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Jens Buehren, Christine Titke, Oliver Klaproth, Laura Ihrlich, Thomas Kohnen; Significantly aberrated ocular condition (SAOC): Higher-order aberrations in patients with visual symptoms in native eyes. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2127.
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To test the hypothesis that patients with visual complaints such as monocular diplopia in native eyes have elevated total, corneal and internal higher-order aberrations (HOA) compared to a young normal population.
In a retrospective analysis, data from 44 native symptomatic eyes (30 patients, mean age 48 ±11 a) and 50 asymptomatic control eyes (50 subjects, mean age 27 ±4 a) were analyzed. Total, corneal and internal aberrations were measured using a combined ray tracing/Placido device (iTrace). Wavefront reconstruction was performed with a Zernike fit to ray tracing and corneal curvature data over a pupil diameter of 6 mm. Retinal image quality was expressed as the visual Strehl ratio based on the optical transfer function for the best-corrected state (BCVSOTF). Inter-group differences were compared using a Student t test or a Mann-Whitney U test.
Mean log BCVSOTF was -1.16 ±0.28 for symptomatic and -0.7 ±0.22 for control eyes (P <0.001). Symptomatic eyes exhibited significantly higher coma RMS (0.502 ±0.291 vs. 0.287 ±0.122 µm, P<0.001), spherical aberration RMS (0.301 vs. 0.184 µm, P<0.001) and residual HOA (non-coma, non spherical) RMS (0.497 ±0.329 vs. 0.088 ±0.074 µm, P<0.001). C3-1 and C40 were the single coefficients with the highest mean inter-group differences (0.190 µm and 0.172 µm). There were also significant differences among internal corneal coma and residual HOA RMS. C40 was the single internal coefficient with the highest inter-group differences (0.174 µm). Among corneal aberrations only coma and residual HOA RMS, but neither spherical aberration RMS nor single coefficients were significantly different. Retinal image quality was reduced significantly by internal aberrations in the group of symptomatic eyes (mean BCVSOTF decrease by internal aberrations -0.27 ±0.28 log units, P<0.001 vs. 0); this effect could not be observed in the control group (-0.05 ±0.26 log BCVSOTF, P>0.05).
Patients who complained about symptoms such as monocular diplopia in native eyes, had significantly elevated HOA and a lower retinal image quality compared to a control group. In the majority of cases internal aberrations, namely coma and spherical aberration, were the source of reduced image quality.
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