PDF(Pubmed)
Abstract：
Background: Presbyopia is an age-related ocular condition, typically affecting individuals aged over 40 years, characterized by a gradual and irreversible decline in the eye\'s ability to focus on nearby objects. Correction methods for presbyopia encompass the use of corrective lenses, surgical interventions (corneal or lens based), and, more recently, the FDA-approved topical administration of 1.25% pilocarpine. While prior research has demonstrated the efficacy of daily pilocarpine eye drop application in enhancing near visual acuity by increasing the depth of focus leveraging the pinhole effect, limited knowledge exists regarding its influence on visual acuity under varying conditions of contrast and ambient luminance. Methods: This study aims to investigate the impact of these variables on visual acuity, employing the VA-CAL test, among 11 emmetropic and 11 presbyopic volunteers who reported subjective difficulties with near vision. This study includes evaluations under natural conditions with a pinhole occluder (diameter of 2 mm), and subsequent administration of 1% pilocarpine (Pilomann, Bausch + Lomb, Laval, Canada). Results: The VA-CAL results demonstrate the expected, statistically significant effects of contrast and ambient luminance on visual acuity in both emmetropic and presbyopic volunteers. Furthermore, in emmetropic individuals, the application of pilocarpine resulted in a statistically significant reduction in visual acuity. In contrast, presbyopes did not exhibit statistically significant differences in the visual acuity space under either the pinhole or pilocarpine conditions when compared to natural conditions. Conclusions: The pharmacological treatment of presbyopia with pilocarpine eye drops, intended to enhance near vision, does not adversely affect visual acuity in presbyopes. This suggests that pilocarpine may offer a viable alternative for individuals averse to wearing corrective eyewear.
摘要：
背景：老花眼是一种与年龄有关的眼部疾病，通常影响40岁以上的人，其特征是眼睛聚焦于附近物体的能力逐渐和不可逆转地下降。老花眼的矫正方法包括使用矫正镜片，手术干预（基于角膜或晶状体），and,最近,FDA批准的1.25%毛果芸香碱的局部给药。虽然先前的研究已经证明了每天使用毛果芸香碱滴眼液通过利用针孔效应增加焦点深度来增强近视力的功效，在不同的对比度和环境亮度条件下，关于其对视敏度的影响的知识有限。方法：本研究旨在调查这些变量对视力的影响，采用VA-CAL测试，在11名主视和11名远视志愿者中，他们报告了近视力的主观困难。这项研究包括在自然条件下使用针孔封堵器（直径为2毫米）进行评估，随后服用1%毛果芸香碱(Pilomann，Bausch+Lomb,拉瓦尔,加拿大)。结果：VA-CAL结果证明了预期的结果，对比度和环境亮度对正视眼和老花眼志愿者视力的统计学显着影响。此外，在正视个体中，毛果芸香碱的应用导致视力有统计学意义的显著下降。相比之下,与自然条件相比，在针孔或毛果芸香碱条件下，长老的视敏度空间均未表现出统计学上的显着差异。结论:毛果芸香碱滴眼液治疗老花眼,旨在增强近视力，不会对老年期的视力产生不利影响。这表明毛果芸香碱可能为不愿佩戴矫正眼镜的个人提供可行的替代方案。
