- •Contents
- •Foreword
- •Dedication
- •Message
- •About the Editors
- •List of Contributors
- •Acknowledgments
- •Introduction
- •Methodologic Issues
- •Review of Studies (Table 1)
- •Cohort Effects on Myopia
- •Risk Factors for Myopia
- •Near work
- •Education/Income
- •Outdoor activity
- •Race/Ethnicity
- •Nuclear cataract
- •Family aggregation/Genetics
- •Siblings
- •Parent-child
- •Other family members
- •Genetics
- •Comments
- •Acknowledgments
- •References
- •Introduction
- •Definition of Myopia in Epidemiologic Studies
- •Risk Factors for Myopia and Ocular Biometry
- •Family history of myopia
- •Near work
- •Outdoor activity
- •Stature
- •Birth parameters
- •Smoking history
- •Breastfeeding
- •Conclusion
- •References
- •Introduction
- •Aetiological Heterogeneity of Myopia
- •Clearly genetic forms of myopia
- •School or acquired myopia
- •Misunderstandings of Heritability and Twin Studies
- •But Heritability has Its Uses
- •Evidence for Genetic Associations of School Myopia
- •Evidence for the Impact of Environmental Factors on Myopia Phenotypes
- •Gene-Environment Interactions and Ethnicity
- •Gene-Environment Interactions and Parental Myopia
- •Conclusion
- •Acknowledgments
- •References
- •Introduction
- •Economic evaluations
- •Full vs partial evaluations
- •Economic evaluation of myopia
- •The Economic Cost of Myopia: A Burden-of-Disease Study
- •China
- •India
- •Europe
- •Singapore
- •Southeast Asia
- •Africa
- •South America
- •Bangladesh
- •ii. Proportion of myopes paying for correction
- •Uncorrected and undercorrected refractive error, spectacle coverage rate and reasons for spectacles nonwear
- •iii. Amount paid for myopic correction
- •Singapore
- •The burden of myopia
- •Further Directions for Economic Research
- •References
- •Introduction
- •Impact of Myopia in Adults
- •Overall Conclusion
- •Future Studies
- •References
- •Introduction
- •Definition of Pathological Myopia
- •Cataract
- •Glaucoma
- •Myopic Maculopathy
- •Myopic Retinopathy
- •Retinal Detachment
- •Optic Disc Abnormalities
- •References
- •Conclusion
- •Introduction
- •The Association Between Myopia and POAG
- •Information from epidemiological studies
- •Asian populations: Myopia and POAG
- •Myopia in other situations
- •Myopia and ocular hypertension
- •Myopia in angle closure
- •Myopia in Pigment Dispersion Syndrome (PDS)
- •Theories for a Link Between Myopia and POAG
- •Glaucoma Assessment in Myopic Eyes
- •Biometric differences
- •Axial length and CCT
- •Optic disc assessment in myopic eyes
- •Visual fields in myopic eyes
- •Imaging tests and variations with myopia
- •ONH susceptibility to damage
- •The Influence of Myopia on the Clinical Management of the Glaucoma Patient
- •Glaucoma progression and myopia
- •References
- •Posterior Staphyloma
- •Myopic Chorioretinal Atrophy
- •Lacquer Cracks
- •Myopic Choroidal Neovascularization
- •Myopic Foveoschisis
- •Myopic macular hole detachments
- •Lattice degeneration
- •Retinal tears and detachments
- •References
- •Introduction
- •Electroretinography
- •Ganzfeld electroretinography
- •Multifocal electroretinography
- •Assessment of Retinal Function
- •Outer retinal (photoreceptor) function
- •Post-receptoral (bipolar cell) and retinal transmission function
- •Inner retinal function
- •Macular function in myopic retina
- •Effect of Long-Term Atropine Usage on Retinal Function
- •Macular Function Associates with Myopia Progression
- •Factors Associated with ERG Changes in Myopia
- •Conclusion
- •References
- •Introduction
- •Genomic Convergence Using Genomic Content
- •Pathway Analysis
- •Pathway analysis in cancer genomics
- •Pathway analysis in GWAS
- •Non-parametric approaches
- •Parametric approaches
- •P-values combining approaches
- •Conclusion
- •References
- •Introduction
- •Definition of Myopia
- •The Classical Twin Model
- •What is the classical twin model?
- •Historical perspective
- •Statistical approaches
- •Twins, Myopia and Heritability Studies
- •Heritability studies for myopia using twins
- •Limitations of using twins in heritability studies
- •Twins and Myopia — Other Studies
- •The Importance of Twin Registries
- •Concluding Comments
- •Acknowledgments
- •References
- •Introduction
- •Candidate Gene Selection Strategies for Myopia
- •Genes Associated With Myopia-Related Phenotypes
- •The HGF/cMET ligand-receptor axis
- •The collagen family of genes
- •Concluding Remarks
- •Acknowledgments
- •References
- •Introduction
- •Phenotypes for Myopia Genetic Studies
- •Study Design
- •Genotyping and Quality Controls
- •Population Structure
- •Association Tests
- •Correlated Phenotypes
- •Imputation and Meta-Analysis
- •Visualization Tools
- •Drawing Conclusions
- •Acknowledgments
- •References
- •Introduction
- •The Search for Error Signals
- •The blur hypothesis
- •Bidirectional lens-compensation
- •Recovery from ametropia vs. compensation for lenses
- •The complication of the emmetropization end-point
- •Optical aberrations as error signals
- •Other possible visual error signals
- •How Important is Having a Fovea?
- •Mechanisms of Emmetropization
- •Scleral similarities and differences between humans and chickens
- •Retinal signals
- •Glucagon-insulin
- •Retinoic acid
- •Dopamine
- •Acetylcholine
- •Choroidal signals
- •The Role of the Choroid in the Control of Ocular Growth
- •Diurnal rhythms and control of ocular growth
- •Conclusions
- •References
- •Introduction
- •Gross Scleral Anatomy
- •Structural organization of the sclera
- •Cellular content of the sclera
- •Mechanical properties of the sclera
- •Structural Changes to the Sclera in Myopia
- •Development of structural and ultrastructural scleral changes in myopia
- •Scleral pathology and staphyloma
- •Biochemical Changes in the Sclera of Myopic Eyes
- •Structural biochemistry of the sclera in myopia
- •Degradative processes in the sclera of myopic eyes
- •Cellular changes in the sclera in myopia
- •Biomechanical Changes in the Sclera of Myopic Eyes
- •Regulators of scleral myofibroblast differentiation
- •Myofibroblast-extracellular matrix interactions
- •Cellular and matrix contributions to altered scleral biomechanics and myopia
- •Scleral Changes in Myopia are Reversible
- •Eye growth regulation during recovery from induced myopia
- •Summary and Conclusions
- •Acknowledgments
- •References
- •Introduction
- •Spatial Visual Performance and Optical Features of the Eye
- •Axial eye growth and development of refractive state
- •Lens thickness and vitreous chamber depth
- •Corneal radius of curvature
- •Schematic eye data
- •Techniques Currently Available for Myopia Studies in the Mouse, Both for Its Induction and Measurement
- •Devices to induce refractive errors
- •Techniques to measure the induced refractive errors and changes in eye growth
- •Refractive state
- •Corneal radius of curvature
- •Axial length measurements and ocular biometry
- •Measurements of the optical aberrations of the mouse eye
- •Behavioral measurement of grating acuity and contrast sensitivity in the mouse
- •Recent Studies on Myopia in the Mouse Model: Some Examples
- •Magnitudes of experimentally induced refractive errors in wild-type mice
- •Refractive development in mutant mice
- •Pharmacological studies to inhibit axial eye growth in mice
- •Image processing and regulation of retinal genes and proteins
- •Summary
- •Acknowledgments
- •References
- •Introduction
- •A Brief Introduction to Comparative Genomics
- •Comparative Expression
- •Genes in Retina and Sclera in Animal Models of Myopia
- •ZENK (EGR-1)
- •Scleral Gene Expression in a Mouse Model of Myopia
- •RNA, Target cDNA and Microarray Chip Preparation
- •Microarray Data Analysis
- •Scleral Gene Expression in the Myopic Mouse
- •Summary
- •References
- •Introduction
- •Possible Mechanisms of Pharmacological Treatment
- •Efficacy Studies
- •Other Issues Related to Drugs
- •Potential Side Effects
- •The Future of Drug Treatment in Myopia
- •Conclusions
- •References
- •Introduction
- •Accommodation
- •Close work
- •Physical characteristics of the retinal image
- •Visual deprivation
- •Compensatory changes in refraction
- •Intensity and periodicity of light exposure
- •Spatial frequency
- •Light periodicity
- •Image clarity
- •Outdoor activity and retinal image blur
- •Light vergence and photon catch
- •Chromaticity
- •Therapeutic implications
- •References
- •Index
245 The Relevance of Studies in Chicks for Understanding Myopia in Humans
the eye beyond its set-point and made it grow in the hyperopic direction, as one would expect for bidirectional lens-compensation. This individual variation in set-points may account for why some tree shrews became hyperopic and others myopic in the experiment described above in which animals wore positive lenses briefly each day.
In this regard, the chick eye is most useful because it emmetropizes to within a few diopters of emmetropia within a week of hatching and compensates for lenses from –10 D to +15 D. Therefore, if one controls the viewing distance and accommodation, one can be certain that the defocus is hyperopic with negative lenses and myopic with positive lenses, and therefore that this end-point complication does not apply.
Optical aberrations as error signals
The existence of bidirectional lens-compensation raises the question of what error signal could provide the growth-guiding signal. In a perfect optical system, one could not distinguish myopic from hyperopic defocus unless one knew the object being imaged. However, real eyes are not perfect optical systems, and so the issue is what aberrations might provide the signed error signal. Among the monochromatic aberrations (that is, the ones that exist in monochromatic light), it is well known that spherical aberration (the difference in focal length between the center and periphery of the lens) can interact with defocus to give a signal that distinguishes myopic from hyperopic defocus,30 so that the focused image is not necessarily the clearest.31 This may be responsible for the finding in some humans that the refractive error depends on the spatial frequency of the stimuli viewed.32 It may also account for the ability of humans to learn to discriminate whether small letters are defocused in the myopic or hyperopic direction, when presented under carefully controlled conditions.33 Arguing against the use of these aberrations is the fact that individual eyes have different aberrations, and the visual system would seem to have to know the aberrations of the particular eye to use them to distinguish the sign of defocus.
A simpler error signal would make use of the longitudinal chromatic aberration of the eye. Because short-wavelength (blue) light is focused more strongly than long-wavelength (red) light, if a black/white edge is in focus, the blue light will be focused in front of the photoreceptors, while the red would be focused behind the photoreceptors. Thus, if the blue aspect of the image were sharper than the red aspect, it would indicate that
246 J. Wallman and D.L. Nickla
the eye was defocused in the hyperopic direction (image focused behind the photoreceptors), whereas if the red aspect were sharper, it would indicate myopic defocus.
The interest in chromatic aberration as an error signal for emmetropization and lens-compensation was diminished by studies some years ago showing that chicks raised in monochromatic illumination could compensate for lenses, although no comparison of wavelengths could be made under these conditions. These findings do not imply that chromatic aberration is not used, but only that other error signals can be used. In fact, because chicks can compensate for as much as 10 D of defocus imposed by eyeglass lenses,34 the existence of other error signals is implied because chromatic aberration would provide a useful error signal only in the range of 1–3 diopters.
To make a stronger test of whether chromatic aberration is used, we arranged to have chicks presented with wallpaper that simulated the chromatic contrasts that would be present at black/white edges if the eye were myopic or hyperopic. We found clear evidence that the eye grew in the direction that compensated for the simulated refractive error.35 This result shows that chromatic cues can be used to distinguish myopic from hyperopic defocus because no other cues were available from this simple striped wallpaper.
Because there is credible evidence that humans use chromatic aberration to determine in which direction to accommodate,36 it is plausible that humans use chromatic aberration in emmetropization as well. The fact that both chickens and humans have cones sensitive to blue, green, and red light argues that chicks may, in this regard, be more similar to humans than most mammals, which have only two cone-types.
Other possible visual error signals
The possible error signals are limited by the reader’s imagination, maybe not even by that. The aberration of astigmatism results in light being focused at two different planes, much like chromatic aberration. If the eye knew the sign of its astigmatism, it could sense changes in the sign of its defocus by a change in which lines were sharper. If the eye could compare the image quality in the ventral visual field (which is myopic37) with that in the central visual field, it could determine whether it was myopic or hyperopic. If it could keep track of the changes in image quality with accommodation, this too could yield the sign of defocus, as could
