Peripheral Refractive Error and its Association with Myopia Development and Progression. An examination of the role that peripheral retinal defocus may play in the origin and progression of myopia
View/
PhD Thesis (5.580Mb)
Download
Publication date
2019Supervisor
Mallen, Edward A.H.Barrett, Brendan T.
Keyword
Relative peripheral refractionMyopia development
Myopia progression
Peripheral refractive error
Peripheral retinal defocus
Children
Rights
The University of Bradford theses are licenced under a Creative Commons Licence.
Institution
University of BradfordDepartment
Faculty of Life SciencesAwarded
2019Metadata
Show full item recordAbstract
Purpose: Currently there are attempts to slow myopia progression by manipulating peripheral refractive error. This study proposed to establish the distribution of peripheral refractive errors in hyperopic, emmetropic and myopic children and to test the hypothesis that relative peripheral hyperopia is a risk factor in the onset and progression of myopia. Methods: Refraction was measured under non-cycloplegic conditions, at 0°, 10° (superior, inferior, temporal and nasal retina) and 30° (temporal and nasal retina), at distance and near. Central spherical equivalent refractive error (SER) was used to classify the eyes as myopic (≤ −0.75 D), emmetropic (−0.75 < SER < +0.75 D) or hyperopic (≥ +0.75 D). Relative peripheral refraction was calculated as the difference between the central (i.e. foveal) and peripheral refractive measurements. At baseline, measurements were taken from 554 children and in a subset of 300 of these same children at the follow-up visit. The time interval between initial and follow-up measurement was 9.71 ± 0.87 months. Results: Results were analysed on 528 participants (10.21 ±0.94 years old) at baseline and 286 longitudinally. At baseline, myopic children (n=61) had relative peripheral hyperopia at all eccentricities at distance and near, except at 10°-superior retina where relative peripheral myopia was observed at near. Hyperopic eyes displayed relative peripheral myopia at all eccentricities, at distance and near. The emmetropes showed a shift from relative peripheral myopia at distance to relative peripheral hyperopia at near at all eccentricities, except at 10°-superior retina, where the relative peripheral myopia was maintained at near. In the longitudinal data analysis, myopes who became more myopic did not show greater relative peripheral hyperopia at baseline compared with myopic sub-groups whose central refraction remained stable. Conclusions: The peripheral refractive profile differences between different refractive groups that are reported in other studies have been confirmed in this study. Relative peripheral hyperopia is not found to be a significant risk factor in the onset or progression of myopia in children.Type
ThesisQualification name
PhDCollections
Related items
Showing items related by title, author, creator and subject.
-
The role of endothelial cell reactive antibodies in peripheral arterial diseaseObjectives It is hypothesised that endothelial cell reactive antibodies (ECRA) play a role in the progression of PAD through activation of endothelial cells and the release of inflammatory cytokines. We aimed to test this hypothesis by assessing levels of ECRA, E-selectin and IL-6 in patients with PAD of varying severity in a case controlled study. Design, materials, methods Patients were assessed clinically and with ankle¿brachial pressure indices. Patients with critical ischaemia (CI, n=30), stable claudicants (SC, n=30), and age-matched controls (AMC, n=20) were studied. Antibody, E-selectin and IL-6 levels were measured using ELISA. Results ECRA levels were significantly raised in the CI group over AMC. IL-6 levels were significantly elevated in both SC and CI over the control group and in CI over SC. There were no significant differences in E-selectin levels between the AMC, SC and CI. Conclusion Our findings support the hypothesis that autoantibodies play a role in promoting PAD by elevating IL-6. The absence of an elevation in E-selectin in this study may be due to its short half-life, and casts doubt on its value as a marker of inflammation in atherosclerosis.
-
Effects of Chemical and Radiation Sterilisation on the Biological and Biomechanical Properties of Decellularised Porcine Peripheral NervesThere is a clinical need for novel graft materials for the repair of peripheral nerve defects. A decellularisation process has been developed for porcine peripheral nerves, yielding a material with potentially significant advantages over other devices currently being used clinically (such as autografts and nerve guidance conduits). Grafts derived from xenogeneic tissues should undergo sterilisation prior to clinical use. It has been reported that sterilisation methods may adversely affect the properties of decellularised tissues, and therefore potentially negatively impact on the ability to promote tissue regeneration. In this study, decellularised nerves were produced and sterilised by treatment with 0.1% (v/v) PAA, gamma radiation (25-28 kGy) or E Beam (33-37 kGy). The effect of sterilisation on the decellularised nerves was determined by cytotoxicity testing, histological staining, hydroxyproline assays, uniaxial tensile testing, antibody labelling for collagen type IV, laminin and fibronectin in the basal lamina, and differential scanning calorimetry. This study concluded that decellularised nerves retained biocompatibility following sterilisation. However, sterilisation affected the mechanical properties (PAA, gamma radiation), endoneurial structure and basement membrane composition (PAA) of decellularised nerves. No such alterations were observed following E Beam treatment, suggesting that this method may be preferable for the sterilisation of decellularised porcine peripheral nerves.
-
Effects of Graphene Oxide in vitro on DNA Damage in Human Whole Blood and Peripheral Blood Lymphocytes from Healthy individuals and Pulmonary Disease Patients: Asthma, COPD, and Lung CancerFor the past few decades, the popularity of graphene oxide (GO) nanomaterials (NMs) has increased exceedingly due to their biomedical applications in drug delivery of anti-cancer drugs. Their unique physicochemical properties such as high surface area and good surface chemistry with unbound surface functional groups (e.g. hydroxyl - OH, carboxyl /ketone C=O, epoxy/alkoxy C-O, aromatic group C=C, etc) which enable covalent bonding with organic molecules (e.g. RNA, DNA) make GO NMs as excellent candidates in drug delivery nanocarriers. Despite the overwhelming biomedical applications, there are concerns about their genotoxicity on human DNA. Published genotoxicity studies on GO NMs were performed using non-commercial GO with 2-3 layers of GO sheets, synthesized in various laboratories with the potential for inter-laboratory variabilities. However, what has not been studied before is the effects of the commercial GO (15-20 sheets; 4-10% edge-oxidized; 1 mg/mL) in vitro on DNA damage in human whole blood and peripheral blood lymphocytes (PBL) from real-life patients diagnosed with chronic pulmonary diseases [asthma, chronic obstructive pulmonary disease (COPD), and lung cancer], and genotoxic endpoints compared with those from healthy control individuals to determine whether there are any differences in GO sensitivity. Thus, in the present study, we had characterized GO NMs using Zetasizer Nano for Dynamic Light Scattering (DLS) and zeta potential (ZP) in the aqueous solution, and electron microscopy using the Scanning Electron Microscope (SEM) and Transmission Electron Microscope (TEM) in the dry state, respectively. Cytotoxicity studies were conducted on human PBL from healthy individuals and patients (asthma, COPD, and lung cancer) using the Methylthiazolyldiphenyl-tetrazolium bromide (MTT) and Neutral Red Uptake (NRU) assays, respectively. The genotoxicity (DNA damage) and cytogenetic effects (chromosome aberration parameters) induced by GO NMs on human whole blood from healthy individuals and patients were studied using the Alkaline Comet Assay and Cytokinesis-blocked Micronucleus (CBMN) assay, respectively. Our results showed concentration-dependent increases in cytotoxicity, genotoxicity, and chromosome aberrations, with blood samples from COPD and lung cancer patients being more sensitive to DNA damage insults compared with asthma patients and healthy control individuals. Furthermore, the relative gene and protein expressions of TP53, CDKN1A/p21, and BCL-2 relative to GAPDH on human PBL were studied using the Reverse Transcription Quantitative Polymerase Chain Reaction (RT-qPCR) and Western Blot techniques, respectively. Our results have shown altered gene and protein expression levels. Specifically, GO-induced cytotoxicity, genotoxicity, and micronuclei aberrations were associated with TP53 upregulation - a biomarker of DNA damage - in both patients and healthy individuals. These effects show that GO NMs have promising roles in drug delivery applications when formulated to deliver drug payload to COPD and cancer cells. However, the fact that cytotoxicity, genotoxicity, chromosome instability, and gene/protein expressions - biomarkers of cancer risk - were observed in healthy individuals are of concern to public health, especially in occupational exposures at micro levels at the workplace.
