Lag of accommodation predicts clinically significant change of spherical equivalents after cycloplegia

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<0.0001), with the ΔSE of hyperopia group (1.12±0.64 D) larger than that of the emmetropia (0.56±0.43 D, P=0.001) and myopia group (0.32±0.28 D, P<0.0001). The ΔSE was correlated with LOA (B=-0.54, P<0.0001), cycloplegic SE (B=0.10, P<0.0001) and age (B=-0.04, P=0.015). ROC curve indicated that LOA predicted clinically significant ΔSE by 82% [area under the curve (AUC)=0.82] alone, while the value was slightly improved to 85% (AUC=0.85) in combination with axial length and 86% (AUC=0.86) in association with axial length as well as age. CONCLUSION: After cycloplegia with cyclopentolate, the ΔSE decreases with larger LOA, longer axial length and older age. Specifically, LOA plays a more vital role in predicting clinically significant ΔSE.

The Accommodation Response and Facility between Children and Young Adults

Tonic accommodation decreased with age among children. In young adults, late-onset myopia will develop due to occupational near vision demands. This study aims to investigate the accommodation response and facility between children and young adults, in emmetrope (non-myopic) and myope group. The accommodation response and facility of young adults and children were measured using monocular estimation method (MEM), monocular accommodative facility (MAF) and binocular accommodative facility (BAF) with an exposure of near task for 15 minutes. Near task has significantly increased the lag of accommodation in all groups (p<0.05). However, the accommodation facility was not affected by near work in all groups (p>0.05). Keywords: accommodation response, accommodation facility, myopes, emmetropes. eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v5i14.2168

Comparación del LAG de acomodación con la retinoscopía de Nott entre ojo derecho e izquierdo de los 5 a 19 años

El LAG de acomodación es el desfase en la respuesta en dioptrías del sistema acomodativo del ojo en relación con estímulo en dioptrías de acomodación demandada. Por lo cual, una respuesta acomodativa inferior o LAG acomodativo consiste en una respuesta (en dioptrías) menor con relación al estímulo, lo que significa que, el ojo acomoda menos de lo que realmente debería. Por el contrario, en un exceso acomodativo, la respuesta (en dioptrías) es superior con relación al estímulo, es decir, el sistema acomoda más de lo necesario. Está reportado que una distribución normal en valor del LAG para ambos ojos, las medias y desviaciones estándar son para el ojo derecho de +0.33 dioptrías (±0.35) y para el ojo izquierdo +0.35 dioptrías (±0.34). Con el objetivo de comparar los valores del LAG de acomodación en ojo derecho e izquierdo en una población entre los 5 a 19 años de los colegios públicos de la ciudad de Pereira, entre los años 2013 a 2015, se utilizó la retinocopia de Nott, se midió el LAG de acomodación en los dos ojos a 505 sujetos, 392 seleccionados una vez analizado los criterios de inclusión y exclusión, pertenecientes a los colegios públicos de la Ciudad de Pereira, Colombia. Los datos de LAG no presentaron una distribución normal (Shapiro Wilk, p<0,001), el LAG de acomodación fue igual entre los dos ojos (-0,008D; p=0,110). Se concluye que el LAG de acomodación en esta población no presentó diferencias clínicas ni estadísticamente significativas entre ojo derecho e izquierdo. Palabras clave: LAG de Acomodación, retinoscopía de Nott, método de estimación monocular, estímulo acomodativo, respuesta acomodativa. Abstract The LAG of accommodation is the gap in the response in diopters of the accommodative system of the eye in relation to stimulus in diopters of demanded accommodation. Therefore, a lower accommodative response or accommodative LAG consists of a smaller response (in diopters) in relation to the stimulus, which means that the eye accommodates less than it really should. On the contrary, in an accommodative excess, the response (in diopters) is higher in relation to the stimulus, that is, the system accommodates more than necessary. It is reported that a normal distribution in LAG value for both eyes, means and standard deviations are for the right eye of +0.33 diopters (± 0.35) and for the left eye +0.35 diopters (± 0.34). With the objective of comparing LAG values ​​of accommodation in the right and left eye in a population between 5 to 19 years of public schools in the city of Pereira, between 2013 and 2015, Nott Retinoscopy was used, was measured the LAG of accommodation in both eyes to 505 subjects, 392 selected once analyzed the inclusion and exclusion criteria, belonging to the public schools of the City of Pereira, Colombia. The LAG data did not show a normal distribution (Shapiro Wilk, p <0.001), the accommodation LAG was the same between the two eyes (-0.008D, p = 0.110). It is concluded that the LAG of accommodation in this population did not present clinical or statistically significant differences between right and left eye. Keywords: LAG of Accommodation, Nott Retinoscopy, Monocular Estimated Method, Accommodative Stimulus, Accommodative Response

Comparación del LAG de acomodación con la retinoscopía de Nott entre ojo derecho e izquierdo de los 5 a 19 años

El LAG de acomodación es el desfase en la respuesta en dioptrías del sistema acomodativo del ojo en relación con estímulo en dioptrías de acomodación demandada. Por lo cual, una respuesta acomodativa inferior o LAG acomodativo consiste en una respuesta (en dioptrías) menor con relación al estímulo, lo que significa que, el ojo acomoda menos de lo que realmente debería. Por el contrario, en un exceso acomodativo, la respuesta (en dioptrías) es superior con relación al estímulo, es decir, el sistema acomoda más de lo necesario. Está reportado que una distribución normal en valor del LAG para ambos ojos, las medias y desviaciones estándar son para el ojo derecho de +0.33 dioptrías (±0.35) y para el ojo izquierdo +0.35 dioptrías (±0.34). Con el objetivo de comparar los valores del LAG de acomodación en ojo derecho e izquierdo en una población entre los 5 a 19 años de los colegios públicos de la ciudad de Pereira, entre los años 2013 a 2015, se utilizó la retinocopia de Nott, se midió el LAG de acomodación en los dos ojos a 505 sujetos, 392 seleccionados una vez analizado los criterios de inclusión y exclusión, pertenecientes a los colegios públicos de la Ciudad de Pereira, Colombia. Los datos de LAG no presentaron una distribución normal (Shapiro Wilk, p<0,001), el LAG de acomodación fue igual entre los dos ojos (-0,008D; p=0,110). Se concluye que el LAG de acomodación en esta población no presentó diferencias clínicas ni estadísticamente significativas entre ojo derecho e izquierdo. Palabras clave: LAG de Acomodación, retinoscopía de Nott, método de estimación monocular, estímulo acomodativo, respuesta acomodativa. Abstract The LAG of accommodation is the gap in the response in diopters of the accommodative system of the eye in relation to stimulus in diopters of demanded accommodation. Therefore, a lower accommodative response or accommodative LAG consists of a smaller response (in diopters) in relation to the stimulus, which means that the eye accommodates less than it really should. On the contrary, in an accommodative excess, the response (in diopters) is higher in relation to the stimulus, that is, the system accommodates more than necessary. It is reported that a normal distribution in LAG value for both eyes, means and standard deviations are for the right eye of +0.33 diopters (± 0.35) and for the left eye +0.35 diopters (± 0.34). With the objective of comparing LAG values ​​of accommodation in the right and left eye in a population between 5 to 19 years of public schools in the city of Pereira, between 2013 and 2015, Nott Retinoscopy was used, was measured the LAG of accommodation in both eyes to 505 subjects, 392 selected once analyzed the inclusion and exclusion criteria, belonging to the public schools of the City of Pereira, Colombia. The LAG data did not show a normal distribution (Shapiro Wilk, p <0.001), the accommodation LAG was the same between the two eyes (-0.008D, p = 0.110). It is concluded that the LAG of accommodation in this population did not present clinical or statistically significant differences between right and left eye. Keywords: LAG of Accommodation, Nott Retinoscopy, Monocular Estimated Method, Accommodative Stimulus, Accommodative Response

Effect of Atropine Eye Drops on Choroidal Thinning Induced by Hyperopic Retinal Defocus

Purpose. To investigate the effects of atropine on choroidal thinning induced by hyperopic retinal defocus. Methods. Ten young adults with myopia (−1.00 D to −5.00 D) viewed a video at 6 metres for 60 minutes on successive days. On day 1, one eye (control) was distance corrected with a contact lens; the other (experimental) eye wore a contact lens imposing 2.00 D of hyperopic retinal defocus. Sub- and perifoveal choroidal thickness (SFCT, PFCT) were monitored with optical coherence tomography. On day 2, the procedure was repeated but the experimental eye had received one drop of 0.5% atropine 22 hours earlier. Results. On day 1, eyes exposed to hyperopic defocus developed progressively thinner choroids (SFCT (baseline) = 253 ± 32 μm versus SFCT (40 mins) = 244 ± 31 μm, p=0.004), whereas SFCT and PFCT in control eyes did not change (p>0.17). On day 2 (22 hours after instilling atropine), baseline SFCT and PFCT were not different to day 1 (p>0.05) and hyperopic defocus failed to thin the choroid (max change in SFCT = +2 ± 2 μm, p=0.36). Conclusions. Atropine abolished choroidal thinning induced by hyperopic defocus without changing baseline choroidal thickness. The results suggest that atropine inhibits signals associated with hyperopic defocus, for example, from lag of accommodation during near work. This trial is registered with ACTRN12617001519347.

Real-Time Measurement of Ocular Wavefront Aberrations in Symptomatic Subjects

The purpose of this work was to study the real-time changes of the optical properties of the eye with accommodation in subjects with symptoms of accommodative disorders. From ocular aberrations, it is possible to compute several parameters like the response and lag of accommodation. The ocular aberrations were measured in 4 subjects, with different accommodative disorders, during several cycles of accommodation/disaccommodation and for different accommodative stimuli. The measurement was done continuously and in real time during different accommodative stimuli. It was possible to see the changes in accommodative response during the several stimuli of accommodation. Subjects with accommodative disorders showed different accommodative responses. The use of wavefront ocular aberrations can be a tool to diagnose accommodative disorders. In some subjects with complaints, this method showed irregularities even when the results of the usual clinical exams were normal.