Thickness Changes in the Fovea and Peripapillary Retinal Nerve Fiber Layer Depend on the Degree of Myopia

Purpose: To investigate changes in the thickness of the fovea and peripapillary RNFL associated with myopia. Methods: Sixty-five Korean adults (for a total of 130 eyes) between 23 and 26 years of age were selected as test subjects. Thirty-eight test subjects were male, and 27 were female. Subjects with glaucoma or other identified ocular diseases were excluded. Patients whose manifest refraction measurement values ranged between 0 to-2D were classified as group one (emmetropia and low myopia), those between-2 to-5D were classified as group two (moderate myopia), and those more than-5D were classified as group three (high myopia). Using the OCT, the thickness of the fovea and peripapillary RNFL were measured for every subject. Results: The thicknesses of the fovea for each of three groups were 142.16±8.99 µm in group one (45 eyes), 153.58±17.63 µm in group two (43 eyes) and 158.86±11.93 µm in group three (28 eyes). The data showed significant differences in fovea thickness between the groups. The average thicknesses of the peripapillary RNFL for each of three groups were 113.29±10.80 µm in group one, 103.85±14.48 µm in group two and 100.74±9.15 µm in group three. A statistically significant difference was found between group one and the other groups (p<0.05). Conclusions: As the level of myopia increased, the thickness of the fovea also increased, while the thickness of the peripapillary RNFL decreased. Therefore, when interpreting OCT results in the clinic, careful consideration should be given to various changes associated with myopia. Korean Journal of Ophthal

Global variations and time trends in the prevalence of childhood myopia, a systematic review and quantitative meta-analysis: implications for aetiology and early prevention.

The aim of this review was to quantify the global variation in childhood myopia prevalence over time taking account of demographic and study design factors. A systematic review identified population-based surveys with estimates of childhood myopia prevalence published by February 2015. Multilevel binomial logistic regression of log odds of myopia was used to examine the association with age, gender, urban versus rural setting and survey year, among populations of different ethnic origins, adjusting for study design factors. 143 published articles (42 countries, 374 349 subjects aged 1-18 years, 74 847 myopia cases) were included. Increase in myopia prevalence with age varied by ethnicity. East Asians showed the highest prevalence, reaching 69% (95% credible intervals (CrI) 61% to 77%) at 15 years of age (86% among Singaporean-Chinese). Blacks in Africa had the lowest prevalence; 5.5% at 15 years (95% CrI 3% to 9%). Time trends in myopia prevalence over the last decade were small in whites, increased by 23% in East Asians, with a weaker increase among South Asians. Children from urban environments have 2.6 times the odds of myopia compared with those from rural environments. In whites and East Asians sex differences emerge at about 9 years of age; by late adolescence girls are twice as likely as boys to be myopic. Marked ethnic differences in age-specific prevalence of myopia exist. Rapid increases in myopia prevalence over time, particularly in East Asians, combined with a universally higher risk of myopia in urban settings, suggest that environmental factors play an important role in myopia development, which may offer scope for prevention

Health state utilities in patients with diabetic retinopathy, diabetic macular oedema and age-related macular degeneration: a systematic review

Background Health state utility values (HSUVs) are important in the assessment of the cost effectiveness of new interventions. In the case of visual conditions, models generally tend have tended to be built around a set of health states defined by visual acuity (VA). The aim of this review was to assess the impact of VA on HSUVs in patients with diabetic retinopathy, diabetic macular oedema or age-related macular degeneration. Methods A systematic literature search was undertaken in major bibliographic databases to identify articles reporting on the relationship between HSUVs and vision. Data were extracted for population characteristics, visual levels and estimated utilities. Evidence from reported statistical models, where available, was considered in the evaluation of vision in the better-seeing eye and the worse-seeing eye. Due to the heterogeneity of included studies, a narrative synthesis was undertaken. Results Of the 17 relevant studies, 9 studies had data that could be used in the analysis of the impact of vision on HSUVs. Visual loss was associated with a marked impact on health utilities. However, the relationship was not comparable between conditions or by measure of HSUVs. Key results included the finding that overall, self-rated time-trade off estimates were more likely to discriminate between different VA levels than EQ-5D values. Additionally, a stronger correlation was observed between HSUVs and better-seeing eye VA compared to worse-seeing eye VA. Conclusions Visual acuity has a significant impact on HSUVs. Nevertheless, care must be taken in the interpretation and use of estimates in cost-effectiveness models due to differences in measures and population diversity

Initial experience of macular translocation in Singapore - One-year results

Annals of the Academy of Medicine Singapore335641-648AAMS