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Stöhr M, Dekowski D, Bechrakis N, Oeverhaus M, Eckstein A. Evaluation of a Retinal Projection Laser Eyeware in Patients with Visual Impairment Caused by Corneal Diseases in a Randomized Trial. Ophthalmology 2024; 131:545-556. [PMID: 38000547 DOI: 10.1016/j.ophtha.2023.11.011] [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: 05/13/2022] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
PURPOSE Patients with incurable corneal diseases experience visual impairment (VI) despite having a healthy retina and optic pathway. Low-vision aids (LVAs) can optimize the use of remaining vision through magnification and contrast enhancement, but do not harness the full visual capacity because they rely on the optic media. Therefore, we investigated a novel laser eyewear (LEW) technology that bypasses the anterior segment of the eye. Images captured by an integrated camera are projected directly onto the retina using a low-energy laser. The patient is able to view a full-color video, realized as augmented reality. We aimed to evaluate the efficacy of the LEW to enhance the vision of individuals with corneal diseases. DESIGN Prospective, randomized, crossover clinical trial. PARTICIPANTS We examined the retinal projection glasses in 21 patients (25-69 years) with VI (0.7 logarithm of the minimum angle of resolution [logMAR] or worse) resulting from corneal diseases. Patients with comorbidities that impact vision, such as retinal disorders, were excluded. METHODS Standardized measurements of visual acuity (VA) for near vision (NV) and distance vision (DV) were conducted using ETDRS charts with the respective best correction (BC) and then with LEW. In addition reading speed, vision-related quality of life (QoL) and capacity to carry out daily tasks were assessed at an initial visit and at 2 subsequent visits after a home phase with and without the device. Six weeks after last use of the LEW, an ophthalmologic examination including spectral-domain-OCT or full-field-electroretinography was conducted and compared with baseline findings to evaluate the safety of the device. Four patients participated and completed a subsequent 12-month follow-up phase. MAIN OUTCOME MEASURES Improvement of VA using the LEW. Secondary objectives included safety, reading speed, QoL, and usability in daily activities. RESULTS The mean VA in patients with VI was improved by 0.43 logMAR in DV using the LEW compared with BC (P < 0.0001). Using the ×2 magnification mode of the LEW resulted in an average improvement of 0.66 logMAR compared with BC (P < 0.0001). In NV, an increase of 0.47 logMAR was achieved compared with BC (P < 0.0001). Although only 4 of 21 participants were able to read with BC, 17 of 21 participants were able to read with the LEW. Quality of life significantly improved in the 17 participants who completed all visits. CONCLUSIONS We demonstrated that the retinal projection glasses resulted in enhanced VA for all participants by directly projecting images onto the intact retina. In future, the LEW could represent a new option as an LVA for patients with corneal diseases. No pathological alterations were observed in the safety assessments. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Mareile Stöhr
- Department of Ophthalmology, University Hospital Essen, Essen, Germany.
| | - Dirk Dekowski
- Department of Ophthalmology, University Hospital Essen, Essen, Germany
| | | | - Michael Oeverhaus
- Department of Ophthalmology, University Hospital Essen, Essen, Germany
| | - Anja Eckstein
- Department of Ophthalmology, University Hospital Essen, Essen, Germany
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Prihatningtias R, Hardiyanti D, Valencia L. Converting LEA to Pelli-Robson contrast sensitivity score in neuro-ophthalmology patients. Indian J Ophthalmol 2024; 72:S505-S508. [PMID: 38648459 DOI: 10.4103/ijo.ijo_3039_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/08/2024] [Indexed: 04/25/2024] Open
Abstract
PURPOSE The Pelli-Robson and LEA contrast sensitivity charts are commonly used in clinical settings to measure contrast sensitivity. Although the Pelli-Robson chart is considered the gold standard, it is limited by its bulky size. The LEA chart, on the contrary, offers a more practical and portable option that is still reliable. This has led to questions about whether we can predict Pelli-Robson scores based on LEA scores. This study developed a conversion method to help transition from the LEA chart to the Pelli-Robson chart and validate the conversion score. METHODS In this retrospective study, we analyzed the relationship between LEA and the Pelli-Robson contrast sensitivity test. Our study examined a total of 120 eyes. We developed a conversion table through the equipercentile equating method. Subsequently, we assessed the reliability and accuracy of this algorithm for converting LEA results into Pelli-Robson contrast sensitivity scores. RESULTS The study used a conversion table to convert LEA scores to Pelli-Robson scores. The conversion table achieved a reliability of 0.91 based on intraclass correlation, and the algorithm had an accuracy of 81.6% within a 1-point difference from the raw score. CONCLUSIONS This study reported a reliable and comparable conversion algorithm for transforming LEA scores into converted estimated Pelli-Robson scores, thereby improving the usefulness of existing data in both clinical and research contexts.
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Affiliation(s)
- Riski Prihatningtias
- Department of Ophthalmology, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
- Department of Ophthalmology, Dr. Kariadi General Hospital, Semarang, Indonesia
| | - Disti Hardiyanti
- Department of Ophthalmology, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
- Department of Ophthalmology, Diponegoro National Hospital, Semarang, Indonesia
| | - Lovenia Valencia
- Department of Ophthalmology, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
- Department of Ophthalmology, Dr. Kariadi General Hospital, Semarang, Indonesia
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Rao A, Padhy D, Pal A, Roy AK. Visual function tests for glaucoma practice - What is relevant? Indian J Ophthalmol 2022; 70:749-758. [PMID: 35225508 PMCID: PMC9114550 DOI: 10.4103/ijo.ijo_1390_21] [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] [Indexed: 11/11/2022] Open
Abstract
Glaucoma represents one of the most important ocular diseases causing irreversible ganglion cell death. It is one of the most common causes of visual impairment and morbidity in the elderly population. There are various tests for measuring visual function in glaucoma. While visual field remains the undisputed method for screening, diagnosis, and monitoring disease progression, other tests have been studied for their utility in glaucoma practice. This review discusses some of the commonly used tests of visual function that can be routinely used in clinics for glaucoma management. Among the various modalities of testing visual function in glaucoma, this review highlights the tests that are most clinically relevant.
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Affiliation(s)
- Aparna Rao
- Department of Glaucoma Services, L. V. Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Debananda Padhy
- Department of Glaucoma Services, L. V. Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Anindita Pal
- Department of Glaucoma Services, L. V. Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Avik Kumar Roy
- Department of Glaucoma Services, L. V. Prasad Eye Institute, Bhubaneswar, Odisha, India
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Lam AKN, To E, Weinreb RN, Yu M, Mak H, Lai G, Chiu V, Wu K, Zhang X, Cheng TPH, Guo PY, Leung CKS. Use of Virtual Reality Simulation to Identify Vision-Related Disability in Patients With Glaucoma. JAMA Ophthalmol 2021; 138:490-498. [PMID: 32191274 DOI: 10.1001/jamaophthalmol.2020.0392] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Importance Clinical assessment of vision-related disability is hampered by the lack of instruments to assess visual performance in real-world situations. Interactive virtual reality (VR) environments displayed in a binocular stereoscopic VR headset have been designed, presumably simulating day-to-day activities to evaluate vision-related disability. Objective To investigate the application of VR to identify vision-related disability in patients with glaucoma. Design, Setting, and Participants In a cross-sectional study, 98 patients with glaucoma and 50 healthy individuals were consecutively recruited from a university eye clinic; all participants were Chinese. The study was conducted between August 30, 2016, and July 31, 2017; data analysis was performed from December 1, 2017, to October 30, 2018. Exposures Measurements of visual acuity, contrast sensitivity, visual field (VF), National Eye Institute 25-item Visual Function Questionnaire Rasch score, and VR disability scores determined from 5 VR simulations: supermarket shopping, stair and city navigations in daytime, and stair and city navigations in nighttime. Duration required to complete the simulation, number of items incorrectly identified, and number of collisions were measured to compute task-specific and overall VR disability scores. Vision-related disability was identified when the VR disability score was outside the normal age-adjusted 95% confidence region. Main Outcomes and Measures Virtual reality disability score. Results In the 98 patients with glaucoma, mean (SD) age was 49.8 (11.6) years and 60 were men (61.2%); in the 50 healthy individuals, mean (SD) age was 48.3 (14.8) years and 16 were men (32.0%). The patients with glaucoma had different degrees of VF loss (122 eyes [62.2%] had moderate or advanced VF defects). The time required to complete the activities by patients with glaucoma vs healthy individuals was longer by 15.2 seconds (95% CI, 5.5-24.9 seconds) or 34.1% (95% CI, 12.4%-55.7%) for the shopping simulation, 72.8 seconds (95% CI, 23.0-122.6 seconds) or 33.8% (95% CI, 10.7%-56.9%) for the nighttime stair navigation, and 38.1 seconds (95% CI, 10.9-65.2 seconds) or 30.8% (95% CI, 8.8%-52.8%) for the nighttime city navigation. The mean (SD) duration was not significantly different between the glaucoma and healthy groups in daytime stair (203.7 [93.7] vs 192.9 [89.1] seconds, P = .52) and city (118.7 [41.5] vs 117.0 [52.3] seconds, P = .85) navigation. For each decibel decrease in binocular VF sensitivity, the risk of collision increased by 15% in nighttime stair (hazard ratio [HR], 1.15; 95% CI, 1.08-1.22) and city (HR, 1.15; 95% CI, 1.08-1.23) navigations. Fifty-eight patients (59.1%) with glaucoma had vision-related disability in at least 1 simulated daily task; a higher proportion of patients had vision-related disability in nighttime city (27 of 88 [30.7%]) and stair (27 of 90 [30.0%]) navigation than in daytime city (7 of 88 [8.0%]) and stair (19 of 96 [19.8%]) navigation. The overall VR disability score was associated with the National Eye Institute 25-item Visual Function Questionnaire Rasch score (R2 = 0.207). Conclusions and Relevance These findings suggest that vision-related disability is associated with lighting condition and task in patients with glaucoma. Virtual reality may allow eye care professionals to understand the patients' perspectives on how visual impairment imparts disability in daily living and provide a new paradigm to augment the assessment of vision-related disability.
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Affiliation(s)
- Alexander K N Lam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Elaine To
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Robert N Weinreb
- Department of Ophthalmology, University of California, San Diego, La Jolla
| | - Marco Yu
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Heather Mak
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Gilda Lai
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Vivian Chiu
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Ken Wu
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Xiujuan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Timothy P H Cheng
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Philip Yawen Guo
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Christopher K S Leung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China.,Division of Biomedical Engineering, The Hong Kong University of Science and Technology, Hong Kong, People's Republic of China
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Reighard CL, Pillai MR, Shroff S, Spaeth GL, Schilling SG, Wizov SS, Stein JD, Robin AL, Raja V, Ehrlich JR. Glaucoma-Associated Visual Task Performance and Vision-Related Quality of Life in South India. Ophthalmol Glaucoma 2019; 2:357-363. [PMID: 31552395 PMCID: PMC6759221 DOI: 10.1016/j.ogla.2019.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE/PURPOSE Performance-based measures may provide an objective assessment of how glaucoma affects daily functioning. We sought to validate a clinically-applicable performance-based measure of visual ability for patients with glaucoma in south India and to describe its relationship to clinical and patient-reported outcomes. DESIGN Cross-sectional validation study. SUBJECTS/PARTICIPANTS/CONTROLS 145 participants with glaucoma were recruited at Aravind Eye Hospital. METHODS/INTERVENTION/TESTING We modified the compressed assessment of activities related to vision (CAARV), a performance-based measure validated in the U.S., to be culturally relevant in south India. Participants underwent a series of tests, including the Indian CAARV (I-CAARV), Indian Visual Functioning Questionnaire (IND-VFQ), Spaeth/Richman Contrast Sensitivity (SPARCS) test, standard automated perimetry, and visual acuity (VA). Factor analysis and Rasch modeling were used to validate the I-CAARV. Correlations between the I-CAARV and other outcomes were evaluated. MAIN OUTCOME MEASURE Psychometric properties of the I-CAARV for individuals with glaucoma in south India. RESULTS The study included 142 participants (51.7% female, mean age 56.4 years). Average presenting visual acuity and visual field mean deviation (MD) in the better-seeing eye were 0.26 logMAR and -6.57 dB, respectively. The four tasks of the I-CAARV were found to measure a single underlying construct. Rasch analysis of the I-CAARV revealed that the outcome measure had moderate reliability, good construct and content validity, and fair measurement precision. Tasks were well-targeted to the study sample. Rasch-calibrated scores on the I-CAARV were significantly correlated with Rasch-calibrated IND-VFQ scores (r=-0.54) and with visual field MD, presenting VA, best-corrected VA, and SPARCS contrast sensitivity in both the better-seeing eye (r=0.60, -0.51, -0.53, 0.76, respectively) and worse-seeing eye (r=0.48, -0.61, -0.46, 0.69, respectively). CONCLUSIONS The I-CAARV is a valid performance-based measure of vision-dependent functioning in glaucoma in south India. This study also found that I-CAARV task performance was strongly correlated with contrast sensitivity and suggests that performance-based and patient-reported outcomes are related but distinct measures of the impact of glaucoma on functioning and vision-related quality of life. Future studies are needed to determine the sensitivity of the I-CAARV to detect changes due to disease progression that are relevant to functioning and vision-related quality of life.
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Affiliation(s)
- Chelsea L. Reighard
- Department of Ophthalmology and Visual Sciences, Center for Eye Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | | | | | - George L. Spaeth
- Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Sheryl S. Wizov
- Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA
| | - Joshua D. Stein
- Department of Ophthalmology and Visual Sciences, Center for Eye Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Alan L. Robin
- Department of Ophthalmology and Visual Sciences, Center for Eye Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
- Department of Ophthalmology, Johns Hopkins University, Baltimore, MD, USA
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Vidya Raja
- Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Joshua R. Ehrlich
- Department of Ophthalmology and Visual Sciences, Center for Eye Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
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Eshraghi H, Sanvicente CT, Gogte P, Waisbourd M, Lee D, Manzi RR, Leiby BE, Richman J, Wizov SS, Spaeth GL. Measuring Contrast Sensitivity in Specific Areas of Vision – A Meaningful Way to Assess Quality of Life and Ability to Perform Daily Activities in Glaucoma. Ophthalmic Epidemiol 2019; 26:301-310. [DOI: 10.1080/09286586.2019.1616773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Hamoon Eshraghi
- Rutgers Robert Wood Johnson Medical School; New Brunswick, NJ, United States
| | | | | | - Michael Waisbourd
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Lee
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA
| | - Remy R.S. Manzi
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Benjamin E Leiby
- Pharmacology & Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jesse Richman
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA
| | - Sheryl S Wizov
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA
| | - George L Spaeth
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA, USA
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7
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Vision-related Performance and Quality of Life of Patients With Rapid Glaucoma Progression. J Glaucoma 2019; 28:216-222. [DOI: 10.1097/ijg.0000000000001179] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Skalicky SE, Kong GY. Novel Means of Clinical Visual Function Testing among Glaucoma Patients, Including Virtual Reality. J Curr Glaucoma Pract 2019; 13:83-87. [PMID: 32431476 PMCID: PMC7221241 DOI: 10.5005/jp-journals-10078-1265] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Computed perimetry remains the gold standard of visual field measurement among glaucoma patients. However, several emerging technologies, made possible by advances in computer programming, smartphone, tablet, or virtual reality, allow alternative means of visual function assessment. These new visual tests may one day have a useful complementary role in visual field testing and to bridge the gap between perimetry and daily experience. Many of these emerging technologies have distinct practical advantages over Ganzfield bowl-based computed perimetry. This paper outlines a discussion of some of these emerging techniques in visual function assessment in glaucoma.
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Affiliation(s)
- Simon E Skalicky
- Department of Ophthalmology, Centre for Eye Research Australia, University of Melbourne, Victoria, Australia; Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, Victoria, Australia
| | - George Yx Kong
- Department of Ophthalmology, Centre for Eye Research Australia, University of Melbourne, Victoria, Australia; Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, Victoria, Australia
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Abstract
Many diseases are related to age, among these neurodegeneration is particularly important. Alzheimer's disease Parkinson's and Glaucoma have many common pathogenic events including oxidative damage, Mitochondrial dysfunction, endothelial alterations and changes in the visual field. These are well known in the case of glaucoma, less in the case of neurodegeneration of the brain. Many other molecular aspects are common, such as the role of endoplasmic reticulum autophagy and neuronal apoptosis while others have been neglected due to lack of space such as inflammatory cytokine or miRNA. Moreover, the loss of specific neuronal populations, the induction of similar mechanisms of cell injury and the deposition of protein aggregates in specific anatomical areas are very similar events between these diseases. Intracellular and/or extracellular accumulation of protein aggregates is a key feature of many neurodegenerative disorders. The existence of abnormal protein aggregates has been documented in the RGCs of glaucomatous patients such as the anomalous Tau protein or the β-amyloid accumulations. Intra-cell catabolic processes also appear to be common in both glaucoma and neurodegeneration. They also help us to understand how the basis between these diseases is common and how the visual aspects can be a serious problem for those who are affected.
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Affiliation(s)
- Sergio Claudio Saccà
- Department of Head/Neck Pathologies, St Martino Hospital, Ophthalmology Unit, Genoa, Italy.
| | - Carlo Alberto Cutolo
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Science, University of Genoa, Policlinico San Martino Hospital, Eye Clinic Genoa, Genoa, Italy
| | - Tommaso Rossi
- Department of Head/Neck Pathologies, St Martino Hospital, Ophthalmology Unit, Genoa, Italy
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Cui QN, Singh K, Spaeth GL. From the Patient's Point of View, How Should Minimally Invasive Glaucoma Surgeries Be Evaluated? Am J Ophthalmol 2016; 172:xii-xiv. [PMID: 28327295 DOI: 10.1016/j.ajo.2016.09.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 09/14/2016] [Accepted: 09/16/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Qi N Cui
- Wills Eye Hospital, Philadelphia, Pennsylvania
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12
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Ihrig C. Steps to Offering Low Vision Rehabilitation Services through Clinical Video Telehealth. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2016. [DOI: 10.1177/0145482x1611000607] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Carolyn Ihrig
- Chief of service, VISOR (Vision Impairment Services for Outpatient Rehabilitation), Department of Veteran Affairs, Western New York Healthcare System, 3495 Bailey Avenue, Room 117, Buffalo, NY 14215, and clinical assistant professor, Department of Ophthalmology, Division of Low Vision, State University of New York at Buffalo School of Medicine, Ira G. Ross Eye Institute, 1176 Main Street, Buffalo, NY 14209
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Sun Y, Lin C, Waisbourd M, Ekici F, Erdem E, Wizov SS, Hark LA, Spaeth GL. The Impact of Visual Field Clusters on Performance-based Measures and Vision-Related Quality of Life in Patients With Glaucoma. Am J Ophthalmol 2016; 163:45-52. [PMID: 26701273 DOI: 10.1016/j.ajo.2015.12.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 12/05/2015] [Accepted: 12/08/2015] [Indexed: 11/17/2022]
Abstract
PURPOSE To investigate how visual field (VF) clusters affect performance-based measures of the ability to perform activities of daily living and subjective measures of vision-related quality of life (QoL) in patients with glaucoma. DESIGN Prospective, cross-sectional study. METHODS setting: Institutional - Wills Eye Hospital. STUDY POPULATION 322 eyes of 161 patients with moderate-stage glaucoma. OBSERVATION VF tests were conducted using the Humphrey 24-2 Swedish Interactive Thresholding Algorithm standard perimeter. The VFs of each patient were divided into 5 clusters: nasal, temporal, central, paracentral, and peripheral. The score for each cluster was the averaged total deviation scores of all tested points within the cluster. Each cluster score was correlated with performance-based measures of visual function and subjective assessment of vision-related QoL. MAIN OUTCOME MEASURES The Compressed Assessment of Ability Related to Vision, the National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25), and the Modified Glaucoma Symptom Scale. RESULTS The central VF cluster in the better eye was positively correlated with all Compressed Assessment of Ability Related to Vision (performance-based measure) subscales. The strongest correlation for the better eye was between the central VF cluster and total Compressed Assessment of Ability Related to Vision score (0.39, P < .001). The inferior VF hemisphere in both eyes was positively correlated with most Compressed Assessment of Ability Related to Vision subscales. Central VF clusters in the better eye were positively correlated with a majority of the NEI VFQ-25 subscales. There were no significant correlations between VF clusters and Modified Glaucoma Symptom Scale subscales. CONCLUSIONS Scores of central VF defects in the better eye and inferior hemisphere defects in both eyes were positively correlated with performance-based measures of the ability to perform activities of daily living. Glaucoma patients with central defects in the better eye were more likely to have reduced scores on assessments of vision-related QoL.
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Affiliation(s)
- Yi Sun
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Clarissa Lin
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Michael Waisbourd
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Feyzahan Ekici
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Elif Erdem
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Sheryl S Wizov
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - Lisa A Hark
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania
| | - George L Spaeth
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania.
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Schmidt H, Kunnig A. Family Board: A new means for people with visual impairment to communicate inner pictures of social relations. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2016. [DOI: 10.1177/0264619615610157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Visual impairment often entails changes in social relations. In order to identify supportive needs and provide tailored support, it is helpful to analyse these changes. Non-verbal methods have proven useful to facilitate this process but had so far not been available for visually impaired people. The Family Board, an established method of depicting social relations, was adapted for use by blind people and pilot-tested in this study. After adaptation and pretest, seven visually impaired adults undergoing rehabilitative treatment volunteered to participate in this qualitative pilot-study. Results showed that the method of the Family Board was well accepted and that the adapted board provides a feasible new non-verbal medium of communication for visually impaired people. The Family Board could be used to complement qualitative methods in further research on changes of social relations due to the loss of eyesight, to follow changes during coping and adaptation and to monitor effects of counselling.
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15
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Crabb DP. A view on glaucoma--are we seeing it clearly? Eye (Lond) 2015; 30:304-13. [PMID: 26611846 DOI: 10.1038/eye.2015.244] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 10/07/2015] [Indexed: 11/09/2022] Open
Abstract
Successful clinical management of glaucoma should not simply be about control of intraocular pressure, but must equate to correct decisions about intensifying treatment when patients are at risk of developing 'visual disability'. Yet little is known about what visual field defects, at different stages of glaucoma, specifically affect patients' abilities to perform everyday visual tasks. One way to do this is to measure patient performance in tasks in a lab setting. Another way is to ask patients themselves. The latter can be revealing and demystify views about how patients perceive the world. This short commentary highlights some of the current research in this area.
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Affiliation(s)
- D P Crabb
- Optometry and Visual Science, School of Health Sciences, City University London, London, UK
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Waisbourd M, Parker S, Ekici F, Martinez P, Murphy R, Scully K, Wizov SS, Hark LA, Spaeth GL. A prospective, longitudinal, observational cohort study examining how glaucoma affects quality of life and visually-related function over 4 years: design and methodology. BMC Ophthalmol 2015; 15:91. [PMID: 26231376 PMCID: PMC4522094 DOI: 10.1186/s12886-015-0088-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 07/23/2015] [Indexed: 11/23/2022] Open
Abstract
Background The aim of this study is to summarize the design and methodology of a prospective, longitudinal, observational cohort study to investigate how glaucoma affects patients’ quality of life and visually-related function over a 4-year period. Methods/Design One hundred sixty-one (161) subjects were enrolled in this ongoing study. Patients between the ages of 21–85 years with a minimum 2-year diagnosis of primary open-angle glaucoma, chronic primary angle-closure glaucoma or pseudoexfoliation glaucoma were included. Each patient visited Wills Eye Hospital for a baseline visit. Follow-up is planned for a minimum of 4 years, with annual visits. Each visit includes (1) Clinical evaluation: a slit lamp examination, fundoscopy, intraocular pressure measurement, visual field examination, spectral domain optical coherence tomography, Pelli-Robson Contrast Sensitivity test and the Spaeth-Richman Contrast Sensitivity test; (2) a performance based measure: the Compressed Assessment of Ability Related to Vision; and (3) Subjective measures of vision-related quality of life (the National Eye Institute Visual Functioning Questionnaire 25 and the Modified Glaucoma Symptom Scale). Discussion The results of this ongoing, prospective, longitudinal study are expected to shed light on the relationships between clinical measures, performance-based measures and subjective measures of well-being, in order to assess changes in the quality of life and the ability to function of patients with glaucoma over time.
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Affiliation(s)
- Michael Waisbourd
- Glaucoma Research Center, Wills Eye Hospital, 840 Walnut Street, Philadelphia, PA, 19107, USA.
| | - Samantha Parker
- Glaucoma Research Center, Wills Eye Hospital, 840 Walnut Street, Philadelphia, PA, 19107, USA.
| | - Feyzahan Ekici
- Glaucoma Research Center, Wills Eye Hospital, 840 Walnut Street, Philadelphia, PA, 19107, USA.
| | - Patricia Martinez
- Glaucoma Research Center, Wills Eye Hospital, 840 Walnut Street, Philadelphia, PA, 19107, USA.
| | - Rachel Murphy
- Glaucoma Research Center, Wills Eye Hospital, 840 Walnut Street, Philadelphia, PA, 19107, USA.
| | - Katie Scully
- Glaucoma Research Center, Wills Eye Hospital, 840 Walnut Street, Philadelphia, PA, 19107, USA.
| | - Sheryl S Wizov
- Glaucoma Research Center, Wills Eye Hospital, 840 Walnut Street, Philadelphia, PA, 19107, USA.
| | - Lisa A Hark
- Glaucoma Research Center, Wills Eye Hospital, 840 Walnut Street, Philadelphia, PA, 19107, USA.
| | - George L Spaeth
- Glaucoma Research Center, Wills Eye Hospital, 840 Walnut Street, Philadelphia, PA, 19107, USA.
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Chandrakumar M, Colpa L, Reginald YA, Goltz HC, Wong AMF. Measuring contrast sensitivity using the M&S Smart System II versus the Pelli-Robson chart. Ophthalmology 2013; 120:2160-1.e1. [PMID: 24090954 DOI: 10.1016/j.ophtha.2013.07.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 07/16/2013] [Indexed: 12/01/2022] Open
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