Agreement of Anterior Segment Parameters Obtained From Swept-Source Fourier-Domain and Time-Domain Anterior Segment Optical Coherence Tomography.

PurposeTo assess the interdevice agreement between swept-source Fourier-domain and time-domain anterior segment optical coherence tomography (AS-OCT).MethodsFifty-three eyes from 41 subjects underwent CASIA2 and Visante OCT imaging. One hundred eighty-degree axis images were measured with the built-in two-dimensional analysis software for the swept-source Fourier-domain AS-OCT (CASIA2) and a customized program for the time-domain AS-OCT (Visante OCT). In both devices, we examined the angle opening distance (AOD), trabecular iris space area (TISA), angle recess area (ARA), anterior chamber depth (ACD), anterior chamber width (ACW), and lens vault (LV). Bland-Altman plots and intraclass correlation (ICC) were performed. Orthogonal linear regression assessed any proportional bias.ResultsICC showed strong correlation for LV (0.925) and ACD (0.992) and moderate agreement for ACW (0.801). ICC suggested good agreement for all angle parameters (0.771-0.878) except temporal AOD500 (0.743) and ARA750 (nasal 0.481; temporal 0.481). There was a proportional bias in nasal ARA750 (slope 2.44, 95% confidence interval [CI]: 1.95-3.18), temporal ARA750 (slope 2.57, 95% CI: 2.04-3.40), and nasal TISA500 (slope 1.30, 95% CI: 1.12-1.54). Bland-Altman plots demonstrated in all measured parameters a minimal mean difference between the two devices (-0.089 to 0.063); however, evidence of constant bias was found in nasal AOD250, nasal AOD500, nasal AOD750, nasal ARA750, temporal AOD500, temporal AOD750, temporal ARA750, and ACD. Among the parameters with constant biases, CASIA2 tends to give the larger numbers.ConclusionsBoth devices had generally good agreement. However, there were proportional and constant biases in most angle parameters. Thus, it is not recommended that values be used interchangeably

Association of antioxidants use with the risk of dementia among community-dwelling adults in the United Kingdom biobank

BackgroundData regarding the association between antioxidant supplementation and incident dementia are limited.MethodsWe included 494,632 adults (54.5% females) aged 40–71 years at baseline from the United Kingdom Biobank in the final analysis. Incident dementia was ascertained using hospital inpatient and death records up to January 2021.ResultsOver a median follow-up of 11.9 years, 7,128 new cases of all-cause dementia, 2,772 cases of Alzheimer’s disease, and 1,397 cases of vascular dementia were recorded. The hazard ratio (95% CI) for incident dementia associated with zinc supplementation was 0.84 (0.74–0.96), and the association remained significant after adjusting for all confounders (0.84 (0.74–0.96)). In the full model, zinc supplementation was associated with a reduced risk of Alzheimer’s disease [HR (95% CI): 0.71 (0.57–0.88)]. There was no significant association between zinc supplementation and the risk of vascular dementia. No significant associations with incident dementia were observed for other antioxidant supplementation. The association between zinc supplementation and incident dementia was significant among individuals with [HR (95% CI): 0.34 (0.15–0.77)] and without cataract [0.87 (0.77–0.99)] but it was stronger among those with cataract (p value for interaction = 0.0271).ConclusionOur findings suggest that zinc supplementation may help reduce the risk of all-cause dementia and Alzheimer’s disease in middle-aged or older adults, especially among those with cataracts

You Only Need Two Detectors to Achieve Multi-Modal 3D Multi-Object Tracking

Firstly, a new multi-object tracking framework is proposed in this paper based on multi-modal fusion. By integrating object detection and multi-object tracking into the same model, this framework avoids the complex data association process in the classical TBD paradigm, and requires no additional training. Secondly, confidence of historical trajectory regression is explored, possible states of a trajectory in the current frame (weak object or strong object) are analyzed and a confidence fusion module is designed to guide non-maximum suppression of trajectory and detection for ordered association. Finally, extensive experiments are conducted on the KITTI and Waymo datasets. The results show that the proposed method can achieve robust tracking by using only two modal detectors and it is more accurate than many of the latest TBD paradigm-based multi-modal tracking methods. The source codes of the proposed method are available at https://github.com/wangxiyang2022/YONTD-MOTComment: 10 pages, 9 figure

Willingness to Pay for Cataract Surgery in Rural Southern China

This paper examines the willingness of patients in China to pay for cataract surgery

Higher intraocular pressure is associated with slower axial growth in children with non-pathological high myopia

ObjectivesTo investigate the association between intraocular pressure (IOP) and axial elongation rate in highly myopic children from the ZOC-BHVI High Myopia Cohort Study.Methods162 eyes of 81 healthy children (baseline spherical equivalent: −6.25 D to −15.50 D) aged 7–12 years with non-pathological high myopia were studied over five biennial visits. The mean (SD) follow-up duration was 5.2 (3.3) years. A linear mixed-effects model (LMM) was used to assess the association between IOP (at time point t−1) and axial elongation rate (annual rate of change in AL from t−1 to t), controlling for a pre-defined set of covariates including sex, age, central corneal thickness, anterior chamber depth and lens thickness (at t−1). LMM was also used to assess the contemporaneous association between IOP and axial length (AL) at t, controlling for the same set of covariates (at t) as before.ResultsHigher IOP was associated with slower axial growth (β = −0.01, 95% CI −0.02 to −0.005, p = 0.001). There was a positive contemporaneous association between IOP and AL (β = 0.03, 95% CI 0.01–0.05, p = 0.004), but this association became progressively less positive with increasing age, as indicated by a negative interaction effect between IOP and age on AL (β = −0.01, 95% CI −0.01 to −0.003, p = 0.001).ConclusionsHigher IOP is associated with slower rather than faster axial growth in children with non-pathological high myopia, an association plausibly confounded by the increased influence of ocular compliance on IOP

Iris volume change with physiologic mydriasis to identify development of angle closure: the Zhongshan Angle Closure Prevention Trial

AIMS: To assess dynamic change of iris area (Iarea) and volume (VOL) with physiologic pupil dilation for progression of primary angle closure suspects. METHODS: Participants underwent baseline examinations including gonioscopy and anterior segment OCT (AS-OCT) as part of the Zhongshan Angle Closure Prevention Trial. The AS-OCT images were obtained both in the dark and light. Progression was defined as development of primary angle closure or an acute angle closure attack. Static ocular biometrics and dynamic changes were compared between progressors and non-progressors and multivariable logistic regression was developed to assess risk factors for progression. RESULTS: A mean 16.8% decrease in Iarea and a mean 6.26% decrease in VOL occurred with pupil dilation, while 22.96% non-progressors and 40% progressors presented VOL increases with pupil dilation. Iarea in light and dark and VOL in light were significantly smaller in progressors. In a multivariable logistic model, older age (p=0.008), narrower horizontal angle opening distance (AOD) 250 µm from the scleral spur (AOD250, p=0.001), flatter iris curvature (IC, p=0.006) and lower loss of iris volume (ΔVOL, p=0.04) were significantly associated with progression. With receiver operating characteristic analysis, the area under the curve for ΔVOL alone was 0.621, while that for the combined index (age, AOD250, IC and ΔVOL) was 0.824. Eyes with elevated intraocular pressure had less VOL loss compared with progressors developing peripheral anterior synechiae alone (p=0.055 for ΔVOL adjusted for pupil enlargement). CONCLUSION: A smaller change in ΔVOL is an additive risk factor to identify eyes more likely to develop angle closure disease. TRIAL REGISTRATION NUMBER: ISRCTN45213099

The epidemics of myopia: Aetiology and prevention

There is an epidemic of myopia in East and Southeast Asia, with the prevalence of myopia in young adults around 80-90%, and an accompanying high prevalence of high myopia in young adults (10-20%). This may foreshadow an increase in low vision and blindness due to pathological myopia. These two epidemics are linked, since the increasingly early onset of myopia, combined with high progression rates, naturally generates an epidemic of high myopia, with high prevalences of "acquired" high myopia appearing around the age of 11-13. The major risk factors identified are intensive education, and limited time outdoors. The localization of the epidemic appears to be due to the high educational pressures and limited time outdoors in the region, rather than to genetically elevated sensitivity to these factors. Causality has been demonstrated in the case of time outdoors through randomized clinical trials in which increased time outdoors in schools has prevented the onset of myopia. In the case of educational pressures, evidence of causality comes from the high prevalence of myopia and high myopia in Jewish boys attending Orthodox schools in Israel compared to their sisters attending religious schools, and boys and girls attending secular schools. Combining increased time outdoors in schools, to slow the onset of myopia, with clinical methods for slowing myopic progression, should lead to the control of this epidemic, which would otherwise pose a major health challenge. Reforms to the organization of school systems to reduce intense early competition for accelerated learning pathways may also be important

Six-year changes in refraction and related ocular biometric factors in an adult Chinese population

Methods 1817 subjects aged ≥ 35 years were randomly recruited from Yuexiu district, Guangzhou, China in 2008. Of which 1595 (87.8%) were reexamined in 2010 and 1427 (78.5%) were reexamined in 2014. Non-cycloplegic automated refraction and visual acuity test were performed at baseline and the 6-year follow-up examination for all participants. In addition, 50% of the participants were randomly selected for axial length (AL), anterior chamber depth (ACD) and lens thickness (LT) measurements using non-contact partial coherence laser interferometry. Lens power (LP) was calculated with the Bennett’s equation. Results A total of 1300 participants were included in current analysis (2008 mean [SD] age, 51.4 [10.6] years; 54.5% women). Mean change in spherical equivalence (SE) was +0.24 (95% confidence interval [CI], +0.19 to +0.30), +0.51 (95% CI, +0.46 to +0.57), +0.26 (95% CI, +0.15 to +0.38) and -0.05 (95% CI, -0.21 to +0.10) diopters (D) for individuals in the age groups of 35 to 44, 45 to 54, 55 to 64 and 65+ years at baseline, respectively. Corneal power, AL and LT increased while ACD and LP decreased during the follow-up. Baseline SE and changes in biometric factors could explain 97.2% of the variance in longitudinal SE change while LP solely could explain 65.2%. Six-year mean change in cylinder power was -0.16 (95% CI, -0.19 to -0.13) D, the axis of astigmatism changed from “with-the-rule” to “against-the-rule” in 16.4% of the participants and to “oblique” in 0.9%. Conclusions This study confirms a hyperopic shift in the elderly before 65 years old and a myopic shift thereafter. Longitudinal refraction change could be well explained by corresponding biometry changes, especially LP. There is also a shift to “against-the-rule” astigmatism for the adult population.This study was supported by the World Health Organization, Geneva, Switzerland (under National Institutes of Health, Bethesda, MD, contract No. N01-EY-2103) and the by Fundamental Research Funds of the State Key Laboratory of Ophthalmology at the Zhongshan Ophthalmic Center. Prof. He receives support from the University of Melbourne at Research Accelerator Program and the CERA Foundation. The Centre for Eye Research Australia receives Operational Infrastructure Support from the Victorian State Government. The sponsor or funding organization had no role in the design or conduct of this research

14-Year Outcome of Angle-Closure Prevention with Laser Iridotomy in the Zhongshan Angle Closure Prevention Study: Extended Follow-Up of a Randomized Controlled Trial

Purpose: This study aimed to evaluate the efficacy of laser peripheral iridotomy (LPI) prophylaxis for primary angle closure suspects (PACS) after 14 years and to identify risk factors for the conversion from PACS to primary angle closure (PAC)./ Design: An extended follow-up of Zhongshan Angle Closure Prevention (ZAP) study./ Participants: A total of 889 Chinese patients aged 50 to 70 years with bilateral PACS./ Methods: Each patient received LPI in one randomly selected eye, with the fellow untreated eye serving as a control. Since the risk of glaucoma was low and acute angle closure (AAC) only occurred in rare cases, the follow-up was extended to 14 years despite substantial benefits of LPI reported after the 6-year visit./ Main Outcome Measures: The primary outcome was incidence of PAC, a composite endpoint including peripheral anterior synechiae (PAS), intraocular pressure (IOP) > 24 mmHg, or AAC. Results During the 14 years, 390 LPI-treated eyes and 388 control eyes were lost to the follow-up. A total of 33 LPI-treated eyes and 105 control eyes reached primary endpoints (P <0.01). Within them, twelve eyes developed AAC or primary angle closure glaucoma (AAC: five control eyes and one LPI-treated eye; PACG: four control eyes and two LPI-treated eyes). The hazard ratio for progression to PAC was 0.31 (95% confidence interval, 0.21–0.46) in LPI-treated eyes compared with control eyes. At the 14-year visit, LPI-treated eyes had severer nuclear cataract, higher IOP, larger angle width and limbal anterior chamber depth (LACD) than control eyes. Higher IOP, shallower LACD, and central anterior chamber depth (CACD) were associated with an increased risk of developing endpoints in control eyes. In the treated group, eyes with higher IOP, shallower LACD, or less IOP elevation after dark room–prone provocative tests (DRPPT) were more likely to develop PAC after LPI./ Conclusions: Despite a two-third decrease in PAC incidence after LPI, the cumulative risk of PAC was relatively low in the community-based PACS population over 14 years. Apart from IOP, IOP elevation after DRPPT, CACD, and LACD, more risk factors are needed to achieve precise prediction of PAC occurrence and guide clinical practice

Safety of Spectacles for Children's Vision: A Cluster-Randomized Controlled Trial.

PURPOSE: To study safety of children&apos;s glasses in rural China, where fear that glasses harm vision is an important barrier for families and policy makers. DESIGN: Exploratory analysis from a cluster-randomized, investigator-masked, controlled trial. METHODS: Among primary schools (n = 252) in western China, children were randomized by school to 1 of 3 interventions: free glasses provided in class, vouchers for free glasses at a local facility, or glasses prescriptions only (Control group). The main outcome of this analysis is uncorrected visual acuity after 8 months, adjusted for baseline acuity. RESULTS: Among 19 934 children randomly selected for screening, 5852 myopic (spherical equivalent refractive error &lt;=-0.5 diopters) eyes cif 3001 children (14.7%, mean age 10.5 years) had VA &lt;= 6/12 without glasses correctable to &gt;6/12 with glasses, and were eligible. Among these, 1903 (32.5%), 1798 (30.7%), and 2151 (36.8%) were randomized to Control, Voucher, and Free Glasses, respectively. Intention-to-treat analyses were performed on all 1831 (96.2%), 1699 (94.5%), and 2007 (93.3%) eyes of children with follow-up in Control, Voucher, and Free Glasses groups. Final visual acuity for eyes of children in the treatment groups (Free Glasses and Voucher) was significantly better than for Control children, adjusting only for baseline visual acuity (difference of 0.023 logMAR units [0.23 vision chart lines, 95% CI: 0.03, 0.43]) or for other baseline factors as well (0.025 logMAR units [0.25 lines, 95% CI 0.04, 0.45]). CONCLUSION: We found no evidence that spectacles promote decline in uncorrected vision with aging among children. (C) 2015 by Elsevier Inc. All rights reserved.ONESIGHT (MASON, OHIO); LUXOTTICA-CHINA (SHANGHAI); ESSILOR-CHINA (SHANGHAI); CREDIT LYONAIS Securities Asia (Asia Pacific Markets; Hong Kong); Charity Aid Foundation (Sydney); Chinese government; Ulverscroft Foundation; OneSight, Luxottica-China; Essilor-ChinaSCI(E)[email protected]