| Purpose: To evaluate the dynamic changes of higher-order aberrations(HOAs)in myopic and emmetropic eyes after correction of lower-order aberrations(LOAs)with adaptive optics(AO);To evalue the effects of HOAs on visual Perceptual Lerning(PL)of residual amblyopia using adaptive optics visual simulator system(AOVS).Methods: 1、A closed-loop AOVS was used to correct the LOAs in 22 emmetropic eyes and 22 myopic eyes.The dynamic changes of HOAs were recorded for 10 seconds after correction of LOAs.HOAs were analyzed in Zernike coefficients.Generalized Additive Mixed Models(GAMMs)and Threshold Effect were used to evaluate the dynamic changes of HOAs and to find out the turning point in each group.All data was analyzed with Empower Stats.2、Randomized controlled clinical study.20 patients with residual amblyopia randomly divided into two groups: Experimental group(A)treated with visual PL on the basic of LOAs and HOAs corrected,but control group(B)treated with visual PL on the basic of LOAs corrected.PL was once a day for 50 minutes,for 10 days.The visual acuity and contrast sensitivity were measured before and after the visual PL.All data was analyzed with SPSS.Results: 1.After the correction of LOAs,the RMS of LOAs decreased to 0.026 μm from 1.070 μm in myopic group(t = 16.424,p < 0.0001)and to 0.017 μm from 0.606 μm in emmetropic group(t = 16.127,p < 0.0001)with statistical significance.2.After the correction of LOAs,the vertical coma presented a positive shift in both groups,0.013 μm in myopia group and 0.006 μm in emmetropia group.It was significant difference(95% CI(0.007,0.018),p <0.0001)in myopia and wasn’t significant difference in emmetropia group(95% CI(-0.001,0.012),p = 0.093).There was no significant difference between myopia and emmetropia(p = 0.097).3.After the correction of LOAs,the horizontal coma presented a negative shift in both groups,0.005 μm in myopia group and 0.004 μm in emmetropia group without significant difference both groups(95% CI(-0.012,0.002),p = 0.168;95%CI(-0.011,0.004),p = 0.321).There was no significant difference between myopia and emmetropia(p = 0.770).4.After the correction of LOAs,in myopia group the vertical trefoil positive changed in 0.051 μm with significant difference(95% CI(0.006,0.097),p = 0.028),but the vertical trefoil was stable in emmetropia group(β = 0.000,95% CI(-0.001,0.001),p = 0.832).There was significant difference between myopia and emmetropia(p = 0.029).5.After the correction of LOAs,the horizontal trefoil presented a negative shift,0.008 μm in myopia group and 0.007 μm in emmetropia group,with significant difference(95% CI(-0.016,0.000),p = 0.041;95% CI(-0.011,-0.003),p = 0.0002).There was no significant difference between myopia and emmetropia(p = 0.881).6.After the correction of LOAs,in the early stage the spherical aberration presented a positive shift,0.015 μm in myopia group and 0.010 μm in emmetropia group with significant difference(95% CI(0.010,0.020),p < 0.0001;95% CI(-0.011,-0.003),p = 0.0002).There was no significant difference between myopia and emmetropia(p = 0.243).7.In group A,the contrast sensitivity of low and modest spatial frequency(1c/d,2c/d,4c/d and 8c/d)showed significant increase after the visual PL(t =-2.501,p = 0.037;t =-2.504,p = 0.037;t =-2.649,p = 0.029;t =-2.511,p = 0.036).8.In group B some contrast sensitivity improved,but the difference were not statistically significant.9.After the visual P L,only the contrast sensitivity of 1c/d and 4 c/d in group A was significantly higher than group B(45.045 ± 15.308 vs 21.087 ± 18.021,t =-2.877,p = 0.012;39.708 ± 16.759 vs 20.377 ± 18.048,t =-2.214,p = 0.044;respectively).Conclusions: 1.After the correction of LOAs,vertical coma and spherical aberration positive changed in both group;horizontal coma and horizontal trefoil nagative changed in both group.2.In myopia group the vertical coma,vertical trefoil,horizontal trefoil and spherical aberration changed with significant difference.In emmetropia group the spherical aberrationand horizontal trefoil changed significantly,others were stable after LOAs correction.3.So to improve the optical correction can help improve the curative effect of visual Perceptual Learning. |
