Purpose: To assess the reproducibility (i.e., inter-device reliability) of the biometers Topcon MYAH, Oculus MyopiaMaster and Haag-Streit Lenstar LS 900 with the Carl Zeiss IOLMaster 700 and the intrasubject repeatability in myopic children to reliably detect axial growth for myopia management. Methods: 22 myopic children (11.1 ± 2.4 yr) with a spherical equivalent of -3.53 ± 2.35 D were subject to each of the biometers to assess axial length (AL), corneal parameters (steepK, flatK, meanK, vectors J0, J45), of which 16 children agreed to a second round of measurements. Reproducibility of the first measurements between the IOLMaster and every other biometer was assessed employing a Bland-Altman approach and paired Student t-test. Repeatability was assessed as intra-subject standard deviation and was used to estimate the minimum time interval required between two axial length measurements to reliably detect axial growth of an eye of at least 0.1 mm/year. Results: Repeatability for AL measurements was IOLMaster: 0.05 mm, MyopiaMaster: 0.06 mm, Myah: 0.06 mm, Lenstar: 0.04 mm; the respective minimal time interval for axial growth assessment in myopia management was estimated as 5.6, 6.6, 6.7, and 5.0 months, respectively. Best reproducibility in AL measurement was found between IOLMaster and Lenstar (95% Limits of Agreement (LoA) for reproducibility -0.06 to 0.02). As for the means, Lenstar measures AL longer than IOLMaster by 0.02 mm (p<0.001). MyopiaMaster measures meanK significantly lower (by 0.21 D with p<0.001) than IOLMaster. Regarding J0, all biometers deviate significantly from IOLMaster measurements (p<0.05). Conclusion: A generally good agreement was observed between all the biometers. When assessing myopia progression in children a timeframe of at least six months between the AL measurements is advisable to reliably determine any deviation from a normal growth pattern.
Hintergrund: Es soll die Sicherheit im Straßenverkehr beim Tragen von Brillengläsern mit Defocus Incorporated Multiple Segments (DIMS) Technologie in der Kombination mit Atropin evaluiert werden. Patienten und Methoden: An 12 jungen Erwachsenen (Alter: 24 bis 45; 30,1 ± 5,7 Jahre) wurde der Fernvisus und die Kontrastempfindlichkeit (KE), sowie Blendempfindlichkeit bei Versorgung mit DIMS-Brillengläsern allein und in der Kombination mit 0,01% Atropin untersucht. Ergebnisse: Durch Atropineinwirkung vermindert sich der Fernvisus beim Blick durch den zentralen Bereich des DIMS-Brillenglases nicht; bei Blendung und unter Atropin kommt es zu einem Visusabfall um 0,10 LogMAR. Beim erzwungenen Blick durch den DIMS-Bereich vermindert sich der Fernvisus durch Atropineinwirkung ohne Blendung um 0,09 LogMAR; bei Blendung ist durch Atropin kein weiterer Visusabfall zu beobachten. Die Kontrastempfindlichkeit mit DIMS-Gläsern wird durch Atropineinwirkung nicht relevant verändert. Hinsichtlich der Blendempfindlichkeit findet sich bei DIMS-Gläsern keine für das Sehen und die Sicherheit im Straßenverkehr relevante Sehbeeinträchtigung. Zusätzliche Atropinisierung hat keinen Einfluss auf die Blendempfindlichkeit. Schlussfolgerung: DIMS-Brillengläser sind sicher im Straßenverkehr und verursachen keine relevante Beeinträchtigung des Sehens, auch nicht unter Einfluss von 0,01 % Atropin. DIMS Brillengläser sind daher auch bei der Behandlung von progressiven Myopien in der Kombinationstherapie mit Atropin sicher. Background: The aim of this study was to evaluate traffic safety of Defocus Incorporated Multiple Segments (DIMS) spectacle lenses in combination therapy with atropine. Patients and Methods: 12 young adults (age: 24 -45; 30,1 ± 5,7 years) were recruited to evaluate corrected distance visual acuity (CDVA), contrast sensitivity (CS) (FrACT), glare sensitivity (Mesotest) under the influence of DIMS-spectacle correction alone and combination therapy with 0,01% atropine. Results: When looking through the central area of the DIMS lens, far vision does not decrease due to the influence of atropine; influence of glare and atropine leads to a reduction of CDVA by 0.10 LogMAR. When forced to look through the DIMS area, far vision is reduced by 0.09 LogMAR due to the influence of atropine in the absence of glare; in the presence of glare, no further loss of visual acuity can be observed under the influence of atropine. Contrast vision with DIMS glasses is not altered by the effects of atropine. Concerning glare sensitivity, DIMS lenses did not show any visual impairment that would be relevant to vision and road safety. Additional atropinization does not affect glare sensitivity. Conclusion: DIMS spectacle lenses are safe for participation in road traffic and do not relevantly impair traffic safety, neither alone nor under the acute influence of 0,01 % atropine.
Eine 11-jährige Patientin wurde in unserer Myopiesprechstunde vorstellig mit der Frage nach Behandlung bei hochgradiger progredienter Myopie und schwankendem Visus. Die Patientin verwendete bereits niedrig dosierte Atropin-Augentropfen (0,01 %). Die Mutter ist hyperop, der Vater emmetrop. Allgemeinanamnestisch wurde das Kind von der Mutter als gesund beschrieben.
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