The Impact of Early Lens Opacity Progression on Visual Acuity and Refraction

Rouhiainen, Päivi; Rouhiainen, Harri; Salonen, Jukka T.

doi:10.1159/000310799

Cited by 8 publications

(6 citation statements)

References 11 publications

(15 reference statements)

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“…Planter 6 suggested that cortical opacity can induce significant hyperopic shifts, but this claim has not been repeated. 7 Review papers have suggested that cortical opacity can induce astigmatic changes. 3 8 However, these reports were based on clinical impression with no supporting data.…”

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confidence: 99%

Refractive error changes in cortical, nuclear, and posterior subcapsular cataracts

Pesudovs

Elliott²

2003

British Journal of Ophthalmology

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Aims: To determine the effect of the three main morphological types of cataract on refractive error. Methods: Data were prospectively collected from 77 subjects (age 67 (SD 8) years) with one morphological type of cataract. 34 had cortical, 21 had nuclear, and 21 had posterior subcapsular cataract. 22 subjects with clear lenses (60 (7) years) were recruited as controls. The spherical equivalent and astigmatic vector change between spectacle correction and optimal refraction were calculated. Results: The cortical cataract group showed a significant astigmatic change of 0.71 (0.67) D (mean (1 SD)) compared to the control group (0.24 (0.20) D), with 24% outside the 95% confidence limit (0.63 D). The nuclear cataract group showed a significant myopic shift of −0.38 (0.60) D compared to the control group (+0.02 (0.21) D), with 52% beyond the minus 95% confidence limit (−0.39 D). Conclusion: A quarter of subjects with cortical cataract showed larger changes in astigmatism than subjects with clear lenses. This is probably because of the localised refractive index changes along cortical spoke opacities within the pupillary area. The well known myopic shift of nuclear cataract was also demonstrated.T he purpose of this study was to determine the effect, if any, of the three main morphological types of age related cataract on refractive error. It is well known that nuclear cataract can cause a myopic shift in some cases. [1][2][3][4][5] This change accounts for the "second sight of the elderly" in which the myopic shift provides normal reading ability without the need for spectacles, although distance vision worsens. 3 The effect of cortical and posterior subcapsular (PSC) cataract on refractive error is less clear. Planter 6 suggested that cortical opacity can induce significant hyperopic shifts, but this claim has not been repeated. 7 Review papers have suggested that cortical opacity can induce astigmatic changes.3 8 However, these reports were based on clinical impression with no supporting data. Early experimental studies found no evidence that age related cataracts induce astigmatic shifts in refractive error.9 10 However, this is worth re-examining as improved methods such as vector analysis of astigmatism and better cataract grading systems should increase the sensitivity to detect these changes if they exist. MATERIALS AND METHODS SubjectsSubjects were recruited from the elderly patients attending for routine examination in an optometric practice in the United Kingdom between January 2001 and January 2002. The tenets of the Declaration of Helsinki were followed and the study gained approval from the university ethics committee.Informed consent was obtained from all subjects after the nature of the study had been fully explained. Inclusion criteria included age related cataract of one morphological type (patients aged over 50 years) and the ability to provide accurate responses during subjective refraction. Exclusion criteria included other ocular or systemic disease that could cause shifts in refractive error, s...

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confidence: 99%

Refractive error changes in cortical, nuclear, and posterior subcapsular cataracts

Pesudovs

Elliott²

2003

British Journal of Ophthalmology

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“…Elliott et al found that some of their patients with extensive cortical opacity retained excellent visual acuity and attributed this to the ability to look through a “hole” in the cataract 11. Rouhiainen et al found that a decrease in Snellen acuity was associated with increasing nuclear opacification but not with early cortical opacity 10. Pesudovs and Coster found that a score of visual disability in cataract patients was related to nuclear opacity and to posterior subcapsular cataract but not to cortical cataract 12…”

Section: Discussionmentioning

confidence: 99%

The assessment of lens opacities in clinical practice: results of a national survey

Frost

Sparrow²

2001

British Journal of Ophthalmology

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Aim-To investigate the examination of lens opacities in routine ophthalmic clinical practice. Method-A questionnaire survey was mailed to 703 consultant ophthalmologists in the UK. The surgeons were asked which lens feature(s) they assessed in their clinics when deciding whether to oVer cataract surgery. Results-489 replies were received. A broad range of lens opacities was assessed, with diVerences between surgeons for some opacities with high prevalences in the population, particularly cortical opacities. Many (74% of 467) surgeons assessed one or more lens opacities (anterior subcapsular cataract, vacuoles, water clefts, coronary flakes, focal dots, retrodots, fibre folds) which may be visually important but which have received relatively little attention by researchers. Conclusions-Some classes of lens opacity which are traditionally measured by researchers may be ignored in clinical practice and opacities which are traditionally ignored by some researchers are regarded as clinically important by a substantial number of surgeons. (Br J Ophthalmol 2001;85:319-321)

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“…Cyanopeptolins A (44) -D were isolated from Microcystis sp. 119 The depsipeptide is constructed using the standard NRPS machinery by genes apdA, B, and D, which contained two, four, and one NRPS modules, respectively. Structures were solved by a combination of amino acid analysis, GC, and 2D NMR, with total correlation spectroscopy (TOCSY) experiments proving crucial in the structural determination of the unusual Ahp residue.…”

Section: Cyanopeptolinsmentioning

confidence: 99%