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D O Mutti

Publications and source records attributed to D O Mutti.

At least 37 records · Page 2Linked to original sources
PubMed1998

Optical and structural development of the crystalline lens in childhood.

PURPOSE: To document the development of key optical and structural parameters of the crystalline lens throughout childhood and examine possible mechanisms by which lens power remains coordinated with the growth of the eye to maintain emmetropia. METHODS: Using cycloplegic autorefraction, video-based phakometry, and ultrasonography, the authors measured refractive error and crystalline lens parameters in 994 children in the first through eighth grades, who participated in the Orinda Longitudinal Study of Myopia, between one and five times from 1989 through 1993. Polynomial growth curves were fit to the data by maximum likelihood estimation. The average annual rates of change in each parameter from each subject's longitudinal data were also estimated. RESULTS: The lens radii of curvature flattened throughout childhood, yet decreases in lens equivalent power stopped after 10 years of age. This indicates that the refractive index of the lens increased during later childhood. Lens thinning in early childhood also ceased after 10 years of age. The spherical volume of the lens showed no appreciable net increase, but the axial length of the eye continued to grow throughout childhood. The prevalence of myopia in our data increased sharply at age 10 years, reaching 21.3% by the age of 14 years. CONCLUSIONS: Concurrent thinning and flattening of the crystalline lens imply that the lens is mechanically stretched by the equatorial growth of the eye during childhood. Changes in the patterns of lens development near the age of 10 years, concurrent with the onset of myopia, suggest that forces arise which interfere with equatorial growth. Such forces might diminish the decreases in lens power and amplify axial elongation to promote myopia.

Adolescent↗
PubMed1998

Retinoscopy.

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Diagnostic Techniques, Ophthalmological↗
PubMed1997

The artifact of retinoscopy revisited: comparison of refractive error measured by retinoscopy and visual evoked potential in the rat.

PURPOSE: The validity of retinoscopy in small eyes has not been clearly established due to uncertainty regarding the source of the ocular reflections assessed during this procedure. A widely cited model which proposes that their origin is the inner limiting membrane of the retina was evaluated in the rat by comparing refractive errors measured by retinoscopy to those measured by visual evoked potentials (VEPs). METHODS: Ten rats were refracted both by cycloplegic streak retinoscopy and by VEP while viewing 0.05 to 0.15 cpd square-wave gratings-reversed at 1.875 Hz. Spherical aberration of the rat eye was assessed as a potentially confounding variable in VEP refraction by sequential retinoscopic refractions across the rat's natural pupil through a 1.5-mm pinhole. RESULTS: All animals were moderately to highly hyperopic by both methods (range = +4.5 to +18.5 D). Spherical aberration was minimal (median = 3.5 D of overcorrected aberration). The median difference between retinoscopic refractions and those by VEP was not significant (+1.94 D more hyperopia by retinoscopy; p = 0.062, Wilcoxon signed rank) but was significantly less than the +9.64 D difference predicted by an inner limiting membrane model (upper 95% limit = +3.76 D). CONCLUSION: This suggests that the origin of the retinoscopic reflex is located in the outer retina rather than at the inner limiting membrane. Correction factors for retinoscopy in small eyes may be smaller than previously assumed.

Animals↗
PubMed1997

Comparison of corneal versus through-the-lid A-scan ultrasound biometry.

BACKGROUND: Accurate ultrasonography data on axial ocular dimensions in infants and toddlers are essential for understanding ocular development. Conventional methods using corneal contact with topical anesthesia but without sedation are not feasible for most of these patients. We evaluate an alternative method which places the probe on the closed eyelid. METHODS: We compared A-scan ultrasound biometry measurements taken with the probe directly on the cornea with those with the probe on the closed eyelid on the right eye of 35 young adult subjects. RESULTS: There was no significant difference between methods for mean anterior chamber depth (corneal = 3.83 mm, lid = 3.87 mm, p = 0.13, paired t-test). The mean lens thickness (corneal = 3.63 mm, lid = 3.75 mm, p = 0.0001, paired t-test) and mean vitreous chamber depth (corneal = 17.50 mm, lid = 17.68 mm, p = 0.0440, paired t-test) were significantly different. CONCLUSION: Ultrasonography through the closed eyelid appears to be a viable method with acceptable validity compared with corneal ultrasound. Poorer agreement for lens thickness and vitreous chamber depth may be undesirable, but these data should be useful for planning future studies of infants and toddlers.

Adult↗
PubMed1997

Effect of optical defocus on visual acuity in dogs.

OBJECTIVE: To determine the effect of optical defocus (such as what develops in spontaneous myopia and subsequent to cataract extraction) on visual acuity in dogs. ANIMALS: 3 young adult male Beagles. PROCEDURE: The effect of optical defocus on visual acuity was determined by sweep visual evoked potential, using a within-subjects/repeated measures design in which each dog served as its own control. Dogs were positioned so that the eye being tested was 60 cm in front of the video display, and the target was centered on the area centralis. To create ametropia relative to the video screen, a series of concave and convex spherical lenses were placed 1 cm in front of the eye, and sweep visual evoked potential acuities were obtained. RESULTS: Maximal acuity was 7.0 to 9.5 cycles/degree. Defocusing by 2.0 diopters reduces Beagle grating acuity approximately 1 octave. Mimicking aphakia resulted in a marked depression of acuity to 0.7 cycles/degree or less. CONCLUSIONS: Even mild degrees of ametropia have appreciable impact on the resolving power of the canine visual system. CLINICAL RELEVANCE: Spontaneous myopia is encountered in dogs and may be associated with impaired visual performance attributable to a reduction in visual acuity. Previous reports indicate the possibility of myopia in dogs to have a heritable component. On the basis of our results, refractive correction of aphakia is advisable, and refractive screening of dogs with demanding visual tasks (eg, service dogs, field-trial Labrador Retrievers) is recommended.

Animals↗
PubMed1996

Validity of surveys reporting myopia, astigmatism, and presbyopia.

Validation of surveys is an important step in establishing the usefulness of questionnaires for gathering information in clinical studies. Often in large studies of refractive error, it is not possible to examine and refract all subjects and their relatives. Therefore, we used 3 methods to evaluate 112 consecutive clinic patients' abilities to report myopia through a survey: (1) The Lay Terms Method asks: "are you nearsighted?"; (2) The Direct Method asks: "are you myopic?"; and (3) The Indirect Method uses a series of questions about the use of eyeglasses and age at first dispensing. Patient responses to the survey before examination were compared to subjective refraction findings at the completion of the eye examination. The Lay Terms Method had the highest sensitivity (0.98) but poor specificity (0.48), and the Direct Method yielded the highest specificity (0.83) but poor sensitivity (0.54). The rate of nonresponse ("don't know") was high (25.9 and 46.4% for the Lay Term and Direct Methods, respectively). The Indirect Method gave both high sensitivity and specificity (0.76 and 0.74, respectively), and only an 8.9% don't know response rate. The survey method that reports the presence or absence of myopia with the best balance of sensitivity and specificity and fewest don't know responses is the Indirect Method, suggesting it is the most suitable of our three approaches for use in clinical studies.

Adolescent↗
PubMed1996

Corneal changes in schoolchildren.

Videokeratography (TMS-1) data from the right eyes of 788 children between the ages of 6 and 14 years, examined in 1994 as part of the Orinda Longitudinal Study of Myopia, were analyzed using the Fast Fourier Transform (FFT) to quantify corneal power, toricity, and toricity axis. Cross-sectional analysis showed no statistically significant age trend for these parameters. Conversely, longitudinal analysis of data for 387 of these children, first measured in 1991, showed a statistically significant decrease in corneal power. Corneal toricity did not change significantly over this 3-year period, although there was a minute but statistically significant clockwise axis shift. From this we conclude that in the elementary and junior high school years-during which period axial length is known to increase-corneal flattening continues, but corneal toricity is stable.

Adolescent↗
PubMed1996

Crystalline lens parameters in infancy.

Despite the importance of lens power to ocular development, few data are available regarding infant crystalline lens parameters. Lens and corneal radii of curvature were measured in the horizontal meridian using a video-based keratophakometer, and refractive error was measured by cycloplegic retinoscopy in 19 out of 27 infants ranging in age from 3 to 18 months. The median refractive error was +1.50 D, and the median corneal power was 43.5 D. Using previously reported values for axial ocular dimensions, the median anterior and posterior lens radii of curvature were 8.7 and 5.6 mm, respectively, both substantially flatter than infant schematic eye values. The median equivalent refractive index of the lens was 1.49, considerably higher than previous reported schematic values for infants or children. There was a significant reduction in hyperopia with age (r = -0.47, P = 0.043), but no age-related trends in lens or corneal radii of curvature, suggesting that calculated values for lens power and equivalent index may undergo substantial decline with age during early childhood development as axial length increases. Most of the decrease in lens power (75%) may be due to decreases in equivalent index rather than to flattening of the surface radii of curvature. Videophakometry appears to be a feasible and useful technique for documenting the role of the crystalline lens in infant ocular development.

Anthropometry↗
PubMed1996

Is computer use a risk factor for myopia?

BACKGROUND: Many patients who become myopic or who undergo increases in myopia as adults have concerns about whether the use of video display terminals (VDTs) contributes to these changes in refractive error. This paper is an overview of the current literature on topics concerning VDTs and factors related to proposed etiologies for myopia. METHODS: Selected literature is reviewed on the relationship between VDTs and asthenopia, fatigue, accommodation, and vergence. Clinical studies of myopic progression and transient myopia among VDT users are considered, as is television viewing as a risk factor for juvenile myopia. RESULTS/CONCLUSIONS: Reports of asthenopia are common with VDT use by a factor of 1.4 to 1.5, compared to conventional office work. Questions of comparability remain between VDT users and nonusers with respect to confounding variables such as the number of work hours. Proofreading on a VDT appears to be less efficient than using printed copy. Despite screen flicker and reflections, the accommodative response appears to be accurate to a VDT. Transient, fatigue-induced changes in accommodation and vergence may occur after work with VDTs. Despite these near point changes, there is no compelling evidence in the literature that suggests there is a significant increase in the risk of myopia onset or progression from the use of VDTs by adults compared to other forms of near work.

Accommodation, Ocular↗
PubMed1996

Factors influencing graft clarity.

Successful penetrating keratoplasty depends on both host- and donor-related factors. We compared the results of keratoplasty in a group with a wide range of donor ages to gauge the effect of donor age on graft success. We conducted a retrospective review of donor data, recipient age, preoperative diagnosis, and postoperative complications with respect to graft clarity at 24 months after surgery in 99 consecutive patients in an effort to determine the role of donor age in graft clarity. The only factors that we isolated that appeared to influence graft clarity at 24 months postoperatively were a preoperative diagnosis classified as inflammatory/traumatic and the occurrence of postoperative complications. There was no association between graft clarity and recipient age, donor age, death-to-preservation time, or preservation-to-surgery time.

Age Factors↗
PubMed1995

The utility of three predictors of childhood myopia: a Bayesian analysis.

Any treatment to prevent the onset of juvenile myopia will require predictive tests in order to determine which children should receive treatment. Three risk factors for myopia were evaluated for their ability to predict myopia: (a) refraction at school entry; (b) refraction in infancy; and (c) parental history of myopia. Bayes' theorem was used to estimate these conditional probabilities. Refraction at school entry had twice the power to predict myopia (probability of juvenile myopia given the child is near emmetropia at school entry = 0.53) compared to either infant refraction (0.21-0.28) or parental myopia (0.20-0.25). While a history of any parent having myopia had the highest test sensitivity (probability of a positive family history of myopia given juvenile myopia in the child = 0.90) and refraction at school entry the highest test specificity (probability of more hyperopia than +0.50 D at school entry given no juvenile myopia = 0.91), none of these three factors had high values for both sensitivity and specificity. Further work is required to develop a battery of tests which could predict the onset of juvenile myopia with both adequate sensitivity and specificity.

Age Factors↗
PubMed1995

How applicable are animal myopia models to human juvenile onset myopia?

Investigations into the plasticity of eye growth and refractive error development have significantly expanded our knowledge of animal models of myopia in the last 15 yr. The applicability of this information is as yet undetermined, but hopefully this information will be useful in learning more about human myopia. This paper presents a critical review of the animal myopia literature as those data relate to the human condition. Differences between the chicken, tree shrew, and primate animal models of myopia are outlined, and the various experimental paradigms used to investigate refractive error development and ocular growth in the chicken are compared. Specific arguments against the application of animal models of myopia to the etiology of human juvenile onset myopia include the following: (1) there is no deprivation of form vision in the environment of the school-aged child as severe as that required to induce myopia in animals; (2) the sensitive period for deprivation myopia in animals appears to be too early to account for human juvenile onset myopia; and (3) studies in the chicken using spectacle lenses to create dioptric blur involve a choroidal thickness modulation that has no human analog. Ultimately, the results of investigations into the cellular and biochemical modulation of eye growth in animals may be the most relevant to human myopia.

Animals↗
PubMed1995

The equivalent refractive index of the crystalline lens in childhood.

Despite the importance of crystalline lens power in ocular development, schematic refractive index values used to calculate lens power have been validated for children. We measured refractive error and ocular component dimensions in 519 schoolchildren, calculating lens power using phakometrically measured lens radii and three different refractive index profiles: (1) Gullstrand-Emsley schematic indices [Gullstrand-Emsley lens power (GELP)]; (2) a 10-shell gradient index model [gradient index lens power (GILP)]; and (3) the equivalent refractive index (IND) needed to bring calculated and measured refractive error into agreement [calculated lens power (CLP)]. GELP was significantly lower than either GILP or CLP, indicating the Gullstrand-Emsley refractive index of 1.416 is too low for use in children. Variation in IND cannot be explained by measurement error alone. GILP and CLP also differed as a function of lens shape, with GILP greater than CLP at steeper external curvatures and less than CLP at flatter external curvatures. Variation in equatorial gradient index profile as a function of lens shape is proposed as an explanation for this bias. Equivalent index appears to be a useful tool for encompassing individual variation in lens gradient profiles as well as for assessing the relative role of lens surface curvature and refractive index changes during lens power development in childhood.

Adolescent↗
PubMed1995

Longitudinal evidence of crystalline lens thinning in children.

PURPOSE: Most earlier studies indicated that the eye's crystalline lens grows continually throughout life, but cross-sectional results of crystalline lens thinning during childhood have been reported. The authors investigated crystalline lens thickness in childhood using cross-sectional and longitudinal data. METHODS: The Orinda Longitudinal Study of Myopia is a community-based study of normal eye growth and myopia development in school-age children. During a 1-to 3-year period, A-scan ultrasonographic lens thickness measurements of 869 children 6 through 14 years of age were analyzed. RESULTS: On average, between the ages of 6 and 10 years, the crystalline lens thins in its axial dimension by almost 0.2 mm. This thinning can be depicted by a cubic model. In this sample, the children with myopia had thinner crystalline lenses than the children with emmetropia of the same age. CONCLUSIONS: This article provides the first longitudinal evidence that the crystalline lens thins during the period of coordinated ocular growth between the ages of 6 and 10 years. Further, it shows that lens thickness is associated with refractive error. Thinner crystalline lenses in children with myopia may result from one of two underlying mechanisms: Either the crystalline lens exhausts its ability to compensate for axial elongation after undergoing accelerated lens thinning before the onset of myopia, or the crystalline lens in the myopic eye may be thinner throughout childhood, during which it thins at a rate consistent with other refractive errors. If mechanical forces link eye growth to crystalline lens compensation, more complex, visually guided feedback loops may not be needed to explain the normal eye growth that results in emmetropization.

Adolescent↗