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Li D, Chan VF, Virgili G, Mavi S, Pundir S, Singh MK, She X, Piyasena P, Clarke M, Whitestone N, Patnaik JL, Xiao B, Cherwek DH, Negash H, O'Connor S, Prakalapakorn SG, Huang H, Wang H, Boswell M, Congdon N. Impact of Vision Impairment and Ocular Morbidity and Their Treatment on Quality of Life in Children: A Systematic Review. Ophthalmology 2024; 131:188-207. [PMID: 37696451 DOI: 10.1016/j.ophtha.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/16/2023] [Accepted: 09/05/2023] [Indexed: 09/13/2023] Open
Abstract
TOPIC This review summarizes existing evidence of the impact of vision impairment and ocular morbidity and their treatment on children's quality of life (QoL). CLINICAL RELEVANCE Myopia and strabismus are associated with reduced QoL among children. Surgical treatment of strabismus significantly improves affected children's QoL. METHODS We conducted a systematic review and meta-analysis by screening articles in any language in 9 databases published from inception through August 22, 2022, addressing the impact of vision impairment, ocular morbidity, and their treatment on QoL in children. We reported pooled standardized mean differences (SMDs) using random-effects meta-analysis models. Quality appraisal was performed using Joanna Briggs Institute and National Institutes of Health tools. This study was registered with the International Prospective Register of Systematic Reviews (identifier, CRD42021233323). RESULTS Our search identified 29 118 articles, 44 studies (0.15%) of which were included for analysis that included 32 318 participants from 14 countries between 2005 and 2022. Seventeen observational and 4 interventional studies concerned vision impairment, whereas 10 observational and 13 interventional studies described strabismus and other ocular morbidities. Twenty-one studies were included in the meta-analysis. The QoL scores did not differ between children with and without vision impairment (SMD, -1.04; 95% confidence interval [CI], -2.11 to 0.03; P = 0.06; 9 studies). Myopic children demonstrated significantly lower QoL scores than those with normal vision (SMD, -0.60; 95% CI, -1.09 to -0.11; P = 0.02; 7 studies). Children with strabismus showed a significantly lower QoL score compared with those without (SMD, -1.19; 95% CI, -1.66 to -0.73; P < 0.001; 7 studies). Strabismus surgery significantly improved QoL in children (SMD, 1.36; 95% CI, 0.48-2.23; P < 0.001; 7 studies). No randomized controlled trials (RCTs) concerning refractive error and QoL were identified. Among all included studies, 35 (79.5%) were scored as low to moderate quality; the remaining met all quality appraisal tools criteria. DISCUSSION Reduced QoL was identified in children with myopia and strabismus. Surgical correction of strabismus improves the QoL of affected children, which supports insurance coverage of strabismus surgery. Further studies, especially RCTs, investigating the impact of correction of myopia on QoL are needed. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Dongfeng Li
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China; Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Ving Fai Chan
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Gianni Virgili
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom; Department Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Sonia Mavi
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Sheetal Pundir
- Department of Ophthalmology, McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Xinshu She
- School of Medicine, Stanford University, Stanford, California
| | - Prabhath Piyasena
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Mike Clarke
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | | | - Jennifer L Patnaik
- Orbis International, New York, New York; Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado
| | - Baixiang Xiao
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom; Affiliated Eye Hospital of Nanchang University, Nanchang City, China
| | | | | | - Sara O'Connor
- Advanced Center for Eyecare Global, Bakersfield, California
| | - S Grace Prakalapakorn
- Departments of Ophthalmology and Pediatrics, Duke University Medical Center, Durham, North Carolina; Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Huilan Huang
- Shandong First Medical University (Shandong Academy of Medical Science), Jinan, China
| | - Huan Wang
- Centre on China's Economy and Institutions, Stanford University, Stanford, California
| | - Matthew Boswell
- Centre on China's Economy and Institutions, Stanford University, Stanford, California
| | - Nathan Congdon
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom; Orbis International, New York, New York; Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou City, China.
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Heravian Shandiz J, Momeni Moghaddam H, Wolffsohn JS, Karimpour M. Exploratory and confirmatory factor analysis of the Persian version of the low-vision quality-of-life questionnaire. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2023. [DOI: 10.1177/02646196231154473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Most of the vision quality assessment questionnaires are in English. None of the low-vision-related quality-of-life questionnaires have been translated or developed in Persian. It will help Persian optometrists and ophthalmologists to assess improvement of visual function and quality of life during their low-vision rehabilitation programs. In this study, we aimed to translate the low-vision quality-of-life (LVQOL) questionnaire in Persian language and apply exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to assess the construct validity and fit model. Translation and cultural adjustment of the English language LVQOL questionnaire to Persian was undertaken. Overall, 100 low-vision patients were participated to validate and model the assessment questionnaire by both EFA and CFA methods. Complementary EFA and CFA results provide detailed information about item and scale performance of the Persian LVQOL. EFA showed Items 15, 16, and 21 which had factor loadings lower than 0.3. The modified model had the comparative fit index (CFI) and root mean square error of approximation (RMSEA) of 0.89 and 0.06, respectively. The translation, adjustment, and fit analysis of the LVQOL questionnaire into Persian were successful and it will be valuable in both clinical practice and research.
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Vingopoulos F, Kasetty M, Garg I, Silverman RF, Katz R, Vasan RA, Lorch AC, Luo ZK, Miller JB. Active Learning to Characterize the Full Contrast Sensitivity Function in Cataracts. Clin Ophthalmol 2022; 16:3109-3118. [PMID: 36168557 PMCID: PMC9509679 DOI: 10.2147/opth.s367490] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/03/2022] [Indexed: 11/23/2022] Open
Abstract
Background To characterize contrast sensitivity function (CSF) in cataractous and pseudophakic eyes compared to healthy control eyes using a novel quantitative CSF test with active learning algorithms. Methods This is a prospective observational study at an academic medical center. CSF was measured in eyes with visually significant cataract, at least 2+ nuclear sclerosis (NS) and visual acuity (VA) ≥ 20/50, in pseudophakic eyes and in healthy controls with no more than 1+ NS and no visual complaints, using the Manifold Contrast Vision Meter. Outcomes included Area under the Log CSF (AULCSF) and CS thresholds at 1, 1.5, 3, 6, 12, and 18 cycles per degree (cpd). A subgroup analysis as performed on cataract eyes with VA ≥ 20/25. Results A total of 167 eyes were included, 58 eyes in the cataract group, 77 controls, and 32 pseudophakic eyes with respective median AULCSF of 1.053 (0.352) vs 1.228 (0.318) vs 1.256 (0.360). In our multivariate regression model, cataract was associated with significantly reduced AULCSF (P= 0.04, β= −0.11) and contrast threshold at 6 cpd (P= 0.01, β= −0.16) compared to controls. Contrast threshold at 6 cpd was significantly reduced even in the subgroup of cataractous eyes with VA ≥ 20/25 (P=0.02, β=−0.16). Conclusion The novel qCSF test detected disproportionate significant contrast deficits at 6 cpd in cataract eyes; this remained significant even in the cataractous eyes with VA ≥ 20/25. CSF testing may enhance cataract evaluation and surgical decision-making, particularly in patients with subjective visual complaints despite good VA.
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Affiliation(s)
- Filippos Vingopoulos
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Megan Kasetty
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Itika Garg
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Rebecca F Silverman
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Raviv Katz
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Ryan A Vasan
- Comprehensive Ophthalmology and Cataract Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Alice C Lorch
- Comprehensive Ophthalmology and Cataract Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Zhonghui K Luo
- Comprehensive Ophthalmology and Cataract Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - John B Miller
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
- Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
- Correspondence: John B Miller, Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles St, Boston, MA, USA, Tel +1 617 573-3750, Fax +1 617 573-3698, Email
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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] [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.
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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
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Wu SZ, Nolan-Kenney R, Moehringer NJ, Hasanaj LF, Joseph BM, Clayton AM, Rucker JC, Galetta SL, Wisniewski TM, Masurkar AV, Balcer LJ. Exploration of Rapid Automatized Naming and Standard Visual Tests in Prodromal Alzheimer Disease Detection. J Neuroophthalmol 2022; 42:79-87. [PMID: 34029274 PMCID: PMC8595455 DOI: 10.1097/wno.0000000000001228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
BACKGROUND Visual tests in Alzheimer disease (AD) have been examined over the last several decades to identify a sensitive and noninvasive marker of the disease. Rapid automatized naming (RAN) tasks have shown promise for detecting prodromal AD or mild cognitive impairment (MCI). The purpose of this investigation was to determine the capacity for new rapid image and number naming tests and other measures of visual pathway structure and function to distinguish individuals with MCI due to AD from those with normal aging and cognition. The relation of these tests to vision-specific quality of life scores was also examined in this pilot study. METHODS Participants with MCI due to AD and controls from well-characterized NYU research and clinical cohorts performed high and low-contrast letter acuity (LCLA) testing, as well as RAN using the Mobile Universal Lexicon Evaluation System (MULES) and Staggered Uneven Number test, and vision-specific quality of life scales, including the 25-Item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and 10-Item Neuro-Ophthalmic Supplement. Individuals also underwent optical coherence tomography scans to assess peripapillary retinal nerve fiber layer and ganglion cell/inner plexiform layer thicknesses. Hippocampal atrophy on brain MRI was also determined from the participants' Alzheimer disease research center or clinical data. RESULTS Participants with MCI (n = 14) had worse binocular LCLA at 1.25% contrast compared with controls (P = 0.009) and longer (worse) MULES test times (P = 0.006) with more errors in naming images (P = 0.009) compared with controls (n = 16). These were the only significantly different visual tests between groups. MULES test times (area under the receiver operating characteristic curve [AUC] = 0.79), MULES errors (AUC = 0.78), and binocular 1.25% LCLA (AUC = 0.78) showed good diagnostic accuracy for distinguishing MCI from controls. A combination of the MULES score and 1.25% LCLA demonstrated the greatest capacity to distinguish (AUC = 0.87). These visual measures were better predictors of MCI vs control status than the presence of hippocampal atrophy on brain MRI in this cohort. A greater number of MULES test errors (rs = -0.50, P = 0.005) and worse 1.25% LCLA scores (rs = 0.39, P = 0.03) were associated with lower (worse) NEI-VFQ-25 scores. CONCLUSIONS Rapid image naming (MULES) and LCLA are able to distinguish MCI due to AD from normal aging and reflect vision-specific quality of life. Larger studies will determine how these easily administered tests may identify patients at risk for AD and serve as measures in disease-modifying therapy clinical trials.
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Affiliation(s)
- Shirley Z Wu
- Departments of Neurology (SZW, RNK, NM, LH, BJ, AC, JCR, SLG, TMW, AVM, and LJB), Population Health (RNK and LJB), and Ophthalmology (SZW, JCR, SLG, and LJB), New York University Grossman School of Medicine, New York, New York
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Marta A, Marques JH, Almeida D, José D, Barbosa I. Keratoconus and Visual Performance with Different Contact Lenses. Clin Ophthalmol 2021; 15:4697-4705. [PMID: 34949911 PMCID: PMC8689658 DOI: 10.2147/opth.s345154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 11/25/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To analyze the visual performance in contact lens wearers with keratoconus. Methods A retrospective study including contact lens (CL) wearers was performed. The current best-corrected visual acuity with contact lens (BCVA-CL) and with spectacles (BCVA-S) correction, contrast sensitivity (CS) (by Metrovision-MonPack3®), analysis of light scattering in the retina and vision break-up time (HD Analyzer®), and corneal tomography (Oculus Pentacam® HR) were evaluated. Results This study included 96 eyes of 59 patients with Keratoconus. Rigid gas permeable contact lenses (RGPCL), hybrid contact lenses (HCL), and silicone hydrogel/hydrogel contact lenses (HGCL) were fitted in 67, 17, and 12 eyes, respectively. Dynamic objective scatter index (OSI) (p = 0.024), minimum OSI (p = 0.037) and maximum OSI (p = 0.040) were significantly better with RGPCL and worse with HGCL. Mean CS in photopic conditions was significantly worse with HGCL and better with HCL (p = 0.006), without differences in mesopic conditions (p = 0.121). RGPCL wearers showed a higher mean K (p = 0.020), and a lower corneal thickness at the thinnest point (p=0.011). Conclusion Visual quality varied significantly with different types of CL. Although RGPCL was fitted in patients with worse Pentacam tomographic parameters, RGPCL was associated with a better dynamic visual quality.
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Affiliation(s)
- Ana Marta
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto (CHUPorto), Oporto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Oporto, Portugal
| | - João Heitor Marques
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto (CHUPorto), Oporto, Portugal
| | - Daniel Almeida
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto (CHUPorto), Oporto, Portugal
| | - Diana José
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto (CHUPorto), Oporto, Portugal
| | - Irene Barbosa
- Department of Ophthalmology, Centro Hospitalar Universitário do Porto (CHUPorto), Oporto, Portugal.,Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Oporto, Portugal
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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 AND VISION 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] [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.
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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
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Gothwal VK, Wright TA, Lamoureux EL, Pesudovs K. Multiplicative rating scales do not enable measurement of vision‐related quality of life. Clin Exp Optom 2021; 94:52-62. [DOI: 10.1111/j.1444-0938.2010.00554.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Vijaya K Gothwal
- NHMRC Centre for Clinical Eye Research, Discipline of Ophthalmology and Discipline of Optometry and Vision Science, Flinders Medical Centre and Flinders University of South Australia, Bedford Park, South Australia, Australia
- Meera and L B Deshpande Centre for Sight Enhancement, Vision Rehabilitation Centres, L V Prasad Eye Institute, Hyderabad, India
| | - Thomas A Wright
- NHMRC Centre for Clinical Eye Research, Discipline of Ophthalmology and Discipline of Optometry and Vision Science, Flinders Medical Centre and Flinders University of South Australia, Bedford Park, South Australia, Australia
| | - Ecosse L Lamoureux
- Centre for Eye Research Australia, Department of Ophthalmology, University of Melbourne, Victoria, Australia
- Vision CRC, Sydney, Australia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
E‐mail:
| | - Konrad Pesudovs
- NHMRC Centre for Clinical Eye Research, Discipline of Ophthalmology and Discipline of Optometry and Vision Science, Flinders Medical Centre and Flinders University of South Australia, Bedford Park, South Australia, Australia
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Tamura N, Sasai-Sakuma T, Morita Y, Okawa M, Inoue S, Inoue Y. Prevalence and associated factors of circadian rhythm sleep-wake disorders and insomnia among visually impaired Japanese individuals. BMC Public Health 2021; 21:31. [PMID: 33407286 PMCID: PMC7789312 DOI: 10.1186/s12889-020-09993-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 11/30/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Although earlier studies have demonstrated that circadian rhythm sleep-wake disorders (CRSWD) are more prevalent in visually impaired individuals, the actual prevalence of CRSWD and insomnia among the visually impaired Japanese population remains unclear. The aim of this cross-sectional, telephone-based study was to estimate the prevalence of CRSWD and insomnia, and explore factors associated with CRSWD and insomnia among visually impaired Japanese individuals. METHODS A nationwide telephone survey was conducted among visually-impaired individuals through local branches of the Japan Federation of the Blind. In total, 157 visually impaired individuals were eligible for this study. Demographic information and information about visual impairments, lifestyle, and sleep patterns were assessed using questionnaires and subsequent telephone interviews. CRSWD and insomnia were defined according to the International Classification of Sleep Disorders-Third Edition criteria. RESULTS The prevalence of CRSWD in visually impaired individuals was 33.1%. Among those with CRSWD, a non-24-h/irregular sleep-wake rhythm type was the most frequently observed (26.8%), followed by an advanced sleep-wake phase type and a delayed sleep-wake phase type (3.8 and 2.5%, respectively). Furthermore, 28.7% of the visually impaired individuals were found to have insomnia. In the visually impaired individuals, the absence of light perception, unemployment, living alone, and use of hypnotics were significantly associated with CRSWD, whereas only the use of hypnotics was extracted as a marginally associated factor of insomnia. CONCLUSIONS CRSWD and insomnia were highly prevalent in visually impaired Japanese individuals. The presence of CRSWD among the visually impaired individuals was associated with a lack of light perception and/or social zeitgebers.
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Affiliation(s)
- Norihisa Tamura
- Department of Psychology, Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
| | - Taeko Sasai-Sakuma
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
- Department of Clinical Laboratory Science, Teikyo University, Tokyo, Japan
| | - Yuko Morita
- Department of Liberal Arts, Faculty of Science and Technology, Tokyo University of Science, Chiba, Japan
| | - Masako Okawa
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
- Yoyogi Sleep Disorder Center, Tokyo, Japan
- Japan Foundation for Neuroscience and Mental Health, Tokyo, Japan
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Tokyo, Japan.
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan.
- Yoyogi Sleep Disorder Center, Tokyo, Japan.
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Wu SZ, Masurkar AV, Balcer LJ. Afferent and Efferent Visual Markers of Alzheimer's Disease: A Review and Update in Early Stage Disease. Front Aging Neurosci 2020; 12:572337. [PMID: 33061906 PMCID: PMC7518395 DOI: 10.3389/fnagi.2020.572337] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 08/20/2020] [Indexed: 01/06/2023] Open
Abstract
Vision, which requires extensive neural involvement, is often impaired in Alzheimer's disease (AD). Over the last few decades, accumulating evidence has shown that various visual functions and structures are compromised in Alzheimer's dementia and when measured can detect those with dementia from those with normal aging. These visual changes involve both the afferent and efferent parts of the visual system, which correspond to the sensory and eye movement aspects of vision, respectively. There are fewer, but a growing number of studies, that focus on the detection of predementia stages. Visual biomarkers that detect these stages are paramount in the development of successful disease-modifying therapies by identifying appropriate research participants and in identifying those who would receive future therapies. This review provides a summary and update on common afferent and efferent visual markers of AD with a focus on mild cognitive impairment (MCI) and preclinical disease detection. We further propose future directions in this area. Given the ease of performing visual tests, the accessibility of the eye, and advances in ocular technology, visual measures have the potential to be effective, practical, and non-invasive biomarkers of AD.
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Affiliation(s)
- Shirley Z. Wu
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, United States
- Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY, United States
| | - Arjun V. Masurkar
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, United States
| | - Laura J. Balcer
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, United States
- Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY, United States
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
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11
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Hamedani M, Dulley B, Murdoch I. Glaucoma and glare. Eye (Lond) 2020; 35:1741-1747. [PMID: 32873944 DOI: 10.1038/s41433-020-01164-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 08/15/2020] [Accepted: 08/20/2020] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To determine whether a purpose-built glare tester, in combination with new glare-specific questions, can better assess glaucoma patients' experience of glare and visual disability than visual acuity (VA) or visual fields alone. PATIENTS AND METHODS Consecutive patients attending for visual fields in a single glaucoma clinic from 03/06/2019-01/11/2019 underwent VA assessment using a Brightness Acuity Tester as a glare source, examination for media opacities, and completed the VFQ-25 with four additional glare-related questions. One hundred and sixteen eyes (64 patients) were included for analysis. The amount of disability glare (VA reduction due to glare) was compared according to presence/absence of media opacity and glaucoma severity. Subjective glare symptoms were compared with objective disability glare measurement using a Bland-Altman plot. RESULTS Patients with advanced-severe glaucoma had significantly worse disability glare than those with mild-moderate glaucoma. VA reduction due to glare from mild-moderate to acute-severe glaucoma (mean -3.4 letters, P = 0.01, CI -0.8, -6.0) was of almost identical magnitude to that due to presence of any media opacity (mean -3.3 letters, P = 0.03, CI -0.4, -6.2). There was a trend towards greater disability glare in more symptomatic patients, with good agreement between subjective and objective glare measurements for those with few glare signs or symptoms, but progressively more variation either side of agreement as either measurement worsened. CONCLUSIONS Glaucoma is associated with objective and subjective acuity reduction in the presence of glare. We demonstrated an increase in disability glare in patients with more severe glaucoma. The worse the glare symptoms or signs, the more variable the agreement between objective and subjective assessments.
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12
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Gong L, Min SH, Chen S, Wei J, Kong D, Tao C, Zhang P, Huang PC, Zhou J. Reduced Monocular Luminance Increases Monocular Temporal Synchrony Threshold in Human Adults. Invest Ophthalmol Vis Sci 2020; 61:1. [PMID: 32609295 PMCID: PMC7425744 DOI: 10.1167/iovs.61.8.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to present our investigation of the influence of reduced monocular luminance on monocular and dichoptic temporal synchrony processing in healthy adults. Methods Ten adults with normal or corrected to normal visual acuity participated in our psychophysical study. The temporal synchrony threshold in dichoptic (experiment 1), monocular (experiment 2), and binocular (experiment 3) viewing configurations was obtained from each observer. Four flickering Gaussian dots (one synchronous and one asynchronous pair of two dots) were displayed, from which the observers were asked to identify the asynchronous pair. The temporal phase lag in the signal pair (asynchronous) but not in the reference pair (synchronous) was varied. In addition, a neutral density (ND) filter of various intensities (1.3 and 2.0 log units) was placed before the dominant eye throughout the behavioral measurement. In the end, dichoptic, monocular, and binocular thresholds were measured for each observer. Results With decreasing monocular luminance, the dichoptic threshold (2 ND vs. 0 ND, P < 0.001; 2 ND vs. 1.3 ND P = 0.001) and monocular threshold (2 ND vs. 0 ND, P < 0.001; 2 ND vs. 1.3 ND, P = 0.003) increased; however, the bincoular threshold remained unaffected (P = 0.576). Conclusions Reduced luminance induces delay and disturbs the discrimination of temporal synchrony. Our findings have clinical implications in visual disorders.
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13
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Spooner K, Fraser-Bell S, Hong T, Chang A. Patient-reported outcomes from a phase IV study of aflibercept in patients with refractory retinal vein occlusions. Taiwan J Ophthalmol 2020; 11:244-250. [PMID: 34703739 PMCID: PMC8493984 DOI: 10.4103/tjo.tjo_19_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 04/09/2020] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To determine the patient-centered effectiveness of switching patients with persistent macular edema due to retinal vein occlusion (RVO) to aflibercept using the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25). MATERIALS AND METHODS Prospective study of eyes with persistent cystoid macular edema due to RVO despite regular treatment with bevacizumab or ranibizumab switched to aflibercept. Three loading doses of intravitreal aflibercept were administered every 4 weeks and thereafter every 8 weeks until week 48. Vision-related quality of life (VRQoL) using NEI-VFQ-25 was measured at baseline, 24 weeks, and 48 weeks following the switch. Baseline scores were compared to week 24 and 48 using paired t-test. Relationship between best-corrected visual acuity (BCVA) in the study eye and the NEI-VFQ-25 composite and subscale scores was investigated. RESULTS Eighteen patients with RVO were enrolled in the study with a mean age of 70.3 ± 8.6 years. The mean change in BCVA and central macular thickness (CMT) from baseline to 48 weeks was +20.6 ± 5.2 Early Treatment of Diabetic Retinopathy Score letters and -109.2 ± 82.8 µm, respectively. VRQoL improved significantly, with an increase of mean NEI-VFQ composite score of 11.5 ± 9.5; the corresponding improvements in near and distant activities were 13.3 ± 19.4 and 8.4 ± 10.4, respectively (P < 0.001 for both). Logistic regression analysis demonstrated that BCVA gain of >15 letters and CMT < 300 µm at the end of the study predicted a higher change in VFQ-25. CONCLUSION Switching eyes with persistent macular edema due to RVO to aflibercept resulted in significant improvement in visual function and patient satisfaction.
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Affiliation(s)
- Kimberly Spooner
- Sydney Retina, NSW, Australia.,Sydney Institute of Vision Science, NSW, Australia.,University of Sydney, NSW, Australia
| | | | - Thomas Hong
- Sydney Retina, NSW, Australia.,Sydney Institute of Vision Science, NSW, Australia
| | - Andrew Chang
- Sydney Retina, NSW, Australia.,Sydney Institute of Vision Science, NSW, Australia.,University of Sydney, NSW, Australia
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14
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Allen PM, Latham K, Ravensbergen RHJC, Myint J, Mann DL. Rifle Shooting for Athletes With Vision Impairment: Does One Class Fit All? Front Psychol 2019; 10:1727. [PMID: 31417457 PMCID: PMC6684738 DOI: 10.3389/fpsyg.2019.01727] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 07/11/2019] [Indexed: 12/02/2022] Open
Abstract
Revised evidence-based classification criteria introduced for shooting for athletes with vision impairment (VI shooting) suggest that athletes with impaired contrast sensitivity (CS) and visual acuity (VA) should be eligible for inclusion in the sport but should all eligible athletes compete against each other in the same "class" or is more than one class necessary? Twenty-five elite VI shooting athletes took part in the study. Two measures of visual function were assessed under standardized conditions: VA (using an ETDRS logMAR letter chart, and/or a BRVT chart) and CS (using both a Pelli-Robson chart and a Mars number chart). Shooting performance, in both prone and standing events, was measured during an international VI shooting competition. Fourteen of the 25 athletes had measurable VA, and for CS, 8 athletes had measurable function with the Pelli-Robson chart and 13 with the Mars chart. The remaining athletes had function not numerically measurable by the charts and were considered to have no residual vision. There was no indication that shooting performance varied with visual function, and individuals that had residual vision had no advantage over those without vision for either prone or standing shooting. The modifications made to VI shooting, including the use of auditory tones to guide the gun barrel, appear to have successfully rendered the sport equitable for all eligible athletes. Only one class is necessary for athletes. An improved method of measuring CS in athletes with profound VI would be advantageous.
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Affiliation(s)
- Peter M. Allen
- Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, United Kingdom
- Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, United Kingdom
| | - Keziah Latham
- Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, United Kingdom
- Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, United Kingdom
| | - Rianne H. J. C. Ravensbergen
- Department of Human Movement Sciences, IPC Research and Development Centre for the Classification of Athletes with Vision Impairment, Amsterdam Movement Sciences, Institute of Brain and Behavior, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Joy Myint
- Department of Clinical and Pharmaceutical Sciences, Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - David L. Mann
- Department of Human Movement Sciences, IPC Research and Development Centre for the Classification of Athletes with Vision Impairment, Amsterdam Movement Sciences, Institute of Brain and Behavior, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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15
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CAPTCHA as a Visual Performance Metric in Active Macular Disease. J Ophthalmol 2019; 2019:6710754. [PMID: 31281669 PMCID: PMC6590550 DOI: 10.1155/2019/6710754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 04/25/2019] [Accepted: 05/16/2019] [Indexed: 11/21/2022] Open
Abstract
Purpose CAPTCHA (completely automated public turing test to tell computers and humans apart) was designed as a spam prevention test. In patients with visual impairment, completion of this task has been assumed to be difficult; but to date, no study has proven this to be true. As visual function is not well measured by Snellen visual acuity (VA) alone, we theorized that CAPTCHA performance may provide additional information on macular disease-related visual dysfunction. Methods This was designed as a pilot study. Active disease was defined as the presence of either intraretinal fluid (IRF) or subretinal fluid (SRF) on spectral-domain optical coherence tomography. CAPTCHA performance was tested using 10 prompts. In addition, near and distance VA, contrast sensitivity, and reading speed were measured. Visual acuity matched pseudophakic patients were used as controls. Primary outcome measures were average edit distance and percent of correct responses. Results 70 patients were recruited: 33 with active macular disease and 37 control subjects. Contrast sensitivity was found to be significantly different in both the IRF (p < 0.01) and SRF groups (p < 0.01). No significant difference was found comparing the odds ratio of average edit distance of active disease (IRF, SRF) vs. control (OR 1.09 (0.62, 1.90), 1.10 (0.58, 2.05), p=0.77, 0.77) or percent correct responses of active disease vs. control (OR 0.98 (0.96, 1.01), 1.09 (0.58, 2.05), p=0.22, 0.51) in CAPTCHA testing. The goodness of fit using logistic regression analysis for the dependent variables of either IRF or SRF did not improve accounting for average edit distance (p=0.49, p=0.27) or percent correct (p=0.89, p=0.61). Conclusions Distance VA and contrast sensitivity are positively correlated with the presence of IRF and SRF in active macular disease. CAPTCHA performance did not appear to be a significant predictor of either IRF or SRF in our pilot study.
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16
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Allen PM, Ravensbergen RHJC, Latham K, Rose A, Myint J, Mann DL. Contrast Sensitivity Is a Significant Predictor of Performance in Rifle Shooting for Athletes With Vision Impairment. Front Psychol 2018; 9:950. [PMID: 29997538 PMCID: PMC6028709 DOI: 10.3389/fpsyg.2018.00950] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/23/2018] [Indexed: 11/13/2022] Open
Abstract
Purpose: In order to develop an evidence-based, sport-specific minimum impairment criteria (MIC) for the sport of vision-impaired (VI) shooting, this study aimed to determine the relative influence of losses in visual acuity (VA) and contrast sensitivity (CS) on shooting performance. Presently, VA but not CS is used to determine eligibility to compete in VI shooting. Methods: Elite able-sighted athletes (n = 27) shot under standard conditions with their habitual vision, and with their vision impaired by the use of simulation spectacles (filters which reduce both VA and CS) and refractive blur (lenses which reduce VA with less effect on CS). Habitual shooting scores were used to establish a cut-off in order to determine when shooting performance was ‘below expected’ in the presence of vision impairment. Logistic regression and decision tree analyses were then used to assess the relationship between visual function and shooting performance. Results: Mild reductions in VA and/or CS did not alter shooting performance, with greater reductions required for shooting performance to fall below habitual levels (below 87% of normalized performance). Stepwise logistic regression selected CS as the most significant predictor of shooting performance, with VA subsequently improving the validity of the model. In an unconstrained decision tree analysis, CS was selected as the sole criterion (80%) for predicting ‘below expected’ shooting score. Conclusion: Shooting performance is better predicted by losses in CS than by VA. Given that it is not presently tested during classification, the results suggest that CS is an important measure to include in testing for the classification of vision impairment for athletes competing in VI shooting.
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Affiliation(s)
- Peter M Allen
- Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, United Kingdom.,Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, United Kingdom
| | - Rianne H J C Ravensbergen
- Department of Human Movement Sciences, IPC Research and Development Centre for the Classification of Athletes with Vision Impairment, Amsterdam Movement Sciences and Institute of Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Keziah Latham
- Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, United Kingdom.,Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, United Kingdom
| | - Amy Rose
- Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Joy Myint
- Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - David L Mann
- Department of Human Movement Sciences, IPC Research and Development Centre for the Classification of Athletes with Vision Impairment, Amsterdam Movement Sciences and Institute of Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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17
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Farhoudi DB, Behndig A, Montan P, Lundström M, Zetterström C, Kugelberg M. Spectacle use after routine cataract surgery: a study from the Swedish National Cataract Register. Acta Ophthalmol 2018; 96:283-287. [PMID: 28857438 DOI: 10.1111/aos.13554] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 06/27/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE To explore patients' obtaining and use of spectacles after routine cataract surgery. METHODS The study included 1329 patients who underwent bilateral surgery with the second eye operated during March 2013 at 38 different clinics in Sweden. Five months after the second-eye surgery, patients completed a five-item questionnaire about their spectacle use preoperatively and postoperatively. The responses were linked to data from the registry on multiple variables including postoperative refraction, age and gender. RESULTS Of the 387 patients who were advised by their surgeons to obtain distance spectacles postoperatively, most did so (77.3%, n = 299), while of the 691 patients who were not so advised, most did not obtain spectacles (78.9%, n = 545). Nevertheless, almost 50% of patients with both spherical and cylindrical errors exceeding 1 dioptre (D) did not obtain new distance spectacles postoperatively, while about 25% of patients with bilateral emmetropia (spherical error <0.5 D, cylinder <1 D) obtained new distance spectacles postoperatively. CONCLUSION Patients' choices regarding obtaining and using new spectacles postoperatively are strongly correlated with advice given by the surgeon about the need for distance correction. The large difference between groups who were and were not advised to obtain spectacles for distance correction was only partially reflected in the postoperative refractive errors. Similarly, the patterns of preoperative spectacle use and gender or age differences did not explain this difference.
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Affiliation(s)
- Daniel B. Farhoudi
- St. Erik Eye Hospital; Stockholm Sweden
- Department of Clinical Neuroscience; Division of Ophthalmology and Vision; Karolinska Institutet; Stockholm Sweden
| | - Anders Behndig
- Department of Clinical Sciences/Ophthalmology; Umeå University Hospital; Umeå Sweden
| | - Per Montan
- St. Erik Eye Hospital; Stockholm Sweden
- Department of Clinical Neuroscience; Division of Ophthalmology and Vision; Karolinska Institutet; Stockholm Sweden
| | - Mats Lundström
- Department of Clinical Sciences; Ophthalmology; Faculty of Medicine; Lund University; Lund Sweden
| | - Charlotta Zetterström
- Department of Clinical Neuroscience; Division of Ophthalmology and Vision; Karolinska Institutet; Stockholm Sweden
- EyeNet Sweden; Blekinge Hospital; Karlskrona Sweden
| | - Maria Kugelberg
- St. Erik Eye Hospital; Stockholm Sweden
- Department of Clinical Neuroscience; Division of Ophthalmology and Vision; Karolinska Institutet; Stockholm Sweden
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18
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Tanaka Y, Yokoyama S, Horai R, Kojima T, Hiroyuki S, Kato Y, Takagi M, Nakamura H, Tanaka K, Ichikawa K, Tanabe S. Effect of Background Luminance Level on the Assessment of Color Visual Acuity Using Colored Landolt Rings in Young Healthy Subjects. Curr Eye Res 2017; 43:428-434. [DOI: 10.1080/02713683.2017.1405043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Yoshiki Tanaka
- Institute of Visual Science, Chukyo Eye Clinic, Sanbonmatsu-cho, Atsuta-ku, Nagoya, Aichi, Japan
| | - Sho Yokoyama
- Department of Ophthalmology, Japan Community Healthcare Organization Chukyo Hospital, Minami-ku, Nagoya, Aichi, Japan
| | - Rie Horai
- Institute of Visual Science, Chukyo Eye Clinic, Sanbonmatsu-cho, Atsuta-ku, Nagoya, Aichi, Japan
| | - Takashi Kojima
- Department of Ophthalmology, Keio University School of Medicine, Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Sato Hiroyuki
- Satoh Yuya Eye Clinic, Itsutsubashi Aobaku, Sendai, Japan, Miyagi
| | - Yukihito Kato
- Institute of Visual Science, Chukyo Eye Clinic, Sanbonmatsu-cho, Atsuta-ku, Nagoya, Aichi, Japan
| | - Mari Takagi
- Department of Ophthalmology, Japanese Red Cross Gifu Hospital, Iwakura-cho, Gifu-shi, Gifu, Japan
| | | | - Kiyoshi Tanaka
- Faculty of Engineering, Shinshu University, Wakasato, Nagano-shi, Nagano, Japan
| | - Kazuo Ichikawa
- Institute of Visual Science, Chukyo Eye Clinic, Sanbonmatsu-cho, Atsuta-ku, Nagoya, Aichi, Japan
| | - Shoko Tanabe
- Institute of Visual Science, Chukyo Eye Clinic, Sanbonmatsu-cho, Atsuta-ku, Nagoya, Aichi, Japan
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19
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Baptista AMG, Serra PM, McAlinden C, Barrett BT. Vision in high-level football officials. PLoS One 2017; 12:e0188463. [PMID: 29161310 PMCID: PMC5697857 DOI: 10.1371/journal.pone.0188463] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 11/07/2017] [Indexed: 11/23/2022] Open
Abstract
Officiating in football depends, at least to some extent, upon adequate visual function. However, there is no vision standard for football officiating and the nature of the relationship between officiating performance and level of vision is unknown. As a first step in characterising this relationship, we report on the clinically-measured vision and on the perceived level of vision in elite-level, Portuguese football officials. Seventy-one referees (R) and assistant referees (AR) participated in the study, representing 92% of the total population of elite level football officials in Portugal in the 2013/2014 season. Nine of the 22 Rs (40.9%) and ten of the 49 ARs (20.4%) were international-level. Information about visual history was also gathered. Perceived vision was assessed using the preference-values-assigned-to-global-visual-status (PVVS) and the Quality-of-Vision (QoV) questionnaire. Standard clinical vision measures (including visual acuity, contrast sensitivity and stereopsis) were gathered in a subset (n = 44, 62%) of the participants. Data were analysed according to the type (R/AR) and level (international/national) of official, and Bonferroni corrections were applied to reduce the risk of type I errors. Adopting criterion for statistical significance of p<0.01, PVVS scores did not differ between R and AR (p = 0.88), or between national- and international-level officials (p = 0.66). Similarly, QoV scores did not differ between R and AR in frequency (p = 0.50), severity (p = 0.71) or bothersomeness (p = 0.81) of symptoms, or between international-level vs national-level officials for frequency (p = 0.03) or bothersomeness (p = 0.07) of symptoms. However, international-level officials reported less severe symptoms than their national-level counterparts (p<0.01). Overall, 18.3% of officials had either never had an eye examination or if they had, it was more than 3 years previously. Regarding refractive correction, 4.2% had undergone refractive surgery and 23.9% wear contact lenses when officiating. Clinical vision measures in the football officials were similar to published normative values for young, adult populations and similar between R and AR. Clinically-measured vision did not differ according to officiating level. Visual acuity measured with and without a pinhole disc indicated that around one quarter of participants may be capable of better vision when officiating, as evidenced by better acuity (≥1 line of letters) using the pinhole. Amongst the clinical visual tests we used, we did not find evidence for above-average performance in elite-level football officials. Although the impact of uncorrected mild to moderate refractive error upon officiating performance is unknown, with a greater uptake of eye examinations, visual acuity may be improved in around a quarter of officials.
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Affiliation(s)
| | - Pedro M. Serra
- School of Health Professions, Faculty of Health and Human Sciences, Plymouth University, United Kingdom
| | - Colm McAlinden
- Department of Ophthalmology, Glangwili Hospital, Hywel Dda University Health Board, Carmarthen, United Kingdom
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Brendan T. Barrett
- School of Optometry & Vision Science, University of Bradford, Richmond Road, Bradford, United Kingdom
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20
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Pennos A, Ginis H, Arias A, Christaras D, Artal P. Performance of a differential contrast sensitivity method to measure intraocular scattering. BIOMEDICAL OPTICS EXPRESS 2017; 8:1382-1389. [PMID: 28663835 PMCID: PMC5480550 DOI: 10.1364/boe.8.001382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 01/31/2017] [Accepted: 02/02/2017] [Indexed: 06/07/2023]
Abstract
Increased intraocular scatter degrades quality of vision, especially in the presence of glare sources. Standard tests, such as visual acuity, are not well suited to capture this condition. There are specific methods to measure intraocular scatter, but require dedicated instruments. In this work, we propose a method to estimate the amount of scatter by combining to sequential measurements of the contrast sensitivity function for two conditions, with and without a glare source. We applied the approach in a group of young subjects with no know ocular pathology fitted with photographic diffusing filters. The straylight estimates were compared with those provided by two alternative techniques, one based on the compensation comparison method and the other the optical integration. The results obtained with the three approaches were in a good agreement, demonstrating the feasibility of the proposed method.
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Affiliation(s)
- Alexandros Pennos
- Laboratorio de Optica, Universidad de Murcia, Campus de Espinardo (Ed 34), 30100 Murcia, Spain
| | - Harilaos Ginis
- Laboratorio de Optica, Universidad de Murcia, Campus de Espinardo (Ed 34), 30100 Murcia, Spain
- Department of Research, Athens Eye Hospital, Athens, Greece
| | - Augusto Arias
- Laboratorio de Optica, Universidad de Murcia, Campus de Espinardo (Ed 34), 30100 Murcia, Spain
| | - Dimitrios Christaras
- Laboratorio de Optica, Universidad de Murcia, Campus de Espinardo (Ed 34), 30100 Murcia, Spain
- UCL Institute of Ophthalmology, University College London, London, England, UK
| | - Pablo Artal
- Laboratorio de Optica, Universidad de Murcia, Campus de Espinardo (Ed 34), 30100 Murcia, Spain
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21
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Balcer LJ, Raynowska J, Nolan R, Galetta SL, Kapoor R, Benedict R, Phillips G, LaRocca N, Hudson L, Rudick R. Validity of low-contrast letter acuity as a visual performance outcome measure for multiple sclerosis. Mult Scler 2017; 23:734-747. [PMID: 28206829 PMCID: PMC5407511 DOI: 10.1177/1352458517690822] [Citation(s) in RCA: 127] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Low-contrast letter acuity (LCLA) has emerged as the leading outcome measure to assess visual disability in multiple sclerosis (MS) research. As visual dysfunction is one of the most common manifestations of MS, sensitive visual outcome measures are important in examining the effect of treatment. Low-contrast acuity captures visual loss not seen in high-contrast visual acuity (HCVA) measurements. These issues are addressed by the MS Outcome Assessments Consortium (MSOAC), including representatives from advocacy organizations, Food and Drug Administration (FDA), European Medicines Agency (EMA), National Institute of Neurological Disorders and Stroke (NINDS), academic institutions, and industry partners along with persons living with MS. MSOAC goals are acceptance and qualification by regulators of performance outcomes that are highly reliable and valid, practical, cost-effective, and meaningful to persons with MS. A critical step is elucidation of clinically relevant benchmarks, well-defined degrees of disability, and gradients of change that are clinically meaningful. This review shows that MS and disease-free controls have similar median HCVA, while MS patients have significantly lower LCLA. Deficits in LCLA and vision-specific quality of life are found many years after an episode of acute optic neuritis, even when HCVA has recovered. Studies reveal correlations between LCLA and the Expanded Disability Status Score (EDSS), Multiple Sclerosis Functional Composite (MSFC), retinal nerve fiber layer (RNFL) and ganglion cell layer plus inner plexiform layer (GCL + IPL) thickness on optical coherence tomography (OCT), brain magnetic resonance imaging (MRI), visual evoked potential (VEP), electroretinogram (ERG), pupillary function, and King-Devick testing. This review also concludes that a 7-point change in LCLA is clinically meaningful. The overall goal of this review is to describe and characterize the LCLA metric for research and clinical use among persons with MS.
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Affiliation(s)
- Laura J Balcer
- Department of Neurology, New York University School of Medicine, New York, NY, USA
| | - Jenelle Raynowska
- Department of Neurology, New York University School of Medicine, New York, NY, USA
| | - Rachel Nolan
- Department of Neurology, New York University School of Medicine, New York, NY, USA
| | - Steven L Galetta
- Department of Neurology, New York University School of Medicine, New York, NY, USA
| | - Raju Kapoor
- National Hospital for Neurology and Neurosurgery, London, UK
| | - Ralph Benedict
- Department of Neurology, University at Buffalo, Buffalo, NY, USA
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- Multiple Sclerosis Outcome Assessments Consortium (MSOAC), Critical Path Institute, Tucson, AZ, USA
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22
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Niemeyer JE, Paradiso MA. Contrast sensitivity, V1 neural activity, and natural vision. J Neurophysiol 2017; 117:492-508. [PMID: 27832603 PMCID: PMC5288473 DOI: 10.1152/jn.00635.2016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 10/30/2016] [Indexed: 11/22/2022] Open
Abstract
Contrast sensitivity is fundamental to natural visual processing and an important tool for characterizing both visual function and clinical disorders. We simultaneously measured contrast sensitivity and neural contrast response functions and compared measurements in common laboratory conditions with naturalistic conditions. In typical experiments, a subject holds fixation and a stimulus is flashed on, whereas in natural vision, saccades bring stimuli into view. Motivated by our previous V1 findings, we tested the hypothesis that perceptual contrast sensitivity is lower in natural vision and that this effect is associated with corresponding changes in V1 activity. We found that contrast sensitivity and V1 activity are correlated and that the relationship is similar in laboratory and naturalistic paradigms. However, in the more natural situation, contrast sensitivity is reduced up to 25% compared with that in a standard fixation paradigm, particularly at lower spatial frequencies, and this effect correlates with significant reductions in V1 responses. Our data suggest that these reductions in natural vision result from fast adaptation on one fixation that lowers the response on a subsequent fixation. This is the first demonstration of rapid, natural-image adaptation that carries across saccades, a process that appears to constantly influence visual sensitivity in natural vision. NEW & NOTEWORTHY Visual sensitivity and activity in brain area V1 were studied in a paradigm that included saccadic eye movements and natural visual input. V1 responses and contrast sensitivity were significantly reduced compared with results in common laboratory paradigms. The parallel neural and perceptual effects of eye movements and stimulus complexity appear to be due to a form of rapid adaptation that carries across saccades.
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Affiliation(s)
- James E Niemeyer
- Department of Neuroscience, Brown University, Providence, Rhode Island
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Gupta L, Cvintal V, Delvadia R, Sun Y, Erdem E, Zangalli C, Lu L, Wizov SS, Richman J, Spaeth E, Spaeth GL. SPARCS and Pelli-Robson contrast sensitivity testing in normal controls and patients with cataract. Eye (Lond) 2017; 31:753-761. [PMID: 28106888 DOI: 10.1038/eye.2016.319] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 12/01/2016] [Indexed: 11/09/2022] Open
Abstract
PurposeTo determine the ability of the newly developed internet-based Spaeth/Richman Contrast Sensitivity (SPARCS) test to assess contrast sensitivity centrally and peripherally in cataract subjects and controls, in comparison with the Pelli-Robson (PR) test.MethodsIn this prospective cross-sectional study, cataract subjects and age-matched normal controls were evaluated using the SPARCS and PR tests. Contrast sensitivity testing was performed in each eye twice in a standardized testing environment in randomized order. SPARCS scores were obtained for central, right upper (RUQ), right lower (RLQ), left upper (LUQ), and left lower quadrants (LLQ). PR scores were obtained for central contrast sensitivity. PR and SPARCS scores in cataract subjects were compared with controls. Intraclass correlation coefficients (ICC) and Bland Altman analysis were used to determine test-retest reliability and correlation.ResultsA total of 162 eyes from 84 subjects were analyzed: 43 eyes from 23 cataract subjects, and 119 eyes from 61 controls. The mean scores for SPARCS centrally were 13.4 and 14.5 in the cataract and control groups, respectively (P=0.001). PR mean scores were 1.31 and 1.45 in cataract and control groups, respectively (P<0.001). ICC values for test-retest reliability for cataract subjects were 0.75 for PR and 0.61 for the SPARCS total. There was acceptable agreement between the ability of PR and SPARCS to detect the effect of cataract on central contrast sensitivity.ConclusionsBoth SPARCS and PR demonstrate a significant influence of cataract on contrast sensitivity. SPARCS offers the advantage of determining contrast sensitivity peripherally and centrally, without being influenced by literacy.
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Affiliation(s)
- L Gupta
- George Washington University School of Medicine, Washington, DC, USA
| | - V Cvintal
- Instituto de Oftalmologia Tadeu Cvintal, Sao Paulo, Brazil
| | - R Delvadia
- Department of Anesthesiology, George Washington University Hospital, Washington, DC, USA
| | - Y Sun
- Department of Ophthalmology, The Third People's Hospital of Chengdu, Sichuan, China
| | - E Erdem
- Faculty of Medicine, Department of Ophthalmology, University of Cukurova, Adana, Turkey
| | - C Zangalli
- Department of Ophthalmology, State University of Campinas, Sao Paulo, Brazil
| | - L Lu
- Department of Ophthalmology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - S S Wizov
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA
| | - J Richman
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA
| | - E Spaeth
- Independent Researcher, Philadelphia, PA, USA
| | - G L Spaeth
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA
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Tamura N, Sasai-Sakuma T, Morita Y, Okawa M, Inoue S, Inoue Y. A Nationwide Cross-Sectional Survey of Sleep-Related Problems in Japanese Visually Impaired Patients: Prevalence and Association with Health-Related Quality of Life. J Clin Sleep Med 2016; 12:1659-1667. [PMID: 27655465 DOI: 10.5664/jcsm.6354] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 08/08/2016] [Indexed: 01/31/2023]
Abstract
STUDY OBJECTIVES This questionnaire-based cross-sectional study was conducted (1) to estimate the prevalence of sleep-related problems, and (2) to explore factors associated with lower physical/mental quality of life (QOL), particularly addressing sleep-related problems among Japanese visually impaired people. METHODS This nationwide questionnaire-based survey was administered to visually impaired individuals through the Japan Federation of the Blind. Visually impaired individuals without light perception (LP) (n = 311), those with LP (n = 287), and age-matched and gender-matched controls (n = 615) were eligible for this study. Study questionnaires elicited demographic information, and information about visual impairment status, sleep-related problems, and health-related quality of life. RESULTS Visually impaired individuals with and without LP showed higher prevalence rates of irregular sleep-wake patterns and difficulty maintaining sleep than controls (34.7% and 29.4% vs. 15.8%, 60.1% and 46.7% vs. 26.8%, respectively; p < 0.001). These sleep-related problems were observed more frequently in visually impaired individuals without LP than in those with LP. Non-restorative sleep or excessive daytime sleepiness was associated with lower mental/physical QOL in visually impaired individuals with LP and in control subjects. However, visually impaired individuals without LP showed irregular sleep-wake pattern or difficulty waking up at the desired time, which was associated with lower mental/physical QOL. CONCLUSIONS Sleep-related problems were observed more frequently in visually impaired individuals than in controls. Moreover, the rates of difficulties were higher among subjects without LP. Sleep-related problems, especially circadian rhythm-related ones, can be associated with lower mental/physical QOL in visually impaired individuals without LP.
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Affiliation(s)
- Norihisa Tamura
- Department of Somnology, Tokyo Medical University, Tokyo, Japan.,Yoyogi Sleep Disorder Center, Tokyo, Japan
| | - Taeko Sasai-Sakuma
- Department of Somnology, Tokyo Medical University, Tokyo, Japan.,Department of Life Sciences and Bio-informatics, Division of Biomedical Laboratory Sciences, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuko Morita
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Masako Okawa
- Department of Somnology, Tokyo Medical University, Tokyo, Japan.,Yoyogi Sleep Disorder Center, Tokyo, Japan.,Japan Foundation for Neuroscience and Mental Health, Tokyo, Japan
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Japan
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Tokyo, Japan.,Yoyogi Sleep Disorder Center, Tokyo, Japan.,Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
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Abstract
Health expectancy measures incorporating mortality and morbidity may better determine the future needs of older people than current methods solely using mortality rates. Life expectancy with and without visual disability was calculated from two longitudinal studies of the elderly. Various scenarios of changing input transition rates were then explored. Women had a greater probability of transition to disability. Thus, increases in incidence had a larger impact for women than for men on resulting life-years with visual disability, reducing the proportion of remaining disability-free life by 2.1%. When mortality continued to decrease but incidence increased and recovery decreased, there was an increase in life expectancy, although for women this was offset by an even greater increase in years spent with visual disability. Health expectancy calculated from longitudinal data may be useful in exploring potential future variations in incidence, treatment, and mortality rates and their effect on population health.
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Myint J, Latham K, Mann D, Gomersall P, Wilkins AJ, Allen PM. The relationship between visual function and performance in rifle shooting for athletes with vision impairment. BMJ Open Sport Exerc Med 2016; 2:e000080. [PMID: 27900160 PMCID: PMC5117046 DOI: 10.1136/bmjsem-2015-000080] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2015] [Indexed: 11/18/2022] Open
Abstract
Background Paralympic sports provide opportunities for those who have an impairment that might otherwise be a barrier to participation in regular sporting competition. Rifle shooting represents an ideal sport for persons with vision impairment (VI) because the direction of the rifle can be guided by auditory information when vision is impaired. However, it is unknown whether those with some remaining vision when shooting with auditory guidance would be at an advantage when compared with those with no vision at all. If this were the case then it would be necessary for those with and without remaining vision to compete in separate classes of competition. Materials and method The associations between shooting performance and 3 measures of visual function thought important for shooting were assessed for 10 elite VI shooters currently classified as VI. A conventional audiogram was also obtained. Results The sample size, though small, included the majority of European VI shooters competing at this level. The relationships between visual functions and performance confirmed that individuals with residual vision had no advantage over those without vision when auditory guidance was available. Auditory function was within normal limits for age, and showed no relationship with performance. Summary The findings suggest that rifle-shooting athletes with VI are able to use auditory information to overcome their impairment and optimise performance. Paralympic competition should be structured in a way that ensures that all shooters who qualify to compete in VI shooting participate within the same class irrespective of their level of VI.
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Affiliation(s)
- Joy Myint
- Postgraduate Medicine, Life and Medical Sciences , University of Hertfordshire , Hatfield , UK
| | - Keziah Latham
- Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, UK; Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK
| | - David Mann
- Department of Human Movement Sciences , Research Institute MOVE Amsterdam, Vrije Universiteit Amsterdam , Amsterdam , The Netherlands
| | - Phil Gomersall
- Department of Vision and Hearing Sciences , Anglia Ruskin University , Cambridge , UK
| | - Arnold J Wilkins
- Department of Psychology , University of Essex , Colchester , UK
| | - Peter M Allen
- Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, UK; Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK
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Frampton G, Harris P, Cooper K, Lotery A, Shepherd J. The clinical effectiveness and cost-effectiveness of second-eye cataract surgery: a systematic review and economic evaluation. Health Technol Assess 2015; 18:1-205, v-vi. [PMID: 25405576 DOI: 10.3310/hta18680] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Elective cataract surgery is the most commonly performed surgical procedure in the NHS. In bilateral cataracts, the eye with greatest vision impairment from cataract is operated on first. First-eye surgery can improve vision and quality of life. However, it is unclear whether or not cataract surgery on the second eye provides enough incremental benefit to be considered clinically effective and cost-effective. OBJECTIVE To conduct a systematic review of clinical effectiveness and analysis of cost-effectiveness of second-eye cataract surgery in England and Wales, based on an economic model informed by systematic reviews of cost-effectiveness and quality of life. DATA SOURCES Twelve electronic bibliographic databases, including MEDLINE, EMBASE, Web of Science, The Cochrane Library and the Centre for Reviews and Dissemination databases were searched from database inception to April 2013, with searches updated in July 2013. Reference lists of relevant publications were also checked and experts consulted. REVIEW METHODS Two reviewers independently screened references, extracted and checked data from the included studies and appraised their risk of bias. Based on the review of cost-effectiveness, a de novo economic model was developed to estimate the cost-effectiveness of second-eye surgery in bilateral cataract patients. The model is based on changes in quality of life following second-eye surgery and includes post-surgical complications. RESULTS Three randomised controlled trials (RCTs) of clinical effectiveness, three studies of cost-effectiveness and 10 studies of health-related quality of life (HRQoL) met the inclusion criteria for the systematic reviews and, where possible, were used to inform the economic analysis. Heterogeneity of studies precluded meta-analyses, and instead data were synthesised narratively. The RCTs assessed visual acuity, contrast sensitivity, stereopsis and several measures of HRQoL. Improvements in binocular visual acuity and contrast sensitivity were small and unlikely to be of clinical significance, but stereopsis was improved to a clinically meaningful extent following second-eye surgery. Studies did not provide evidence that second-eye surgery significantly affected HRQoL, apart from an improvement in the mental health component of HRQoL in one RCT. In the model, second-eye surgery generated 0.68 incremental quality-adjusted life-years with an incremental cost-effectiveness ratio of £1964. Model results were most sensitive to changes in the utility gain associated with second-eye surgery, but otherwise robust to changes in parameter values. The probability that second-eye surgery is cost-effective at willingness-to-pay thresholds of £10,000 and £20,000 is 100%. LIMITATIONS Clinical effectiveness studies were all conducted more than 9 years ago. Patients had good vision pre surgery which may not represent all patients eligible for second-eye surgery. For some vision-related patient-reported outcomes and HRQoL measures, thresholds for determining important clinical effects are either unclear or have not been determined. CONCLUSIONS Second-eye cataract surgery is generally cost-effective based on the best available data and under most assumptions. However, more up-to-date data are needed. A well-conducted RCT that reflects current populations and enables the estimation of health state utility values would be appropriate. Guidance is required on which vision-related, patient-reported outcomes are suitable for assessing effects of cataract surgery in the NHS and how these measures should be interpreted clinically. STUDY REGISTRATION This project is registered as PROSPERO CRD42013004211. FUNDING This project was funded by the National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Geoff Frampton
- Southampton Health Technology Assessments Centre (SHTAC), University of Southampton, Southampton, UK
| | - Petra Harris
- Southampton Health Technology Assessments Centre (SHTAC), University of Southampton, Southampton, UK
| | - Keith Cooper
- Southampton Health Technology Assessments Centre (SHTAC), University of Southampton, Southampton, UK
| | - Andrew Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Jonathan Shepherd
- Southampton Health Technology Assessments Centre (SHTAC), University of Southampton, Southampton, UK
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Raina UK, Gupta A, Bhambhwani V, Bhushan G, Seth A, Ghosh B. The Optical Performance of Spherical and Aspheric Intraocular Lenses in Pediatric Eyes: A Comparative Study. J Pediatr Ophthalmol Strabismus 2015; 52:232-8. [PMID: 26043004 DOI: 10.3928/01913913-20150520-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 02/04/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the optical performance of aspheric intraocular lenses (IOLs) designed to correct the corneal spherical aberration versus spherical IOLs in pediatric eyes after cataract surgery. METHODS In this prospective study, 40 eyes of patients 6 to 16 years old with developmental cataract were randomly assigned to receive a spherical IOL or an aspheric IOL after pediatric cataract surgery. At 3 months postoperatively, the outcomes compared between the two groups were best-corrected visual acuity, contrast sensitivity, and wavefront aberrometry. RESULTS The mean best-corrected visual acuity was 0.32 ± 0.19 logMAR in the spherical IOL group and 0.28 ± 0.16 logMAR in the aspheric IOL group (P = .179). The aspheric IOL group showed better contrast sensitivity at 1.5, 3, and 6 cycles per degree than the spherical IOL group (P < .05). Total ocular aberrations, higher-order aberrations, and spherical aberrations were significantly lower in the aspheric IOL group (P < .05). CONCLUSIONS The results suggest that aspheric IOLs compensate for the spherical aberration of pediatric eyes. In comparison to spherical IOLs, eyes with aspheric IOLs had decreased ocular aberrations, particularly spherical aberration, which contributed to better contrast sensitivity in these eyes. Further studies are required to evaluate the role of aspheric IOLs in children.
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Epitropoulos AT, Fram NR, Masket S, Price FW, Snyder ME, Stulting RD. Evaluation of a New Controlled Point Source LED Glare Tester for Disability Glare Detection in Participants With and Without Cataracts. J Refract Surg 2015; 31:196-201. [PMID: 25751837 DOI: 10.3928/1081597x-20150225-03] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 01/28/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine glare-induced change during visual acuity testing in patients with and without cataract using the controlled point source light-emitting diode (LED) glare tester (EpiGlare Tester; Epico, LLC, Columbus, OH), a new medical device for identification of glare disability. METHODS This prospective, multicenter study enrolled 40 patients (80 eyes with cataracts) and 49 control subjects (98 eyes without cataracts). Corrected distance visual acuity (CDVA) was measured with and without glare using the EpiGlare Tester as a glare source. Functional visual ability was evaluated using driving and glare subscales from the Refractive Status Vision Profile questionnaire. The primary efficacy measure was change in CDVA measurement with and without glare in patients with senile cataract compared to participants without cataract. Secondary efficacy measures included correlation of the CDVA change caused by functional glare disability and subjective patient and investigator assessments. RESULTS CDVA reduction was greater for patients with cataract, with a mean reduction of -0.49 ± 0.3 logMAR, than for participants without cataracts at -0.13 ± 0.2 logMAR (P < .001). This equates to a 5-line Snellen reduction (0.49 logMAR) in patients with cataracts and a 1-line reduction (-0.13 logMAR) in patients without cataracts. Among patients with cataracts, 83% stated the device accurately represented the difficulty experienced while driving at night (P < .001); among participants without cataracts, 71% reported being minimally affected by glare from the device (P = .003). CONCLUSIONS A new controlled point source LED glare tester demonstrated the adverse effect on visual acuity due to glare in patients with cataract, accurately simulated night driving glare issues for patients with cataracts, and was rated as easy to use and useful by investigators.
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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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Chen G, Hou F, Yan FF, Zhang P, Xi J, Zhou Y, Lu ZL, Huang CB. Noise provides new insights on contrast sensitivity function. PLoS One 2014; 9:e90579. [PMID: 24626135 PMCID: PMC3953123 DOI: 10.1371/journal.pone.0090579] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 02/03/2014] [Indexed: 11/27/2022] Open
Abstract
Sensitivity to luminance difference, or contrast sensitivity, is critical for animals to survive in and interact with the external world. The contrast sensitivity function (CSF), which measures visual sensitivity to spatial patterns over a wide range of spatial frequencies, provides a comprehensive characterization of the visual system. Despite its popularity and significance in both basic research and clinical practice, it hasn’t been clear what determines the CSF and how the factors underlying the CSF change in different conditions. In the current study, we applied the external noise method and perceptual template model to a wide range of external noise and spatial frequency (SF) conditions, and evaluated how the various sources of observer inefficiency changed with SF and determined the limiting factors underlying the CSF. We found that only internal additive noise and template gain changed significantly with SF, while the transducer non-linearity and coefficient for multiplicative noise were constant. The 12-parameter model provided a very good account of all the data in the 200 tested conditions (86.5%, 86.2%, 89.5%, and 96.4% for the four subjects, respectively). Our results suggest a re-consideration of the popular spatial vision model that employs the CSF as the front-end filter and constant internal additive noise across spatial frequencies. The study will also be of interest to scientists and clinicians engaged in characterizing spatial vision deficits and/or developing rehabilitation methods to restore spatial vision in clinical populations.
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Affiliation(s)
- Ge Chen
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Fang Hou
- Center for Cognitive and Brain Sciences, Department of Psychology, Ohio State University, Columbus, Ohio, United States of America
| | - Fang-Fang Yan
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Pan Zhang
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jie Xi
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Yifeng Zhou
- Key Laboratory of Brain Function and Diseases, Chinese Academy of Sciences, and School of Life Sciences, University of Science and Technology of China, Hefei, Anhui, China
| | - Zhong-Lin Lu
- Center for Cognitive and Brain Sciences, Department of Psychology, Ohio State University, Columbus, Ohio, United States of America
| | - Chang-Bing Huang
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- * E-mail:
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Abstract
PURPOSE To determine how accurate normally sighted male and female pedestrians were at making time-to-arrival (TTA) judgments of approaching vehicles when using just their hearing or both their hearing and vision. METHODS Ten male and 14 female subjects with confirmed normal vision and hearing estimated the TTA of approaching vehicles along an unsignalized street under two sensory conditions: (1) using both habitual vision and hearing and (2) using habitual hearing only. All subjects estimated how long the approaching vehicle would take to reach them (i.e., the TTA). The actual TTA of vehicles was also measured using custom-made sensors. The error in TTA judgments for each subject under each sensory condition was calculated as the difference between the actual and estimated TTA. A secondary timing experiment was also conducted to adjust each subject's TTA judgments for their "internal metronome." RESULTS Error in TTA judgments changed significantly as a function of both the actual TTA (p < 0.0001) and sensory condition (p < 0.0001). Although no main effect for gender was found (p = 0.19), the way the TTA judgments varied within each sensory condition for each gender was different (p < 0.0001). Females tended to be as accurate under either condition (p ≥ 0.01), with the exception of TTA judgments made when the actual TTA was 2 seconds or less and 8 seconds or longer, during which the vision-and-hearing condition was more accurate (p ≤ 0.002). Males made more accurate TTA judgments under the hearing only condition for actual TTA values 5 seconds or less (p < 0.0001), after which there were no significant differences between the two conditions (p ≥ 0.01). CONCLUSIONS Our data suggest that males and females use visual and auditory information differently when making TTA judgments. Although the sensory condition did not affect the females' accuracy in judgments, males initially tended to be more accurate when using their hearing only.
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Mousa A, Al Ghamdi AH, Kalantan H, Al Muammar AR. Development and validation of an Arabic version of the Visual Functioning Index VF-14 for cataract patients. Middle East Afr J Ophthalmol 2013; 19:309-13. [PMID: 22837625 PMCID: PMC3401801 DOI: 10.4103/0974-9233.97932] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose: To develop and validate an Arabic version of the Visual Functioning Index (VF-14) for patients with cataracts. Materials and Methods: The VF-14 was translated into Arabic by an epidemiologist and an ophthalmologist, both fluent in Arabic and English. The VF-14 was administered to patients diagnosed with cataract at two hospitals in Egypt and two hospitals in Saudi Arabia. Patients were also administered three other forms; the cataract symptoms score (CSS); global measure of vision; and cataract medical form. Internal reliability and external validity were measured. Index sensitivity to visual acuity was detected and potential effective factors were investigated. Correlation analyses were performed. A p value less than 0.05 was considered statistically significant. Results: The translated VF-14 was consistent and reliable (σ = 0.763, p < 0.0001). It was also statistically significantly sensitive to vision (p < 0.0001). The mean calculated index was 62.18 ± 19.34, and was highly correlated with; CSS and other scores (p < 0.0001, all cases). Factors that may affect the index are; age, sex, vision, wearing glasses, type, position, and severity of cataract. Conclusion: The Arabic VF 14 is a reliable and valid tool for evaluation of both visual functioning and quality of visual life among cataract patients. It is also sensitive to changes in visual acuity, demographic, and clinical characteristics.
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Affiliation(s)
- Ahmed Mousa
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Abstract
PURPOSE Age-related macular degeneration is the leading cause of vision loss among Americans aged >65 years. Currently, no effective treatment can reverse the central vision loss associated with most age-related macular degeneration. Digital image-processing techniques have been developed to improve image visibility for peripheral vision; however, both the selection and efficacy of such methods are limited. Progress has been difficult for two reasons: the exact nature of image enhancement that might benefit peripheral vision is not well understood, and efficient methods for testing such techniques have been elusive. The current study aims to develop both an effective image enhancement technique for peripheral vision and an efficient means for validating the technique. METHODS We used a novel contour-detection algorithm to locate shape-defining edges in images based on natural-image statistics. We then enhanced the scene by locally boosting the luminance contrast along such contours. Using a gaze-contingent display, we simulated central visual field loss in normally sighted young (aged 18-30 years) and older adults (aged 58-88 years). Visual search performance was measured as a function of contour enhancement strength ["original" (unenhanced), "medium," and "high"]. For preference task, a separate group of subjects judged which image in a pair "would lead to better search performance." RESULTS We found that although contour enhancement had no significant effect on search time and accuracy in young adults, Medium enhancement resulted in significantly shorter search time in older adults (about 13% reduction relative to original). Both age-groups preferred images with Medium enhancement over original (2-7 times). Furthermore, across age-groups, image content types, and enhancement strengths, there was a robust correlation between preference and performance. CONCLUSIONS Our findings demonstrate a beneficial role of contour enhancement in peripheral vision for older adults. Our findings further suggest that task-specific preference judgments can be an efficient surrogate for performance testing.
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van den Berg TJTP, Franssen L, Kruijt B, Coppens JE. History of ocular straylight measurement: A review. Z Med Phys 2012. [PMID: 23182462 DOI: 10.1016/j.zemedi.2012.10.009] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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.
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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.
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Gothwal VK, Sumalini R, Bharani S, Reddy SP, Bagga DK. The Second Version of the L. V. Prasad-Functional Vision Questionnaire. Optom Vis Sci 2012; 89:1601-10. [DOI: 10.1097/opx.0b013e31826ca291] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
AIMS To assess the vision-related quality of life of corneal transplant recipients using the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25), and to identify the socio-demographic factors that associate with patients' self-assessment of perceived visual function. METHODS Thirty patients who received corneal transplants were included in this prospective observational, cross-sectional study. Socio-demographic and clinical data, including age, sex, systemic health status, employment status, visual acuity, reason of corneal transplantation, laterality of corneal graft, and follow-up period were collected. NEI VFQ-25 was scored using Rasch analysis. Subgroup analyses were also performed. RESULTS Age, sex, visual acuity, and health status had no significant correlation or association with the Rasch-transformed score. Patients who received bilateral corneal grafts were significantly less able socioemotionally than those with unilateral graft. Patients who became unemployed or retired after transplantation were also significantly less able in both visual functioning and socioemotional status. CONCLUSION Corneal transplant recipients had a decreased vision-related quality of life as demonstrated by the NEI VFQ-25. Apart from anatomical success and visual acuity, ophthalmologists should also consider other aspects of visual outcome. In particular, those who received bilateral grafts require more attention. Employment programmes should be part of corneal transplantation rehabilitation planning.
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Affiliation(s)
- S T Mak
- Department of Ophthalmology, Caritas Medical Centre, Kowloon, Hong Kong.
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Morales EL, Rocha KM, Chalita MR, Nosé W, Avila MP. Comparison of optical aberrations and contrast sensitivity between aspheric and spherical intraocular lenses. J Refract Surg 2011; 27:723-8. [PMID: 21853963 DOI: 10.3928/1081597x-20110708-02] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2011] [Accepted: 06/03/2011] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare visual acuity, aberrometry, and contrast sensitivity in patients who had a spherical intraocular lens (IOL) (SoFlex SE, Bausch & Lomb) implanted in one eye and an aspheric IOL (SofPort AO, Bausch & Lomb) implanted in the fellow eye during uncomplicated cataract surgery. METHODS A prospective, multicenter, double-blind study was performed. Forty patients (80 eyes) underwent bilateral phacoemulsification with implantation of a spherical IOL in one eye and an aspheric IOL in the fellow eye. Postoperatively, visual acuity, aberrometry, and contrast sensitivity tests were performed. Statistical analyses were performed using Student t and Wilcoxon tests, and mixed effects were used for each contrast condition situation. RESULTS Thirty-nine patients (30 women, 9 men; 78 eyes) with a mean age of 69.3±6.17 years (range: 51 to 82 years) completed the study. No statistical differences were found regarding visual acuity among eyes. Lower levels of higher order aberrations were achieved in the aspheric group. No statistical difference between groups under photopic conditions was noted. In low spatial frequencies, better performance was observed with the aspheric IOL under mesopic conditions. In high spatial frequencies, the spherical IOL produced better quality of vision. Comparing mesopic conditions with glare, visual performance was statistically better using the aspheric IOL. CONCLUSIONS Cataract surgery results cannot be measured by means of visual acuity alone. Quality of vision must be considered, and implantation of IOLs with low levels of spherical aberrations and better contrast sensitivity are preferred. In this study, the aspheric IOL demonstrated better visual function, especially at night, when compared with spherical IOLs.
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Alió JL, Plaza-Puche AB, Piñero DP, Amparo F, Rodríguez-Prats JL, Ayala MJ. Quality of life evaluation after implantation of 2 multifocal intraocular lens models and a monofocal model. J Cataract Refract Surg 2011; 37:638-48. [PMID: 21420587 DOI: 10.1016/j.jcrs.2010.10.056] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Revised: 10/21/2010] [Accepted: 10/22/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE To compare vision-related quality of life using the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) in patients with 1 of 3 types of intraocular lenses (IOLs) and to correlate it with postoperative visual outcomes. SETTING Vissum Corporation-Instituto Oftalmológico de Alicante, Alicante, Spain. DESIGN Comparative case series. METHODS This study comprised eyes having cataract surgery with bilateral implantation of a monofocal IOL (Group A), apodized multifocal IOL (Group B), or full diffractive multifocal IOL (Group C). Distance and near visual acuities, contrast sensitivity, and quality of life were evaluated preoperatively and postoperatively. RESULTS The study enrolled 106 eyes (53 patients; age range 49 to 80 years). All groups had significant improvement in uncorrected and corrected distance visual acuities postoperatively (P ≤.05). Near vision outcomes were significantly better in Groups B and C (P ≤.01). Groups B and C had significantly less difficulty in some near tasks, such as reading the newspaper (A-B, P=.02; A-C, P=.02) or reading bills (A-B, P=.04; A-C, P=.004). Group C also had significantly less difficulty driving at night than Group B (P<.01). Near visual acuity and contrast sensitivity were significantly correlated with difficulty in near visual tasks in Groups B and C. Night-driving difficulty correlated significantly with contrast sensitivity in Group B. CONCLUSIONS Patients with multifocal IOLs could perform several daily tasks at near and intermediate distances, with less night-driving limitation with the full diffractive IOL than with apodized multifocal and monofocal IOLs. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Jorge L Alió
- Vissum Corporation-Instituto Oftalmológico de Alicante, Avenida de Denia s/n, Edificio Vissum, 03016 Alicante, Spain.
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The impact of penetrating keratoplasty in patients with keratoconus using the VF-14 questionnaire. Int Ophthalmol 2011; 31:89-92. [PMID: 21267632 DOI: 10.1007/s10792-010-9414-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2010] [Accepted: 12/30/2010] [Indexed: 10/18/2022]
Abstract
To assess the visual function of patients with keratoconus who underwent penetrating keratoplasty with the use of the VF-14 questionnaire. Fourteen patients (9 male and 5 female) with a mean age of 38 years (SD 13.59) participated in the study. All patients had keratoconus, confirmed by corneal topography, and all had previously undergone penetrating keratoplasty in one eye. Their mean best-corrected visual acuity (BCVA) binocularly was 0.185 (SD 0.077) LogMAR. None of the grafted eyes had a BCVA < 0.300 LogMAR. Fourteen healthy volunteers, age- and sex-matched, also participated in the study as control subjects. The VF-14 questionnaire was used to evaluate the effect of the ocular status in the daily life activities of the patients. The mean VF-14 result for the grafted patients with keratoconus was 62.37% (SD 22.60) and for the control group it was 100% (P < 0.001). There was only a weak correlation between the VF-14 score and the binocular BCVA (r = -0.394, P = 0.163). The mean VF-14 result in grafted patients with keratoconus is indicative of low functional ability despite the satisfactory postoperative BCVA. The absence of a significant correlation between the VF-14 score and the mean BCVA indicates that the low functional visual ability in these patients is probably associated more with the 'perceived by themselves' difficulty due to their ophthalmological condition.
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Idil A, Ozen M, Atak N, Elhan A, Pehlivan S. Validity and reliability study of Turkish version on low vision with quality of life questionnaire. Int J Ophthalmol 2011; 4:546-51. [PMID: 22553719 DOI: 10.3980/j.issn.2222-3959.2011.05.17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Accepted: 08/16/2011] [Indexed: 12/14/2022] Open
Abstract
AIM To adapt the low vision-related quality of life (LVQOL) instrument into Turkish language and to assess its validity and reliability. METHODS The study was conducted in 387 patients attending the Centre of Low Vision Rehabilitation, Faculty of Medicine, Ankara University. For statistical analyses, the Spearman's correlation coefficient, Cronbach's alpha coefficient and Confirmatory Factor Analysis (CFA) were used. RESULTS According to results of CFA, the item in the "Adjustment" subscale because of having the factor loading below 0.40, was excluded from the questionnaire. The reliability of the questionnaire was assessed according to Cronbach's alpha coefficients. The reliability of the "Distance Vision, Mobility, and Lighting" subscale was α=0.863; of the "Adjustment" subscale wasα=0.694; "Reading and Fine Work" wasα=0.791, and "Activities of Daily Living" was α=0.770. So these results indicate that the questionnaire is reliable to measure the vision related quality of life of low-vision patients. The correlations between the subscales were also analyzed, and the correlation between "Adjustment" and "Reading and Fine Work" was found to be the lowest (r(s)=0.336, P<0.001), whereas the strongest correlation was found between the "Reading and Fine Work", and "Activities of Daily Living". Additionally, the "Adjustment" dimension showed the strongest correlation with only "Distance Vision, Mobility, and Lighting" dimension. CONCLUSION After removing the last item in the second dimension, the Turkish adaptation of all dimensions of the LVQOL has been shown to be reliable, valid and suitable for use in patients with low vision in Turkey.
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Affiliation(s)
- Aysun Idil
- Department of Public Health, Centre of Low Vision Rehabilitation, Faculty of Medicine, Ankara University, Ankara, Turkey
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Gothwal VK, Wright T, Lamoureux EL, Pesudovs K. Psychometric properties of visual functioning index using Rasch analysis. Acta Ophthalmol 2010; 88:797-803. [PMID: 19563369 DOI: 10.1111/j.1755-3768.2009.01562.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The visual functioning index (VFI) was one of the first questionnaires developed using classical test theory to assess outcomes of cataract surgery. However, it was not Rasch-validated. The objective of this study was to examine the psychometric properties of the VFI using Rasch analysis in patients with cataract. METHODS The 11-item VFI was self-administered to 243 patients (mean age 73.9 years) drawn from a cataract surgery waiting list. We examined the response category thresholds, item fit statistics, differential item functioning and unidimensionality for the VFI and its three subscales. RESULTS Category thresholds were ordered. The person separation and reliability were low, indicating the poor discriminatory ability of the VFI. No items misfit but there was suboptimal targeting of item difficulty to patient ability. On the whole the items in the VFI were too easy for the sample. Only one item showed moderate differential item functioning. CONCLUSION The VFI does not meet the stringent requirements of the Rasch model. However adding more items to suit the more able patients with cataract as well as those awaiting second-eye cataract surgery could optimize the VFI.
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Affiliation(s)
- Vijaya K Gothwal
- National Health and Medical Research Council Centre for Clinical Eye Research, Department of Ophthalmology, Flinders University of South Australia, Adelaide, Australia
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Burggraaff MC, van Nispen RMA, Hoek S, Knol DL, van Rens GHMB. Feasibility of the Radner Reading Charts in low-vision patients. Graefes Arch Clin Exp Ophthalmol 2010; 248:1631-7. [DOI: 10.1007/s00417-010-1402-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2009] [Revised: 03/05/2010] [Accepted: 04/26/2010] [Indexed: 10/19/2022] Open
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Moussa S, Ansari-Shahrezaei S, Smretschnig E, Hagen S, Steindl-Kuscher K, Krebs I, Binder S. Contrast sensitivity after intravitreal antivascular endothelial growth factor therapy for myopic choroidal neovascularization. Graefes Arch Clin Exp Ophthalmol 2010; 248:1087-90. [PMID: 20232077 DOI: 10.1007/s00417-010-1341-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Revised: 01/31/2010] [Accepted: 02/14/2010] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND To evaluate contrast sensitivity (CS) using Pelli-Robson charts after intravitreal ranibizumab (IVR) (Lucentis, Novartis, Basel, Switzerland) or bevacizumab (IVB) (Avastin, Genentech, South San Francisco, California, USA) in eyes with myopic choroidal neovascularization (mCNV). METHODS A retrospective review was performed of 17 consecutive patients treated with IVR (n = 10; 0.5 mg) or IVB (n = 7; 1.25 mg) for mCNV from July, 2006 with follow-ups through September, 2009. Re-treatment was performed at monthly or longer intervals if there was fluorescein leakage in fluorescein angiogram (FAG) and or apparent subretinal fluid in optical coherence tomography (OCT) persisted. RESULTS CS improved by a mean of one letter at 1 month (n = 17; p = 0.32), four letters at 3 months (n = 17; p = 0.02), four letters at 6 months (n = 15; p = 0.01), five letters at 9 months (n = 14; p = 0.04) and six letters at 12 months (n = 13; p = 0.03). The mean number of IVR/IVB was 1.6/1.6, 2.6/2.3, 3.1/3.2, 4.1/4.2 and 4.5/4.6 at 1 month, 3 months, 6 months, 9 months, and 12 months, respectively. CONCLUSIONS Improvements in Pelli-Robson CS scores were observed during the first year after IVR/IVB in eyes with mCNV.
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Affiliation(s)
- Sarah Moussa
- The Ludwig Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery, Vienna, Austria
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Gothwal VK, Wright TA, Lamoureux EL, Lundström M, Pesudovs K. Catquest questionnaire: re-validation in an Australian cataract population. Clin Exp Ophthalmol 2009; 37:785-94. [DOI: 10.1111/j.1442-9071.2009.02133.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gothwal VK, Wright TA, Lamoureux EL, Pesudovs K. Cataract Symptom Score Questionnaire: Rasch Revalidation. Ophthalmic Epidemiol 2009. [DOI: 10.1080/09286580902999454] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gothwal VK, Wright TA, Lamoureux EL, Pesudovs K. Using Rasch analysis to revisit the validity of the Cataract TyPE Spec instrument for measuring cataract surgery outcomes. J Cataract Refract Surg 2009; 35:1509-17. [DOI: 10.1016/j.jcrs.2009.03.056] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Accepted: 03/30/2009] [Indexed: 10/20/2022]
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Michael R, van Rijn LJ, van den Berg TJTP, Barraquer RI, Grabner G, Wilhelm H, Coeckelbergh T, Emesz M, Marvan P, Nischler C. Association of lens opacities, intraocular straylight, contrast sensitivity and visual acuity in European drivers. Acta Ophthalmol 2009; 87:666-71. [PMID: 18786129 DOI: 10.1111/j.1755-3768.2008.01326.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To study the relationship between lens opacity and intraocular straylight, visual acuity and contrast sensitivity. METHODS We investigated 2422 drivers in five clinics in different European Union (EU) member states aged between 20 and 89 years as part of a European study into the prevalence of visual function disorders in drivers. We measured visual acuity [Early Treatment Diabetic Retinopathy Study (ETDRS) chart], contrast sensitivity (Pelli-Robson chart) and intraocular straylight (computerized straylight meter). Lens opacities were graded with the Lens Opacities Classification System III (LOCS) without pupillary dilation. Participants answered the National Eye Institute Visual Functioning Questionnaire - 25. RESULTS Intraocular straylight was related more strongly to LOCS score than to both visual acuity and contrast sensitivity. Visual acuity and contrast sensitivity were correlated to each other well, but to intraocular straylight to a much lesser extent. Self-reported visual quality was best related to contrast sensitivity; night driving difficulty was best related to visual acuity. CONCLUSION Straylight is found to have added value for visual function assessment in drivers, whereas if visual acuity is known contrast sensitivity has limited added value.
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Acosta-Rojas ER, Comas M, Sala M, Castells X. Association Between Visual Impairment and Patient-Reported Visual Disability at Different Stages of Cataract Surgery. Ophthalmic Epidemiol 2009; 13:299-307. [PMID: 17060108 DOI: 10.1080/09286580600694464] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate the association between visual impairment (visual acuity, contrast sensitivity, stereopsis) and patient-reported visual disability at different stages of cataract surgery. METHODS A cohort of 104 patients aged 60 years and over with bilateral cataract was assessed preoperatively, after first-eye surgery (monocular pseudophakia) and after second-eye surgery (binocular pseudophakia). Partial correlation coefficients (PCC) and linear regression models were calculated. RESULTS In patients with bilateral cataracts, visual disability was associated with visual acuity (PCC = -0.30) and, to a lesser extent, with contrast sensitivity (PCC = 0.16) and stereopsis (PCC = -0.09). In monocular and binocular pseudophakia, visual disability was more strongly associated with stereopsis (PCC = -0.26 monocular and -0.51 binocular) and contrast sensitivity (PCC = 0.18 monocular and 0.34 binocular) than with visual acuity (PCC = -0.18 monocular and -0.18 binocular). Visual acuity, contrast sensitivity and stereopsis accounted for between 17% and 42% of variance in visual disability. CONCLUSIONS The association of visual impairment with patient-reported visual disability differed at each stage of cataract surgery. Measuring other forms of visual impairment independently from visual acuity, such as contrast sensitivity or stereopsis, could be important in evaluating both needs and outcomes in cataract surgery. More comprehensive assessment of the impact of cataract on patients should include measurement of both visual impairment and visual disability.
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Affiliation(s)
- E Ruthy Acosta-Rojas
- Evaluation and Clinical Epidemiology Department, Municipal Institute of Health Care (IMAS) and Health Services Research Unit, Municipal Institute of Medical Research (IMIM-IMAS), Barcelona, Spain
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