June 2017
Volume 58, Issue 8
ARVO Annual Meeting Abstract  |   June 2017
Effect of Accommodative Therapy on Ciliary Muscle Thickness
Author Affiliations & Notes
  • Marjean T Kulp
    The OSU College of Optometry, Columbus, Ohio, United States
  • Nahrain Shasteen
    The OSU College of Optometry, Columbus, Ohio, United States
  • G.Lynn Mitchell
    The OSU College of Optometry, Columbus, Ohio, United States
  • Melissa Bailey
    The OSU College of Optometry, Columbus, Ohio, United States
  • Chiu-Yen Kao
    Claremont McKenna College, Claremont, California, United States
  • Kathryn Richdale
    SUNY College of Optometry, New York, New York, United States
  • Footnotes
    Commercial Relationships   Marjean Kulp, None; Nahrain Shasteen, None; G.Lynn Mitchell, None; Melissa Bailey, Patent number 9,060,717 (P); Chiu-Yen Kao, Patent number 9,060,717 (P); Kathryn Richdale, None
  • Footnotes
    Support  Colllege of Optometrists in Vision Development
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2710. doi:
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      Marjean T Kulp, Nahrain Shasteen, G.Lynn Mitchell, Melissa Bailey, Chiu-Yen Kao, Kathryn Richdale; Effect of Accommodative Therapy on Ciliary Muscle Thickness. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2710.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Accommodative therapy has been shown to improve both signs and symptoms associated with accommodative insufficiency (AI). The underlying mechanism has not yet been shown. The ciliary muscle is a multi-unit smooth muscle which may retain the ability to undergo changes in size and contractile ability. The purpose of this study was to investigate whether a change in ciliary muscle thickness (CMT) occurs in subjects with AI following accommodative therapy.

Methods : Subjects, ages 9 to 30 years, with AI were recruited. Anterior segment optical coherence tomography was used to measure maximum ciliary thickness (CMTMAX) and ciliary muscle thickness at 1mm (CMT1), 2mm (CMT2) and 3 mm (CMT3) posterior to the scleral spur of the right eye while subjects viewed a distance target before and after therapy. Therapy consisted of 8 weeks of in-office weekly accommodative therapy (1 hour/week) with home reinforcement therapy (15 minutes/day, 5 days/week).

Results : Subjects with AI (N = 16, mean age = 17.4 years) were enrolled and completed the therapy. CMT measurements at baseline were 776.96 ± 67.12µm at CMTMAX, 756.76 ± 66.91µm at CMT1, 554.14 ± 74.30µm at CMT2, and 335.14 ± 49.48µm at CMT3. After accommodative therapy, CMT measurements showed thickening of at least 20μm (CMTMAX: mean difference 31.54µm, p=0.012; CMT1: 28.42 µm, p=0.043, CMT2: 40.42 µm, p=0.006, CMT3: 21.59 µm, p=0.009).

Conclusions : Accommodative therapy increased CMT in subjects with AI. The increase in muscle thickness provides a potential mechanism for the improvements in signs and symptoms seen with therapy.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.


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