Autonomic, biometric and oculomotor correlates of myopia in young adults

The principal work reported in this thesis is the examination of autonomic profile of ciliary muscle innervation as a risk factor in myopia development. Deficiency in sympathetic inhibitory control of accommodation has been proposed as a contributory factor in the development of late onset myopia (LOM). Complementary measurements of ocular biometry, oculomotor function and dynamic accommodation response were carried out on the same subject cohort, thus allowing cross-correlation of these factors with. autonomic profile. Subjects were undergraduate and postgraduate students of Aston University. A 2.5 year longitudinal study of refractive error progression in 40 subjects revealed the onset of LOM in 10, initially emmetropic, young adult subjects (age range 18-24 years) undertaking substantial amounts of near work. A controlled, double blind experimental protocol was conducted concurrently to measure post-task open-loop accommodative regression following distance (0 D) or near (3 D above baseline tonic accommodation) closed-loop tasks of short (10 second) or long (3 minute) duration. Closed-loop tasks consisted of observation of a high contrast Maltese cross target; open-loop conditions were imposed by observation of a 0.2 c/deg Difference of Gaussian target. Accommodation responses were recorded continuously at 42 Hz using a modified Shin-Nippon SRW-5000 open-view infra-red optometer. Blockade of the sympathetic branch of accommodative control was achieved by topical instillation of the non-selective b-adrenoceptor antagonist timolol maleate. Betaxolol hydrochloride (non-selective b1-adrenoceptor antagonist) and normal saline were employed as control agents. Retarded open-loop accommodative regression under b2 blockade following the 3 minute near task indicated the presence of sympathetic facility. Sympathetic inhibitory facility in accommodation control was found in similar proportions between LOM and stable emmetropic subjects. A cross-sectional study (N=60) of autonomic profile showed that sympathetic innervation of ciliary muscle is present in similar proportions between emmetropes, early-, and late-onset myopes. Sympathetic facility was identified in 27% of emmetropes, 21% of EOMs and 29% of LOMs

Eye shape and retinal shape, and their relation to peripheral refraction

Purpose: We provide an account of the relationships between eye shape, retinal shape and peripheral refraction. Recent findings: We discuss how eye and retinal shapes may be described as conicoids, and we describe an axis and section reference system for determining shapes. Explanations are given of how patterns of retinal expansion during the development of myopia may contribute to changing patterns of peripheral refraction, and how pre-existing retinal shape might contribute to the development of myopia. Direct and indirect techniques for determining eye and retinal shape are described, and results are discussed. There is reasonable consistency in the literature of eye length increasing at a greater rate than height and width as the degree of myopia increases, so that eyes may be described as changing from oblate/spherical shapes to prolate shapes. However, one study indicates that the retina itself, while showing the same trend, remains oblate in shape for most eyes (discounting high myopia). Eye shape and retinal shape are not the same and merely describing an eye shape as being prolate or oblate is insufficient without some understanding of the parameters contributing to this; in myopia a prolate eye shape is likely to involve both a steepening retina near the posterior pole combined with a flattening (or a reduction in steepening compared with an emmetrope) away from the pole

Multifractal nature of ocular aberration dynamics of the human eye

Ocular monochromatic aberrations display dynamic behavior even when the eye is fixating on a stationary stimulus. The fluctuations are commonly characterized in the frequency domain using the power spectrum obtained via the Fourier transform. In this paper we used a wavelet-based multifractal analytical approach to provide a more in depth analysis of the nature of the aberration fluctuations. The aberrations of five subjects were measured at 21 Hz using an open-view Shack-Hartmann sensor. We show that the aberration dynamics are multifractal. The most frequently occurring Hölder exponent for the rms wavefront error, averaged across the five subjects, was 0.31 ± 0.10. This suggests that the time course of the aberration fluctuations is antipersistant. Future applications of multifractal analysis are discussed

Influence of gravity on ocular lens position.

yesPurpose: To determine whether human ocular lens position is influenced by gravity. Methods: Anterior chamber depth and lens thickness were determined with a Haag-Streit Lenstar LS900 for right eyes of participants in two age groups, with a young group of 13 participants aged 18 to 21 years (mean 21 years, SD 1 year) and an older group of 10 participants aged 50 to 63 years (58 years, 4 years). There were two sessions for each participant separated by at least 48 hours, with one session for the usual upright head position and one session for a downwards head position. In a session, testing was done for minimum accommodation followed by testing at maximum accommodation. A drop of 2% pilocarpine nitrate was instilled, and testing was repeated after 30 minutes under minimum and maximum accommodation conditions. Results: Gravity, manipulated through head posture, affected anterior chamber depth for both young adult and older adult groups but mean effects were only small, ranging from 0.04 to 0.12mm, and for the older group required the instillation of an accommodation-stimulating drug. Gravity had a weakly significant effect on lens thickness for the young group without accommodation or a drug, but the effect was small at 0.04±0.06mm (mean±SD, p = 0.04). Conclusion: There is a small but real effect of gravity on crystalline lens position, manifested as reduction in anterior chamber depth at high levels of accommodative effort with the head in a downwards position. This provides evidence of the ability of zonules to slacken during strong accommodation

The role of peripheral ocular length and peripheral corneal radius of curvature in determining refractive error

PURPOSE: The purpose of this study was to extend the knowledge of peripheral biometric component and its relationship to refractive status in healthy individuals by determining the correlation between peripheral ocular length to peripheral corneal radius ratio and the refractive error. METHODS: This prospective study was conducted on thirty-three healthy adult participants. Refractive error was assessed objectively and subjectively and recorded as the mean spherical equivalent. Central and peripheral ocular lengths at 30° were assessed using partial coherence interferometry under dilation with 1% tropicamide. Central and peripheral corneal radius of curvature was assessed using Scheimpflug topography. Peripheral ocular lengths at 30° were paired with peripheral corneal curvatures at the incident points of the IOLMaster beam (3.8 mm away from corneal apex) superiorly, inferiorly, temporally and nasally to calculate the peripheral ocular length-peripheral corneal radius ratio. Descriptive statistics were used to describe the distribution and spread of the data. Pearson’s correlation analysis was used to present the association between biometric and refractive variables. RESULTS: Refractive error was negatively correlated with the axial length-central corneal radius ratio (r = −0.91; p < 0.001) and with 30° peripheral ocular length-peripheral corneal radius ratio in all four meridians (r ≤ −0.76; p < 0.001). The strength of the correlation was considerably lower when only axial length or peripheral ocular lengths were used. CONCLUSION: Using the ratios of peripheral ocular length-peripheral corneal radius to predict refractive error is more effective than using peripheral corneal radius or peripheral ocular length alone

Clinical evaluation of the Shin-Nippon SRW-5000 autorefractor in adults:an update

Purpose: The Shin-Nippon SRW-5000 is an open view autorefractor that superseded the Canon R-1 autorefractor in the mid-1990s and has been used widely in optometry and vision science laboratories. It has been used to measure refractive error, accommodation responses both statically and dynamically, off-axis refractive error, and adapted to measure pupil size. This paper presents an overview of the original 2001 clinical evaluation of the SRW-5000 in adults (Mallen et al., Ophthal Physiol Opt 2001; 21: 101) and provides an update on the use and modification of the instrument since the original publication. Recent findings: The SRW-5000 instrument, and the family of devices which followed, have shown excellent validity, repeatability, and utility in clinical and research settings. The instruments have also shown great potential for increased research functionality following a number of modifications. Summary: The SRW-5000 and its derivatives have been, and continue to be, of significant importance in our drive to understand myopia progression, myopia control techniques, and oculomotor function in human vision

Исследование коррозионных свойств биосовместимых покрытий на основе титана, осажденных методом реактивного магнетронного распыления

В работе изучались свойства Ti-O-N покрытий, нанесенных на стальные подложки методом реактивного магнетронного напыления, такие как коррозионная стойкость, термическая устойчивость, а так же диффузионные процессы в физиологических растворах. Методами инфракрасной спектроскопии и атомно-эмиссионного анализа была установлена химическая инертность пленки, а так же потенциальная биологическая активность в виду обнаружения оксида азота в модельных растворах после контакта с покрытиями Ti-O-N.The properties of Ti-O-N coatings deposited on steel substrates by the method of reactive magnetron sputtering, such as corrosion resistance, thermal stability, as well as diffusion processes in physiological solutions were studied. By the methods of infrared spectroscopy and atomic emission analysis, the chemical inertness of the film was established, as well as the potential biological activity in the form of detection of nitrogen oxide in model solutions after contact with Ti-O-N coatings

Impact of Frailty on Emergency Department Encounters for Cardiovascular Disease: A Retrospective Cohort Study

Data are limited on whether the causes of emergency department (ED) encounters for cardiovascular diseases (CVDs) and associated clinical outcomes vary by frailty status. Using the United States Nationwide ED Sample, selected CVD encounters (acute myocardial infarction [AMI], ischemic stroke, atrial fibrillation [AF], heart failure [HF], pulmonary embolism, cardiac arrest, and hemorrhagic stroke) were stratified by hospital frailty risk score (HFRS). Logistic regression was used to determine the adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of ED mortality among the different frailty groups. A total of 8,577,028 selected CVD ED encounters were included. A total of 5,120,843 (59.7%) had a low HFRS (15). Ischemic stroke was the most common reason for the encounter in the high HFRS group (66.9%), followed by hemorrhagic stroke (11.7%) and AMI (7.2%). For the low HFRS group, AF was the most common reason for the encounter (30.2%), followed by AMI (23.6%) and HF (16.8%). Compared with the low-risk group, high-risk patients had a decreased ED mortality and an increased overall mortality across most CVD encounters (p <0.001). The strongest association with overall mortality was observed among patients with a high HFRS admitted for AF (aOR 27.14, 95% CI 25.03 to 29.43) and HF (aOR 13.71, 95% CI 12.95 to 14.51) compared with their low-risk counterparts. In conclusion, patients presenting to the ED with acute CVD have a significant frailty burden, with different patterns of CVD according to frailty status. Frailty is associated with an increased all-cause mortality in patients for most CVD encounters