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Manna P, Karmakar S, Mondal A, Sarbajna P, Bhardwaj GK. Effects of Two Vision Therapy Approaches on Accommodative Insufficiency and Post-therapy Stability. J Pediatr Ophthalmol Strabismus 2024:1-15. [PMID: 39254187 DOI: 10.3928/01913913-20240807-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
PURPOSE To evaluate the effect of the EYEPORT II vision training system (Bernell) on accommodation in cases of accommodative insufficiency. METHODS The experimental study was conducted in a binocular vision clinic. Of 230 patients, 36 were eligible and willing to participate in office-based therapy. Participants were randomly divided into two groups: control and EYEPORT. The control group received conventional therapy and the EYEPORT group received conventional therapy combined with the EYEPORT II vision training device. The therapy lasted for 1 hour daily over 6 days in a week, with 24 sessions administered over 4 weeks. Accommodative parameters were reevaluated 2 weeks, 4 weeks, and 3 months after treatment. RESULTS The study included 19 men and 17 women, with a median age of 27.50 years. After 24 sessions of vision therapy, accommodative parameters improved significantly, with more pronounced results compared with baseline measurements, as demonstrated by the Wilcoxon signed-rank test (P < .05). The Mann-Whitney U test indicated a significant (P < .05) improvement in treatment outcomes for the EYEPORT group using the EYEPORT device together with conventional therapy. The median accommodation amplitude increased by 6.95 diopters (D), the accommodation lag decreased by -0.25 D, the positive relative accommodation improved by -1.63 D, and the accommodative facility increased by 13 cycles/minute. After 3 months without therapy, the treatment outcome was maintained. CONCLUSIONS Office-based vision therapy can effectively treat accommodative insufficiency. Both groups showed improvement in the accommodative amplitude and other parameters. The EYEPORT group was more stable at 3 months. [J Pediatr Ophthalmol Strabismus. 20XX;XX(X):XXX-XXX.].
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Gómez-Patiño A, Piñero DP, Molina-Martín A. Impact of Immersive Virtual Reality on the Binocular and Accommodative Function: A Systematic Review About Literature and Its Current Limitations. Semin Ophthalmol 2024; 39:429-439. [PMID: 38900011 DOI: 10.1080/08820538.2024.2368013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/31/2024] [Accepted: 06/06/2024] [Indexed: 06/21/2024]
Abstract
PURPOSE The aim of this study is to analyze the scientific literature about the effect of VR on the accommodative and binocular function of healthy subjects with both normal visual conditions and binocular anomalies assessing the quality of the existing studies to detect possible limitations and improve future study designs. METHODS A search was performed in PubMed, Web of Science and Scopus databases with the search equation (Virtual reality OR head-mounted displays) AND (accommodation OR accommodative) AND (vergence* OR convergence OR divergence OR binocular vision). A limitation was made in terms of the date of publication from 2010 onwards, identifying a total of 198 publications. Finally, 15 publications were included in the quality analysis. After a comprehensive analysis of the publications, a quality assessment was performed using a Quality Appraisal Checklist. RESULTS Research on effects of immersive VR on accommodative and binocular function to this date was focused on quasi-experimental pre-post studies well written and with results supporting their conclusions. Unfortunately, this scientific evidence provides heterogeneous outcomes, being the results in some cases even contradictory. CONCLUSIONS Information about the devices, its interpupillary distance adjustment, the software characteristics and type of task performed by users should be better controlled in future studies. Additionally, participants accommodative and binocular baseline characteristics should be better analyzed to obtain firm conclusions about the consequences of the proper immersive VR experience on visual function.
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Affiliation(s)
- Andrea Gómez-Patiño
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - David P Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
| | - Ainhoa Molina-Martín
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
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Leal-Vega L, Piñero DP, Molina-Martín A, Hernández-Rodríguez CJ, Cuadrado-Asensio R, Martín-Gutiérrez A, Arenillas Lara JF, Coco Martín MB. Pilot Study Assessing the Safety and Acceptance of a Novel Virtual Reality System to Improve Visual Function. Semin Ophthalmol 2024; 39:394-399. [PMID: 38426308 DOI: 10.1080/08820538.2024.2324074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/22/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE To assess the feasibility of the clinical use of a novel Virtual Reality (VR) training software designed to be used for active vision therapy in amblyopic patients by determining its preliminary safety and acceptance on the visual function of healthy adults. METHODS Pilot study enrolling 10 individuals (3 men, 7 women, mean age: 31.8 ± 6.5 years) with a best-corrected visual acuity (BCVA) of ≥ .90 (decimal) in both eyes were evaluated before and after 20 minutes of exposure to the NEIVATECH VR system using the HTC Vive Pro Eye head mounted display. Visual function assessment included near (40 cm) and distance (6 m) cover test (CT), stereopsis, binocular accommodative facility (BAF), near point of convergence (NPC), near point of accommodation (NPA), accommodative-convergence over accommodation (AC/A) ratio and positive and negative fusional vergences. Safety was assessed using the VR Sickness Questionnaire (VRSQ) and acceptance using the Technology Acceptance Model ;(TAM). Changes in all these variables after VR exposure were analyzed. RESULTS Short-term exposure to the NEIVATECH VR system only induced statistically significant changes in distance phoria (p = .016), but these changes were not clinically relevant. No significant changes were observed in VRSQ oculo-motricity and disorientation scores after exposure (p = .197 and .317, respectively). TAM scores showed a good acceptance of the system in terms of perceived enjoyment and perceived ease of use, although some concerns were raised in relation to the intention-to-use domain. CONCLUSION Exposure to the NEIVATECH VR system does not seem to adversely affect the visual function in healthy adults and its safety and acceptance profile seems to be adequate for supporting its potential use in other populations, such as amblyopic patients.
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Affiliation(s)
- Luis Leal-Vega
- Group of Applied Clinical Neurosciences, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Valladolid, Spain
| | - David P Piñero
- Group of Applied Clinical Neurosciences, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Valladolid, Spain
- Clinical Optometry Unit, Department of Ophthalmology, Hospital Vithas Medimar International, Alicante, Spain
| | - Ainhoa Molina-Martín
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Carlos J Hernández-Rodríguez
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- Clinical Optometry Unit. Department of Ophthalmology, Centro Médico Virgen de la Caridad Hospital, Cartagena, España
| | | | - Adrián Martín-Gutiérrez
- Group of Applied Clinical Neurosciences, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Valladolid, Spain
| | - Juan Francisco Arenillas Lara
- Group of Applied Clinical Neurosciences, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Valladolid, Spain
- Stroke Unit & Stroke Program, Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - María Begoña Coco Martín
- Group of Applied Clinical Neurosciences, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Valladolid, Spain
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Molina-Martín A, Leal-Vega L, de Fez D, Martínez-Plaza E, Coco-Martín MB, Piñero DP. Amblyopia Treatment through Immersive Virtual Reality: A Preliminary Experience in Anisometropic Children. Vision (Basel) 2023; 7:vision7020042. [PMID: 37218960 DOI: 10.3390/vision7020042] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 05/24/2023] Open
Abstract
The use of digital devices provides a wide range of possibilities for measuring and improving visual function, including concepts such as perceptual learning and dichoptic therapy. Different technologies can be used to apply these concepts, including, in recent years, the introduction of virtual reality (VR) systems. A preliminary experience in treating anisometropic amblyopia through an immersive VR device and using prototype software is described. A total of 4 children were treated by performing 18 office-based sessions. Results showed that distance VA in amblyopic eyes remained constant in two subjects, whereas the younger subjects improved after the training. Near VA improved in three subjects. All subjects showed an increase in the stereopsis of at least one step, with three subjects showing a final stereopsis of a 60 s arc. A total of three subjects showed an increase of approximately 0.5 CS units for the spatial frequency of 3 cpd after the training. Results from this pilot study suggest that visual training based on perceptual learning through an immersive VR environment could be a viable treatment for improving CS, VA, and stereopsis in some children with anisometropic amblyopia. Future studies should support these preliminary results.
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Affiliation(s)
- Ainhoa Molina-Martín
- Group of Optics and Visual Perception. Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 San Vicente del Raspeig, Spain
| | - Luis Leal-Vega
- Department of Medicine, Dermatology and Toxicology, Faculty of Medicine, University of Valladolid, 47003 Valladolid, Spain
| | - Dolores de Fez
- Group of Optics and Visual Perception. Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 San Vicente del Raspeig, Spain
| | - Elena Martínez-Plaza
- Group of Optics and Visual Perception. Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 San Vicente del Raspeig, Spain
- University of Valladolid, 47003 Valladolid, Spain
| | - María Begoña Coco-Martín
- Department of Medicine, Dermatology and Toxicology, Faculty of Medicine, University of Valladolid, 47003 Valladolid, Spain
| | - David P Piñero
- Group of Optics and Visual Perception. Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 San Vicente del Raspeig, Spain
- Department of Ophthalmology, Vithas Medimar International Hospital, 03016 Alicante, Spain
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Fan L, Wang J, Li Q, Song Z, Dong J, Bao F, Wang X. Eye movement characteristics and visual fatigue assessment of virtual reality games with different interaction modes. Front Neurosci 2023; 17:1173127. [PMID: 37065908 PMCID: PMC10102480 DOI: 10.3389/fnins.2023.1173127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 03/13/2023] [Indexed: 04/03/2023] Open
Abstract
This study aimed to investigate the eye movement characteristics and visual fatigue of virtual reality games with different interaction modes. Eye movement data were recorded using the built-in eye tracker of the VR device and eye movement parameters were calculated from the recorded raw data. The Visual Fatigue Scales and Simulator Sickness Questionnaire were used to subjectively assess visual fatigue and overall discomfort of the VR experience. Sixteen male and 17 female students were recruited for this study. Results showed that both the primary and 360 mode of VR could cause visual fatigue after 30 min of gameplay, with significant differences observed in eye movement behavior between the two modes. The primary mode was more likely to cause visual fatigue, as shown by objective measurements of blinking and pupil diameter. Fixation and saccade parameters also showed significant differences between the two modes, possibly due to the different interaction modes employed in the 360 mode. Further research is required to examine the effects of different content and interactive modes of VR on visual fatigue, as well as to develop more objective measures for assessing it.
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Affiliation(s)
- Lei Fan
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- School of Ophthalmology and Optometry and School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, China
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Junjie Wang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- School of Ophthalmology and Optometry and School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, China
| | - Qi Li
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Zhenhao Song
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Jinhui Dong
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Fangjun Bao
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- School of Ophthalmology and Optometry and School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, China
- *Correspondence: Fangjun Bao,
| | - Xiaofei Wang
- School of Ophthalmology and Optometry and School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, China
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Xiaofei Wang,
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Chen Z, Li Y, Zhang Y, Zhang Z, Wang J, Deng X, Liu C, Chen N, Jiang C, Li W, Song B. Analysis of Visual Risk Factors of Anterior Cruciate Ligament Injury of Knee Joint. J Clin Med 2022; 11:jcm11195602. [PMID: 36233483 PMCID: PMC9573435 DOI: 10.3390/jcm11195602] [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: 08/05/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to explore whether the defect of visual function is a risk factor of knee anterior cruciate ligament (ACL) sports injury and to provide a theoretical basis for the primary prevention of ACL sports injury. This cross-sectional study included 392 participants divided into two groups: the sports injury group (287 with sports injury of knee) and the control group (105 healthy volunteers). Participants in the sports injury group were further divided into the ACL-Intact group (133) and the ACL-Deficient group (154). Participants in the sports injury group received a questionnaire about the conditions of their injury (including injury action, site condition, weather, contact) and a visual examination by synoptophore (including binocular vision, subjective and objective oblique angle, visual fusion range, stereoacuity). Participants in the control group only received the visual examination. In the end, we found that low visual fusion range (p = 0.003) and injury action, especially quick turn (p = 0.001), sudden stop (p < 0.001) and jump (p = 0.001), are the major risk factors for ACL injury in the analysis of the integrated data. In addition, athletes with low vision fusion range have increased risk of ACL sports injury when they make a sudden stop on wooden floor, plastic floor or cement floor on cloudy days (OR = 13.208). Visual factors, especially low fusion range, significantly increase the risk of ACL sports injury.
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Affiliation(s)
- Zhong Chen
- Department of Sports Medicine, Sun Yat-sen Memorial Hospital, No.107 on Yanjiang Road West, Guangzhou 510120, China
| | - Yuheng Li
- Department of Trauma Orthopedics, Chongqing Ninth People’s Hospital, Chongqing 400700, China
| | - Yichi Zhang
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, No.107 on Yanjiang Road West, Guangzhou 510120, China
| | - Zhengzheng Zhang
- Department of Sports Medicine, Sun Yat-sen Memorial Hospital, No.107 on Yanjiang Road West, Guangzhou 510120, China
| | - Jingsong Wang
- Department of Sports Medicine, Sun Yat-sen Memorial Hospital, No.107 on Yanjiang Road West, Guangzhou 510120, China
| | - Xinghao Deng
- Department of Sports Medicine, Sun Yat-sen Memorial Hospital, No.107 on Yanjiang Road West, Guangzhou 510120, China
| | - Chengxiao Liu
- Department of Sports Medicine, Sun Yat-sen Memorial Hospital, No.107 on Yanjiang Road West, Guangzhou 510120, China
| | - Na Chen
- Clinical Research Center, Sun Yat-sen Memorial Hospital, No.107 on Yanjiang Road West, Guangzhou 510120, China
| | - Chuan Jiang
- Department of Sports Medicine, Sun Yat-sen Memorial Hospital, No.107 on Yanjiang Road West, Guangzhou 510120, China
| | - Weiping Li
- Department of Sports Medicine, Sun Yat-sen Memorial Hospital, No.107 on Yanjiang Road West, Guangzhou 510120, China
- Correspondence: (W.L.); (B.S.); Tel.: +86-020-81332496 (W.L.); +86-020-81332496 (B.S.)
| | - Bin Song
- Department of Sports Medicine, Sun Yat-sen Memorial Hospital, No.107 on Yanjiang Road West, Guangzhou 510120, China
- Correspondence: (W.L.); (B.S.); Tel.: +86-020-81332496 (W.L.); +86-020-81332496 (B.S.)
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