Sicherheit von Brillengläsern mit DIMS-Technologie und Atropin in der Kombinationstherapie der Myopieprogression

Abstract

Hintergrund: Es soll die Sicherheit im Straßenverkehr beim Tragen von Brillengläsern mit Defocus Incorporated Multiple Segments (DIMS) Technologie in der Kombination mit Atropin evaluiert werden. Patienten und Methoden: An 12 jungen Erwachsenen (Alter: 24 bis 45; 30,1 ± 5,7 Jahre) wurde der Fernvisus und die Kontrastempfindlichkeit (KE), sowie Blendempfindlichkeit bei Versorgung mit DIMS-Brillengläsern allein und in der Kombination mit 0,01% Atropin untersucht. Ergebnisse: Durch Atropineinwirkung vermindert sich der Fernvisus beim Blick durch den zentralen Bereich des DIMS-Brillenglases nicht; bei Blendung und unter Atropin kommt es zu einem Visusabfall um 0,10 LogMAR. Beim erzwungenen Blick durch den DIMS-Bereich vermindert sich der Fernvisus durch Atropineinwirkung ohne Blendung um 0,09 LogMAR; bei Blendung ist durch Atropin kein weiterer Visusabfall zu beobachten. Die Kontrastempfindlichkeit mit DIMS-Gläsern wird durch Atropineinwirkung nicht relevant verändert. Hinsichtlich der Blendempfindlichkeit findet sich bei DIMS-Gläsern keine für das Sehen und die Sicherheit im Straßenverkehr relevante Sehbeeinträchtigung. Zusätzliche Atropinisierung hat keinen Einfluss auf die Blendempfindlichkeit. Schlussfolgerung: DIMS-Brillengläser sind sicher im Straßenverkehr und verursachen keine relevante Beeinträchtigung des Sehens, auch nicht unter Einfluss von 0,01 % Atropin. DIMS Brillengläser sind daher auch bei der Behandlung von progressiven Myopien in der Kombinationstherapie mit Atropin sicher. Background: The aim of this study was to evaluate traffic safety of Defocus Incorporated Multiple Segments (DIMS) spectacle lenses in combination therapy with atropine. Patients and Methods: 12 young adults (age: 24 -45; 30,1 ± 5,7 years) were recruited to evaluate corrected distance visual acuity (CDVA), contrast sensitivity (CS) (FrACT), glare sensitivity (Mesotest) under the influence of DIMS-spectacle correction alone and combination therapy with 0,01% atropine. Results: When looking through the central area of the DIMS lens, far vision does not decrease due to the influence of atropine; influence of glare and atropine leads to a reduction of CDVA by 0.10 LogMAR. When forced to look through the DIMS area, far vision is reduced by 0.09 LogMAR due to the influence of atropine in the absence of glare; in the presence of glare, no further loss of visual acuity can be observed under the influence of atropine. Contrast vision with DIMS glasses is not altered by the effects of atropine. Concerning glare sensitivity, DIMS lenses did not show any visual impairment that would be relevant to vision and road safety. Additional atropinization does not affect glare sensitivity. Conclusion: DIMS spectacle lenses are safe for participation in road traffic and do not relevantly impair traffic safety, neither alone nor under the acute influence of 0,01 % atropine.

Impact of defocus incorporated multiple segments (DIMS) spectacle lenses for myopia control on quality of life of the children: a qualitative study

“… 16 Although all children reported to have peripheral blurred vision, it had no impact on their ADLs. This aligns with the current literature which states that even though DIMS lenses can decrease visual acuity in the periphery by 0.3 log MAR units, 14 16 neither it affects the gross recognition of objects 14 nor causes any significant alterations in the monocular or binocular visual functions of the eyes. 12 13 15 Apart from peripheral blurred vision, DIMS wearers reported many other symptoms, eye strain being one of them.…”

“…Several studies 12–15 have assessed the effect of DIMS on the visual functions of the eye and it was found that DIMS do not alter any visual functions of the eye apart from peripheral visual acuity and contrast sensitivity. A couple of studies 14 16 reported that DIMS can decrease visual acuity in the periphery by as much as 0.3 Log MAR units. However, all these studies assess the objective parameters and patient-reported outcome measures (PROMs) have received less attention in the current literature.…”

Astigmatism and maternal myopia as important factors affecting success rate of DIMS lens treatment

“…Taken together, the mean progression and per cent of non-progressing myopes also show close resemblance to the only available large-scale retrospective study conducted in real-world clinical settings 74. It has been shown that both children and adults tolerate DIMS lenses well,43 69 82 with minimal mid-peripheral visual acuity and contrast sensitivity reduction in nasal and temporal gaze. We assessed acceptance throughout the 1-year treatment and obtained similar results, with minimal habituation complaints in children wearing DIMS lenses, primarily in the initial period of wear.…”

Safety Aspects of DIMS Technology Glasses, Fixation as a Marker for Amblyopia, Bielschowsky Head Tilt Test in Superior Oblique Paresis and Successful Late Topical Treatment of Orbital Infantile Hemangioma

“…However, both treatments may substantially alter visual performance required for driving or participation in road traffic. Kaymak et al therefore studied the impact of the combination of DIMS spectacle lenses and low-dose atropine (0.01 %) on pupil and visual functions, including visual acuity, photopic and mesopic contrast sensitivity, mesopic vision, and glare sensitivity [13]. Looking through the lenslets area and atropine reduced visual acuity by 0.24 and 0.27 logMAR, respectively.…”