Normative Reference Ranges for Macula and Retinal Layer Thickness in Healthy Spanish Children

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MÀSTER UNIVERSITARI EN OPTOMETRIA I CIÈNCIES DE LA VISIÓ
TREBALL FINAL DE MÀSTER
NORMATIVE REFERENCE RANGES FOR MACULA AND RETINAL
LAYER THICKNESS IN HEALTHY SPANISH CHILDREN
SARA FONT ARMADANS
DIRECTOR: JUAN CARLOS ONDATEGUI PARRA
DEPARTAMENT D’ÒPTICA I OPTOMETRIA
16 de Juny del 2021
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MÀSTER UNIVERSITARI EN OPTOMETRIA I CIÈNCIES DE LA VISIÓ
El S . Juan Ca los Onda egui Pa a, com a di ec o del eball,
CERTIFICA
Que Sa a Fon A madans ha eali za so a la se a supe isió el eball
“No ma i e e e ence anges o macula and e inal laye hickness
in heal hy Spanish child en” que es ecull en aques a memò ia pe op a
al í ol de Màs e Op ome ia i Ciències de la Visió.
I pe a què cons i, signen aques ce i ica .
S . Juan Ca los Onda egui Pa a
Di ec o del TFM
Te assa, 16 de Juny de 2021
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MÀSTER UNIVERSITARI EN OPTOMETRIA I CIÈNCIES DE LA VISIÓ
RANGS DE REFERÈNCIA NORMATIVA PER LA ZONA MACULAR I
EL GRUIX DE LA RETINA EN NENS SANS ESPANYOLS
RESUM
OBJECTIU: C ea una base de dades amb uns angs de e e encia no ma i a pe al g uix de la màcula
i la capa de e ina en nens sans espanyols mi jançan Tomog a ia de Cohe ència Óp ica (OCT).
MÉTODES: Es udi ans e sal, p ospec iu i desc ip iu de casos no consecu ius. Un o al de 92 nens
(55 nenes i 37 nens) de 3 a 17 anys an se inclosos a l’es udi. Els pa icipan s es an so me e a un
examen ocula comple es du a e me la mesu a de l’agudesa isual amb la millo co ecció
d’almenys 0,2 log MAR, l’a aluació de la mo ili a ocula i un examen de binocula i a . A con inuació,
la omog a ia de cohe encia óp ica es a eali za mi jançan DRI OCT T i on (Topcon) i la mesu a de
la longi ud axial mi jançan el biòme e òp ic AL-scan (NIDEK). Es a egis a el g uix macula cen al
i mi jà de la població pedià ica i es a elaciona amb l'eda , l'equi alen es è ic i la longi ud axial.
RESULTATS: L’eda mi jana global dels subjec es a se de 9,33 ± 3,24 anys ( ang: 3 -17 anys). La
mi jana global de l’equi alen es è ic a se de -0,10 ± 1,74D ( ang: -5,50 a + 4,38D) i la mi jana global
de la longi ud axial a se de 23,00 ± 1,06mm ( ang: 20,58 - 25,33mm). Es a obse a una co elació
signi ica i a en e l'eda dels pa icipan s i la longi ud axial ( = 0,449 **, p <0,001), de mane a que
els angs de e e ència no ma i a de la base de dades pe a la longi ud axial es a de ini pe eda i
equi alen es è ic. Amés, ambé es a obse a una elació di ec a en e l’equi alen es è ic i el g uix
mi jà amb explo ació adial i g uix o al amb explo ació 3D, i una endència en l’augmen del g uix a
les capes de e ina, GCL +, GCL ++ i co oides es a elaciona amb l’equi alen es è ic.
CONCLUSIONS: Pe conclou e, el p esen es udi de ineix bioma cado s pa ològics en nens sans
espanyols mi jançan SS DRI-OCT T i on plus, que poden se ú ils pe a la de ecció p ecoç d’anomalies
de la e ina en aques ang de població.
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MÀSTER UNIVERSITARI EN OPTOMETRIA I CIÈNCIES DE LA VISIÓ
RANGOS DE REFERENCIA NORMATIVA PARA LA ZONA
MACULAR Y EL ESPESOR DE LA RETINA EN NIÑOS SANOS
ESPAÑOLES
RESUMEN
•
OBJETIVO: C ea una base de da os no malizada con angos de e e encia no ma i a pa a el g oso
de la mácula y la capa e iniana en niños españoles sanos median e la Tomog a ía de Cohe encia
Óp ica (OCT).
MÉTODOS: Es udio p ospec i o, ans e sal y desc ip i o de casos no consecu i os. En es e es udio
se incluyó un o al de 92 niños (55 niñas y 37 niños) de en e 3 y 17 años. Los pa icipan es se
some ie on a un examen ocula comple o que incluyó la medición de la agudeza isual con
co ección, de al menos 0,2 log MAR, la e aluación de la mo ilidad ocula y la alineación de los ejes
isuales. A con inuación, se ealizó una explo ación macula u ilizando el DRI OCT T i on (Topcon) y
una medición de longi ud axial u ilizando un bióme o óp ico AL-scan (NIDEK).
Se egis ó el g oso macula cen al y medio pa a la población pediá ica y se elacionó con la edad,
el equi alen e es é ico y la longi ud axial.
RESULTADOS: La edad media global de los suje os ue de 9,33 ± 3,24 años ( ango: 3-17 años). El
equi alen e es é ico medio global ue -0,10 ± 1,74 D ( ango: -5,50 a + 4,38 D), y la longi ud axial
media global ue 23,00 ± 1,06 mm ( ango: 20,58 - 25,33 mm). Se obse ó una co elación signi ica i a
en e la edad de los pa icipan es y la longi ud axial ( = 0,449 **, p <0,001), po lo que la base de
da os no malizada pa a la longi ud axial se de inió po edad y equi alen e es é ico. Además, se
de ec ó una elación di ec a en e el equi alen e es é ico y el g oso medio con escaneo adial y el
g oso o al con escaneo 3D, y una endencia de aumen o de g oso en e ina, GCL +, GCL ++ y capas
co oideas se elacionó con el equi alen e es é ico.
CONCLUSIONES: En conclusión, el p esen e es udio de ine bioma cado es pa ológicos en niños
españoles sanos u ilizando SS DRI-OCT T i on plus, que pueden se ú iles pa a la de ección p ecoz de
anomalías e inianas en es e ango de población.
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MÀSTER UNIVERSITARI EN OPTOMETRIA I CIÈNCIES DE LA VISIÓ
NORMATIVE REFERENCE RANGES FOR MACULA AND RETINAL
LAYER THICKNESS IN HEALTHY SPANISH CHILDREN
SUMMARY
PURPOSE: C ea e a no malized da abase e e ence ange o macula and e inal laye hickness in
heal hy Spanish child en.
METHODS: P ospec i e c oss-sec ional and desc ip i e s udy o non-consecu i e cases. A o al o 92
child en (55 gi ls and 37 boys) aged 3-17 yea s old we e included in his s udy. Pa icipan s
unde wen a comp ehensi e ocula examina ion ha included measu emen o he bes -co ec ed
isual acui y o a leas 0.2 log MAR, assessmen o ocula mo ili y and alignmen . Subsequen ly,
macula scanning was pe o med using a DRI OCT T i on (Topcon) and axial leng h (AL)
measu emen s we e aken using op ical biome e AL-scan (NIDEK). Cen al and a e age macula
hicknesses we e eco ded and ela ed o age, sphe ical equi alen (SE) and AL.
RESULTS: The global mean age o he subjec s was 9.33±3.24 yea s wi h a global mean o SE -
0.10±1.74D ( ange: -5.50 o +4.38D), and a global mean o AL 23.00±1.06mm ( ange:20.58-
25.33mm). A signi ican co ela ion was ound be ween he age o pa icipan s and axial leng h ( =
0.449, p < 0.001), and a no malized da abase e e ence o AL was de ined by age and SE. An accu a e
ela ion was obse ed be ween SE and a e age hickness wi h a end o inc easing hickness in
e ina, ganglion cell laye + (GCL+), ganglion cell laye ++ (GCL++) and cho oid. As such, a conclusion
can be d awn ha a minimum alue should be egis e ed o a di e en SE g oup, which would be
de ined as a pa hological bioma ke .
CONCLUSIONS: To conclude, he p esen s udy de ines no ma i e bioma ke s in heal hy Spanish
child en using DRI-OCT T i on, which can be use ul o ea ly de ec ion o e inal abno mali ies in his
sec o o he popula ion.

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INDEX
The p esen a ion o his inal mas e ’s hesis consis s o a scien i ic a icle wi h he aim o publishing
i in he Jou nal o Op ome y.
PAPER …………………………………………………………………………………………………………….…………………..…. Pag. 7
ABSTRACT 1. INSTRUCTIONS FOR AUTHORS: Jou nal o Op ome y……………………………………...… Pag. 17
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No ma i e Re e ence Ranges o Macula and Re inal Laye
Thickness in Heal hy Spanish Child en
Sa a Fon A madans
1
, Juan Ca los Onda egui-Pa a
2
Abs ac
Pu pose: C ea e a no malized da abase e e ence ange o macula and e inal laye hickness in heal hy
Spanish child en.
Me hods: P ospec i e c oss-sec ional and desc ip i e s udy o non-consecu i e cases. A o al o 92
child en (55 gi ls and 37 boys) aged 3-17 yea s old we e included in his s udy. Pa icipan s unde wen
a comp ehensi e ocula examina ion ha included measu emen o he bes -co ec ed isual acui y o
a leas 0.2 logMAR, assessmen o ocula mo ili y and alignmen . Subsequen ly, macula scanning was
pe o med using a DRI OCT T i on (Topcon) and axial leng h (AL) measu emen s we e aken using
op ical biome e AL-scan (NIDEK). Cen al and a e age macula hicknesses we e eco ded and ela ed
o age, sphe ical equi alen (SE) and AL.
Resul s: The global mean age o he subjec s was 9.33±3.24 yea s wi h a global mean o SE -0.10±1.74D
( ange: -5.50 o +4.38D), and a global mean o AL 23.00±1.06mm ( ange:20.58-25.33mm). A
signi ican co ela ion was ound be ween he age o pa icipan s and AL ( = 0.449, p < 0.001), and a
no malized da abase e e ence o AL was de ined by age and SE. An accu a e ela ion was obse ed
be ween SE and a e age hickness wi h a end o inc easing hickness in e ina, ganglion cell laye +
(GCL+), ganglion cell laye ++ (GCL++) and cho oid. As such, a conclusion can be d awn ha a
minimum alue should be egis e ed o a di e en SE g oup, which would be de ined as a pa hological
bioma ke .
Conclusions: To conclude, he p esen s udy de ines no ma i e bioma ke s in heal hy Spanish child en
using DRI-OCT T i on, which can be use ul o ea ly de ec ion o e inal abno mali ies in his sec o o
he popula ion.
Keywo ds: No ma i e da abase, child popula ion, Op ical Cohe ence Tomog aphy (OCT), axial leng h
(AL), e ac i e e o
1
Co esponding au ho a : Fon A madans, Sa a. E-mail: sa a on [email protected]
2
Depa men o Op ics and Op ome y, Uni e si a Poli ècnica de Ca alunya, Te assa, Spain.
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1. In oduc ion
I is becoming inc easingly common o
oph halmological examina ions o include
objec i e and quan i a i e complemen a y es s
o e inal s uc u es. The mos widely used
me hod is he Op ical Cohe ence Tomog aphy
(OCT), a non-in asi e and non-con ac
imaging echnique ha p o ides high-
esolu ion c oss-sec ional images o he e ina
wi h high-speed scanning o he s udy and
ollow-up o he pos e io pole.1,2 The
ins umen employs b oadband ligh sou ces
ope a ing a a wa eleng h o 1050nm 3–5 which
a e e lec ed o cons uc a dep h p o ile o a
sample2 and inally a speci ic algo i hm
au oma ically measu es mo phology and
assesses changes in e inal diseases.6
This de ice is pa icula ly ele an o
child en, whe e collabo a ion is some imes
challenging. Ha ing a high-speed scanning
de ice ha p o ides objec i e and eliable da a
o ea ly de ec ion o possible pos e io pole
al e a ions and hei p ecise moni o ing.
Despi e he ac ha accu a e assessmen o
a ia ions in e inal measu emen s necessa ily
equi es a compa ison wi h e e ence anges o
he heal hy popula ion, OCT de ices ha e an
age-ma ched no ma i e da abase which only
includes adul popula ions o 18 yea s o
olde .7–9 No comme cially a ailable OCT
de ice includes an age-no malized da abase o
indi iduals younge han 18 yea s old 1 and, as
such, he analysis o OCT in child en is
some imes con using.9
Acco dingly, i is impo an o analyse how
age can a ec he hickness o he di e en
laye s o he e ina, and how he sphe ical
equi alen (SE) and axial leng h (AL) a ec he
di e en hicknesses, in acco dance wi h he
changes ha we a e obse ing in ou socie y.
I is impo an o ake in o accoun he
changes ha we ha e been obse ing in ecen
yea s du ing he emme opiza ion p ocess o
child en, whe e he p e alence o myopia is
inc easing and appea ing a younge ages 10,
and hese modi ica ions migh di ec ly
in luence he in e p e a ion o he ob ained
esul s.
In o de o a oid misin e p e a ions, i is
necessa y o de ine a no malized da abase ha
p o ides a eliable analysis, aking in o accoun
a iables such as age, sphe ical equi alen and
axial leng h o he pa ien , as i has been
obse ed ha hey may ha e a di ec
ela ionship wi h he ob ained esul s.6,9,11,12
In consequence, he main objec i e o ou
pape is o desc ibe no ma i e da abase
e e ence anges o macula and e inal laye
hickness in heal hy Spanish child en using
DRI OCT T i on Swep sou ce (TOPCON), and
o analyse he in luence o age, sphe ical
equi alen and axial leng h in he da a ob ained
om OCT o de ine pa hological bioma ke s
based on hese a iables.
2. Me hods
2.1 Subjec s
The design o his s udy was an
obse a ional, mul icen ic, p ospec i e, c oss-
sec ional and desc ip i e s udy o non-
consecu i e cases. Resea ch ollowed he ene s
o he Decla a ion o Helsinki, and e hical
app o al was ob ained om he E hics
Commi ee and Resea ch Boa d o he
pa icipa ing cen e s.
Child en we e en olled h ough
p ima y heal h ca e cen e s: Hospi al San Joan
de Déu Ba celona and Al haia Xa xa
Assis encial Uni e si à ia Man esa, Hospi al
San Joan de Déu Man esa (Ba celona, Spain).
All subjec s ecei ed de ailed in o ma ion
abou he s udy and he pa en s o legal
gua dians ga e w i en in o med consen o
pa icipa ing in he s udy.
The s udy in ol ed he examina ion o
92 eyes om 92 child en (55 gi ls and 37 boys)
aged 3-17. None o he subjec s has p e iously
epo ed a his o y o ocula o sys emic disease,
and he esul s o a comp ehensi e eye
examina ion we e no mal in all pa icipan s.
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The inclusion c i e ia we e based on
age (be ween 3 o 17 yea s old), sphe ical
equi alen (be ween -5.50D o +5.50D), bes -
co ec ed isual acui y (BCVA) o a leas 0.2
logMAR, no di e ences in BCVA be ween
bo h eyes g ea e han one line o ision, and
no ha ing any sys ema ic disease.
The exclusion c i e ia o he s udy we e
p esen ing anisome opia (g ea e han 2D o
di e ence in any ame opia), p esen ing
s abismus and ha ing a his o y o eye su ge y.
In addi ion, child en who could no
coope a e wi h he examina ion o whose
pa en s o legal gua dians did no p o ide
consen we e also excluded om he s udy.
2.2 S udy p o ocol
All subjec s unde wen a
comp ehensi e ocula examina ion ha
included measu emen o he BCVA,
assessmen o ocula mo ili y and alignmen .
Axial leng h measu emen s we e aken using an
op ical biome e AL-scan (NIDEK). The
a e age o i e axial leng h measu emen s we e
eco ded and any wi h a signal- o-noise a io
(SNR) below 2.0 we e epea ed. 13
Finally, he eyes s udied we e imaged wi h wo
macula scans cen e ed on he o ea, 3D-
Macula 7x7 mm p o ocol and adial macula
12x6mm p o ocol.
The OCT scan we e acqui ed wi h SS
DRI-OCT T i on plus (TOPCON) wi hou
pupilla y dila a ion.
Swep sou ce echnology p o ides scan speeds
o 100.000 A-scan pe second wi h an
op imized long wa eleng h scanning ligh
(1,050nm), wi h be e pene a ion and eal
ime- acking. The longe wa eleng h ligh
p o ides be e issue pene a ion, allowing
isualiza ion o he deepes laye s o he eyes,
and he as e scanning speed enables he
cap u e o a clea B-scan by acqui ing mo e A-
scans wi hin a gi en image acquisi ion ime. I
helps o educe e o s caused by in olun a y
eye mo emen . 4,5
Only high-quali y scans wi hou in olun a y
saccade o blinking a e ac s, we e used o he
analysis.12,14 Radial macula scans had a TopQ
Image Quali y ≥ 80, and 3D macula scans had
a TopQ Image Quali y ≥ 45. 1
2.3 Measu emen endpoin s
The measu emen s ha we e aken we e on
he one hand he OCT pa ame e s and on he
o he hand axial leng h alue.
On he OCT pa ame e s, wo scans we e
pe o med, i s an Ea ly T ea men Diabe ic
Re inopa hy S udy (ETDRS) g id, placed
au oma ically a he o eal cen e and sec o s
such as cen al o ea, supe io , nasal, in e io ,
and empo al inne quad an s; supe io , nasal,
Figu e 1.Op ical Cohe ence Tomog aphy scans. A = Ea ly T ea men Diabe ic Re inopa hy (ETDRS) , B = Macula 6 g id, C
= C oss-sec ional image o he e ina.
Abb e ia ions: CT = Cen al hickness, ILM = In e nal limi ing memb ane, RNFL = Re inal ne e ibe laye , GCL =
Ganglion cell laye , IPL = In e n plexi o m laye , INL = In e n nuclea laye , IS = inne segmen , OS = ou e segmen , RPL
= Re inal pigmen laye , BM = B unch Memb ane, CSI = Cho oid Scle a Junc ion.
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Scopus
Types o a icle
Full-leng h O iginal A icles
Full-leng h O iginal A icles ollow he gene al Ins uc ions o Au ho s o J Op om in sec ions 3 and 4.
Manusc ip s should ha e a maximum leng h o 20 Din A4 pages include a 250-wo d s uc u ed Abs ac
(Pu pose, Me hods, Resul s and Conclusion), In oduc ion, Me hods, Resul s, Discussion, and up o 4
ables and 4 igu es (wi h hei co esponding oo no es) will be accep ed. Keywo ds will be equi ed.
The e should be no mo e han 20-30 li e a u e e e ences. Fo he p epa a ion o con olled clinical ials
he CONSORT guidelines should be ollowed. A ailable a : h p://www.conso -s a emen .o g/
Re iews
Re iews a e in ended o p o ide an upda ed pe spec i e on a ce ain subjec ha could be ele an o
he eade ship o he jou nal. They will ha e a maximum leng h o 25 Din-A4 pages and include a 250-
wo d non s uc u ed Abs ac and up o 6 ables and 6 igu es will be accep ed. The e should be no mo e
han 40-50 li e a u e e e ences. Keywo ds will be equi ed.
Scien i ic Le e s
They will desc ibe a Case Repo o a Technical Repo (in ended o p esen p elimina y o iginal esul s,
new ins umen a ion o new clinical es s ha could be o ele ance o he eade ship o he jou nal
when he au ho s conside ha his o m o publica ion can be mo e sui able in e ms o cla i y, apid
sha e o aluable in o ma ion and easiness o communica ion o hei esul s han he ex ended Full-
leng h e sion). They mus no exceed 800 wo ds o ex and will no include igu es o ables. Le e s
should ha e up o 10 li e a u e e e ences. The abs ac and he keywo ds will no be equi ed.
Le e s o he edi o
They will p o ide in o ma ion on a opic o in e es o commen on p e iously published a icles o he
Jou nal. Le e s abou ecen A icles published in he J Op om should be submi ed wi hin 6 mon hs o
he A icle’s publica ion. Co espondence may co ec e o s, make commen s, ques ions, o c i icisms
abou published a icles in he J Op om, o simply o e di e en poin s o iew and addi ional
in o ma ion ha could be ele an o he eade ship o he jou nal and he scien i ic communi y as a
whole. Co espondence submi ed should no exceed 500 wo ds o ex and 10 e e ences. One o he
e e ences should be he A icle in ques ion. Figu es and ables a e no accep ed. The au ho s o he
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a icles discussed in he co espondence will be gi en an oppo uni y o espond, p e e ably in he same
issue in which he o iginal co espondence appea s.
Con ac de ails o submission
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Language
This jou nal is published in English language.
Submission checklis
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e iew. Please check he ele an sec ion in his Guide o Au ho s o mo e de ails.
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All necessa y iles ha e been uploaded:
Manusc ip :
• Include keywo ds
• All igu es (include ele an cap ions)
• All ables (including i les, desc ip ion, oo no es)
• Ensu e all igu e and able ci a ions in he ex ma ch he iles p o ided
• Indica e clea ly i colo should be used o any igu es in p in
G aphical Abs ac s / Highligh s iles (whe e applicable)
Supplemen al iles (whe e applicable)
Fu he conside a ions
• Manusc ip has been 'spell checked' and 'g amma checked'
• All e e ences men ioned in he Re e ence Lis a e ci ed in he ex , and ice e sa
• Pe mission has been ob ained o use o copy igh ed ma e ial om o he sou ces (including
he In e ne )
• A compe ing in e es s s a emen is p o ided, e en i he au ho s ha e no compe ing in e es s o
decla e
• Jou nal policies de ailed in his guide ha e been e iewed
• Re e ee sugges ions and con ac de ails p o ided, based on jou nal equi emen s
Fo u he in o ma ion, isi ou Suppo Cen e .
BEFORE YOU BEGIN
E hics in publishing
Please see ou in o ma ion pages on E hics in publishing and E hical guidelines o jou nal publica ion.
S udies in humans and animals
I he wo k in ol es he use o human subjec s, he au ho should ensu e ha he wo k desc ibed has
been ca ied ou in acco dance wi h The Code o E hics o he Wo ld Medical Associa ion (Decla a ion
o Helsinki) o expe imen s in ol ing humans. The manusc ip should be in line wi h
he Recommenda ions o he Conduc , Repo ing, Edi ing and Publica ion o Schola ly Wo k in
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Medical Jou nals and aim o he inclusion o ep esen a i e human popula ions (sex, age and e hnici y)
as pe hose ecommenda ions. The e ms sex and gende should be used co ec ly.
Au ho s should include a s a emen in he manusc ip ha in o med consen was ob ained o
expe imen a ion wi h human subjec s. The p i acy igh s o human subjec s mus always be obse ed.
All animal expe imen s should comply wi h he ARRIVE guidelines and should be ca ied ou in
acco dance wi h he U.K. Animals (Scien i ic P ocedu es) Ac , 1986 and associa ed guidelines, EU
Di ec i e 2010/63/EU o animal expe imen s, o he Na ional Ins i u es o Heal h guide o he ca e
and use o Labo a o y animals (NIH Publica ions No. 8023, e ised 1978) and he au ho s should clea ly
indica e in he manusc ip ha such guidelines ha e been ollowed. The sex o animals mus be
indica ed, and whe e app op ia e, he in luence (o associa ion) o sex on he esul s o he s udy.
In o med consen and pa ien de ails
S udies on pa ien s o olun ee s equi e e hics commi ee app o al and in o med consen , which should
be documen ed in he pape . App op ia e consen s, pe missions and eleases mus be ob ained whe e
an au ho wishes o include case de ails o o he pe sonal in o ma ion o images o pa ien s and any
o he indi iduals in an Else ie publica ion. W i en consen s mus be e ained by he au ho bu copies
should no be p o ided o he jou nal. Only i speci ically eques ed by he jou nal in excep ional
ci cums ances ( o example i a legal issue a ises) he au ho mus p o ide copies o he consen s o
e idence ha such consen s ha e been ob ained. Fo mo e in o ma ion, please e iew he Else ie
Policy on he Use o Images o Pe sonal In o ma ion o Pa ien s o o he Indi iduals. Unless you ha e
w i en pe mission om he pa ien (o , whe e applicable, he nex o kin), he pe sonal de ails o any
pa ien included in any pa o he a icle and in any supplemen a y ma e ials (including all illus a ions
and ideos) mus be emo ed be o e submission.
Decla a ion o in e es
All au ho s mus disclose any inancial and pe sonal ela ionships wi h o he people o o ganiza ions
ha could inapp op ia ely in luence (bias) hei wo k. Examples o po en ial compe ing in e es s include
employmen , consul ancies, s ock owne ship, hono a ia, paid expe es imony, pa en
applica ions/ egis a ions, and g an s o o he unding. Au ho s mus disclose any in e es s in wo
places: 1. A summa y decla a ion o in e es s a emen in he i le page ile (i double-blind) o he
manusc ip ile (i single-blind). I he e a e no in e es s o decla e hen please s a e his: 'Decla a ions
o in e es : none'. This summa y s a emen will be ul ima ely published i he a icle is accep ed. 2.
De ailed disclosu es as pa o a sepa a e Decla a ion o In e es o m, which o ms pa o he jou nal's
o icial eco ds. I is impo an o po en ial in e es s o be decla ed in bo h places and ha he
in o ma ion ma ches. Mo e in o ma ion.
Submission decla a ion and e i ica ion
Submission o an a icle implies ha he wo k desc ibed has no been published p e iously (excep in
he o m o an abs ac o as pa o a published lec u e o academic hesis, see 'Mul iple, edundan o
concu en publica ion' sec ion o ou e hics policy o mo e in o ma ion), ha i is no unde
conside a ion o publica ion elsewhe e, ha i s publica ion is app o ed by all au ho s and aci ly o
explici ly by he esponsible au ho i ies whe e he wo k was ca ied ou , and ha , i accep ed, i will
no be published elsewhe e in he same o m, in English o in any o he language, including
elec onically wi hou he w i en consen o he copy igh -holde . To e i y o iginali y, you a icle
may be checked by he o iginali y de ec ion se ice C oss e Simila i y Check.
Use o inclusi e language
Inclusi e language acknowledges di e si y, con eys espec o all people, is sensi i e o di e ences,
and p omo es equal oppo uni ies. A icles should make no assump ions abou he belie s o
commi men s o any eade , should con ain no hing which migh imply ha one indi idual is supe io
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o ano he on he g ounds o ace, sex, cul u e o any o he cha ac e is ic, and should use inclusi e
language h oughou . Au ho s should ensu e ha w i ing is ee om bias, o ins ance by using 'he o
she', 'his/he ' ins ead o 'he' o 'his', and by making use o job i les ha a e ee o s e eo yping (e.g.
'chai pe son' ins ead o 'chai man' and ' ligh a endan ' ins ead o 's ewa dess').
Au ho ship
All au ho s should ha e made subs an ial con ibu ions o all o he ollowing: (1) he concep ion and
design o he s udy, o acquisi ion o da a, o analysis and in e p e a ion o da a, (2) d a ing he a icle
o e ising i c i ically o impo an in ellec ual con en , (3) inal app o al o he e sion o be
submi ed.
Changes o au ho ship
Au ho s a e expec ed o conside ca e ully he lis and o de o au ho s be o e submi ing hei
manusc ip and p o ide he de ini i e lis o au ho s a he ime o he o iginal submission. Any addi ion,
dele ion o ea angemen o au ho names in he au ho ship lis should be made only be o e he
manusc ip has been accep ed and only i app o ed by he jou nal Edi o . To eques such a change, he
Edi o mus ecei e he ollowing om he co esponding au ho : (a) he eason o he change in
au ho lis and (b) w i en con i ma ion (e-mail, le e ) om all au ho s ha hey ag ee wi h he addi ion,
emo al o ea angemen . In he case o addi ion o emo al o au ho s, his includes con i ma ion
om he au ho being added o emo ed.
Only in excep ional ci cums ances will he Edi o conside he addi ion, dele ion o ea angemen o
au ho s a e he manusc ip has been accep ed. While he Edi o conside s he eques , publica ion o
he manusc ip will be suspended. I he manusc ip has al eady been published in an online issue, any
eques s app o ed by he Edi o will esul in a co igendum.
Clinical ial esul s
In line wi h he posi ion o he In e na ional Commi ee o Medical Jou nal Edi o s, he jou nal will no
conside esul s pos ed in he same clinical ials egis y in which p ima y egis a ion esides o be
p io publica ion i he esul s pos ed a e p esen ed in he o m o a b ie s uc u ed (less han 500 wo ds)
abs ac o able. Howe e , di ulging esul s in o he ci cums ances (e.g., in es o s' mee ings) is
discou aged and may jeopa dise conside a ion o he manusc ip . Au ho s should ully disclose all
pos ing in egis ies o esul s o he same o closely ela ed wo k.
Repo ing clinical ials
Randomized con olled ials should be p esen ed acco ding o he CONSORT guidelines. A
manusc ip submission, au ho s mus p o ide he CONSORT checklis accompanied by a low diag am
ha illus a es he p og ess o pa ien s h ough he ial, including ec ui men , en ollmen ,
andomiza ion, wi hd awal and comple ion, and a de ailed desc ip ion o he andomiza ion p ocedu e.
The CONSORT checklis and empla e low diag am a e a ailable online.
Regis a ion o clinical ials
Regis a ion in a public ials egis y is a condi ion o publica ion o clinical ials in his jou nal in
acco dance wi h In e na ional Commi ee o Medical Jou nal Edi o s ecommenda ions. T ials mus
egis e a o be o e he onse o pa ien en olmen . The clinical ial egis a ion numbe should be
included a he end o he abs ac o he a icle. A clinical ial is de ined as any esea ch s udy ha
p ospec i ely assigns human pa icipan s o g oups o humans o one o mo e heal h- ela ed
in e en ions o e alua e he e ec s o heal h ou comes. Heal h- ela ed in e en ions include any
in e en ion used o modi y a biomedical o heal h- ela ed ou come ( o example d ugs, su gical
p ocedu es, de ices, beha iou al ea men s, die a y in e en ions, and p ocess-o -ca e changes).
Heal h ou comes include any biomedical o heal h- ela ed measu es ob ained in pa ien s o pa icipan s,
including pha macokine ic measu es and ad e se e en s. Pu ely obse a ional s udies ( hose in which
he assignmen o he medical in e en ion is no a he disc e ion o he in es iga o ) will no equi e
egis a ion.
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Copy igh
Upon accep ance o an a icle, au ho s will be asked o comple e an 'Exclusi e License Ag eemen '
(see mo e in o ma ion on his). Pe mi ed hi d pa y euse o open access a icles is de e mined by he
au ho 's choice o use license.
Au ho igh s
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in o ma ion.
Else ie suppo s esponsible sha ing
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Role o he unding sou ce
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collec ion, analysis and in e p e a ion o da a; in he w i ing o he epo ; and in he decision o submi
he a icle o publica ion. I he unding sou ce(s) had no such in ol emen hen his should be s a ed.
Open Access
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open-accesss o mo e in o ma ion.
Else ie Resea che Academy
Resea che Academy is a ee e-lea ning pla o m designed o suppo ea ly and mid-ca ee esea che s
h oughou hei esea ch jou ney. The "Lea n" en i onmen a Resea che Academy o e s se e al
in e ac i e modules, webina s, downloadable guides and esou ces o guide you h ough he p ocess o
w i ing o esea ch and going h ough pee e iew. Feel ee o use hese ee esou ces o imp o e
you submission and na iga e he publica ion p ocess wi h ease.
Language (usage and edi ing se ices)
Please w i e you ex in good English (Ame ican o B i ish usage is accep ed, bu no a mix u e o
hese). Au ho s who eel hei English language manusc ip may equi e edi ing o elimina e possible
g amma ical o spelling e o s and o con o m o co ec scien i ic English may wish o use he English
Language Edi ing se ice a ailable om Else ie 's Au ho Se ices.
Submission
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and uploading you iles. The sys em con e s you a icle iles o a single PDF ile used in he pee -
e iew p ocess. Edi able iles (e.g., Wo d, LaTeX) a e equi ed o ypese you a icle o inal
publica ion. All co espondence, including no i ica ion o he Edi o 's decision and eques s o
e ision, is sen by e-mail.
Submi you a icle
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Re e ees
Please submi he names and ins i u ional e-mail add esses o se e al po en ial e e ees. Fo mo e
de ails, isi ou Suppo si e. No e ha he edi o e ains he sole igh o decide whe he o no he
sugges ed e iewe s a e used.

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Addi ional in o ma ion
I you ha e any ques ion, please, send you que y o his e-mail ad ess: jop om@else ie .com
PREPARATION
Pee e iew
This jou nal ope a es a double blind e iew p ocess. All con ibu ions will be ini ially assessed by he
edi o o sui abili y o he jou nal. Pape s deemed sui able a e hen ypically sen o a minimum o wo
independen expe e iewe s o assess he scien i ic quali y o he pape . The Edi o is esponsible o
he inal decision ega ding accep ance o ejec ion o a icles. The Edi o 's decision is inal. Mo e
in o ma ion on ypes o pee e iew.
Double-blind e iew
This jou nal uses double-blind e iew, which means he iden i ies o he au ho s a e concealed om he
e iewe s, and ice e sa. Mo e in o ma ion is a ailable on ou websi e. To acili a e his, please
include he ollowing sepa a ely:
Ti le page (wi h au ho de ails): This should include he i le, au ho s' names a ilia ions,
acknowledgemen s and any Decla a ion o In e es s a emen , and a comple e add ess o he
co esponding au ho including an e-mail add ess.
Blinded manusc ip (no au ho de ails): The main body o he pape (including he e e ences, igu es,
ables and any acknowledgemen s) should no include any iden i ying in o ma ion, such as he au ho s'
names o a ilia ions.
Use o wo d p ocessing so wa e
I is impo an ha he ile be sa ed in he na i e o ma o he wo d p ocesso used. The ex should be
in single-column o ma . Keep he layou o he ex as simple as possible. Mos o ma ing codes will
be emo ed and eplaced on p ocessing he a icle. In pa icula , do no use he wo d p ocesso 's op ions
o jus i y ex o o hyphena e wo ds. Howe e , do use bold ace, i alics, subsc ip s, supe sc ip s e c.
When p epa ing ables, i you a e using a able g id, use only one g id o each indi idual able and no
a g id o each ow. I no g id is used, use abs, no spaces, o align columns. The elec onic ex should
be p epa ed in a way e y simila o ha o con en ional manusc ip s (see also he Guide o Publishing
wi h Else ie ). No e ha sou ce iles o igu es, ables and ex g aphics will be equi ed whe he o no
you embed you igu es in he ex . See also he sec ion on Elec onic a wo k.
To a oid unnecessa y e o s you a e s ongly ad ised o use he 'spell-check' and 'g amma -check'
unc ions o you wo d p ocesso .
A icle s uc u e
Subdi ision - unnumbe ed sec ions
Di ide you a icle in o clea ly de ined sec ions. Each subsec ion is gi en a b ie heading. Each heading
should appea on i s own sepa a e line. Subsec ions should be used as much as possible when c oss-
e e encing ex : e e o he subsec ion by heading as opposed o simply ' he ex '.
In oduc ion
S a e he objec i es o he wo k and p o ide an adequa e backg ound, a oiding a de ailed li e a u e
su ey o a summa y o he esul s.
Ma e ial and me hods
P o ide su icien de ails o allow he wo k o be ep oduced by an independen esea che . Me hods
ha a e al eady published should be summa ized, and indica ed by a e e ence. I quo ing di ec ly om
a p e iously published me hod, use quo a ion ma ks and also ci e he sou ce. Any modi ica ions o
exis ing me hods should also be desc ibed.
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Resul s
Resul s should be clea and concise.
Discussion
This should explo e he signi icance o he esul s o he wo k, no epea hem. A combined Resul s
and Discussion sec ion is o en app op ia e. A oid ex ensi e ci a ions and discussion o published
li e a u e.
Conclusions
The main conclusions o he s udy may be p esen ed in a sho Conclusions sec ion, which may s and
alone o o m a subsec ion o a Discussion o Resul s and Discussion sec ion.
Appendices
I he e is mo e han one appendix, hey should be iden i ied as A, B, e c. Fo mulae and equa ions in
appendices should be gi en sepa a e numbe ing: Eq. (A.1), Eq. (A.2), e c.; in a subsequen appendix,
Eq. (B.1) and so on. Simila ly o ables and igu es: Table A.1; Fig. A.1, e c.
Essen ial i le page in o ma ion
• Ti le. Concise and in o ma i e. Ti les a e o en used in in o ma ion- e ie al sys ems. A oid
abb e ia ions and o mulae whe e possible.
• Au ho names and a ilia ions. Please clea ly indica e he gi en name(s) and amily name(s) o each
au ho and check ha all names a e accu a ely spelled. You can add you name be ween pa en heses in
you own sc ip behind he English ansli e a ion. P esen he au ho s' a ilia ion add esses (whe e he
ac ual wo k was done) below he names. Indica e all a ilia ions wi h a lowe -case supe sc ip le e
immedia ely a e he au ho 's name and in on o he app op ia e add ess. P o ide he ull pos al
add ess o each a ilia ion, including he coun y name and, i a ailable, he e-mail add ess o each
au ho .
• Co esponding au ho . Clea ly indica e who will handle co espondence a all s ages o e e eeing
and publica ion, also pos -publica ion. This esponsibili y includes answe ing any u u e que ies abou
Me hodology and Ma e ials. Ensu e ha he e-mail add ess is gi en and ha con ac de ails a e
kep up o da e by he co esponding au ho .
• P esen /pe manen add ess. I an au ho has mo ed since he wo k desc ibed in he a icle was done,
o was isi ing a he ime, a 'P esen add ess' (o 'Pe manen add ess') may be indica ed as a oo no e
o ha au ho 's name. The add ess a which he au ho ac ually did he wo k mus be e ained as he
main, a ilia ion add ess. Supe sc ip A abic nume als a e used o such oo no es.
Highligh s
Highligh s a e op ional ye highly encou aged o his jou nal, as hey inc ease he disco e abili y o
you a icle ia sea ch engines. They consis o a sho collec ion o bulle poin s ha cap u e he no el
esul s o you esea ch as well as new me hods ha we e used du ing he s udy (i any). Please ha e a
look a he examples he e: example Highligh s.
Highligh s should be submi ed in a sepa a e edi able ile in he online submission sys em. Please use
'Highligh s' in he ile name and include 3 o 5 bulle poin s (maximum 85 cha ac e s, including spaces,
pe bulle poin ).
S uc u ed abs ac
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A s uc u ed abs ac , by means o app op ia e headings, should p o ide he con ex o backg ound o
he esea ch and should s a e i s pu pose, basic p ocedu es (selec ion o s udy subjec s o labo a o y
animals, obse a ional and analy ical me hods), main indings (gi ing speci ic e ec sizes and hei
s a is ical signi icance, i possible), and p incipal conclusions. I should emphasize new and impo an
aspec s o he s udy o obse a ions.
G aphical abs ac
Al hough a g aphical abs ac is op ional, i s use is encou aged as i d aws mo e a en ion o he online
a icle. The g aphical abs ac should summa ize he con en s o he a icle in a concise, pic o ial o m
designed o cap u e he a en ion o a wide eade ship. G aphical abs ac s should be submi ed as a
sepa a e ile in he online submission sys em. Image size: Please p o ide an image wi h a minimum o
531 × 1328 pixels (h × w) o p opo ionally mo e. The image should be eadable a a size o 5 × 13 cm
using a egula sc een esolu ion o 96 dpi. P e e ed ile ypes: TIFF, EPS, PDF o MS O ice iles.
You can iew Example G aphical Abs ac s on ou in o ma ion si e.
Au ho s can make use o Else ie 's Illus a ion and Enhancemen se ice o ensu e he bes p esen a ion
o hei images and in acco dance wi h all echnical equi emen s: Illus a ion Se ice.
Keywo ds
Immedia ely a e he abs ac , p o ide a maximum o 6 keywo ds, using B i ish spelling and a oiding
gene al and plu al e ms and mul iple concep s (a oid, o example, 'and', 'o '). Be spa ing wi h
abb e ia ions: only abb e ia ions i mly es ablished in he ield may be eligible. These keywo ds will
be used o indexing pu poses.
Abb e ia ions
De ine abb e ia ions ha a e no s anda d in his ield in a oo no e o be placed on he i s page o he
a icle. Such abb e ia ions ha a e una oidable in he abs ac mus be de ined a hei i s men ion
he e, as well as in he oo no e. Ensu e consis ency o abb e ia ions h oughou he a icle.
Acknowledgemen s
Colla e acknowledgemen s in a sepa a e sec ion a he end o he a icle be o e he e e ences and do
no , he e o e, include hem on he i le page, as a oo no e o he i le o o he wise. Lis he e hose
indi iduals who p o ided help du ing he esea ch (e.g., p o iding language help, w i ing assis ance o
p oo eading he a icle, e c.).
Fo ma ing o unding sou ces
Lis unding sou ces in his s anda d way o acili a e compliance o unde 's equi emen s:
Funding: This wo k was suppo ed by he Na ional Ins i u es o Heal h [g an numbe s xxxx, yyyy]; he
Bill & Melinda Ga es Founda ion, Sea le, WA [g an numbe zzzz]; and he Uni ed S a es Ins i u es o
Peace [g an numbe aaaa].
I is no necessa y o include de ailed desc ip ions on he p og am o ype o g an s and awa ds. When
unding is om a block g an o o he esou ces a ailable o a uni e si y, college, o o he esea ch
ins i u ion, submi he name o he ins i u e o o ganiza ion ha p o ided he unding.
I no unding has been p o ided o he esea ch, please include he ollowing sen ence:
This esea ch did no ecei e any speci ic g an om unding agencies in he public, comme cial, o
no - o -p o i sec o s.
Facul a d’Óp ica i Op ome ía de Te assa
© Uni e si a Poli ècnica de Ca alunya, any 2021. To s els d e s ese a s
25
Uni s
Follow in e na ionally accep ed ules and con en ions: use he in e na ional sys em o uni s (SI). I
o he uni s a e men ioned, please gi e hei equi alen in SI.
Foo no es
Foo no es should be used spa ingly. Numbe hem consecu i ely h oughou he a icle. Many wo d
p ocesso s can build oo no es in o he ex , and his ea u e may be used. O he wise, please indica e
he posi ion o oo no es in he ex and lis he oo no es hemsel es sepa a ely a he end o he a icle.
Do no include oo no es in he Re e ence lis .
A wo k
Image manipula ion
Whils i is accep ed ha au ho s some imes need o manipula e images o cla i y, manipula ion o
pu poses o decep ion o aud will be seen as scien i ic e hical abuse and will be deal wi h acco dingly.
Fo g aphical images, his jou nal is applying he ollowing policy: no speci ic ea u e wi hin an image
may be enhanced, obscu ed, mo ed, emo ed, o in oduced. Adjus men s o b igh ness, con as , o
colo balance a e accep able i and as long as hey do no obscu e o elimina e any in o ma ion p esen
in he o iginal. Nonlinea adjus men s (e.g. changes o gamma se ings) mus be disclosed in he igu e
legend.
Elec onic a wo k
Gene al poin s
• Make su e you use uni o m le e ing and sizing o you o iginal a wo k.
• Embed he used on s i he applica ion p o ides ha op ion.
• Aim o use he ollowing on s in you illus a ions: A ial, Cou ie , Times New Roman,
Symbol, o use on s ha look simila .
• Numbe he illus a ions acco ding o hei sequence in he ex .
• Use a logical naming con en ion o you a wo k iles.
• P o ide cap ions o illus a ions sepa a ely.
• Size he illus a ions close o he desi ed dimensions o he published e sion.
• Submi each illus a ion as a sepa a e ile.
• Ensu e ha colo images a e accessible o all, including hose wi h impai ed colo ision.
A de ailed guide on elec onic a wo k is a ailable.
You a e u ged o isi his si e; some exce p s om he de ailed in o ma ion a e gi en he e.
Fo ma s
I you elec onic a wo k is c ea ed in a Mic oso O ice applica ion (Wo d, Powe Poin , Excel) hen
please supply 'as is' in he na i e documen o ma .
Rega dless o he applica ion used o he han Mic oso O ice, when you elec onic a wo k is
inalized, please 'Sa e as' o con e he images o one o he ollowing o ma s (no e he esolu ion
equi emen s o line d awings, hal ones, and line/hal one combina ions gi en below):
EPS (o PDF): Vec o d awings, embed all used on s.
TIFF (o JPEG): Colo o g ayscale pho og aphs (hal ones), keep o a minimum o 300 dpi.
TIFF (o JPEG): Bi mapped (pu e black & whi e pixels) line d awings, keep o a minimum o 1000
dpi.
TIFF (o JPEG): Combina ions bi mapped line/hal - one (colo o g ayscale), keep o a minimum o
500 dpi.