To investigate the effectiveness of a novel spectacle lens designed to slow the progression of myopia in children. A prospective, randomized, double blind clinical trial. One hundred twenty-six Israeli children aged 6-13 years with spherical equivalent (SER) refractive errors of -0.5 to -6.25 diopters (D) were randomized into either the Shamir Myopia Control (SMC) lens design group or the conventional single-vision spectacle lenses (SVL), the control group. Outcomes measured were changes in axial length and cycloplegic refraction as well as subjective rating of visual experience over a period of 12 months. At 12 months, AL and SER progression were slowed by 0.11 mm (35%, P < .05) and 0.16 D (25%, P = .122), respectively. In the subgroup of 6-10-year-olds, AL and SER progression were slowed by 0.17 mm (41%, P < .05) and 0.31 D (43%, P < .05), respectively. Similarly, for the subgroup of children with 2 myopic parents AL and SER progression were slowed by 0.15 mm (45% P < .05) and 0.36 D (42%, P < .05), respectively. Subjective visual experience reported in the 12-month questionnaire revealed no difference between the SMC and SVL groups, and average daily wearing hours were also not different between the groups: 14 (±1.4) and 13.8 (±2.3) hours, respectively. The study continues to its second year. SMC lenses were effective in slowing the progression of SER and AL, especially for younger children and those having 2 myopic parents. The subjective rating of visual experience and the daily duration of use reported by the SMC group at 12 months were similar to the control group, indicating good lens tolerability.
1 May 2023 in Journal of Cataract & Refractive Surgery
Purpose: To evaluate the agreement in biometry measurements and intraocular lens (IOL) power prediction between the Eyestar 900 and the IOLMaster 700. Setting: Institutional. Design: Retrospective comparative study. Methods: Patients were evaluated before cataract surgery using both devices on the same visit. Axial length, anterior and posterior keratometry, anterior chamber depth, corneal diameter (CD), central corneal thickness, and lens thickness were recorded by both devices. The agreement in measurements and in IOL power calculations was evaluated using the Barrett Universal II (BU-II) formula with either predicted or measured posterior keratometry. Results: In total, 402 eyes of 402 consecutive patients were included. The mean age was 72.0 ± 9.2 years. Clinically, mean differences in measured variables were small, albeit slightly larger for posterior flat and steep keratometry (0.43 diopters [D] and 0.42 D, respectively). The measurement correlation and agreement between the devices were good for all variables with slightly lower agreement in CD measurements. Consistent bias was seen in measurements of posterior flat and steep keratometry. Good agreement was also found in anterior and posterior astigmatism measurements. Good IOL power calculation agreement was found using either predicted posterior keratometry (95% limits of agreement [LoA] of −0.40 to +0.30 D) or measured posterior keratometry (95% LoA of −0.45 to +0.40 D). The agreement was within ±0.5 D in 394 eyes (98.0%) using predicted posterior keratometry and in 386 eyes (96.0%) using measured posterior keratometry. Conclusions: The Eyestar 900 and the IOLMaster 700 show strong agreement in biometry measurements and IOL power prediction by the BU-II formula using either standard or total corneal keratometry and can be used interchangeably.
Purpose. Injection of anti-VEGF antibody into the vitreous body is a well-established treatment for ischemic central retinal vein occlusion (CRVO) associated macular edema. Various treatment regimens regarding the timing, number, and frequency of injections have been proposed. Methods. We reviewed the medical records of 68 patients treated by intravitreal bevacizumab (Avastin) injections for macular edema due to CRVO. We examined final visual acuity six months following the last injection in relation to injection policy (one primary injection followed by subsequent injections based on anatomical response versus a prescheduled protocol of one injection per month for the first 3 months) and in relation to the time lapsing from CRVO diagnosis to the first injection. Results. Mean visual acuity improved more for patients treated by a protocol of 3 prescheduled injections than for those treated with one primary injection. Improvement in mean visual acuity was greater for patients who received their first injection within the first month than those treated after 3 months (). Conclusion. A protocol of three prescheduled injections of bevacizumab, starting within one month of a CRVO event, was associated with better visual outcome compared to single injection and/or treatment starting more than 3 months following the time of diagnosis.
16 January 2013 in Graefe's Archive for Clinical and Experimental Ophthalmology
We describe the prevalence and treatment of glaucoma in a Muslim Arab population in Israel. Based on the medical records of 15 122 persons, the overall prevalence of glaucoma was 3.9%. Prevalence rates of primary open angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) were 3.0% and 0.42%, respectively. Prevalence rates of women were 135% that of men considering all types of glaucoma, 143% for POAG, and 96% for PACG. Prostaglandin analogs and beta blockers, alone or combined with carbonic anhydrase inhibitors, were the preferred medications. Of 68 patients who underwent trabeculectomy, 27 (39.7%) required medications, postoperatively, for treatment of glaucoma; following Ex-Press shunt surgery, 3/11 (27.3%) required medications. During the last three years, 16 (1.3%) individuals with POAG were recorded as legally blind as a result of glaucoma.
Purpose: To examine the association between refraction, ocular biometry and a child’s behavioral disorder using the Conners’ Parent Rating Scale. Materials and Methods: This cohort study recruited 139 children aged 6– 9 years old. Their legal guardians completed the Conners’ Parent Rating Scale [the revised-long version (CPRS-R-L)], and the individual responses were entered into the software scoring program, resulting in 14 scores for behavioral disorders. Cycloplegic refraction and ocular biometry were performed. Correlation analyses among the 14 behavioral scores, refraction, and biometry were performed. The analyses were performed for three refractive groups: hyperopia, emmetropia, and myopia. Results: Children (N = 93) with mean age of 7.2 ± 1.2 y were included. Spherical equivalent (SE) of the refractive groups were +3.46± 1.71 diopters (D), 0.61 ± 0.41 D and − 1.76 ± 2.15 D (p < 0.0001). The CPRS-R-L subscale scores positively correlated with sphere, SE, and negatively correlated with cylinder. With the exception of oppositional behavioral subscale that had higher than mean score, 13 CPRS-R-L scores fell within the normal range, regardless of refraction. CPRS-R-L subscale scores negatively correlated with axial length. Axial length shorter than 22.5 mm had CPRS-R-L 95th percentile, some of which surpassed the normal range score of CPRS-R-L, and indicate the presence of ADHD concerns. Conclusion: Refraction, astigmatism, and axial length were associated with Conners’ behavioral subscales and warrant additional studies to clarify any cause–effect relationship.