Safety of DIMS Spectacle Lenses and Atropine as Combination Therapy for Myopia Progression

Abstract

Background: The aim of this study was to evaluate traffic safety of Defocus Incorporated Multiple Segments (DIMS) spectacle lenses in combination therapy with atropine.

Patients and methods: 12 young adults (age: 24 - 45; 30,1 ± 5,7 years) were recruited to evaluate corrected distance visual acuity (CDVA), contrast sensitivity (CS; FrACT), glare sensitivity (Mesotest) under the influence of DIMS spectacle correction alone and combination therapy with 0,01% atropine.

Results: When looking through the central area of the DIMS lens, far vision does not decrease due to the influence of atropine; influence of glare and atropine leads to a reduction of CDVA by 0.10 logMAR. When forced to look through the DIMS area, far vision is reduced by 0.09 logMAR due to the influence of atropine in the absence of glare; in the presence of glare, no further loss of visual acuity can be observed under the influence of atropine. Contrast vision with DIMS glasses is not altered by the effects of atropine. Concerning glare sensitivity, DIMS lenses did not show any visual impairment that would be relevant to vision and road safety. Additional atropinization does not affect glare sensitivity.

Conclusion: DIMS spectacle lenses are safe for participation in road traffic and do not relevantly impair traffic safety, neither alone nor under the acute influence of 0,01% atropine.

Fig. 1

Influence of acute atropinization with 0.01% atropine on pupil dynamic (bar graph) and pupil size (error bars) over time (before atropine administration [0 hrs] and 45 – 60 mins [1 hr], 4 hours and 8 hours after atropine administration).

Fig. 2

Percentage of test subjects who were able to see the contrast levels using the Mesotest instrument with DIMS lenses, in each case with and without glare and with and without atropine; 1 : 23 corresponds to the highest contrast setting, and 1 : 2 the lowest contrast. (Being able to see a contrast of 1 : 23 is the requirement for a Class B driver license.)

Fig. 3

Contrast sensitivity at 1,5, 3, 6, 12, and 18 cpd, determined in 12 trial subjects before atropinization (0 hrs) and approx. 60 minutes after atropinization (1 hr). a  Under photopic conditions. b  Under mesopic conditions. c ,  d  As for a and b , but with glare.

Abb. 1

Einfluss der akuten Atropinisierung mit 0,01% Atropin auf Pupillendynamik (Balkendiagramm) und Pupillengröße (Fehlerbalken) über die Zeit (vor Atropingabe [0 h] bzw. 45 – 60 min [1 h], 4 h und 8 h nach Atropingabe).

Abb. 2

Prozentualer Anteil der Probanden, die mit DIMS-Gläsern die Kontraststufen am Mesotest erkannten, jeweils mit und ohne Blendung und jeweils ohne Atropinisierung; 1 : 23 entspricht dem höchsten einstellbaren Kontrast, 1 : 2 dem geringsten Kontrast. (Das Sehen eines Kontrastes von 1 : 23 ist die Anforderung für Führerscheinklasse B.)

Abb. 3

Kontrastempfindlichkeit bei 1,5, 3, 6, 12 und 18 cpd, bestimmt bei 12 Probanden jeweils vor Atropinisierung (0 h) und ca. 60 min danach (1 h). a  Unter photopischen Bedingungen. b  Unter mesopischen Bedingungen. c, d  Jeweils wie a und b , aber mit Blendung.