Visual Psychophysics / Physiological Optics - ARVO

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ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group – Visual Psychophysics / Physiological Opticsrespectively). To assess the impact of dominance on visualperformance, through-focus visual acuity (VA) from 0.0 to 3.0D at0.5D step with a 4mm artificial pupil was measured under twoconditions by assigning dominant and non-dominant eye to distanceand near, respectively, and vice versa. Traditional monovision of1.5D anisometropia was measured for comparison.Results: Sensory eye dominance spanned from weak (DOD=4%) tostrong (DOD=23%) dominance with average DOD=9±8%. Theaverage difference in through-focus VA between switching eyeassignment for distance in modified and traditional monovision was -0.01±0.04 and 0.00±0.03 logMAR, respectively. The subject with thestrongest dominance experienced a loss in intermediate (0.5-1.5D)VA of 0.16±0.09 and 0.05±0.01 logMAR with modified andtraditional monovision, respectively, when the non-dominant eye wasassigned to distance compared to assigning the non-dominant eye tonear.Conclusions: For subjects with typical low and moderate levels ofsensory eye dominance, the degree of dominance did not have asignificant effect on through-focus VA in monovision regardless ofwhich eye was assigned to distance and near. However, it isimportant for subjects with strong eye dominance to assign thedominant eye to distance vision for optimal through-focus VA,especially in modified monovision correction.Commercial Relationships: Len Zheleznyak, None; Aixa Alarcon,None; Kevin C. Dieter, None; Duje Tadin, None; GeunyoungYoon, Bausch & Lomb (F), Johnson & Johnson (F), Allergan (C),Staar Surgical (C), CIBA Vision (F), Acufocus (C)Support: NIH Grant EY014999, Research to Prevent BlindnessUnrestricted/Challenge Grant, NIH Training Grant T32 EY007125Program Number: 4253 Poster Board Number: B0290Presentation Time: 8:30 AM - 10:15 AMCustomizing depth of focus outcomes in Hyperopic Lasik usingan Adaptive Optics Vision AnalyzerGuillermo M. Perez 1 , Eloy A. Villegas 2 , Benjamin Leray 3 , Francois J.Malecaze 3 , Pablo Artal 2 . 1 Voptica S.L., Murcia, Spain; 2 Laboratoriode Optica, Universidad de Murcia, Murcia, Spain; 3 Serviced'Ophtalmologie, CHU Toulouse-Purpan, Toulouse, France.Purpose: LASIK allows not only to correct for the refractive errorbut also to extend depth of focus by inducing controlled amounts ofspherical aberration (SA). However the success of the procedure maydepend on the particular SA values required by each patient. Weevaluate a customization procedure where the optimum values of SAwere determined for each patient using an adaptive optics visionanalyzer before the surgery.Methods: A group of 38 hyperopic/presbyopic patients wereevaluated before and after surgery using the Adaptive Optics VisionAnalyzer (AOVA, Voptica SL, Murcia, Spain). This is a clinicalinstrument to perform vision testing with full control of the opticalaberrations induced in the patient’s eye non-invasively. The AOVAincludes a wave-front sensor, a liquid crystal on silicon spatial lightmodulator to induce any desired aberration profile on the patient’seye, and a micro-display to present the visual stimuli. Visual acuitywas measured for defined combinations of residual defocus and SA atinfinity, 60 cm and 40 cm. In each patient, the sets of optimizedvalues of defocus and SA required to maintain adequate near and farVA were determined. Then, and taking into account the patient’scorneal asphericity (Q-value), the LASIK procedure (WaveLightAllegretto Wave Eye-Q Laser, Alcon) was settled to induce thedesired range of negative SA in one eye. The fellow dominant eyewas treated only to reach emmetropia without inducing SA. After thesurgery, through focus VA, residual refraction, and SA was measuredusing the AOVA in each patient.Results: The average Q-value changed from -0.1 to -0.6 in thedominant eyes, and from -0.05 to -0.8 in the eyes treated for inducingextra asphericity. The average value of SA providing an extendeddepth of focus was around -0.2 microns for 4.5-mm pupil. In theseeyes, the required positive addition for intermediate and near visionchanged from +1.00D and +1.70D to +0.40D and +1.00Drespectively. In those eyes with no SA induced, the positive additionrequired hardly changed.Conclusions: Hyperopic presbyopic patients are ideal candidates forcustomized LASIK to induce an extended depth of focus. Thisprocedure can be optimized when mediated with adaptive to predictthe right amount of SA to be induced. These results suggest that theLASIK guided with and AOVA can provide improved visualoutcomes at all distances.Commercial Relationships: Guillermo M. Perez, VOPTICA (E);Eloy A. Villegas, Voptica, S.L. (I), Calhoun Vision (F); BenjaminLeray, None; Francois J. Malecaze, None; Pablo Artal, AMO (C),Voptica SL (P), Voptica SL (I), AMO (F), Calhoun Vision (F),Calhoun Vision (C), AcuFocus (C)Support: Ministerio de Ciencia e Innovación, Spain (grantsFIS2010-14926 and CSD2007-00013), Fundación Séneca (Region deMurcia, Spain), grant 4524/GERM/06.Program Number: 4254 Poster Board Number: B0291Presentation Time: 8:30 AM - 10:15 AMEffect of Age on Amplitude of Accommodation in BoliviaMagnus Andersson, Baskar Theagarayan. Section of Optometry andVision Science, Linnaeus University, Kalmar, Sweden.Purpose: The purpose of this study was to investigate the impact ofage on Amplitude of Accommodation (AA) in a Bolivian populationand compare it with previously published data. We were alsointerested in finding out the age of onset of Presbyopia in thispopulation.Methods: A sample of 197 Bolivian subjects aged between 8 to 60years, attending three different field clinics provided by Vision ForAll (non-profit organization, Sweden) was used in the study. All thesubjects were refracted binocularly and had at least best correctionVisual acuity of 20/25. None of the subjects had any visiblestrabismus or ocular pathology. The AA was measured using thepush-up and push-down method with a Royal Air Force (RAF) ruler.The ruler has both a metric scale in centimeters and a dioptric scale.The subjects were asked to read letters of N5 print size and reportfirst sustained blur in push-up method and first sustained clear in thepush-down method. The subjects had their correction in place duringthe measurements. Among the presbyopic subjects a +2.00D lens wasplaced as an addition to bring the target within measurable limits. Theaverage of push-up and push-down readings was used as thesubjective AA.Results: Independent samples t-test showed no statisticallysignificant difference between the present and the previous AAstudies (p > 0.05). The AA of the Bolivian population was generallylower compared to previous investigations. Regression analysisshowed a significant correlation between age and the AA (r = 0.80, p< 0.05). The onset of presbyopia among the Bolivian population wasfound to be 38 years.Conclusions: This result supports the theory that there is a lower AAamong people in tropical zones compared to those from temperatezones. The onset of presbyopia for this Bolivian population wasseven years earlier than the Hofstetter formula would predict and fiveyears earlier compared to Duane’s (Duane A, Trans Am OphthalmolSoc, 1922; 20:132-157) values.Commercial Relationships: Magnus Andersson, None; BaskarTheagarayan, None©2013, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permissionto reproduce any abstract, contact the ARVO Office at arvo@arvo.org.
ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group – Visual Psychophysics / Physiological OpticsProgram Number: 4255 Poster Board Number: B0292Presentation Time: 8:30 AM - 10:15 AMInfluences of cycloplegia with topical cyclopentolate on higherorderaberrations in myopic childrenTakahiro Hiraoka 1 , Kazunori Miyata 2 , Fumiki Okamoto 1 , TetsuroOshika 1 . 1 Dept of Ophthalmology, University of Tsukuba, Tsukuba,Japan; 2 Miyata Eye Hospital, Miyakonojo, Japan.Purpose: It is little known about the effect of cycloplegia withtopical cyclopentolate on optical quality of the eye in myopicchildren. We conducted this prospective study to investigate theinfluence of topical cyclopentolate on higher-order aberrations(HOAs) in myopic children.Methods: Twenty-eight eyes of 28 myopic children (17 boys and 11girls), ranging in age from 4 to 12 years (7.25 ± 2.55, mean ±standard deviation), were enrolled in this study. We evaluatedrefraction and wavefront aberrations before and after cycloplegiawith topical instillation of 1% cyclopentolate hydrochloride. Ocularand corneal aberrations were simultaneously measured and comparedwith each other. Individual Zernike components were also analyzedfor a 6-mm pupil up to the sixth order. All these parameters werecompared before and after cycloplegia. In addition, the obtained datawere compared with other 23 subjects with hyperopia.Results: Cycloplegia with topical cyclopentolate induced significanthyperopic changes from -3.07 ± 2.23 to -2.57 ± 2.15 D (P < 0.001,paired t-test). Ocular higher-order aberrations (HOAs) increasedsignificantly from 0.243 ± 0.111 to 0.263 ± 0.105 μm for coma-likeaberrations (P = 0.042), from 0.124 ± 0.041 to 0.138 ± 0.037 μm forspherical-like aberrations (P = 0.012), and from 0.279 ± 0.105 to0.304 ± 0.096 μm for total HOAs (P = 0.015). Corneal HOAs did notchange by cycloplegia. When corneal and ocular HOAs werecompared, the ocular HOAs were significantly smaller than thecorneal HOAs in spherical-like aberrations (P < 0.001) and totalHOAs (P = 0.006). When compared between myopic and hyperopicchildren, spherical-like aberrations and total HOAs were significantlylarger in hyperopia than in myopia (P = 0.001 and P = 0.042,unpaired t-test). However, each Zernike component showed a largestandard deviation in both groups.Conclusions: Internal optics compensate for corneal HOAs also inmyopic children, and paralysis of tonic accommodation withcyclopentolate considerably affects ocular HOAs. It may be thatphysiological tonic accommodation is done to improve retinal imagequality by reducing HOAs. In addition, HOAs tend to be smaller inmyopia than in hyperopia, but inter-individual variation in eachZernike component is quite large in both myopic and hyperopicchildren.Commercial Relationships: Takahiro Hiraoka, None; KazunoriMiyata, None; Fumiki Okamoto, None; Tetsuro Oshika, NoneProgram Number: 4256 Poster Board Number: B0293Presentation Time: 8:30 AM - 10:15 AMFive-year Incidence of Loss of Accommodative Ability in theBeaver Dam Offspring StudyDayna S. Dalton, Karen J. Cruickshanks, Mary E. Fischer, BarbaraE. Klein, Ronald Klein, Aaron A. Pinto. Ophthalmology and VisualSciences, University of Wisconsin, Madison, WI.Purpose: To determine the 5-year incidence of loss ofaccommodative ability in a large cohort of adults.Methods: Subjects (n=2256, age 21-84 years at baseline) participatedin both the baseline (2005-2008) and 5-yr follow-up exam (2010 -2012) of Beaver Dam Offspring Study. At each visit a Grand SeikoAutorefractor was used to obtain three measures of refractive error;distance correction and with correction focusing on two near targets;one requiring 2 diopters (D) and the other 4.5D. Readings wereconverted to spherical equivalent (sphere + ½ cylinder) (SE).Participants were classified as myopic (SE ≤ -1.00), hyperopic (SE ≥+1.00) or emmetropic (SE > -1.00 and < +1.00). At each of the twonear targets, the participant was considered to have lostaccommodative ability if the spherical equivalent was ≥ -0.50.Subjects with cataract surgery were excluded.Results: In preliminary analyses of right eyes, there were 741participants in the baseline exam who were able to accommodate atboth targets. Of those, 333 (45%) were not accommodating at the 2Dtarget and 241 (33%) were not accommodating at the 4.5D target atthe 5-yr follow-up exam. Age was highly associated with theincidence of loss of accommodative ability (mean age ofaccommodating at 2D = 38.2 years; 4.5D = 38.7 years, notaccommodating at 2D = 44.7 years; 4.5D = 46.1 years) and risk oflosing accommodative ability increased with increasing age (OR3.18, 95% CI 2.59-3.90 for each 5 years of age). Participants withhyperopia were less likely to lose accommodative ability (OR 0.01,95% CI 0.00 - 0.04) compared to those with emmetropia. There wasno association between myopia or sex with loss of accommodativeability. Eight participants over the age of 55 years at the baselineexamination had accommodative ability at both distances at bothexaminations.Conclusions: Loss of accommodative ability is very common inmiddle-age. These data show that adjusting for age, hyperopia wasassociated with decreased risk. In spite of the strong age effect, asmall number of people retain accommodative ability beyond midlife.Further investigation is necessary to identify factors that areassociated with retention of accommodative ability. To the best ofour knowledge, this is the first longitudinal study using an objectivemeasure to investigate the loss of accommodative ability.Commercial Relationships: Dayna S. Dalton, None; Karen J.Cruickshanks, None; Mary E. Fischer, None; Barbara E. Klein,None; Ronald Klein, None; Aaron A. Pinto, NoneSupport: NIH Grant AG021917Program Number: 4257 Poster Board Number: B0294Presentation Time: 8:30 AM - 10:15 AMEffect of Unclean Display on Accommodative ResponseMasakazu Hirota 1 , Hiroshi Uozato 1, 2 , Shinji Arai 1 , Yuko Shibata 1 .1 Ophthalmology & Visual Sciences, Kitasato Univ Graduate School,Minami-ku, Sagamihara-shi, Japan; 2 Orthoptics & Visual Sciences,Kitasato University School of Allied Health Science, Minami-ku,Sagamihara-shi, Japan.Purpose: To assess change of accommodative response when wewatched an unclean display.Methods: Twenty volunteers (5 men and 15 women; mean ±standard deviation age, 22.2 ± 3.4 years; range, 19 to 33 years)participated in our study. All subjects had a visual acuity of 20/20 orbetter. In addition, we confirmed that all subjects had enoughaccommodation more than 7.00 D (mean ± standard deviation, 12.31± 0.54 D) and their near reflex was normal. Each subject’saccommodative response was measured by a target moving systemWMT-1 (Grand Seiko Co., Ltd, Hiroshima, Japan). WMT-1 canmove a target optionally from 0.2 to 1.0 m and it include a binocularAutorefractor WAM-5500 (Grand Seiko Co., Ltd, Hiroshima, Japan)that can measure refraction every 0.2 second in open field. Weadopted iPad (Apple Inc., Cupertino, CA) on WMT-1 as a target. Asan unclean display model, we covered closely to 3 pieces of tracingpaper upon the iPad’s display. We compared accommodativeresponse of a clean display and an unclean display in target distanceof 1 m, 0.5 m, and 0.2 m.Results: The accommodative response of unclean display increased©2013, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permissionto reproduce any abstract, contact the ARVO Office at arvo@arvo.org.
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