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Abstract Background To generate and validate a method to estimate axial length estimated (ALest) from spherical equivalent (SE) and corneal curvature [keratometry (K)], and to determine if this ALest can replace actual axial length (ALact) for correcting transverse magnification error in optical coherence tomography angiography (OCTA) images using the Littmann-Bennett formula. Methods Data from 1301 participants of the Raine Study Gen2-20 year follow-up were divided into two datasets to generate (n = 650) and validate (n = 651) a relationship between AL, SE, and K. The developed formula was then applied to a separate dataset of 46 participants with AL, SE, and K measurements and OCTA images to estimate and compare the performance of ALest against ALact in correcting transverse magnification error in OCTA images when measuring the foveal avascular zone area (FAZA). Results The formula for ALest yielded the equation: ALest = 2.102K − 0.4125SE + 7.268, R2 = 0.794. There was good agreement between ALest and ALact for both study cohorts. The mean difference [standard deviation (SD)] between FAZA corrected with ALest and ALact was 0.002 (0.015) mm2 with the 95% limits of agreement (LoA) of − 0.027 to 0.031 mm2. In comparison, mean difference (SD) between FAZA uncorrected and corrected with ALact was − 0.005 (0.030) mm2, with 95% LoA of − 0.064 to 0.054 mm2. Conclusions ALact is more accurate than ALest and hence should be used preferentially in magnification error correction in the clinical setting. FAZA corrected with ALest is comparable to FAZA corrected with ALact, while FAZA measurements using images corrected with ALest have a greater accuracy than measurements on uncorrected images. Hence, in the absence of ALact, clinicians should use ALest to correct for magnification error as this provides for more accurate measurements of fundus parameters than uncorrected images.

AIM: To investigate the effect of 0.01% atropine sulphate eye gel on myopia progression and axial elongation in a 6-month treatment in children. METHODS: Totally 185 children aged 6-12y with binocular myopia of 3.0 D or less in both eyes were enrolled in this prospective cohort study. The atropine group (n=125) received one drop of 0.01% atropine sulphate eye gel in each eye before bedtime daily. The control group included 60 matched children without drug intervention during the same period. The spherical equivalent and axial length was recorded at baseline and the sixth month of treatment. The efficacy was evaluated by the change of the spherical equivalent and axial length. Adverse events were also recorded. RESULTS: The average spherical equivalent and axial length at baseline were not statistically significant between the atropine group (-1.64±0.80 D, 24.13±0.76 mm) and the control group (-1.59±0.94 D, 24.06±0.77 mm, P>0.05). After 6mo, there was significantly difference in the spherical equivalent progression between the atropine and the control group (-0.27±0.33 vs -0.60±0.35 D, P

Jasenka Petrovic Jurcevic,1 Marko Jurcevic,2 Mateja Jagic,3 Anamarija Jazbec,4 Kresimir Mandic,5 Jelena Juri Mandic5 1Medical School University of Zagreb, PhD Candidate on the Programme “Biomedicine and Health”, Zagreb, Croatia; 2University of Zagreb Faculty of Electrical Engineering and Computing, Department of Electrical Engineering Fundamentals and Measurements, Zagreb, Croatia; 3Special Hospital „Svjetlost“, Department of Refractive Surgery, Zagreb, Croatia; 4University of Zagreb Faculty of Forestry and Wood Technology, Department for Forest Inventory and Management, Zagreb, HR-10000, Croatia; 5Clinical Department of Ophthalmology, University Hospital Center Zagreb, Zagreb, CroatiaCorrespondence: Jasenka Petrovic Jurcevic, Medical School University of Zagreb, Šalata 4a, Zagreb, Croatia, Email jpetrovic@mef.hrPurpose: Clinical experience regarding the fluctuations of the refractive error of the eye during the different stages of Graves’ ophthalmopathy observed through outpatient clinic frequent check-ups points towards an underestimated and often overlooked problem. Published data about it are sparse. The clinical manifestations of Graves’ ophthalmopathy can be understood from the perspective of “compartment syndrome” and literature implies how such changes can affect the refractive error and consequently, the visual acuity. The purpose of the study was to explore how the clinical activity score of Graves’ ophthalmopathy affects refractive error and visual acuity.Patients and Methods: The study was prospective and observational, including 60 eyes of 30 patients with clinically active Graves’ ophthalmopathy. All the patients were monitored and evaluated over a period of 36 months by the clinical activity score, spherical equivalent and visual acuity. All the observed parameters were statistically analyzed.Results: The mean values of spherical equivalent and visual acuity throughout the observed period showed continuous fluctuation. Repeated measure analysis of variance showed statistically significant differences in visual acuity and spherical equivalent over the observed period. There was a statistically significant positive correlation between visual acuity and clinical activity score. The correlation between spherical equivalent and clinical activity score was also positive but not statistically significant.Conclusion: A decrease in the clinical activity score is either the result of a spontaneously resolving course of Graves’ ophthalmopathy or a consequence of treatment, so lowering in fluctuation of refractive error and improved visual acuity may be associated with a reduction in orbital inflammation.Keywords: Graves’ ophthalmopathy, clinical activity score, refractive error, spherical equivalent, visual acuity

This study aimed to investigate changes in non-cycloplegic ocular biometrics during the initial six months of treatment with a 0.1% atropine loading dose and 0.01% atropine compared with a placebo and analyze their contribution to the treatment effect on cycloplegic spherical equivalent (SE) progression. The study was based on a randomized, double-masked, placebo-controlled, multicenter trial evaluating a 0.1% atropine six-month loading dose and 0.01% atropine in reducing myopic progression in Danish children. The treatment phase was 24 months, and the washout phase was 12 months. Parameters measured included changes in axial length (AL), anterior chamber depth (ACD), lens thickness (LT), vitreous chamber depth (VCD), and choroidal thickness (ChT), while cycloplegic SE and lens power were calculated. Longitudinal changes and contributions to treatment effects were analyzed using constrained linear mixed models and mediation analyses, respectively. After six months, AL was 0.13 mm shorter (95% confidence interval [CI], −0.18 to −0.07 [adjusted p < 0.001]) and 0.06 mm shorter (95% CI, −0.11 to −0.01 [adjusted p = 0.060]) with a 0.1% atropine loading dose and 0.01% atropine, respectively, compared to the placebo group. Similar concentration-dependent changes were found with ACD, LT, VCD, ChT, and cycloplegic SE. Although the treatment effects trended toward concentration-dependent responses, only the treatment effect mediated by AL at three months differed significantly between 0.01% atropine and a 0.1% atropine loading dose (adjusted p = 0.023). Several ocular biometrics, including AL, ACD, and LT, changed dose-dependently during low-dose atropine treatment. Moreover, the treatment effect of atropine on SE progression was mediated by a subset of ocular biometrics, mainly AL, with trends toward concentration dependency and distributional shifts over time. [ABSTRACT FROM AUTHOR]

The effect and safety of low-dose atropine in myopia control have not been studied in randomized, placebo-controlled trials outside Asia. We investigated the efficacy and safety of 0.1% atropine loading dose and 0.01% atropine compared with a placebo in a European population. Investigator-initiated, randomized, double-masked, placebo-controlled, equal-allocation, multicenter study comparing 0.1% atropine loading dose (six months) followed by 0.01% atropine (18 months), 0.01% atropine (24 months), and placebo (24 months). Participants were monitored for a 12-months washout period. Outcome measures were axial length (AL), cycloplegic spherical equivalent (SE), photopic and mesopic pupil size, accommodation amplitude, visual acuity, intraocular pressure (IOP), and adverse reactions and events. We randomized 97 participants (mean [standard deviation] age, 9.4 [1.7] years; 55 girls (57%) and 42 boys (43%)). After six months, AL was 0.13 mm shorter (95% confidence interval [CI], −0.18 to −0.07 [adjusted p < 0.001]) with 0.1% atropine loading dose and 0.06 mm shorter (95% CI, −0.11 to −0.01 [adjusted p = 0.06]) with 0.01% atropine than in the placebo group. We observed similar dose-dependent changes in SE, pupil size, accommodation amplitude, and adverse reactions. No significant differences in visual acuity or IOP were found between groups, and no serious adverse reactions were reported. We found a dose-dependent effect of low-dose atropine in European children without adverse reactions requiring photochromatic or progressive spectacles. Our results are comparable to those observed in East Asia, indicating that results on myopia control with low-dose atropine are generalizable across populations with different racial backgrounds. [ABSTRACT FROM AUTHOR]

Introduction: Myopia has a multifactorial aetiology, involving interplay between environmental, genetic and behavioural factors. In today's times of digitalisation, young people are now more exposed to digital devices, which is another possible risk factor for myopia. Aim: To determine the effect of mobile and laptop overuse on progression of myopia in young people at three time points of six months interval. Materials and Methods: This prospective observational study was conducted in the Department of Ophthalmology, Shyam Shah Medical College and associated Gandhi Memorial Hospital, Rewa, Madhya Pradesh, India, from of January 2019 to September 2020. A total of 400 eyes of 200 myopic patients were included. All the eyes were categorised into three groups based upon degree of myopia at the time of presentation. Cycloplegic autorefraction followed by subjective refinement of refraction was done and Spherical Equivalent (SE) was calculated in time 1, time 2 and time 3. Progression of myopia was calculated as increase in myopic refraction of subject's eye between time 1 and time 3. Questionnaire survey about amount of time spent on mobile and laptop and their working distance was done. Then task-specificdiopter-hours per day were calculated. Multivariate analysis was done to estimate the adjusted odds ratio for mobile and laptop use associated with myopia progression. Results: The present study was conducted on 200 patients having varying degree of myopia. Mean age of patients with low, moderate and high myopia was 18.62±3.18, 17.65±3.59 and 17.49±3.91 years, respectively. The male to female ratio was 1.04:1. This study documents task specific mobile and laptop diopter hours per day was significantly higher in eyes with progression as compared to no progression in low, moderate as well as in high myopes (p-value<0.05). Conclusion: In the present study, risk of progression of myopia was significantly higher in patients engaged for longer duration on mobile and laptop and at near distance. Thus, this study concludes that overuse of electronic gadgets has a significant adverse impact on myopia progression in young people. [ABSTRACT FROM AUTHOR]

Objective To explore the relationship of aniseikonia with differences of diopter and axial length in myopia patients, and the possible factors causing aniseikonia. Methods A total of 322 myopia patients (4~40 years old) were selected from May to August, 2021, who underwent optometry in the Ophthalmology Outpatient Department of the Affiliated Hospital of North Sichuan Medical College. ARK-510A autorefractor and Dk-700 optometry system were used for optometry. IOL-Master 700 was used for the measurement of axial length. Aniseikonia were evaluated by binocular aniseikonia test. Gender, age, diopter (sphericity, cylindricity and spherical equivalent), axial length and range of aniseikonia were recorded. Spearman test, chi-square test and multiple linear regression were used to analyze the aniseikonia with the differences of diopter and axial length. At the same time, receiver operating characteristic (ROC) curve of the differences of diopter and axial length was drawn for aniseikonia. Results A total of 322 patients (159 males and 163 females) were included, at an age of (17.77±7.69) years, and the overall prevalence rate of aniseikonia was 15.22% (49 cases). In univariate analysis, the absolute values of all parameter were included in the analysis, the differences of sphericity (r=0.449, P < 0.001), cylindricity (r=0.596, P < 0.001), spherical equivalent (r=0.479, P < 0.001) and axial length (r=0.417, P < 0.001) were all positively correlated with range of aniseikonia. Multivariate analysis indicated that the difference between cylindricity and spherical equivalent showed greater effect on the range of aniseikonia, and the regression equation was Y=0.009-0.626X1 (cylindrical difference)-0.22 X2 (spherical equivalent difference)(F=159.17, P < 0.001, adjusted R2=0.496). In the analysis of risk factors, when the difference of sphericity was more than -2.00 D, and that of cylindricity and spherical equivalent was more than -1.00 D, the risk of aniseikonia was increased. In the diagnostic analysis, the difference of cylindricity (AUC=0.778; 95%CI: 0.69~0.87; P < 0.001; sensitivity: 53.06%, specificity: 99.63%) had the highest value in the diagnosis of aniseikonia. Conclusion Anisometropia does not necessarily lead to aniseikonia. The difference between cylindricity and spherical equivalent is the key factor for aniseikonia, and great attention should be paid in clinical diagnosis and treatment.

AIM: To observe the epidemiological characteristics of myopia among primary school students in Xindu District of Chengdu before and after COVID-19 home isolation period(from Jan.-May 2020).METHODS:Cross-sectional study. A total of 10 153 primary school students from grade 1-6(age 6-13, three classes per grade)were selected from four primary schools in Xindu District of Chengdu for three consecutive years(2018-2020), by using a random stratified cluster sampling method. All students' visual acuity and spherical equivalent refraction(SE)were measured, a further cycloplegia optometry was conducted for those whose visual acuity was less than 5.0. The SE was recorded and the prevalence of myopia was calculated. Chi-square test was used to compare the difference of prevalence of myopia between different years. One-way Anova was used to compare the difference of SE among different years.RESULTS: There was statistical difference in prevalence of myopia between the three years(2018: 35.98%, 2019: 36.29%, 2020: 42.52%; χ2=39.374, P0.05).CONCLUSION: After the COVID-19 home isolation period, there was a significant myopic shift among students aged 6-9 years old. We should pay more attention to the window period for myopia prevention and control of 6-9 years old.

Introduction: Myopia has a multifactorial aetiology, involving interplay between environmental, genetic and behavioural factors. In today’s times of digitalisation, young people are now more exposed to digital devices, which is another possible risk factor for myopia. Aim: To determine the effect of mobile and laptop overuse on progression of myopia in young people at three time points of six months interval. Materials and Methods: This prospective observational study was conducted in the Department of Ophthalmology, Shyam Shah Medical College and associated Gandhi Memorial Hospital, Rewa, Madhya Pradesh, India, from of January 2019 to September 2020. A total of 400 eyes of 200 myopic patients were included. All the eyes were categorised into three groups based upon degree of myopia at the time of presentation. Cycloplegic autorefraction followed by subjective refinement of refraction was done and Spherical Equivalent (SE) was calculated in time 1, time 2 and time 3. Progression of myopia was calculated as increase in myopic refraction of subject’s eye between time 1 and time 3. Questionnaire survey about amount of time spent on mobile and laptop and their working distance was done. Then task-specific-diopter-hours per day were calculated. Multivariate analysis was done to estimate the adjusted odds ratio for mobile and laptop use associated with myopia progression. Results: The present study was conducted on 200 patients having varying degree of myopia. Mean age of patients with low, moderate and high myopia was 18.62±3.18, 17.65±3.59 and 17.49±3.91 years, respectively. The male to female ratio was 1.04:1. This study documents task specific mobile and laptop diopter hours per day was significantly higher in eyes with progression as compared to no progression in low, moderate as well as in high myopes (p-value

PurposeWe performed this study to determine the relationship between serum vitamin D levels and refractive status in adolescents aged 12–19 years.MethodsCross-sectional study using the National Health and Nutrition Examination Survey (NHANES) database from 2001 to 2006. We used weighted multivariate linear regression models to assess the association between serum vitamin levels and adolescent refractive status and then built a smooth curve fitting to investigate their internal non-linear relationships. Finally, subgroup analysis was performed according to gender, and the threshold effect of serum vitamin D levels on spherical equivalent degree was analyzed using a two-piecewise linear regression model.ResultA total of 5,901 adolescents aged 12 to 19 years were included in this study. After adjusting for all confounding factors, the multiple linear regression model showed no significant correlation between adolescent spherical equivalent degree and serum vitamin D [0.0019 (−0.0018, 0.0046)]. However, smooth curve fitting analysis showed an inverted U-shaped curve relationship between spherical equivalent degree and serum vitamin D levels in adolescents (turning point: 58.1 nmol/L). In analyses by gender subgroup, this inverted U-shaped relationship was found to be more pronounced in female adolescents (turning point: 61.6 nmol/L).ConclusionOur results suggest that the correlation between refractive status and serum vitamin D in adolescents differs by gender. When serum vitamin D concentrations were

Purpose: Myopia is the most common type of refractive error and the leading cause of functional visual loss. Increased risk of myopic maculopathy, retinal detachment, glaucoma and cataract has been seen with a myopia of as low as -1D. This study was done to determine the effect of atropine 0.01% eye drops on the progression of myopia in children >5 years.Methods: This was a single-blind, prospective, randomized case-control study which included children of 5-15 years with myopia of >2D and were divided into treatment group (group 1) and placebo group (group 2). Children under treatment group were treated with application of 0.01% atropine at night. Children with history of any ocular surgery, chronic ophthalmic illness, squint and amblyopia were excluded from the study. The follow-up for myopia progression was done for two years.Results: This study showed a significant difference in increase of spherical equivalent and axial length among treatment and placebo groups after a duration of two years. Total duration of follow up was twenty-four months. Mean increase in axial length of group 1 and 2 was 0.115 mm and 0.32 mm, respectively. Mean increase in refraction of groups 1 and 2 was -0.30 D and -0.88 D, respectively, showing significant change in axial length and refraction (P < 0.0001).Conclusion: This study supports the use of atropine 0.01% eye drops in reducing the progression of myopia. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the correlations of spherical equivalent (SE), axial length (AL), and AL to corneal curvature radius ratio (AL/CR) with anterior segment biometrics in candidates for myopic refractive surgery., Methods: Anterior segment biometrics of 2,478 myopic refractive surgery candidates measured by Pentacam were collected retrospectively. The anterior segment biometrics included anterior corneal curvature (ACC), posterior corneal curvature (PCC), white-to-white corneal diameter (WTW), central corneal thickness (CCT), corneal volume at 3mm (CV), anterior corneal astigmatism (ACA), posterior corneal astigmatism (PCA), anterior corneal eccentricity (ACE), posterior corneal eccentricity (PCE), anterior corneal asphericity (ACAP), posterior corneal asphericity (PCAP), anterior chamber depth (ACD), and anterior chamber volume (ACV). The eyes were divided into four groups according to the AL: group 1, AL≤24mm; group 2, 24mm

Purpose: To investigate the differences in corneal biomechanical parameter stress–strain index (SSI) among different degrees of myopic eyes in Chinese individuals and to analyze the relevant factors of the SSI.Methods: This study analyzed the right eyes of 240 participants (240 eyes) aged 18–34 years. The participants were divided into low-, moderate-, high-, and ultra-high myopia groups according to their spherical equivalent (SE), with 60 eyes included in each group. Spherical, cylinder, and SE were measured via automatically integrated optometry. Intraocular pressure (IOP) was measured using a non-contact tonometer. AL was measured using an IOLMaster device. Corneal curvature and central corneal thickness (CCT) were measured using a Pentacam. SSI and biomechanical corrected IOP (bIOP) were measured via corneal visualization Scheimpflug technology (Corvis ST). The statistical analyses included one-sample Kolmogorov–Smirnov tests and normal distribution histogram methods, Levene variance homogeneity tests, Pearson’s correlation analyses, multiple linear stepwise regression analyses, one-way ANOVA, and LSD t-tests.Results: The mean (±SD) age of the 240 participants was (24.97 ± 4.16) years. The SSI was positively correlated with spherical, cylinder, SE, CCT, IOP, and bIOP and negatively correlated with K1 and AL (r = 0.475, 0.371, 0.497, 0.169, 0.291, 0.144, −0.154, and −0.464, respectively; all p < 0.05), but were not correlated with age, K2, or Km (all p > 0.05). Multiple linear regression analysis performed with SSI as the dependent variable, and spherical, cylinder, K1, CCT, and IOP as independent variables produced the following regression equation: SSI = 0.989 + 0.017 spherical + 0.042 cylinder +0.018 IOP (R2 = 0.402, F = 31.518, p < 0.001). The SSI values in the low-, moderate-, high-, and ultra-high myopia groups were 0.945 ± 0.135, 0.940 ± 0.128, 0.874 ± 0.110, and 0.771 ± 0.104, respectively. The values decreased sequentially, and the differences between pairs were statistically significant (all p < 0.05), except for that between the low- and moderate-myopia groups (p > 0.05).Conclusion: SSI decreased with increasing myopia and astigmatism in the Chinese participants. The SSI was significantly lower in high and ultra-high myopia, especially ultra-high myopia. These findings indicate that increased corneal elasticity may be related to the pathogenesis of high and ultra-high myopia.

ObjectivesThe aim of this study was to assess the association between axial length/corneal radius ratio (AL/CR ratio), AL, and refractive status and evaluate the accuracy of AL and AL/CR ratio for myopia assessment among Chinese children.MethodsA diagnostic trial was conducted in Shenzhen Eye Hospital from June 2020 to December 2020. Cycloplegic refraction and demographic characteristic survey were carried out, and AL and CR were measured. The Pearson correlation analysis between AL, AL/CR ratio, and spherical equivalent (SE) was carried out. The sensitivity, specificity, Youden index, positive predictive value, and negative predictive value of the AL/CR ratio and AL for myopia assessment were analyzed using cycloplegic refraction as the gold standard by drawing receiver operating characteristic (ROC) curves.ResultsA total of 300 children aged 8–18 years participated in this study. The Pearson correlation coefficient between AL and SE was −0.667 (P < 0.05) and −0.754 (P < 0.05) between AL/CR ratio and SE. There were significant differences in SE, AL, and AL/CR ratio among different age groups (p < 0.05). SE decreased by 1.185 diopter (D) for every 1 mm increase in AL and decreased by 0.667 D for every 0.1 increase in the AL/CR ratio. Taking cycloplegic refraction SE ≤ −0.50 D as the gold standard for the diagnosis of myopia, the area under the ROC curve of AL for myopia assessment was 0.836 (95% confidence interval [CI]: 0.767–0.906), with specificity, sensitivity, and Youden index of 0.833, 0.767, and 0.600, respectively. The area under the ROC curve of AL/CR ratio for myopia assessment was 0.937 (95% CI: 0.878–0.996), with specificity, sensitivity, Youden index, positive predictive value, and negative predictive value of 0.703, 0.913, 0.622, 0.956, and 0.771, respectively. The area under the ROC curve of the combination of AL/CR ratio and parental myopia for myopia assessment was 0.976 (95% CI: 0.957–0.996).ConclusionThe correlation between SE and AL/CR ratio was stronger than that between SE and AL in children. The AL/CR ratio may be an alternative indicator for myopia assessment in children, and the combination of demographic factors and AL/CR ratio can improve the accuracy of myopia assessment.

Association between gene-environment interaction and myopia/spherical equivalent has not been systematically reported. This paper reviewed nine studies concerning gene-environment interaction in myopia. We obtained relevant studies concerning gene-environment interaction in myopia by systematically searching the MEDLINE(PubMed), Cochrane, Web of Science, CNKI, Wanfang databases before 31 March 2020. Data were analyzed by STATA version 16.0 software, and figures were drawn by ArcGIS V.10.0 software. Nine studies were included in this review concerning gene-environment interaction. Gene and education interaction in adult cohorts suggested a more significant genetic effect in higher education levels than lower education levels, using both candidate genes and PRS approaches. Several interacted genetic variants, including ZMAT4(rs2137277), GJD2(rs524952), TJP2 (rs11145488) from adult study and ZMAT4(rs7829127) from child study are pinpointed out, but the replication attempts were limited. Besides, the genetic effect was associated with a significant shift at a higher educational level (Pooled β = −0.15,95%CI = −0.19–0.11) towards myopia than that at a lower education level (Pooled β = −0.10,95%CI = −0.11–0.09). This study summarizes the relationship between gene-environment interaction and myopia, and interaction effect of the gene or genetic risk score with the environment could be found in these studies. The effect of gene-environment (higher education) interaction substantially impacts myopia in adult studies. Evidence that environmental factors (Increased near-work time/decreased outdoor activities) increase the genetic risk is still limited, and specific SNPs contributing to gene-environment effect are not determined yet. [ABSTRACT FROM AUTHOR]

Purpose: Clinical experience regarding the fluctuations of the refractive error of the eye during the different stages of Graves' ophthalmopathy observed through outpatient clinic frequent check-ups points towards an underestimated and often overlooked problem. Published data about it are sparse. The clinical manifestations of Graves' ophthalmopathy can be understood from the perspective of "compartment syndrome" and literature implies how such changes can affect the refractive error and consequently, the visual acuity. The purpose of the study was to explore how the clinical activity score of Graves' ophthalmopathy affects refractive error and visual acuity. Patients and Methods: The study was prospective and observational, including 60 eyes of 30 patients with clinically active Graves' ophthalmopathy. All the patients were monitored and evaluated over a period of 36 months by the clinical activity score, spherical equivalent and visual acuity. All the observed parameters were statistically analyzed. Results: The mean values of spherical equivalent and visual acuity throughout the observed period showed continuous fluctuation. Repeated measure analysis of variance showed statistically significant differences in visual acuity and spherical equivalent over the observed period. There was a statistically significant positive correlation between visual acuity and clinical activity score. The correlation between spherical equivalent and clinical activity score was also positive but not statistically significant. Conclusion: A decrease in the clinical activity score is either the result of a spontaneously resolving course of Graves' ophthalmopathy or a consequence of treatment, so lowering in fluctuation of refractive error and improved visual acuity may be associated with a reduction in orbital inflammation. [ABSTRACT FROM AUTHOR]

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AIM: To evaluate related factors with the change of spherical equivalents (ΔSE) and determine the suitable predictor of clinically significant ΔSE (≥0.50 D) with cyclopentolate hydrochloride on Chinese children. METHODS: A total of 145 right eyes of 145 children aged 4 to 15y were enrolled. Intraocular pressure, axial length and lag of accommodation (LOA) were assessed before cycloplegia induced by 3 drops of 1% cyclopentolate at 5-minute intervals. SE was measured before and 1h after the first drop of cyclopentolate. ΔSE was compared between different gender groups and among refractive groups. Multivariate linear regression analysis was performed to find related factors with ΔSE. ROC analysis was used to figure out the suitable predictor of clinically significant ΔSE. RESULTS: For the total 145 eyes, the mean SE reached up to -0.70±1.86 D from -1.30±1.62 D, with the mean ΔSE of 0.60±0.55 D. The mean ΔSE were 0.63±0.55 D and 0.57±0.56 D respectively in the male and female group (P=0.40). The mean ΔSE was significantly different among different refractive groups (P

PurposeTo investigate the prevalence of myopia and factors associated with spherical equivalent (SE), axial length (AL), and axial length to corneal radius of curvature (AL/CR) ratio among Japanese preschool children.Study DesignProspective observational study.MethodsThis cross-sectional study evaluated subjects aged 4–6 years from a preschool. Non-cycloplegic autorefraction was measured using the Spot Vision Screener, while AL and corneal radius (CR) were measured using the Myopia Master. Parental myopia and environmental factors were investigated using the myopia-related factor questionnaire. The worse eye with higher myopic SE was chosen for analysis, and multiple linear regression models was performed using AL, SE, and AL/CR ratio as dependent variables.ResultsA total of 457 out of 514 participants (239 males, 52.3%) aged 4–6 years (mean 4.77 ± 0.65 years) were included. The mean SE was 0.13 ± 0.63 D, AL was 22.35 ± 0.67 mm, CR was 7.76 ± 0.25 mm, and AL/CR ratio was 2.88 ± 0.72. The overall prevalence of myopia and high myopia were 2.9 and 0.2%, respectively. Multiple regression analysis showed that myopic SE was significantly associated with male sex (β = −0.14, p = 0.02) and parental myopia (β = −0.15, p = 0.04). Meanwhile, longer AL was significantly associated with older age (β = 0.13, p = 0.02), male sex (β = 0.44, p < 0.001), parental myopia (β = 0.24, p = 0.01), and screen time (including smartphones, tablets, and computers) (>1 h, β = 0.14, p = 0.04). A higher AL/CR was significantly associated with older age (β = 0.02, p < 0.001), male sex (β = 0.03, p < 0.001), ratio and parental myopia (β = 0.03, p = 0.02).ConclusionThe prevalence of myopia and high myopia were 2.9 and 0.2%, respectively, among Japanese preschool children in 2021. Longer AL was associated with older age, male sex, parental myopia, and screen time in children aged 4–6 years. Children with a high risk of myopia can be identified early based on parental myopia information for early prevention.

Background: To perform a systematic review and meta-analysis of the refractive outcomes of non-toric and toric intraocular lenses (IOLs) in keratoconus (KC) using different IOL power calculation formulas. Methods: A systematic search was conducted to identify studies that report on refractive outcomes of different IOL power calculation formulas in KC patients undergoing cataract surgery. Inclusion criteria were primary posterior chamber non-toric and toric monofocal intraocular lens implantation, data on the degree of KC, explicit mention of the formula used for each stage of KC, and the number of eyes in each category. We calculated and compared the absolute and mean prediction errors, percentage of eyes within 0.5 D and 1 D from target, and the weighted absolute prediction errors of IOL formulas, all were given for KC degrees I–III. Results: The bibliographic search yielded 582 studies published between 1996 and 2020, 14 of which (in total 456 eyes) met the criteria: three studies on non-toric IOL (98 eyes), eight studies on toric IOLs (98 eyes) and three studies of unknown separation between non-toric and toric IOLs (260 eyes). The lowest absolute prediction error (APE) for mild, moderate, and advanced KC was seen with Kane's IOL power formula with keratoconus adjustment. The APE for the top five IOL power formulas ranged 0.49–0.73 diopters (D) for mild (83–94%) of eyes within 1 D from the target), 1.08–1.21 D for moderate (51–57% within 1 D), and 1.44–2.86 D for advanced KC (12–48% within 1 D). Conclusions: Cataract surgery in eyes with mild-to-moderate KC generally achieves satisfactory postoperative refractive results. In patients with advanced KC, a minority of the eyes achieved spherical equivalent refraction within 1 D from the target. The Kane's formula with keratoconus adjustment showed the best results in all KC stages. [ABSTRACT FROM AUTHOR]

PURPOSE: To report the results of cataract surgeries in keratoconus patients at 1 and 6 months postoperatively, and to compare the standard intraocular lens (IOL) calculation formulas in this population. METHODS: This is a retrospective study, carried out in 44 eyes of 26 patients known to have keratoconus who underwent cataract surgery at Beirut Eye and ENT Specialist Hospital between 2010 and 2021. The patients were divided into groups based on Dr Jarade updated algorithm. Visual acuities before and after cataract surgery, at 1 and 6 months were recorded, as well as spherical equivalent. The difference between the expected spherical equivalent with each formula was subtracted from the actual resultant refraction, and its absolute value deduced. The means of the values were calculated and the 4 standard formulas (SRK/T, SRK/II, Holladay, and Hoffer Q) were compared. RESULTS: Six eyes had similar topographic and manifest axes (category 1) and underwent toric IOL implantation. Corrected distance visual acuity (CDVA) at 1 and 6 months was 0.2 and 0.1 logMAR, respectively. 26 eyes had mismatching axes and had monofocal IOL placement. CDVA at 1 and 6 months was 0.3. Six eyes required intrastromal corneal ring placement before operating (category 3). CDVA was 0.3 and 0.2 at 1 and 6 months, respectively. Regarding category 4, requiring keratoplasty and cataract extraction, CDVA was 0.4 at both follow‑ups. No statistically significant difference was found between the different formulas. CONCLUSION: Categorization of keratoconus patients gave favorable results after cataract surgery. No superior IOL formula was found. [ABSTRACT FROM AUTHOR]

Purpose The aim of this study was to assess the safety profile and efficacy of a new implantable phakic contact lens (IPCL V2.0) in patients with a high degree of myopia. Patients and methods This is a prospective study that was carried out to evaluate the surgical outcome of IPCL V2 implantation in 46 eyes of 32 patients with a high degree of myopia. The refractive results, visual acuity (LogMar values), endothelial cell count of the cornea and intraocular pressure were evaluated at baseline and at 1, 6, and 12 months postsurgery. Any complications either during or after surgery were assessed. Results A significant improvement in the uncorrected distance visual acuity was achieved. It improved from 1.2±0.21 at baseline to 0.36±0.20 at 12 months postoperatively (P=0.002). The index of efficacy [uncorrected distance visual acuity at 12 months postoperatively/corrected distance visual acuity (CDVA) at baseline) was 1.1 and the safety index (CDVA at 12 months/CDVA at baseline] was 1.5. The mean spherical equivalent at baseline was −13.8±4.1 diopters (D) and improved to −0.6±0.7 D at 12 months postoperatively (P

Purpose: The purpose of the study is to evaluate the effects of 0.01% atropine eye drops on accommodative system parameters among teenagers with low myopia. Methods: Ninety-five myopic teenagers [39 boys (8.69 ± 2.473) and 56 girls (8.54 ± 2.054) aged 5–17 years] with no history of eye disease were enrolled. Biometric and accommodative system parameters were evaluated before and at 1 week, 1 month, 3 months, and 6 months of 0.01% atropine eye drop instillation. Results: Participants without accommodative demand at 6 months demonstrated insignificant changes after the atropine instillation (all p > 0.05). Nevertheless, there were significant differences in accommodative sensitivity, accommodative amplitude, accommodative responsiveness, and negative relative accommodation (NRA) at 3 months compared with baseline after atropine instillation (all p < 0.05). Except spherical equivalent refraction, cornea thickness, intraocular pressure, and axial length were stable after the 0.01% atropine instillation (all p > 0.05). Conclusion: Morphologically, current measurements suggested that 0.01% atropine had favorable reduction of accommodation for childhood low myopia over a half-year period. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate peripapillary-RNFL thickness in myopia by Cirrus OCT among north Indian population by spherical equivalent (SE), age, gender, and axial length (AL).Methods: This was a cross-sectional study held during 2019-2020. Patients aged 18-60 years underwent ophthalmic examination including retinoscopy, AL, and OCT RNFL thickness. Persons with previous ocular surgery or ocular ailment other than refractive error were excluded. The peripapillary-RNFL thickness was noted and compared by demographic determinants.Results: We examined 300 eyes of 300 persons (mean age: 30.75 ± 8.57 years; 144 males/156 females). Among them, 224 were myopes and 76 were emmetropes (EM). The mean SE was - 3.3 ± 0.4D (range: -11.0D to + 0.37D). The mean AL was 24.61 ± 1.92 mm (22.1-29.5). Overall temporal, nasal, superior, inferior, and mean peripapillary-RNFL thickness was 66.31 ± 7.58, 78.57 ± 16.00, 120.63 ± 11.69, 116.60 ± 15.80, and 95.50 ± 10.84 μm, respectively. Temporal, nasal, superior, inferior, and mean peripapillary-RNFL thickness was 73.97 ± 8.36, 94.84 ± 7.63, 127.96 ± 8.96, 136.89 ± 6.53, and 108.34 ± 6.28 μm, respectively, in EM eyes as compared to 63.71 ± 6.18, 73.05 ± 14.24, 118.21 ± 11.53, 109.71 ± 11.50, and 91.14 ± 8.31 μm, respectively, in myopic eyes (P < 0.001). Association of peripapillary-RNFL thickness with myopia and its different grades was P < 0.001. Association of mean peripapillary-RNFL thickness with age was P > 0.005 and gender was P = 0.168. Correlation between SE and RNFL thickness was positive and significant. Correlation between AL and RNFL thickness was negative but statistically significant. Association of AL with SE was P < 0.001.Conclusion: We provide normative peripapillary-RNFL thickness in the north Indian population in order to help in screening for myopia with comorbidity such as glaucoma based on RNFL thickness. [ABSTRACT FROM AUTHOR]

Objective To observe the changes of superficial retinal microcirculation in macular area of 62 children and adolescents with myopia. Method We selected 62 children and adolescents with myopia (123 eyes) and 50 children and adolescents with normal vision (naked-eye vision ≥1. 0) (69 eyes), and compared the spherical equivalent degree (SE degree) and axial length (AL) of them. Sixty-two children and adolescents with myopia (123 eyes) were divided as follows：SE ≥ –0. 50 D (12 eyes), –0. 50 D> SE ≥–1. 00 D (10 eyes), –1. 00 D > SE ≥–3. 00 D (70 eyes), – 3. 00 D > SE (31 eyes) according to SE degree; AL > 25. 0 mm (36 eyes), 25. 0 mm≥AL > 24. 0mm (53 eyes), AL≤ 24. 0 mm (34 eyes) according to AL; retinal vascular length density (VLD), vascular perfusion density (VPD), macular fovea non-perfusion area (FAz-A), macular fovea non-perfusion area circumference (FAZ-P), macular fovea non-perfusion morphology index (FAZ-CI) were compared among all groups, and the correlation among SE, AL, VLD, VPD, FAZA, FAZ-P and FAZ-CI was analyzed in 62 children and adolescents with myopia (123 eyes) . Results Compared with normal children and adolescents, myopic children and adolescents had lower SE degree and longer AL (both P<0. 05) . There was no difference in the superficial retinal microcirculation in macular area with different SE degrees, but with the increase of myopia, the superficial retinal microcirculation in macular area decreased (P>0. 05) . There were statistically significant differences in the FAZ-A and FAZ-P in different AL (all P<0. 05), while no statistically significant differences were found in the other parameters (all P>0. 05) . However, numerically, with the prolongation of AL, except the central VLD and VPD, the other parameters showed a decreasing trend; statistically significant differences were found in FAZ-A and FAZ-P in the group with AL > 25. 0 mm and AL≤24. 0 mm, and in FAZ-A in the group with AL > 25. 0 mm and AL≤ 24. 0 mm (all P<0. 05) . SE degree was positively correlated with inner VPD, outer VPD and overall VPD (r=0. 183, 0. 206, 0. 194, respectively; all P<0. 05) ; there was no correlation between SE degree and central VLD, inner VLD, outer VLD, whole VLD, central VPD, FAZ-A, FAZ-P, and FAZ-CI (r=–0. 037, 0. 144, 0. 154, 0. 150, –0. 006, 0. 044, 0. 016, and 0. 049, respectively; all P>0. 05) . AL was positively correlated with central VLD and central VPD (r=0. 222 and 0. 187, both P<0. 05), and negatively correlated with FAZ-A, FAZ-P, and Faz-CI (r=–0. 305, –0. 224, and–0. 188, respectively; all P<0. 05), that was, with the increase of axial length, VLD and VPD in the center gradually increased, and the non-perfusion area of macular fovea decreased; there was no correlation between AL and inner VLD, outer VLD, whole VLD, inner VPD, outer VPD and whole VPD (r=–0. 120, –0. 090, –0. 068, –0. 174, –0. 166, and–0. 161, respectively; all P>0. 05) . There was a negative correlation between AL and SE degree (r=–0. 503, P<0. 05), indicating that the myopia degree increased and the ocular axis lengthened with the decrease of spherical equivalent. Conclusion With the increase of myopia degree and the extension of eye axis, the superficial retinal microcirculation in macular area of children and adolescents with myopia is reduced in different degrees, and there is superficial retinal microcirculation disorder in macular area, so improving the microcirculation disorder may control or delay the occurrence and development of myopia. [ABSTRACT FROM AUTHOR]

AIM: To evaluate the effectiveness of Grand Seiko Ref/Keratometer WAM-5500 compared to Topcon KR800 autorefractor in detecting refractive error in large scale vision screening for Chinese school age children with the WHO criteria. METHODS: A total of 886 participants were enrolled with mean age of 9.49±1.88y from Tianjin, China. Spherical equivalent (SE) was obtained from un-cycloplegic autorefraction and cycloplegic autorefraction. Topcon KR 800 (Topcon) and Grand Seiko WAM-5500 (WAM) autorefractors were used. Bland-Altman Plot and regression were generated to compare their performance. The overall effectiveness of detecting early stage refractive error was analyzed with receiver operating characteristic (ROC) curves. RESULTS: The mean SE was -0.98±1.81 diopter (D) and the prevalence of myopia was 48.9% defined by WHO criteria according to the result of cycloplegic autorefraction. The mean SE of un-cycloplegic autorefraction with Topcon and WAM were -1.21±1.65 and -1.20±1.68 D respectively. There was a strong linear agreement between result obtained from WAM and cycloplegic autorefraction with an R2 of 0.8318. Bland-Altman plot indicated a moderate agreement of cylinder values between the two methods. The sensitivity and specificity for detecting hyperopia were 90.52% and 83.51%; for detecting myopia were 95.60% and 90.24%; for detecting astigmatism were 79.40% and 90.21%; for detecting high myopia were 98.16% and 98.91% respectively. CONCLUSION: These findings suggest that both Grand Seiko and Topcon autorefractor can be used in large-scale vision screening for detecting refractive error in Chinese population. Grand Seiko gives relatively better performance in detecting myopia, hyperopia, and high myopia for school age children.

Purpose: To analyze the reliability of the refractive results prediction obtained in intraocular lens (IOL) calculation using bicylindric power calculation method, with the use of steep and flat keratometry readings compared with the classical mean keratometry calculation method. Methods: Fifty-seven eyes of 57 subjects who underwent cataract surgery were included in this prospective study. Optical biometry was performed with IOLMaster 700 and IOL power calculation was performed using both keratometry readings and the surgically induced astigmatism. Four weeks after surgery, subjective refraction was done. Finally, results obtained with both IOL calculation methods were compared. Results: Mean spherical equivalent using bicylindric IOL power calculation method was -0.082 ± 0.296D, and achieved mean spherical equivalent using classical IOL power method with Haigis formula was -0.088 ± 0.405D. Achieved mean spherical equivalent obtained in subjective refraction after surgery was -0.101 ± 0.265D. Linear correlation between bicylindric method spherical equivalent calculation and achieved spherical equivalent was statistically significant (r = 0.761, P < 0.001), also correlation between Haigis spherical equivalent calculation and achieved spherical equivalent was statistically significant (r = 0.339, P = 0.010). Emmetropia was achieved in 49 of 57 (85.86%) subjects and bicylindric method calculated that 49 of 57 (85.86%) of subjects would get emmetropia (P = 1.000). Classical IOL power calculation estimated that 38/57 subjects would get emmetropia (66.67%) (P = 0.026). Conclusion: The IOL power calculation including both keratometry readings and surgically induced astigmatism seems to be more accurate and provides more precision in refractive prediction than classical calculation method.

Purpose: The purpose of the study is to evaluate the effects of 0.01% atropine eye drops on accommodative system parameters among teenagers with low myopia.Methods: Ninety-five myopic teenagers [39 boys (8.69 ± 2.473) and 56 girls (8.54 ± 2.054) aged 5–17 years] with no history of eye disease were enrolled. Biometric and accommodative system parameters were evaluated before and at 1 week, 1 month, 3 months, and 6 months of 0.01% atropine eye drop instillation.Results: Participants without accommodative demand at 6 months demonstrated insignificant changes after the atropine instillation (all p > 0.05). Nevertheless, there were significant differences in accommodative sensitivity, accommodative amplitude, accommodative responsiveness, and negative relative accommodation (NRA) at 3 months compared with baseline after atropine instillation (all p < 0.05). Except spherical equivalent refraction, cornea thickness, intraocular pressure, and axial length were stable after the 0.01% atropine instillation (all p > 0.05).Conclusion: Morphologically, current measurements suggested that 0.01% atropine had favorable reduction of accommodation for childhood low myopia over a half-year period.

Background: Knowledge about refractive stabilization and the accuracy of postoperative refractive error measurements are crucial for improved patient outcomes after phacoemulsification. Existing guidelines typically recommend waiting 4-6 wk before prescribing corrective lenses. Our research focused on identifying factors that influence refractive errors in the early stages of post-cataract surgery, thus contributing to the existing literature on this topic., Aim: To investigate the time required for refraction stability after uneventful phacoemulsification surgery., Methods: We compared the variation and statistical significance of the difference in spherical, cylindrical components, and the spherical equivalent between the 1- and 6-wk follow-up period in a group of 257 eyes that underwent uneventful phacoemulsification with foldable intraocular lens implantation, all performed by a single experienced surgeon. The Wilcoxon-Signed Rank Test was utilized to assess the magnitude of the change and determine its statistical significance. The refractive stability was defined as the point at which the change in spherical equivalent was within ± 0.5 dioptres for two consecutive visits., Results: The average age of the patients was 64.9 ± 8.9 yr. The differences observed in both the visits in spherical power (0.1 ± 0.2), cylinder power (0.3 ± 0.4), and spherical equivalent (0.2 ± 0.2) were minimal and not statistically significant. The majority of eyes (93.4%) achieved refractive stability within 6 wk after the surgery. The cylindrical power differed between age groups at the 6 th wk post-operative and the difference was statistically significant ( P value 0.013). There were no significant differences in refractive stability when considering sex and axial length., Conclusion: Phacoemulsification with foldable intraocular lens implantation results in no significant changes in refraction for the majority of cases during the 6-wk follow-up period. Therefore, a spectacle prescription can be given at the completion of 1 wk., Competing Interests: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Objective: To assess the effect of Neodymium: Yttrium-Aluminium (Nd: YAG) laser posterior capsulotomy on the refractive status of the eye. Setting: This Quasi-experimental study was conducted at the Outpatient department of Benazir Bhutto Hospital, Rawalpindi from 1st January 2017 to 30th June 2017. Materials and Methods: A total of 95 eyes of 95 patients were included in this study. The patients were selected based on non - randomized convenient sampling. Among these patients 49 were females and 46 were males. The age range was 43 years to 85 years. These patients were those who had undergone uncomplicated cataract surgery with intraocular lens implantation 6 months or more than 6 months before presentation with posterior capsular opacification. Before Nd: YAG laser posterior capsulotomy, complete anterior and posterior segment examinations of these patients was performed and they were found to have no other associated anterior or posterior segment pathologies. Post YAG capsulotomy, Autorefractometre readings were recorded again on the same day, at 1 week and the end of 4 weeks. Readings at the end of 4 weeks were considered for result purposes. Results: Data was analyzed through the SPSS version 18. The mean age was 60.14 years with a standard deviation of 9.241. Spherical equivalents were compared before and after YAG capsulotomy. Wilcoxon signed ranks test was applied. P-value (0.70) was found to be statistically insignificant which supported our hypothesis. Conclusion: Nd: YAG laser capsulotomy does not change the refractive status of the eye. [ABSTRACT FROM AUTHOR]

Objective: The aim of our study was to find out the efficacy of low dose atropine drops in slowing myopia progression. Methodology: This was a comparative randomized controlled study done at the ophthalmology department of Shalimar Hospital, Lahore for a period of Two years from February 2019 to February 2021. Totally 160 patients were included in our study, 80 each in atropine group and control group. The rate of spherical equivalent and axial length at baseline, 6 month and 12 months after treatment with 0.01% atropine were evaluated and compared in both atropine and control group. Any adverse effects were also noted. Results: The mean change in Spherical Equivalent (SE) and Axial Length (AL) after six month for atropine group was -0.23±0.25 D and 0.18±0.16mm respectively while for control group, after six month the mean SE and AL was -0.38±0.33D and 0.23±0.15mm respectively. The mean change in SE and AL after one year for atropine group was -0.46±0.35 D and 0.36±0.21mm respectively while for control group, after one year the mean SE and AL was -0.75±0.21D and 0.44±0.15mm respectively. The mean difference in SE and AL after one year for atropine group as compared to controlled group was -0.29 (0.21) D and 0.08 (0.06) mm. For both the groups no serious adverse effects were noted. Conclusions: Our study concludes that myopia progression can be reduced by atropine, 0.01%, eye drops. Further studies should be done to determine long term potential effects. [ABSTRACT FROM AUTHOR]

AIM: To investigate the changes of corneal epithelial thickness following small incision lenticule extraction(SMILE), and its relationship with the ablation depth, spherical equivalent and optical zone. METHODS: Sixty-one myopic patients with or without astigmatism who underwent SMILE in our hospital from August 2017 to November 2017 were selected. RTvue-OCT was performed before surgery, 1wk, 1mo and 6mo after surgery, respectively, and the corneal epithelial thickness of patients were measured. The changes of corneal epithelial thickness following small incision lenticule extraction(SMILE), and its relationship with the ablation depth, spherical equivalent and optical zone were studied.RESULTS: There was no statistically significant difference in the thickness of corneal epithelium among the three regions(central corneal region, para-central corneal region and peripheral region)before surgery(P>0.05). Compared with the baseline values before surgery, the thickness of corneal epithelium in the three areas was significantly thickened 1wk, 1mo and 6mo after surgery(PCONCLUSION: The corneal epithelial thickness increases after SMILE in different regions, and the thickening value was positively correlated with the spherical equivalent, ablation depth.

Abstract Background To examine the retinal structure–vascular-function relationship using optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) in myopia. Methods This was a prospective cross-sectional study comprising 86 eyes of 45 individuals with varying axial lengths and spherical equivalents and no posterior segment abnormalities. All eyes underwent optical coherence tomography with the Spectralis SD-OCT and OCTA with RTVue-XR Avanti; Optovue. Individual macular retinal layer thicknesses and flow areas and vessel densities were measured on OCT and OCTA, respectively. Linear correlations were made between the macular layer thicknesses, flow areas and vessel densities with axial length, spherical equivalent and visual acuity. Results The participants’ mean ages were 33.34 ± 14.45 years, mean spherical equivalent refractions were − 7.17 ± 5.71 D and axial lengths were 25.95 ± 2.41 mm. There were significant positive correlations of foveal angle (r = 0.757, p = 0.001), inner retinal (r = 0.764, p = 0.001) and outer plexiform layer (r = 0.771, p = 0.001) thickness on OCT and vessel densities in deep capillary plexus (r = 0.313, p = 0.003) on OCTA with axial length and negative correlations with spherical equivalents and visual acuity. Significant negative correlations of outer nuclear layer (r = − 0.560, p = 0.03) and photoreceptor outer segment layer thickness (r = − 0.856, p

AIM: To explore the factors of macular parameters in the patients with the different degrees of myopia.METHODS: Totally 313 myopia patients who volunteered to participate in the study were selected and divided into mild, moderate and severe myopia groups. Optical coherence tomography(OCT)was used to measure the central area of the macula thickness, the temporal, upper, nasal and lower areas of the inner and outer ring. And the correlation between the macular parameters and age, gender, different of eyes, axial length and spherical equivalent were analyzed.RESULTS: The central fovea of macula was the thinnest. The superior and the nasal of inner ring were the thinner among all parts of macular and there were significant differences in macular thickness among three groups(PP>0.05). Macular thickness in different areas were correlated with gender, and the thickness in women was thinner than men(PPPCONCLUSION: The macular parameters of myopia were closely linked to the spherical equivalent and axial length.

Objectives:Our aim was to compare the refractive status and anterior segment parameters of patients with juvenile open-angle glaucoma (JOAG) and normal subjects.Materials and Methods:Twenty-five recently diagnosed cases of JOAG and 24 normal subjects were included in this prospective controlled clinical trial. Central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), axial length (AL), K1 and K2 keratometry, and white-to-white distance (WTW) measurements were performed with optical biometry (LenStar LS 900, Haag Streit Diagnostics). Spherical equivalent (SE) values and anterior segment parameters were statistically compared by chi-square, Kolmogorov- Smirnov, and independent samples t-tests.Results:The mean age of the 15 male and 10 female JOAG patients was 11.8±2.78 (8-18) years and the mean age of the 14 male and 10 female normal subjects was 11.58±3.04 (7-16) years (age: p=0.51; sex: p=0.18). Mean intraocular pressure in the JOAG group before treatment was 30.08±4.3 mmHg. The mean SE values of the JOAG and the control group were -1.94±1.86 (+2.35/-5.5) and -0.76±2.03 (+2.25/-4.85) diopters, respectively (p=0.048). JOAG patients had lower mean CCT values (p=0.016) and higher mean AL and ACD values (p=0.049 and p=0.016). There were no significant differences between the groups for LT, WTW, K1, or K2 (p=0.61; p=0.52; p=0.95; p=0.31 respectively).Conclusion:JOAG patients were found to be more myopic and have lower CCT and greater AL and ACD values than normal subjects. These anterior segment changes may be associated with myopia, which is common in JOAG.

Purpose: To assess visual recovery after small incision lenticule extraction (SMILE) in relation to pre-operative spherical equivalent. Methods: Two hundred fourteen eyes of 107 patients were enrolled. Following surgery, patients were examined pre-operatively, 1 day, 2 weeks, 1 month and 3 months later. High myopia was defined as pre-operative spherical equivalent ≤ − 5 D. A linear mixed-effects model was used. Results: Mean ± standard deviation pre-operative spherical equivalent was − 5.30 ± 1.36 D that reduced significantly to 0.04 ± 0.70 D (p < 0.001) at 1 month and − 0.02 ± 0.66 D (p < 0.001) at 3 months. Mean pre-operative LogMAR uncorrected distance visual acuity ± SD was 0.97 ± 0.09 that improved significantly to 0.04 ± 0.06 at 2 weeks (p < 0.001), 0.01 ± 0.04 at 1 month (p < 0.001) and 0.01 ± 0.04 at 3 months (p < 0.001). Eighty-eight eyes (41.2%) had uncorrected distance visual acuities of 0.0 at 1 day, 154 eyes (72.0%) at 2 weeks,194 eyes (90.7%) at 1 month and 199 eyes (93.0%) at 3 months. Significantly more eyes with low myopia (> − 5 D) achieved acuities of 0.0 at 1 day and 2 weeks (p = 0.041 and p < 0.001). Post-operative acuities were not associated with refractive targets, laser cut energy settings or other variables. Two hundred nine eyes (97.7%) were within ± 0.5 D of target and 213 eyes (99.5%) were within ± 1 D. Conclusions: SMILE for low myopia had faster visual recovery in the early post-operative period with no significant differences between groups detected by 1 and 3 months. [ABSTRACT FROM AUTHOR]

Background: Hyperopia is a significant refractive error in children, often leading to vision impairment. This study aimed to investigate whether partial or full spectacle correction is benefit for hyperopia in preschool-aged children. Methods: A retrospective study was conducted on hyperopic children visited to teaching medical center outpatient clinic between October 2011 and October 2018, and were categorized into three groups: full correction, overcorrection, and undercorrection. The study was approved by the institutional ethical committee of Tri-Service General Hospital. Results: Following a minimum of one-year follow-up period, no statistically significant differences were observed in best-corrected visual acuity (BCVA) among children receiving full, over, or under spectacle correction. Notably, the overcorrection group exhibited a significant reduction in spherical equivalent (SE) compared to both the full and under correction groups, indicating a better SE with spectacle overcorrection. Conclusions: Spectacle overcorrection may offer potential benefits for enhancing SE in preschool children with hyperopia. Nevertheless, further investigation through randomized controlled trials is warranted to establish the validity of this approach and its impact on visual outcomes in this hyperopic pediatric population., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

Background: This study aimed to explore the postoperative myopic shift and its relationship to visual acuity rehabilitation in patients with bilateral congenital cataracts (CCs)., Methods: Bilateral CC patients who underwent cataract extraction and primary intraocular lens implantations before 6 years old were included and divided into five groups according to surgical ages (<2, 2-3, 3-4, 4-5, and 5-6 years). The postoperative myopic shift rates, spherical equivalents (SEs), and the best corrected visual acuity (BCVA) were measured and analyzed., Results: A total of 1,137 refractive measurements from 234 patients were included, with a mean follow-up period of 34 months. The postoperative mean SEs at each follow-up in the five groups were linearly fitted with a mean R 2  = 0.93 ± 0.03, which showed a downtrend of SE with age (linear regression). Among patients with a follow-up of 4 years, the mean postoperative myopic shift rate was 0.84, 0.81, 0.68, 0.24, and 0.28 diopters per year (D/y) in the five age groups (from young to old), respectively. The BCVA of those with a surgical age of <2 years at the 4-year visit was 0.26 (LogMAR), and the mean postoperative myopic shift rate was 0.84 D/y. For patients with a surgical age of 2-6 years, a poorer BCVA at the 4-year visit was found in those with higher postoperative myopic shift rates ( r  = 0.974, p  = 0.026, Pearson's correlation test)., Conclusion: Performing cataract surgery for patients before 2 years old and decreasing the postoperative myopic shift rates for those with a surgical age of 2-6 years may benefit visual acuity rehabilitation., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Lin, Zhu, Zhang, Zhou, Zhao, Wang, Chen, Chen, Lin, Feng, Zhong, Chen, Lin, Li, Xiao, Zhou, Wang, Li and Chen.)

Aim: To analyze the distribution of refractive status in school-age children with different corneal curvatures (CC) and the correlation between CC and refractive status., Methods: A total of 2214 school-aged children of grade 4 in Hangzhou who were screened for school myopia were included. Uncorrected distance visual acuity (UCDVA), non-cycloplegic refraction, axial length (AL), horizontal and vertical corneal curvature (K 1 , K 2 ) were measured and spherical equivalent (SE), corneal curvature radius (CCR) and axial length/corneal radius of curvature ratio (AL/CR) were calculated. UCDVA<5.0 and SE≤-0.50 D were classified as school-screening myopia. According to the different CCRs, the patients were divided into the lower corneal curvature (LCC) group (CCR≥7.92) and the higher corneal curvature (HCC) group (CCR<7.92). Each group was further divided into the normal AL subgroup and the long AL subgroup. The refractive parameters were compared to identify any differences between the two groups., Results: Both SE and AL were greater in the LCC group ( P =0.013, P <0.001). The prevalence of myopia was 38% in the LCC group and 44% in the HCC group ( P <0.001). The proportion of children without screening myopia was higher in the LCC group (62%) than in the HCC group (56%). Among these children without screening myopia, the proportion of long AL in the LCC group (24%) was significantly higher than that in the HCC group (0.012%; P <0.001). The change of SE in the LCC group was less affected by the increase of AL than that in the HCC group., Conclusion: School-aged children in the LCC group have a lower incidence of screening myopia and longer AL. Low CC can mask SE reduction and AL growth to some extent, and the change of AL growth change more in children with low CC than high CC. Before the onset of myopia, its growth rate is even faster than that after the onset of myopia., Competing Interests: Conflicts of Interest: He SY, None; He T, None; Xu MY, None; Ni YJ, None; Hong CY, None; Shen T, None., (International Journal of Ophthalmology Press.)

AIM:To investigate the effectiveness of three cycloplegia drugs: atropine, cyclopentolate and tropicamide on school-age children, and provid theoretical basis in choosing cycloplegic drugs for school-age children. METHODS: Totally 420 myopic school-age students(818 eyes)in out-patients department were selected during July to August 2017. Candidates were divided into three medicine groups according to their age: Group A: 12 years old, utilizing the tropicamide. The difference of refraction degree before and after medicine application were calculated. RESULTS: The coincidence rate of spherical equivalent refraction with cycloplegia and without cycloplegia was 81.0% in atropine group, 81.3% in cyclopentolate group and 79.4% in tropicamide group respectively. There was statistical difference of refraction results of the Group A between with atropine cycloplegia and without cycloplegia. The mean difference was -0.113±0.226D(t=-4.663, Pt=-1.665, P=0.099). So does the difference of Group C between with tropicamide cycloplegia and without cycloplegia, which was -0.026±0.193D(t=1.760, P=0.080). CONCLUSION: For children older than 8-years old and without strabismus and amblyopia, cyclopentolate or tropicamide can be used to give cycloplegia refraction for the first time, which is convenient for their daily activities. The cycloplegia refraction results should been re-checked after used atropine, and giving prescription by using the principle of maximum plus to maximum visual acuity(MPMVA).

To investigate the effect of capsulotomy size on refraction and anterior chamber parameters following Nd:YAG laser treatment. Fifty-six eyes of 56 pseudophakic patients with posterior capsular opacification (PCO) were reviewed. Patients were divided into two groups according to the capsulotomy size. Changes in best corrected visual acuity (BCVA), spherical equivalent (SE), anterior chamber depth (ACD), anterior chamber volume (ACV) and anterior chamber angle (ACA) were compared between groups. A hyperopic shift was remarkable in the 1st week in both groups but SE declined about to preoperative levels at 1 month after laser capsulotomy in both groups (p=0,056). In both groups, ACD decreased 1 week after laser capsulotomy (p [Med-Science 2018; 7(3.000): 571-4]

Yang Yang, Huibin Lv, Yuexin Wang, Xiaodan Jiang, Mingzhou Zhang, Xuemin Li Department of Ophthalmology, Peking University Third Hospital, Beijing, China Purpose: The aim of this study was to evaluate visual, refractive and patient satisfaction outcomes following implantation of a trifocal diffractive intraocular lens (IOL). Patients and methods: This prospective, consecutive study included patients undergoing lens phacoemulsification of cataract and implantation of a trifocal diffractive IOL (AT LISA tri 839MP). Visual outcomes, including near, intermediate and distance visual acuity (VA), refractive error, contrast sensitivity, defocus curve and patient satisfaction were assessed preoperatively and postoperatively. Results: Thirty IOLs were implanted in 26 patients. Distance VA improved significantly from 0.70±0.45 to 0.08±0.11 logMAR (p

AIM:To observe the different effect of controlling myopia by orthokeratopraxis with different width between defocus circle and the rim around the cornea.METHODS: A retrospective case-control study. A total of 45 patients(85 eyes)who came to our hospital for orthokeratopraxis lens fitting during January 2014 to December 2015 were selected. The diameter of the orthokeratopraxis lens was 90%-95% of the diameter of the cornea. So the patients were divided into three groups according to the different diameter of the orthokeratopraxis lens. The diameter of the orthokeratopraxis lens for the patients whose corneal diameter was between 12.1 to 13.00mm was 11.0-11.2mm(Group A). The diameter of the orthokeratopraxis lens for the patients whose corneal diameter was between 11.1-12.00mm was 10.5-10.9mm(Group B). The diameter of the orthokeratopraxis lens for the patients whose corneal diameter was between 10.0-11.00mm was 10.0-10.4mm(Group C). The change of the spherical equivalent(SE)and axial length(AL)were analyzed after wearing the lens for 1a and 2a.RESULTS: Before wearing lens, the age, SE(D)and AL(mm)was not statistically significant in the three groups(P>0.05). After wearing lens for 1a and 2a, the change of SE(D)and AL(mm)was not statistically significant in Group A and Group B(P>0.05)and the change was statistically significant in Group C(PPPCONCLUSION: The effect of controlling myopia by orthokeratopraxis with different position of defocus circle on cornea is different. The position of defocus circle is more close to the corneal limbus, the effect is weaker.

Purpose: To investigate the variance in keratometric (K) values after administration of different eye drops (three tested), and the effects on intraocular lens (IOL) power calculations in relation to standard cataract surgery. Methods: A prospective intervention study (pilot study) on 38 participants (22 women, 16 men, 58–88 years) undergoing 57 cataract surgeries. Three keratometries on each eye were performed: a baseline ('standard') keratometry about 9 weeks preoperatively, and two on the operation day; a 'dry'‐measurement before interventions and a 'wet'‐measurement after applying one of three eye drops (saline, Systane Ultra®, or Systane Complete®). All standard cataract operations were uneventful. Variabilities in K‐values, spherical equivalents (SEQs) for IOL power calculations (Barrett TK Universal II) and subjective manifest refractions (SRs) 6 weeks postoperatively were compared between groups. Results: The 'wet' K‐values had a similar variability to those of the 'standard' and 'dry' K‐values (p > 0.05, anova on ranks). The mean paired differences in K‐measurements between groups ranged within a small interval from −0.0107 to 0.0096 mm. After comparing the SEQ predictions with SR‐measurements, the most precise IOL calculation was achieved after administration of a saline eye drop, but the precision was not statistically improved compared to the other drop modalities. Conclusion: The variability in K‐values was not significantly changed by administration of any of the different eye drops tested, suggesting that artificial eye drops do not impact the keratometry or IOL power prediction. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the reliability of the refractive results prediction obtained in intraocular lens (IOL) calculation using bicylindric power calculation method, with the use of steep and flat keratometry readings compared with the classical mean keratometry calculation method.Methods: Fifty-seven eyes of 57 subjects who underwent cataract surgery were included in this prospective study. Optical biometry was performed with IOLMaster 700 and IOL power calculation was performed using both keratometry readings and the surgically induced astigmatism. Four weeks after surgery, subjective refraction was done. Finally, results obtained with both IOL calculation methods were compared.Results: Mean spherical equivalent using bicylindric IOL power calculation method was -0.082 ± 0.296D, and achieved mean spherical equivalent using classical IOL power method with Haigis formula was -0.088 ± 0.405D. Achieved mean spherical equivalent obtained in subjective refraction after surgery was -0.101 ± 0.265D. Linear correlation between bicylindric method spherical equivalent calculation and achieved spherical equivalent was statistically significant (r = 0.761, P < 0.001), also correlation between Haigis spherical equivalent calculation and achieved spherical equivalent was statistically significant (r = 0.339, P = 0.010). Emmetropia was achieved in 49 of 57 (85.86%) subjects and bicylindric method calculated that 49 of 57 (85.86%) of subjects would get emmetropia (P = 1.000). Classical IOL power calculation estimated that 38/57 subjects would get emmetropia (66.67%) (P = 0.026).Conclusion: The IOL power calculation including both keratometry readings and surgically induced astigmatism seems to be more accurate and provides more precision in refractive prediction than classical calculation method. [ABSTRACT FROM AUTHOR]

Myopia is a growing pandemic, especially in children, who risk low vision later in life. Home confinement during the COVID-19 pandemic may have increased myopia progression through increased screentime, decreased time outdoors and increased near work activities. The aim of this study is to compare progression of myopia in children during home confinement period in the COVID-19 pandemic with pre-COVID-19 progression. On January 2023 PubMed, EMBASE and Cochrane were searched for relevant studies. Studies meeting the following criteria were eligible for inclusion: children (under 18 years), home confinement due to COVID-19, spherical equivalent refractive (SER) and axial length (AL) measurements and a follow-up period to measure progression. Quality appraisal was performed by two reviewers independently using the Joanna Briggs Institute tool for cohort studies. Outcomes for myopia were assessed through meta-analysis, analyzing SER (random effects) and AL (fixed effects). Hundred and two articles were identified in the search, of which five studies were included in the analysis. Risk of bias is moderate with a few critical flaws in the studies. Myopia progressed more rapidly during the COVID-19 pandemic compared to the pre-COVID-19 period, both in terms of SER (-0.83D [95 %CI, −1.22, −0.43] and AL (0.36 mm [95 %CI, 0.13, 0.39]). Progression of myopia during the COVID-19 pandemic accelerated more rapidly compared to the pre-COVID-19 period. Impact of home confinement on myopia may be considered when future lockdown measures are being contemplated. [ABSTRACT FROM AUTHOR]