IMI Accommodation and Binocular Vision in Myopia Development and Progression

Logan, Nicola S; Radhakrishnan, Hema; Cruickshank, Fiona E; Allen, Peter M.; Bandela, Praveen K.; Davies, Leon N.; Hasebe, Shinji; Khanal, Safal; Schmid, Katrina L.; Vera-Díaz, Fuensanta A; Wolffsohn, James S.

doi:10.1167/iovs.62.5.4

Cited by 64 publications

(72 citation statements)

References 274 publications

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“…The literature has information concerning a potential ciliary muscle mechanism for myopia development. 20 One suggestion is that during accommodation, the ciliary muscle pulls on the smooth muscle of the choroid, mechanically thins the choroid, and produces the measured axial length increase. Another possibility is that a change to choroidal blood flow occurs with ciliary muscle contraction due to activation of the autonomic innervation.…”

mentioning

confidence: 99%

Ciliary Muscle Dimension Changes With Accommodation Vary in Myopia and Emmetropia

Kaphle

Schmid

Davies

et al. 2022

Invest. Ophthalmol. Vis. Sci.

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Purpose The purpose of this study was to determine whether accommodation-induced changes in ciliary muscle dimensions vary between emmetropes and myopes, and the effect of the image analysis method. Methods Seventy adults aged 18 to 27 years consisted of 25 people with emmetropia (spherical equivalent refraction [SER] +0.21 ± 0.36 diopters [D]) and 45 people with myopia (−2.84 ± 1.72 D). There were 23 people with low myopia (>−3 D) and 22 people with moderate myopia (−3 to −6 D). Right eye ciliary muscles were imaged (Visante OCT; Carl Zeiss Meditec) at 0 D and 6 D demands. Measures included ciliary muscle length (CML), ciliary muscle curved length (CMLarc), maximum ciliary muscle thickness (CMTmax), CMT1, CMT2, and CMT3 (fixed distances 1–3 mm from the scleral spur), CM25, CM50, and CM75 (proportional distances 25%–75%). Linear mixed model analysis determined effects of refractive groups, race, and demand on dimensions. Significance was set at P < 0.05. Results Myopic eyes had greater CML and CMLarc nasally than emmetropic eyes. Myopic eyes had thicker muscles than emmetropic eyes at nasal positions, except CM25 and CMT3, and at CM75 temporally. During accommodation and only nasally, CML reduced in emmetropic and myopic eyes, and CMLarc reduced in myopic eyes only. During accommodation, both nasally and temporally, muscles thickened anteriorly (CMT1 and CM25) and thinned posteriorly (CMT3 and CM75) except for temporal CM75. Moderate myopic eyes had greater temporal CMLarc than low myopic eyes, and the moderate myopes had thicker muscles both nasally and temporally using fixed and proportional distances. Conclusions People with myopia had longer and thicker ciliary muscles than people with emmetropia. During accommodation, the anterior muscle thickened and the curved nasal muscle length shortened, more in myopic than in emmetropic eyes. The fixed distance method is recommended for repeat measures in the same individual. The proportional distance method is recommended for comparisons between refractive groups.

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mentioning

confidence: 99%

Ciliary Muscle Dimension Changes With Accommodation Vary in Myopia and Emmetropia

Kaphle

Schmid

Davies

et al. 2022

Invest. Ophthalmol. Vis. Sci.

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“…There is much evidence suggesting that accommodation is a key factor in the development of myopia, although its exact mechanism is yet to be determined [ 24 , 25 , 26 ]. Retinal hyperopic defocus is regarded as a possible cause contributing to myopia, as is the link between near-vision work and myopia.…”

Section: Discussionmentioning

confidence: 99%

Reduction in Accommodative Response of Schoolchildren by a Double-Mirror System

Yeh

Lee

et al. 2021

IJERPH

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Purpose: This study first proposed the application of a double-mirror system (DMS) to extend viewing distance and investigate the accommodative response of schoolchildren under a DMS. Method: Fifty-seven subjects aged between 7 and 12 years old were recruited in this study, and the experiment was divided into two stages. The first stage consisted of a case history inquiry, a refraction state, and a visual function examination. In the second stage, the subjects gazed at an object at distances of 0.4 m, 2.285 m, and through a DMS, respectively, and their accommodative responses were measured using an open-field autorefractor. Results: There was no significant difference in the schoolchildren’s accommodative response between subjects gazing at an object at 2.285 m (0.14 ± 0.35 D, p > 0.05) and those gazing at it through a DMS (0.20 ± 0.35 D). However, their accommodative response showed a significant difference between subjects gazing at an object at 0.4 m and 2.285 m and those gazing at it at 0.4 m and through a DMS. Conclusion: In this experiment, the results of the children’s accommodative response measured at 2.285 m or through a DMS are very similar. The viewing distance can be extended by a DMS, resulting in accommodative relaxation. This result may have potential applications in myopia control.

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“…Es ist deshalb nicht verwunderlich, dass der letzte zusammenfassende Satz aus einer neueren und sehr detaillierten Arbeit über die Rolle der Akkommodation bei der Myopieentstehung folgendermaßen lautet: "Current evidence does not point toward a role of accommodation and binocular vision in myopia development and progression." [22] Dies ist insofern bemerkenswert, weil in vielen Studien die zeitliche Menge an Naharbeit und der Arbeitsabstand bei der Myopieentstehung und -progression nachgewiesen ist.…”

Section: Akkommodation Und Amblyopieunclassified

“…Diese Unterakkommodation führt zu einer Defokussierung und könnte hypothetisch ein Bulbuswachstum anregen. In einigen Studien wurde nachgewiesen, dass die Unterakkommodation bei Nahblick bei Myopen ausgeprägter ist als bei Emmetropie, andere Studien fanden diesbezüglich keinen Unterschied (Überblick in 22 ). Diese Unterakkommodation bei Nahblick, die bis zu 1 dpt und mehr betragen kann, ist, so attraktiv diese Hypothese scheint, nach derzeitiger Studienlage nicht für die Myopieentstehung oder -progression verantwortlich.…”

Section: Akkommodation Und Entstehung/progression Einer Myopieunclassified

“…Diese und weitere mit dem Akkommodationsvorgang einhergehenden Veränderungen am Auge wie eine Verminderung der Skleradicke insbesondere im temporal unteren Bereich des Äquators können zum jetzigen Zeitpunkt jedoch nicht als entscheidender Faktor für die Myopieentstehung oder -progression verantwortlich gemacht werden. Es ist deshalb nicht verwunderlich, dass der letzte zusammenfassende Satz aus einer neueren und sehr detaillierten Arbeit über die Rolle der Akkommodation bei der Myopieentstehung folgendermaßen lautet: „Current evidence does not point toward a role of accommodation and binocular vision in myopia development and progression.“ 22 Dies ist insofern bemerkenswert, weil in vielen Studien die zeitliche Menge an Naharbeit und der Arbeitsabstand bei der Myopieentstehung und -progression nachgewiesen ist.…”

Section: Akkommodation Und Entstehung/progression Einer Myopieunclassified

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Akkommodation

Steffen¹

2022

Augenheilkunde up2date

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ZusammenfassungAkkommodation ist die natürliche Zu- oder Abnahme der Refraktion des Auges bei Änderung des Beobachtungsabstands. Sie beruht auf der Verformbarkeit der natürlichen Augenlinse. Durch Untersuchung der Akkommodation und der an sie gekoppelten Konvergenz lassen sich definierte Krankheitsbilder diagnostizieren und von neuroophthalmologischen Erkrankungen abgrenzen. Überflüssige diagnostische Maßnahmen werden so vermieden, Patientenängste reduziert.

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IMI Accommodation and Binocular Vision in Myopia Development and Progression

Cited by 64 publications

References 274 publications

Ciliary Muscle Dimension Changes With Accommodation Vary in Myopia and Emmetropia

Ciliary Muscle Dimension Changes With Accommodation Vary in Myopia and Emmetropia

Reduction in Accommodative Response of Schoolchildren by a Double-Mirror System

Akkommodation

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