Examinations
blurred vision, gastrointestinal symptoms, itching, tachycardia, choroidal thickness, edema, throat, pain, dry mouth, photophobia, dryness, urinary retention
EDEMA, ACD, SIDE EFFECTS, LENS, DRY MOUTH, CYCLOPLEGIA, ALLERGIC REACTIONS
Participants were examined at the screening-, baseline-, 3-, 6-, 9- and 12-month visits. Best-corrected visual acuity (BCVA) was measured using the HOTV chart (Precision Vision, La Salle, IL, USA) at near and distance (40 cm and 4 m). Amplitude of accommodation was measured using a Royal Air Force near point ruler using best-corrected distance spectacles. Autorefraction (Right group, Retinomax K-plus 3, Tokyo, Japan) was performed in non-cycloplegia and cycloplegia (by twice-applied cyclopentolate 1% eye drops (Minims Cyclopentolate Hydrochloride 1%, Bausch & Lomb Nordic AB, Stockholm, Sweden) five minutes apart followed by a 30-minute wait). SER was calculated as half the cylindrical refraction added to the spherical refraction. Push-plus subjective refraction was performed using autorefraction and current prescription as starting points. AL, ACD, central corneal thickness (CCT) and lens thickness were measured by optical biometry (IOLMaster 700, Carl Zeiss AG, Oberkochen, Germany). Iridocorneal angle was determined by Scheimflug imaging (Oculus GmbH, Pentacam HR System, Wetzlar, Germany). Sub-foveal choroidal thickness was determined by swept source optical coherence tomography (OCT, Topcon Europe Medical BV, Capelle aan den Ijssel, The Netherlands), before administration of dilating eye drops. The choroid was automatically segmented by the Topcon Automated Boundary Software (Topcon Europe Medical BV, The Netherlands) and afterwards reviewed by experienced observers who corrected any lingering mis-segmentation manually. Of the nine sectors automatically generated by the software, only the sub-foveal choroidal thickness was analyzed. Intra-ocular pressure (IOP) was measured by a rebound tonometer (iCare USA, iCare, Raleigh, North Carolina, United States) as the mean of five measurements. Pupil diameter was measured as the mean of five measurements under mesopic (4 lx) and photopic (300 lx) light intensities by pupillometry (DP-2000 Pupillometer, NeurOptics, CA, USA). Participants were asked at each visit whether they experienced any side effects including visual, ocular, peri-ocular or systemic anti-cholinergic side effects. Participants were specifically questioned about photophobia and blurred vision for distance and near. Ocular side effects questioned included eye redness/irritation, itching, pain, changes in lacrimal production and allergic reactions. Side effects from the eye-surroundings questioned were skin-changes, itching, edema or dryness. Systemic anti-cholinergic side effects questioned included dry skin, dry mouth or throat, facial redness, gastrointestinal symptoms, urinary retention or tachycardia.