{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T03:10:54Z","timestamp":1780110654746,"version":"3.54.0"},"reference-count":36,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T00:00:00Z","timestamp":1597708800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Presbyopia is increasing globally due to aging and the widespread use of visual display terminals. Presbyopia is a decrease in the eye\u2019s amplitude of accommodation (AA) due to loss of crystalline lens elasticity. AA differs widely among individuals. We aimed to determine the factors that cause presbyopia, other than advanced age, for early medical intervention. We examined 95 eyes of 95 healthy volunteers (33 men, 62 women) aged 22\u201362 years (mean: 37.22 \u00b1 9.77 years) with a corrected visual acuity of \u22651.0 and without other eye afflictions except ametropia. Subjective refraction, AA, maximum and minimum pupillary diameters during accommodation, axial length of the eye, and crystalline lens thickness were measured. AA was measured using an auto refractometer\/keratometer\/tonometer\/pachymeter. The difference between maximum and minimum pupillary diameters was calculated. On multiple regression analysis, age and difference in pupillary diameter were both significantly and independently associated with AA in participants aged &lt;44 years, but not in those aged \u226545 years. Our results suggest that the difference in pupillary diameter could be an important age-independent factor for evaluating AA in healthy individuals without cataract. Thus, improving the difference in pupillary diameter values could be an early treatment target for presbyopia.<\/jats:p>","DOI":"10.3390\/jcm9082678","type":"journal-article","created":{"date-parts":[[2020,8,19]],"date-time":"2020-08-19T21:37:40Z","timestamp":1597873060000},"page":"2678","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Difference in Pupillary Diameter as an Important Factor for Evaluating Amplitude of Accommodation: A Prospective Observational Study"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2750-4546","authenticated-orcid":false,"given":"Miyuki","family":"Kubota","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan"},{"name":"Department of Ophthalmology, Shonan Keiiku Hospital, Kanagawa 252-0816, Japan"},{"name":"Graduate School of Media and Governance, Keio University, Kanagawa 252-0882, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Kubota","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan"},{"name":"Department of Ophthalmology, Shonan Keiiku Hospital, Kanagawa 252-0816, Japan"},{"name":"Graduate School of Media and Governance, Keio University, Kanagawa 252-0882, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0767-4214","authenticated-orcid":false,"given":"Hidenaga","family":"Kobashi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan"},{"name":"Graduate School of Media and Governance, Keio University, Kanagawa 252-0882, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9481-0164","authenticated-orcid":false,"given":"Masahiko","family":"Ayaki","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan"},{"name":"Department of Ophthalmology, Otake Clinic Moon View Eye Center, Kanagawa 224-0001, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2892-9810","authenticated-orcid":false,"given":"Kazuno","family":"Negishi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8874-7111","authenticated-orcid":false,"given":"Kazuo","family":"Tsubota","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan"},{"name":"Tsubota Laboratory, Inc., Tokyo 160-0016, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,8,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1492","DOI":"10.1016\/j.ophtha.2018.04.013","article-title":"Global Prevalence of Presbyopia and Vision Impairment from Uncorrected Presbyopia: Systematic Review, Meta-analysis, and Modelling","volume":"125","author":"Fricke","year":"2018","journal-title":"Ophthalmology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/cxo.12798","article-title":"Management of digital eye strain","volume":"102","author":"Sulley","year":"2019","journal-title":"Clin. 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