Baskar Theagarayan

Anglia Ruskin University, Cambridge, England, United Kingdom

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Publications (9)16.55 Total impact

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    ABSTRACT: To identify variables associated with myopia progression and to identify any interaction between accommodative function, myopia progression, age, and treatment effect in the Cambridge Anti-Myopia Study. Contact lenses were used to improve static accommodation by altering ocular spherical aberration, and vision training was performed to improve dynamic accommodation. One hundred forty-two subjects, aged 14-21 years, were recruited who had a minimum of -0.75D of myopia. Subjects were assigned to contact lens treatment only, vision training only, contact lens treatment and vision training, or control group. Spherical aberration, lag of accommodation, accommodative convergence/accommodation (AC/A) ratio, accommodative facility, ocular biometry, and refractive error were measured at regular intervals throughout the 2-year trial. Ninety-five subjects completed the 24-month trial period. There was no significant difference in myopia progression between the four treatment groups at 24 months. Age, lag of accommodation, and AC/A ratio were significantly associated with myopia progression. There was a significant treatment effect at 12 months in the contact lens treatment group in younger subjects, based on a median split, aged under 16.9 years (p = 0.005). This treatment effect was not maintained over the second year of the trial. Younger subjects experienced a greater reduction in lag of accommodation with the treatment contact lens at 3 months (p = 0.03), compared to older contact lens treatment and control groups. There was no interaction between AC/A ratio and contact lens treatment effect. Age, lag of accommodation, and AC/A ratio were significantly associated with myopia progression. Although there was no significant treatment effect at 24 months, an interaction between age and contact lens treatment suggests younger subjects may be more amenable, at least in the short term, to alteration of the visual system using optical treatments.
    Optometry and vision science: official publication of the American Academy of Optometry 10/2013; 90(11). DOI:10.1097/OPX.0000000000000067 · 1.60 Impact Factor
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    ABSTRACT: To evaluate the effect of a dual treatment modality for myopia, by improving accommodative functions, on myopia progression. A double blind randomised control trial was conducted on 96 subjects. The treatment modality for the trial employed custom designed contact lenses which control spherical aberration in an attempt to optimise static accommodation responses during near-work, and a vision-training programme to improve accommodation dynamics. Myopia progression was assessed over a 2 year period using cycloplegic autorefraction and biometry. The mean progression was found to be -0.33 Dioptres (D) over the 2 years of the study. There was no interaction between contact lens treatment and vision training treatment at 24 months (p = 0.72). There was no significant treatment effect of either Vision Training or Contact Lens Spherical Aberration control on myopia progression. This study is unable to demonstrate that the progression of myopia can be reduced over a 2 year period by either of the two treatments aimed at improving accommodative function. Neither treatment group (contact lens or vision training) progressed at a slower rate over the 2 years of the study than did the appropriate control group.
    Ophthalmic and Physiological Optics 05/2013; 33(3):267-76. DOI:10.1111/opo.12035 · 2.18 Impact Factor
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    ABSTRACT: Purpose: To evaluate the changes in peripheral refraction profiles associated with myopia progression and treatment modalities used in the Cambridge Anti-Myopia Study. Methods: one hundred and seventy-seven myopes in the age range of 14 to 22 years were enrolled in the study. The mean spherical equivalent refractive error was 3.12 1.87 diopters (D) and the refractive error of each participant was corrected with contact lenses. The participants were randomly assigned to one of four treatment groups, which included: altered spherical aberration and vision training, altered spherical aberration only, vision training only, and control. Peripheral refractive error was measured using an open field autorefractor in the central 60° of the retina in 10° steps. The refractive error was measured using cycloplegic autorefraction. Two-year refractive progression data and initial peripheral refraction measurements were available in 113 participants. Measurements of peripheral refraction and cycloplegic refraction were obtained at three visits over 2 years in 12-month intervals for 92 participants. Results: All subjects showed a relative peripheral hyperopia, especially in the nasal retina. A limited magnitude of myopia progression of -0.34 ± 0.36 D over 2 years was found in each of the four groups on average. There were no significant differences in the rate of progression between any of the treatment groups (P > 0.05). Initial peripheral J45 astigmatic refractive error at 20° and 30° in the nasal retina was weakly correlated with progression of myopia over 2 years (r = -0.27, P = 0.004 and r = -0.20, P = 0.040, respectively; n = 113). The change in spherical equivalent peripheral refractive error at 30° nasal retina over time was also significantly correlated with progression of myopia especially at 24 months (r = -0.24, P = 0.017, n = 92). Conclusions: Relative peripheral hyperopia is associated with myopia. Myopia progression may be weakly linked to changes in the peripheral refraction profiles in the nasal retina. However, a causative link between peripheral refractive error and myopia progression could not be established.
    Investigative ophthalmology & visual science 02/2013; 54(2). DOI:10.1167/iovs.12-10278 · 3.40 Impact Factor
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    Karthikeyan Baskaran · Baskar Theagarayan · Staffan Carius · Jörgen Gustafsson ·
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    ABSTRACT: The purpose of this study is to assess the intrasession repeatability of ocular aberration measurements in the peripheral visual field with a commercially available Shack-Hartmann aberrometer (complete ophthalmic analysis system-high definition-vision research). The higher-order off-axis aberrations data in young healthy emmetropic eyes are also reported. The aberrations of the right eye of 18 emmetropes were measured using an aberrometer with an open field of view that allows peripheral measurements. Five repeated measures of ocular aberrations were obtained and assessed in steps of 10° out to ±40° in the horizontal visual field (nasal + and temporal -) and -20° in the inferior visual field. The coefficient of repeatability, coefficient of variation, and the intraclass correlation coefficient were calculated as a measure of intrasession repeatability. In all eccentric angles, the repeatability of the third- and fourth-order aberrations was better than the fifth and sixth order aberrations. The coefficient of variation was <30% and the intraclass correlation coefficient was >0.90 for the third and fourth order but reduced gradually for higher orders. There was no statistical significant difference in variance of total higher-order root mean square between on- and off-axis measurements (p > 0.05). The aberration data in this group of young emmetropes showed that the horizontal coma (C(3)(1)) was most positive at 40° in the temporal field, decreasing linearly toward negative values with increasing off-axis angle into the nasal field, whereas all other higher-order aberrations showed little or no change. The complete ophthalmic analysis system-high definition-vision research provides fast, repeatable, and valid peripheral aberration measurements and can be used efficiently to measure off-axis aberrations in the peripheral visual field.
    Optometry and vision science: official publication of the American Academy of Optometry 10/2010; 87(10):751-9. DOI:10.1097/OPX.0b013e3181f36336 · 1.60 Impact Factor
  • K. Baskaran · B. Theagarayan · S. Carius · J. Gustafsson ·
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    ABSTRACT: Purpose:The interest in off-axis aberrations has increased with the discovery of a possible link between myopia development and peripheral optics. The most common technology to measure the off-axis aberrations is a Shack-Hartmann wavefront aberrometer. This is the first study to report peripheral aberrations in a large sample of emmetropic population with a commercial open-view Shack-Hartmann aberrometer. Methods:The commercial open-view Shack-Hartmann aberrometer COAS-HD VR was used to measure the aberrations in the peripheral vision. Aberrations of the right eye of 30 emmetropes (24 ± 4 years) were studied. Off-axis aberrations were measured in steps of 10° out to ± 30° in the horizontal visual field. The subjects turned their eye to view the off-axis fixation target (light emitting diode placed at 3 meters) during the measurement. The resulting wavefront aberrations were parameterized with Zernike coefficients for a 5 mm diameter pupil. All analyzes are reported according to optical society of America (OSA) recommended standards. Results:Aberrations from the 2nd to 6th order and the total higher-order root-mean-square (HO RMS) were analyzed using one-way ANOVA. The defocus C02 was significantly myopic in the nasal visual field (+20°, +30°) whereas there was no significant difference in the temporal visual field. Astigmatism C22 increased quadratically from ±10° in the periphery and coma C13 showed a linear increase across the horizontal visual field (p < 0.05). The spherical aberration C04 and the total HO RMS showed a significant change at ±30o. Conclusions:Our results showed that in young emmetropes there was a significant increase of HO RMS at ±30°, which is expected. Astigmatism, horizontal coma, and spherical aberration vary systematically across the horizontal visual field in agreement with Seidel theory. The findings of our study with a large sample of emmetropic population agree with the previous studies done with laboratory built aberrometers.
    ARVO Annual Meeting, Fort Lauderdale, Florida, USA; 04/2010
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    Baskar Theagarayan ·

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    ABSTRACT: To evaluate the effects of a customised manipulation of spherical aberration (SA) on the high and low contrast visual acuities and contrast sensitivity of young adult myopes. A placebo-controlled double masked trial of customised spherical aberration controlling soft contact lenses was undertaken in myopes aged 15-23. Participants wore customised soft contact lenses with either (i) zero spherical aberration or (ii) negative spherical aberration that resulted in a net SA (eye plus lens) of -0.1 micron. High and low contrast log MAR visual acuities and Pelli Robson contrast sensitivity were assessed in 196 eyes of 98 subjects after a period of 12 months wearing the lenses. Both high and low contrast acuities were significantly better in the group wearing the contact lenses with negative spherical aberration (high contrast log MAR, p = 0.043; low contrast log MAR, p = 0.043) which was not due to differences in residual astigmatism or pupil size between the two groups. Pelli Robson contrast sensitivity was not significantly different in the two groups. Manipulation of spherical aberration, taking account of the participants' baseline level of aberration, can cause statistically significant improvements in high and low contrast distance visual acuity although these improvements are too small in magnitude to be of clinical significance.
    Ophthalmic and Physiological Optics 09/2009; 29(6):593-601. DOI:10.1111/j.1475-1313.2009.00678.x · 2.18 Impact Factor
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    ABSTRACT: To test the efficacy of a novel dual treatment for improving accommodative accuracy and dynamics in young persons with myopia. Ninety-three young persons with myopia (mean spherical equivalent, -3.0 +/- 1.8 D; age 16.8 +/- 2.1 years; spherical aberration +0.06 +/- 0.04 microm) participated in the study. Custom-designed soft contact lenses were used to alter ocular SA to -0.10 microm to improve accommodative accuracy and reduce any lag of accommodation. A vision training regimen was performed for 18 minutes per day for up to 6 weeks to improve speed of dynamic accommodation. Control groups had contact lenses with no added SA and/or no exercises. To avoid any effects of natural levels of negative aberration on the results of the study, all participants who had negative SA were excluded. The treatment contact lenses produced a significant reduction in lag of accommodation (P < 0.05) at all proximal viewing distances measured. The vision training measurement and treatment resulted in a significant increase in distance facility rate for all groups compared with their own baselines (P < 0.05). Near facility rate improved in the vision training treatment group only compared with its baseline (P < 0.05). Both positive and negative response times for distant viewing were significantly shorter in all groups after training compared with their baseline values (P < 0.05). At near, the positive response times were decreased significantly (P < 0.05) in both groups, whereas the negative response times decreased significantly only in the vision training treatment group. After 3 months, the dual treatments (altering SA and vision training) used in the study were effective in modifying accommodation. The static accommodative response to targets at proximal distances was increased by the altered SA contact lenses and rates of dynamic accommodation improved with vision training.
    Investigative ophthalmology & visual science 08/2009; 50(11):5120-9. DOI:10.1167/iovs.08-2865 · 3.40 Impact Factor
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    ABSTRACT: To investigate the effect of altering the spherical aberration (SA) of the eye on the static accommodative response. Participants were fitted with nominally afocal contact lenses with controlled amounts of SA of either -0.2, -0.1, 0.0, +0.1 or +0.2 microm for a 5-mm pupil. Measurements of SA and root mean square (RMS) total aberration for the eye plus lens for each participant were determined with a Complete Ophthalmic Analysis System aberrometer. Accommodation was stimulated either by placing targets at different dioptric distances from the eye, or by using a fixed distance target and placing negative-powered lenses in front of the eye. Accommodation responses were determined with a Shin-Nippon autorefractor. For both stimuli situations, the slope of the accommodation stimulus-response function was lowest for the lenses with +0.2 microm SA, and increased as the amount of SA was reduced. There was a significant negative correlation between SA and slope. Lag of accommodation at 33 cm correlated well with added SA, but did not correlate with total RMS error. There was no significant difference between the responses at 30 min after lens wear started and the responses after 1 h. Adding negative SA to the eye generally improves the slope of the accommodation stimulus-response curve and decreases lag of accommodation, and positive added SA depresses the slope of the stimulus-response curve and increases lag. The effect seems to be specific to SA, as there was no relationship between lag and RMS error. Altering SA may be a viable way of changing accommodative functions in clinical situations.
    Ophthalmic and Physiological Optics 02/2009; 29(1):65-71. DOI:10.1111/j.1475-1313.2008.00610.x · 2.18 Impact Factor