Optik und Mechatronik
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Institute
- Optik und Mechatronik (106)
Purpose: The purpose of this thesis is to provide a comprehensive literature review about albinism as an inherited metabolic disorder of melanin synthesis along with those related conditions impacting the visual system. As such, it addresses eye care emphasizing the visual consequences of albinism along with diagnostic and treatment options.
Methods: Background knowledge about ocular development is given as well as information about etiological biochemical and genetic processes. The current classification, clinical findings and their assessment and management options are presented based on recent results of research. In conclusion, two case reports are described as examples of visual care options.
Results: Melanin plays a big role in the retinal and chiasmal development. Melanin biosynthesis can be disrupted by different genes in various ways which leads to the current classification of albinism. Clinical findings include fundus hypopigmenta-tion, nystagmus, iris transillumination, photophobia, foveal hypoplasia, excessive chiasmal decussation, reduced visual acuity, high astigmatism (with-the-rule), strabismus and decreased stereopsis. Treatment options to improve visual acuity, fixation and binocularity are (tinted) prescription lenses and contact lenses, low vision aids, surgical procedures and vision therapy. Medication and supplementa-tion for increased pigmentation are currently being tested on mice.
Conclusions: Albinism is caused by genetic mutations resulting in ocular and cutaneous hypopigmentation. It establishes various phenotypes that require different therapy approaches in order to improve vision and therefore quality of life.
Purpose: Recent studies found a reduction of myopia progression with multifocal contact lenses, however, with yet unclear mechanism. This raises the hypothesis that the addition zones of the multifocal contact lenses induce myopic defocus on the retina, which consequentially leads to choroidal thickening and therefore inhibited eye growth. We tested the effect of the optical design of multifocal contact lenses on choroidal thickness.
Methods: 18 myopic students wore four different contact lenses ((1) single-vision lens corrected for distance, (2) single-vision lens with +2.50 D full-field defocus, (3) “Multifocal center-distance” design, addition +2.50 D, (4) “Multifocal center-near” design, addition +2.50 D) for each 30 minutes on their right eye. Automated analysis of the macular choroidal thickness, vitreous chamber depth and eccentric photorefraction were performed before and after each contact lens.
Results: Choroidal thickness and vitreous chamber depth showed no significant differences to baseline with none of the contact lenses. Choroidal thickness increased the most with the “Multifocal center-distance” and the full-field defocus lens, followed by the “Multifocal center-near” and the single-vision contact lens (+2.1 ± 11.1 μm, +2.0 ± 11.1 μm, +1.6 ± 11.3 μm, +0.9 ± 11.2 μm, respectively). The “Multifocal center-distance” design showed an overall more myopic refractive profile than the other lenses. Changes of vitreous chamber depth occurred in anti-phase to these of choroidal thickness.
Conclusion: Multifocal contact lenses have no significant influence on choroidal thickness and after short-term wear. Therefore, it is assumed that it is not the main contributor to the protective effect of multifocal contact lenses in myopia control.
Purpose
To determine the stereo threshold and inherent variability with a monitor-based two-rod test at various eccentricities of the visual field. Additionally, to evaluate the duration of this procedure.
Subjects and methods
A pilot trial was conducted in five ophthalmologically normal subjects (2 male and 3 female) aged 21 – 23 years. Two black rods on white background, which appeared under an angle of 1° were presented in a viewing distance of 5.0 meters. The right rod was stationary, whilst the left rod appeared under a stereoscopic parallax, with an either proximal or distal displacement to the image plane. Threshold determination was assessed at seven eccentricities of the visual field by a staircase method. Eccentricities were 0° centrally, 5° to the right and left, 10° to the right and left and 15° to the right and left of the visual field. Proximal and distal displacement as well as the sequence of eccentricities were presented in random order. Stereo acuity was measured in two different sessions for four subjects and in five different sessions for one subject. For all sessions the duration was recorded. All sessions were separated by a time interval of at least 24 hours and no longer than 7 days. Evaluation was made by Wilcoxon test and Kruskal Wallis test at the 95% confidence level (CI) and the median was assessed for all thresholds.
Results
Stereo acuity declines with increasing eccentricities of the retina similar to visual acuity. While at 0° eccentricity thresholds were found to be lowest with (median) 5.0 seconds of arc (‘’) and the CI (0.5’’, 30.5’’) for all measurements, they increased to 112.2’’ at 15° eccentricity to the left in proximal displacement. Distal it was 19.9’’ centrally and 112.2’’ to the right at 15° eccentricity with CI (0.5’’, 30.5’’) for all measurements.
Repeatability of the threshold determination was found to be best at 0° eccentricity with proximal displacement showing the exact same result in the repetitive session and poorest repetition was found at 15° eccentricity to the left with distal displacement. Distal repeatability was worse than proximal. Median and CI of duration time was 5.3 (3.2, 8.3) minutes.
Conclusion
Stereo acuity thresholds are repeatable however increase with increasing eccentricity. Repetitions of the threshold determination do not vary considerably. The duration of these measurements indicates the monitor-based two-rod test as a fast procedure, that can be applied in future studies. The test program is limited by an imperfect algorithm and the stereoscopic images evoke cues, this should be reworked.
Subsea shut-off device
(2021)