopic patients with various axial lengths (AL) during ICL surgery. The concentrations of TGF-ß1, TGF-ß2, TGF-ß3, MMP-1, MMP-2, MMP-7, MMP-9, MMP-10, TIMP-1, TIMP-2, TIMP-3 and TIMP-4 were measured using Luminex xMAP Technology kits (Milliplex xMAP kits). The association between TGFß and MMP/TIMP levels were analyzed based on the Spearman's correlation test or Pearson's correlation test. RESULTS: There was a negative correlation between TGF-ß1 and MMP-1, TIMP-2, TIMP-3 and TIMP-4 in the AH, and a positive correlation between TGF-ß1 and MMP-1 in the PL. In the AH, levels of TGF-ß2 were positively correlated with levels of TIMP-3 (r=0.441; P < 0.001). In the PL, levels of TGF-ß2 also correlated positively with levels of TIMP-3 (r=0.427; P < 0.001)). CONCLUSION: The level of TGF-ß2 was the highest among TGF-ßs in the AH. A consistent positive correlation between TGF-ß2 and TIMP-3 was found both in the AH and PL, indicating that systemic levels of TGF-ß2 and MMPs/TIMPs may also play a role in myopic progression.


Assuntos
Miopia , Fator de Crescimento Transformador beta2 , Humanos , Humor Aquoso , Inibidor Tecidual de Metaloproteinase-3 , Inibidor Tecidual de Metaloproteinase-2 , Fator de Crescimento Transformador beta1 , Metaloproteinase 1 da Matriz , Fatores de Crescimento Transformadores
10.
Invest Ophthalmol Vis Sci ; 63(12): 19, 2022 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-36374513

RESUMO

Purpose: The purpose of this study was to determine the prevalence of myopia among patients with primary angle closure disease (PACD) in rural China and their ocular biometric characteristics. Methods: Study subjects were recruited from the Handan Eye Study. A/B-mode scan (Cine Scan, Quantel Medical, Cedex, France) was used to measure the axial length, anterior chamber depth (ACD), and lens thickness (LT). PACD was defined as the anterior chamber angle being considered closed when 180 degrees or more of the posterior pigmented trabecular meshwork were not visible on the gonioscopy. Myopia was defined as a spherical equivalent (SE) refractive error ≤-0.5 diopter (D). Persons who did not meet PACD definition were classified as the open-angle (OA) group. Results: The overall prevalence of myopia in persons with PACD was 13.7% (11.6% in primary angle closure suspect [PACS], 21.6% in primary angle closure [PAC], 62.5% in primary angle closure glaucoma [PACG]). The age-specific prevalence of myopia in PACD eyes was 41.7% at 30 to 39 years old, 12.3% at 40 to 49 years old, 8.7% at 50 to 59 years old, 10.7% at 60 to 69 years old, and 31.7% at age 70 years and over. PACD had shorter AL (22.2 ± 0.8 vs. 22.9 ± 0.9 mm, P < 0.001), shallower ACD (2.3 ± 0.3 vs. 2.8 ± 0.4 mm, P < 0.001), and greater LT (5.0 ± 0.5 vs. 4.7 ± 0.5 mm, P < 0.001). PACD had even thicker lenses and deeper ACD with age than those with OA (all P ≤ 0.025) from 30 years to 70 years of age and over. Conclusions: Myopia was common among persons with PACD who were less than 40 years of age in this rural Chinese population, and over half of those with PACG were myopic.


Assuntos
Glaucoma de Ângulo Fechado , Miopia , Humanos , Idoso , Adulto , Pessoa de Meia-Idade , Glaucoma de Ângulo Fechado/diagnóstico , Glaucoma de Ângulo Fechado/epidemiologia , Prevalência , Gonioscopia , Biometria/métodos , Miopia/diagnóstico , Miopia/epidemiologia , China/epidemiologia , Pressão Intraocular
11.
Invest Ophthalmol Vis Sci ; 63(12): 17, 2022 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-36374515

RESUMO

Purpose: We investigated decline in the visual function of eyes with retrodots (RDs)-a subtype of cataract. Method: This study included 57 eyes with RD opacity only (mean age 72.3 ± 5.2 years) and 34 eyes with transparent lenses (mean age 71.4 ± 3.7 years). A physician diagnosed lens opacity. Using the Kanazawa Medical University Classification and Grading System, the eyes were classified into the RD-1 (37 eyes, RDs <25% of the 3-mm pupil area) and RD-2 (20 eyes, RDs ≥25% of the 3-mm pupil area) groups. Corrected distance visual acuity, contrast visual acuity, ocular refractive power, lens power, straylight, and backward light-scattering intensity and their relationship with visual function decline and optical characteristics of the eyeball were evaluated. Results: Corrected distance visual acuity was significantly lower in the RD eyes than in controls. Contrast visual acuity decreased significantly in the RD-2 eyes in all environments and in the RD-1 eyes in the evening (EVE) and EVE + glare. Straylight was significantly higher in the RD-2 eyes than in the controls and RD-1 eyes but not different between the RD-1 eyes and controls. The RD-2 eyes were significantly more myopic than the controls and RD-1 eyes. Conclusion: When the opacity of RD eyes is ≥25%, the visual acuity and contrast visual acuity decrease and straylight increases. Furthermore, myopia occurs as the refractive power of the lens increases. Moreover, visual function decline may be due to an increase in the straylight value, which is necessary for determining surgical indications.


Assuntos
Catarata , Miopia , Humanos , Idoso , Espalhamento de Radiação , Ofuscação , Acuidade Visual , Pupila
12.
Sci Rep ; 12(1): 19713, 2022 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-36385309

RESUMO

We investigated birefringence-derived scleral artifacts in optical coherence tomography (OCT) images of eyes with pathologic myopia. This study included 76 eyes of 42 patients with pathologic myopia. Five sets of OCT B-scan images of the macula were obtained using commercial swept-source OCT. A dataset of prototype swept-source polarization-diversity OCT images was used to identify polarization-dependent OCT images (i.e., complex averaging of OCT signals from two polarization channels) and polarization-independent OCT images (i.e., intensity averaging of two OCT signals). Polarization-dependent OCT images and commercial OCT images were assessed for the presence of birefringence-derived artifacts by comparison with polarization-independent OCT images. Both polarization-dependent OCT images and commercial OCT images contained scleral vessel artifacts. Scleral vessel artifacts were present in 46 of 76 eyes (60.5%) imaged by polarization-dependent OCT and 17 of 76 eyes (22.4%) imaged by commercial OCT. The proportion of images that showed scleral vessel artifacts was significantly greater among polarization-dependent OCT images than among commercial OCT images (P < 0.001). Additionally, polarization-dependent OCT images showed low-intensity band artifacts. This study demonstrated the existence of birefringence-derived scleral artifacts in commercial OCT images and indicated that polarization-diversity OCT is an effective tool to evaluate the presence of these artifacts.


Assuntos
Miopia , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Birrefringência , Artefatos , Esclera/diagnóstico por imagem , Esclera/patologia , Miopia/diagnóstico por imagem , Miopia/patologia
13.
Front Public Health ; 10: 1047116, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36388306

RESUMO

Objectives: This study aimed to explore the current status, hotspots, and emerging research trends regarding the relationship between outdoor activities and myopia. Methods: Publications on the relationship between outdoor activities and myopia from 2006 to 2021 were collected from the Web of Science Core Collection database. CiteSpace (version 6.1.R2) was used to performed a bibliometric analysis, and R software (version 4.1.0) was used to visualize the trends and hot map of publications. Results: A total of 640 publications were collected and analyzed in the present study. China was the major contributor (n = 204), followed by the United States of America (n = 181) and Australia (n = 137). The United States of America had the most extensive foreign cooperation (centrality = 0.25), followed by Australia (centrality = 0.20). The National University of Singapore contributed the largest number of publications (n = 48), followed by Sun Yat-Sen University (n = 41) and the Australian National University (n = 41). Among institutions, Cardiff University in the United Kingdom had the most extensive foreign cooperation (centrality = 0.12), followed by the National University of Singapore (centrality = 0.11). Saw S from Singapore had the largest number of publications (n = 39), followed by Morgan I from Australia (n = 27) and Jonas J from Germany (n = 23). Investigative ophthalmology & visual science is the most important journal to study the relationship between outdoor activities and myopia. "Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050" published by Holden BA was the most cited paper in this field with 177 citations. Co-occurrence and burst analyses of keywords showed that research trends and hotspots in this field focused mainly on "risk," "prevention" and "school". Conclusions: The influence of outdoor activities on myopia remains a concern. In the future, deeper cooperation between countries or institutions is required to explore the effects of outdoor activities on myopia. Outdoor activities for the prevention of myopia and reduction of the risk of myopia among school students may be the focus of future research.


Assuntos
Bibliometria , Miopia , Humanos , Estados Unidos/epidemiologia , Austrália/epidemiologia , Publicações , Bases de Dados Factuais , Miopia/epidemiologia
14.
PLoS Genet ; 18(11): e1010478, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36395078

RESUMO

Myopia most often develops during school age, with the highest incidence in countries with intensive education systems. Interactions between genetic variants and educational exposure are hypothesized to confer susceptibility to myopia, but few such interactions have been identified. Here, we aimed to identify genetic variants that interact with education level to confer susceptibility to myopia. Two groups of unrelated participants of European ancestry from UK Biobank were studied. A 'Stage-I' sample of 88,334 participants whose refractive error (avMSE) was measured by autorefraction and a 'Stage-II' sample of 252,838 participants who self-reported their age-of-onset of spectacle wear (AOSW) but who did not undergo autorefraction. Genetic variants were prioritized via a 2-step screening process in the Stage-I sample: Step 1 was a genome-wide association study for avMSE; Step 2 was a variance heterogeneity analysis for avMSE. Genotype-by-education interaction tests were performed in the Stage-II sample, with University education coded as a binary exposure. On average, participants were 58 years-old and left full-time education when they were 18 years-old; 35% reported University level education. The 2-step screening strategy in the Stage-I sample prioritized 25 genetic variants (GWAS P < 1e-04; variance heterogeneity P < 5e-05). In the Stage-II sample, 19 of the 25 (76%) genetic variants demonstrated evidence of variance heterogeneity, suggesting the majority were true positives. Five genetic variants located near GJD2, RBFOX1, LAMA2, KCNQ5 and LRRC4C had evidence of a genotype-by-education interaction in the Stage-II sample (P < 0.002) and consistent evidence of a genotype-by-education interaction in the Stage-I sample. For all 5 variants, University-level education was associated with an increased effect of the risk allele. In this cohort, additional years of education were associated with an enhanced effect of genetic variants that have roles including axon guidance and the development of neuronal synapses and neural circuits.


Assuntos
Miopia , Erros de Refração , Humanos , Pessoa de Meia-Idade , Adolescente , Estudo de Associação Genômica Ampla , Miopia/genética , Escolaridade , Erros de Refração/genética , Alelos , Fatores de Processamento de RNA/genética
15.
J Refract Surg ; 38(11): 725-732, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36367263

RESUMO

PURPOSE: To study the objective change in light disturbance around a glare source using the Light Disturbance Analyzer (LDA) (Binarytarget Lda) and correlate this with the validated subjective quality of vision (QoV) questionnaire in small incision lenticule extraction (SMILE) for high compound myopic astigmatism. METHODS: This was a prospective study recruiting 114 patients undergoing SMILE with attempted spherical equivalent refraction (SEQ) correction from -9.00 to -13.00 diopters (D), and cylinder up to 5.00 D. The LDA was used before and 3 and 12 months after surgery to evaluate the Light Disturbance Area, Light Disturbance Index, Best Fit Circle Radius, and Best Fit Circle Irregularity. Patients completed the Rasch-validated QoV questionnaire before and 12 months after surgery. Correlation analysis was performed between the LDA parameters and the QoV frequency, severity, and bothersomeness for halos and starbursts. RESULTS: At 12 months, there was a non-statistically signifcant change of 11.9% for Light Disturbance Area and Light Disturbance Index and 6.5% for Best Fit Circle Radius. There was an increase of 81.9% for Best Fit Circle Irregularity (P = .017). Light Disturbance Area, Light Disturbance Index, and Best Fit Circle Radius correlated with bothersomeness for QoV halos, and with frequency, severity and bothersomeness for QoV star-bursts (P < .05), albeit with a low correlation coefficient (R2 < 0.13). There was no correlation between increase in Best Fit Circle Irregularity and the halo and starburst scores from the QoV questionnaire. CONCLUSIONS: LDA Best Fit Circle Irregularity was found to increase following high myopic SMILE. Other LDA parameters appeared to increase, but a much larger sample would be required to find statistical significance. The change in LDA parameters was only weakly correlated with QoV halo and starburst metrics, representing the wide variation in inter-subject perception. [J Refract Surg. 2022;38(11):725-732.].


Assuntos
Astigmatismo , Cirurgia da Córnea a Laser , Miopia , Humanos , Astigmatismo/cirurgia , Estudos Prospectivos , Substância Própria/cirurgia , Acuidade Visual , Miopia/cirurgia , Refração Ocular , Lasers de Excimer/uso terapêutico , Resultado do Tratamento
16.
J Refract Surg ; 38(11): 708-715, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36367258

RESUMO

PURPOSE: To investigate changes in corneal curvature in different zones of the posterior corneal surface during a 6-month follow-up period after transepithelial photorefractive keratectomy (tPRK), femtosecond laser-assisted excimer laser in situ keratomileusis (FS-LASIK), and small incision lenticule extraction (SMILE). METHODS: The study included a total of 202 eyes, including 65, 77, and 60 that underwent tPRK, FS-LASIK, and SMILE, respectively. Elevation data for the posterior surface were obtained preoperatively (pre), as well as 1 week (pos1w), 1 month (pos1m), 3 months (pos3m), and 6 months (pos6m) postoperatively. Changes in posterior corneal curvature (M) were analyzed in the central (diameter: 0 to 3 mm), paracentral (diameter: 3 to 6 mm), and peripheral (diameter: 6 to 9 mm) regions. RESULTS: Over all follow-up periods, the central region of the posterior surface in all patients became flatter (P < .05), with FS-LASIK showing the largest change, whereas the paracentral and peripheral regions became steeper. The posterior curvature changes between pre and pos6m, determined before and after correction for ablated stromal depth, tended to follow similar trends in the three regions and after the three surgeries. There was also no significant correlation (P > .05) between the changes in the mean curvature (M, recorded between pre and pos6m) and each of the refractive error corrections, the changes in spherical aberration postoperatively, the optical zone diameter, ablated stromal depth, and residual stromal bed thickness in the central and peripheral regions, but the correlation was significant in the paracentral region. CONCLUSIONS: The postoperative changes in posterior corneal shape followed different trends in the central, paracentral, and peripheral regions. The FS-LASIK group exhibited the most notable changes in posterior corneal curvature, especially in the central region. These changes were statistically correlated with variations in spherical aberration, and ablated and residential stromal thickness in the paracentral region. [J Refract Surg. 2022;38(11):708-715.].


Assuntos
Aberrações de Frente de Onda da Córnea , Ceratomileuse Assistida por Excimer Laser In Situ , Miopia , Ceratectomia Fotorrefrativa , Ferida Cirúrgica , Humanos , Seguimentos , Miopia/cirurgia , Substância Própria/cirurgia , Acuidade Visual , Lasers de Excimer/uso terapêutico , Aberrações de Frente de Onda da Córnea/cirurgia
17.
J Refract Surg ; 38(11): 733-740, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36367261

RESUMO

PURPOSE: To evaluate the safety, efficacy, and predictability of photorefractive keratectomy (PRK) at least 4 years after primary laser in situ keratomileusis (LASIK) and compare it to the United States Food and Drug Administration (FDA) criteria. METHODS: This retrospective, single-site study compared patients who underwent PRK enhancement from 2014 to 2019 after primary LASIK to those who only underwent primary LASIK without re-treatment from the same time period. Patient demographics and clinical information were compared between the two groups. Visual outcomes and postoperative complications were evaluated in the enhancement group. RESULTS: A total of 374 eyes with PRK enhancement were compared to 472 without re-treatment. Age, sex, surgical eye, and preoperative sphere, and spherical equivalent (SE) were significantly different between the enhancement and control groups (P < .05). At 12 months post-enhancement, 67% had uncorrected distance visual acuity (UDVA) of 20/20 or better, 98% had UDVA of 20/40 or better, and 0.4% of eyes lost at least two lines of corrected distance visual acuity (CDVA). A total of 83% and 98% of eyes were within ±0.50 and ±1.00 diopters of the target, respectively. Post-enhancement complications (n = 66) included dryness (6.1%), epithelial ingrowth (2.7%), and haze (2.7%). CONCLUSIONS: Older age at the time of the primary LASIK, female sex, right surgical eye, and more myopic sphere and SE were risk factors for enhancement. Although PRK enhancements are considered off-label procedures, they produce favorable outcomes at 3 and 12 months postoperatively while meeting FDA benchmarks for safety, efficacy, and predictability. [J Refract Surg. 2022;38(11):733-740.].


Assuntos
Ceratomileuse Assistida por Excimer Laser In Situ , Miopia , Ceratectomia Fotorrefrativa , Humanos , Feminino , Ceratectomia Fotorrefrativa/métodos , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Lasers de Excimer/uso terapêutico , Estudos Retrospectivos , Miopia/cirurgia , Miopia/etiologia , Refração Ocular , Resultado do Tratamento
18.
J Refract Surg ; 38(11): 698-707, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36367259

RESUMO

PURPOSE: To compare two aspheric ablation profiles in myopic refractive surgery using different asphericity targets. METHODS: Patients underwent laser in situ keratomileusis (LASIK) with the WaveLight EX500 laser platform (Alcon, WaveLight Laser Technologie). Asymmetric surgery was performed, programming the wavefront-optimized (WFO) ablation profile in one eye and the custom-Q (CQ) profile in the contralateral eye. The patients were divided into two groups following a systematic randomization method. The Q-target programmed for the preoperative Q group was equal to the preoperative asphericity of the CQ profile, and for the -0.6 Q-target group, the Q-target was set to -0.6. RESULTS: The study included 100 patients (200 eyes). Both groups had comparable safety and efficacy indexes greater than 1. A similar oblate shift in postoperative asphericity was seen in both groups regardless of the ablation profile and programmed Q-target. Asphericity was 0.33 ± 0.34 and 0.35 ± 0.29 (P = .18) in the preoperative Q group and 0.26 ± 0.28 and 0.26 ± 0.27 (P = .89) in the -0.6 Q-target group for WFO and CQ, respectively. A lower spherical aberration was found with CQ compared to WFO when the Q-target was set to -0.6: 0.211 ± 0.121 versus 0.144 ± 0.114 (P < .01). However, no statistically significant differences were found when the preoperative Q-target was used. CONCLUSIONS: WFO and CQ treatments are similar in terms of refractive and visual outcomes. CQ offers greater control over the increase in positive spherical aberration after myopic refractive surgery, but it does not represent an advantage over WFO in the oblate shift in postoperative asphericity regardless of the Q-target programmed. [J Refract Surg. 2022;38(11):698-707.].


Assuntos
Ceratomileuse Assistida por Excimer Laser In Situ , Miopia , Humanos , Lasers de Excimer/uso terapêutico , Acuidade Visual , Miopia/cirurgia , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Refração Ocular , Resultado do Tratamento
19.
BMC Ophthalmol ; 22(1): 429, 2022 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-36357865

RESUMO

BACKGROUND: This study investigated the early outcomes of anterior segment parameters after implanting an implantable collamer lens with a central hole (ICL V4c) in patients with myopia and determined the earliest follow-up time for detecting potential complications. METHODS: Sixty-two patients were included, and the following parameters were measured at baseline (preoperative), 1 day, 1 week, and 1, 3, and 6 months after the operation: intraocular pressure (IOP), endothelial cell density (ECD), central anterior chamber depth (CACD), anterior chamber volume (ACV), nasal and temporal anterior chamber angle (n-ACA and t-ACA), horizontal corneal diameter (white-to-white, WTW), and axial length (AL). The vault was measured at each post-operative timepoint. RESULTS: The postoperative IOP and ECD at the 6 months were both statistically similar to the baseline. The post-operative CACD and ACV were significantly less at all timepoints compared with the baseline (P < 0.001) and stayed stable from 1 day and 1 month after the operation, respectively. Postoperative n-ACA and t-ACA decreased significantly at 1 day and 1 week compared with the baseline (P < 0.001), while tended to stabilization at 1, 3, and 6 months. The vault kept decreasing significantly at 1 day, 1 week, and 1 month, but stayed stable at 3 and 6 months. The postoperative n-ACA and t-ACA positively correlated with the baseline ACA, CACD, and ACV. CONCLUSIONS: The anterior chamber parameters tended to stabilization early after the operation. Thus, it is essential to evaluate patients' anterior segment status at earlier timepoints and prevent complications with prompt and non-invasive intervention.


Assuntos
Miopia , Lentes Intraoculares Fácicas , Humanos , Implante de Lente Intraocular , Acuidade Visual , Miopia/cirurgia , Miopia/diagnóstico , Câmara Anterior
20.
BMC Public Health ; 22(1): 2058, 2022 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-36357862

RESUMO

BACKGROUND: To investigate environmental and social risk factors for myopia in children and adolescents in Germany. METHODS: 1437 children aged between 3 and 18 inclusive were examined as part of the LIFE Child study based in Leipzig, Germany. Information about leisure time activities and social status was ascertained by parents and children in a questionnaire. Refractive status was attained by measuring noncycloplegic autorefraction. Myopia was defined as spherical equivalent (SE) ≤ - 0.75 D. Risk factors were identified using multiple logistic regression analysis. RESULTS: In multiple logistic regression analysis, myopia was significantly associated with less frequent outdoor activity ("once a week" vs. "twice a week or more": odds ratio (OR) 4.35, 95% confidence interval (CI) 1.89-9.98, p<0.01) and longer near work sessions (1-2 h vs. < 1 h: OR 1.83, CI 1.10-3.04, p=0.02; > 3 h vs. < 1 h: OR 3.71, CI 1.43-9.61, p<0.01) after adjustment for age, sex and socioeconomic status (SES). Duration of outdoor activity, near work frequency and SES showed no significant association with myopia (p > 0.05). Children with a lower SES were involved in longer periods of outdoor and near work activities but on fewer occasions over the course of the week, although this connection was not significant. CONCLUSION: Myopia is associated with environmental factors. The present findings suggest that daily exposure to sunlight and a restriction of long-duration near work activities might protect against pathological eye growth. Prevention strategies should be implemented for children at all ages.


Assuntos
Miopia , Criança , Adolescente , Humanos , Pré-Escolar , Miopia/epidemiologia , Miopia/etiologia , Refração Ocular , Atividades de Lazer , Testes Visuais/efeitos adversos , Inquéritos e Questionários , Fatores de Risco , Classe Social
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