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Xu G, Luo Y, Qi H, Liu S, Fu J, Ye Z, Li Z. Trichromatic critical flicker frequency as potential visual test in cataract and macula disease patients. Graefes Arch Clin Exp Ophthalmol 2024; 262:2171-2179. [PMID: 38329529 DOI: 10.1007/s00417-024-06398-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 01/21/2024] [Accepted: 01/30/2024] [Indexed: 02/09/2024] Open
Abstract
PURPOSE To investigate the capacity of critical flicker frequency (CFF) in discriminating cataract eyes with or without macula disease using trichromatic flickers, and to develop a model to predict postoperative best corrected visual acuity (BCVA). METHODS Patients were divided into two groups based on the presence or absence of macular disease. CFF threshold measurements of red (R-CFF), green (G-CFF), and yellow (Y-CFF) flickers were conducted both preoperatively and postoperatively. A generalized estimating equations model (GEE) was employed to examine the relationship between CFF threshold and 3-month postoperative BCVA. RESULTS A total of 115 eyes were enrolled, with 59 eyes in the cataract alone group and 56 eyes in the cataract with macular disease group completing the follow-up. R-CFF was found to be consistent before and after cataract removal (P = 0.06), even in cases where OCT was not performed successfully (P > 0.05). Y-CFF showed the highest AUC (0.798) for differentiating ocular comorbidities. According to the GEE model, in patients with a CFF threshold below 26 Hz, the odds ratios for achieving a postoperative VA of 20/40 or better were 34.8% for R-CFF, 26.0% for G-CFF, and 24.5% for Y-CFF. CONCLUSION CFF emerges as a promising tool for predicting postoperative BCVA, providing valuable supplementary insights when fundus examination is obstructed. R-CFF demonstrates the best resistance to cataracts, while Y-CFF exhibits the highest sensitivity both in identifying macular diseases and predicting postoperative BCVA of 20/40 or better.
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Affiliation(s)
- Guangcan Xu
- School of Medicine, Nankai University, Tianjin, 300071, China
- Department of Ophthalmology, The Third Medical Center, The Chinese PLA General Hospital, Beijing, 100853, China
| | - Yu Luo
- Department of Ophthalmology, The Third Medical Center, The Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Haolan Qi
- School of Medicine, Nankai University, Tianjin, 300071, China
- Department of Ophthalmology, The Third Medical Center, The Chinese PLA General Hospital, Beijing, 100853, China
| | - Sijia Liu
- Department of Ophthalmology, The Third Medical Center, The Chinese PLA General Hospital, Beijing, 100853, China
- Medical School of Chinese PLA, Beijing, 100853, China
| | - Junxia Fu
- Department of Ophthalmology, School of Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Zi Ye
- Department of Ophthalmology, The Third Medical Center, The Chinese PLA General Hospital, Beijing, 100853, China.
- Medical School of Chinese PLA, Beijing, 100853, China.
| | - Zhaohui Li
- School of Medicine, Nankai University, Tianjin, 300071, China.
- Department of Ophthalmology, The Third Medical Center, The Chinese PLA General Hospital, Beijing, 100853, China.
- Medical School of Chinese PLA, Beijing, 100853, China.
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Liu Y, Ren X, Wan Y, Yang L, Zhang R, Li X. Evaluation of visual performance and eye movements in patients with blue light-filtering intraocular lenses versus ultraviolet light-filtering intraocular lenses. Front Neurosci 2023; 17:1207853. [PMID: 38178836 PMCID: PMC10764626 DOI: 10.3389/fnins.2023.1207853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 11/29/2023] [Indexed: 01/06/2024] Open
Abstract
Background Eye movement plays an important role in visual perception and provides essential visual information for everyday tasks. Our previous study indicated that the visual performance and eye movement pattern were impaired in age-related cataract patients and could be improved after cataract surgery, but the impact of different intraocular lens (IOL) types was obscure. Previous studies found that blue light might affect the eye movement pattern and cognitive function. In this study, we explored the visual performance and eye movement pattern in post-cataract surgery patients implanted with blue light-filtering IOLs or ultraviolet (UV) light-filtering IOLs to further understand the impact of different types of IOLs on and daily visual performance and eye movement pattern and to help ophthalmologists and patients make the personalized option of IOL types in future. Methods Patients after both-eye cataract surgeries were included in this study. Eye movement behaviors were automatically recorded by an eye tracker while performing three performance-based everyday tasks (non-social object search, face recognition, and reading). Visual performance and eye movement parameters were compared between participants with blue light-filtering IOLs and UV light-filtering IOLs. The correlation between visual performance and eye movement parameters was explored to determine which eye movement parameters had a significant influence on visual performance outcomes. Results A total of 30 patients (16 with blue light-filtering IOLs and 14 with UV light-filtering IOLs) were included. In this study, we found that the eye movement pattern was slightly different with these two IOLs: during non-social object visual search task, time to first fixation and fixation counts before first fixation were notably increased in yellow-tinted blue light-filtering IOL patients. During reading task, a higher total fixation count was also found in blue light-filtering IOL patients. However, the visual performance of these two IOLs was close, except for a quicker search of the target object with clear UV light-filtering IOLs. Conclusion Both blue light-filtering and UV light-filtering IOLs were able to successfully restore visual function and yield satisfactory outcomes after cataract surgery. Although subtle, yellow-tinted IOLs did have a slight but significant impact on visual performance and the eye movement pattern of elderly patients when handling everyday tasks.
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Affiliation(s)
- Yan Liu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Xiaotong Ren
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Yu Wan
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Luling Yang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Rong Zhang
- Department of Neurobiology, School of Basic Medical Sciences, Peking University, Beijing, China
- Neuroscience Research Institute, Peking University, Beijing, China
- Key Laboratory for Neuroscience, Ministry of Education/National Health and Family Planning Commission, Peking University, Beijing, China
| | - Xuemin Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
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Yu H, Kwon M. Altered Eye Movements During Reading With Simulated Central and Peripheral Visual Field Defects. Invest Ophthalmol Vis Sci 2023; 64:21. [PMID: 37843494 PMCID: PMC10584020 DOI: 10.1167/iovs.64.13.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 09/22/2023] [Indexed: 10/17/2023] Open
Abstract
Purpose Although foveal vision provides fine spatial information, parafoveal and peripheral vision are also known to be important for efficient reading behaviors. Here we systematically investigate how different types and sizes of visual field defects affect the way visual information is acquired via eye movements during reading. Methods Using gaze-contingent displays, simulated scotomas were induced in 24 adults with normal or corrected-to-normal vision during a reading task. The study design included peripheral and central scotomas of varying sizes (aperture or scotoma size of 2°, 4°, 6°, 8°, and 10°) and no-scotoma conditions. Eye movements (e.g., forward/backward saccades, fixations, microsaccades) were plotted as a function of either the aperture or scotoma size, and their relationships were characterized by the best fitting model. Results When the aperture size of the peripheral scotoma decreased below 6° (11 visible letters), there were significant decreases in saccade amplitude and velocity, as well as substantial increases in fixation duration and the number of fixations. Its dependency on the aperture size is best characterized by an exponential decay or growth function in log-linear coordinates. However, saccade amplitude and velocity, fixation duration, and forward/regressive saccades increased more or less linearly with increasing central scotoma size in log-linear coordinates. Conclusions Our results showed differential impacts of central and peripheral vision loss on reading behaviors while lending further support for the importance of foveal and parafoveal vision in reading. These apparently deviated oculomotor behaviors may in part reflect optimal reading strategies to compensate for the loss of visual information.
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Affiliation(s)
- Haojue Yu
- Department of Psychology, Northeastern University, Boston, Massachusetts, United States
| | - MiYoung Kwon
- Department of Psychology, Northeastern University, Boston, Massachusetts, United States
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Comparison of reading performance with low add bifocal and extended depth of focus intraocular lenses implanted with mini-monovision. Int Ophthalmol 2020; 41:315-323. [PMID: 32914276 DOI: 10.1007/s10792-020-01584-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 08/29/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate reading performance, preferred reading distance, and spectacle independence in patients implanted with a low add multifocal or an extended depth of focus (EDOF) intraocular lens (IOL) after phacoemulsification. METHODS In this prospective study, patients were randomized into two groups: the diffractive multifocal Tecnis + 2.75 D (ZKB00) IOL (Tecnis + 2.75 group; 15 patients) or the EDOF Tecnis Symfony (ZXR00) IOL (Symfony group; 14 patients) for bilateral implantation with mini-monovision. Reading performance parameters (reading acuity [RA], critical print size [CPS], and maximum reading speed [MRS]) were evaluated with MNREAD acuity charts at 40 cm, and preferred reading distances and spectacle independence for near activities were assessed preoperatively and at the postoperative 1st, 3rd, and 6th months. RESULTS At the postoperative 6th month, binocular logMAR UNVA and DCNVA were significantly better in the Symfony group than in the Tecnis + 2.75 group (UNVA: 0.15 ± 0.07 vs. 0.22 ± 0.08, p = 0.046; DCNVA: 0.21 ± 0.05 vs. 0.28 ± 0.07, p = 0.043; respectively). There was no significant difference in reading performance parameters between the groups; however, the Symfony group preferred significantly closer reading distance than the Tecnis + 2.75 group (42.00 ± 4.67 cm; 45.87 ± 5.32 cm, respectively, p = 0.030). At the postoperative 6th month, 14.3% and 26.7% of patients reported that they needed spectacles, rarely or occasionally, for near activities in the Symfony and Tecnis + 2.75 groups, respectively (p > 0.05). CONCLUSIONS When implanted with mini-monovision, although functional near visual acuity and a high degree of spectacle independence at near distances were achieved with both IOLs, patients implanted with the EDOF IOL preferred closer reading distance than those implanted with the low add diffractive multifocal IOL.
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Evaluation of eye movements and visual performance in patients with cataract. Sci Rep 2020; 10:9875. [PMID: 32555224 PMCID: PMC7303140 DOI: 10.1038/s41598-020-66817-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/25/2020] [Indexed: 11/11/2022] Open
Abstract
Eye movement is an essential component of visual perception. Eye movement disorders have been observed in many eye disease, and are thought to affect various visual performance in daily life. However, eye movement behaviors of the elderly with cataract are poorly understood, and the impact of cataract surgery on eye movements has not been investigated. In this study, we observed the eye movement behaviors in thirty patients with bilateral age-related cataract while performing three performance-based tasks (visual search, face recognition and reading). Eye movements were automatically recorded by an eye tracker during task performance. We found an overall improved visual performance postoperatively, presented as elevated percentage of correctly identified objects and faces, reduced search time and increased reading speed. Eye movement parameters were found significantly altered after cataract surgery. Fixation count, total fixation duration and total visit duration were markedly increased in the visual search task and face recognition task. The proportion of regressive saccades was obviously decreased in the reading task. These eye movement parameters were found to be correlated with the measures of visual performance. Our findings suggested a potential association between the eye movement disturbance and impaired visual performance, and provided a new insight on the potential usefulness of eye movement as an objective and valid tool to understand visual impairments caused by cataract, as well as evaluate practical outcomes of cataract surgery.
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You JI, Bang SK, Kang MS, Jin KH. Visual Prognosis and Satisfaction of Advanced Cataract Patients Unable to be Evaluated by Fundus Imaging. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2020. [DOI: 10.3341/jkos.2020.61.3.235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jong In You
- Department of Ophthalmology, KyungHee University Medical Center, KyungHee University School of Medicine, Seoul, Korea
| | - Seul Ki Bang
- Department of Ophthalmology, KyungHee University Medical Center, KyungHee University School of Medicine, Seoul, Korea
| | - Min Seok Kang
- Department of Ophthalmology, KyungHee University Medical Center, KyungHee University School of Medicine, Seoul, Korea
| | - Kyung Hyun Jin
- Department of Ophthalmology, KyungHee University Medical Center, KyungHee University School of Medicine, Seoul, Korea
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Hwang JS, Lee YP, Bae SH, Kim HK, Yi K, Shin YJ. Utility of the optical quality analysis system for decision-making in cataract surgery. BMC Ophthalmol 2018; 18:231. [PMID: 30176839 PMCID: PMC6122688 DOI: 10.1186/s12886-018-0904-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 08/28/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND A cataract is a common cause of vision impairment that requires surgery in older subjects. The Optical Quality Analysis System (OQAS, Visiometrics SL, Terrassa, Spain) assesses the optical quality of the eye in cataract patients. This study shows the role of the optical quality evaluation system for decision-making in cataract surgery. We investigated the clinical utility of the OQAS for decision-making in cataract surgery. METHODS Sixty-seven eyes from 67 patients undergoing cataract surgery and 109 eyes from 109 control subjects were compared. The best corrected visual acuity (BCVA) was measured. The objective scatter index (OSI), modulation transfer function (MTF), Strehl ratio, predicted visual acuity (PVA) 100%, PVA 20%, and PVA 10% were measured using the OQAS. The sensitivity and specificity of the different parameters were analyzed using the receiver operating characteristic (ROC) curve. The main parameters measured were sensitivity and specificity. RESULTS The BCVA, OSI, PVA 100%, PVA 20%, and PVA 10% were higher in the cataract group compared to those in the control group, while the MTF and Strehl ratios were lower (p < 0.001 for all). ROC analysis showed that the OSI had the largest area under the curve and that the sensitivity and specificity of the OSI were 83.9 and 84.6%, respectively, at the optimal cut-off point of 2.35. CONCLUSION The MTF, OSI, Strehl ratio, PVA 100%, PVA 20% and PVA 10% may be useful parameters for preoperative decision-making in cataract surgery. The OSI appears to be the most effective parameter for this purpose.
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Affiliation(s)
- Jin Sun Hwang
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, 948-1 Daerim1-dong, Youngdeungpo-gu, Seoul, 150-950, Korea
| | - Yoon Pyo Lee
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, 948-1 Daerim1-dong, Youngdeungpo-gu, Seoul, 150-950, Korea
| | - Seok Hyun Bae
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, 948-1 Daerim1-dong, Youngdeungpo-gu, Seoul, 150-950, Korea
| | - Ha Kyoung Kim
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, 948-1 Daerim1-dong, Youngdeungpo-gu, Seoul, 150-950, Korea
| | - Kayoung Yi
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, 948-1 Daerim1-dong, Youngdeungpo-gu, Seoul, 150-950, Korea
| | - Young Joo Shin
- Department of Ophthalmology, Hallym University Medical Center, Hallym University College of Medicine, 948-1 Daerim1-dong, Youngdeungpo-gu, Seoul, 150-950, Korea.
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Visual and Refractive Outcomes following Bilateral Implantation of Extended Range of Vision Intraocular Lens with Micromonovision. J Ophthalmol 2018; 2018:7321794. [PMID: 29545954 PMCID: PMC5818926 DOI: 10.1155/2018/7321794] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 11/08/2017] [Accepted: 12/06/2017] [Indexed: 11/17/2022] Open
Abstract
Purpose To evaluate the outcomes following bilateral ERV intraocular lens implantation with micromonovision. Methods 25 subjects underwent bilateral Tecnis Symfony IOL implantation with micromonovision. The dominant eye was targeted for emmetropia and the nondominant eye for myopia of -0.75 D. Uncorrected and corrected distance (UDVA, CDVA), intermediate (UIVA, CIVA), and near visual acuity (UNVA, DCNVA); reading performance; defocus curve; and contrast sensitivity were studied. Follow-ups were conducted at 1 week and 1 and 6 months postoperatively. Results At 6 months postoperatively, the mean binocular UDVA, CDVA, UNVA, and DCNVA were -0.036 ± 0.09, -0.108 ± 0.07, 0.152 ± 0.11, and 0.216 ± 0.10 logMAR, respectively. Binocular UIVA and DCIVA were 0.048 ± 0.09 and 0.104 ± 0.08 logMAR, respectively, at 60 cm and -0.044 ± 0.09 and 0.012 ± 0.09 logMAR, respectively, at 80 cm. All patients had ≥0.2 logMAR UDVA and UNVA. Reading acuity and reading speeds showed improvement over time. Between defocus range of -2.50 and +1.00 D, the visual acuity remained ≥0.2 logMAR. Contrast sensitivity scores were within the normal range. 4 patients used reading glasses for very fine print. Conclusion Bilateral ERV IOL implantation leads to excellent outcomes for far and intermediate vision, satisfactory outcomes for near vision, and good tolerance to micromonovision at the end of the 6 months. This trial is registered with CTRI/2015/10/006246.
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Nischler C, Michael R, Wintersteller C, Marvan P, Emesz M, Van Rijn LJ, Van Den Berg TJ, Wilhelm H, Coeckelbergh T, Barraquer RI, Grabner G, Hitzl W. Cataract and Pseudophakia in Elderly European Drivers. Eur J Ophthalmol 2018; 20:892-901. [DOI: 10.1177/112067211002000513] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Christian Nischler
- Department of Ophthalmology, Paracelsus Private Medical University Salzburg, Salzburg - Austria
| | | | - Christine Wintersteller
- Department of Ophthalmology, Paracelsus Private Medical University Salzburg, Salzburg - Austria
| | - Patrick Marvan
- Department of Ophthalmology, Paracelsus Private Medical University Salzburg, Salzburg - Austria
| | - Martin Emesz
- Department of Ophthalmology, Paracelsus Private Medical University Salzburg, Salzburg - Austria
| | | | | | - Helmut Wilhelm
- Department of Ophthalmology, University of Tübingen, Tübingen - Germany
| | - Tanja Coeckelbergh
- Department of Ophthalmology, Universitair Ziekenhuis Antwerpen, Antwerpen - Belgium
| | | | - Günther Grabner
- Department of Ophthalmology, Paracelsus Private Medical University Salzburg, Salzburg - Austria
| | - Wolfgang Hitzl
- Department of Ophthalmology, Paracelsus Private Medical University Salzburg, Salzburg - Austria
- Research Office, Paracelsus Private Medical University Salzburg, Salzburg - Austria
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Radner W. Reading charts in ophthalmology. Graefes Arch Clin Exp Ophthalmol 2017; 255:1465-1482. [PMID: 28411305 PMCID: PMC5541099 DOI: 10.1007/s00417-017-3659-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 03/12/2017] [Accepted: 03/22/2017] [Indexed: 11/26/2022] Open
Abstract
A new generation of logarithmic reading charts has sparked interest in standardized reading performance analyses. Such reading charts have been developed according to the standards of the International Council of Ophthalmology. The print size progression in these calibrated charts is in accordance with the mathematical background of EN ISO 8596. These reading charts are: the Bailey–Lovie Word Reading Chart, the Colenbrander English Continuous Text Near Vision Cards, the Oculus Reading Probe II, the MNREAD Charts, the SKread Charts, and the RADNER Reading Charts. The test items used for these reading charts differ among the charts and are standardized to various extents. The Bailey–Lovie Charts, MNREAD Charts, SKread Charts, and RADNER Charts are also meant to measure reading speed and allow determination of further reading parameters such as reading acuity, reading speed based on reading acuity, critical print size, reading score, and logMAR/logRAD ratio. Such calibrated reading charts have already provided valuable insights into the reading performance of patients in many research studies. They are available in many languages and thus facilitate international communication about near visual performance. In the present review article, the backgrounds of these modern reading charts are presented, and their different levels of test-item standardization are discussed. Clinical research studies are mentioned, and a discussion about the immoderately high number of reading acuity notations is included. Using the logReading Acuity Determination ([logRAD] = reading acuity equivalent of logMAR) measure for research purposes would give reading acuity its own identity as a standardized reading parameter in ophthalmology.
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Affiliation(s)
- W Radner
- Austrian Academy of Ophthalmology, Mollgasse 11, 1180, Vienna, Austria.
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Alabdulkader B, Leat SJ. Toward developing a standardized Arabic continuous text reading chart. JOURNAL OF OPTOMETRY 2017; 10:84-94. [PMID: 27162118 PMCID: PMC5383463 DOI: 10.1016/j.optom.2016.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 03/22/2016] [Accepted: 03/29/2016] [Indexed: 06/05/2023]
Abstract
PURPOSE Near visual acuity is an essential measurement during an oculo-visual assessment. Short duration continuous text reading charts measure reading acuity and other aspects of reading performance. There is no standardized version of such chart in Arabic. The aim of this study is to create sentences of equal readability to use in the development of a standardized Arabic continuous text reading chart. METHODS Initially, 109 Arabic pairs of sentences were created for use in constructing a chart with similar layout to the Colenbrander chart. They were created to have the same grade level of difficulty and physical length. Fifty-three adults and sixteen children were recruited to validate the sentences. Reading speed in correct words per minute (CWPM) and standard length words per minute (SLWPM) was measured and errors were counted. Criteria based on reading speed and errors made in each sentence pair were used to exclude sentence pairs with more outlying characteristics, and to select the final group of sentence pairs. RESULTS Forty-five sentence pairs were selected according to the elimination criteria. For adults, the average reading speed for the final sentences was 166 CWPM and 187 SLWPM and the average number of errors per sentence pair was 0.21. Childrens' average reading speed for the final group of sentences was 61 CWPM and 72 SLWPM. Their average error rate was 1.71. CONCLUSIONS The reliability analysis showed that the final 45 sentence pairs are highly comparable. They will be used in constructing an Arabic short duration continuous text reading chart.
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Radner W. Near vision examination in presbyopia patients: Do we need good homologated near vision charts? EYE AND VISION 2016; 3:29. [PMID: 27844022 PMCID: PMC5103453 DOI: 10.1186/s40662-016-0061-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 10/27/2016] [Indexed: 11/15/2022]
Abstract
Presbyopia correction is mainly concerned with the goal of regaining an uncorrected reading performance. Since historic reading charts do not provide a unique standard that is applicable for the analysis of clinical and scientific reading performance, new standardized reading charts have been developed, in order to provide reading performance analyses analogous to modern single-optotype distance acuity measurements: the Bailey-Lovie Word Reading Chart, the Colenbrander English Continuous Text Near Vision Cards, the MNREAD Charts, and the RADNER Reading Charts. The last three are also meant to measure reading speed, thus allowing detailed analysis of the reading capabilities of the patient’s functional vision. Furthermore, these reading charts can be declared homologated, based on the standards that were published for reading charts by the Visual Function Committee of the International Council of Ophthalmology (ICO) in 1988. Many research studies have shown that by analyzing the reading performance with homologated reading charts, valuable insight into the reading performance of patients suffering from various diseases can be obtained. These reading charts have also been successfully used in presbyopia research. It therefore seems evident that homologated, standardized reading charts facilitate not only research concerning functional vision in many fields of ophthalmology but also international communication about near visual performance. Homologated reading charts are available in almost all languages and have become a valuable tool in analyzing reading performance. We argue in this review that homologated reading charts are clearly a necessity for presbyopia research.
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Affiliation(s)
- Wolfgang Radner
- Austrian Academy of Ophthalmology, Mollgasse 11, A-1180 Vienna, Austria
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Brussee T, van Nispen RMA, van Rens GHMB. Measurement properties of continuous text reading performance tests. Ophthalmic Physiol Opt 2015; 34:636-57. [PMID: 25331578 DOI: 10.1111/opo.12158] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 09/04/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE Measurement properties of tests to assess reading acuity or reading performance have not been extensively evaluated. This study aims to provide an overview of the literature on available continuous text reading tests and their measurement properties. METHODS A literature search was performed in PubMed, Embase and PsycInfo. Subsequently, information on design and content of reading tests, study design and measurement properties were extracted using consensus-based standards for selection of health measurement instruments. Quality of studies, reading tests and measurement properties were systematically assessed using pre-specified criteria. RESULTS From 2334 identified articles, 20 relevant articles were found on measurement properties of three reading tests in various languages: IReST, MNread Reading Test and Radner Reading Charts. All three reading tests scored high on content validity. Reproducibility studies (repeated measurements between different testing sessions) of the IReST and MNread of commercially available reading tests in different languages were missing. The IReST scored best on inter-language comparison, the MNread scored well in repeatability studies (repeated measurements under the same conditions) and the Radner showed good reproducibility in studies. CONCLUSIONS Although in daily practice there are other continuous text reading tests available meeting the criteria of this review, measurement properties were described in scientific studies for only three of them. Of the few available studies, the quality and content of study design and methodology used varied. For testing existing reading tests and the development of new ones, for example in other languages, we make several recommendations, including careful description of patient characteristics, use of objective and subjective lighting levels, good control of working distance, documentation of the number of raters and their training, careful documentation of scoring rules and the use of Bland-Altman analyses or similar for reproducibility and repeatability studies.
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Affiliation(s)
- Tamara Brussee
- Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Department of Ophthalmology, Elkerliek Hospital, Helmond, The Netherlands
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Brussee T, van Nispen RMA, Klerkx EMFJ, Knol DL, van Rens GHMB. Comparison of reading performance tests concerning difficulty of sentences and paragraphs and their reliability. Ophthalmic Physiol Opt 2015; 35:324-35. [DOI: 10.1111/opo.12204] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 02/17/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Tamara Brussee
- Department of Ophthalmology; VU University Medical Center; Amsterdam The Netherlands
- EMGO+ Institute for Health and Care Research; VU University Medical Center; Amsterdam The Netherlands
- Department of Ophthalmology; Elkerliek Hospital; Helmond The Netherlands
| | - Ruth M. A. van Nispen
- Department of Ophthalmology; VU University Medical Center; Amsterdam The Netherlands
- EMGO+ Institute for Health and Care Research; VU University Medical Center; Amsterdam The Netherlands
| | - Edwin M. F. J. Klerkx
- Department of Ophthalmology; VU University Medical Center; Amsterdam The Netherlands
| | - Dirk L. Knol
- Department of Epidemiology and Biostatistics; VU University Medical Center; Amsterdam The Netherlands
| | - Ger H. M. B. van Rens
- Department of Ophthalmology; VU University Medical Center; Amsterdam The Netherlands
- EMGO+ Institute for Health and Care Research; VU University Medical Center; Amsterdam The Netherlands
- Department of Ophthalmology; Elkerliek Hospital; Helmond The Netherlands
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Calossi A, Boccardo L, Fossetti A, Radner W. Design of short Italian sentences to assess near vision performance. JOURNAL OF OPTOMETRY 2014; 7:203-209. [PMID: 25323641 PMCID: PMC4213852 DOI: 10.1016/j.optom.2014.05.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 03/20/2014] [Accepted: 03/20/2014] [Indexed: 06/04/2023]
Abstract
PURPOSE To develop and validate 28 short Italian sentences for the construction of the Italian version of the Radner Reading Chart to simultaneously measure near visual acuity and reading speed. METHODS 41 sentences were constructed in Italian language, following the procedure defined by Radner, to obtain "sentence optotypes" with comparable structure and with the same lexical and grammatical difficulty. Sentences were statistically selected and used in 211 normal, non-presbyopic, native Italian-speaking persons. The most equally matched sentences in terms of reading speed and number of reading errors were selected. To assess the validity of the reading speed results obtained with the 28 selected short sentences, we compared the reading speed and reading errors with the average obtained by reading two long 4th-grade paragraphs (97 and 90 words) under the same conditions. RESULTS The overall mean reading speed of the tested persons was 189±26wpm. The 28 sentences more similar in terms of reading times were selected, achieving a coefficient of variation (the relative SD) of 2.2%. The reliability analyses yielded an overall Cronbach's alpha coefficient of 0.98. The correlation between the short sentences and the long paragraph was high (r=0.85, P<0.0001). CONCLUSIONS The 28 short single Italian sentences optotypes were highly comparable in syntactical structure, number, position, and length of words, lexical difficulty, and reading length. The resulting Italian Radner Reading Chart is precise (high consistency) and practical (short sentences) and therefore useful for research and clinical practice to simultaneously measure near reading acuity and reading speed.
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Affiliation(s)
- Antonio Calossi
- Department of Physics (Optics and Optometry), University of Florence, Italy; School of Optics and Optometry I.R.S.O.O., Vinci, Italy.
| | | | - Alessandro Fossetti
- Department of Physics (Optics and Optometry), University of Florence, Italy; School of Optics and Optometry I.R.S.O.O., Vinci, Italy
| | - Wolfgang Radner
- Austrian Academy of Ophthalmology and Optometry, Vienna, Austria
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Xu X, Zhu MM, Zou HD. Refractive Versus Diffractive Multifocal Intraocular Lenses in Cataract Surgery: A Meta-analysis of Randomized Controlled Trials. J Refract Surg 2014; 30:634-44. [PMID: 25250421 DOI: 10.3928/1081597x-20140814-04] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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English sentence optotypes for measuring reading acuity and speed--the English version of the Radner Reading Charts. Graefes Arch Clin Exp Ophthalmol 2014; 252:1297-303. [PMID: 24796772 DOI: 10.1007/s00417-014-2646-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 04/06/2014] [Accepted: 04/09/2014] [Indexed: 10/25/2022] Open
Abstract
PURPOSE To develop 28 short sentence optotypes for the English version of the Radner Reading Charts that are as comparable as possible in number and length of words, as well as in difficulty and syntactical construction. METHODS Thirty-four English sentences were constructed following the method used for other Radner Reading Charts to obtain "sentence optotypes" with comparable structure and the same lexical and grammatical difficulty. Best comparable sentences were statistically selected and standardized in 50 volunteers. Reading speed and the number of errors were determined. Validity was analyzed with a 124-word long 4th-grade paragraph of the Florida Comprehensive Assessment Test®. Computerized measurements of reading parameters were performed with the RADNER Reading Device (RAD-RD©; in conjunction with a PC and microphone). RESULTS The mean reading speed obtained with the 28 selected short sentences was 201.53 ± 35.88 words per minute (wpm), as compared to 215.01 ± 30.37 wpm for the long paragraph. The mean reading times were 4.30 ± 0.79 s and 35.26 ± 4.85 s, respectively. The mean number of reading errors was 0.11 ± 0.34. The correlation between the short sentences and the long paragraph was high (r = 0.76; p < 0.05; n = 50). Reliability analyses yielded an overall Cronbach's alpha coefficient of 0.9743. CONCLUSION The present study indicates that the 28 selected English sentence optotypes are comparable in terms of both lexical difficulty as well as in reading length, and it demonstrates the validity and reliability of such sentences as test items for determining reading parameters such as reading acuity and speed.
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Working-Age Cataract Patients: Visual Results, Reading Performance, and Quality of Life with Three Diffractive Multifocal Intraocular Lenses. Ophthalmology 2014; 121:34-44. [DOI: 10.1016/j.ophtha.2013.06.034] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 05/29/2013] [Accepted: 06/17/2013] [Indexed: 11/23/2022] Open
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Iida Y, Shimizu K, Ito M. Pseudophakic monovision using monofocal and multifocal intraocular lenses: hybrid monovision. J Cataract Refract Surg 2012; 37:2001-5. [PMID: 22018364 DOI: 10.1016/j.jcrs.2011.05.032] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Revised: 04/28/2011] [Accepted: 05/12/2011] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate the visual function after bilateral cataract surgery performed with a new technique (hybrid monovision) that uses a monofocal intraocular lens (IOL) and a diffractive multifocal IOL. SETTING Department of Ophthalmology, Kitasato University Hospital, Kanagawa, Japan. DESIGN Case series. METHODS Hybrid monovision was achieved by implanting a monofocal IOL (AQ310Ai) in the dominant eye and a diffractive multifocal IOL (Tecnis ZM900) in the nondominant contralateral eye. The target refraction was emmetropia in both eyes. Visual acuity at various distances, contrast sensitivity, near stereopsis, reading ability, and the degree of patient satisfaction were measured. RESULTS The study enrolled 32 patients with a mean age of 61.2 years ± 14.7 (SD). At all distances, the mean binocular visual acuity was better than 0.1 logMAR. Binocular contrast sensitivity was better than monocular vision in the eye with the diffractive multifocal IOL. Near stereopsis within normal range was maintained in 62.5% of patients. Of the patients, 18.8% reported spectacle dependence. With binocular vision, no patients reported waxy vision (ie, as though they were looking through water). CONCLUSION Hybrid monovision may be an effective approach for managing loss of accommodation after cataract surgery and may be the method of choice in cases of waxy vision caused by bilateral multifocal IOL implantation. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Yoshihiko Iida
- Department of Ophthalmology, School of Medicine, Kitasato University, Kanagawa, Japan.
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Richter-Mueksch S, Sacu S, Weingessel B, Vécsei-Marlovits VP, Schmidt-Erfurth U. The influence of cortical, nuclear, subcortical posterior, and mixed cataract on the results of microperimetry. Eye (Lond) 2011; 25:1317-21. [PMID: 21738231 DOI: 10.1038/eye.2011.156] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Microperimetry is a useful instrument for evaluating sensitivity threshold due to retinal pathologies. The aim of the study is to assess the impact of different forms of cataract on microperimetry results. METHODS In a prospective design, patients were recruited for cataract surgery at the Department of Ophthalmology, Medical University of Vienna. Exclusion criteria were any other ophthalmic disease except cataract, that is, macular pathology. Using the Lens Opacities Classification System III classification, patients were classified into four groups: nuclear, cortical, subcapsular posterior, and mixed cataract. Then patients underwent microperimetry: results were analyzed for magnitude of retinal sensitivity loss and correlated to the forms and density of the cataract. RESULTS Mean density of cataract was LOCS 3.2-3.5 in the four groups. Differences were not statistically significant. The best-corrected visual acuity (BCVA) was LogMAR 0.5 ± 0.13 in nuclear, LogMAR 0.49 ± 0.21 in cortical, and LogMAR 0.58 ± 0.12 in mixed cataract patients, and significantly worse in patients with subcapsular posterior cataract (LogMAR 0.64 ± 0.12). Microperimetry shows a mean sensitivity of 11.4-12.6 dB without significant group differences. The BCVA is correlated with microperimetry in patients with nuclear and cortical cataract. Density of cataract is highly correlated with microperimetry results in all groups. CONCLUSION The present study shows a good correlation of microperimetry results with the BCVA of patients with nuclear and cortical cataract. In patients with subcapsular posterior cataract, microperimetry results were better than estimated by BCVA. Density of cataract is highly correlated with macular sensitivity. A reduction of 1 dB in microperimetry per 1 posterior capsule opacification score increase can be estimated for these patients.
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Affiliation(s)
- S Richter-Mueksch
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
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Sun Y, Zheng D, Song T, Liu Y. Visual Function After Bilateral Implantation of Apodized Diffractive Multifocal IOL With a +3.0 or +4.0 D Addition. Ophthalmic Surg Lasers Imaging Retina 2011; 42:302-7. [DOI: 10.3928/15428877-20110421-02] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Accepted: 03/15/2011] [Indexed: 11/20/2022]
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Santhiago MR, Netto MV, Espindola RF, Mazurek MG, de Gomes BA, Parede TR, Harooni H, Kara-Junior N. Comparison of reading performance after bilateral implantation of multifocal intraocular lenses with +3.00 or +4.00 diopter addition. J Cataract Refract Surg 2010; 36:1874-9. [DOI: 10.1016/j.jcrs.2010.05.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Revised: 05/18/2010] [Accepted: 05/19/2010] [Indexed: 10/18/2022]
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Ito M, Shimizu K. Reading ability with pseudophakic monovision and with refractive multifocal intraocular lenses: Comparative study. J Cataract Refract Surg 2009; 35:1501-4. [DOI: 10.1016/j.jcrs.2009.03.051] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2008] [Revised: 03/26/2009] [Accepted: 03/27/2009] [Indexed: 10/20/2022]
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Alió JL, Radner W, Plaza-Puche AB, Ortiz D, Neipp CM, Quiles JM, Rodríguez-Marín J. Design of short Spanish sentences for measuring reading performance: Radner-Vissum test. J Cataract Refract Surg 2008; 34:638-42. [DOI: 10.1016/j.jcrs.2007.11.046] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2007] [Accepted: 11/11/2007] [Indexed: 10/22/2022]
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Reply : Reading performance after pseudoaccommodating IOLs. J Cataract Refract Surg 2008. [DOI: 10.1016/j.jcrs.2007.09.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Hütz WW, Eckhardt HB, Röhrig B, Grolmus R. Reading ability with 3 multifocal intraocular lens models. J Cataract Refract Surg 2006; 32:2015-21. [PMID: 17137977 DOI: 10.1016/j.jcrs.2006.08.029] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2006] [Accepted: 08/12/2006] [Indexed: 11/16/2022]
Abstract
PURPOSE To prospectively evaluate reading performance with of 3 types of multifocal intraocular lenses (IOLs) under different lighting conditions based on reading acuity and reading speed tests. SETTING Augenklinik, Bad Hersfeld, Germany. METHODS This randomized study comprised 60 cataract patients (120 eyes) randomly assigned to receive an SA40N IOL (AMO) (Group 1, 20 patients), Tecnis ZM001 IOL (AMO) (Group 2, 20 patients), or AcrySof ReSTOR SA60D3 IOL (Alcon) (Group 3, 20 patients). Pupil size and reading ability at near (visual acuity, reading speed) without correction, with best distance correction, and with best near correction were assessed 6 weeks postoperatively under low-light conditions (6 cd/m(2)) and bright-light conditions (100 cd/m(2)) using the Radner Reading Charts. RESULTS Six weeks postoperatively, there was no significant difference between groups in pupil size measured under low-light (6 cd/m(2)) or bright-light (100 cd/m(2)) conditions. When assessed under low-light conditions, near visual acuity and reading speed with or without correction were generally better in Group 2 than in Groups 1 and 3; there were no significant difference between Groups 1 and 3. Under bright-light conditions, Groups 2 and 3 performed significantly better than Group 1 and Group 2 performed better than Group 3. CONCLUSIONS Under bright-light conditions, second-generation multifocal IOLs provided better reading performance than the Array SA40N IOL. However, when tested under low-light conditions, patients with the Tecnis ZM001 IOL had the best reading acuity and reading speed.
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Douthwaite WA, Vianya-Estopà M, Elliott DB. Predictions of postoperative visual outcome in subjects with cataract: a preoperative and postoperative study. Br J Ophthalmol 2006; 91:638-43. [PMID: 17124240 PMCID: PMC1954778 DOI: 10.1136/bjo.2006.093401] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To assess the ability of critical flicker frequency (CFF) and optimal reading speed (ORS) to predict the potential vision in patients with cataract with and without ocular comorbidity. METHODS The two novel tests were compared with two well established potential vision tests (PVTs), the potential acuity meter (PAM) and the laser interferometer (LI). Measurements were made preoperatively in 1 eye of 88 subjects using the battery of 4 PVTs. Postoperative measurements were made with the CFF and the ORS. The subjects studied were consecutive cases over a 12-month period who fulfilled the inclusion and exclusion criteria, and agreed to participate in this study. RESULTS CFF was the PVT most resistant to the presence of cataract. Both CFF and ORS give a similar predictive precision in the presence of cataract and ocular comorbidity, although CFF seems more precise when the cataract is dense. CONCLUSIONS The PAM and the LI showed a limited clinical capability in predicting postoperative visual acuity, particularly with dense opacities. The CFF shows the most promise as a PVT, particularly with dense cataract. Further evaluation is required for both CFF and ORS.
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Affiliation(s)
- William A Douthwaite
- Department of Optometry, University of Bradford, Bradford, West Yorkshire BD7 1DP, UK.
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Vianya-Estopà M, Douthwaite WA, Noble BA, Elliott DB. Capabilities of potential vision test measurements. J Cataract Refract Surg 2006; 32:1151-60. [PMID: 16857502 DOI: 10.1016/j.jcrs.2006.01.111] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2005] [Accepted: 01/29/2006] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the usefulness of a battery of potential vision tests (PVTs) including potential acuity meter (PAM), laser interferometer (LI), critical flicker/fusion frequency (CFF), superilluminated pinhole at distance (SPH(d)) and near (SPH(n)), and optimal reading speed (ORS) by their independence of the effects of cataracts and sensitivity to macular disease (MD). SETTING Department of Optometry, University of Bradford, Bradford and Leeds General Infirmary, Leeds, United Kingdom. METHODS Potential vision test measurements were determined in 76 patients with age-related cataract and no other eye disease, 52 patients with MD and clear ocular media, and 28 patients with normal, healthy eyes. RESULTS Potential vision tests were independent of the degrading effects of cataract up to a visual acuity (VA) level of 20/200 or worse (CFF), 20/125 (ORS and SPH), and 20/40 (PAM and LI). A high degree of association was found between PVT scores and distance VA in the MD group for SPH(d) (r2 = 0.93), SPH(n) (r2 = 0.89), and PAM (r2 = 0.71). A moderate correlation was found for LI (r2 = 0.55), CFF (r2 = 0.50), and ORS (r2 = 0.45). CONCLUSIONS Potential acuity meter and LI showed very limited independence to moderate/dense cataracts and inaccurate predictions in patients with MD. Superilluminated pinhole was relatively unaffected by moderate/dense cataract and yet provided accurate predictions in the presence of MD and clear ocular media. Critical flicker/fusion frequency showed the greatest ability to bypass cataracts, although its ability to predict VA in patients with early MD was limited. The ORS was relatively unaffected by moderate/dense cataract, but its poor ability to predict VA in MD may limit its clinical suitability as a PVT.
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Affiliation(s)
- Marta Vianya-Estopà
- Department of Optometry, University of Bradford, Bradford, West Yorkshire, United Kingdom
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Déruaz A, Goldschmidt M, Mermoud C, Whatham AR, Safran AB. The relationship between word length and threshold character size in patients with central scotoma and eccentric fixation. Graefes Arch Clin Exp Ophthalmol 2006; 244:570-6. [PMID: 16163495 DOI: 10.1007/s00417-005-0111-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2005] [Revised: 07/14/2005] [Accepted: 08/03/2005] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Understanding limitations on text reading with eccentric fixation is of major concern in low vision research. Our objective was to determine, in patients with a central scotoma, whether threshold character size is similar for different word lengths and paragraphed texts. METHODS In 19 patients, we retrospectively analyzed the relationship between minimum readable character size for isolated words and text. Isolated letters, two, five, and ten-letter words and a paragraphed text were presented randomly through a scanning laser ophthalmoscope in eight different character sizes. RESULTS Threshold character size varied according to the text stimulus (p<0.05). Threshold character sizes for single letters and two-letter words were matched (p>0.99), as were those for five-letter words, ten-letter words, and paragraphed text (p>0.99). Threshold character size for single letters and two-letter words was significantly lower than that measured with other text stimuli. DISCUSSION Reading performance is influenced by a variety of factors such as crowding, contextual effects, visual span, degree of oculomotor adaptation needed, and frequency of a defined word. Globally, when reading with a central scotoma, it appears that within word characteristics have more impact than inter-word parameters on threshold character size.
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Affiliation(s)
- Anouk Déruaz
- Clinique d'Ophtalmologie, Hôpitaux Universitaires de Genève, 22, Alcide-Jentzer, 1211, Genève 14, Switzerland.
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Tan AG, Wang JJ, Rochtchina E, Mitchell P. Comparison of age-specific cataract prevalence in two population-based surveys 6 years apart. BMC Ophthalmol 2006; 6:17. [PMID: 16623958 PMCID: PMC1524813 DOI: 10.1186/1471-2415-6-17] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2005] [Accepted: 04/20/2006] [Indexed: 11/17/2022] Open
Abstract
Background In this study, we aimed to compare age-specific cortical, nuclear and posterior subcapsular (PSC) cataract prevalence in two surveys 6 years apart. Methods The Blue Mountains Eye Study examined 3654 participants (82.4% of those eligible) in cross-section I (1992–4) and 3509 participants (75.1% of survivors and 85.2% of newly eligible) in cross-section II (1997–2000, 66.5% overlap with cross-section I). Cataract was assessed from lens photographs following the Wisconsin Cataract Grading System. Cortical cataract was defined if cortical opacity comprised ≥ 5% of lens area. Nuclear cataract was defined if nuclear opacity ≥ Wisconsin standard 4. PSC was defined if any present. Any cataract was defined to include persons who had previous cataract surgery. Weighted kappa for inter-grader reliability was 0.82, 0.55 and 0.82 for cortical, nuclear and PSC cataract, respectively. We assessed age-specific prevalence using an interval of 5 years, so that participants within each age group were independent between the two surveys. Results Age and gender distributions were similar between the two populations. The age-specific prevalence of cortical (23.8% in 1st, 23.7% in 2nd) and PSC cataract (6.3%, 6.0%) was similar. The prevalence of nuclear cataract increased slightly from 18.7% to 23.9%. After age standardization, the similar prevalence of cortical (23.8%, 23.5%) and PSC cataract (6.3%, 5.9%), and the increased prevalence of nuclear cataract (18.7%, 24.2%) remained. Conclusion In two surveys of two population-based samples with similar age and gender distributions, we found a relatively stable cortical and PSC cataract prevalence over a 6-year period. The increased prevalence of nuclear cataract deserves further study.
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Affiliation(s)
- Ava Grace Tan
- Centre for Vision Research, Westmead Millennium Institute, Department of Ophthalmology, University of Sydney, Westmead Hospital, Westmead, NSW, Australia
| | - Jie Jin Wang
- Centre for Vision Research, Westmead Millennium Institute, Department of Ophthalmology, University of Sydney, Westmead Hospital, Westmead, NSW, Australia
| | - Elena Rochtchina
- Centre for Vision Research, Westmead Millennium Institute, Department of Ophthalmology, University of Sydney, Westmead Hospital, Westmead, NSW, Australia
| | - Paul Mitchell
- Centre for Vision Research, Westmead Millennium Institute, Department of Ophthalmology, University of Sydney, Westmead Hospital, Westmead, NSW, Australia
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Stifter E, Weghaupt H, Benesch T, Thaler A, Radner W. Discriminative power of reading tests to differentiate visual impairment caused by cataract and age-related macular degeneration. J Cataract Refract Surg 2006; 31:2111-9. [PMID: 16412924 DOI: 10.1016/j.jcrs.2005.03.080] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2005] [Indexed: 11/16/2022]
Abstract
PURPOSE To determine whether preoperative reading tests can be used for differentiating visual impairments with regard to the diagnosis of cataract and age-related macular degeneration (ARMD). SETTING Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS Reading performance of patients with nuclear cataract, posterior subcapsular cataract, and ARMD were evaluated with respect to reading acuity, maximum reading speed, and critical print size; normal-sighted participants were tested as controls. A multivariate discriminant analysis of the 4 groups (100 eyes of 100 participants) was performed to evaluate how many patients could be correctly diagnosed by significant differences in the tested reading parameters. Subsequently, the nuclear cataract and posterior subcapsular cataract patients were compared with cataract patients with coexisting ARMD. RESULTS Distance visual acuity was comparable in the nuclear cataract, posterior subcapsular cataract, and ARMD groups (P>.05). Reading acuity was significantly reduced in posterior subcapsular cataract and ARMD patients compared with nuclear cataract patients and controls (P<.0001). No significant difference in maximum reading speed was found between the nuclear cataract patients and the controls (P = .07), whereas the maximum reading speed of the posterior subcapsular cataract and ARMD patients was significantly reduced (P<.0001). In the discriminant analysis, it was possible to assign the correct diagnosis to 72% of the nuclear cataract patients, 76% of the posterior subcapsular cataract patients, 72% of the ARMD patients, and 92% of the controls. Comparing the reading performance of nuclear cataract and posterior subcapsular cataract patients and cataract patients with coexisting ARMD showed that reading performance was significantly impaired in the comorbid patients (nuclear cataract and ARMD, P<.001; posterior subcapsular cataract and ARMD, P<.05). CONCLUSION The high discriminant accuracy shows that this standardized reading test system is a valuable diagnostic tool for evaluating functional visual impairments when distance visual acuity alone cannot elucidate the origin of functional impairment. Considering the significant discrepancies in reading performance among patients with nuclear cataract, posterior subcapsular cataract, and ARMD, reading tests may relevantly improve the clinical evaluation of patients with visual loss, even of patients with ocular comorbidity.
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Affiliation(s)
- Eva Stifter
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
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Stifter E, Burggasser G, Hirmann E, Thaler A, Radner W. Monocular and binocular reading performance in children with microstrabismic amblyopia. Br J Ophthalmol 2005; 89:1324-9. [PMID: 16170125 PMCID: PMC1772895 DOI: 10.1136/bjo.2005.066688] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To evaluate if functionally relevant deficits in reading performance exist in children with essential microstrabismic amblyopia by comparing the monocular and binocular reading performance with the reading performance of normal sighted children with full visual acuity in both eyes. METHODS The reading performance of 40 children (mean age 11.6 (SD 1.4) years) was evaluated monocularly and binocularly in randomised order, using standardised reading charts for the simultaneous determination of reading acuity and speed. 20 of the tested children were under treatment for unilateral microstrabismic amblyopia (visual acuity in the amblyopic eyes: logMAR 0.19 (0.15); fellow eyes -0.1 (0.07)); the others were normal sighted controls (visual acuity in the right eyes -0.04 (0.15); left eyes -0.08 (0.07)). RESULTS In respect of the binocular maximum reading speed (MRS), significant differences were found between the children with microstrabismic amblyopia and the normal controls (p = 0.03): whereas the controls achieved a binocular MRS of 200.4 (11) wpm (words per minute), the children with unilateral amblyopia achieved only a binocular MRS of 172.9 (43.9) wpm. No significant differences between the two groups were found in respect of the binocular logMAR visual acuity and reading acuity (p>0.05). For the monocular reading performance, significant impairment was found in the amblyopic eyes, whereas no significant differences were found between the sound fellow eyes of the amblyopic children and the control group. CONCLUSION In binocular MRS, significant differences could be found between children with microstrabismic amblyopia and normal controls. This result indicates the presence of a functionally relevant reading impairment, even though the binocular visual acuity and reading acuity were both comparable with the control group.
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Affiliation(s)
- E Stifter
- Department of Ophthalmology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
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Stifter E, Burggasser G, Hirmann E, Thaler A, Radner W. Evaluating reading acuity and speed in children with microstrabismic amblyopia using a standardized reading chart system. Graefes Arch Clin Exp Ophthalmol 2005; 243:1228-35. [PMID: 16003512 DOI: 10.1007/s00417-005-1187-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2004] [Revised: 01/29/2005] [Accepted: 03/15/2005] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND To examine if standardized reading charts with highly comparable test items can be used for evaluating impairments in the monocular reading performance of children with microstrabismic amblyopia characterized by a small angle of squint with less than 5 degrees. METHODS The reading performance of 22 children (mean age: 11.7+/-1.6 years) with unilateral microstrabismic amblyopia was evaluated monocularly in both eyes, using standardized reading charts for the simultaneous determination of reading acuity and speed. The print sizes of the highly comparable sentence optotypes were logarithmically graded, providing constant geometric proportions for all testing distances in order to control contour interaction. All children were under continuous amblyopia therapy. RESULTS In the amblyopic eyes, reading acuity and maximum reading speed were significantly impaired when compared to the sound fellow eyes (P<0.001). In respect of the maximum reading speed, a mean inter-ocular difference of 33+/-19 words per minute was found, revealing functionally relevant deficits in monocular reading performance. The amblyopic eyes achieved only a significantly reduced reading acuity (mean inter-ocular difference: LogRAD 0.5+/-0.24; P<0.001). In eight children, the amblyopic eyes achieved a best-corrected visual acuity of LogMAR 0.0 or better: in respect of the visual acuity, there was no significant inter-ocular difference, but reading acuity and maximum reading speed were significantly impaired when compared to the fellow eyes. CONCLUSIONS Microstrabismic amblyopia was associated with significant impairment of reading acuity and speed in treated amblyopes, even in those with no persistent acuity deficit. To improve treatment addressing these functional deficits, reading performance should be monitored over time using standardized reading tests, which provide essential information about functionally relevant reading impairments.
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Affiliation(s)
- E Stifter
- Department of Ophthalmology, Medical University of Vienna, Austria
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Stifter E, Sacu S, Weghaupt H. Functional vision with cataracts of different morphologies: Comparative study. J Cataract Refract Surg 2004; 30:1883-91. [PMID: 15342050 DOI: 10.1016/j.jcrs.2004.01.038] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2004] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate the influence of cataract morphology on the functional vision of patients with age-related cataract and normal macular function and compare subjectively perceived functional impairments to distance visual acuity, reading acuity, and maximum reading speed between cataract types. SETTING Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. METHODS Seventy-five patients awaiting first-eye cataract surgery were asked to characterize their visual difficulties in everyday life using a German version of the VF-14 questionnaire. Cataracts were categorized and graded using the Lens Opacities Classification System III. Monocular and binocular visual acuity and reading performance were determined in randomized order. RESULTS There were significant differences in functional vision between nuclear cataracts and posterior subcapsular cataracts (PSC); the VF-14 score and the self-reported visual satisfaction were significantly lower in PSC patients (P<.05). Posterior subcapsular cataracts significantly increased self-reported impairment in distance and near vision, although the visual acuity was comparable to that in the other groups (P =.9). Significant differences in functional vision were also seen between PSC and nuclear-cortical cataracts (P<.05). No significant differences in functional vision were found between nuclear cataracts and nuclear-cortical cataracts (P>.05). CONCLUSIONS The VF-14 questionnaire reliably evaluated functional differences caused by different cataract morphologies; these differences were underestimated when only visual acuity was measured. Patients with PSC had increased functional impairment, indicating that cataract surgical intervention is indicated at an earlier stage in these patients. The significant differences between the morphological types of cataract should be taken into consideration when the benefit of cataract surgery is to be measured on the basis of functional improvement.
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Affiliation(s)
- Eva Stifter
- Department of Ophthalmology, Medical University of Vienna, A-1090 Vienna, Austria.
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