Abstract
Purpose :
Visual Acuity (VA) is an important clinical measure of visual function and an outcome measure in clinical trials for treatment in retinal diseases. However, anterior segment changes in aging eyes often impact image quality on the retina, but are not reported in a quantitative manner. Wavefront aberrations are known to increase with aging when measured for large pupil sizes. We hypothesize that a 3 mm pupil could allow wavefront data collection in most subjects and simultaneously minimize unwanted differences in aberrations for aging compared to the 5 mm pupil. We measured the means of lower order and higher order wavefront aberrations and the test-retest values as a function of age.
Methods :
The wavefront aberrations of normally sighted adults (N=39, Age = 41.9 +/-16.3 yr) were measured for a 3 mm and 5 mm pupil setting, without pupil dilation. All were consented and tested in a manner approved by the Indiana University Institutional Review Board, which adhered to the Declaration of Helsinki. Three sets of measurements were acquired for each subject with a commercially available, multi-function instrument (Pentacam AXL Wave, OCULUS). The mean of the three measurements provided the aging data across subjects. The difference of measurement 1 – measurement 2 provided the test-retest values. Linear regression as a function age was computed for the mean and the test-retest values for the all aberrations.
Results :
3 mm pupil variability was less than 5 mm variability for all 26 measured aberrations (orders 1-6) which was statistically significant (F = 54.625, P = <0.001.) 3mm pupil also had reduced average aberration for all 26 measures (21 of 26 were statistically significant, P <0.05.) Regression analysis indicated that most mean aberrations did vary significantly with age for a 3 mm pupil for 4 of aberrations. The range for these was large in the older subjects, with some older subjects being similar to the younger ones but others with a more negative cylinder or a greater vertical astigmatism.
Conclusions :
The trend of larger aberrations for cylinder and vertical astigmatism with increasing age is consistent with previous measurements of increased corneal astigmatism with age. Not all older subjects followed this trend, i.e. older subjects had greater individual differences. These data contribute to the basis for examining the impact of optical aberrations to improve VA measurement.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.