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PubMed · 8334928

Accommodative response changes with age measured by pattern electroretinogram.

Abstract

To evaluate whether the transient pattern electroretinogram reflects accommodation, we studied the amplitudes of the P-N component of transient pattern electroretinograms that were elicited in normal volunteers by reversing the checkerboard pattern. The stimuli were presented at a rate of three-reversals per second at a viewing distance of 20 cm. Each subject wore a lens that corrected for distance vision. The ophthalmic lenses were placed in front of the eye. A +12-diopter lens was used first, followed by lenses in decreasing 1-diopter steps, including minus lenses, until no response was recordable. The P-N amplitude was then plotted against increased accommodative stimulus. The graph showed a rapid increase to around 4 diopters, and then a slow decrease with increasing minus lens power. The gradually decreasing part of the graph became steeper under cycloplegic conditions. The amplitude of accommodative response was defined as the difference in diopters between the lens powers for eliciting an electroretinogram amplitude after cycloplegia was achieved and in the untreated pupil. The amplitude of accommodative response attenuated significantly in those subjects older than 40 years.

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BibTeXRIS

N Toyonaga, E Adachi-Usami. 1993. Accommodative response changes with age measured by pattern electroretinogram.. https://doi.org/10.1007/bf01206211

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Diagnosis and treatment of exotropia with a high accommodation convergence-accommodation ratio.

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Does overcorrecting minus lens therapy for intermittent exotropia cause myopia?

BACKGROUND: Overcorrecting minus lens therapy has been used as a treatment for intermittent exotropia. It is based on the principle that an exotropic deviation will be decreased by stimulating accommodative convergence with additional minus power in spectacles. Because excessive accommodation has been implicated as a cause of myopia, there is theoretical concern that overcorrecting minus lens therapy for exotropia may cause myopia. OBJECTIVE: To investigate the effect of overcorrecting minus lens therapy for exotropia on the progression of myopia. DESIGN: A retrospective chart review. SUBJECTS AND METHODS: Seventy-four patients with intermittent exotropia were treated with overcorrecting minus lens therapy for at least 6 months (6-month treatment group), and a 34-patient subset of them received overcorrecting minus lens therapy for 5 years (5-year treatment group). The mean change in refractive error (spherical equivalent of the fixing eye) of these 2 groups 5 years after initial examination was compared with the mean change in refractive error of a control group of 45 patients with intermittent exotropia who did not receive overcorrecting minus lens therapy. RESULTS: At the time of initial examination, the mean (+/-SD) refractive error was 0.00 +/- 1.40 diopters (D) in the control group, 0.00 +/- 1.50 D in the study group, and -0.10 +/- 1.50 D in the 5-year study group, all of which were essentially identical. Five years after initial examination, the mean change in refractive error was -1.40 +/- 2.80 D in the control group, -1.52 +/- 1.80 D in the 6-month treatment group, and -1.54 +/- 1.80 D in the 5-year treatment group. These differences in the change in refractive error (myopic shift) were not statistically significant (t test), and the differences are clinically unimportant. CONCLUSION: Overcorrecting minus lens therapy for intermittent exotropia does not appear to cause myopia.

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