The Illinois College of Optometry (ICO) is a private optometry college in Chicago, Illinois. Graduating approximately 160 optometrists a year, it is the largest optometry college in the United States and is the oldest continually operating educational facility dedicated solely to the teaching of optometrists. The college complex incorporates more than 366,000 square feet (34,000 m2) including an on-site eye care clinic, electronically enhanced lecture center, library, computerized clinical learning equipment, cafeteria, fitness center, and living facilities..
Purpose:To quantify the value of using prior changes in spherical equivalent refractive error (SER) and axial length (AL) to predict future myopia progression. Methods:For this post hoc analysis of a randomized controlled trial, we used data from children ages 5 to 12 years with SER -1.00 to -6.00 D who had been randomized 2:1 to 0.01% atropine or placebo eye drops for 24 months. Multivariable linear regression evaluated the association of baseline-to-12-month change in SER and AL versus 12-to-24-month change while controlling for age and SER or AL at 12 months. Treatment groups were pooled for analyses; sensitivity analyses were conducted using only the placebo group. Results:Among 187 children, 136 (73%) with complete data were included. For predicting a 0.50-D-or-more SER increase of myopia in the second 12 months based on observing a 0.50-D-or-more increase of myopia in the first 12 months, the positive predictive value was 42% (19 of 45; 95% confidence interval [CI], 29%-57%). Greater baseline-to-12-month SER change was weakly associated with greater 12-to-24-month SER change (0.20 D per additional 1.00 D; 95% CI, 0.02 to 0.39; P = 0.03; partial R2 = 0.03). The 95% prediction interval half-width for 12-to-24-month change was ±0.66 D with prior change versus ±0.67 D without (difference = 0.01 D; 95% CI, -0.05 to 0.07). Analyses of AL and sensitivity analyses limited to the placebo group were qualitatively similar. Conclusions:Changes in SER and AL of children in the prior 12 months were poor predictors of future myopia progression, limiting their usefulness for clinical decision-making or selecting participants for clinical trials.
Purpose:To compare and evaluate the clinical performance and fit success of lehfilcon A and lotrafilcon B multifocal soft contact lenses (MfSCLs). Patients and Methods:This was a prospective, randomized, double-masked, crossover, dispensing clinical study. Eligible wearers were fitted and wore study MfSCLs bilaterally (≥8 hours/day, ≥5 days/week) over 30 days. Endpoints: binocular visual acuity (VA) at distance (4 m), intermediate (80 cm), and near (40 cm) at day 30; fit rate success; eye care professional (ECP) rating, study dispensed lens power at visit 1; lens fit, and surface characteristics at dispense and day 30; safety assessments. Results:Overall, 101 subjects were enrolled. At day 30, lehfilcon A MfSCLs were noninferior to lotrafilcon B MfSCLs for distance, intermediate, and near VA (non-inferiority margin: 0.05; 95% UCL of LSM difference 0.00, 0.02, 0.04; mean VA, lehfilcon A: -0.10 ± 0.08, -0.10 ± 0.08, and 0.01 ± 0.12; lotrafilcon B: -0.09 ± 0.07, -0.11 ± 0.08, and -0.02 ± 0.11). At visit 1, ≥99.5% of both MfSCLs achieved successful fit with 1-2 lenses/eye. Mean ECP ratings for ease of fit: lehfilcon A 9.8 ± 0.6; lotrafilcon B: 9.7 ± 0.6. About 96.0% of subjects had same sphere (D) power and 100.0% had same ADD power in both eyes for both lenses. All MfSCLs had optimal/acceptable fit. Majority of MfSCLs (>96%) had grade 0/1 front surface wettability and front/back surface deposits. No serious AEs were reported, and all biomicroscopy findings were graded 2 (mild) or lower. Conclusion:Lehfilcon A multifocal contact lenses combine excellent visual performance, high fit success, and a stable, comfortable wearing experience over 30 days of daily wear. With their water-gradient surface, favorable safety profile, and ease of fit, they represent a reliable and beneficial option for clinicians to consider when selecting multifocal lenses for presbyopic patients.
Background Low fruit intake is a global risk factor for cardiometabolic diseases. This study sought to investigate vascular and metabolic effects of increasing total and select fruit intake in adults with prediabetes. Methods This randomized, 2‐arm parallel, partially controlled feeding study provided participants (n=82, aged 45±15 years, 30±6 kg/m2) weekly diets (1500 [women] or 1750 kcal/d [men]) incorporating 1 avocado and 1 cup of mango (avocado–mango diet) daily for 8 weeks or energy‐matched low‐fat, low‐fiber foods (control diet). Flow‐mediated vasodilation was the primary end point. Central and brachial blood pressure; pulse‐wave velocity; metabolic, inflammatory, and kidney function markers; and dietary intake were secondary end points. Change (Δ) data were analyzed by mixed model ANCOVA or Wilcoxon rank‐sum test, and postprandial and dietary intake data by repeated‐measures ANOVA using SAS 9.4 (SAS Institute, Cary, NC). Results Changes in percentage of flow‐mediated vasodilation were significantly different between interventions (effect, −2.11±0.77%; P=0.008), increasing ≈1% on the avocado–mango diet and decreasing on the control diet, as were changes in central and brachial diastolic blood pressure (P=0.07 and P=0.03, respectively), specifically in men. Other end points were generally not different between diets (P>0.05), although select lipids and kidney markers were marginally different (P<0.1). Total fruit, dietary fiber, vitamin C, and monounsaturated fat intake significantly increased during the avocado–mango diet compared with the control diet (P<0.05). Conclusions In adults with prediabetes, daily inclusion of avocado and mango increases fruit consumption, diversifies nutrient composition, and improves vascular function associated with cardiovascular health. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT05353790.
Background/Objectives: As scleral lens (SL) use continues to expand, particularly for medically necessary management of corneal irregularity and ocular surface disease, it is important to determine if wear of these lenses is associated with eyelid disease. This study evaluated habitual SL wearers for meibomian gland obstruction, meibum quality, and signs of lid margin inflammation. Methods: Eligible participants wore scleral lenses in one or both eyes for any indication and had been wearing their current lens design(s) for at least six months, with habitual wear of ≥5 h per day, six days per week. Eyelid inflammation metrics were specifically assessed. Results: Forty-nine scleral lens wearers (32 females) were enrolled. Upper lid wiper epitheliopathy (LWE) was present in 21 eyes (43%), and lower LWE was present in 15 eyes (31%). Thirty-nine eyes (80%) had expressible meibomian glands. Eyes with no expressible meibum were significantly higher in ocular surface disease (39%, 7/18) than corneal irregularity (11%, 3/27) (p = 0.03). Lid margin telangiectasia was present in wearers with ocular surface disease (61%, 11/18) and corneal irregularity (19%, 5/26) (p = 0.005). Conclusions: Eyelid disease was common among habitual scleral wearers regardless of indication for lens use. Eyes with ocular surface disease demonstrated a higher prevalence of meibomian gland obstruction and lid margin telangiectasia compared to those with corneal irregularity.
PURPOSE:The balance of responses between the ON and OFF pathways is believed to play an important role in myopia. This pilot study compared the difference in visual acuity under two contrast polarities between myopic children (corrected and uncorrected) and emmetropic children. METHODS:Two groups of children aged 8-12 years were enrolled: a myopic group (spherical equivalent [SEQ] between -0.75 D and -6.00 D, N = 11) and a normal control group (N = 16). Visual acuities were measured using an Early Treatment Diabetic Retinopathy Study program, which presented either white letters against a black background or black letters against a white background. Visual acuity (corrected and uncorrected for the myopic group) under both polarities was tested in randomized order and repeated after a 30-min interval. Visual acuities were reported as letter scores. The ON/OFF ratios of visual acuity scores under the two polarity conditions were calculated and correlated with SEQ. RESULTS:When uncorrected, white-letter visual acuity was significantly better than black-letter visual acuity (p < 0.001) for the myopic group, with a difference of 6 letters (equivalent to 0.12 logMAR). No significant differences in visual acuity scores between the two polarities were found when the myopic group was corrected or in the control group. This suggests that uncorrected myopic eyes have greater difficulty in resolving the spatial resolution of black letters as compared to white letters. The ON/OFF ratio in the uncorrected myopic group was significantly higher than in the corrected myopic group and the control group (1.14 ± 0.09 vs. 0.99 ± 0.04, 1.00 ± 0.03, p < 0.001). When uncorrected, the ON/OFF ratio correlated with SEQ (R = 0.38, t = -2.4, p = 0.02), indicating that the ON/OFF imbalance increases with the magnitude of uncorrected myopic blur. CONCLUSIONS:Children with uncorrected myopic eyes had more difficulty in recognizing black letters compared to white letters, and the ON/OFF imbalance was correlated with the magnitude of uncorrected myopic blur.
