1
|
Łabuz G, Khoramnia R, Yan W, van den Berg TJTP, Auffarth GU, Naujokaitis T, Tandogan T. Characterizing glare effects associated with diffractive optics in presbyopia-correcting intraocular lenses. J Cataract Refract Surg 2024; 50:413-419. [PMID: 38237073 DOI: 10.1097/j.jcrs.0000000000001398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/08/2024] [Indexed: 03/26/2024]
Abstract
PURPOSE To objectively quantify glare of intraocular lenses (IOLs) using a diffractive principle to extend the visual range and to identify models with increased susceptibility to inducing glare. SETTING David J Apple Laboratory, Heidelberg, Germany. DESIGN Laboratory investigation. METHODS Glare was assessed by means of a straylight parameter with a standard C-Quant intended for 7 degrees. In addition, 2 C-Quant modifications were used to test lower angles (ie, 2.5 degrees and 3.5 degrees). The following IOL models were assessed: PanOptix, AT Lisa Tri, Synergy, and Triumf, the latter 2 with chromatic aberration correction at distance. Straylight from trifocal IOLs was compared against a monofocal W-60R lens. The C-Quant test was performed through the studied IOLs by using additional optical components attached to their ocular. RESULTS Straylight (deg 2 sr -1 ) of the control was <1 at all tested angles, with the trifocal models showing comparable straylight at 7 degrees. At 3.5 degrees, Triumf's straylight increased to 15.5 ± 0.6, followed by Synergy (6.2 ± 1.1), PanOptix (4.1 ± 0.3), and AT Lisa Tri (2.0 ± 0.8). The chromatic aberration-correcting models demonstrated correspondingly higher straylight (Synergy: 18.8 ± 1.3; Triumf: 17.3 ± 0.5) at 2.5 degrees compared with PanOptix (4.3 ± 0.4), AT Lisa Tri (2.1 ± 0.1), and monofocal IOLs yielding minimal or no increase. CONCLUSIONS Trifocal IOLs induced increased straylight, but it was limited to lower angles, which may cause difficulties detecting these effects using a standard clinical approach. The latest IOL designs featuring chromatic aberration correction at far focus seem more susceptible than the established trifocal IOLs to inducing a glare phenomenon.
Collapse
Affiliation(s)
- Grzegorz Łabuz
- From the The David J Apple Center for Vision Research, Department of Ophthalmology, University Hospital Heidelberg, Heidelberg, Germany (Łabuz, Khoramnia, Yan, Auffarth, Naujokaitis, Tandogan); Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands (van den Berg); Augenklinik Pallas, Olten, Switzerland (Tandogan)
| | | | | | | | | | | | | |
Collapse
|
2
|
Mackenbrock LHB, Labuz G, Baur ID, Yildirim TM, Auffarth GU, Khoramnia R. Cataract Classification Systems: A Review. Klin Monbl Augenheilkd 2024; 241:75-83. [PMID: 38242135 DOI: 10.1055/a-2003-2369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
Cataract is among the leading causes of visual impairment worldwide. Innovations in treatment have drastically improved patient outcomes, but to be properly implemented, it is necessary to have the right diagnostic tools. This review explores the cataract grading systems developed by researchers in recent decades and provides insight into both merits and limitations. To this day, the gold standard for cataract classification is the Lens Opacity Classification System III. Different cataract features are graded according to standard photographs during slit lamp examination. Although widely used in research, its clinical application is rare, and it is limited by its subjective nature. Meanwhile, recent advancements in imaging technology, notably Scheimpflug imaging and optical coherence tomography, have opened the possibility of objective assessment of lens structure. With the use of automatic lens anatomy detection software, researchers demonstrated a good correlation to functional and surgical metrics such as visual acuity, phacoemulsification energy, and surgical time. The development of deep learning networks has further increased the capability of these grading systems by improving interpretability and increasing robustness when applied to norm-deviating cases. These classification systems, which can be used for both screening and preoperative diagnostics, are of value for targeted prospective studies, but still require implementation and validation in everyday clinical practice.
Collapse
Affiliation(s)
- Lars H B Mackenbrock
- Department of Ophthalmology, Heidelberg University Hospital, Heidelberg, Germany
| | - Grzegorz Labuz
- Department of Ophthalmology, Heidelberg University Hospital, Heidelberg, Germany
| | - Isabella D Baur
- Department of Ophthalmology, Heidelberg University Hospital, Heidelberg, Germany
| | - Timur M Yildirim
- Department of Ophthalmology, Heidelberg University Hospital, Heidelberg, Germany
| | - Gerd U Auffarth
- Department of Ophthalmology, Heidelberg University Hospital, Heidelberg, Germany
| | - Ramin Khoramnia
- Department of Ophthalmology, Heidelberg University Hospital, Heidelberg, Germany
| |
Collapse
|
3
|
van de Wouw DS, de Jong B, van der Meulen IJE, van den Berg TJTP. Straylight in fish-eye disease: visual quality and angular dependence of straylight. Expert Review of Ophthalmology 2022. [DOI: 10.1080/17469899.2022.2098717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
| | - Bram de Jong
- Department of Ophthalmology, Amsterdam UMC, University of Amsterdam, Netherlands
| | - IJE van der Meulen
- Department of Ophthalmology, Amsterdam UMC, University of Amsterdam, Netherlands
| | | |
Collapse
|
4
|
Martino F, Castro‐Torres JJ, Casares‐López M, Ortiz‐Peregrina S, Ortiz C, Jiménez JR. Effect of interocular differences on binocular visual performance after inducing forward scattering. Ophthalmic Physiol Opt 2022; 42:730-743. [PMID: 35499140 PMCID: PMC9321610 DOI: 10.1111/opo.12992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 12/19/2022]
Abstract
Purpose To assess binocular visual performance by means of binocular summation on visual function after inducing monocular forward scattering, and to study the influence of interocular differences on ocular parameters. Methods Seven young healthy subjects were recruited. Four Bangerter foils and five fog filters were used to induce monocular forward scattering. To analyse the impact of the scatter, visual acuity, contrast sensitivity, visual discrimination capacity and distance stereoacuity were measured binocularly with the filter placed over the dominant eye. Additionally, interocular differences were calculated for four ocular parameters: the Objective Scatter Index (OSI), Strehl ratio (SR), modulation transfer function cut‐off (MTF cut off) and straylight (log[s]). Binocular summation was determined for these visual functions. Results A statistically significant deterioration in visual acuity, contrast sensitivity and stereoacuity was seen for all of the filter conditions with respect to the natural state (baseline), with the largest change being recorded for the Bangerter foils. Similarly, the interocular difference for the three retinal image quality parameters (OSI, SR and MTF cut‐off) and log(s) increased significantly for the Bangerter foil condition, but not for the fog filters (except log(s)). Binocular summation declined gradually with the Bangerter foils, but not for the fog filters. Statistically significant correlations were found, that is, the greater the interocular differences, the lower the binocular summation of the visual functions and the greater the distance stereoacuity. Conclusion Increased forward scattering in the dominant eye resulted in interocular differences, which reduced the overall binocular visual performance, including the binocular summation of several visual functions and distance stereoacuity. The results suggest that marked interocular differences in ocular parameters should be avoided in cases of ocular pathology, amblyopia and emmetropisation procedures (such as refractive surgery) or a monovision correction for presbyopia.
Collapse
Affiliation(s)
- Francesco Martino
- Laboratory of Vision Sciences and Applications (LabVisGra), Department of Optics University of Granada Granada Spain
| | - José J. Castro‐Torres
- Laboratory of Vision Sciences and Applications (LabVisGra), Department of Optics University of Granada Granada Spain
| | - Miriam Casares‐López
- Laboratory of Vision Sciences and Applications (LabVisGra), Department of Optics University of Granada Granada Spain
| | - Sonia Ortiz‐Peregrina
- Laboratory of Vision Sciences and Applications (LabVisGra), Department of Optics University of Granada Granada Spain
| | - Carolina Ortiz
- Laboratory of Vision Sciences and Applications (LabVisGra), Department of Optics University of Granada Granada Spain
| | - José R. Jiménez
- Laboratory of Vision Sciences and Applications (LabVisGra), Department of Optics University of Granada Granada Spain
| |
Collapse
|
5
|
Shah N, Dakin SC, Mulholland PJ, Racheva K, Matlach J, Anderson RS. The Effect of Induced Intraocular Stray Light on Recognition Thresholds for Pseudo-High-Pass Filtered Letters. Transl Vis Sci Technol 2022; 11:4. [PMID: 35511149 PMCID: PMC9078078 DOI: 10.1167/tvst.11.5.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The Moorfields Acuity Chart (MAC)—comprising pseudo-high-pass filtered “vanishing optotype” (VO) letters—is more sensitive to functional visual loss in age-related macular degeneration (AMD) compared to conventional letter charts. It is currently unknown the degree to which MAC acuity is affected by optical factors such as cataract. This is important to know when determining whether an individual's vision loss owes more to neural or optical factors. Here we estimate recognition acuity for VOs and conventional letters with simulated lens aging, achieved using different levels of induced intraocular light scatter. Methods Recognition thresholds were determined for two experienced and one naive participant with conventional and VO letters. Stimuli were presented either foveally or at 10 degrees in the horizontal temporal retina, under varying degrees of intraocular light scatter induced by white resin opacity-containing filters (WOFs grades 1 to 5). Results Foveal acuity only became significantly different from baseline (no filter) for WOF grade 5 with conventional letters and WOF grades 4 and 5 with VOs. In the periphery, no statistical difference was found for any stray-light level for both conventional and VOs. Conclusions Recognition acuity measured with conventional and VOs is robust to the effects of simulated lens opacification, and thus its higher sensitivity to neural damage should not simultaneously be confounded by such optical factors. Translational Relevance The MAC may be better able to differentiate between neural and optical deficits of visual performance, making it more suitable for the assessment of patients with AMD, who may display both types of functional visual loss.
Collapse
Affiliation(s)
- Nilpa Shah
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Steven C Dakin
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.,School of Optometry & Vision Science, University of Auckland, Auckland, New Zealand
| | - Pádraig J Mulholland
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.,Centre for Optometry and Vision Science, School of Biomedical Sciences, University of Ulster at Coleraine, N Ireland, UK
| | - Kalina Racheva
- Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Juliane Matlach
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.,Department of Ophthalmology, University Medical Centre, Johannes Gutenberg University Mainz, Germany
| | - Roger S Anderson
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.,Centre for Optometry and Vision Science, School of Biomedical Sciences, University of Ulster at Coleraine, N Ireland, UK
| |
Collapse
|
6
|
Holgueras A, Marcos M, Martínez-Plaza E, López-Miguel A, Mansilla A, Maldonado MJ. Mesopic Disability Glare in Stage-Two Dysfunctional Lens Syndrome. Ophthalmol Ther 2022. [PMID: 35107813 DOI: 10.1007/s40123-022-00462-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/12/2022] [Indexed: 12/31/2022] Open
Abstract
Introduction There is a lack of evidence about the exact deterioration of visual function associated with the age-related natural changes in the lens, particularly in intermediate (stage-2) dysfunctional lens syndrome (DLS). Standard photopic visual acuity and contrast sensitivity tests may not show the visual worsening in daily life activities, such as oncoming vehicle headlights at night. The purpose of this study was to analyze visual function under different conditions and glare sources in stage-2 DLS. Methods Forty patients over 49 years of age with initial bilateral lens opacification (Lens Opacities Classification System III [LOCS-III] scores up to 3), best-corrected visual acuity of 20/25 or better, and no ocular disease were evaluated. Binocular photopic and mesopic contrast sensitivity (CS) with/without halogen and xenon increasing glare sources were analyzed. Mesopic disability glare (MDG) was calculated as the difference between mesopic CS with/without the glare source. Results The median logarithmic CS (logCS) values were lower under mesopic conditions (1.05) than under photopic illumination (1.65; P < 0.001). Halogen and xenon glare further decreased mesopic CS (both, median logCS 0.75, P < 0.001). The mean MDG was 0.31 ± 0.10 log units for halogen glare and 0.33 ± 0.09 log units for xenon glare. The mesopic CS and MDG were not associated with any photopic test. The mesopic CS with glare but not photopic CS or mesopic CS was correlated with the LOCS-III scores. The best association was provided by MDG, which showed a pooled correlation with LOCS-III nuclear opalescence (r = 0.411, P < 0.001) and cortical scores (r = 0.226, P = 0.04). Conclusion The mesopic CS under a glare source is an independent early indicator of visual impairment in stage-2 DLS patients, and appears to be substantial. Furthermore, the MDG is more sensitive than photopic and mesopic CS for evaluating patients with initial phacosclerosis. Surgeons should consider this in the decision-making process of the correct timing for lens surgery.
Collapse
|
7
|
Affiliation(s)
| | - Kevin Shotliff
- Consultant Endocrinologist, Chelsea and Westminster Hospital London UK
| |
Collapse
|
8
|
Piñero DP, Molina-Martin A, Ramón ML, Rincón JL, Fernández C, de Fez D, Arenillas JF, Leal-Vega L, Coco-Martín MB, Maldonado MJ. Preliminary Evaluation of the Clinical Benefit of a Novel Visual Rehabilitation Program in Patients Implanted with Trifocal Diffractive Intraocular Lenses: A Blinded Randomized Placebo-Controlled Clinical Trial. Brain Sci 2021; 11:1181. [PMID: 34573202 DOI: 10.3390/brainsci11091181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 11/30/2022] Open
Abstract
The authors of this study evaluated the potential benefit on visual performance of a novel 3 week visual rehabilitation program based on the use of Gabor patches in patients undergoing bilateral cataract surgery with the implantation of two models of trifocal diffractive intraocular lens (IOL). A total of 30 patients were randomly assigned to two groups: a study group (15 patients) that used a videogame based on Gabor patches and a placebo group (15 patients) that used a videogame without specific stimuli for improving visual performance. No statistically significant differences between groups were found in distance, intermediate, and near post-training visual acuity (p ≥ 0.15). Significantly better distance contrast sensitivity (CS) was found for the spatial frequencies of 6 (p = 0.02) and 12 cpd (p = 0.01) in the study group. Likewise, significantly better values of near CS were found in the study group compared to the placebo group for the spatial frequency of 1.5 cpd (p = 0.02). In conclusion, a 3 week visual rehabilitation program based on the use of Gabor patches in the immediate postoperative period after the bilateral implantation of trifocal diffractive IOLs seems to be beneficial for improving both distance and near visual performance achieved with the implant.
Collapse
|
9
|
Łabuz G, Yildirim TM, Khoramnia R, Son H, Auffarth GU. Optical function of intraocular lenses in different opacification patterns: metrology analysis of 67 explants. J Cataract Refract Surg 2021; 47:1210-7. [DOI: 10.1097/j.jcrs.0000000000000553] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 12/05/2020] [Indexed: 11/25/2022]
|
10
|
Casares-López M, Castro-Torres JJ, Ortiz-Peregrina S, Martino F, Ortiz C. Changes in Visual Performance under the Effects of Moderate-High Alcohol Consumption: The Influence of Biological Sex. Int J Environ Res Public Health 2021; 18:6790. [PMID: 34202674 PMCID: PMC8297204 DOI: 10.3390/ijerph18136790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 01/14/2023]
Abstract
The purpose of this study was to analyze the changes in visual functions under the effects of moderate-high breath alcohol concentrations (BrACs), and the influence of biological sex on visual deterioration, considering different factors. A total of 37 healthy habitual alcohol users were enrolled in the experiment. The participants underwent a baseline session and a second session after an intake of 450 mL of red wine, so that all of them reached a BrAC above 0.25 mg/L. Visual performance was assessed by measuring the contrast sensitivity function, the halo perception, the stereopsis, and finally the retinal image quality. A Visual Deterioration Score (VDS) was calculated using the deterioration of these visual variables. All visual functions analyzed were significantly impaired following alcohol consumption (p < 0.05). The VDS was associated with the BrAC (ρ = -0.476). The VDS was also significantly higher in females, with the BrAC having a significant effect on the variability of the VDS in males and females (p < 0.05). However, the body mass index showed no significant effect (p > 0.05). Visual functions were significantly impaired under the influence of alcohol, and this deterioration was greater in females. The deterioration depends on the BrAC reached, being the primary thing responsible for the differences observed between males and females.
Collapse
Affiliation(s)
- Miriam Casares-López
- Laboratory of Vision Sciences and Applications, Department of Optics, Facultad de Ciencias (Edificio Mecenas), University of Granada, Avenida Fuentenueva s/n, 18071 Granada, Spain; (S.O.-P.); (F.M.); (C.O.)
| | - José J. Castro-Torres
- Laboratory of Vision Sciences and Applications, Department of Optics, Facultad de Ciencias (Edificio Mecenas), University of Granada, Avenida Fuentenueva s/n, 18071 Granada, Spain; (S.O.-P.); (F.M.); (C.O.)
| | | | | | | |
Collapse
|
11
|
Castro-Torres JJ, Martino F, Casares-López M, Ortiz-Peregrina S, Ortiz C. Visual performance after the deterioration of retinal image quality: induced forward scattering using Bangerter foils and fog filters. Biomed Opt Express 2021; 12:2902-2918. [PMID: 34123509 PMCID: PMC8176796 DOI: 10.1364/boe.424715] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 05/09/2023]
Abstract
We induced and evaluated different levels of retinal-image degradation using Bangerter foils and fog filters. We found increased straylight and an important deterioration in visual performance, assessed by means of visual acuity, contrast threshold, and visual discrimination capacity. Bangerter foils induced forward scattering levels comparable to those observed in mature to severe cataracts, with an important impact of halos and starbursts. Fog filters induced lower levels of intraocular scattering, although luminous veils and circular halos were reported. The visual disturbance index positively correlated with intraocular scattering and straylight. Our results show retinal-image quality has an important influence on night-vision performance.
Collapse
|
12
|
Łabuz G, Yildirim TM, Auffarth GU, Son HS, Khoramnia R. Laboratory evaluation of higher-order aberrations and light scattering in explanted opacified intraocular lenses. Eye Vis (Lond) 2021; 8:14. [PMID: 33883039 PMCID: PMC8061033 DOI: 10.1186/s40662-021-00235-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 03/16/2021] [Indexed: 11/10/2022]
Abstract
Background Intraocular lens (IOL) calcification is a serious condition that can only be treated by removing the clouded lens. Since explantation bears the risk of complications, it is often deferred until the patient finds the symptoms intolerable. Usually, as the IOL opacifies, visual acuity is minimally affected early on. In this study, we assessed the impact of IOL opacification on optical quality. Methods We analyzed ten opacified explanted IOLs (Oculentis GmbH). Wavefront aberrations were obtained with a SHSOphthalmic device (Optocraft GmbH), which features a Hartmann-Shack sensor. The root mean square (RMS) of higher-order aberrations (HOAs) was compared. The effect of calcification on image quality was assessed through the Strehl ratio (SR). We detected light scattering with a C-Quant (Oculus GmbH) and expressed it as a straylight parameter. Results At 2 mm, 3 mm and 4 mm, the mean RMS (±standard deviation) was 0.033 μm (±0.026 μm), 0.044 μm (±0.027), and 0.087 μm (±0.049), respectively. The mean SR value was 0.81 ± 0.15 at 3 mm, with four IOLs showing a nearly diffraction-limited performance, but in two explants, opacification precluded reliable measurements. Increased straylight was found in all opacified IOLs with a mean value of 150.2 ± 56.3 deg2/sr at 3 mm. Conclusions We demonstrated that IOL opacification induces HOAs. However, the RMS remained low, which resulted only in a slight reduction of the SR-derived optical quality. On the other hand, we found a severe straylight elevation in the opacified lenses, which may result in dysphotopsia, such as glare, and subjective complaints, despite good visual acuity.
Collapse
Affiliation(s)
- Grzegorz Łabuz
- David J Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Timur M Yildirim
- David J Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Gerd U Auffarth
- David J Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Hyeck-Soo Son
- David J Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Ramin Khoramnia
- David J Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| |
Collapse
|
13
|
Ortiz-Peregrina S, Ortiz C, Casares-López M, Castro-Torres JJ, Jiménez del Barco L, Anera RG. Impact of Age-Related Vision Changes on Driving. Int J Environ Res Public Health 2020; 17:ijerph17207416. [PMID: 33053876 PMCID: PMC7601873 DOI: 10.3390/ijerph17207416] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/07/2020] [Accepted: 10/09/2020] [Indexed: 12/05/2022]
Abstract
Aging leads to impaired visual function, which can affect driving—a very visually demanding task—and has a direct impact on an individual’s quality of life if their license is withdrawn. This study examined the associations between age-related vision changes and simulated driving performance. To this end, we attempted to determine the most significant visual parameters in terms of evaluating elderly drivers’ eyesight. Twenty-one younger drivers (aged 25–40) were compared to 21 older drivers (aged 56–71). Study participants were assessed for visual acuity, contrast sensitivity, halos, and intraocular straylight, which causes veiling luminance on the retina and degrades vision. Driving performance was evaluated using a driving simulator. The relationships between simulated driving performance and the visual parameters tested were examined with correlation analyses and linear regression models. Older drivers presented impairment in most visual parameters (p < 0.05), with straylight being the most significantly affected (we also measured the associated effect size). Older drivers performed significantly worse (p < 0.05) in the simulator test, with a markedly lower performance in lane stability. The results of the multiple linear regression model evidenced that intraocular straylight is the best visual parameter for predicting simulated driving performance (R2 = 0.513). Older drivers have shown significantly poorer results in several aspects of visual function, as well as difficulties in driving simulator performance. Our results suggest that the non-standardized straylight evaluation could be significant in driver assessments, especially at the onset of age-related vision changes.
Collapse
|
14
|
Hammond BR, Buch J, Hacker L, Cannon J, Toubouti Y, Renzi-Hammond LM. The effects of light scatter when using a photochromic vs. non-photochromic contact lens. J Optom 2020; 13:227-234. [PMID: 32331922 PMCID: PMC7520527 DOI: 10.1016/j.optom.2020.03.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 05/23/2023]
Abstract
PURPOSE To assess the visual effects of wearing both an activated and an inactivated photochromic contact lens, with a direct comparison to a non-photochromic contact lens worn in the fellow eye. This study focused on the visual effects of scatter quantified as the minimum distance between two points of light, and the diameter of the halo and starbursts that surround a bright white point source. METHODS 60 subjects (aged 18-65 years) were measured in a contralateral design where lens type was randomly assigned, one type to each eye. During activated testing, all visual measures of both study lenses were made while each eye was illuminated by a violet (λmax=365, half bandwidth 20nm) activator, which caused steady-state activation of the photochromic lens during the period of testing. Two-point thresholds were determined by measuring the minimum distance between two points of broadband xenon light. Glare geometry was measured using an aperture (∼4mm) that created a bright point source of light 45 inches from the plane of the eye. Between the point source and subject, a centering precision caliper was used to measure lateral spread of halos (diffusion around the source) and visual spokes. The head was stabilized using an adjustable head-rest assembly and the eye was aligned and monitored with a bore camera. RESULTS Compared to the non-photochromic lens, and based on the stimulus conditions used in these measurements, the activated and inactivated photochromic lens reduced the light spread using the two-point threshold technique by 32% and 19% respectively; the diameter of the halos were reduced by 44% and 16% respectively; and the spokes were narrowed by 39% and 20% respectively. Based on 95% confidence interval testing, these effects were all statistically significant (p<0.05). CONCLUSIONS These results are consistent with previous data showing that soft contact lenses with a photochromic additive can improve many aspects of visual function, consistent with their level or activation. Our past data focused on visual function under bright light conditions (e.g., glare disability, discomfort, photostress recovery and chromatic contrast) with an activated photochromic. In this study, we found differences even in the inactivated state, using less intense stimuli (10cd/m2 at the source). This suggests that the photochromic lens improves the effects of light scatter even at lower luminance.
Collapse
Affiliation(s)
- Billy R Hammond
- Vision Sciences Laboratory, Behavioral and Brain Sciences Program, Department of Psychology, The University of Georgia, United States
| | - John Buch
- Johnson and Johnson Vision Care, Inc., United States
| | | | | | | | - Lisa M Renzi-Hammond
- Human Biofactors Laboratory, Institute of Gerontology, Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, United States.
| |
Collapse
|
15
|
Středová M, Řeháková T, Veliká V, Rozsíval P, Hejsek L, Jirásková N. Evaluation of retinal light scattering, visual acuity, refraction and subjective satisfaction in patients after Acrysof IQ PanOptix intraocular lens implantation. Cesk Slov Oftalmol 2020; 75:316-322. [PMID: 32911947 DOI: 10.31348/2019/6/4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM To evaluate the retinal light scattering, visual acuity, refraction and subjective satisfaction in patients after implantation of Acrysof IQ PanOptix intraocular lens. METHODS Our group included 32 eyes of 21 patients who underwent cataract surgery or refractive lensectomy with Acrysof IQ PanOptix multifocal intraocular lens implantation at the Ophthalmology Clinic of Faculty Hospital Hradec Králové during the time from September 2015 to December 2017. The observed parameters were visual acuity, subjective refraction, retinal light scattering and patient subjective satisfaction. Preoperative refractive values and visual acuity values were compared with results obtained on day 1, 1 month and at an average of 27 months postoperatively. Subjective satisfaction and degree of light scattering on the retina were evaluated at the end of the follow-up period. RESULTS Preoperative, uncorrected distant visual acuity improved from an average of 0,51 ± 0,29 (expressed in decimal values) to 0,94 ± 0,10 at the end of the follow-up period. Preoperative best-corrected distance visual acuity improved from an average of 0,95 ± 0,19 to 1,00 ± 0,09 at the end of the follow-up period. The mean value of preoperative uncorrected near visual acuity was 8,29 ± 4,93 of Jaeger charts, the mean value of uncorrected near visual acuity at the end of the follow-up period was 1,00 ± 0 of Jaeger charts. Subjective satisfaction was assessed using a standardized VF-14 questionnaire at least 1 year after surgery (mean follow-up of 27 months). Retinal light scattering was examined using an Oculus C-Quant instrument. The retinal light scattering value in our sample was 1,12 ± 0,19. In only 6 eyes of 4 patients, the resulting value was outside the physiological range used for eyes with lens crystallina Conclusion: The value of light scattering on the retina is a factor affecting the degree of sensitivity to glare after implantation of multifocal intraocular lenses. In our group, we observed a deviation from the physiological range of retinal light scattering in only 6 eyes of 4 patients, but this did not lead to a deterioration in subjective postoperative satisfaction.
Collapse
|
16
|
Casares-López M, Castro-Torres JJ, Martino F, Ortiz-Peregrina S, Ortiz C, Anera RG. Contrast sensitivity and retinal straylight after alcohol consumption: effects on driving performance. Sci Rep 2020; 10:13599. [PMID: 32788613 PMCID: PMC7423611 DOI: 10.1038/s41598-020-70645-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 07/30/2020] [Indexed: 01/11/2023] Open
Abstract
In this study, we aimed to investigate the effects of alcohol intake on visual function and driving performance, as well as on the relationship between these. A total of 40 healthy participants took part in three experimental sessions: one baseline session and two further sessions after consuming two different quantities of alcohol (300 ml and 450 ml of red wine). The breath alcohol content (BrAC) was measured using a breath analyzer. The contrast sensitivity and retinal straylight due to the forward intraocular scattering were measured to characterize visual function, and driving performance was assessed in three different scenarios using a driving simulator. The results showed a deterioration in contrast sensitivity and retinal straylight after drinking alcohol, in addition to an impaired ability to drive, especially for the highest alcohol intake. We also observed that the deteriorated driving performance was a function of the contrast sensitivity and retinal straylight under the effects of alcohol, indicating that these visual variables can partially predict driving performance in these conditions.
Collapse
Affiliation(s)
- Miriam Casares-López
- Laboratory of Vision Sciences and Applications, Department of Optics, Facultad de Ciencias (Edificio Mecenas), University of Granada, Avenida Fuentenueva s/n, 18071, Granada, Spain
| | - José J Castro-Torres
- Laboratory of Vision Sciences and Applications, Department of Optics, Facultad de Ciencias (Edificio Mecenas), University of Granada, Avenida Fuentenueva s/n, 18071, Granada, Spain.
| | - Francesco Martino
- Laboratory of Vision Sciences and Applications, Department of Optics, Facultad de Ciencias (Edificio Mecenas), University of Granada, Avenida Fuentenueva s/n, 18071, Granada, Spain
| | - Sonia Ortiz-Peregrina
- Laboratory of Vision Sciences and Applications, Department of Optics, Facultad de Ciencias (Edificio Mecenas), University of Granada, Avenida Fuentenueva s/n, 18071, Granada, Spain
| | - Carolina Ortiz
- Laboratory of Vision Sciences and Applications, Department of Optics, Facultad de Ciencias (Edificio Mecenas), University of Granada, Avenida Fuentenueva s/n, 18071, Granada, Spain
| | - Rosario G Anera
- Laboratory of Vision Sciences and Applications, Department of Optics, Facultad de Ciencias (Edificio Mecenas), University of Granada, Avenida Fuentenueva s/n, 18071, Granada, Spain
| |
Collapse
|
17
|
Yildirim TM, Fang H, Schickhardt SK, Wang Q, Merz PR, Auffarth GU. Glistening formation in a new hydrophobic acrylic intraocular lens. BMC Ophthalmol 2020; 20:186. [PMID: 32375708 PMCID: PMC7204243 DOI: 10.1186/s12886-020-01430-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 04/13/2020] [Indexed: 11/10/2022] Open
Abstract
Background The formation of fluid-filled microvacuoles, termed glistenings, is a common complication of intraocular lenses (IOLs) made from hydrophobic acrylate. Using our well-established in-vitro laboratory method, we evaluated a new IOL material’s resistance to glistening formation. Methods An in-vitro stress test for glistening induction was performed on 20 samples of hydrophobic acrylic IOLs: ten of the new Eyecryl ASHFY600 (Biotech Vision Care, Ahmedabad, India) compared with ten samples of AcrySof IQ SN60WF (Alcon, Fort Worth, USA). The number of microvacuoles per square millimetre (MV/mm2) was evaluated in five sections of each IOL. The results for each model were compared and rated on a modified Miyata Scale for grading glistening severity. Results In all cases, glistening number was higher in the central section of the IOL optic than in the periphery. Mean number of MV/mm2 was highest in the central part of the AcrySof IQ SN60WF, with 41.84 (±27.67) MVs/mm2. The lowest number of glistenings was found in the five sections of the Eyecryl ASHFY600 with 0.52 (±0.24) MVs/mm2. Mean value of the Eyecryl ASHFY600 IOL, using the Miyata Scale, was Zero. Conclusion In this in-vitro laboratory study, the new hydrophobic acrylic IOL showed a high resistance to microvacuole formation. Results from this in-vitro study suggest that glistening numbers will be low in clinical use in the Eyecryl ASHFY600.
Collapse
Affiliation(s)
- Timur M Yildirim
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Hui Fang
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Sonja K Schickhardt
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Qiang Wang
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.,Department of Ophthalmology, The Third Affiliated Hospital of Wenzhou Medical University, 108# Wansong Road, Rui'an, Zhejiang, 325200, China
| | - Patrick R Merz
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Gerd U Auffarth
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| |
Collapse
|
18
|
Li J, Yu Z, Song H. The Effect of Capsulotomy Shape on Intraocular Light-Scattering after Nd:YAG Laser Capsulotomy. J Ophthalmol 2020; 2020:4153109. [PMID: 32280520 DOI: 10.1155/2020/4153109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 02/14/2020] [Accepted: 02/15/2020] [Indexed: 11/20/2022] Open
Abstract
Purpose To investigate the effects of capsulotomy shape on the visual acuity and visual quality after neodymium: yttrium aluminum garnet laser capsulotomy. Methods In this study, a total of 42 eyes from 35 patients with posterior capsule opacification were divided into the circular and cruciate groups. The corrected distance visual acuity (CDVA), objective scatter index (OSI), modulation transfer function cutoff (MTF cutoff), Strehl ratio, and Optical Quality Analysis System values at contrasts of 100%, 20%, and 9% (OV-100, OV-20, and OV-9) were measured at precapsulotomy and 1 week and 1 month postcapsulotomy. The pseudophakic dysphotopsia questionnaire (PDQ) was used to evaluate the subjects' satisfaction with treatment. Results OSI values were significantly higher in the cruciate group than in the circular group at 1 week and 1 month after capsulotomy (P=0.013 and P < 0.001). No significant difference was found in the OSI values between the two groups before capsulotomy (t = 0.52; P=0.61). The decrease in OSI was higher in the circular group than in the cruciate group at 1 week and 1 month after capsulotomy (P=0.036 and P=0.019). No significant differences were found in the Strehl ratio, MTF cutoff, CDVA, OV-100, OV-20, and OV-9 between the two groups at 1 week and 1 month after capsulotomy (P > 0.05). The PDQ results showed that patients with circular-shaped capsulotomy complained less with intolerance of bright lights than those with cruciate-shaped capsulotomy. Conclusions Circular-shaped capsulotomy can induce less intraocular light scattering and increase patient satisfaction.
Collapse
|
19
|
Łabuz G, Knebel D, Auffarth GU, Fang H, van den Berg TJ, Yildirim TM, Son HS, Khoramnia R. Glistening Formation and Light Scattering in Six Hydrophobic-Acrylic Intraocular Lenses. Am J Ophthalmol 2018; 196:112-120. [PMID: 30189220 DOI: 10.1016/j.ajo.2018.08.032] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/16/2018] [Accepted: 08/24/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE To study the glistening formation in various hydrophobic-acrylic intraocular lens (IOL) models, and to evaluate the effect of glistenings on light scattering in these IOLs. DESIGN Laboratory investigation. METHODS The susceptibility of the hydrophobic-acrylic material to develop glistenings was evaluated in 6 IOL models. Accelerated lens aging was induced by immersing the IOLs in a solution at 45 C for 24 hours and cooled to 37 C for 2.5 hours. Light microscopy and image acquisition were performed. Glistening statistics-that is, microvacuoles' (MV) number and size-were derived from image analysis. Light scattering was measured using a clinical device featuring an adaptation for in vitro IOL assessment. RESULTS The number of glistenings differed among the studied IOLs and ranged from 0 to 3532 MV/mm2. In 1 model, glistenings were found only at the periphery, with diffuse light scattering observed centrally despite the absence of microvacuoles. The mean size of glistenings ranged from 5.2 to 10.2 μm. The mean straylight parameter of the IOLs increased from 0.6 to 5.0 deg2/sr after accelerated aging. Straylight elevation demonstrated a proportional relationship with the glistening number. CONCLUSIONS We showed that hydrophobic-acrylic lenses differ in their resistance to glistenings, as one group proved to be glistening-free, but the other models revealed varying grades of glistenings. Moreover, we demonstrated that the presence of glistenings results in increased straylight, and that straylight proportionally depends on the glistenings number irrespective of the IOL model. However, more research is needed to confirm that the relationship we found holds for all hydrophobic-acrylic IOLs.
Collapse
Affiliation(s)
- Grzegorz Łabuz
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Dominik Knebel
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Gerd U Auffarth
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany.
| | - Hui Fang
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Thomas Jtp van den Berg
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, Netherlands
| | - Timur M Yildirim
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Hyeck-Soo Son
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Ramin Khoramnia
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
20
|
Ortiz C, Ortiz-Peregrina S, Castro JJ, Casares-López M, Salas C. Driver distraction by smartphone use (WhatsApp) in different age groups. Accid Anal Prev 2018; 117:239-249. [PMID: 29723735 DOI: 10.1016/j.aap.2018.04.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 04/11/2018] [Accepted: 04/14/2018] [Indexed: 05/24/2023]
Abstract
This paper investigates the effect that texting with WhatsApp, one of the most common applications for instant messaging, exerts on driving performance. Because distracted driving also affects older drivers, who can have seriously compromised vision, we also analysed the associations between visual-function parameters and driving performance. A total of 75 drivers, experienced in sending WhatsApp messages (≥10WhatsApp messages/week), participated in this study and were divided into four age categories. Visual-function tests included contrast sensitivity with and without glare, retinal straylight and objective assessment of optical quality. Simulated driving performance was assessed under a baseline driving condition (without distraction) as well as a texting condition (WhatsApp messages) while driving. The participants used their own mobile phone. Lastly, objective results of driving performance were compared with subjective self-report data from the Driver Behaviour Questionnaire (DBQ). The analysis indicated that functional changes occurring with age, such as a lower contrast sensitivity and greater retinal straylight, were correlated with a higher number of collisions, longer distances driven outside the lane, and greater standard deviation of lateral position (SDLP). The results showed a significant main effect of age for the driving-performance parameters. Also, compared to the baseline, texting WhatsApp messages while driving worsens driving performance for all age groups, most notably among older participants. Thus, the older drivers' SDLP was ∼14% higher than that for the baseline average of all the other drivers and rose to 29% under distraction, reflecting the impact of secondary tasks. The negative effect of the use of the smartphone during driving was also reflected in the number of collisions, with a greater risk of accidents in all the groups of drivers (by 8.3% for young adults, 25.0% for adults, 80.5% for middle-aged adults, and 134.5% for older drivers). Lastly, participants' subjective responses indicated that younger drivers (18-24 years) had a higher risk of deliberately violating safe driving practices (p < 0.05). The present study demonstrates that texting WhatsApp messages while driving significantly impairs the ability to drive safely, with older drivers being the group most adversely affected. It would be recommendable to include other nonstandard vision tests, which have shown associations with driving performance, in the examination for driver licensing. This would help raise the awareness of older drivers concerning their visual limitations, permitting them to adopt compensatory measures to improve their driving safety. Nevertheless, it is also necessary to raise awareness among the younger drivers of the risks involved in behaviour behind the wheel.
Collapse
Affiliation(s)
- C Ortiz
- Department of Optics, Laboratory of Vision Sciences and Applications, University of Granada, Granada, 18071, Spain.
| | - S Ortiz-Peregrina
- Department of Optics, Laboratory of Vision Sciences and Applications, University of Granada, Granada, 18071, Spain
| | - J J Castro
- Department of Optics, Laboratory of Vision Sciences and Applications, University of Granada, Granada, 18071, Spain
| | - M Casares-López
- Department of Optics, Laboratory of Vision Sciences and Applications, University of Granada, Granada, 18071, Spain
| | - C Salas
- Department of Optics, Laboratory of Vision Sciences and Applications, University of Granada, Granada, 18071, Spain
| |
Collapse
|
21
|
Kanai M, Koh S, Masuda D, Koseki M, Nishida K. Clinical features and visual function in a patient with Fish-eye disease: Quantitative measurements and optical coherence tomography. Am J Ophthalmol Case Rep 2018; 10:137-141. [PMID: 29687088 PMCID: PMC5910509 DOI: 10.1016/j.ajoc.2018.02.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 02/20/2018] [Accepted: 02/21/2018] [Indexed: 11/28/2022] Open
Abstract
Purpose We describe a case of fish-eye disease (FED) where the clinical features and visual function were investigated using anterior segment optical coherence tomography (OCT) and quantitative measurements. Observations A 36-year-old Japanese woman with FED presented with bilateral corneal opacities and visual complaints. Both contrast sensitivity and straylight were measured and OCT imaging was performed. Contrast sensitivity and straylight measurements revealed remarkably decreased visual function, despite good visual acuity. OCT demonstrated homogenously hyper-reflective corneal opacification, and a normal total corneal thickness. Conclusions and Importance The findings from this case suggest that OCT is useful for analyzing the clinical features of FED, and that the quantitative measurement of visual function furthers the understanding of vision-related symptoms in FED, despite good visual acuity.
Collapse
Affiliation(s)
- Masanori Kanai
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shizuka Koh
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.,Department of Innovative Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Daisaku Masuda
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masahiro Koseki
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.,Health Care Division, Health and Counseling Center, Osaka University, Japan
| | - Kohji Nishida
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
| |
Collapse
|
22
|
van den Berg TJTP. Intraocular light scatter, reflections, fluorescence and absorption: what we see in the slit lamp. Ophthalmic Physiol Opt 2018; 38:6-25. [PMID: 29265476 DOI: 10.1111/opo.12426] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 10/22/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE Much knowledge has been collected over the past 20 years about light scattering in the eye- in particular in the eye lens- and its visual effect, called straylight. It is the purpose of this review to discuss how these insights can be applied to understanding the slit lamp image. RESULTS The slit lamp image mainly results from back scattering, whereas the effects on vision result mainly from forward scatter. Forward scatter originates from particles of about wavelength size distributed throughout the lens. Most of the slit lamp image originates from small particle scatter (Rayleigh scatter). For a population of middle aged lenses it will be shown that both these scatter components remove around 10% of the light from the direct beam. For slit lamp observation close to the reflection angles, zones of discontinuity (Wasserspalten) at anterior and posterior parts of the lens show up as rough surface reflections. All these light scatter effects increase with age, but the correlations with age, and also between the different components, are weak. For retro-illumination imaging it will be argued that the density or opacity seen in areas of cortical or posterior subcapsular cataract show up because of light scattering, not because of light loss. NOTES: (1) Light scatter must not be confused with aberrations. Light penetrating the eye is divided into two parts: a relatively small part is scattered, and removed from the direct beam. Most of the light is not scattered, but continues as the direct beam. This non-scattered part is the basis for functional imaging, but its quality is under the control of aberrations. Aberrations deflect light mainly over small angles (<1°), whereas light scatter is important because of the straylight effects over large angles (>1°), causing problems like glare and hazy vision. (2) The slit lamp image in older lenses and nuclear cataract is strongly influenced by absorption. However, this effect is greatly exaggerated by the light path lengths concerned. This obviates proper judgement of the functional importance of absorption, and hinders the appreciation of the Rayleigh nature of what is seen in the slit lamp image.
Collapse
Affiliation(s)
- Thomas J T P van den Berg
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| |
Collapse
|
23
|
Abstract
PURPOSE Multifocal contact lenses have been growing in popularity as a modality to correct presbyopic eyes, although visual side effects such as disability glare have been reported. The objective of this study was to investigate the effect of multifocal contact lenses on disability glare by means of ocular straylight. METHODS A prospective randomized, comparative study was performed that included 16 subjects free of ocular pathology. Straylight was measured using a commercial straylight meter with the natural and dilated pupil. Participants were fitted with Proclear Multifocal (Distance/Near), ACUVUE Oasys for Presbyopia, and Air Optix Aqua Multifocal randomized to the left or right eye. Straylight measurements were repeated with the contact lens in situ after the pupil dilation. Results obtained with the dilated pupil without contact lens acted as a control. RESULTS Diameter of the natural and dilated pupil was 2.87 ± 0.40 mm and 7.45 ± 0.86 mm, respectively (P < .001). After pupil dilation, straylight increased from 0.92 ± 0.13 log(s) to 1.04 ± 0.11 log(s) (P < .001). Of the four studied lenses, a significant difference was only found between Air Optix and the control group (P = .006). The latter showed also slightly increased light scatter. CONCLUSIONS A difference in measured straylight was found between the studied multifocal lenses. The observed variability and the straylight-pupil size dependency should be taken into account to avoid elevated straylight in multifocal contact lens wearers. The reason for the observed differences in straylight must be the subject of future studies.
Collapse
|
24
|
Abstract
PURPOSE To investigate the individual effects of forward light scatter (FLS) and refractive blur on low-contrast vision and the size of the disk halo produced in response to an external glare source. METHODS Monocular disk halo radius, high- and low-contrast distance visual acuity (HCVA, LCVA), and contrast sensitivity (CS) were determined in 25 eyes of 25 healthy subjects under normal, FLS, and blur conditions. FLS was induced using the filter Black ProMist 2 to simulate an early cataract. Blur was induced using a +1.00 diopter lens to simulate an uncorrected refractive error. RESULTS Similar significant mean increases in halo radius were observed for the FLS (0.32 ± 0.10 log arc min; P < .0001) and refractive blur (0.40 ± 0.18 log arc min; P < .0001). Under induced blur, 3 lines of HCVA (0.32 ± 0.15 logMAR; P < .0001) and 4 lines of LCVA (0.39 ± 0.16 logMAR; P < .0001) were lost. FLS had a minimal (but significant) effect on HCVA, but worsened mean LCVA by more than 1 line (0.13 ± 0.10 logMAR; P < .0001). Similar significant mean CS reductions of 0.17 ± 0.12 (P < .0001) and 0.14 ± 0.12 log units (P < .0001) were produced in response to FLS and refractive blur, respectively (approximately 1 triplet). CONCLUSIONS Forward light scatter and refractive blur contributed to an increased size of the disk halo produced by a glare source in similar proportion. Although defocus blur has a substantial effect on LCVA, a loss of more than 1 line of LCVA after best refractive correction would be indicative of FLS.
Collapse
|
25
|
Gholami S, Reus NJ, van den Berg TJTP. Changes in Intraocular Straylight and Visual Acuity with Age in Cataracts of Different Morphologies. J Ophthalmol 2017; 2017:5649532. [PMID: 28831307 DOI: 10.1155/2017/5649532] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 06/07/2017] [Indexed: 11/22/2022] Open
Abstract
Purpose To investigate the significance of difference in straylight of cataract eyes with different morphologies, as a function of age and visual acuity. Methods A literature review to collect relevant papers on straylight, age, and visual acuity of three common cataract morphologies leads to including five eligible papers for the analysis. The effect of morphology was incorporated to categorize straylight dependency on the two variables. We also determined the amount of progression in a cataract group using a control group. Results The mean straylight was 1.22 log units ± 0.20 (SD) in nuclear (592 eyes), 1.26 log units ± 0.23 in cortical (776 eyes), and 1.48 log units ± 0.34 in posterior subcapsular (75 eyes) groups. The slope of straylight-age relationship was 0.009 (R2 = 0.20) in nuclear, 0.012 (R2 = 0.22) in cortical, and 0.014 (R2 = 0.11) in posterior subcapsular groups. The slope of straylight-visual acuity relationship was 0.62 (R2 = 0.25) in nuclear, 0.33 (R2 = 0.13) in cortical, and 1.03 (R2 = 0.34) in posterior subcapsular groups. Conclusion Considering morphology of cataract provides a better insight in assessing visual functions of cataract eyes, in posterior subcapsular cataract, particularly, in spite of notable elevated straylight, visual acuity might not manifest severe loss.
Collapse
|
26
|
Abstract
Diabetic retinopathy is the most common cause of vision loss in people with diabetes mellitus; however, other causes of visual impairment/loss include other retinal and non-retinal visual problems, including glaucoma, age-related macular degeneration, non-arteritic anterior ischaemic optic neuropathy and cataracts. Additionally, when a person with diabetes complains of visual disturbance despite a visual acuity of 6/6, abnormalities in refraction, contrast sensitivity, straylight and amplitude of accommodation should be considered. We review and highlight these visual problems for physicians who manage people with diabetes to ensure timely referral and treatment to limit visual disability, which can have a significant impact on daily living, especially for those participating in sports and driving.
Collapse
Affiliation(s)
- A Khan
- Weill Cornell Medicine-Qatar, Doha, Qatar
| | | | | | - R A Malik
- Weill Cornell Medicine-Qatar, Doha, Qatar
| |
Collapse
|
27
|
van den Berg TJTP. The (lack of) relation between straylight and visual acuity. Two domains of the point-spread-function. Ophthalmic Physiol Opt 2017; 37:333-341. [PMID: 28271538 DOI: 10.1111/opo.12368] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 02/07/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE The effect of cataract and other media opacities on functional vision is typically assessed clinically using visual acuity. In both clinical and basic research, straylight (the functional result of light scattering in the eye) is commonly measured. The purpose of the present study was to determine the link between these two measures: is visual acuity in cataract and other media opacities related to straylight? METHODS Interdependence between acuity and straylight is addressed from three different points of view: (1) Methodological: can acuity differences affect the measurement value of straylight, and vice versa? (2) Basic optics: does the optical process of light scattering in the human eye affect both straylight and visual acuity? (3) Statistical: how strongly are acuity and straylight correlated in the practice of important clinical conditions? Experimental and theoretical aspects will be considered, with a focus on normal ageing and cataract formation. RESULTS (1) Methodological: testing potential effects of acuity, artificially manipulated with positive trial lenses, showed no effect on measured straylight values. Since light scattering in the eye involves a low percentage of the light and has large angular spreading, contrast reduction due to straylight is limited, resulting in virtually absent acuity effects. (2) Basic optics: light scattering from the human donor eye lens is found to have virtually no effect in the centre of the point-spread-function, also for cataractous lenses, resulting in virtually absent acuity effects. (3) Statistical: literature data on straylight and visual acuity show a weak correlation for the important groups of normal ageing and cataract populations. CONCLUSIONS The point-spread-function of the normal ageing and cataractous human eye is built upon two rather independent basic parts. Aberrations control the central peak. Light scattering controls the periphery from about 1° onwards. The way acuity and straylight are measured ensures no confounding between them. Statistically within the normal ageing and cataract populations, visual acuity and straylight vary quite independently from each other. Visual acuity losses with cataract and other media opacities are not due to straylight, but caused by aberrations and micro-aberrations. Straylight defines disability glare, and causes symptoms of glare, haloes, hazy vision etc. Overall, visual acuity and straylight are rather independent aspects of quality of vision.
Collapse
Affiliation(s)
- Thomas J T P van den Berg
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| |
Collapse
|
28
|
Zhu X, Ye H, He W, Yang J, Dai J, Lu Y. Objective functional visual outcomes of cataract surgery in patients with good preoperative visual acuity. Eye (Lond) 2017; 31:452-9. [PMID: 27858933 DOI: 10.1038/eye.2016.239] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 08/30/2016] [Indexed: 12/22/2022] Open
Abstract
PurposeTo explore the objective functional visual outcomes of cataract surgery in patients with good preoperative visual acuity.MethodsWe enrolled 130 cataract patients whose best-corrected visual acuity (BCVA) was 20/40 or better preoperatively. Objective visual functions were evaluated with a KR-1W analyzer before and at 1 month after cataract surgery.ResultsThe nuclear (N), cortical (C), and N+C groups had very high preoperative ocular and internal total high-order aberrations (HOAs), coma, and abnormal spherical aberrations. At 1 month after cataract surgery, in addition to the remarkable increase of both uncorrected visual acuity and BCVA, both ocular and internal HOAs in the three groups decreased significantly after cataract surgery (all P<0.05). Point spread function and modulation transfer functions were also improved significantly in these patients (all P<0.05).ConclusionsThe objective functional vision of patients with 20/40 or better preoperative BCVA improved significantly after cataract surgery. This finding shows that the arbitrary threshold of BCVA worse than 20/40 in China cannot always be used to determine who will benefit from cataract surgery.
Collapse
|
29
|
Cochener B, Patel SR, Galliot F. Correlational Analysis of Objective and Subjective Measures of Cataract Quantification. J Refract Surg 2016; 32:104-9. [PMID: 26856427 DOI: 10.3928/1081597x-20151222-01] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 11/10/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate whether correlations exist between objective and subjective measures of vision quality as a consequence of cataract and whether this may qualify the Objective Scatter Index as a supplementary means of cataract assessment. METHODS A prospective multicenter, cross-sectional study was conducted in 10 centers across France in patients undergoing cataract extraction surgery (lens opacity evaluated with the Lens Opacities Classification System III). A quality of life assessment using the Visual Function Index-14 (VF-14) (14 questions scored from 0 to 4) and measurement of visual acuity and evaluation of the Objective Scatter Index (HD Analyzer, Visiometrics SL, Terrassa, Spain) to assess the alteration of light scatter were used as measures in the study. RESULTS The study included 1,768 eyes of 1,768 patients (mean age: 72.5 years; range: 28 to 93 years). The average OSI score was 4.97 ± 3.13 (range: 0.4 to 20.5). There was good correlation between visual acuity and OSI (r = -0.47, P < .001) and between OSI and VF-14 (r = -0.11, P < .001). CONCLUSIONS The results presented in this study confirm that the Objective Scatter Index has sufficient correlations with visual acuity and VF-14 to supplement existing cataract diagnosis in a large population encompassing a broad spectrum of cataract presentations.
Collapse
|
30
|
van de Wouw DS, van der Meulen IJE, van Vliet JMJ, Lapid-gortzak R, Nieuwendaal CP, van den Berg TJTP. Increased Straylight in Patients With Keratoconjunctivitis Sicca. Cornea 2016; 35:749-53. [DOI: 10.1097/ico.0000000000000828] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
31
|
Rozema JJ, Sanchez V, Artal N, Gramajo AL, Torres E, Luna JD, Iribarren R, Tassignon MJ, Juarez CP; PROVIM Study Group. Lens opacity based modelling of the age-related straylight increase. Vision Res 2015; 117:25-33. [PMID: 26459146 DOI: 10.1016/j.visres.2015.08.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 08/04/2015] [Accepted: 08/10/2015] [Indexed: 11/20/2022]
Abstract
This work studies ethnic and geographical differences in the age-related straylight increase by means of a stochastic model and unpublished lens opacity data of 559 residents of Villa Maria (Argentina), as well as data of 912 Indonesian subjects published previously by Husain et al. For both cohorts the prevalence of each type and grade of lens opacity was determined as a function of age, from which a stochastic model was derived capable of simulating the lens opacity prevalence for both populations. These simulated lens opacity data were then converted to estimated straylight by means of an equation derived from previously recorded data of 107 eyes with varying degrees of cataract. Based on these opacity templates 2500 random sets of subject age and lens opacity data were generated by the stochastic model for each dataset, from which estimated straylight could be calculated. For the Argentinian data the estimated straylight was found to closely resemble the published models for age-related straylight increase. For younger eyes the straylight variation of the model was the same as what was previously published (in both cases ±0.200logunits), which doubled in size for older eyes. For the Indonesian data, however, this age-related straylight increase was found to be fundamentally different from the published age model. This suggests that current normative curves for age-related straylight increase may not always be appropriate for non-European populations, and that the inter-individual straylight variations in young, healthy eyes may possibly be due to variations in lens opacities.
Collapse
|
32
|
Hwang HB, Yim HB, Chung SK. Effect of diabetic retinopathy and diabetes on the intraocular straylight in pseudophakic eyes. BMC Ophthalmol 2015; 15:130. [PMID: 26464020 PMCID: PMC4604714 DOI: 10.1186/s12886-015-0120-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 09/29/2015] [Indexed: 11/27/2022] Open
Abstract
Background The aim of this study was to prove the relationship between the intraocular straylight level and diabetic retinopathy (DR) according to disease severity. Also, we aimed to evaluate whether diabetes mellitus (DM) per se could be a risk factor of increased intraocular straylight although we did not rely on a definite sign of DR in this study. Methods In this prospective comparative study, ninety three eyes were enrolled and divided into four groups as follows: Group 1 (26 eyes), without DR or DM; Group 2 (25 eyes), with DM but without DR; Group 3 (21 eyes), mild to moderate non-proliferative DR; and Group 4 (21 eyes), severe non-proliferative DR. To measure the intraocular straylight in an objective manner, the C-quant straylight meter was used to preoperatively and 2 months postoperatively in all patients who underwent phacoemulsification surgery. All the patients also underwent a macular optical coherence tomography and hemoglobin A1c (HbA1c) analysis. A comparison of straylight levels adjusted by age among four groups was performed postoperatively. Results The postoperative level of intraocular straylight was statistically significantly different among four groups (P <0.05). When adjusted for ages, Group 4 showed the highest straylight level when compared with Group 3 and the other two groups (P <0.05). Group 1 showed the lowest straylight level in comparison with Group 2 and the other two groups (P <0.05). There was no significant correlation between HbA1c level, duration of diabetes and postoperative straylight level. Conclusions The level of intraocular straylight at 2 months postoperatively had a tendency to increase as the severity of DR increased. Additionally, the straylight level was higher in DM patients without DR than in patients without DM. Therefore, the severity of DR seemed to influence the intraocular straylight level. Although there is no definite sign of DR, DM per se can be a risk factor for increasing intraocular straylight. In conclusion, the level of intraocular straylight seems to be a sensitive test for detecting early retinal damage secondary to DM.
Collapse
Affiliation(s)
- Hyung Bin Hwang
- Department of Ophthalmology and Visual Science, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea.
| | - Hye Bin Yim
- Department of Ophthalmology and Visual Science, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea.
| | - Sung Kun Chung
- Postal address: Department of Ophthalmology and Visual Science, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea.
| |
Collapse
|
33
|
Abstract
Intra-ocular straylight can cause decreased visual functioning, and it may cause diminished vision-related quality of life (VRQOL). This cross-sectional population-based study investigates the association between straylight and VRQOL in middle-aged and elderly individuals. Multivariable linear regression analyses were used to assess the association between straylight modeled continuously and cutoff at the recommended fitness-to-drive value, straylight ≥ 1.4 log(s), and VRQOL. The study showed that participants with normal straylight values, straylight ≤ 1.4 log(s), rated their VRQOL slightly better than those with high straylight values (straylight ≥ 1.4 log(s)). Furthermore, multivariable regression analysis revealed a borderline statistical significant association (p = .06) between intra-ocular straylight and self-reported VRQOL in middle-aged and elderly individuals. The association between straylight and self-reported VRQOL was not influenced by the status of the intra-ocular lens (natural vs. artificial intra-ocular lens after cataract extraction) or the number of (instrumental) activities of daily living that were reported as difficult for the elderly individuals.
Collapse
Affiliation(s)
- Sigrid Mueller-Schotte
- University Medical Center Utrecht, The Netherlands; University of Applied Sciences Utrecht, The Netherlands
| | | | - Marieke J Schuurmans
- University Medical Center Utrecht, The Netherlands; University of Applied Sciences Utrecht, The Netherlands
| |
Collapse
|
34
|
Adnan X, Suheimat M, Mathur A, Efron N, Atchison DA. Straylight, lens yellowing and aberrations of eyes in Type 1 diabetes. Biomed Opt Express 2015; 6:1282-1292. [PMID: 25909012 PMCID: PMC4399667 DOI: 10.1364/boe.6.001282] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 03/01/2015] [Accepted: 03/03/2015] [Indexed: 06/04/2023]
Abstract
Straylight, lens yellowing and ocular aberrations were assessed in a group of people with type 1 diabetes and in an age matched control group. Most of the former had low levels of neuropathy. Relative to the control group, the type 1 diabetes group demonstrated greater straylight, greater lens yellowing, and differences in some higher-order aberration co-efficients without significant increase in root-mean-square higher-order aberrations. Differences between groups did not increase significantly with age. The results are similar to the findings for ocular biometry reported previously for this group of participants, and suggest that age-related changes in the optics of the eyes of people with well-controlled diabetes need not be accelerated.
Collapse
|
35
|
Affiliation(s)
- Seung Yong Choi
- Department of Ophthalmology and Visual Science, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Yu Li Park
- Department of Ophthalmology and Visual Science, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hyun Seung Kim
- Department of Ophthalmology and Visual Science, The Catholic University of Korea College of Medicine, Seoul, Korea
| |
Collapse
|
36
|
Rzemyk V, Cochener B. [Quality of vision studied by comparative measurement of light scattering]. J Fr Ophtalmol 2014; 37:540-7. [PMID: 25059995 DOI: 10.1016/j.jfo.2014.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 12/28/2013] [Accepted: 01/06/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE To assess quality of vision by measuring ocular light scattering with two platforms and comparing them to traditional tests, in healthy subjects and cataract patients. PATIENTS AND METHODS One hundred and sixty-eight eyes divided in two groups were examined by the same clinician in a prospective study (group 1, healthy controls, with a mean age of 31.22 [± 6.76]; and group 2, patients presenting with cataract, with a mean age of 60.36 [± 10.27]). Patients with ocular surface disease were excluded from this study. Each group responded to the VF-14 questionnaire, underwent an examination with lens opacities assessed by LOCS III and a measurement of ocular light scattering with two platforms: the OQAS (Visiometrics(©)) and the C-Quant (Oculus(©)). We analyzed correlations between indices of light scattering with the two platforms (respectively OSI and log(s)) and traditional quality of vision tests (VF-14 questionnaire and LOCS III). RESULTS Strong correlations were found between the OSI and LOCS III. Moderate correlations were found between the OSI and the VF-14 questionnaire, as well as between log(s), VF-14 questionnaire and LOCS III. CONCLUSION Indices of light scattering seems to be valid tools to assess quality of vision, thus lending themselves to routine testing of visual function.
Collapse
Affiliation(s)
- V Rzemyk
- Service d'ophtalmologie, CHRU Morvan, 2, avenue Foch, 29200 Brest, France.
| | - B Cochener
- Service d'ophtalmologie, CHRU Morvan, 2, avenue Foch, 29200 Brest, France
| |
Collapse
|
37
|
Peng C, Zhao J, Ma L, Qu B, Sun Q, Zhang J. Optical performance after bilateral implantation of apodized aspheric diffractive multifocal intraocular lenses with +3.00-D addition power. Acta Ophthalmol 2012. [PMID: 23194310 DOI: 10.1111/j.1755-3768.2012.02497.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine whether bilateral implantation of an aspheric apodized diffractive multifocal intraocular lens (IOL) with +3.00 diopters (D) results in optical adverse effects compared with an aspheric monofocal IOL. METHODS In a prospective, randomized study of 204 eyes (102 patients) with bilateral implantation of an AcrySof ReSTOR SN6AD1 IOL or an AcrySof IQ SN60WF IOL, binocular uncorrected (UDVA) and corrected distance visual acuities (CDVA), uncorrected (UIVA) and distance-corrected intermediate visual acuities (DCIVA), uncorrected (UNVA) and distance-corrected near visual acuities (DCNVA), defocus curve, intraocular straylight, wavefront aberrations, modulation transfer functions (MTF) and patient questionnaires were evaluated postoperatively. RESULTS Both groups resulted in similar UDVA and CDVA (p > 0.05), whereas the multifocal IOL group performed significantly better UIVA and DCIVA at 50, 60 cm, and better UNVA and DCNVA at 40 cm (p ≤ 0.001). Higher intraocular straylight was obtained in the multifocal IOL group (p = 0.016). Total, higher-order, spherical and coma aberrations performed similar in both groups (p > 0.05). MTF was lower in the multifocal IOL group than in the monofocal IOL group with 3.0-mm pupils at 5 and 10 cycles per degree (cpd). Although patients in the multifocal IOL group complained more glare/flare, problems with night vision, and halos, they reported excellent spectacle independence, and high satisfaction. CONCLUSIONS Compared with the AcrySof IQ IOL, the ReSTOR SN6AD1 IOL provided excellent visual outcomes, satisfactory spectacle independence without compromising wavefront aberrations; however, optical adverse effects with respect to higher intraocular straylight and lower MTF at lower spatial frequency were demonstrated.
Collapse
Affiliation(s)
- Cheng Peng
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Shenyang, China
| | | | | | | | | | | |
Collapse
|
38
|
Abstract
The earliest studies on 'disability glare' date from the early 20(th) century. The condition was defined as the negative effect on visual function of a bright light located at some distance in the visual field. It was found that for larger angles (>1 degree) the functional effect corresponded precisely to the effect of a light with a luminosity equal to that of the light that is perceived spreading around such a bright source. This perceived spreading of light was called straylight and by international standard disability glare was defined as identical to straylight. The phenomenon was recognized in the ophthalmological community as an important aspect of the quality of vision and attempts were made to design instruments to measure it. This must not be confused with instruments that assess light spreading over small distances (<1 degree), as originating from (higher order) aberrations and defocus. In recent years a new instrument has gained acceptance (C-Quant) for objective and controllable assessment of straylight in the clinical setting. This overview provides a sketch of the historical development of straylight measurement, as well as the results of studies on the origins of straylight (or disability glare) in the normal eye, and on findings on cataract (surgery) and corneal conditions.
Collapse
Affiliation(s)
- Thomas J T P van den Berg
- Netherlands Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105 BA Amsterdam, The Netherlands.
| | | | | | | |
Collapse
|
39
|
Hammond BR, Fletcher LM. Influence of the dietary carotenoids lutein and zeaxanthin on visual performance: application to baseball. Am J Clin Nutr 2012; 96:1207S-13S. [PMID: 23053558 DOI: 10.3945/ajcn.112.034876] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Macular pigment (MP) is composed of the yellow, blue-absorbing carotenoids lutein and zeaxanthin. Although distributed throughout the visual system, MP is heavily concentrated in the central retinal area (eg, screening the foveal cones). Because light must pass through MP before reaching the receptors, it filters significant amounts of short-wave energy. Individual variation in peak absorbance is large and ranges from 0.0 to 1.6 optical density units depending largely on dietary intake. Several important functions of MP have been proposed. MP may serve to protect the retina from damage by absorbing actinic short-wave light (analogous to internal sunglasses) or by inactivating highly reactive free radicals and oxygen triplicates that are the by-product of light-driven cellular activity. MP may also serve, as proposed more than a century ago, to improve the retinal image through optical mechanisms. Recent data suggest that the MP carotenoids reduce glare discomfort and disability, shorten photostress recovery times, enhance chromatic contrast, and increase visual range (how far one can see in the distance). Lutein and zeaxanthin within the brain might also increase temporal processing speeds. This article reviews the influences of MP on visual function by exploring the implications of these visual improvements for baseball players.
Collapse
Affiliation(s)
- Billy R Hammond
- Vision Sciences Laboratory, University of Georgia, Athens, GA 30602-3013, USA.
| | | |
Collapse
|
40
|
Loughman J, Hewitt C, Judge C, Martin L, Moulds C, Davison PA. Clinical applicability of the Macular Degeneration Detection Device (MDD-2): a novel photostress recovery measurement device. Clin Exp Optom 2012; 96:272-7. [PMID: 23106424 DOI: 10.1111/j.1444-0938.2012.00813.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 07/18/2012] [Accepted: 08/02/2012] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Diseases affecting the macula, such as age-related macular degeneration (AMD), diabetic retinopathy and central serous retinopathy can result in impaired photostress recovery time (PSRT) despite normal visual acuity and fundoscopic appearance. The MDD-2 Macular Degeneration Detection Device is a novel flash photostress recovery device. In this study, we examine the repeatability of the MDD-2 in a normal population and its suitability for incorporation into routine clinical practice. METHODS One hundred (60 female) subjects (mean age 35 ± 8 years; range 18 to 66 years) were recruited to partake in this study. The photostress recovery time was measured using the MDD-2 on three occasions in the dominant eye and one final occasion in the non-dominant eye to assess measurement repeatability. All subjects were in good ocular health. Visual acuity and iris colour were recorded for each participant. RESULTS Repeated measures analysis of variance revealed a statistically significant learning effect on intra-measurement repeatability (p < 0.01). Although paired t-test analysis revealed statistically significant differences between repeated measures both within and between eyes (p < 0.05 for all) the correlation between repeat measurements is statistically significant (p < 0.05 for all), and the coefficient of repeatability reaches clinically acceptable levels once the initial photostress recovery time, which demonstrated increased variability and latency compared to all subsequent measures, is excluded. CONCLUSION The MDD-2 provides highly repeatable measurements of photostress recovery time among young naïve subjects, following verbal explanation of the task and only one 'practise' measurement. The measurement is also highly repeatable between eyes, providing a potential immediate clinical biomarker of ocular health.
Collapse
Affiliation(s)
- James Loughman
- Optometry Department, College of Sciences & Health, Dublin Institute of Technology, Dublin, Ireland.
| | | | | | | | | | | |
Collapse
|
41
|
|
42
|
van der Meulen IJE, van Riet TCT, Lapid-gortzak R, Nieuwendaal CP, van den Berg TJTP. Correlation of Straylight and Visual Acuity in Long-Term Follow-up of Manual Descemet Stripping Endothelial Keratoplasty. Cornea 2012; 31:380-6. [DOI: 10.1097/ico.0b013e31823f8ab7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
43
|
Ehmer A, Rabsilber T, Mannsfeld A, Sanchez M, Holzer M, Auffarth G. Einfluss verschiedener multifokaler Intraokularlinsenkonzepte auf den Streulichtparameter. Ophthalmologe 2011; 108:952-6. [DOI: 10.1007/s00347-011-2411-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
44
|
Abstract
Cataract is a visible opacity in the lens substance, which, when located on the visual axis, leads to visual loss. Age-related cataract is a cause of blindness on a global scale involving genetic and environmental influences. With ageing, lens proteins undergo non-enzymatic, post-translational modification and the accumulation of fluorescent chromophores, increasing susceptibility to oxidation and cross-linking and increased light-scatter. Because the human lens grows throughout life, the lens core is exposed for a longer period to such influences and the risk of oxidative damage increases in the fourth decade when a barrier to the transport of glutathione forms around the lens nucleus. Consequently, as the lens ages, its transparency falls and the nucleus becomes more rigid, resisting the change in shape necessary for accommodation. This is the basis of presbyopia. In some individuals, the steady accumulation of chromophores and complex, insoluble crystallin aggregates in the lens nucleus leads to the formation of a brown nuclear cataract. The process is homogeneous and the affected lens fibres retain their gross morphology. Cortical opacities are due to changes in membrane permeability and enzyme function and shear-stress damage to lens fibres with continued accommodative effort. Unlike nuclear cataract, progression is intermittent, stepwise and non-uniform.
Collapse
Affiliation(s)
- R Michael
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Laforja 88, 08021 Barcelona, Spain.
| | | |
Collapse
|
45
|
Affiliation(s)
- So Yeon Lee
- Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea
| | - Jung Hyub Oh
- Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea
| |
Collapse
|
46
|
de Vries NE, Webers CA, Verbakel F, de Brabander J, Berendschot TT, Cheng YY, Doors M, Nuijts RM. Visual outcome and patient satisfaction after multifocal intraocular lens implantation: Aspheric versus spherical design. J Cataract Refract Surg 2010; 36:1897-904. [DOI: 10.1016/j.jcrs.2010.05.030] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2009] [Revised: 05/15/2010] [Accepted: 05/20/2010] [Indexed: 10/18/2022]
|
47
|
|
48
|
de Vries NE, Webers CA, Montés-Micó R, Ferrer-Blasco T, Nuijts RM. Visual outcomes after cataract surgery with implantation of a +3.00 D or +4.00 D aspheric diffractive multifocal intraocular lens: Comparative study. J Cataract Refract Surg 2010; 36:1316-22. [DOI: 10.1016/j.jcrs.2010.01.036] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2009] [Revised: 01/23/2010] [Accepted: 01/27/2010] [Indexed: 10/19/2022]
|
49
|
Montenegro GA, Marvan P, Dexl A, Picó A, Canut MI, Grabner G, Barraquer RI, Michael R. Posterior capsule opacification assessment and factors that influence visual quality after posterior capsulotomy. Am J Ophthalmol 2010; 150:248-53. [PMID: 20541740 DOI: 10.1016/j.ajo.2010.02.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Revised: 02/26/2010] [Accepted: 02/28/2010] [Indexed: 11/29/2022]
Abstract
PURPOSE To study the correlation between posterior capsule opacification (PCO) and intraocular straylight and visual acuity. DESIGN Prospective noninterventional study. METHODS We measured visual acuity (VA), logarithm of minimal angle of resolution (logMAR) and intraocular straylight (C-Quant straylight parameter log[s]) under photopic conditions before and 2 weeks after YAG capsulotomy in 41 patients (53 eyes) from the Centro de Oftalmología Barraquer in Barcelona and the University Eye Clinic, Paracelsus Medical University in Salzburg. Photopic pupil diameter was also measured. To document the level of opacification, pupils were dilated and photographs were taken with a slit lamp, using retroillumination and the reflected light of a wide slit beam at an angle of 45 degrees. PCO was subjectively graded on a scale of 0 to 10 and using the POCOman system. A multiple regression analysis was performed to evaluate factors that influence straylight after capsulotomy. RESULTS Straylight correlated well with retroillumination and reflected-light PCO scores, whereas VA only correlated with retroillumination. Both VA and straylight improved after capsulotomy. Straylight values varied widely after capsulotomy. Multiple regression analysis showed that older age, large ocular axial length, hydrophobic acrylic intraocular lenses (IOLs), and small capsulotomies are factors that increased intraocular straylight. CONCLUSION Intraocular straylight is a useful tool in the assessment of PCO. It correlates well with PCO severity scoring methods. When performing a posterior capsulotomy, factors such as age, IOL material, axial length, and capsulotomy size must be taken into consideration, as they influence intraocular straylight.
Collapse
Affiliation(s)
- Gustavo A Montenegro
- Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Laforja 88, Barcelona, Spain
| | | | | | | | | | | | | | | |
Collapse
|