Subclinical Decrease in Central Inner Retinal Activity Is Associated With Myopia Development in Children

Li, Serena Zhe-Chuang; Yu, Wing Yan; Choi, Kai Yip; Lam, Christie Hang-I; Lakshmanan, Yamunadevi; Wong, Francisca Siu-Yin; Chan, Ho Lung Henry

doi:10.1167/iovs.16-21279

Cited by 14 publications

(20 citation statements)

References 25 publications

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“…23 Our results suggested that the enhanced inner retinal response in the central and para-macular regions under +7.50 D DF condition may reflect that these two regions are involved in the detection of defocus induced by DFCL. Furthermore, the electrophysiological study by Li et al 24 showed that central inner retinal activity, in terms of IC amplitude, is inversely related to myopia development. Whether this enhanced central inner retinal response by the DFCL contributes to its myopia control effect 12,13 warrants further study.…”

Section: Discussionmentioning

confidence: 99%

The effect of simultaneous dual‐focus integration on the global flash multifocal electroretinogram in the human eye

Fung

Choi

Chan

2020

Ophthalmic Physiologic Optic

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Purpose To investigate the effect of simultaneous dual‐focus (DF) on retinal activities measured by global flash multifocal electroretinogram (mfERG). Methods Thirty adults were recruited for mfERG measurement under three conditions: in‐focus (i.e., no defocus), +2.50 D DF and +7.50 D DF, administered using single vision contact lenses and DF lenses. The direct component (DC) and the induced component (IC) of the mfERG were pooled into central macular (0–8°), para‐macular (8–18°) and peri‐macular (18–30°) regions, and then compared across the three conditions using two‐way, repeated measures ANOVA. Results Simultaneous DF had a significant effect on the IC amplitude, which was significantly stronger under +7.50 D DF (p < 0.01) than for the in‐focus condition, which was mostly derived from the central and para‐macular regions. No significant effect was observed for the +2.50 D DF condition. Conclusion Under the effect of relatively strong simultaneous DF integration, the retina showed an enhanced retinal response, which originated from the inner retina. Compared with the peri‐macular region, central and para‐macular responses appeared to be enhanced.

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Section: Discussionmentioning

confidence: 99%

The effect of simultaneous dual‐focus integration on the global flash multifocal electroretinogram in the human eye

Fung

Choi

Chan

2020

Ophthalmic Physiologic Optic

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“…While the targeting tissue and mechanism for myopia control were elusive, retina was one of the suggested origins of action. However, the interaction between atropine and retinal function on myopia development remains unclear, given that our previous findings suggested weakened retinal function precedes myopia development 18 , 19 . The current double-blind randomized clinical trial was designed to investigate the relationship between the baseline MOFO mfERG and the subsequent change in refractive error following treatment with 0.01% atropine or placebo.…”

Section: Introductionmentioning

confidence: 92%

“…The global-flash mfERG (MOFO mfERG), which incorporates a periodic bright frame within conventional mfERG stimulation, selectively enhances the detection of the inner retinal response 16 , 17 . Previous studies revealed that the foveal MOFO mfERG at baseline predicted the subsequent change in refractive error in emmetropic children with normal visual acuity 18 , 19 . Specifically, children with a weak central inner retinal MOFO mfERG response had more severe myopia progression subsequently, showing that subclinical impairment of retinal function, as measured by mfERG, may be a predictor for myopia development.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of 0.01% atropine for myopia control in a randomized, placebo-controlled trial depends on baseline electroretinal response

Chan

Choi

et al. 2022

Sci Rep

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This study aimed to evaluate the efficacy of 18-month 0.01% atropine in 61 myopic children (aged 7–10) and the relationship with central retinal response (by multifocal electroretinogram [mfERG]) in a double-masked randomized placebo-controlled clinical trial. Global-flash mfERG was measured at baseline, while cycloplegic spherical equivalent refraction (SER) and axial length (AL) were measured at baseline and at 6-month intervals. Annualized change in SER and AL were compared between atropine and control groups, and the relationships with baseline mfERG were evaluated. Changes in SER (−0.70 ± 0.39D vs. −0.66 ± 0.41D, p = 0.63) and AL (0.32 ± 0.16 mm vs. 0.30 ± 0.22 mm, p = 0.52) were similar in atropine and control groups. Interestingly, in the placebo group, mfERG amplitude was negatively correlated with axial elongation (Rp = −0.44, p = 0.03) as in our previous study. However, in the atropine group, an opposite trend was observed that axial elongation was positively correlated with mfERG amplitude (Ra = 0.37, p = 0.04). Annualized myopia progression demonstrated similar opposite effect between atropine and placebo groups but did not reach statistical significance. An ERG screening protocol may be warranted to identify suitable candidates to reduce the likelihood of an unfavorable treatment response by 0.01% atropine.

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“…While it is expected that the amplitude in the electroretinogram depends on the length of the eye [41] and is inversely correlated with its axial length [42], it is more interesting to look into functional changes in the retina when myopia just starts to develop. In fact, changes in the induced component of the mfERG were found in children already when they just started to develop myopia and had still less than 0.5D [43]. Chen et al showed that the delayed mfERG response in myopic subjects was not due to longer eyes but due to changes in retinal processing [44].…”

Section: Evidence For Changes In "Retinal Activity" During Myopia Indmentioning

confidence: 99%

Changes in fundus reflectivity during myopia development in chickens

Świątczak

Feldkaemper

Schaeffel

2019

Biomed. Opt. Express

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Previous studies have shown that changes in functional activity in the retina can be visualized as changes in fundus reflectivity. When the image projected on the retina is low pass filtered or defocused by covering the eye with a frosted diffuser or a negative lens, it starts growing longer and develops myopia. We have tested the hypothesis that the resulting altered retinal activity may show up as changes in fundus reflectivity. Fundus reflectivity was measured in chickens in vivo, both in visible (400-800 nm, white) and near ultraviolet (UV) light (315-380 nm). Two CCD cameras were used; a RGB camera and a camera sensitive in near UV light (peak sensitivity at 360 nm). White and UV LEDs, respectively, placed in the center of the camera lens aperture, served as light sources. Software was written to flash the LEDs and record the average brightness of the pupil that was illuminated by light reflected from the fundus. The average pixel grey level (px) in the pupil was taken as a measure of the amount of reflected light while refractive errors were corrected by trial lenses after pupil brightness was corrected for pupil size. It was found that myopic eyes had brighter pupils in UV light, compared to eyes with normal vision, no matter whether myopia was induced by diffusers or negative lenses (48 ± 9 vs. 28 ± 3, p<0.001 and 47 ± 7 vs. 27 ± 2, respectively). Using SD-OCT in alert chickens it was found that the retinal nerve fiber layer (RNFL) and the retinal ganglion cell layer (RGCL) in the central retina became thinner already at early stages of myopia development, compared to controls (31.2 ± 5.8 µm vs. 43.9 ± 2.6 µm, p<0.001 and 36.9 ± 1.2 µm vs. 44 ± 0.5 µm, respectively). While the decrease in RNFL thickness occurred concomitantly with the increase in UV reflectivity, it remains unclear whether these changes were causally linked. Thinning of the RNFL could be due to reduced neural activity in retinal ganglion cells but also due to metabolic changes in the retina during myopia development.

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Subclinical Decrease in Central Inner Retinal Activity Is Associated With Myopia Development in Children

Cited by 14 publications

References 25 publications

The effect of simultaneous dual‐focus integration on the global flash multifocal electroretinogram in the human eye

The effect of simultaneous dual‐focus integration on the global flash multifocal electroretinogram in the human eye

Efficacy of 0.01% atropine for myopia control in a randomized, placebo-controlled trial depends on baseline electroretinal response

Changes in fundus reflectivity during myopia development in chickens

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