| Welcome to our monthly research update |
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| Research Update is a resource available exclusively to IACLE and BCLA members to support your teaching and practice. Each month we send you a summary of some of the interesting findings appearing in peer-reviewed journals that month. Our aim is to help you keep up to date with the latest contact lens and anterior eye research, and to locate articles when you want to know more about a particular topic. |
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| More information on Research Update and how to use it in your contact lens teaching here. Access archived issues via Member Login under Research. |
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| Issue 16 – April 2018 |
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 Keratoconus seems to be the flavour of the season. In this issue, we include a paper that compares vision and stereoacuity in keratoconus corrected with spectacles and with rigid gas-permeable lenses. A group from Jordan assesses the barriers to rigid gas-permeable lens wear for vision rehabilitation in keratoconus. And we review a longitudinal study that assesses the 10-year follow-up efficacy and safety of riboflavin ultraviolet A-induced cross-linking.
Continuing our quest to understand myopia, we report on diet and risk of myopia in children. Another study evaluates the effect of transient glare on shape discrimination threshold in myopic adults.
Since contact lens users are growing worldwide, and awareness and better diagnostics are available, Acanthamoeba keratitis will become increasingly important over time. Hence, we include a review that focuses on the present status and future prospects of its re-emerging pathology. And finally, we look at the important clinical implications of environmental pollution for the ocular surface.
Happy reading! |
| The IACLE Education Team |
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| Journals reviewed in this issue |
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| KERATOCONUS |
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| Vision in keratoconus: spectacles or RGP lenses? |
| Nilagiri et al compared changes in logMAR and stereoacuity from best corrected sphero-cylindrical spectacles to rigid gas-permeable contact lenses (RGPCL) in 30 bilateral and 10 unilateral keratoconus versus 20 age-matched control subjects. Monocular and binocular logMAR and stereoacuity improved from spectacles to RGPCL in bilateral keratoconus. Only monocular acuity of the affected eye and stereoacuity improved from spectacles to RGPCL in uniocular keratoconus. Clinicians can consider RGPCL as a management modality in keratoconus patients complaining of depth-related difficulties with spectacles.
Optom Vis Sci 2018;95:4 391-398. Click here for abstract |
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| KERATOCONUS |
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| Patient-related barriers to RGP lens wear |
| To assess potential patient-related barriers to rigid gas-permeable (RGP) lens wear for vision rehabilitation in keratoconus (KC) patients in Jordan, Bakkar et al identified barriers after a focus group discussion and used them to design a questionnaire. A total of 204 KC patients (86 females, 118 males), who had never tried RGP lenses, were involved in a semi-structured interview to complete the questionnaire. Major barriers identified were: lack of awareness of the benefits of RGP lenses, fear of possible lens complications, lack of medical insurance and high cost of the lenses.
Cont Lens Anterior Eye 2017; https://doi.org/10.1016/j.clae.2017.12.007. Click here for full text |
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| KERATOCONUS |
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| Corneal collagen cross-linking: 10-year results |
| A prospective longitudinal cohort study by Mazzotta et al assessed the 10-year follow-up efficacy and safety of riboflavin ultraviolet A-induced cross-linking (CXL) in patients aged 18 years and younger with progressive keratoconus (KC). CXL slowed down KC progression in pediatric patients, improving functional performance. KC stability was recorded after 10 years of follow-up in nearly 80% of patients, but there was a 24% regression rate in patients aged 15 years and younger. Parents of these younger patients must be clearly informed that, 7-10 years after therapy, nearly one in four patients may need to be re-treated.
Cornea 2018;37:5 560-566. Click here for abstract |
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| MYOPIA |
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| Diet and risk of myopia: the GUSTO cohort |
| Chua et al investigated the relationship between dietary intakes at 6, 9 and 12 months and risk of myopia in 317 three-year-old children in the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) birth cohort. Dietary intake was recorded using 24-hour recalls or three-day food diaries completed by parents. There was no evidence that diet at 6, 9 and 12 months was related to spherical equivalent, axial length or myopia at three years. Further studies are needed to understand the influence of diet on children’s eye development.
Clin Exp Optom 2018; https://doi.org/10.1111/cxo.12677. Click here for abstract |
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| MYOPIA |
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| Transient glare and myopia |
| Su et al evaluated the effect of transient glare on shape discrimination threshold (SDT) in 162 myopic adults. SDTs were measured under two conditions, with and without the presence of transient glare, while the stimulus was displayed. SDT was increased by the presence of transient glare in myopic subjects. The increment in SDTs among subjects with high myopia was significantly larger than with low-mid myopia. Further work is needed to see if the patients who cannot cope well with post-surgery glare are those who show a larger increase in SDT under transient glare.
Clin Exp Optom 2018;101:2 220-224. Click here for abstract |
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| PATHOLOGY |
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| Acanthamoeba in the eye: latest developments |
| A review by Juárez et al highlights current information about Acanthamoeba keratitis (AK) including general characteristics, epidemiology, clinical aspects, diagnosis and treatment. Recent discoveries in the biology of the parasite involve changes in the prognosis and treatment of AK. Recent studies have reported different genotypes that have not been previously associated with this disease. In addition, Acanthamoeba can act as a reservoir for phylogenetically diverse microorganisms. Giant viruses called Pandoravirus have been found within genotypes producing keratitis. What potential risk this poses is not yet known.
Cont Lens Anterior Eye 2017; https://doi.org/10.1016/j.clae.2017.12.017. Click here for full text |
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| ENVIRONMENT |
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| Ocular surface effects of pollution |
| Jung et al reviewed the literature over the past 10 years to determine the effects of environmental pollution on the ocular surface. Sources of pollution are varied, ranging from gases (such as ozone and NO2) and particulate matter from traffic, to other hazards associated with indoor environments. Mechanisms causing ocular surface disease involve toxicity, oxidative stress, and inflammation. Certain occupations with high exposure to irritants require regular screening and protective measures, as do those with atopy/allergies.
Ocul Surf 2018;16:2 198-205. Click here for abstract |
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| For more information on Research Update visit www.iacle.org. |
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