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E. Costantini, O. Touzeau, R. Kopito, T. Gaujoux, J. C. Gavrilof, C. Agate, V. M. Borderie, L. Laroche; Age-Related Changes in Subjective Astigmatism and Corneal Astigmatism. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1028.
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To analyze the influence of the age on subjective (refractive) astigmatism and on corneal astigmatism in a normal population.
We prospectively recorded the subjective refraction and topography (Orbscan) of 500 healthy eyes (including ametropia) of 250 patients (age range: 9 to 97 years). Polar values (cylinder, axis) of regular astigmatism were transformed into rectangular coordinates (x,y) in a dioptric plane. WTR/ATR component (ortho-astigmatism 0°/90°JCC ), oblique component (45°/135°JCC) and mirror-image symmetry (enantiomorphism) of astigmatism were quantified. The different characteristics of the astigmatism were correlated to the age.
While the magnitude of subjective astigmatism does not significantly change with the age (p=0.42), the axis is significantly influenced by the age: the WTR/ATR component is more influenced by the age than the oblique component (r=0.36 p<0.001 and r=0.09 p=0.02). The prevalence of the WTR astigmatism increases with age from nearly 10% in individuals younger than 60 years up to 39% in individuals older than 60 years (p<0.001). The age-related diminution of enantiomorphism (r=0.17 p=0.007) is more related to a diminution of the mirror symmetry of the axis between both eyes (p=0.005) than to a cylindrical asymmetry (p=0.16). Corneal astigmatism is more enantiomorph than subjective astigmatism (p=0.01). The irregularity of the corneal surface and the irregular astigmatism increase with the age (r=0.32 p<0.001 and r=0.12 p<0.001).
The origin of age-related changes of the axis (inversion and diminution of enantiomorphism) is mainly corneal. Finally most of the characteristics of the subjective and corneal astigmatism vary with aging.
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