查看更多>>摘要：Background:With increasing axial length(AL)and myopia progression,the micro-structure of the retina and choroid gradually changes.Our study describes the longitudinal changes in retinal and choroidal thickness in school-aged children with myopia and explores the relationship between changes in choroidal thickness and myopia progression.Methods:An exploratory analysis of a randomized trial was performed.Children(n=168,aged 7 to 12 years)with myopia from-0.75 diopter(D)to-4.00 D were enrolled in this prospective longitudinal study.Cycloplegic refrac-tion,AL,retinal and choroidal thicknesses were measured at baseline and at 1-and 2-year follow-ups."Rapid progression myopia"was defined as increasing in myopia＞1.00 D and"stable progression myopia"was＜1.00 D during the 2-year follow-up.Factors affecting the changes in choroidal thickness were analysed using linear mixed models.Results:AL significantly increased by 0.67 士0.24 mm with a myopic shift of-1.50±0.64 Dover the 2 years.The overall retinal thickness increased from 251.12±15.91 μm at baseline to 253.47±15.74 μm at the 2-year follow-up(F=23.785,P＜0.001).The subfoveal choroidal thickness decreased from 231.03±54.04 μm at baseline to 206.53±59.71 μm at the 2-year follow-up(F=73.358,P＜0.001).Choroidal thinning was significantly associated with AL elongation(β=-43.579 μm/mm,P=0.002)and sex(β=-17.258,P=0.001).Choroidal thickness continued to decrease in subjects with rapid progression(F=92.06,P＜0.001)but notin those with steady progression(F=2.23,P=0.119).Conclusion:Significant choroidal thinning was observed and was associated with rapid progression and sex.These findings indicate a need to understand the role of the choroid in eye growth and myopia development.Synopsis/Precis:The macular choroidal thickness of myopic children is relevant to different degrees of myopic progression in this 2-year longitudinal study.These findings suggest that control of choroidal thickness might work to regulate human ocular growth.
查看更多>>摘要：Background:Myopic maculopathy(MM)has become a major cause of visual impairment and blindness worldwide,especially in East Asian countries.Deep learning approaches such as deep convolutional neural networks(DCNN)have been successfully applied to identify some common retinal diseases and show great potential for the intelligent analysis of MM.This study aimed to build a reliable approach for automated detection of MM from retinal fundus images using DCNN models.Methods:A dual-stream DCNN(DCNN-DS)model that perceives features from both original images and corre-sponding processed images by color histogram distribution optimization method was designed for classification of no MM,tessellated fundus(TF),and pathologic myopia(PM).A total of 36,515 gradable images from four hospitals were used for DCNN model development,and 14,986 gradable images from the other two hospitals for external testing.We also compared the performance of the DCNN-DS model and four ophthalmologists on 3000 randomly sampled fundus images.Results:The DCNN-DS model achieved sensitivities of 93.3％and 91.0％,specificities of 99.6％and 98.7％,areas under the receiver operating characteristic curves(AUCs)of 0.998 and 0.994 for detecting PM,whereas sensitivities of 98.8％and 92.8％,specificities of 95.6％and 94.1％,AUCs of 0.986 and 0.970 for detecting TF in two external testing datasets.In the sampled testing dataset,the sensitivities of four ophthalmologists ranged from 88.3％to 95.8％and 81.1％to 89.1％,and the specificities ranged from 95.9％to 99.2％and 77.8％to 97.3％for detecting PM and TF,respectively.Meanwhile,the DCNN-DS model achieved sensitivities of 90.8％and 97.9％and specificities of 99.1％and 94.0％for detecting PM and TF,respectively.Conclusions:The proposed DCNN-DS approach demonstrated reliable performance with high sensitivity,specificity,and AUC to classify different MM levels on fundus photographs sourced from clinics.It can help identify MM auto-matically among the large myopic groups and show great potential for real-life applications.
查看更多>>摘要：Purpose:To evaluate the influence of corneal ablation patterns on the prediction error after cataract surgery in post-myopic-LASIK eyes.Methods:Eighty-three post-myopic-LASIK eyes of 83 patients that underwent uneventful cataract surgery were ret-rospectively included.Predicted postoperative spherical equivalence(SE)was calculated for the implanted lens using the Haigis-L and Barrett True-K formula.Prediction error at one month postsurgery was calculated as actual SE minus predicted SE.For each eye,area and decentration of the ablation zone was measured using the tangential curvature map.The associations between prediction errors and corneal ablation patterns were investigated.Results:The mean prediction error was-0.83±1.00 D with the Haigis-L formula and-1.00±0.99 D with the Barrett True-K formula.Prediction error was positively correlated with keratometry(K)value and negatively correlated with ablation zone area using either formula,and negatively correlated with decentration of the ablation zone using the BarrettTrue-K formula(all P＜0.05).In the K＜37.08 D group,prediction error was negatively correlated with decentra-tion of the ablation zone with both formulas(all P＜0.05).Multivariate analysis showed that with the Haigis-L formula,prediction error was associated with axial length(AL),K value and decentration,and with the Barrett True-K formula,prediction error was associated with AL and decentration(all P＜0.05).Conclusion:A flatter cornea,larger corneal ablation zone and greater decentration will lead to more myopic predic-tion error after cataract surgery in post-myopic-LASIK eyes.
查看更多>>摘要：Background:The aim of the study was to compare the dynamic defocus curve on patients post-implantation of the extended depth-of-focus(EDOF)and monofocal intraocular lens(IOL).Methods:A total of 62 age-related cataract patients receiving phacoemulsification with implantation ofTECNIS Symfony(ZXR00)or monofocal IOLs were enrolled.The binocular static and dynamic defocus curves with corrected distance visual acuity were evaluated at one month postoperatively.Results:The ZXR00 group achieved significantly better intermediate(P=0.044)and near(P=0.017)visual acuity(VA)than the monofocal group.Two groups had similar uncorrected and corrected distance VA(P＞0.05,respectively).The dynamic defocus curve revealed a smoother decline from 0.0 D to-2.0 D in the ZXR00 group.Defocused dynamic VA in the ZXR00 group was significantly better(P＜0.05)except at 0.0 D(P=0.724)and-0.5 D(P=0.176).The area under the curve(P=0.002)and corrected dynamic vision accommodation(P=0.001)derived from the dynamic defocus curves were better in the ZXR00 group.A positive correlation was observed between defocused dynamic and static VA in both groups(P＜0.001).Multiple linear regression analysis indicated that defocused static VA and cor-rected dynamic vision accommodation were significant influential factors for the defocused dynamic VA from-1.0 D to-3.0 D(P＜0.05).Conclusions:The EDOF IOL provided similar distant vision,better intermediate and near vision,and a better overall dynamic defocus curve than the monofocal IOL.The dynamic defocus curve may be comprehensively applied to evaluate the all-distance dynamic visual performance post-cataract surgery.
NETL
NSTL
万方数据