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Kathleen S. Kunert, Monique Nennstiel, Marcus Blum, Stefan Schramm, Bernd-Ulrich Seifert, Patrick Schikowski, Juergen Prehl, Monika Reder; Presbyopia is the First Stage of Nuclear Cataract-Analysis of Forward and Backward Scattered Straylight in the Presbyopic Human Lens. Invest. Ophthalmol. Vis. Sci. 2011;52(14):826.
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© ARVO (1962-2015); The Authors (2016-present)
The study was conducted as a prospective clinical pilot study to analyse ocular straylight in presbyopia. Changes in the lens with presbyopia might not only result in a loss of accommodation but also in a reduced visual performance due to straylight induced by the lens.
A total of 139 patients (278 eyes) were examined and divided by age (y) into the three following groups: (G1-praepresbyopic-18-35 y; G2-presbyopic-36-50 y; G3-accommodative loss-51-80 y). Two methods were used to measure ocular straylight. First, backward scattered light was evaluated using the Pentacam High Resolution. Second, forward scattered light was subjectively measured with the C-Quant (both instruments from Oculus Optikgeräte GmbH, Germany). Besides, visual acuity was measured with EDTRS-charts and accommodative amplitude with the WAM-5500 (Grand Seiko Co. Ltd., Japan). Differences between the age groups were investigated using the Mann-Whitney-U-test.
Measurement of backward scattered straylight using the Pentacam-Scheimpflug method (linear densitometry) revealed significant differences between all age groups: An increase in the densitometric value Dmax was seen between G1-G2 (p< 3.6 e-14), G1-G3 (p< 0.0001) and G2-G3 (p< 0.0001). The measurement of the subjective forward scattered straylight also showed a significant increase with age. Differences were again significant for all three groups: G1-G2 (p< 0.03), G1-G3 (p< 0.0001) and G2-G3 (p< 5.3 e-09). For both methods, significances were seen already at the stage of presbyopia. Visual acuity was significantly reduced between G1-G3 (p< 0,001), but not between G1-G2. Accommodative amplitude declined with age as expected.
The increase of ocular straylight is reproducibly dependent on age. A significant increase in straylight can be demonstrated at the stage of presbyopia even though visual acuity remains unaffected and accommodative effort of the lens is not yet collapsed.
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