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Weisensee J, Ringhofer OM, Langenbucher A. Prediction of Visual Acuity in Pseudophakic Cataract Population Based on Residual Refraction. Curr Eye Res 2024; 49:1054-1060. [PMID: 38831678 DOI: 10.1080/02713683.2024.2359981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 05/06/2024] [Accepted: 05/21/2024] [Indexed: 06/05/2024]
Abstract
PURPOSE The purpose of the study was to design a simple, handy prediction for the effect of spherical and cylindrical refractive error on the visual acuity degradation at different distances and validate this model on a clinical dataset. METHODS This study examined 70 eyes from 35 patients' post-cataract surgery with aberration-free intraocular lenses. Biometric and corneal data were analysed, and subjective refraction and visual acuity were evaluated by two experienced optometrists. The study computed the spherical equivalent (SEQ), and defocus equivalent via vector addition (DEQ vec), as the sum of absolute values (DEQ abs). Predictive models were developed using univariate regression, with confidence intervals (BCa 95%) calculated through non-parametric bootstrapping (10,000 cycles). RESULTS Various calculated equivalents included -0.44 D for spherical equivalent (SEQ), 0.70 D for defocus equivalent based on vector calculation (DEQ vec), and 0.89 D for defocus equivalent based on absolute values (DEQ abs). Uncorrected and corrected visual acuity averaged 0.07 logMAR and -0.04 logMAR, respectively. The absolute defocus equivalent (DEQ abs) exhibited the smallest confidence interval (BCa 95%) at 0.07. CONCLUSION The defocus equivalent based on the addition of absolute values (DEQ abs) emerged as the most practical predictor for the described applications. Notably, it offers the advantage of easy calculability through a simple equation: VA loss = DEQ abs ⋅ 0.23. In 95% of cases, this predicted loss would have an accuracy of ±0.03 lines.
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Affiliation(s)
- Johannes Weisensee
- Department of Experimental Ophthalmology, Saarland University, Homburg, Saar, Germany
| | | | - Achim Langenbucher
- Department of Experimental Ophthalmology, Saarland University, Homburg, Saar, Germany
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Waugh SJ, Fronius M. Landolt C-Tests With "Fixed" Arcmin Separations Detect Amblyopia But Underestimate Crowding in Moderate-to-Severe Amblyopic Children and Adults. Invest Ophthalmol Vis Sci 2024; 65:33. [PMID: 39177974 PMCID: PMC11346165 DOI: 10.1167/iovs.65.10.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 07/30/2024] [Indexed: 08/24/2024] Open
Abstract
Purpose Crowding is exaggerated in central vision of strabismic amblyopia, impacting on reading ability. Crowding magnitude and interocular differences (IODs) in acuity are indicators for detection, assessment, and monitoring of treatment. Lateral masking (including contour interaction) also affects acuity and can mimic or ameliorate crowding. We investigated lateral masking/contour interaction and crowding impact on crowding magnitude and IOD measures in healthy and amblyopic pediatric and juvenile/adult groups using two Landolt C-tests with "fixed" arcmin separations. Methods Acuity (logMAR) was measured with Landolt C-tests with specified 2.6' ("crowded") and 35' ("uncrowded") separations. Crowding magnitudes (crowded - uncrowded acuities) and IODs were calculated. Participants were 69 subjects with strabismic amblyopia (n = 39 pediatric, i.e. children ≤8 years of age), 31 subjects with anisometropic amblyopia (n = 14 pediatric), and 76 healthy controls (n = 36 pediatric). Subjects with amblyopia were subgrouped by acuity as low severity (<0.4 logMAR) or high severity (≥0.4 logMAR) using the 35' separation C-test. Results Crowding magnitudes were greater in strabismic than in anisometropic amblyopia and control/fellow eyes. They were higher in pediatric control/fellow eyes than in juvenile/adult eyes. In high severity strabismic amblyopia, crowding magnitudes progressively and significantly reduced (slope = -0.17 ± 0.07, P < 0.05) with worsening acuity. IODs for this group were higher on the 2.6' C-test, but lower than expected. In high severity pediatric subjects with anisometropic amblyopia, seven of eight had lower IODs measured with the "crowded" than the "uncrowded" C-tests. Conclusions These C-tests detect amblyopia but underestimate crowding in children and adults with high severity strabismic amblyopia. Separate isolated optotype acuity and crowding distance tests may better target specific functions, while minimizing the impact of masking.
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Affiliation(s)
- Sarah J. Waugh
- Centre for Vision across the Life Span, School of Applied Sciences, University of Huddersfield, United Kingdom
| | - Maria Fronius
- Goethe University Hospital, Department of Ophthalmology, Child Vision Research Unit, Frankfurt, Germany
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Wessels M, Oberfeld D. A binary acceleration signal reduces overestimation in pedestrians' visual time-to-collision estimation for accelerating vehicles. Heliyon 2024; 10:e27483. [PMID: 38496889 PMCID: PMC10944229 DOI: 10.1016/j.heliyon.2024.e27483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 02/19/2024] [Accepted: 02/29/2024] [Indexed: 03/19/2024] Open
Abstract
When a pedestrian intends to cross the street, it is essential for safe mobility to correctly estimate the arrival time (time-to-collision, TTC) of an approaching vehicle. However, visual perception of acceleration is rather imprecise. Previous studies consistently showed that humans (mostly) disregard acceleration, but judge the TTC for an object as if it were traveling at constant speed (first-order estimation), which is associated with overestimated TTCs for positively accelerating objects. In a traffic context, such TTC overestimation could motivate pedestrians to cross in front of an approaching vehicle, although the time remaining is not sufficiently long. Can a simple acceleration signal help improve visual TTC estimation for accelerating objects? The present study investigated whether a signal that only indicates whether a vehicle is accelerating or not can remove the first-order pattern of overestimated TTCs. In a virtual reality simulation, 26 participants estimated the TTC of vehicles that approached with constant velocity or accelerated, from the perspective of a pedestrian at the curb. In half of the experimental blocks, a light band on the windshield illuminated whenever the vehicle accelerated but remained deactivated when the vehicle travelled at a constant speed. In the other blocks, the light band never illuminated, regardless of whether or not the vehicle accelerated. Participants were informed about the light band function in each block. Without acceleration signal, the estimated TTCs for the accelerating vehicles were consistent with an erroneous first-order approximation. In blocks with acceleration signal, participants substantially changed their estimation strategy, so that TTC overestimations for accelerating vehicles were reduced. Our data suggest that a binary acceleration signal helps pedestrians to effectively reduce the TTC overestimation for accelerating vehicles and could therefore increase pedestrian safety.
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Affiliation(s)
- Marlene Wessels
- Institute of Psychology, Section Experimental Psychology, Johannes Gutenberg-Universität Mainz, Wallstrasse 3, 55122, Mainz, Germany
| | - Daniel Oberfeld
- Institute of Psychology, Section Experimental Psychology, Johannes Gutenberg-Universität Mainz, Wallstrasse 3, 55122, Mainz, Germany
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Salmerón-Campillo RM, Varona-Gómez FT, Ogino M, Hunter S, Hussey V, Suh DW, Gore R, Jaskulski M, López-Gil N. Measuring visual acuity and spherical refraction with smartphone screens emitting blue light. JOURNAL OF OPTOMETRY 2024; 17:100494. [PMID: 37939574 PMCID: PMC10654024 DOI: 10.1016/j.optom.2023.100494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/12/2023] [Accepted: 09/19/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION A periodical self-monitoring of spherical refraction using smartphones may potentially allow a quicker intervention by eye care professionals to reduce myopia progression. Unfortunately, at low levels of myopia, the far point (FP) can be located far away from the eye which can make interactions with the device difficult. To partially remedy this issue, a novel method is proposed and tested wherein the longitudinal chromatic aberration (LCA) of blue light is leveraged to optically bring the FP closer to the eye. METHODS Firstly, LCA was obtained by measuring spherical refraction subjectively using blue pixels in stimuli shown on organic light-emitting diode (OLED) screens and also grey stimuli with matching luminance. Secondly, the visual acuity (VA) measured with a smartphone located at 1.0 m and 1.5 m and displaying blue optotypes was compared with that obtained clinically standard measurements. Finally, the spherical over refraction obtained in blue light with a smartphone was compared with clinical over-refraction with black and white (B&W) optotypes placed at 6 m. RESULTS Mean LCA of blue OLED smartphone screens was -0.67 ± 0.11 D. No significant differences (p > 0.05) were found between the VA measured with blue optotypes on a smartphone screen and an eye chart. Mean difference between spherical over-refraction measured subjectively by experienced subjects with smartphones and the one obtained clinically was 0.08 ± 0.34 D. CONCLUSIONS Smartphones using blue light can be used as a tool to detect changes in visual acuity and spherical refraction and facilitate monitoring of myopia progression.
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Affiliation(s)
| | | | - Mari Ogino
- Creighton University School of Medicine, Omaha, NE, United States
| | - Stephen Hunter
- University of California Riverside School of Medicine, Riverside, CA, United States
| | - Vincent Hussey
- University of California Irvine School of Medicine, Irvine, CA, United States
| | - Donny W Suh
- University of California Irvine School of Medicine, Irvine, CA, United States
| | - Rujuta Gore
- University of California Irvine School of Medicine, Irvine, CA, United States
| | - Mateusz Jaskulski
- Grupo de Ciencias de La Visión (CiViUM), Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain; Clinical Optics Research Lab (CORL), Indiana University, Bloomington, IN, United States
| | - Norberto López-Gil
- Grupo de Ciencias de La Visión (CiViUM), Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain; Clínica Universitaria de Visión Integral (CUVI), Universidad de Murcia, Murcia, Spain
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Pars-plana-vitrectomy for endophthalmitis treatment and the role of standardized ultrasound. Int Ophthalmol 2022; 43:1111-1119. [PMID: 36066783 DOI: 10.1007/s10792-022-02508-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/28/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE Endophthalmitis is a severe inflammation following surgery or endogenous spread of pathogens. Besides clinical signs and symptoms, standardized ultrasound might help to confirm the diagnosis. Thus, we analyzed 172 cases of endophthalmitis for pathogens, visual acuity (VA) and the predictive value of standardized ultrasound. METHODS Retrospective analysis of patients treated with pars-plana-vitrectomy for endophthalmitis at the University Eye Hospital was performed. Sex, age, VA at presentation, first day after surgery, four weeks postoperatively, and at last follow-up, as well as pathogen culture, and presence of standardized ultrasound before vitrectomy were recorded. Mann-Whitney U and Chi-square tests were used for groupwise comparisons. RESULTS A total of 172 patients (male = 47.7%) with a median age of 76 years (IQR 65-82 years) treated for endophthalmitis (exogenous = 85.5%) were included. Median follow-up time was 65 days (IQR 12-274 days). Visual acuity at presentation was 2.30 logMAR (IQR 2.70-2.30 logMAR); it increased to 1.00 logMAR (1.4-0.40 logMAR) at last follow-up. A total of 79 patients (45.9%) underwent standardized ultrasound before vitrectomy. Patients with positive ultrasound criteria had a significantly decreased VA at presentation (p = 0.034). Positive microbiological cultures for Streptococcus spp. and Enterococcus faecalis were associated with decreased VA (p = 0.028) at last follow-up. CONCLUSION Standardized ultrasound is an easy and robust tool in the diagnosis of endophthalmitis. Positive criteria are significantly associated with decreased VA at presentation. The recovery of VA depends on pathogens and is significantly worse for certain species (Streptococcus spp., Enterococcus faecalis).
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Hilmers J, Straßer T, Bach M, Stingl K, Zrenner E. Quantification of the Dynamic Visual Acuity Space at Real-World Luminances and Contrasts: The VA-CAL Test. Transl Vis Sci Technol 2022; 11:12. [PMID: 35420645 PMCID: PMC9034710 DOI: 10.1167/tvst.11.4.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 03/25/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose Best-corrected visual acuity (BCVA) is assessed at a single standardized luminance with maximum optotype contrast, not reflecting the constantly changing daily-life viewing conditions. For a more realistic estimation of visual performance at varying object contrasts (Cs) and ambient luminances (ALs), we developed a new VA test, VA-CAL. Methods Landolt-C-rings between 18% and 95% Weber contrast, were presented at 1 m distance (8 Alternative Forced Choice) on a 5.7 degree field in the middle of a frosted glass screen (66 degrees), back-lit by 3060 LEDs (generating ambient luminances between 0-10,000 cd/m²). Visual acuity (VA) was measured in 14 normally sighted participants twice for 8 conditions of ambient luminance and 6 conditions of contrast using a QUEST staircase procedure. Results VA improved continuously up to an ambient luminance of 3000 to 5000 cd/m² (best mean VA ± SEM: -0.47 ± 0.03 logMAR at C = 95%, AL = 3000 cd/m²), followed by a decline of VA at higher luminances with good test-retest variability. As expected, reduced contrast leads to a lower VA (worst mean VA ± SEM: -0.03 ± 0.03 logMAR at C = 18%, AL = 0 cd/m²). A 3D plot of these data shows the VA space (VAS) extending between the contrast and luminance axes, which describes the dynamics of VA continuously changing under varying everyday life conditions. Conclusions VA-CAL, an automated device and procedure, allows for simultaneous evaluation of VA at various contrast-luminance combinations, thus providing a more comprehensive assessment of spatial vision problems not seen with standard BCVA tests. Translational Relevance The new BCVA test VA-CAL incorporates a range of everyday contrast and ambient luminance conditions for a more realistic description of visual performance.
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Affiliation(s)
- Julian Hilmers
- Institute for Ophthalmic Research, University of Tuebingen, Tuebingen, Germany
| | - Torsten Straßer
- Institute for Ophthalmic Research, University of Tuebingen, Tuebingen, Germany
- University Eye Hospital Tuebingen, Tuebingen, Germany
| | - Michael Bach
- Eye Center, Medical Center – Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - Eberhart Zrenner
- Institute for Ophthalmic Research, University of Tuebingen, Tuebingen, Germany
- University Eye Hospital Tuebingen, Tuebingen, Germany
- Werner Reichardt Centre for Integrative Neuroscience (CIN), Tuebingen, Germany
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Wang T, Huang PJ, Chen C, Liu DW, Yi JL. A comparison of visual acuity measured by ETDRS chart and Standard Logarithmic Visual Acuity chart among outpatients. Int J Ophthalmol 2021; 14:536-540. [PMID: 33875944 DOI: 10.18240/ijo.2021.04.09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/22/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To compare the results of visual acuity (VA) measured by Early Treatment Diabetic Retinopathy Study (ETDRS) chart, 5 m Standard Logarithm Visual Acuity (5SL) chart, and 2.5 m Standard Logarithm Visual Acuity (2.5SL) chart in outpatients of age 12-80y. METHODS Each patient (totally 2000 outpatients) had both eyes tested with ETDRS chart at 4 m, 5SL chart at 5 m, and 2.5SL chart at 2.5 m in random order. The VA values of outpatients were categorized by ages. VA values were expressed by logMAR recording method. RESULTS The mean VA results of ETDRS charts, 5SL, and 2.5SL chart were 0.52±0.28, 0.50±0.30, and 0.46±0.28 logMAR, respectively. There was a statistically significant difference in the three eye charts in the whole group (P<0.001). For all subjects, the correlation of VA tested with three charts was statistically significant (Spearman correlation coefficient=0.944, 0.937, 0.946, all P<0.001). Bland-Altman analysis shows the 95% limits of agreement between the 5SL and 2.5SL chart were -0.182 to 0.210, -0.139 to 0.251, and -0.151 to 0.235 logMAR, respectively). CONCLUSION The agreement between the three eye charts is not high. The VA measured by 5SL chart is slightly better than that by ETDRS chart and 5SL chart would be a suitable alternative when ETDRS chart are not available in the clinical situation. The VA measured by 2.5SL chart is about 0.5 line better than VA tested with ETDRS chart, which may overestimate VA.
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Affiliation(s)
- Tao Wang
- Jiangxi Medical College, Nanchang University, Nanchang 330000, Jiangxi Province, China
| | - Pei-Jie Huang
- Department of Ophthalmology, the Affiliated Eye Hospital of Nanchang University, Nanchang 330000, Jiangxi Province, China
| | - Chen Chen
- Department of Ophthalmology, the Affiliated Eye Hospital of Nanchang University, Nanchang 330000, Jiangxi Province, China
| | - Ding-Wei Liu
- Jiangxi Medical College, Nanchang University, Nanchang 330000, Jiangxi Province, China
| | - Jing-Lin Yi
- Department of Ophthalmology, the Affiliated Eye Hospital of Nanchang University, Nanchang 330000, Jiangxi Province, China
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Abstract
After more than 10 years of experience with the femtosecond laser in cataract surgery, it can be concluded that the safety profile of femtosecond laser-assisted cataract surgery (FLACS) is comparable to that of conventional cataract surgery. This technique offers the possibility to perform incisions with a precision superior to that of any surgeon in the world, based on the connection of preoperative and intraoperative diagnostics. This results in new possibilities to revolutionize the surgical procedure of cataract surgery and to generate new therapeutic approaches for the treatment of cataracts. The combination of keratotomy for correcting astigmatism, intraocular lenses supported by capsulotomy and individually adapted fragmentation patterns is already a component of a personalized cataract surgery.
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