Skip to main content

Advertisement

SpringerLink
Log in

Correlation of myopia severity with visual performance

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To describe visual performance in high myopia.

Methods

In this cross-sectional study, 148 emmetropes [spherical equivalent (SE) − 0.50 to + 1.00 D] and 564 high myopes [SE ≤ − 6.00 D] were categorised into three groups (Group 1: SE − 6.00 to > − 8.00 D; Group 2: SE − 8.00 to > − 10.00 D; and Group 3: SE ≤ − 10.00 D). Multivariate regression analyses adjusting for age and ethnicity examined the relationship between corrected distance visual acuity (CDVA) [photopic, mesopic and super vision test-night vision goggles (SVT-NVG)] and contrast sensitivity (CS)] (mesopic and SVT-NVG) with SE and axial length (AL).

Results

Mean age of subjects was 21.07 ± 1.17 years, and majority were Chinese (91.9%). Mean SE was 0.10 ± 0.23 D (emmetropes) and − 8.76 ± 2.04 D (high myopes), p < 0.001. Higher degrees of myopia were associated with reduced CDVA and CS, and increased AL (all p < 0.001). Among high myopes, Group 1 had the highest proportion of subjects with good CDVA (photopic ≤ 0.00 LogMAR, mesopic ≤ 0.00 LogMAR and NVG ≤ 0.10 LogMAR) and CS (mesopic ≥ 0.75 LogCS and NVG ≥ 0.35 LogCS) compared with Groups 2 and 3 (all p < 0.001). Among high myopes with good VA (photopic ≤ 0.00 LogMAR, mesopic ≤ 0.00 LogMAR and NVG ≤ 0.10 LogMAR), Group 1 also had the highest proportion of subjects who achieved mesopic ≥ 0.75 LogCS and NVG ≥ 0.35 LogCS (both p < 0.001). Multivariate analyses demonstrated that reduced VA and CS were associated with decreased SE and increased AL (all p < 0.001).

Conclusions

High myopia is associated with reduced VA and reduced CS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Availability of data and materials

Not applicable.

References

  1. Fredrick DR (2002) Myopia. BMJ 324:1195–1199

    PubMed  PubMed Central  Google Scholar 

  2. Hayashi K, Ohno-Matsui K, Shimada N et al (2010) Long-term pattern of progression of myopic maculopathy: a natural history study. Ophthalmology 117:1595–1611

    PubMed  Google Scholar 

  3. Tan CS, Chan YH, Wong TY et al (2011) Prevalence and risk factors for refractive errors and ocular biometry parameters in an elderly Asian population: the Singapore Longitudinal Aging Study (SLAS). Eye (London) 25:1294–1301

    CAS  Google Scholar 

  4. Lin LL, Shih YF, Hsiao CK et al (2004) Prevalence of myopia in Taiwanese school children. Ann Acad Med Singapore 33:27–33

    CAS  PubMed  Google Scholar 

  5. Wong TY, Foter PJ, Hee J et al (2000) Prevalence and risk factors for refractive errors in adult Chinese in Singapore. Investig Ophthalmol Vis Sci 41:2486–2494

    CAS  Google Scholar 

  6. Koh V, Yang A, Saw SM et al (2014) Differences in prevalence of refractive errors in young Asian males in Singapore between 1996–1997 and 2009–2010. Ophthalmic Epidemiol 21:247–255

    PubMed  Google Scholar 

  7. Hofman A, Grobbee DE, de Jong PT et al (1991) Determinants of disease and disability in the elderly: the Rotterdam Eye Study. Eur J Epidemiol 7:403–422

    CAS  PubMed  Google Scholar 

  8. Wang Q, Klein BE, Klein R et al (1994) Refractive status in the Beaver Dam Eye Study. Investig Ophthalmol Vis Sci 35:4344–4347

    CAS  Google Scholar 

  9. Attebo K, Ivers RQ, Mitchell P (1999) Refractive errors in an older population: the Blue Mountains Eye Study. Ophthalmology 106:1066–1072

    CAS  PubMed  Google Scholar 

  10. Chui TY, Yap MK, Chan HH et al (2005) Retinal stretching limits peripheral visual acuity in myopia. Vis Res 45:593–605

    PubMed  Google Scholar 

  11. Coletta NJ, Watson T (2006) Effect of myopia on visual acuity measured with laser interference fringes. Vis Res 46:636–651

    PubMed  Google Scholar 

  12. Strang NC, Winn B, Bradley A (1998) The role of neural and optical factors in limiting visual resolution in myopia. Vis Res 38:1713–1721

    CAS  PubMed  Google Scholar 

  13. Lü YP, Xia WT, Chu RY et al (2011) Relationship between best corrected visual acuity and refraction parameters in myopia. Fa Yi Xue Za Zhi 27:94–97

    PubMed  Google Scholar 

  14. Wang D, Liu B, Huang S et al (2014) Relationship between refractive error and ocular biometrics in twin children: the Guangzhou Twin Eye Study. Eye Sci 29:129–133

    PubMed  Google Scholar 

  15. Wang YZ, Thibos LN, Bradley A (1997) Effects of refractive error on detection acuity and resolution acuity in peripheral vision. Investig Ophthalmol Vis Sci 38:2134–2143

    CAS  Google Scholar 

  16. Rushton RM, Armstrong RA, Dunne MC (2016) The influence on unaided vision of age, pupil diameter and sphero-cylindrical refractive error. Clin Exp Optom 99:328–335

    PubMed  Google Scholar 

  17. Gupta Y, Rizvi SA, Gupta M (2010) Physiological disproportions between un-corrected vision and degree of myopia. Nepal J Ophthalmol 2:138–144

    CAS  PubMed  Google Scholar 

  18. Raasch TW (1995) Spherocylindrical refractive errors and visual acuity. Optom Vis Sci 72:272–275

    CAS  PubMed  Google Scholar 

  19. Smith G (1991) Relation between spherical refractive error and visual acuity. Optom Vis Sci 68:591–598

    CAS  PubMed  Google Scholar 

  20. Smith G, Jacobs RJ, Chan CD (1989) Effect of defocus on visual acuity as measured by source and observer methods. Optom Vis Sci 66:430–435

    CAS  PubMed  Google Scholar 

  21. Legge GE, Mullen KT, Woo GC et al (1987) Tolerance to visual defocus. J Opt Soc Am A 4:851–863

    CAS  PubMed  Google Scholar 

  22. Atchison DA, Smith G, Efron N (1979) The effect of pupil size on visual acuity in uncorrected and corrected myopia. Am J Optom Physiol Opt 56:315–323

    CAS  PubMed  Google Scholar 

  23. Tucker J, Charman WN (1975) The depth-of-focus of the human eye for Snellen letters. Am J Optom Physiol Opt 52:3–21

    CAS  PubMed  Google Scholar 

  24. Peters HB (1961) The relationship between refractive error and visual acuity at three age levels. Am J Optom Arch Am Acad Optom 38:194–198

    CAS  PubMed  Google Scholar 

  25. Ogle KN (1953) On the problem of an international nomenclature for designating visual acuity. Am J Ophthalmol 36:909–921

    CAS  PubMed  Google Scholar 

  26. Sloan LL (1951) Measurement of visual acuity; a critical review. AMA Arch Ophthalmol 45:704–725

    CAS  PubMed  Google Scholar 

  27. Pincus MH (1946) Unaided visual acuities correlated with refractive errors. Am J Ophthalmol 29:853–858

    CAS  PubMed  Google Scholar 

  28. Crawford JS, Shagass C, Pashby TJ (1945) Relationship between visual acuity and refractive error in Myopia. Am J Ophthalmol 28:1220–1225

    Google Scholar 

  29. Hirsch MJ (1945) Relation of visual acuity to myopia. Arch Ophthalmol 34:418–421

    CAS  Google Scholar 

  30. Kempf GA, Collins SD, Jarman BL (1928) Refractive errors in the eyes of children as determined by retinoscopic examination with a cycloplegic. Results of eye examinations of 1860 white school children in Washington, DC. United States Public Health Service, Public Health Bulletin Number 182. United States Government Printing Office, Washington, DC

  31. Fiorentini A, Maffei L (1976) Spatial contrast sensitivity of myopic subjects. Vis Res 16:437–438

    CAS  PubMed  Google Scholar 

  32. Liou SW, Chiu CJ (2001) Myopia and contrast sensitivity function. Curr Eye Res 22:81–84

    CAS  PubMed  Google Scholar 

  33. Collins JW, Carney LG (1990) Visual performance in high myopia. Curr Eye Res 9:217–223

    CAS  PubMed  Google Scholar 

  34. Stoimenova BD (2007) The effect of myopia on contrast thresholds. Investig Ophthalmol Vis Sci 48:2371–2374

    Google Scholar 

  35. Comerford JP, Thorn F, Corwin TR (1987) Effect of luminance level on contrast sensitivity in myopia. Am J Optom Physiol Opt 64:810–814

    CAS  PubMed  Google Scholar 

  36. Thorn F, Corwin TR, Comerford JP (1986) High myopia does not affect contrast sensitivity. Curr Eye Res 5:635–639

    CAS  PubMed  Google Scholar 

  37. Rabin J, Gooch J, Ivan D et al (2011) Beyond 20/20: new clinical methods to quantify vision performance. Mil Med 176:324–326

    PubMed  Google Scholar 

  38. Sandhu RK, Munoz BE, Swenor BK et al (2012) Refractive error and visual function difficulty in a Latino population. Ophthalmology 119:1731–1736

    PubMed  PubMed Central  Google Scholar 

  39. Applegate RA (1991) Visual acuity and aberrations in myopia. Investig Ophthalmol Vis Sci (Suppl) 32:2657

    Google Scholar 

  40. Collins MJ, Wildsoet CF, Atchison DA (1995) Monochromatic aberrations and myopia. Vis Res 35:1157–1163

    CAS  PubMed  Google Scholar 

  41. Paquin MP, Hamam H, Simonet P (2002) Objective measurement of optical aberrations in myopic eyes. Optom Vis Sci 79:285–291

    PubMed  Google Scholar 

  42. Marcos S, Moreno-Barriuso E, Llorente L, et al (2000) Do myopic eyes suffer from larger amount of aberrations? In: Thorn F, Troilo D, Gwiazda J (eds) Myopia 2000: proceedings of the 8th international conference on Myopia, Boston, MA, pp 118–121

  43. Cheng X, Bradley A, Hong X et al (2003) Relationship between refractive error and monochromatic aberrations of the eye. Optom Vis Sci 80:43–49

    PubMed  Google Scholar 

  44. Porter J, Guirao A, Cox IG et al (2001) Monochromatic aberrations of the human eye in a large population. J Opt Soc Am A Opt Image Sci Vis 18:1793–1803

    CAS  PubMed  Google Scholar 

  45. Zadok D, Levy Y, Segal O et al (2005) Ocular higher-order aberrations in myopia and skiascopic wavefront repeatability. J Cataract Refract Surg 31:1128–1132

    PubMed  Google Scholar 

  46. Rossi EA, Weiser P, Tarrant J et al (2007) Visual performance in emmetropia and low myopia after correction of high-order aberrations. J Vis 7:14

    PubMed  Google Scholar 

  47. Wolsley CJ, Saunders KJ, Silvestri G et al (2008) Investigation of changes in the myopic retina using multifocal electroretinograms, optical coherence tomography and peripheral resolution acuity. Vis Res 48:1554–1561

    PubMed  Google Scholar 

  48. Kawabata H, Adachi-Usami E (1997) Multifocal electroretinogram in myopia. Investig Ophthalmol Vis Sci 38:2844–2851

    CAS  Google Scholar 

  49. Barth B, Alves MR, Kara-José N (2008) Visual performance in myopic correction with spectacles and soft contact lenses. Arq Bras Oftalmol 71:90–96

    PubMed  Google Scholar 

  50. Atchison DA (1995) Aberrations associated with rigid contact lenses. J Opt Soc Am A Opt Image Sci Vis 12:2267–2273

    CAS  PubMed  Google Scholar 

  51. Kamiya K, Shimizu K, Iijima A et al (2014) Factors influencing contrast sensitivity function in myopic eyes. PLoS ONE 9:e113562

    PubMed  PubMed Central  Google Scholar 

  52. Gittings NS, Fozard JL (1986) Age related changes in visual acuity. Exp Gerontol 21:423–433

    CAS  PubMed  Google Scholar 

Download references

Funding

The authors did not receive any funding specifically for this study. A/Prof Tan receives research funding from the National Medical Research Council Transition Award (Code: NMRC/TA/0039/2015). A/Prof Tan also receives conference support from Bayer (South East Asia) Pte. Ltd., Heidelberg Engineering (Heidelberg, Germany), and Novartis (Singapore). The remaining authors do not receive funding.

Author information

Authors and Affiliations

  1. National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore

    Bryan Chin Hou Ang & Colin Siang Hui Tan

  2. Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore

    Kai Xiong Cheong

  3. Vision Performance Centre, Military Medicine Institute, Singapore Armed Forces, Singapore, Singapore

    Bryan Chin Hou Ang, Kai Xiong Cheong, Mellisa Mei Hui Tan, Edmund Wei Long Lim & Marcus Chiang Lee Tan

  4. DSO National Laboratories, Defence Medical and Environmental Research Institute, Singapore, Singapore

    Frederick Lian Kheng Tey

  5. Fundus Image Reading Center, National Healthcare Group Eye Institute, Singapore, Singapore

    Colin Siang Hui Tan

Authors
  1. Bryan Chin Hou Ang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kai Xiong Cheong
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mellisa Mei Hui Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Edmund Wei Long Lim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Frederick Lian Kheng Tey
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Colin Siang Hui Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marcus Chiang Lee Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed equally to the conception of study, collection of data, analysis of collected data, writing of manuscript and critical appraisal of manuscript.

Corresponding author

Correspondence to Bryan Chin Hou Ang.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (SingHealth Centralised Institutional Review Board) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ang, B.C.H., Cheong, K.X., Tan, M.M.H. et al. Correlation of myopia severity with visual performance. Int Ophthalmol 40, 2201–2211 (2020). https://doi.org/10.1007/s10792-020-01403-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-020-01403-7

Keywords

Search

Navigation