Optometry and Vision Sciences - Theses
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ItemThe effects of ageing on ocular surface integrity( 2019)Purpose: Ageing is recognised as a major risk factor for several ocular pathologies, including dry eye disease. The aim of this thesis was to characterise the specific effect of ageing on key ocular surface parameters, in humans and mice. We hypothesised that there would be common ageing effects in both species that paralleled the pathophysiological features observed in dry eye disease. Method: The animal study involved healthy C57BL/6 female mice, aged 2 months (young, n=10) and 22 months (aged, n=10). Clinical assessments included measurements of corneal sensitivity (Cochet-Bonnet aesthesiometry, which is a contact corneal aesthesiometer), tear secretion (Phenol red thread test), tear film osmolarity (TearLab osmometer) and corneal thickness (optical coherence tomography). The anatomical integrity of the corneal nerves was examined ex vivo (using immunohistochemistry) by quantifying nerve density in the superficial epithelium (superficial terminals) and sub-basal plexus. The density and tree area of resident epithelial dendritic cells (DCs) were assessed using immunofluorescence and confocal microscopy. For the clinical study, 37 healthy male and female participants (15 male participants and 22 female participants) were recruited, and divided into four age categories: 20-35 years, 36-50 years, 51-65 years, and >65 years. Participants underwent a comprehensive characterisation of ocular surface health, including quantification of tear osmolarity, blink rate, slit lamp biomicroscopy and corneal sensitivity (using non-contact corneal aesthesiometry). In vivo confocal microscopy (IVCM) was performed to quantify a range of corneal nerve parameters, microneuroma density and DC density, in the central and peripheral cornea. Results: In the animal study, aged mice had significantly higher tear secretion, lower corneal sensitivity and a thicker corneal stroma but thinner epithelium compared with young mice. There was no significant inter-group difference for tear osmolarity. Aged mice showed a significantly lower cornea nerve density, in both the superficial terminals and sub-basal plexus, relative to young mice. DC density and morphology were similar in both age groups. In the human study, older age was associated with a reduction in central corneal sensitivity to a room temperature air stimulus, but not to a cold temperature stimulus. Tear osmolarity remained within normative ranges (<308mOsmol/L) in all age groups, although it was relatively higher in this parameter amongst individuals aged 36 to 50 years, compared to the 20 to 35 year olds (p = 0.0047). A range of ocular surface parameters, including corneal sub-basal nerve plexus density, DC density and microneuroma density were not subject to ageing effects but showed eccentricity-dependent differences. Blink rate and most standard clinical biomicroscopic findings were not significantly different between age groups. Conclusion: Ageing has differential effects on ocular surface parameters. A reduction in corneal sensitivity, and a relative maintenance of corneal DC density, was evident in older eyes in both species. The apparently disparate findings in relation to corneal nerve density between mice and humans may relate to the established limitations of in vivo imaging techniques, particularly with respect to image resolution. These findings, relating to ocular surface changes with physiological ageing, are of value for understanding the potential contribution of the ageing process to ocular surface diseases.
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ItemThe effects of ageing and visual field loss on visuomotor control( 2012)Aspects of visual localisation, such as foveal hyperacuity, decline with age. However, the effect of ageing on the visual localisation judgements required for goal-directed reaching movements has not been studied. It is also unknown whether pointing precision to such visual stimuli are altered with ageing. Further, the effects of visual impairment on these tasks are not understood. This thesis aimed to investigate the effects of ageing and compromised peripheral visual function on visual localisation and pointing precision. The first part of this thesis aimed to investigate the effects of ageing on visual localisation and pointing precision (Chapter 4). Experiment 1 consisted of a cohort of younger and older observers performing visual localisation and pointing tasks. The results suggest that both the visual localisation and pointing systems remain largely intact with ageing. However, the visual localisation precision of older adults was more affected by the removal of visual references than younger observers. These findings are encouraging for older adults; especially with the increasingly active part they play in the workforce, and society at large. In order to further probe the state of the older visuomotor system, the second part of this thesis investigated the pointing and visual localisation precision of older observers with compromised visual status (Chapter 5). Older adults with glaucoma, a chronic eye disease that results in reduced visual field sensitivity, were used as the model for compromised visual status in Experiment 2. Results suggest that patients with glaucoma show a reduced ability to locate objects both visually and manually. However, perimetry – a clinical measure of visual field sensitivity – provides only a small indication of the degree of this difficulty. Observers with glaucoma also showed a reduced benefit of binocularity compared with their older controls for visual localisation tasks, suggesting that reduced visual field sensitivity may inhibit aspects of binocular processing.