Rafael Iribarren

Favaloro Foundation

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Abel Szeps

Hospital Posadas

J. Rozema

Antwerp University Hospital

Carla Lança

New York University

Andrzej Grzybowski

University of Warmia and Mazury in Olsztyn

Guillermo Iribarren

Hospital Alemán

Ian G. Morgan

Australian National University

Leonardo Fernández Irigaray

Nano Hydrophobics (United States)

Akbar Fotouhi

Tehran University of Medical Sciences

Hassan Hashemi

Noor Eye Hospital

Martín De Tomás

Cooperative Institutions

University of Warmia and Mazury in Olsztyn

Charité - Universitätsmedizin Berlin

Universidade Nova de Lisboa

Instituto Politécnico de Lisboa

Hospital Posadas

University of Buenos Aires

National University of Singapore

Singapore Eye Research Institute

Singapore National Eye Center

Sun Yat-sen University

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Ophthalmology (2003)

Rafael Iribarren

10.1016/s0161-6420(02)01987-5

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Axial Growth and Lens Power Loss at Myopia Onset in Singaporean Children

Investigative Ophthalmology & Visual Science (2019)

J. Rozema Sebastián Dankert Rafael Iribarren Carla Lança Seang‐Mei Saw

Purpose: We studied biometry changes before and after myopia onset in a cohort of Singaporean children. Methods: All data were taken from the Singapore Cohort Study of the Risk Factors for Myopia (SCORM). Participants underwent refraction and biometry measurements with a follow-up of 3 to 6 years. The longitudinal ocular biometry (spherical equivalent refraction, axial length, and lens power) changes were compared between children who suffered myopia during the study (N = 303), emmetropic children (N = 490), and children myopic at baseline (N = 509). Results: At myopia onset, the myopic shift increased to 0.50 diopters (D)/y or more in new myopes compared to the minor changes in emmetropes of the same age. New myopes had higher axial growth rates than emmetropes, even years before myopia onset (0.37 and 0.14 mm/y, respectively; ANOVA with Bonferroni post hoc test, P < 0.001). After onset, the change in both parameters slowed down gradually, but significantly (P < 0.05). In new myopes, lens power loss (−0.71 D/y) was significantly higher up to 1 year before myopia onset compared to emmetropes (−0.46 D/y), after which lens power loss slows down rapidly. At age 7 years, (future) new myopes had lens power values close to those of emmetropes (25.12 and 25.23 D, respectively), while later these values approached those of children who were myopic at baseline (23.06 and 22.79 D, respectively, compared to 23.71 D for emmetropes; P < 0.001). Conclusions: New myopes have higher axial growth rates and lens power loss before myopia onset than persistent emmetropes.

Emmetropia

10.1167/iovs.18-26247

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A Clinical-Based Study on Accommodative-Vergence Disorders in Children in Argentina

SSRN Electronic Journal (2022)

Alejandra Iurescia Andrzej Grzybowski Rafael Iribarren Carla Lança

Purpose: To determine the relative prevalence and risk factors of accommodative-vergence disorders among children attending a paediatric Ophthalmology clinic.Methods: This study recruited consecutive children aged 5 to 18 years attending regular annual visits at an ophthalmology clinic. Cycloplegic autorefraction and accommodative and vergence measurements were performed. Age, sex, heterophoria and refractive error were evaluated as risk factors for anomalies of binocular vision or myopia ( ≤ -0.50 D).Results: A total of 404 children were evaluated. Their mean age was 10.96 ± 3.03 years and 59.4% were girls. Non-strabismic accommodative-vergence disorders and myopia were diagnosed in 40.1% and 35.1 % of the children, respectively. Non-strabismic children with accommodative-vergence disorders reported higher proportion of reading problems (73.7 %) compared with children with no accommodative-vergence disorders (26.3 %; p<0.001). Children with reading problems were more likely to have accommodative infacility (57.9 %) compared with children without (42.1 %; p<0.001). Non-strabismic accommodative-vergence disorders were associated with female sex (Odds Ratio [OR]=1.62; 95% CI, 1.04 - 2.52) and heterophoria (OR=1.07; 95% CI, 1.02 - 1.13). Refractive error was not associated with accommodative-vergence disorders (p=0.34).Conclusions: Accommodative-vergence disorders and myopia accounted for 40% of the volume of an ophthalmology pediatric clinic. Accommodative and vergence disorders may impair reading performance in children and myopia may lead to visual impairment in adulthood. Thus, further research is necessary to understand the potential of public health policies to prevent, diagnose and treat those conditions.Funding: None to declare. Declaration of Interest: Ethical Approval: Verbal consent was obtained from all parents after the nature of the study was explained. As there was no therapeutic intervention within the protocol, the current legislation in Argentina does not consider authorization by an accredited ethics committee to be necessary. Nevertheless, The Argentinian Council Ethics Committee was consulted and as no intervention or new test was going to be administered the Committee suggested that approval was not necessary. Data were completely anonymized and in full compliance with data protection laws.

Vergence (optics)

10.2139/ssrn.4236426

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Corneal Power Is Correlated with Anterior Chamber Diameter

Investigative Ophthalmology & Visual Science (2012)

Rafael Iribarren Fernando Fuentes Bonthoux Timo‐Kolja Pförtner Pablo Chiaradía William K. Stell

Purpose.: Although corneal power and axial length are known to be inversely correlated, the biological determinants of corneal power are unknown. To elucidate this correlation further, study authors investigated the relationships among corneal power, corneal diameter, anterior chamber diameter, and axial length in a sample of human adults. Methods.: The eyes of 61 subjects seen consecutively in an eye clinic were studied with a high-resolution optimal coherence tomography (OCT) pachymetry device and ophthalmic optical biometer. The relationships between corneal power, white-to-white (WTW) corneal diameter, anterior chamber diameter, and axial length were assessed with Pearson correlations. Results.: The mean age of the 61 subjects was 48.7 ± 19.4 years. Corneal power was negatively correlated with axial length (r = −0.303, P < 0.01); WTW corneal diameter (r = −0.399, P < 0.001); and most interestingly, anterior chamber diameter (r = −0.646, P < 0.001). There was also a positive correlation between anterior chamber diameter and axial length (r = 0.489, P < 0.001). Conclusions.: Greater anterior chamber diameters were associated with flatter corneas and, conversely, smaller anterior chamber diameters with steeper corneas. The growth patterns of the anterior segment may be determinants of corneal power.

Anterior chamber angle

Positive correlation

10.1167/iovs.11-8949

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Choroidal Control Technology: New Horizons in Maculopathy and Presbyopia

Graefe s Archive for Clinical and Experimental Ophthalmology (2024)

Abel Szeps Juan Manuel Suarez Rodrigo Torres Rafael Iribarren

Presbyopia

New horizons

10.1007/s00417-024-06633-4

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Prevalencia de astigmatismo alto en la provincia de Salta, Argentina

Luis Zeman Rubén D. Danza Laura Fejerman Rafael Iribarren

Purpose: Refractive errors are the first cause of visual impairment across the world. Prevalence data are crucial for planning visual health strategies, since early detection and treatment of refractive errors in children has a key role on normal vision development. This is the largest report in Argentina that has studied refractive errors under cycloplegic refraction in school-aged children.Methods: Cross-sectional population based study, which involved school children aged 4-15 year-old examined from March to November 2014. Automated cycloplegic refractive error measurement and subjective refraction were performed. Myopia was considered as the spherical equivalent refractive error +2.00 D. For the purpose of this study, astigmatism was considered as that equal or greater than -2.00 diopters.Results: The sample consisted of 1852 children aged 8.03 ± 2.57 years, range 4 to 15 years of whom 967 (52.2%) were females. 116 subjects (6.26%) had a spherical equivalent lower or equal than -0.50 diopters and there were 111 (5.99%) subjects with refractive cylinder ≤ -2.00 diopters (limit -7.50 diopters). In the Seclantas zone (mountainside) the sample comprised 157 children, of whom 20 (12.75%) had astigmatic values in the right eyes ≤ than -2.00 diopters.Conclusion: An elevated prevalence of high astigmatism and a very low prevalence of myopia were found in this population. Future studies including diverse populations with high prevalence of high astigmatism could contribute to a better understanding of the relevant factors in the etiology of this trait.

Astigmatism

Subjective refraction

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Editorial: Myopia: Public health challenges and interventions

Frontiers in Public Health (2022)

Rafael Iribarren Andrzej Grzybowski Carla Lança

EDITORIAL article Front. Public Health, 14 September 2022Sec. Public Health Education and Promotion https://doi.org/10.3389/fpubh.2022.1008858

Public Health Interventions

10.3389/fpubh.2022.1008858

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Non-Miotic Improvement in Binocular Near Vision with a Topical Compound Formula for Presbyopia Correction

Ophthalmology and Therapy (2023)

Felipe Vejarano Jorge L. Alió Rafael Iribarren Carla Lança

The aim of this case series was to examine the association between unaided binocular visual acuity for near vision and pupil change after the instillation of a special topical formulation for presbyopia treatment.This was a case series consisting of consecutive participants with presbyopia aged 40-70 years who were tested for visual acuity and pupil diameter before and 2 h after instillation of a formulation of pilocarpine and phenylephrine drops (FOV Tears) for presbyopia. Participants underwent subjective refraction, photopic and scotopic pupil diameter measurement and unaided monocular and binocular visual acuity testing by logMAR for distance and near vision both pre- and post-instillation of eye drops.The study enrolled 363 subjects (n = 176 women, 48%) with a mean (± standard deviation) age of 50.4 ± 5.8 years. Mean spherical equivalent (SE) changed significantly (- 0.17 Diopters) after instillation of the FOV Tears formulation (p < 0.001). Post-instillation of eye drops, the scotopic pupil diameter decreased by 0.97 ± 0.98 mm, and the near visual acuity by logMAR improved significantly by nearly two lines (p < 0.01). In the linear regression analyses, age (p < 0.001) and SE pre-drop instillation (p < 0.001) were associated with unaided binocular visual acuity. The changes in photopic pupil diameter and the scotopic pupil diameter were not associated with unaided binocular visual acuity.The use of the pilocarpine and phenylephrine formulation (FOV Tears) improved binocular visual acuity for near vision in presbyopic patients, and the effect was independent of pupil change.

Scotopic vision

Presbyopia

Mesopic vision

Subjective refraction

10.1007/s40123-023-00648-6

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Datos preliminares del estudio sobre la tolerancia y eficacia de las gafas de desenfoque periférico para el control de la progresión de la miopía en la Argentina (Estudio Myofix Defocus)

Oftalmología clínica y experimental. (2024)

Abel Szeps Carlos Kotlik Leonardo Fernández Irigaray Guillermo Saracco Martín De Tomás

Objetivo: Evaluar la eficacia y tolerabilidad del uso de un nuevo modelo de gafas diseñadas para controlar la progresión de la miopía en la infancia. Materiales y métodos: El estudio Myofix Defocus es un estudio de investigación longitudinal, prospectivo, intervencionista y no aleatorizado para gafas de control de la miopía. Este estudio de campo incluye a 48 niños miopes de entre 8 y 15 años sin otra patología ocular inscritos desde junio de 2023 hasta abril de 2024. En este estudio se ofreció a los pacientes la opción de someterse a un tratamiento accesible en nuestra región (gotas de atropina diluidas compuestas) o a un tratamiento posiblemente igual de eficaz con gafas especiales diseñadas en nuestro país. En el presente estudio, se realizó una evaluación oftalmológica inicial completa con refracción objetiva bajo cicloplejía con registro de medidas de longitud axial y una encuesta sobre hábitos, estilo de vida y antecedentes familiares de alta miopía. Resultados: Los datos iniciales mostraron una edad media de 10,72 ± 2,48 años y que 23/48 de ellos eran niñas. Su equivalente esférico medio era de -2,61 ± 1,12 dioptrías en el ojo derecho y de -2,37 ± 1,12 dioptrías en el ojo izquierdo. La queratometría media era de 43,52 ± 1,32 dioptrías en el ojo derecho y en el izquierdo. La longitud axial media fue de 24,38 ± 0,79 mm en el ojo derecho y de 24,34 ± 0,79 mm en el ojo izquierdo. Conclusiones: Los datos iniciales del Estudio de Desenfoque Myofix comprenden una muestra de escolares miopes propensos a la miopía progresiva según su edad media. Palabras clave: gafas de desenfoque periférico, control de la miopía, diseño novedoso.

10.70313/2718.7446.v17.n03.350

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Progresión de la miopía en la infancia durante el confinamiento del COVID-19 en la Argentina

Carolina Picotti Victoria Sanchez Leonardo Fernández Irigaray Ian G. Morgan Rafael Iribarren

Abstract Purpose: To determine whether the progression of myopia in children was faster during school closures and home confinement during the COVID-19 pandemic.Methods: This was a case series study collecting retrospective data on refractive error for 2018 and 2019 in consecutive myopic patients attending regular checkups for their spectacle prescription from September to December 2020. Inclusion criteria were age from 5 to 18 years, and spherical equivalent between -0.50 and -6.00 diopters for the three examinations. Patients receiving any treatment for arresting myopia progression were excluded. Cycloplegic spherical equivalent in both eyes was recorded for 2018, 2019 and 2020. Annualized mean progressions over the two periods 2018-2019 and 2019-2020 were calculated.Results: At the 2020 visit after confinement, mean age of the 115 enrolled patients was 11.89 ± 3.68 years and 60% were girls. The mean annualized progression for the right eyes in 2018-2019 was -0.43 ± 0.52 D and -0.58 ± 0.53 D in 2019-2020 during the period that included home confinement (p=0·012, Wilcoxon text), an increase of 32%. The median values of progression for these two periods were -0.27 D and -0.53 D.Conclusion: Annual progression rates over the period that included strict pandemic home confinement were higher than in the previous year, in contrast to the general slowing of progression as children get older.

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