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accommodation in human eye models:a comparison between the optical designs of Navarro,Arizona and Liou-Brennan

International Journal of Ophthalmology(English edition) 2017年第1期10卷 43-50页

作者： Georgios Zoulinakis Jose Juan Esteve-Taboada Teresa Ferrer-Blasco David Madrid-Costa Robert Montés-Mico Department of Optics and Physics Faculty University 46100Spain Optometry and Vision Sciencesof ValenciaBurjassotValencia Interuniversity laboratory for research in Vision and Optometry Mixed group University of ValenciaUniversity of MurciaSpain

AIM： To simulate and compare accommodation in accommodative and non-accommodative human eye models.METHODS： Ray tracing and optical design program was used. Three eye models were designed and studied： the Navarro, the Arizona and the Liou-Brennan. In order to make the Navarro and Liou-Brennan models to accommodate, specific geometric parameters of the models were altered with values that were chosen from the literature. For the Arizona model, its’ mathematical functions for accommodation were used for the same accommodative demands. The simulation included four distances of accommodation for each model： at infinity, 3, 1 and 0.5 m.The results were diffraction images of a “letter F” for graphical comparison, spot diagrams on the retinal field and Modulation Transfer Function （MTF） graphs.RESULTS：Zernike coefficients for the aberrations, Airy disk diameter, root mean square （RMS） error diameter and total axial length of the model were provided from the program. These were compared between them in all distances. The Navarro model had the smallest axial length change as a simple model. The Arizona did not change its axial length because it is designed to be accommodative. The Liou-Brennan model had different results concerning the aberrations because of the decentration of the pupil. The MTF graphs showed small differences between the models because of the differences in their designs.CONCLUSION： All the three models are able to simulate accommodation with the expected results. There is no model that can be assumed as the best choice. accommodation can be simulated in non-accommodativemodels and in customized ones.

关键词： accommodation design eye model optical

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accommodation function comparison following use of contact lens for orthokeratology and spectacle use in myopic children: a prospective controlled trial

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International Journal of Ophthalmology(English edition) 2018年第7期11卷 1234-1238页

作者： Yang Yang Li Wang Peng Li Jun Li Optometry Teaching & Research Office Xi'an Medical University Ophthalmology Department the 451~(st) Hospital of PLA Centers for Juvenile Myopia Control and Prevention Shaanxi Institute of Ophthalmology

AIM： To study effects of orthokeratology（Ortho-k） on accommodation function in myopic children. METHODS： A prospective, non-randomized, case-control study was performed from September to October 2016. Eighty-three children with myopia were divided into two groups. One group was treated with the rigid contact lens for overnight Ortho-k, and the other was treated with single-vision spectacle lens（SVL）. accommodation function were assessed by accommodative amplitude（AA）, accommodative sensitivity（AS）, accommodative lag（Lag）, negative relative accommodation（NRA）, and positive relative accommodation（PRA） before and 1, 3, 6 and 12 mo after treated. RESULTS： Totally 72 myopic children were finished the follow-up： 37 in Ortho-k group and 35 in SVL group. Wearing time had a significant effect on AA, AS, Lag, and NRA of myopic children in two groups（all P〈0.05）. Meanwhile, there was an interaction effect between wearing time and wearing types（FAA=5.3, FAS=45.5, FLag=7.0, FNRA=3.7, all P〈0.05）. However, the between-group difference of AA（F=0.1）, AS（F=3.2）, Lag（F=1.1）, NRA（F=0.3）, and PRA（F=0.1） showed no significance. AA, AS, NRA, Lag and PRA were improved significantly in Ortho-k group within 1 to 6 mo after wearing. CONCLUSION： Wearing Ortho-k can improve the accommodation function of myopic children, which might be one of the mechanisms for myopia control.

关键词： orthokeratology accommodation myopia children

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Peripheral refraction of myopic eyes with spectacle lenses correction and lens free emmetropes during accommodation

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Eye and Vision 2021年第1期8卷 454-461页

作者： António Queirós Alejandro Cerviño JoséManuel González‑Méijome Clinical&Experimental Optometry Research Lab(CEORLab) Center of Physics(Optometry)University of MinhoCampus de Gualtar4710‑057 BragaPortugal Optometry Research Group Department of Optics and Optometry and Vision SciencesUniversity of ValenciaValenciaSpain

Purpose:To measure axial and off-axis refraction patterns in myopic eyes with spectacle lenses correction and lens free emmetropes in young healthy subjects at different target distances from 2.00 m(0.50 D)to 0.20 m(5.00 D)in terms of sphere,astigmatism,and spherical equivalent refraction.Methods:Refraction was measured at the center,20 and 40 degrees from the line of sight both nasally and temporally in 15 emmetropic and 25 myopic young healthy subjects with an open field,binocular,infrared autorefractor(Grand Seiko WAM-5500,Hiroshima,Japan).Fixation target was a Maltese cross set at 2.00,0.50,0.33 and 0.20 m from the corneal plane.Changes in off-axis refraction with accommodation level were normalized with respect to distance axial values and compared between myopic eyes with spectacle lenses correction and lens free emmetropes.Results:Off-axis refraction in myopic eyes with spectacle lenses correction was significantly more myopic in the temporal retina compared to lens free emmetropes except for the closest target distance.Relative off-axis refractive error changed significantly with accommodation when compared to axial refraction particularly in the myopic group.This change in the negative direction was due to changes in the spherical component of refraction that became more myopic relative to the center at the 0.20 m distance as the J0 component of astigmatism was significantly reduced in both emmetropes and myopes for the closest target.Conclusion:accommodation to very near targets(up to 0.20 m)makes the off-axis refraction of myopes wearing their spectacle correction similar to that of lens free emmetropes.A significant reduction in off-axis astigmatism was also observed for the 0.20 m distance.

关键词： Off-axis refraction Refractive error accommodation Myopia progression

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Vision, subjective accommodation and lens mobility after TetraFlex accommodative intraocular lens implantation

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Chinese Medical Journal 2010年第16期123卷 2221-2224页

作者： DONG Zhe WANG Ning-li LI Jun-hong Beijing Tongren Eye Center Beijing Tongren Hospital Capital Medical UniversityBeijing Ophthalmol and Visual Science Key Labratory Beijing 100730 China Shanxi Eye Hospital Taiyuan Shanxi 030002 China

Background The TetraFlex accommodating intraocular lens （IOL） was designed to supply the patients both satisfied far and near vision after cataract surgery.So we need to evaluate the safety, distance and near visual acuity, subjective accommodation and IOL mobility with the TetraFlex accommodating IOL implantation.Methods Fifty eyes of 42 study-eligible cataract patients, who gave informed consent at a single eye clinic in China over a 10-month period, underwent phacoemulsification with TetraFlex IOL implantation.At three months postoperation,uncorrected visual acuities （UCVA）, best corrected visual acuities （BCVA）, distance-corrected near visual acuities （DCNVA）, subjective accommodation using the defocus method, and pilocarpine-induced IOL mobility were measured.Results No postoperative complications were noted in the study.Three months postoperation UCVA and BCVA were 20/40 or bettter in 82% （41/50） and 92% （46/50） of eyes, respectively; 66% （33/50） of the eyes had DCNVA of Jager （J） 4or better at 3 months.In addition, the mean subjective accommodation was （0.94±0.61） diopters （D）（range from 0.50 to 1.50 D） and pilocarpine-induced IOL mobility was （337±124） μm （range from 121 to 501 μm） with the TetraFlex.High relationship （r2=0.901, P 〈0.01） was found between these two measurements.Conclusion Implantation of the TetraFlex is safe and leads to excellent uncorrected distance vision and good uncorrected near vision.

关键词： cataract vision accommodation accommodative intraocular lens

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Photopic pupil size change in myopic orthokeratology and its influence on axial length elongation

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International Journal of Ophthalmology(English edition) 2022年第8期15卷 1322-1330页

作者： Meng-Jun Zhu Li Ding Lin-Lin Du Jun Chen Xian-Gui He Shan-Shan Li Hai-Dong Zou Shanghai Eye Disease Prevention&Treatment Center/Shanghai Eye Hospital Shanghai 200040China Shanghai General Hospital National Clinical Research Center for Eye DiseasesShanghai Key Laboratory of Ocular Fundus DiseasesShanghai Engineering Center for Visual Science and PhotomedicineShanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye DiseasesShanghai 200080China

AIM:To explore the photopic pupil size behavior in myopic children undergoing overnight orthokeratology(ortho-k)over 1-year period and its effects on the axial elongation.METHODS:A total of 202 Chinese myopic children were enrolled in this prospective clinical trial.Ninetyfive subjects in ortho-k group and eighty-eight subjects in spectacle group completed the 1-year study.Axial length(AL)was measured before enrollment and every 6mo after the start of ortho-k.The photopic pupil diameter(PPD)was determined using the Pentacam AXL and measured in an examination room with lighting of 300-310 Lx.Stepwise multiple linear regression analysis was used to identify variables contribution to axial elongation.RESULTS:Compared with spectacle group,the average 1-year axial elongation was significantly slower in the ortho-k group(0.25±0.27 vs 0.44±0.23 mm,P0.05,Bonferroni correction).The 4.81 mm PPD may be a possible cutoff point in the ortho-k group.Subjects with PPD below or equal to 4.81 mm tended to have smaller axial elongation compared to subjects with PPD above 4.81 mm after 1-year period(t=-3.09,P=0.003).In ortho-k group,univariate analyses indicated that those with older age,greater degree of myopia,longer AL,smaller baseline PPD(PPDbaseline)experienced a smaller change in AL.In multivariate analyses,older age,greater AL and smaller PPDbaseline were associated with smaller increases in AL.In spectacle group,PPD tended to be stable(P>0.05,Bonferroni correction)and did not affect axial growth.CONCLUSION:PPDs experience significantly decreases at 1-month and 3-month ortho-k treatment.Children with smaller PPD tend to experience slower axial elongation and may benefit more from ortho-k.

关键词： orthokeratology myopia axial length pupil diameter accommodation

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Virtual reality training improves accommodative facility and accommodative range

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International Journal of Ophthalmology(English edition) 2022年第7期15卷 1116-1121页

作者： Dong-Yu Guo Yuan-Yuan Shen Miao-Miao Zhu Yang-Yang Zhan Xia-Wei Wang Jian-Hua Xia Bo Jiang Yang-Shun Gu Yan Long Department of Ophthalmology First Affiliated Hospital of Zhejiang UniversityHangzhou 310000Zhejiang ProvinceChina Department of Internal Medicine Liangzhu HospitalYuhang DistrictHangzhou 310000Zhejiang ProvinceChina Department of Ophthalmology Shulan HospitalHangzhou 310000Zhejiang ProvinceChina

AIM: To evaluate the effects of virtual reality(VR) training on different parameters of vision.METHODS: Sixty individuals ranged 18-60 years old with asthenopia were randomly divided into short-term(n=40) and long-term(n=20) treatment groups. They were given a specially designed VR training device only once for 15 min or 3-4 times a day for 15 min each time for 1 mo. The visual acuity, spherical equivalent, accommodative range, accommodative facility, pupil size, and visual fatigue were evaluated before(control) and after VR training. RESULTS: The visual acuity, accommodative range, and accommodative facility increased in subjects of the shortterm treatment group, whereas their pupil size contracted significantly. No significant changes in spherical equivalent and visual fatigue were observed. The changes in distant vision and corrected visual acuity were positively correlated with those in pupil size, but not with spherical equivalent. The accommodative range and accommodative facility improved significantly in subjects of the long-term treatment group. No significant changes in visual acuity, spherical equivalent, pupil size, and visual fatigue were noted. CONCLUSION: VR training can improve the accommodative range and accommodative facility of human eyes. Although short-term VR training can transiently improve vision, which probably due to bright light adaptation, there is no evidence that it can improve myopia.

关键词： virtual reality visual function myopia visual fatigue accommodation

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Long scan depth optical coherence tomography on imaging accommodation: impact of enhanced axial resolution, signal-to-noise ratio and speed

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Eye and Vision 2018年第1期5卷 151-162页

作者： Yilei Shao Aizhu Tao Hong Jiang Meixiao Shen Dexi Zhu Fan Lu Carol LKarp Yufeng Ye Jianhua Wang Bascom Palmer Eye Institute University of MiamiMiamiFLUSA School of Ophthalmology and Optometry Wenzhou Medical UniversityWenzhouZhejiangChina Hangzhou First People’s Hospital HangzhouChina Electrical and Computer Engineering University of MiamiMiamiFLUSA Bascom Palmer Eye Institute University of MiamiMiller School of Medicine1638 NW 10th AvenueMcKnight Building-Room 202AMiamiFL 33136USA

Background:Spectral domain optical coherence tomography(SD-OCT)was a useful tool to study accommodation in human eye,but the maximum image depth is limited due to the decreased signal-to-noise ratio(SNR).In this study,improving optical resolutions,speeds and the SNR were achieved by custom built SD-OCT,and the evaluation of the impact of the improvement during accommodation was investigated.Methods:Three systems with different spectrometer designs,including two Charge Coupled Device(CCD)cameras and one Complementary Metal-Oxide-Semiconductor Transistor(CMOS)camera,were tested.We measured the point spread functions of a mirror at different positions to obtain the axial resolution and the SNR of three OCT systems powered with a light source with a 50 nm bandwidth,centered at a wavelength of 840 nm.Two normal subjects,aged 26 and 47,respectively,and one 75-year-old patient with an intraocular lens implanted were imaged.Results:The results indicated that spectrometers using cameras with 4096 camera pixels optimized the axial resolutions,due to the use of the full spectrum provided by the light source.The CCD camera system with 4096 pixels had the highest SNR and the best image quality.The system with the CMOS camera with 4096 pixels had the highest speed but had a compromised SNR compared to the CCD camera with 4096 pixels.Conclusions:Using these three OCT systems,we imaged the anterior segment of the human eye before and after accommodation,which showed similar results among the different systems.The system using the CMOS camera with an ultra-long scan depth,high resolution and high scan speed exhibited the best overall performance and therefore was recommended for imaging real-time accommodation.

关键词： Optical coherence tomography Axial resolution Signal-to-noise ratio accommodation Anterior segment

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Clinical features and treatment of near-work-related acquired esotropia

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International Journal of Ophthalmology(English edition) 2022年第8期15卷 1338-1343页

作者： Rui-Lin Guo Li-Kun Ai Shi-Qiang Zhao Department of Ophthalmology Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical UniversityBeijing 100730China

AIM:To investigate the characteristics of near-workrelated esotropia and the clinical efficacy of botulinum toxin type A(BTXA)injection therapy on it.METHODS:A total of 107 patients aged 15-57y with near-work-related esotropia were taken as the BTXA-treated group,and 30 other peers without near-work-related esotropia were included in the control group.All participants were refractive corrected to analyse the clinical characteristics of near-work-related esotropia.All subjects were examined including Worth4 spot examination,stereoscopic vision,strabismus angle,accommodative convergence to accommodation ratio(AC/A),far and near positive and negative convergence,positive and negative fusion range,positive and negative relative accommodation.Clinical efficacy was evaluated at a period of 10mo follow-up.RESULTS:The distant and near stereopsis were found in 84.9%and 77.5%of patients in the BTXA-treated group,respectively.In the control group,all patients had distant and near stereopsis.The incidence of taking off one's glasses to see close objects was significantly higher in the BTXA-treated group than in the control group(Paccommodation function and the habit of near work without wearing spectacles are associated with near-work-related esotropia,while the length of time for near work and the onset time are independent of near-work-related esotropia.Additionally,BTXA injection therapy plays a vital role in relieving diplopia and restoring eye position.

关键词： esotropia near-work botulinum toxin accommodation electromyography

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Effect of Laser in situ Keratomileusis on accommodation

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2008年第5期28卷 596-598页

作者：刘磊袁菁栗静李新宇王渝龙 Refractive Surgery Center Tongji Hospital Tongji Medical College Huazhong University of Science and Technology

The accommodative function before and after laser in situ keratomileusis （LASIK） was observed, and the effect of LASIK on accommodation was investigated. In a prospective clinical trial, 48 myopic patients （96 eyes） subject to bilateral LASIK in Refractive Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology （China） from March 2006 to June 2006 were selected and studied. Refractions, accommodative range, amplitude of accommodative response and high frequency component （HFC） of accommodative microfluctuations were measured with NEDIK-730A before and one week and 30 days after operation. Dominant and non-dominant eyes were determined by hole-in-card method. It was found that all of the operative eyes showed an uncorrected visual acuity of 0.8 or better one week postoperatively, and 1.0 or better 30 days postoperatively. Compared with those preoperatively, accommodative range and HFC had no significant difference at first week and 30th day after operation in both dominant eyes and non-dominant eyes （P〉0.05）, but there was a significant difference in the amplitude of accommodative response/accommodative stimulus ratio （A/S） after operation （P〈0.01）, and no significant difference was found in accommodation between one week and 30 days postoperation. No ocular dominance＇s change was noted. There was no significant difference in accommodative function between dominant eyes and non-dominant eyes. It was suggested that LASIK produced no significant effect on accommodation.

关键词： laser in situ keratomileusis accommodation dominant eye

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Role of microfluctuations in accommodation: a novel approach to reduce non-accommodative noise

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International Journal of Ophthalmology(English edition) 2019年第4期12卷 681-684页

作者： Núria Lupón Joan Gispets Genis Cardona Alba Tàpia Hector Abril Department of Optics and Optometry Universitat Politècnica de Catalunya Applied Optics and Image Processing Research Group Universitat Politècnica de Catalunya

Accommodative response and its possible role in myopia development has been explored through the study of the microfluctuations(MFs) of accommodation, which are commonly divided in high(1.0 to 2.3 Hz) and low(0.1 to 0.6 Hz) frequency components. Previous research efforts have evidenced that a certain percentage of the amplitude of MFs seems not to originate in the accommodative response. We aimed to develop and test a new approach to reduce this non-accommodative noise. For this purpose, ten healthy participants were enrolled to determine the difference between the amplitude of MFs at near and distance for each range of frequencies, which was defined as the relative amplitude of MFs. The findings support the exploration of the relative rather than absolute values of the amplitude of MFs to better understand the contribution of both accommodative and non-accommodative factors to MFs.

关键词： accommodation cycloplegia microfluctuations myopia photorefraction

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