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Dioptric power expressed in the familiar three-component form of sphere, cylinder, and axis is unsuited to mathematical and statistical treatments; there is a particular class of power that cannot be represented in the familiar form; and it is possible that sphere, cylinder, and axis will prove inadequate in future clinical and research applications in optometry and ophthalmology. Dioptric power expressed as the four-component dioptric power matrix, however, overcomes these shortcomings. The intention in this paper is to provide a definitive statement on the nature, function, and mathematical representation of dioptric power in terms of the matrix and within the limitations of paraxial or linear optics. The approach is universal in the sense that its point of departure is not power of the familiar form (that is, of thin systems) but of systems in general (thick or thin). Familiar types of power are then seen within the context of power in general. Dioptric power is defined, for systems that may be thick and astigmatic, in terms of the ray transfer matrix. A functional definition is presented for dioptric power and its components: it defines the additive contribution of incident position to emergent direction of a ray passing through the system. For systems that are thin (or thin-equivalent) it becomes possible to describe an alternative and more familiar function; for such systems dioptric power can be regarded as the increase in reduced surface curvature of a wavefront brought about by the system as the wavefront passes through it. The curvital and torsional components of the power are explored in some detail. Dioptric power, at its most general, defines a four-dimensional inner product space called dioptric power space. The familiar types of power define a three-dimensional subspace called symmetric dioptric power space. For completeness a one-dimensional antisymmetric power space is also defined: it is orthogonal in four dimensions to symmetric dioptric power space. Various bases are defined for the spaces as are coordinate vectors with respect to them. Vectorial representations of power in the literature apply only to thin systems and are not obviously generalizable to systems in general. They are shown to be merely different coordinate representations of the same subspace, the space of symmetric powers. Some of the uses and disadvantages of the different representations are described. None of the coordinate vectors fully represent, by themselves, the essential character of dioptric power. Their use is limited to applications, such as finding a mean, where addition and scalar multiplication are involved. The full character of power is represented by the dioptric power matrix; it is in this form that power is appropriate for all mathematical relationships.
BACKGROUND: The purposes of the present study were (1) to establish normal values for the regression of log(power) on log(frequency) for, RR-interval fluctuations in healthy middle-aged persons, (2) to determine the effects of myocardial infarction on the regression of log(power) on log(frequency), (3) to determine the effect of cardiac denervation on the regression of log(power) on log(frequency), and (4) to assess the ability of power law regression parameters to predict death after myocardial infarction. METHODS AND RESULTS: We studied three groups: (1) 715 patients with recent myocardial infarction; (2) 274 healthy persons age and sex matched to the infarct sample; and (3) 19 patients with heart transplants. Twenty-four-hour RR-interval power spectra were computed using fast Fourier transforms and log(power) was regressed on log(frequency) between 10(-4) and 10(-2) Hz. There was a power law relation between log(power) and log(frequency). That is, the function described a descending straight line that had a slope of approximately -1 in healthy subjects. For the myocardial infarction group, the regression line for log(power) on log(frequency) was shifted downward and had a steeper negative slope (-1.15). The transplant (denervated) group showed a larger downward shift in the regression line and a much steeper negative slope (-2.08). The correlation between traditional power spectral bands and slope was weak, and that with log(power) at 10(-4) Hz was only moderate. Slope and log(power) at 10(-4) Hz were used to predict mortality and were compared with the predictive value of traditional power spectral bands. Slope and log(power) at 10(-4) Hz were excellent predictors of all-cause mortality or arrhythmic death. To optimize the prediction of death, we calculated a log(power) intercept that was uncorrelated with the slope of the power law regression line. We found that the combination of slope and zero-correlation log(power) was an outstanding predictor, with a relative risk of > 10, and was better than any combination of the traditional power spectral bands. The combination of slope and log(power) at 10(-4) Hz also was an excellent predictor of death after myocardial infarction. CONCLUSIONS: Myocardial infarction or denervation of the heart causes a steeper slope and decreased height of the power law regression relation between log(power) and log(frequency) of RR-interval fluctuations. Individually and, especially, combined, the power law regression parameters are excellent predictors of death of any cause or arrhythmic death and predict these outcomes better than the traditional power spectral bands.
PURPOSE: To compare the relative advantages and disadvantages of four different representations of corneal power--identified as instantaneous, axial, position, and refractive--based on curvature, slope, coordinate position, and focal properties, respectively. METHOD: The four types of corneal power were evaluated by examining their interrelationship for 12 hypothetical corneal shapes chosen to represent the general characteristics of regular, irregular, and surgically altered corneas. RESULTS: There is only a limited association between refractive power and the other three powers, which are based on shape properties. For corneal shapes represented by ellipsoids of low eccentricity (e), refractive power increased as a function of the distance from the reference axis, whereas axial and instantaneous powers were either constant (for e = 0) or decreased, with instantaneous power having the largest decrease. Refractive power decreased for elliptical corneal shapes with eccentricities greater than the reciprocal of the index of refraction, although always decreasing less than the axial or instantaneous power. For various corneal shapes formed by segments of circles (or a polynomial) with large differences in instantaneous power, the refractive power was more closely associated with axial than instantaneous or position powers. CONCLUSIONS: The Purkinje image measurements from videokeratograpy are most closely related to the slope-based axial power because it is slope that determines the direction of reflected rays forming the corneal image. Because of this direct connection, axial power is less sensitive to noise than is refractive, instantaneous, or position power. Present videokeratographs that report axial power provide an approximation of refractive power, but if an exact refractive power is needed it can be calculated easily. Instantaneous power provides the most sensitive measure of local curvature changes, such as those occurring in keratoconus or refractive surgery. There are unique practical applications for each of the four powers.