Relative peripheral hyperopic defocus alters central refractive development in infant monkeys

College of Optometry, University of Houston, Houston, TX 77204-2020, USA.
Vision research (Impact Factor: 1.82). 08/2009; 49(19):2386-92. DOI: 10.1016/j.visres.2009.07.011
Source: PubMed


Understanding the role of peripheral defocus on central refractive development is critical because refractive errors can vary significantly with eccentricity and peripheral refractions have been implicated in the genesis of central refractive errors in humans. Two rearing strategies were used to determine whether peripheral hyperopia alters central refractive development in rhesus monkeys. In intact eyes, lens-induced relative peripheral hyperopia produced central axial myopia. Moreover, eliminating the fovea by laser photoablation did not prevent compensating myopic changes in response to optically imposed hyperopia. These results show that peripheral refractive errors can have a substantial impact on central refractive development in primates.

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    • "Improvements in accommodation performance, i.e., reduced lags, have also been reported with orthokeratology [31], lending further support to the notion that reduction or elimination of accommodative lags contributes to the myopia control effects of such treatments. The notion that the peripheral retina plays a critical role in refractive error development and thus in myopia progression also has its origins in animal model studies [32] [33] [34] [35] [36] and is driving the development of some novel designs of spectacles [7] [8] and soft contact lenses (SCLs) [9] [10] [11] for myopia control. The underlying premise is that by manipulating the defocus experience of the peripheral retina, one can either neutralise the optical defocus stimulus for excessive axial length elongation, i.e., by correcting peripheral (off-axis) hyperopia, or reverse it by imposing myopic defocus, thereby inhibiting eye growth. "
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    ABSTRACT: Purpose: To characterise the effects on accommodation and binocular vision in young adults of 2 distance centre multifocal soft contact lenses (MFSCLs), differing in add power. Methods: Twenty-four young adult myopes (18-28 years; 20 females, 4 males) had baseline visual acuity, accommodation, near phoria, fixation disparity and stereopsis data collected with single vision (SV) SCLs. The same set of measurements was repeated immediately after subjects were fitted with each of two MFSCLs (with either +1.50 or +3.00 D add), and after 2 weeks of daily wear in each case. The order of testing was randomised and a one-week washout period was allowed between the first and second MFSCL trials. Results: Differences in distance and near acuities with MFSCLs compared to SVSCLs were small and clinically insignificant. Compared to responses with SVSCLs, MFSCLs increased accommodative lags with this change reaching statistical significance for the +1.50 D add lens. Furthermore, both MFSCLs induced significant shifts in near phorias in the exo direction. Finally, there were no significant differences in stereopsis and fixation disparity with MFSCLs compared to SVSCLs. Conclusion: Differences in acuities, accommodation accuracy and binocular posture with MFSCLs compared to SVSCLs were clinically small and mostly not significant. These results predict good tolerance of MFSCLs in young patients fitted with them for myopia control.
    Contact lens & anterior eye: the journal of the British Contact Lens Association 10/2015; DOI:10.1016/j.clae.2015.09.004 · 1.37 Impact Factor
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    • "There are also differences in the peripheral refraction and retinal contour between progressing and stable myopes [4]. A previous animal study reported that peripheral hyperopic defocus (behind the retina) could induce central myopic development [5]. "
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    ABSTRACT: Purpose: To evaluate the impact of eye and head rotation in the measurement of peripheral refraction with an open-field autorefractometer in myopic eyes wearing two different center-distance designs of multifocal contact lenses (MFCLs). Methods: Nineteen right eyes from 19 myopic patients (average central M ± SD = -2.67 ± 1.66 D) aged 20-27 years (mean ± SD = 23.2 ± 3.3 years) were evaluated using a Grand-Seiko autorefractometer. Patients were fitted with one multifocal aspheric center-distance contact lens (Biofinity Multifocal D(®)) and with one multi-concentric MFCL (Acuvue Oasys for Presbyopia). Axial and peripheral refraction were evaluated by eye rotation and by head rotation under naked eye condition and with each MFCL fitted randomly and in independent sessions. Results: For the naked eye, refractive pattern (M, J0 and J45) across the central 60° of the horizontal visual field values did not show significant changes measured by rotating the eye or rotating the head (p > 0.05). Similar results were obtained wearing the Biofinity D, for both testing methods, no obtaining significant differences to M, J0 and J45 values (p > 0.05). For Acuvue Oasys for presbyopia, also no differences were found when comparing measurements obtained by eye and head rotation (p > 0.05). Multivariate analysis did not showed a significant interaction between testing method and lens type neither with measuring locations (MANOVA, p > 0.05). There were significant differences in M and J0 values between naked eyes and each MFCL. Conclusion: Measurements of peripheral refraction by rotating the eye or rotating the head in myopic patients wearing dominant design or multi-concentric multifocal silicone hydrogel contact lens are comparable.
    Contact Lens & Anterior Eye 12/2014; 38(2). DOI:10.1016/j.clae.2014.11.201 · 1.37 Impact Factor
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    • "Myopia is thought to be of multifactorial etiology, caused by an interaction between environmental and genetic factors. In recent years, optical factors, such as relative peripheral hyperopic defocus1–3 and the greater accommodative lag4,5 found in myopic eyes, have been linked to axial growth of the eye and, thus, myopia development. Currently available techniques for the measurement of peripheral refraction and accommodative responses are limited, making the investigation of such factors difficult. "
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    ABSTRACT: Purpose The aim of this article was to present the optical design of a new instrument (BHVI-EyeMapper, EM), which is dedicated to rapid peripheral wavefront measurements across the visual field for distance and near, and to compare the peripheral refraction and higher-order aberration profiles obtained in myopic eyes with and without accommodation. Methods Central and peripheral refractive errors (M, J180, and J45) and higher-order aberrations (C[3, 1], C[3, 3], and C[4, 0]) were measured in 26 myopic participants (mean [±SD] age, 20.9 [±2.0] years; mean [±SD] spherical equivalent, −3.00 [±0.90] diopters [D]) corrected for distance. Measurements were performed along the horizontal visual field with (−2.00 to −5.00 D) and without (+1.00 D fogging) accommodation. Changes as a function of accommodation were compared using tilt and curvature coefficients of peripheral refraction and aberration profiles. Results As accommodation increased, the relative peripheral refraction profiles of M and J180 became significantly (p < 0.05) more negative and the profile of M became significantly (p < 0.05) more asymmetric. No significant differences were found for the J45 profiles (p > 0.05). The peripheral aberration profiles of C[3, 1], C[3, 3], and C[4, 0] became significantly (p < 0.05) less asymmetric as accommodation increased, but no differences were found in the curvature. Conclusions The current study showed that significant changes in peripheral refraction and higher-order aberration profiles occurred during accommodation in myopic eyes. With its extended measurement capabilities, that is, permitting rapid peripheral refraction and higher-order aberration measurements up to visual field angles of ±50 degrees for distance and near (up to −5.00 D), the EM is a new advanced instrument that may provide additional insights in the ongoing quest to understand and monitor myopia development.
    Optometry and vision science: official publication of the American Academy of Optometry 08/2014; 91(10). DOI:10.1097/OPX.0000000000000364 · 1.60 Impact Factor
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