Retinal OFF-Pathway Overstimulation Leads to Greater Accommodation-Induced Choroidal Thinning

Hoseini-Yazdi, Seyed Hosein; Read, Scott A.; Alonso‐Caneiro, David; Collins, Michael J.

doi:10.1167/iovs.62.13.5

Cited by 15 publications

(21 citation statements)

References 64 publications

(80 reference statements)

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“…2021;2021). 40 Again, there was no correlation noted with refractive error, in line with our findings and findings by Aleman et al 12 Also, recently, Hogue and Taylor found that the individual sensitivity to ON or OFF stimuli is variable and, interestingly, it was related to axial length as well (Hogue WTC, et al IOVS . 2021;2021:ARVO Abstract).…”

Section: Discussionsupporting

confidence: 90%

Transient Eye Shortening During Reading Text With Inverted Contrast: Effects of Refractive Error and Letter Size

Świątczak

Schaeffel

2022

Trans. Vis. Sci. Tech.

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Purpose Myopes have a reduced ability to elicit transient axial eye shortening after imposed positive defocus, which may be due to changes in the biochemical signaling cascade controlling choroidal thickness. We have investigated whether reading with inverted text contrast can still elicit transient axial eye shortening in myopes, like it has been shown in emmetropes. Methods Changes in axial length before and after reading were measured with the Lenstar LS-900. Text with inverted contrast was read from a large screen at 2 m distance (angular subtense 35.9°, screen luminance matched in all conditions to 86 ± 7 cd/m²) for 30 minutes. Moreover, we investigated the effects of letter sizes. Two text sizes were tested: “small” text (letter height 13.75 arcmin) and “large” text (letter height 34.39 arcmin). Results Reading text with inverted contrast induced eye shortening (–10.2 ± 9.5 µm) in myopic eyes ( n = 11; refraction –3.5 ± 1.9 diopters [D]), showing that an inhibitory signal was still generated by the retina as in emmetropes. In 15 subjects (refraction +1.7 to –4.2 D) we found that small text does not elicit significant differences in axial length ( P = 0.09). However, with large text, changes in axial length were clearly different for the both contrast polarities (standard contrast, +1.7 ± 9.0 µm; inverted contrast, –9.7 ± 8.9 µm; P = 0.0017). Conclusions Although positive defocus may not be an effective intervention to inhibit further eye growth in myopes, other visual stimuli can still trigger choroidal thickening and possibly generate signals to decrease myopia progression. Translational Relevance Our results have shown the optimized text features, which may have a positive impact on myopia control.

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Section: Discussionsupporting

confidence: 90%

Transient Eye Shortening During Reading Text With Inverted Contrast: Effects of Refractive Error and Letter Size

Świątczak

Schaeffel

2022

Trans. Vis. Sci. Tech.

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“…Despite the equivocal evidence about the effect of cyclopentolate-induced cycloplegia on choroidal thickness, some studies have reported thinner 42 or thicker 43 choroidal thickness after cyclopentolate-induced cycloplegia; it is important to acknowledge that the use of cyclopentolate (to eliminate the potential effects of accommodation on choroidal thickness and improve image quality of the optical coherence tomography scan and fundus image) in our study may have impacted the choroidal thickness measurements. Transient thinning in choroidal thickness in the range of −1 to −9 μm in response to 3 to 6 D induced accommodation retinal defocus has been reported previously 44,45 . Even though our study did not strictly control for the effects of retinal defocus (which could potentially influence choroidal thickness), it is unlikely that participants in this study may have been exposed to that level of blur as highlighted, for instance, by the small amount of undercorrection and overcorrection of their spectacles.…”

Section: Discussionmentioning

confidence: 68%

Choroidal Thickness Profiles and Associated Factors in Myopic Children

Kobia‐Acquah¹,

Flitcroft²,

Lingham

et al. 2022

Optom Vis Sci

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SIGNIFICANCEThis study addresses the lack of choroidal thickness (ChT) profile information available in European children and provides a baseline for further evaluation of longitudinal changes in ChT profiles in myopic children as a potential biomarker for myopia treatment and identifying children at risk of myopic progression.PURPOSEThis study aimed to investigate ChT profiles and associated factors in myopic children.METHODSBaseline data of 250 myopic children aged 6 to 16 years in the Myopia Outcome Study of Atropine in Children clinical trial were analyzed. Choroidal thickness images were obtained using swept-source optical coherence tomography (DRI-OCT Triton Plus; Topcon Corporation, Tokyo, Japan). The macula was divided into nine Early Treatment of Diabetic Retinopathy Study locations with diameters of 1, 3, and 6 mm corresponding to the central fovea, parafoveal, and perifoveal regions. Multiple linear regression models were used to investigate determinants of ChT.RESULTSChoroidal thickness varied across the macular Early Treatment of Diabetic Retinopathy Study locations (P < .001): thickest in the perifoveal superior region (mean ± standard deviation, 249.0 ± 60.8 μm) and thinnest in the perifoveal nasal region (155.1 ± 50.3 μm). On average, ChT was greater in all parafoveal (231.8 ± 57.8 μm) compared with perifoveal (218.1 ± 49.1 μm) regions except superiorly where the ChT was greater in the perifoveal region. Longer axial length and higher myopic spherical equivalent refraction were consistently associated with thinner ChT at all locations in the multiple linear regression models. Asian race was significantly associated with thinner ChT only at parafoveal and perifoveal superior regions after Bonferroni correction (P = .004 and P = .001, respectively).CONCLUSIONSChoroidal thickness was thinnest in the nasal macular region and varied systematically across all macular locations, with axial length and spherical equivalent refraction being the strongest determinants of ChT. Longitudinal evidence will need to evaluate whether any differences in ChT profiles are predictive of myopic progression and to determine the role of ChT measurements in identifying myopic children most in need of myopia control treatment.

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“…1 While central eye length is known to increase upon accommodation, there are conflicting results concerning the influence of on-axis refraction, with findings of greater change in emmetropes than in myopes, 2 no differences between the groups, 3 greater changes in myopes than in emmetropes 4,5 and greater changes in higher myopes than in emmetropes and low myopes. 6 The increase in eye length with accommodation has been attributed, at least in part, to decreases in choroidal thickness with accommodation that have been documented in the subfoveal (central) region, 5,7 across the macular region 8,9 and in the peripapillary region. 10 With accommodation relaxed, myopes have thinner choroids than emmetropes, both centrally and out to ~25°.…”

Section: Introductionmentioning

confidence: 99%

Central and peripheral choroidal thickness and eye length changes during accommodation

Kaphle

Schmid

Suheimat

et al. 2023

Ophthalmic Physiologic Optic

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Eye length increases during accommodation, both on-axis and in the periphery. The aim of this study was to determine whether the peripheral choroid thins with accommodation and to determine the relationship with eye length changes measured at the same location. Methods: Subjects included 53 young adults in good ocular and general health, with 19 emmetropes and 34 myopes. Measurements from the right eye were made for 0 D and 6 D accommodation stimuli for ±30° horizontal visual field/retinal locations in 10° steps. Valid eye length and choroidal thickness measurements were obtained for 37 and 47 participants, respectively, and both measures were taken for 31 participants. 2.5% phenylephrine was instilled to dilate the pupils. Participants turned their eyes, without head movement, to fixate targets and to make the target 'as clear as possible' during measurements. Correction was made for the influence of lens thickness changing at different peripheral angles. Choroidal thickness was measured with a spectral-domain-Optical Coherence Tomographer. For peripheral images, the internal cross target on the capture screen was moved from the centre to 17.25° nasal/temporal positions. Results: In accordance with previous literature, eye length increased with accommodation. The greatest change (mean ± SD) of 41 ± 17 μm occurred at the centre, with a mean change across the locations of 33 μm. There were no significant differences between emmetropes and myopes. Choroidal thickness decreased with accommodation, with changes being about two-thirds of those occurring for eye length. The greatest change of −30 ± 1 μm occurred at the centre, with a mean change of −21 μm. Greater choroidal thinning occurred for myopes than for emmetropes (23 ± 11 vs. 17 ± 8 μm, p = 0.02). Conclusions: With accommodation, eye length increased and the choroid thinned, at both central and peripheral positions. Choroidal thinning accounted for approximately 60% of the eye length increase across the horizontal ±30°.

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Retinal OFF-Pathway Overstimulation Leads to Greater Accommodation-Induced Choroidal Thinning

Cited by 15 publications

References 64 publications

Transient Eye Shortening During Reading Text With Inverted Contrast: Effects of Refractive Error and Letter Size

Transient Eye Shortening During Reading Text With Inverted Contrast: Effects of Refractive Error and Letter Size

Choroidal Thickness Profiles and Associated Factors in Myopic Children

Central and peripheral choroidal thickness and eye length changes during accommodation

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