Structural modeling of contrast sensitivity in adulthood

S. Identification of Alzheimer's Disease by Imaging: A Comprehensive Review

In developing countries, there is more concern for Alzheimer's disease (AD) by public health professionals due to its catastrophic effects on the elderly. Early detection of this disease helps in starting the therapy soon and slows down the progression of the disease. Imaging techniques are considered to be the best solutions for its detection. Brain imaging was initially used to diagnose AD. Different techniques for identifying protein accumulation in the nervous system, a sign of Alzheimer's disease, are identified by MRI imaging. Although they were initially attributed to cortical dysfunction, visual system impairments in Alzheimer's patients were also found in the early 1970s. Several non-invasive approaches reported for screening, prevention, and therapy were unsuccessful. It is vitally necessary to develop new diagnostic methods in order to accurately identify patients who are in the early stages of this disease. It would be wonderful to have a quick, non-invasive, affordable, and easily scalable Alzheimer's disease screening. Researchers may be able to identify biomarkers for Alzheimer's disease and understand more about its aetiology with imaging and data processing. This study clarifies the need for medical image processing and analysis strategies which aid in the non-invasive diagnosis of AD.

Structural equation modeling: a framework for ocular and other medical sciences research

Structural equation modeling (SEM) is a modeling framework that encompasses many types of statistical models and can accommodate a variety of estimation and testing methods. SEM has been used primarily in social sciences but is increasingly used in epidemiology, public health, and the medical sciences. SEM provides many advantages for the analysis of survey and clinical data, including the ability to model latent constructs that may not be directly observable. Another major feature is simultaneous estimation of parameters in systems of equations that may include mediated relationships, correlated dependent variables, and in some instances feedback relationships. SEM allows for the specification of theoretically holistic models because multiple and varied relationships may be estimated together in the same model. SEM has recently expanded by adding generalized linear modeling capabilities that include the simultaneous estimation of parameters of different functional form for outcomes with different distributions in the same model. Therefore, mortality modeling and other relevant health outcomes may be evaluated. Random effects estimation using latent variables has been advanced in the SEM literature and software. In addition, SEM software has increased estimation options. Therefore, modern SEM is quite general and includes model types frequently used by health researchers, including generalized linear modeling, mixed effects linear modeling, and population average modeling. This article does not present any new information. It is meant as an introduction to SEM and its uses in ocular and other health research.

Alzheimer's disease in the human eye. Clinical tests that identify ocular and visual information processing deficit as biomarkers

Alzheimer's disease (AD) is the most common form of dementia with progressive deterioration of memory and cognition. Complaints related to vision are common among AD patients. Several changes in the retina, lens, and in the vasculature have been noted in the AD eye that may be the cause of visual symptoms experienced by the AD patient. Anatomical changes have been detected within the eye before signs of cognitive impairment and memory loss are apparent. Unlike the brain, the eye is a unique organ that can be visualized noninvasively at the cellular level because of its transparent nature, which allows for inexpensive testing of biomarkers in a clinical setting. In this review, we have searched for candidate biomarkers that could enable diagnosis of AD, covering ocular neurodegeneration associated with functional tests. We explore the evidence that suggests that inexpensive, noninvasive clinical tests could be used to detect AD ocular biomarkers.

Age-related change in contrast sensitivity among Australian male adults: Florey Adult Male Ageing Study

PURPOSE

To describe the age-related change in contrast sensitivity seen in 35- to 80-year-old men in an Australian population.

METHODS

The Florey Adelaide Male Ageing Study (FAMAS) is a prospective population-based study of men aged 35-80 years randomly selected from the north-west suburbs of Adelaide. We conducted a nested ophthalmic substudy of these men. Contrast sensitivity (CS) was measured at four spatial frequencies (3, 6, 12 and 18 cycles/degree [cpd]) using the Vectorvision CSV-1000 contrast sensitivity test chart (Vectorvision, Dayton, OH, USA), and results were statistically analysed relative to age and cataract type.

RESULTS

There were 2650 eligible subjects in the FAMAS and 1195 participated (45.1%); 472 of those participated in the ophthalmic substudy. A statistically significant decrease in contrast sensitivity was seen with advancing age at each spatial frequency tested [Generalized estimating equations (GEE) multiple linear regression: p ≤ 0.01]. The decline with age was greatest in the highest spatial frequency (18 cpd) and least in the lowest spatial frequency (3 cpd). Posterior subcapsular cataract caused the greatest reduction in contrast sensitivity at all spatial frequencies, while nuclear cataract caused significant reduction only in the intermediate (12 cpd) and high (18 cpd) spatial frequencies. Cortical cataract failed to reach statistical significance in contrast sensitivity reduction at all spatial frequencies tested.

CONCLUSION

Contrast sensitivity declines with age in all spatial frequencies tested with a greater decline occurring in the higher spatial frequencies. Age and cataracts are independently associated with contrast sensitivity decline, and posterior subcapsular cataracts caused the greatest reduction at all spatial frequencies.

Age-related changes in visual temporal order judgment performance: Relation to sensory and cognitive capacities

Five measures of temporal order judgments were obtained from 261 participants, including 146 elder, 44 middle aged, and 71 young participants. Strong age group differences were observed in all five measures, although the group differences were reduced when letter discriminability was matched for all participants. Significant relations were found between these measures of temporal processing and several cognitive and sensory assays, and structural equation modeling revealed the degree to which temporal order processing can be viewed as a latent factor that depends in part on contributions from sensory and cognitive capacities. The best-fitting model involved two different latent factors representing temporal order processing at same and different locations, and the sensory and cognitive factors were more successful predicting performance in the different location factor than the same-location factor. Processing speed, even measured using high-contrast symbols on a paper-and-pencil test, was a surprisingly strong predictor of variability in both latent factors. However, low-level sensory measures also made significant contributions to the latent factors. The results demonstrate the degree to which temporal order processing relates to other perceptual and cognitive capacities, and address the question of whether age-related declines in these capacities share a common cause.

Stimulus Contrast and Word Reading Speed in Alzheimer's Disease

The oral word reading speed of patients with Alzheimer's disease (AD) and healthy young and older control participants was evaluated across a broad range of stimulus contrast levels in two experiments. The impact of stimulus repetition on reading speed also was examined. It was found that the older adult participants, and particularly the AD patients, were more sensitive to contrast reductions. Each subject group was able to read repeated words more rapidly than novel words but this repetition effect emerged only at lower stimulus contrast levels. It was concluded that AD patients have feature extraction speeds comparable to non-demented older adults but only when the stimuli are presented at a relatively high contrast. These findings suggest that the automatic encoding processes involved in word recognition remain intact in mildly demented AD patients given stimuli of sufficient strength.

Are Changes in Ocular Aberrations With Age a Significant Problem for Refractive Surgery?

We discuss current knowledge about the change of aberrations with aging, cataract surgery, and laser in situ keratomileusis (LASIK) for myopia. Based on this evidence, we speculate about the long-term expectations for postoperative LASIK eyes in terms of aberrations. Standard myopic LASIK surgery produces a significant increase in aberrations, particularly corneal spherical aberration, which changes to positive values. Aberrations increase with age, and in particular, the spherical aberration of the crystalline lens shifts toward positive values. Therefore, no compensatory effect is expected to occur with age after standard myopic LASIK, but rather the unusually high amount of aberrations in postoperative LASIK patients is expected to worsen with age. The amount of aberrations in patients after cataract surgery with implantation of standard intraocular lenses (IOLs) is higher than in normal young subjects. If an ideal customized ablation (not inducing aberrations and reducing naturally existing aberrations) is ever possible, the perfect correction will not last (due to the change of aberrations with age), and aberrations of the crystalline lens corrected on the cornea are likely to reappear after conventional cataract surgery. Potential benefits of customized IOLs for cataract surgery and improved optics in older patients are discussed.