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L. A. Shilliam, A. M. Mahmoud, R. G. Lembach, C. J. Roberts; Measured Changes in Accommodative Amplitude With Age Using the Maxwell Ocular Wavefront Aberrometer. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4553.
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To evaluate the Maxwell Ocular Wavefront Aberrometer as a new device capable of measuring accommodative response.
12 eyes of 6 subjects were prospectively recruited (age range: 26 to 51). Subjects who were pregnant or with a history of hypertension, diabetes, eye surgery, or eye disease were excluded. The Maxwell Ocular Wavefront Aberrometer was used to measure both eyes of each subject before and after dilation. Multiple measurements were taken to allow subject adjustment to the procedure followed by 2 study measurements. The best measurement was chosen based on the subject’s ability to focus on the stimulus. Accommodative response was measured as the maximum response minus the minimum response. Linear regression analysis was performed comparing accommodative response vs. age for both the dilated and undilated states. Repeated measures analysis of variance comparing dilation status was also performed. Eyes were also divided into 2 groups: greater than 40 and less than or equal to 40 years of age. Linear regression was performed for accommodative response versus stimulus in the two groups.
Linear regression of measured accommodative response vs. age showed a significant decrease in accommodation with age for both the undilated (p<0.0001, r2=0.8854) and dilated state (p<0.0001, r2=0.8299). Linear regression showed a significant increase in accommodation vs. stimulus for undilated eyes under 40 (p<0.0001, r2=0.8530), dilated eyes under 40 (p<0.0001, r2=0.8798), undilated eyes over 40 (p=0.0006, r2=0.2270), and dilated eyes over 40 (p<0.0001, r2=0.3093). There was no significant difference between response in dilated and undilated eyes (p>0.05).
Previous studies with more sophisticated and cumbersome laboratory techniques have shown characteristic decreases in accommodative response as humans age. The Maxwell Ocular Wavefront Aberrometer produces results consistent with these studies when measuring accommodative response vs. age. The response in older adults is shown to be significantly less than that of younger adults. This device offers a clinically available and easy to use method for evaluating accommodative response. Important uses may include objective evaluation of the efficacy of accommodative restoration procedures.
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