Difference in Pupillary Diameter as an Important Factor for Evaluating Amplitude of Accommodation: A Prospective Observational Study

Kubota, Miyuki; Kubota, Shunsuke; Kobashi, Hidenaga; Ayaki, Masahiko; Negishi, Kazuno; Ohta, Michio

doi:10.3390/jcm9082678

Cited by 10 publications

(9 citation statements)

References 35 publications

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“…In addition to aging as the greatest risk factor for presbyopia progression, myopia [ 27 ], hypermetropia [ 28 ], female sex [ 29 ], diabetes [ 30 ], alcohol intake [ 28 ], smoking [ 20 ], and pneuropsychiatric medications including sleep medicine, muscle relaxant, and sedative may be implicated. Pupillary diameter, corneal multifocality, and aberration may contribute to accommodation [ 31 – 34 ], with pupillary diameter most likely in 2020–21 [ 31 ]. A recent investigation using fMRI and pupillometry in medical residents found neural responsitivity of the noradrenergic locus coeruleus and associated pupil responses are related to changes in anxiety and depression in response to prolonged real-life stress [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Presbyopia developed earlier during the COVID-19 pandemic

Negishi

Ayaki

2021

PLoS ONE

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Purpose The aim of this cohort study was to evaluate the development and progression of presbyopia and the status of dry eye-related symptoms from 2017 to 2020, to assess the impact of the COVID-19 pandemic. Methods Near add power at 30 cm was measured in 339 participants aged between 40 and 55 from 2017 to 2021 at Japanese eye clinics. Regression analysis of near add power and age was analyzed to compare 2017 with later years up to the pandemic. The prevalence of dry eye-related signs and six common symptoms were compared. Results The number and mean age (y) of participants were 183 (48.6±4.1) in 2017, 46 (51.3±7.5) in 2019, and 110 (49.2±3.7) in 2020–21, respectively. The mean progression rate of near add power (D/y) was 0.13 for 2017, 0.09 for 2019 (P = 0.028, vs 2017), and 0.08 for 2020–21 (P<0.001, vs 2017). The slope (rate of presbyopia progression) became flatter from 2017 to 2021 and the estimated near add power at the age of 40 increased from 2017 to 2020–2021, implicating presbyopia developed earlier and worsened during the study period. The 2017 values were comparable with previous studies described in 1922 and 2019. The standardized correlation coefficient between age and near add power was 0.816 for 2017, 0.671 for 2019 (P = 0.084, vs 2017), and 0.572 for 2020–21 (P<0.001, vs 2017). Multiple regression analysis revealed age and COVID-19 pandemic were significantly correlated with near add power. The prevalence of dryness irritation, and pain was greater in 2020–21 than in 2017 with no difference in the prevalence of eye fatigue, blurring, and photophobia. There was no difference in the prevalence of short tear break-up time and positive corneal staining among 2017, 2019 and 2020–21. Conclusion Estimated presbyopia developed earlier and progressed slower from 2017 to 2021, the COVID-19 pandemic. Stress and rapid digitalization related to strict infection control and quarantine might be contributing factors.

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Section: Discussionmentioning

confidence: 99%

Presbyopia developed earlier during the COVID-19 pandemic

Negishi

Ayaki

2021

PLoS ONE

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“…The measurement was completed after a maximum of 30 s, and the device reduced the measurement time in cases of slow or poor accommodative response. Repeatability and reproducibility of this particular type of Nidek autorefractors in AA measurement [16], as well as the association between the pupil size and AA [17], have already been evaluated; thus, these aspects were not assessed.…”

Section: Aa Assessmentmentioning

confidence: 99%

Comparison of the Amplitude of Accommodation Measured Using a New-Generation Closed-Field Autorefractor with Conventional Subjective Methods

et al. 2022

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Purpose: This study aims to compare and assess the agreement of the objective amplitude of accommodation (AA) measured using a new-generation closed-field autorefractor with conventional subjective methods. Methods: In total, 84 healthy individuals with an age range of 19 to 50 years participated in this cross-sectional study. AA was measured objectively with a Nidek autorefractor (AR-1a; Nidek Co., Ltd., Tokyo, Japan) and subjectively using push-up (PU) and minus-lens (ML) methods in a random order. Comparison between different methods was performed using repeated-measures analysis of variance and the Bonferroni test for pairwise comparisons. In addition to the Pearson correlation, the Bland and Altman method and the intraclass correlation coefficient were used to determine the agreement between the three techniques. Only the right-eye results were used for analysis. Results: AA measured using the Nidek autorefractor (3.43 ± 1.94 D) was significantly lower than that measured with PU (7.67 ± 2.38 D; p < 0.001) and ML (7.60 ± 2.81 D; p < 0.001) methods. The difference between the subjective methods was not significant statistically (p = 1.0). The correlation for Nidek measurements and PU and ML methods was moderate (r = 0.5502 and r = 0.6832, respectively), while it was strong when comparing subjective methods (r = 0.7821). The limits of agreement for Nidek vs. PU, Nidek vs. ML, and PU vs. ML methods were −8.28 to −0.23 D, −8.19 to −0.15 D, and −3.38 to 3.51 D, respectively. Conclusions: There was a moderate agreement between AA obtained with subjective methods and objective Nidek measurements. The objective AA measurements obtained with a new Nidek autorefractor were significantly lower than subjective measurements.

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“…There were 47 patients with zero diopter add power and all were myopic. Mean age was 43.3±2.9 (40-49) in men (n = 21) (40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54) in women (n = 26), respectively (P = 0.922, t-test). The spherical equivalent in the right eye was −4.81±2.10D (−1.75-−8.50D) in men and −4.46±2.15D (−0.12-−-8.25D) in women, respectively (P = 0.580, t-test).…”

Section: Plos Onementioning

confidence: 99%

“…The discrepancy between add power and age could be clarified in future research, including retrospective or prospective longitudinal studies. Pupillary diameter, corneal multifocality, and aberration may contribute to this apparently enhanced accommodation [39][40][41][42]. DED is a very common disease in middle adulthood, being associated with decreased QOL, subjective happiness, and sleep quality as reported in numerous studies.…”

Section: Plos Onementioning

confidence: 99%

Sleep and subjective happiness between the ages 40 and 59 in relation to presbyopia and dry eye

et al. 2021

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Purpose The aim of this study was to explore the status of quality of life between the ages 40–59 in relation to presbyopia and dry eye. Methods Near add power and preferred contact lens power were examined in 219 participants at three clinics. 2000 participants completed a web-based survey on presbyopic symptoms, symptomatic dry eye, sleep quality, and subjective happiness. Results Mean preferred corrected visual acuity was less than 20/20 in women (vs men, P<0.01) who were more often prescribed under-corrected contact lenses, whereas men preferred full correction. According to the annual progression rate of near add power in men (0.1468D/year), the estimated difference in presbyopia progression between men and women was 0.75 years in the right eye, and 1.69 years in the left eye, implying men might suffer presbyopia earlier than women due to higher myopic power of daily use contact lenses. The web-based survey revealed that men reported lower subjective happiness than women (P<0.001) and earlier onset of presbyopic symptoms by 1.1–1.7 years (P<0.05). Men received their first reading glasses 0.8 years earlier than women (P = 0.066). Multiple regression analysis demonstrated that awareness of presbyopic symptoms, visual burden, and dry eyes were significantly correlated with poor sleep quality and subjective happiness. Conclusion Presbyopia and dry eye were significantly associated with sleep quality and subjective happiness in middle-adulthood.

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Difference in Pupillary Diameter as an Important Factor for Evaluating Amplitude of Accommodation: A Prospective Observational Study

Cited by 10 publications

References 35 publications

Presbyopia developed earlier during the COVID-19 pandemic

Presbyopia developed earlier during the COVID-19 pandemic

Comparison of the Amplitude of Accommodation Measured Using a New-Generation Closed-Field Autorefractor with Conventional Subjective Methods

Sleep and subjective happiness between the ages 40 and 59 in relation to presbyopia and dry eye

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